Search Results (828)

Objectives: The present study describes the comparative effect of 24-week supplementation of beeswax alcohol (BWA, Raydel^®, 0.5% and 1.0%, wt/wt) and coenzyme Q₁₀ (CoQ₁₀, 0.5% and 1.0%, wt/wt) on plasma oxidative variables and the prevention of organ injury in adult zebrafish subjected to a high-cholesterol (HC, 4%, wt/wt) and -D-galactose (Gal, 30%, wt/wt) diet. Methods: Adult zebrafish were fed various HC+Gal diets enriched with either BWA or CoQ₁₀. After 24 weeks of dietary intervention, blood and organs were harvested for subsequent biochemical and histological evaluations. Results: The HC+Gal-elevated plasma oxidative variables were reverted by the consumption of BWA, marked by the lowest plasma malondialdehyde (MDA) level and highest sulfhydryl content. The HC+Gal-impaired zebrafish swimming ability (staggering movement) was substantially recovered by BWA, manifested by a ~three-fold (p < 0.001) enhancement in swimming distance and speed. Also, the intake of BWA affected the morphology of HC+Gal-compromised kidney and induced histological changes by mitigating reactive oxygen species (ROS) production and cellular senescence, which was markedly more effective than the results seen in the CoQ₁₀ group. Likewise, BWA proved effective in preventing HC+Gal-induced testis damage, apparent in the 48.3% (p < 0.05) higher spermatozoa and 26.3% (p < 0.01) reduced interstitial space between the seminiferous tubules. BWA substantially prevented HC+Gal-induced ovary damage by suppressing oxidative stress, lipid deposition and senescence, leading to the restoration of mature vitellogenic oocyte counts. Conclusion: BWA demonstrated a greater ability than CoQ₁₀ to enhance plasma antioxidant status, suppress ROS generation, delay organ aging and alleviate HC+Gal-induced adversity in zebrafish. Full article

Background: Neurodegenerative diseases (NGD) encompass a range of progressive neurological conditions, such as Alzheimer’s disease (AD) and Parkinson’s disease (PD), characterised by the gradual deterioration of neuronal structure and function. This degeneration manifests as cognitive decline, movement impairment, and dementia. Our focus in this investigation is on PD, a neurodegenerative disorder characterized by the loss of dopamine-producing neurons in the brain, leading to motor disturbances. Early detection of PD is paramount for enhancing quality of life through timely intervention and tailored treatment. However, the subtle nature of initial symptoms, like slow movements, tremors, muscle rigidity, and psychological changes, often reduce daily task performance and complicate early diagnosis. Method: To assist medical professionals in timely diagnosis of PD, we introduce a cutting-edge Multimodal Diagnosis framework (PMMD). Based on deep learning techniques, the PMMD framework integrates imaging, handwriting, drawing, and clinical data to accurately detect PD. Notably, it incorporates cross-modal attention, a methodology previously unexplored within the area, which facilitates the modelling of interactions between different data modalities. Results: The proposed method exhibited an accuracy of 96% on the independent tests set. Comparative analysis against state-of-the-art models, along with an in-depth exploration of attention mechanisms, highlights the efficacy of PMMD in PD classification. Conclusions: The obtained results highlight exciting new prospects for the use of handwriting as a biomarker, along with other information, for optimal model performance. PMMD’s success in integrating diverse data sources through cross-modal attention underscores its potential as a robust diagnostic decision support tool for accurately diagnosing PD. Full article

Human hands have over 20 degrees of freedom, enabled by a complex system of bones, muscles, and joints. Hand differences can significantly impair dexterity and independence in daily activities. Accurate assessment of hand function, particularly digit movement, is vital for effective intervention and rehabilitation. However, current clinical methods rely on subjective observations and limited tests. Smart gloves with inertial measurement unit (IMU) sensors have emerged as tools for capturing digit movements, yet their sensor accuracy remains underexplored. This study developed and validated an IMU-based smart glove system for measuring finger joint movements in individuals with hand differences. The glove measured 3D digit rotations and was evaluated against an industrial robotic arm. Tests included rotations around three axes at 1°, 10°, and 90°, simulating extension/flexion, supination/pronation, and abduction/adduction. The IMU sensors demonstrated high accuracy and reliability, with minimal systematic bias and strong positive correlations (p > 0.95 across all tests). Agreement matrices revealed high agreement (<1°) in 24 trials, moderate (1–10°) in 12 trials, and low (>10°) in only 4 trials. The Root Mean Square Error (RMSE) ranged from 1.357 to 5.262 for the 90° tests, 0.094 to 0.538 for the 10° tests, and 0.129 to 0.36 for the 1° tests. Likewise, mean absolute error (MAE) ranged from 0.967 to 4.679 for the 90° tests, 0.073 to 0.386 for the 10° tests, and 0.102 to 0.309 for the 1° tests. The sensor provided precise measurements of digit angles across 0–90° in multiple directions, enabling reliable clinical assessment, remote monitoring, and improved diagnosis, treatment, and rehabilitation for individuals with hand differences. Full article

Dynamic digital radiography (DDR) is a recent imaging technique that allows for real-time visualization of thoracic and pulmonary movement in synchronization with the breathing cycle, providing useful clinical information. A 46-year-old male, a former smoker, was evaluated for unexplained dyspnea and reduced exercise tolerance. His medical history included a SARS-CoV-2 infection in 2021. On physical examination, decreased breath sounds were noted at the right-lung base. Spirometry showed results below predicted values. A standard chest radiograph revealed an elevated right hemidiaphragm, a finding not present in a previous CT scan performed during his SARS-CoV-2 infection. To better assess the diaphragmatic function, a posteroanterior DDR study was performed in the standing position with X-ray equipment (AeroDR TX, Konica Minolta Inc., Tokyo, Japan) during forced breath, with the following acquisition parameters: tube voltage, 100 kV; tube current, 50 mA; pulse duration of pulsed X-ray, 1.6 ms; source-to-image distance, 2 m; additional filter, 0.5 mm Al + 0.1 mm Cu. The exposure time was 12 s. The pixel size was 388 × 388 μm, the matrix size was 1024 × 768, and the overall image area was 40 × 30 cm. The dynamic imaging, captured at 15 frames/s, was then assessed on a dedicated workstation (Konica Minolta Inc., Tokyo, Japan). The dynamic acquisition showed a markedly reduced motion of the right diaphragm. The diagnosis of diaphragm dysfunction can be challenging due to its range of symptoms, which can vary from mild to severe dyspnea. The standard chest X-ray is usually the first exam to detect an elevated hemidiaphragm, which may suggest motion impairment or paralysis but fails to predict diaphragm function. Ultrasound (US) allows for the direct visualization of the diaphragm and its motion. Still, its effectiveness depends highly on the operator’s experience and could be limited by gas and abdominal fat. Moreover, ultrasound offers limited information regarding the lung parenchyma. On the other hand, high-resolution CT can be useful in identifying causes of diaphragmatic dysfunction, such as atrophy or eventration. However, it does not allow for the quantitative assessment of diaphragmatic movement and the differentiation between paralysis and dysfunction, especially in bilateral dysfunction, which is often overlooked due to the elevation of both hemidiaphragms. Dynamic Digital Radiography (DDR) has emerged as a valuable and innovative imaging technique due to its unique ability to evaluate diaphragm movement in real time, integrating dynamic functional information with static anatomical data. DDR provides both visual and quantitative analysis of the diaphragm’s motion, including excursion and speed, which leads to a definitive diagnosis. Additionally, DDR offers a range of post-processing techniques that provide information on lung movement and pulmonary ventilation. Based on these findings, the patient was referred to a thoracic surgeon and deemed a candidate for surgical plication of the right diaphragm. Full article

Operators in high-stress environments often face significant cognitive demands that can impair their performance, underscoring the need for comprehensive workload assessment. This study aims to study the relationship between subjective self-reported measures, the NASA task load index (NASA-TLX), objective bio-signal measures, and pupillary responses. The participants engaged in either a visual tracking task or a laparoscopic visuomotor task while their eye movements were recorded using a Tobii Pro Nano eye tracker (Tobii Technology Inc., Stockholm, Sweden). Immediately after completing the tasks, participants provided NASA-TLX scores to assess their perceived workload. The study tested three hypotheses: first, whether increased pupil dilation correlates with higher NASA-TLX scores; second, whether task type affects workload; and third, whether task repetition influences workload. The results showed a moderate positive correlation between pupil size and NASA-TLX scores (r = 0.513, p < 0.001). The laparoscopic surgery task, which requires visuomotor coordination, resulted in significantly higher NASA-TLX scores (t = –6.23, p < 0.001), larger original pupil sizes (t = –22.57, p < 0.001), and more adjusted pupil sizes (t = –22.57, p < 0.001) than the purely visual task. Additionally, task repetition led to a significant reduction in the NASA-TLX scores (t = 2.86, p = 0.005), the original mean pupil size (t = 5.50, p < 0.001), and the adjusted pupil size (t = 6.34, p < 0.001). In conclusion, the study confirms a positive correlation between NASA-TLX scores and pupillary responses. Task type and repetition were found to influence workload and pupillary responses. The findings demonstrate the value of using both subjective and objective measures for workload assessments. Full article

Background: Hamstring muscle injuries are common in basketball and result in long periods of inactivity. To reduce their incidence, preventive protocols, including proprioceptive neuromuscular facilitation (PNF) stretches, have been proposed. The aim of this study is to compare the short-term effects of PNF and PNF + neuromuscular electrical stimulation (NMES) on hamstring extensibility and, secondarily, on vertical jump capacity in young basketball players. Materials and Methods: The study was a randomized controlled trial. One group performed a PNF stretching protocol and the other PNF + NMES. Hamstring extensibility was measured using the Sit and Reach test and the popliteal angle and jump capacity were measured using the Counter Movement Jump, both before and immediately after the intervention. Results: Forty-five young male players participated. Both groups showed significant intra-group improvements (p < 0.001) in hamstring flexibility after the intervention. However, there were no significant intra-group differences (p > 0.05) in jump capacity. Additionally, no significant differences (p > 0.05) were observed between the two groups for any of the measured variables. Conclusions: Both programs are effective in increasing hamstring flexibility in the short term without impairing vertical jump capacity in young basketball players. Full article

Eye-movement assessment is a key component of neurological evaluation, offering valuable insights into neural deficits and underlying mechanisms. This narrative review explores the emerging subject of digital eye-movement outcomes (DEMOs) and their potential as sensitive biomarkers for neurological impairment. Eye tracking has become a useful method for investigating visual system functioning, attentional processes, and cognitive mechanisms. Abnormalities in eye movements, such as altered saccadic patterns or impaired smooth pursuit, can act as important diagnostic indicators for various neurological conditions. The non-invasive nature, cost-effectiveness, and ease of implementation of modern eye-tracking systems makes it particularly attractive in both clinical and research settings. Advanced digital eye-tracking technologies and analytical methods enable precise quantification of eye-movement parameters, complementing subjective clinical evaluations with objective data. This review examines how DEMOs could contribute to the localisation and diagnosis of neural impairments, potentially serving as useful biomarkers. By comprehensively exploring the role of eye-movement assessment, this review aims to highlight the common eye-movement deficits seen in neurological injury and disease by using the examples of mild traumatic brain injury and Parkinson’s Disease. This review also aims to enhance the understanding of the potential use of DEMOs in diagnosis, monitoring, and management of neurological disorders, ultimately improving patient care and deepening our understanding of complex neurological processes. Furthermore, we consider the broader implications of this technology in unravelling the complexities of visual processing, attention mechanisms, and cognitive functions. This review summarises how DEMOs could reshape our understanding of brain health and allow for more targeted and effective neurological interventions. Full article

The brain contains many interconnected and complex cellular and molecular mechanisms. Injury to the brain causes permanent dysfunctions in these mechanisms. So, it continues to be an area where surgical intervention cannot be performed except for the removal of tumors and the repair of some aneurysms. Some agents that can cross the blood–brain barrier and reach neurons show neuroprotective effects in the brain due to their anti-apoptotic, anti-inflammatory and antioxidant properties. In particular, some agents act by reducing or modulating the accumulation of protein aggregates in neurodegenerative diseases (Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, Amyotrophic lateral sclerosis, and prion disease) caused by protein accumulation. Substrate accumulation causes increased oxidative stress and stimulates the brain’s immune cells, microglia, and astrocytes, to secrete proinflammatory cytokines. Long-term or chronic neuroinflammatory response triggers apoptosis. Brain damage is observed with neuronal apoptosis and brain functions are impaired. This situation negatively affects processes such as motor movements, memory, perception, and learning. Neuroprotective agents prevent apoptosis by modulating molecules that play a role in apoptosis. In addition, they can improve impaired brain functions by supporting neuroplasticity and neurogenesis. Due to the important roles that these agents play in central nervous system damage or neurodegenerative diseases, it is important to elucidate many mechanisms. This review provides an overview of the mechanisms of flavonoids, which constitute a large part of the agents with neuroprotective effects, as well as vitamins, neurotransmitters, hormones, amino acids, and their derivatives. It is thought that understanding these mechanisms will enable the development of new therapeutic agents and different treatment strategies. Full article

This study investigates the biomechanical differences between typically developed (TD) individuals and those with contralateral hemiplegia (CH) using musculoskeletal modeling in OpenSim. Ten TD participants and ten CH patients were analyzed for joint angles and external joint moments around the three anatomical axes: frontal, sagittal, and transverse. The analysis focused on hip, pelvis, lumbar, knee, ankle, and subtalar joint movements, leveraging MRI-derived bone length data and gait analysis. Significant differences (p < 0.05) were observed in hip flexion, pelvis tilt, lumbar extension, and ankle joint angles, highlighting the impact of hemiplegia on these specific joints. However, parameters like hip adduction and rotation, knee moment, and subtalar joint dynamics did not show significant differences, with p > 0.05. The comparison of joint angle and joint moment correlations between TD and CH participants highlights diverse coordination patterns in CH. Joint angles show significant shifts, such as HF and LR (−0.35 to −0.97) and PR and LR (0.22 to −0.78), reflecting disrupted interactions, while others like HR and LR (0.42 to 0.75) exhibit stronger coupling in CH individuals. Joint moments remain mostly stable, with HF and HA (0.54 to 0.53) and PR and LR (−0.51 to −0.50) showing negligible changes. However, some moments, like KA and HF (0.11 to −0.13) and PT and KA (0.75 to 0.67), reveal weakened or altered relationships. These findings underscore biomechanical adaptations and compensatory strategies in CH patients, affecting joint coordination. Overall, CH individuals exhibit stronger negative correlations, reflecting impaired coordination. These findings provide insight into the musculoskeletal alterations in hemiplegic patients, potentially guiding the development of targeted rehabilitation strategies. Full article

Efficient BCIs (Brain-Computer Interfaces) harnessing EEG (Electroencephalography) have shown potential in controlling mobile robots, also presenting new possibilities for assistive technologies. This study explores the integration of advanced deep learning models—ASTGCN, EEGNetv4, and a combined CNN-LSTM architecture—with ROS (Robot Operating System) to control a two-wheeled mobile robot. The models were trained using a published EEG dataset, which includes signals from subjects performing thought-based tasks. Each model was evaluated based on its accuracy, F1-score, and latency. The CNN-LSTM architecture model exhibited the best performance on the cross-subject strategy with an accuracy of 88.5%, demonstrating significant potential for real-time applications. Integration with ROS was facilitated through a custom middleware, enabling seamless translation of neural commands into robot movements. The findings indicate that the CNN-LSTM model not only outperforms existing EEG-based systems in terms of accuracy but also underscores the practical feasibility of implementing such systems in real-world scenarios. Considering its efficacy, CNN-LSTM shows a great potential for assistive technology in the future. This research contributes to the development of a more intuitive and accessible robotic control system, potentially enhancing the quality of life for individuals with mobility impairments. Full article

Background/Objectives: Wrist/hand injury incidences in the general population are high and contribute to a significant health problem. Fear of pain from movement can impact physical recovery, contributing to prolonged disability and impaired function in an upper limb after wrist/hand injury. The study’s objectives are (1) to evaluate the relationship between kinesiophobia, pain catastrophizing, QuickDASH, and Patient-Rated Wrist Evaluation and (2) to evaluate the data regarding the influence that basal kinesiophobia may have on upper limb functionality after wrist/hand immobilization. Methods: Participants referred from different medical centers with a wrist or hand injury that required immobilization were enrolled in the study. Data were collected just after the post-immobilization period. The following outcome measures were evaluated: the QuickDASH, the PRWE (Patient-Rated Wrist Evaluation), the TSK (Tampa Scale of Kinesiophobia), and the PCS (Pain Catastrophizing Scale). Demographics were summarized with descriptive statistics and linear relationships between variables using Pearson’s correlation coefficient. Furthermore, multivariate linear regression analysis was performed to determine whether kinesiophobia could predict upper functional performance. Results: 64 patients (40 women, 24 men) participated in the study. Significant kinesiophobia positive correlations were found between the TSK and the QuickDASH (r = 0.848, p < 0.001) as well as the TSK and the PCS error (r = 0.521, p < 0.001). The regression model explains 30.4% of the variance in upper limb function, suggesting that the PRWE, the Pain Catastrophizing Scale, and the QuickDASH are important in predicting dysfunction. Conclusions: Kinesiophobia may contribute to but is not a significant predictor of dysfunction in this model. Full article

Background/Objectives: Team handball involves a high number of rapid and forceful muscle actions. Progressive heavy-load resistance training is known to enhance mechanical muscle function; however, its transfer into functional performance in team handball athletes remains largely unknown. The current study aimed to analyze the effects of eight weeks undulating heavy-load resistance training on lower limb mechanical muscle function and sports-specific performance in elite female team handball players. Methods: Players from the Danish Women’s Handball League were block randomized to perform an off-season resistance training program (RT, n = 12, 23.0 ± 2.7 yr) or follow a training-as-usual control program (CON, n = 15, 24.1 ± 3.8 yr). All study participants were tested before and after an eight-week period during the off-season phase, including assessments of maximal isometric knee extensor and flexor peak torque, rate of torque development, countermovement jump (CMJ) power/work, and sports-specific performance (maximal vertical countermovement jump height, sprint capacity, team handball-specific on-court agility). Results: Agility performance improved for RT (−3.5%, p = 0.008), different from CON (p < 0.001) following eight weeks of designated resistance training. Additionally, CON demonstrated impaired agility (+4.0–7.3%, p < 0.05) and 20-m sprint (+1.9%, p = 0.002) performance. Maximal knee extensor peak torque increased in RT (4.5%, p = 0.044). Vertical CMJ flight height (JH) increased in both groups (RT +4.8%, p = 0.012, CON +8.4% p = 0.044); however, jump height relative to ground level (JHGL) increased in RT only (+8.0%, p = 0.013). Conclusions: In conclusion, designated resistance training during the off-season period is effective in maintaining and improving essential components of sports-specific performance and maximal knee extensor strength in elite female team handball players. Comparable protocols of twice-a-week heavy-load resistance training may also be beneficial in other types of intermittent elite team sports (i.e., football, basketball) that include maximal jumping actions, short-distance sprints, and rapid change of direction movements. Full article

Soft exoskeletons (exosuits) are expected to provide a comfortable wearing experience and compliant assistance compared with traditional rigid exoskeleton robots. In this paper, an exosuit with twisted string actuators (TSAs) is developed to provide high-strength and variable-stiffness actuation for hemiplegic patients. By formulating the analytic model of the TSA and decoding the human impedance characteristic, the human-exosuit coupled dynamic model is constructed. An adaptive impedance controller is designed to transfer the skills of the patient’s healthy limb (HL) to the bilateral impaired limb (IL) with a mirror training strategy, including the movement trajectory and stiffness profiles. A reinforcement learning (RL) algorithm is proposed to optimize the robotic assistance by adapting the impedance model parameters to the subject’s performance. Experiments are conducted to demonstrate the effectiveness and superiority of the proposed method. Full article

Background: Damage to the upper trunk of the brachial plexus, often caused by high-energy trauma, leads to significant functional impairment of the upper limb. This injury primarily affects the C5 and C6 roots, resulting in paralysis of muscles critical for shoulder and elbow function. If spontaneous nerve regeneration does not occur within 3–6 months post-injury, surgical intervention, including nerve transfers, is recommended to restore function. Methods: This study evaluates long-term outcomes of nerve transfer surgeries performed between 2013 and 2023 on 16 adult patients with post-traumatic brachial plexus injuries. The most common cause of injury was motorcycle accidents. Nerve transfers targeted shoulder and elbow function restoration, including transfer of the accessory nerve to the suprascapular nerve, the radial nerve branch to the long or medial head of the triceps brachii to the axillary nerve, or the transfer of motor fascicles of the ulnar and median nerves (double Oberlin) to the brachialis and biceps brachii motor nerves. Results: Postoperative results showed varying degrees of functional recovery. In the shoulder, most patients achieved stabilization and partial restoration of active movement, with average flexion up to 92° and abduction up to 78°. In the elbow, full flexion with M4 strength was achieved in 64% of patients. In both the shoulder and the elbow, double nerve transfers yield better long-term outcomes than single transfers. Secondary procedures, such as tendon transfers, were required in some cases to improve limb strength. Conclusions: The study concludes that nerve transfers offer reliable outcomes in restoring upper limb function, although additional surgeries may be necessary in certain cases. Full article

Falls among the elderly have been a significant public health challenge, with severe consequences for individuals and healthcare systems. Traditional balance assessment methods often lack ecological validity, necessitating more comprehensive and adaptable evaluation techniques. This research explores the use of inertial measurement units to assess postural balance in relation to the Berg Balance Scale outcomes. We recruited 14 participants from diverse age groups and health backgrounds, who performed 14 simulated tasks while wearing inertial measurement units on the head, torso, and lower back. Our study introduced a novel metric, i.e., the volume that envelops the 3-dimensional accelerations, calculated as the convex hull space, and used this metric along with others defined in previous studies. Through logistic regression, we demonstrated significant associations between various movement characteristics and the instances of balance loss. In particular, greater movement volume at the lower back (p = 0.021) was associated with better balance, while root-mean-square lower back angular velocity (p = 0.004) correlated with poorer balance. This study revealed that sensor location and task type (static vs. dynamic) significantly influenced the coefficients of the logistic regression model, highlighting the complex nature of balance assessment. These findings underscore the potential of IMUs in providing detailed objective balance assessments in the elderly by identifying specific movement patterns associated with balance impairment across various contexts. This knowledge can guide the development of targeted interventions and strategies for fall prevention, potentially improving the quality of life for older adults. Full article