Search Results (876)

Background/Objectives: Functional abilities are fundamental for social participation. However, functional abilities assessment tools validated for children/and adolescents undergoing cancer treatment are lacking. A preliminary validation of the Gross Motor Function Measure-88 (GMFM-88) scale for children with cancer found that some items are unable to discriminate or distinguish between different gross motor function levels. This study aims to develop and validate the Functional Abilities Assessment in Paediatric Oncology (FAAP-O), starting with GMFM-88. Methods: This multicentre study (ClinicalTrials.gov Identifier: NCT04862130) involved children and adolescents (6 months–18 years old) diagnosed with cancer, in any phase of treatment or less than 1 year of therapy. A multiphase mixed-methods design was employed. The content validity of each item of GMFM-88 for the paediatric oncology population was calculated with the Content Validity Ratio (CVR). Items with a CVR score > 0.70 were included in the FAAP-O scale. Other items with a score between 0 and 0.70 were selected for their relevance by consensus with five focus groups and a plenary meeting. The FAAP-O items set was organised in five dimensions by exploratory factor analyses. The calculation of FAAP-O internal consistency was made using Cronbach’s α while and inter/intra-rater reliability was assessed by intraclass correlation coefficients (ICCs). Results: The study involved 217 subjects. The FAAP-O included 36 items; its internal consistency was good in each dimension (0.90 ≤ α ≤ 0.96) and its inter/intra-rater reliability was excellent (ICC > 0.90). Conclusions: A new specifically validated scale to assess functional abilities in children and adolescents with cancer is provided. Validated tools are necessary for specific, objective rehabilitation assessments, which are fundamental in clinical practice and research. Full article

Introduction: The change in environmental and social context during the COVID-19 pandemic affected daily activities of people with spinal cord injury (SCI), their interactions within the community, and, consequently, their social participation during the first wave of the pandemic. However, there is little information about the changes in social participation as the pandemic evolved in Canada. Objective: Our aim was to explore the change in the social participation of adults with SCI after the first two years of the COVID-19 pandemic in Canada. Methods: A follow-up from a previous study exploring the social participation of adults with SCI living during the first wave was conducted eight months later (second wave). Social participation was measured using the Assessment of Life Habits (LIFE-H 4.0) and Measure of Quality of the Environment (MQE) among 18 adults with SCI. Results: Participants reported increases between both waves of COVID-19 in some life habit categories, including mobility, personal care and health, nutrition, and recreation. New environmental factors were identified as facilitators, including the increased availability of businesses in the community. Conclusion: These findings indicate that people with SCI experienced greater realization and satisfaction with certain life habits. Although most barriers and facilitators showed little or no change between the two waves, the reduction in environmental barriers and the increase in facilitators may have contributed to improved social participation as the pandemic progressed. Full article

Shoulder pain, subluxation, and displacement of the body’s center of gravity due to hemiplegia negatively affect patients’ balance, gait, and functionality post-stroke. This study aimed to investigate the effect of a shoulder orthosis on balance and functional mobility in patients post-stroke. This cross-over clinical study was conducted in rehabilitation centers within the Attica Region and included 26 patients in the subacute phase following a stroke. Outcome measures included dynamic balance and functional mobility, assessed through the Timed Up and Go (TUG) test, the Functional Reach Test (FRT), and the modified Four-Square Step Test (mFSST). Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 29.0.10, with a significance level set at p < 0.05. The results showed significant improvements in patient performance with the shoulder orthosis in the FRT (p = 0.049, d = 0.406), TUG (p = 0.023, d = 0.446), and (mFSST) (p = 0.004, d = 0.565). In addition, correlations were observed between Brunnstrom stages, Functional Ambulation Category (FAC) scores, and performance on the dynamic balance and functional mobility tests. Gender, functional status and hemiplegia side did not have a significant effect on the study outcomes. The use of a shoulder orthosis has a positive effect on dynamic balance and functional mobility in patients in the subacute phase post-stroke. Full article

This systematic review examines and critically classifies the strategies applied to abandoned urban voids through the analysis of peer-reviewed scientific and technical literature, addressing the lack of integrative studies on the topic. A systematic search was conducted in the SCOPUS database for articles published between 2000 and 2025, following the PRISMA 2020 guidelines. Sixteen studies that met the inclusion criteria were analyzed using the digital tool Parsifal. The results reveal that adaptive reuse and architectural regeneration are the predominant strategies for transforming abandoned urban voids, aimed at converting underutilized or abandoned spaces into functional and socially integrated urban assets. In contrast, approaches such as rehabilitation and environmental remediation appear less frequently but highlight the importance of ecological and preparatory interventions. This review also identifies gaps in the psychological and participatory dimensions, proposing their integration into future urban regeneration frameworks. This work provides an updated conceptual foundation for sustainable architectural interventions and emphasizes the need to expand research in diverse geographical contexts, particularly in Latin America. Full article

The neuropeptide’s multifaceted involvement in various components of neural homeostasis impacts pain and behavioral regulation. One of the highly potent neuropeptides is dermorphin, extracted from the skin of the Amazon frog (Phyllomedusa sauvagei). The unique feature of dermorphin is the D-Ala residue in its sequence, which has inspired researchers to search for dermorphin analogs for use as pharmaceuticals. The primary objective of this study is to synthesize several new linear and cyclic dermorphin analogs and evaluate them as potential non-invasive analgesics. By exploring our method for converting linear peptides into 2,5-diketopiperazine(2,5-DKP) derivatives, which stabilize peptide structures, we synthesize several new dermorphin linear peptides and chimeric cyclopeptidomimetics. These compounds were tested in vitro and in vivo to determine their biological activities and potential applicability as pharmaceuticals. For the evaluation of in vitro opioid activity, the “Guinea Pig Ileum” (GPI) test was used. D2 showed the highest activity, and cyclopeptides D3 and D4 showed high activity. We can assume that dermorphin analogues D2, D3, and D4 are potent agonists of µ-type opioid receptors and have high opioid activity. However, this needs to be verified using molecular modeling methods in further research. The analgesic effects of dermorphins have been evaluated in the “Hot-Plate” and “Tail-Flick” tests. In rats, D2 dermorphin analogues demonstrated dose-dependent analgesic effect in the “Water Tail-Flick” test after intranasal administration. A smaller dose of 0.5 µg/kg resulted in 40% analgesia and a short-term state of stupor. The maximum long-lasting analgesia was observed at a dose of 1.0 µg/kg, which induced complete stupor. The analgesic effect of peptide D2 after intraperitoneal administration at a 5.0 mg/kg dose was over 50%. The “Open-Field” test demonstrated a dose-dependent (15, 50, 150 μg/kg) peptide D2 suppression effect on behavioural reactions in rats following intranasal administration. A new modification of linear peptides, combined with a 2,5-DKP scaffold (D3 and D4), proved promising for oral use based on the results of analgesic effect evaluation in mice following intragastric administration. Full article

This study explores how intersecting disabilities and ethnic identities influence key career-related factors, including career decision self-efficacy, career outcome expectations, perceived career barriers, and social support, among college students with disabilities from diverse racial and ethnic backgrounds. Background/Objectives: Applying social cognitive career theory (SCCT) and intersectionality frameworks, this research addresses a critical gap in understanding the unique challenges and strengths experienced by underrepresented students with disabilities in postsecondary education. Method: Quantitative data were collected from approximately 306 participants representing various ethnic groups, including African American, Asian American, Hispanic, and other ethnic backgrounds, alongside European American peers. Results: Findings revealed that underrepresented students with disabilities reported significantly stronger ethnic identity affirmation but also perceived greater career-related barriers compared to their European American counterparts. These results demonstrate the need for culturally responsive career development practices and inclusive campus environments that affirm students’ multiple identities. Conclusions: Implications are discussed for higher education professionals, rehabilitation counselors, disability service providers, and career counselors seeking to promote equitable career outcomes and identity-conscious support systems. Full article

Chimpanzees (Pan troglodytes) rescued from the illegal wildlife trade often suffer from chronic, traumatic injuries that require specialized and prolonged medical treatment in wildlife rehabilitation centers. We present the case report of a two-year-old male chimpanzee admitted at the Tchimpounga Chimpanzee Rehabilitation Center in the Republic of Congo with a chronic periorbital abscess, likely caused by a machete wound sustained during the poaching of his mother. Despite receiving extended antimicrobial therapy, his condition was never fully controlled and progressed to a chronic orbital infection, causing him discomfort and producing chronic purulent discharge. Enucleation was performed under general anesthesia using ketamine and medetomidine, with surgical approach adapted to the distinctive orbital anatomy of chimpanzees. During the procedure, ligation of the optic nerve and ophthalmic vessels was required due to the confined orbital apex and extensive vascularization, ensuring adequate haemostasias and procedural safety. The chimpanzee made an uneventful postoperative recovery, resuming normal feeding and social behavior within 48 h, with complete wound healing occurring within two weeks. This case report highlights the importance of prompt surgical intervention when conservative medical management fails to resolve refractory ocular infections in chimpanzees. It also emphasizes the importance of specific anesthetic protocols, refined surgical techniques and tailored postoperative care in wildlife rehabilitation centers. Documenting and sharing detailed case reports such as this contributes to the limited veterinary literature on great ape surgery and supports evidence-based clinical decision-making to improve the welfare and treatment outcomes of rescued chimpanzees. Full article

Background/Objectives: Pediatric acquired brain injury (ABI) often results in persistent challenges that extend beyond motor impairments, affecting quality of life (QoL), social participation, and engagement in physical activity. Given the complexity and chronicity of these outcomes, there is a pressing need for multidimensional interventions grounded in the International Classification of Functioning, Disability and Health (ICF). Sport-based exercise interventions, when developmentally adapted and tailored to individual interests, may promote intrinsic motivation, peer connection, and sustainable engagement—factors especially relevant in pediatric ABI populations, who often experience reduced physical activity and social isolation. However, standardized, replicable protocols specifically tailored to this population remain scarce. This study presents the protocol for a randomized controlled trial evaluating the effects of a 16-week sport-based intervention on QoL, social participation, physical activity engagement, and motor functioning tailored for adolescents with pediatric ABI. Methods: Participants will be randomly assigned to an intervention group or a control group receiving usual care. The intervention consists of one weekly 60-minute session, led by trained professionals in adapted physical activity and pediatric neurorehabilitation. It combines sport-based motor skill training, cooperative games, and group activities specifically tailored to each child’s developmental level, motor abilities, and preferences. Outcomes will be assessed at baseline and following the 16-week intervention period, focusing on QoL, participation, physical activity engagement, and motor functioning. Discussion: This study introduces a structured, child-centered model that bridges clinical rehabilitation and community-based sport. By integrating motor and psychosocial targets through a group sport-based intervention, it aims to enhance recovery across ICF domains. Findings may inform interdisciplinary practice and support the development of sustainable strategies to promote long-term engagement and well-being in adolescents with ABI. Full article

In socio-economically disadvantaged communities, the challenges faced by children with special needs are often overshadowed by more visible issues such as poverty, family instability, and substance abuse. Children, especially those with special needs, are particularly vulnerable in these settings as they are disproportionately impacted by intersecting adversities, including neglect, exploitation, and limited access to education and healthcare. These adversities create a vicious cycle, where disability exacerbates financial hardship, and in turn, economic deprivation negatively impacts early childhood development, further entrenching disability. Conventional models, which require physical presence and focus primarily on diagnosis and treatment within clinical settings, often fail to address the broader social, environmental, and contextual complexities of disability. We propose an Information Technology-based Exit Pathway as an innovative, scalable solution to disrupt this cycle. Anchored in the five pillars of the Community-Based Rehabilitation (CBR) matrix of Health, Education, Livelihood, Social, and Empowerment, the model envisions a multi-level digital platform that facilitates coordinated support across individual, familial, educational, community, regional, and national levels. By improving access to services, fostering inclusive networks, and enabling early intervention, the proposed approach aims to promote equity, social inclusion, and sustainable development for children with special needs in marginalized communities. Full article

Low back pain (LBP) remains one of the most prevalent and disabling musculoskeletal conditions globally, with profound social, economic, and healthcare implications. The rising incidence and chronic nature of LBP highlight the need for more objective, personalized, and effective approaches to assessment and rehabilitation. In this context, bioengineering has emerged as a transformative field, offering novel tools and methodologies that enhance the understanding and management of LBP. This narrative review examines current bioengineering applications in both diagnostic and therapeutic domains. For assessment, technologies such as wearable inertial sensors, three-dimensional motion capture systems, surface electromyography, and biomechanical modeling provide real-time, quantitative insights into posture, movement patterns, and muscle activity. On the therapeutic front, innovations including robotic exoskeletons, neuromuscular electrical stimulation, virtual reality-based rehabilitation, and tele-rehabilitation platforms are increasingly being integrated into multimodal treatment protocols. These technologies support precision medicine by tailoring interventions to each patient’s biomechanical and functional profile. Furthermore, the incorporation of artificial intelligence into clinical workflows enables automated data analysis, predictive modeling, and decision support systems, while future directions such as digital twin technology hold promise for personalized simulation and outcome forecasting. While these advancements are promising, further validation in large-scale, real-world settings is required to ensure safety, efficacy, and equitable accessibility. Ultimately, bioengineering provides a multidimensional, data-driven framework that has the potential to significantly improve the assessment, rehabilitation, and overall management of LBP. Full article

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in childhood and adolescence, characterized by symptoms of inattention, hyperactivity, and impulsivity. These symptoms often interfere with academic, social, and family functioning. In recent years, the use of digital tools and video games has garnered attention as an innovative and engaging approach for neurocognitive rehabilitation. The primary objective of this randomized controlled study was to investigate the comparative effects of two cognitive intervention approaches—one based on new technologies and one using traditional methods—on attention, inhibitory control, and processing speed in children and adolescents diagnosed with ADHD. Thirty-three participants aged 6–17 years were randomly assigned to either an experimental group (n = 17), which received Nintendo Switch-based therapy, or a control group (n = 16), which received traditional board game therapy. Both interventions lasted 8 weeks and included 16 sessions. Outcomes were assessed using the WISC-V, STROOP, and CARAS-R tests. Results showed significant within-group improvements in both groups. The control group exhibited gains in sustained attention and inhibitory control (CARAS-R and STROOP tests, p < 0.05), while the experimental group improved significantly in processing speed, as measured by the WISC-V (p = 0.001). However, no significant differences were found between groups. These findings suggest that both interventions may be effective for enhancing different cognitive processes in children with ADHD. Importantly, the use of familiar digital technologies like the Nintendo Switch may promote greater motivation and adherence to treatment. Further research with larger samples and long-term follow-up is warranted to validate and extend these preliminary findings, as the current sample size was not powered to detect medium or small effects. Full article

Introduction: Stroke is a leading cause of long-term disability and substantially affects the quality of life (QoL) of both survivors and their caregivers. The transition from hospital to home is a vulnerable period characterized by discontinuity of care and insufficient caregiver support. Dyadic interventions—targeting both the survivor and caregiver—have shown promise in improving recovery outcomes. This protocol outlines a mixed-methods study to evaluate the impact of a video-based training intervention on the stroke survivor–caregiver dyad during the first year post-discharge. Methods: A mixed-methods design based on the TIDieR checklist will be implemented. Stroke survivors and their caregivers will be recruited from stroke units and rehabilitation hospitals across Italy prior to discharge. Approximately 150 dyads will receive a video training intervention followed by nurse-led transitional care support. Assessments will occur at baseline (T0) and at 1 (T1), 3 (T2), 6 (T3), and 12 months (T4) post-discharge. Outcomes will include physical functioning, disability, anxiety, depression, caregiver preparedness, burden, social support, sleep quality, and both generic and stroke-specific QoL. The study is supported by a grant from the Centre of Excellence for Nursing Scholarship, Rome, July 2024. Conclusions: Integrating caregivers into transitional care through structured training and support is essential for improving dyadic outcomes after stroke. Strengthening knowledge and preparedness in both survivors and caregivers enhances recovery, reduces caregiver burden, and may alleviate healthcare system costs associated with poor post-discharge outcomes. Full article

Zoning is vital for balancing biodiversity conservation and sustainable development in protected areas, yet traditional approaches often lead to ecological overprotection and social conflict. This study introduces an integrative modeling framework to optimize zoning strategies in the Longbao Reserve on the Qinghai–Tibet Plateau. We employed MaxEnt and Random Forest algorithms to evaluate habitat suitability for two flagship species: the bar-headed goose (Anser indicus) and the black-necked crane (Grus nigricollis). Results showed that 7.9% of the reserve comprised highly suitable habitats, mainly in the southeast, characterized by wetlands, water proximity, and low human disturbance. Land use and June NDVI emerged as key predictors, contributing over 30% and 35% to model performance, respectively. Based on habitat suitability and current zoning mismatches, we propose a revised four-tier zoning scheme: Core Habitat Conservation (16.9%), Ecological Rehabilitation (7.2%), Ecological Management (53.5%), and Sustainable Utilization Zones (22.4%). This refined framework aligns conservation priorities with local development needs and offers a scalable approach to adaptive protected area management. Full article

Background and Objectives: Cardiovascular diseases (CVDs) remain the leading cause of mortality in Poland, with heart failure (HF) presenting a significant public health issue. Materials and Methods: This study aimed to analyze trends in HF incidence, hospitalization rates, patient demographics, and mortality over two decades A comparative analysis was performed using data from two national reports: (1) the 2013 report “Heart Failure—Analysis of Economic and Social Costs, “ assessing HF patients from 2004 to 2012, and (2) the 2023 report “Heart Failure in Poland 2014–2021,” based on data from the Polish Ministry of Health, National Health Fund, and HTA Consulting. This study examined the prevalence of HF (ICD-10 codes: I50, J81), hospitalization rates, comorbidities, mortality trends, and access to rehabilitation. Results: Between 2014 and 2019, the number of HF patients grew by 34%, reaching 1.02 million in 2019. Only 9% of HF patients were younger than 60 years. Multimorbidity was common, with arterial hypertension, atherosclerotic cardiovascular disease, and arrhythmias, often preceding HF diagnosis. HF-related mortality increased, with 149,963 in 2021, compared to 16,606 in 2012. In 2019, hospitalizations related to HF increased by 41% compared to 2014. The economic burden of HF care increased by 117% between 2014 and 2020, with hospitalizations accounting for 94% of total costs, up from 65% in 2012. Access to cardiac rehabilitation remained limited. Conclusions: HF prevalence, hospitalization rates, and mortality have increased in Poland, alongside a rising burden of multimorbidity. These findings provide a foundation for future healthcare planning to reduce the impact of HF in Poland. Full article

This study investigates urban heat vulnerabilities in Seville, Spain, using a multidimensional framework that integrates remote sensing, Space Syntax, and social vulnerability metrics. This research identifies Heat Boundaries (HBs), which are critical urban entities with elevated Land Surface Temperatures (LSTs) that act as barriers to adjacent vulnerable neighbourhoods, disrupting both physical and social continuity and environmental equity, and examines their relationship with the urban syntax and social vulnerability. The analysis spans two temporal scenarios: a Category 3 heatwave on 26 June 2023 and a normal summer day on 14 July 2024, incorporating both daytime and nighttime satellite-derived LST data (Landsat 9 and ECOSTRESS). The results reveal pronounced spatial disparities in thermal exposure. During the heatwave, peripheral zones recorded extreme LSTs exceeding 53 °C, while river-adjacent neighbourhoods recorded up to 7.28 °C less LST averages. In the non-heatwave scenario, LSTs for advantaged neighbourhoods close to the Guadalquivir River were 2.55 °C lower than vulnerable high-density zones and 3.77 °C lower than the peripheries. Nocturnal patterns showed a reversal, with central high-density districts retaining more heat than the peripheries. Correlation analyses indicate strong associations between LST and built-up intensity (NDBI) and a significant inverse correlation with vegetation cover (NDVI). Syntactic indicators revealed that higher Mean Depth values—indicative of spatial segregation—correspond with elevated thermal stress, particularly during nighttime and heatwave scenarios. HBs occupy 17% of the city, predominantly composed of barren land (42%), industrial zones (30%), and transportation infrastructure (28%), and often border areas with high social vulnerability. This study underscores the critical role of spatial configuration in shaping heat exposure and advocates for targeted climate adaptation measures, such as HB rehabilitation, greening interventions, and Connectivity-based design. It also presents preliminary insights for future deep learning applications to automate HB detection and support predictive urban heat resilience planning. Full article