Search Results (6,241)

Introduction: In patients refractory to vestibular rehabilitation in the management of bilateral vestibulopathy, the cochleo-vestibular implant has emerged as a viable alternative to enhance both audiovestibular function and quality of life. The main objective of this study is to pioneer the use of PET to assess cortical modifications in patients with cochleo-vestibular implants, aiming to evaluate the safety and functional improvements in individuals with bilateral vestibulopathy and severe to profound hearing loss. Methods: A phase I pilot clinical trial was conducted with participants who received a BIONIC-VEST CI24RE cochleo-vestibular implant, with pre- and post-implantation assessments conducted for twelve months. Audiovestibular testing and two PET studies with 18F-FDG under baseline conditions and with active stimulus to observe cortical-level differences were performed. Results: Five patients were included in the study, all of them treated with a cochleo-vestibular implant, none of whom presented postoperative adverse effects. Audiologically, the mean post-implant gain was 56.63 ± 14.53 dB and 50.40 ± 35.54% in terms of speech intelligibility. From a vestibular perspective, the most remarkable findings were observed at the graviceptive pathway level, where a mean posturographic improvement was observed, with a sensory organization test score of 24.20 ± 13.74 and a subjective visual vertical of 1.57° ± 0.79°, achieving, in most cases, results within the normal range (<2.3°) by the end of the follow-up. PET images confirmed that with the electrical stimulus active (implant ON), there was a supratentorial activation pattern, particularly in areas related to somatosensory integration, emotional regulation, and autonomic control. Conclusions: The BIONIC-VEST implant significantly improved the vestibular system, particularly the graviceptive pathway, enhancing balance and SVV and reducing fall risk. PET revealed distinct uptake patterns in baseline and activated conditions, highlighting a cortical-level response with the use of the cochleo-vestibular implant. Full article

Rapid urbanization is causing ecological and environmental issues to worsen. The stability of the ecosystem function of the farming–pastoral ecotone (FPE) in Inner Mongolia is essential to ensuring the sustained growth of the nearby cities, acting as a vital ecological safeguard in China’s northern regions. This study used the “production–living–ecological” spaces (PLES) spatial dynamics, the rate of change index, and the standard deviation ellipse to examine the spatial and temporal evolution of the PLES in the FPE in Inner Mongolia. This study constructed a spatial conflict index model based on the theory of landscape ecology, and evaluated the ecosystem service value (ESV) of the region and visualized the results of the analysis using the micro-scale of the grid. Finally, the relationship between the ESV and PLES spatial conflicts was determined using a bivariate spatial autocorrelation model. The findings show that: (1) During the 20 years, the maximum ecological spatial change rate reached 0.43%, with the cumulative spatial dynamics of PLES totaling 2.49%. Notably, industrial production space activities experienced the most significant increase, amounting to 277.09%. (2) Regional spatial conflict intensity shows an upward trend from 2000 to 2020, with the average conflict level increasing from 0.53 to 0.56, and high conflict values being concentrated in the east. (3) The ESV pattern in the FPE in Inner Mongolia is characterized by “high ESV in the east and low ESV in the central and western regions”, with an overall trend of increasing and then decreasing. A notable negative correlation was observed between ESV and PLES spatial conflicts in the region, with Moran’s I indicating values of−0.196, −0.293, and−0.163, respectively. Specifically, low-value–high-conflict zones were predominantly found in other ecological spaces, high-value–low-conflict zones was concentrated in forest ecological spaces, and high-value–high-conflict zones were predominantly concentrated in aquatic ecological spaces. The research findings serve as a crucial scientific foundation for the development of ecological civilization and the sustainable advancement of the FPE in Inner Mongolia. Full article

Background/Objectives: Dry eye (DE) is mainly characterized by dryness, foreign body sensation, eye pain and visual impairment. Their possible causes are mainly inflammation, tissue damage and neurosensory abnormalities, and vitamin B6 (VitB6) attenuates the inflammatory response by modulating the NF-κB pathway to quench reactive oxygen species (ROS). The aim of this experiment was to investigate the therapeutic effect of VitB6 eye drops on particulate matter 2.5 (PM2.5)-induced dry eye in mice. Methods: Mice induced with the dry eye group were first induced using PM2.5 eye drops in a standard environment for 14 days, and then treated with different concentrations of VitB6 eye drops for 14 consecutive days. The phenol red cotton test was used to measure tear production. Ocular inflammation index and tear film function were evaluated by slim microscopy. Hematoxylin–eosin (HE) staining was used to observe conjunctival and corneal structure. Periodate–Schiff (PAS) staining was used to quantify conjunctival goblet cells. Corneal cell apoptosis was determined by TUNEL assay. The expression of keratin 10 (K10) and p-NF-κB p65 was detected by immunofluorescent staining and Western blot analysis. Results: Mice using only the PM2.5 model all exhibited varying degrees of dry eye symptoms. VitB6 treatment increased tear secretion and reduced inflammatory indices in mice with increased nerve density and number of branches in the basement membrane of the corneal epithelium. Conclusions: We found that administering VitB6 eye drops has a therapeutic effect in PM2.5-induced DE. This observation suggests that VitB6 may be useful in the clinical therapy of DE. Full article

Background/Objectives: Temporary decreases in dermal collagen caused by artificial ultraviolet exposure are largely affected by increased epidermis-derived matrix metalloproteinase (MMP)-1 levels. However, the role of epidermal MMP-1 in dermal tissue remodeling induced by chronic sun exposure remains unclear. This study aimed to clarify the involvement of epidermal and dermal MMP-1 in dermal collagen reduction induced by chronic sun exposure. Methods: Immunofluorescent staining of 30 facial skin tissue samples was performed to visualize MMP-1. The fluorescence intensity of epidermal MMP-1 observed on microscopic images was analyzed in relation to the severity of dermal tissue remodeling and the dermal collagen fiber density. A similar correlation analysis of the number of dermal MMP-1-positive cells was also performed. Results: Epidermal MMP-1 was observed in the stratum spinosum of skin without severe tissue remodeling; however, in skin with severe dermal tissue remodeling, MMP-1 was localized throughout the epidermis. The epidermal MMP-1 signal area and dermal collagen fiber density were negatively correlated (ρ = −0.383; p = 0.0002; n = 90). However, the ratio of dermal MMP-1-positive cells to total dermal cells was only negatively correlated with the collagen fiber density in skin that was not severely remodeled (ρ = −0.746; p = 0.001; n = 15). Conclusions: Epidermal MMP-1 is involved in the tissue remodeling of skin that is subjected to chronic sun exposure and short-term ultraviolet radiation exposure. However, dermal-cell-derived MMP-1 may be involved in biological processes that require an immediate collagen degradation response. The results of this study demonstrate the importance of controlling epidermal MMP-1 to inhibit dermal tissue remodeling induced by chronic sun exposure and provide new insights that are beneficial to the development of anti-photoaging skincare cosmetics. Full article

Background: Metastatic prostate cancer (mPCa) is marked by heterogeneity and therapy resistance, which arise from prolonged therapy regimens. This heterogeneity is reflected in various morphologic and genetic characteristics, biomarker expression, and other molecular mechanisms, thereby contributing to the complexity of the disease. Methods: To investigate tumor heterogeneity, the effects of androgen targeting therapy (ADT) on single-cell PSA secretion was assessed by analyzing the prostate cancer cell lines using a modified ELISpot platform. The FACS and cytospin techniques were employed to understand the influence of the cell cycle on PSA secretion patterns. Additionally, a proteome array was used to identify potential biomarkers from different PCa cell lines with varying metastatic potential. Results: Among the various PCa cell lines examined, PSA expression and secretion could be visualized only from the LNCaPs. PSA secretion from circulating tumor cells (CTCs) further confirmed the validity of this assay. These LNCaPs exhibited heterogeneity in single-cell intracellular and extracellular PSA expression and in their ADT responses. LNCaPs in the G1 phase showed higher PSA secretion than in the S or G2/M phase. Apart from PSA, Cathepsin D, Progranulin, IL-8, Serpin E1, and Enolase 2 were identified as secretome markers from the metastatic PCa cell lines. Conclusions: We observed variability in PSA secretion in LNCaP in response to anti-androgen treatment and a cell cycle-dependent secretion pattern. The notable presence of Progranulin and Cathepsin D in metastatic cell lines makes them promising candidates for use in multiplexing and single-cell platforms, potentially advancing our understanding and treatment of this disease. Full article

Utilizing high-resolution microscopy in conjunction with a new antibody highly specific for rat alpha4 Na,K-ATPase, we describe changes in alpha4 expression during spermatogenesis and in sperm incubated under capacitating and noncapacitating conditions. Immunohistochemical analyses showed alpha4 expression at low levels in spermatogonia and in pachytene spermatocytes. Alpha4 then becomes highly expressed on round spermatids and the midpiece of elongated spermatozoa within the seminiferous tubules. In noncapacitating conditions, alpha4 was confined mainly to the flagellum of mature sperm; however, under capacitating conditions, sperm acquired intense alpha4 staining along the acrosomal region of the sperm head. To visualize the precise localization of alpha4 in the sperm head, we performed an ultrastructural analysis using immuno-scanning electron microscopy. Under capacitating conditions, sperm exhibited alpha4 staining along the dorsal surface of the sperm head associated with the acrosome. In addition, after 4 h of incubation in motility buffer, we observed an increase in alpha4 protein in sperm that could be blocked with chloramphenicol, a mitochondrial-type ribosome inhibitor. These findings demonstrate that both the localization and expression level of alpha4 Na,K-ATPase are dynamic aspects of sperm maturation and suggest that sperm motility and capacitation may be supported by these changes to the location and amount of this protein. Full article

Background/Objectives: Cataract surgery has evolved into a refractive procedure aimed at optimizing both vision quality and quantity. Modern patients, particularly “baby boomers”, expect superior outcomes, increasing demand for premium intraocular lenses (IOLs). However, ocular surface dysfunction (OSD), especially dry eye disease (DED), compromises postoperative satisfaction, with up to 35% of patients dissatisfied despite achieving 20/20 visual acuity. This study aimed to characterize postsurgical ocular surface system failure (OSSF) and explore strategies to improve perioperative management. Methods: An open observational study was conducted at the Ophthalmology Complex Operative Unit, University Campus Bio-Medico, Rome, Italy, enrolling 20 patients with stage N2–3 and C1–2 lens opacities. Patients with diabetes, prior surgeries, or ocular inflammatory diseases were excluded. Preoperative and postoperative assessments included OSDI, SANDE scores, Schirmer test, TBUT, and fluorescein staining. Follow-ups occurred at 1 week, 1 month, and 3 months postoperatively. Statistical analysis used two-way ANOVA (p < 0.05). Results: Despite achieving a BCVA of 20/20, 44% of patients reported OSSF symptoms. Postoperative evaluations revealed significant worsening in OSDI and SANDE scores (p < 0.001), Schirmer test (preoperative mean 19.92 ± 10.06; p < 0.001), and TBUT (preoperative mean 5.88 ± 2.64 s; p < 0.001). Meibomian gland dysfunction and conjunctival hyperemia also worsened. Conclusions: Postsurgical OSSF results from neurogenic inflammation, tear film instability, and meibomian gland dysfunction, exacerbated by surgical trauma. Preoperative and postoperative management, including artificial tears, lid hygiene, and preservative-free regimens, are essential to improve outcomes and patient satisfaction. Comprehensive strategies can mitigate symptoms and enhance the benefits of cataract surgery. Full article

Maintaining optimal levels of engagement during rehabilitation training is crucial for inducing neuroplasticity in the motor cortex, which directly influences positive rehabilitation outcomes. In this research article, we propose a virtual reality (VR) rehabilitation system that incorporates a steady-state visual evoked potential (SSVEP) paradigm to provide engagement feedback. The system utilizes a flickering target and cursor to detect the user’s engagement levels during a target-tracking task. Eighteen healthy participants were recruited to experience three experimental conditions: no feedback (NoF), performance feedback (PF), and neurofeedback (NF). Our results reveal significantly greater Mu suppression in the NF condition compared to the other conditions. However, no significant differences were observed in performance metrics, such as tracking error, among the three conditions. The amount of feedback between the PF and NF conditions also showed no substantial difference. These findings suggest the efficacy of our SSVEP-based engagement feedback paradigm in stimulating motor cortex activity during rehabilitation. Consequently, we conclude that neurofeedback, based on the user’s attentional state, proves to be more effective in promoting motor cortex activation and facilitating neuroplastic changes. This research highlights the potential of integrating VR rehabilitation with an engagement feedback system for successful rehabilitation training. Full article

Landscape visual evaluation is a key method for assessing the value of visual landscape resources. This study aims to enhance the visual environment and sensory quality of urban landscapes by establishing standards for the visual comfort of urban natural landscapes. Using line-of-sight and multi-factor analysis algorithms, the method assesses spatial visibility and visual exposure of building clusters in the core urban areas of Harbin, identifying areas and viewpoints with high visual potential. Focusing on the viewpoints of landmark 3D models and the surrounding landscape’s visual environment, the study uses the city’s sky, greenery, and water features as key visual elements for evaluating the comfort of urban natural landscapes. By integrating GIS data, big data street-view photos, and image semantic recognition, spatial analysis algorithms extract both objective and subjective visual values at observation points, followed by mathematical modeling and quantitative analysis. The study explores the coupling relationship between objective physical visual values and subjective perceived visibility. The results show that 3D visual analysis effectively reveals the relationship between landmark buildings and surrounding landscapes, providing scientific support for urban planning and contributing to the development of a more distinctive and attractive urban space. Full article

ArcGIS Dashboard technology allows for the integration and visualization of various maps, charts, and indicators within a single interface, using databases underneath a geographic information system. The two dashboards of the European project Teaching the Future address the dual objective of (i) cartographically displaying the evolution in four phases of climate change data experienced across the entire planet from 1954 to 2021 in vectorial cells measuring one degree of latitude by one degree of longitude and (ii) spatially representing three scenarios (low, medium, and high greenhouse gas emissions) up to the year 2100, showing potential temperature increases in those same cells. In addition to the maps, the different data and charts contribute to the understanding of anomalies relative to the average, the global increase in each selected area by zooming in on the map, and the evolution of both observed and projected data. Both dashboards represent an accurate and reliable treatment of the data, as well as a cartographic expression that is easy for map readers to understand, making them powerful resources for teaching climate change at any educational level, whether in higher education or schools and for a general audience. Full article

Background/Objectives: Chronic rhinosinusitis with nasal polyps (CRSwNP) represents a debilitating disease with significant morbidity and decreased quality of life (QoL). The introduction of biologics in its management has allowed new therapeutic options, and Dupilumab represents the first approved biologic. This study aims to evaluate a possible relationship between the clinical response to biological therapy and mental health in patients with severe CRSwNP. Methods: This is a multicenter study conducted at the Otolaryngology departments of three major Italian health institutions. Participants were patients with CRSwNP treated with Dupilumab. Patients were assessed at baseline and during treatment by submitting them to a survey consisting of a dedicated questionnaire focused on psychological health and two patient-reported outcome measures (PROMs): the 22-item Sino-Nasal Outcome Test (SNOT-22) and a Visual Analogue Scale (VAS) for nasal symptoms. Results: 86 patients were included in the study (58 males and 28 females; mean age: 58.2 years). There was a significant improvement in both symptoms and QoL, with an enhanced psychological state observed in patients after the first administration and within the first months of therapy. Conclusions: This study evaluated the possible correlations between Dupilumab treatment and improvements in mental health in patients with CRSwNP, as assessed through a survey, and clinical conditions, assessed through SNOT-22 and VAS. Our findings showed that Dupilumab not only improved clinical symptoms but also had a positive impact on patients’ mental health, with benefits observed already after the first administration and the first months of therapy. This survey highlights the relevance of psychological well-being and its implications for patients with chronic diseases such as CRSwNP. Full article

Purpose: Accurate and precise navigation in space and postural stability rely on the central integration of multisensory input (vestibular, proprioceptive, visual), weighted according to its reliability, to continuously update the internal estimate of the direction of gravity. In this study, we examined both peripheral and central vestibular functions in a world-renowned 53-year-old male tightrope walker and investigated the extent to which his exceptional performance was reflected in our findings. Methods: Comprehensive assessments were conducted, including semicircular canal function tests (caloric irrigation, rotatory-chair testing, video head impulse testing of all six canals, dynamic visual acuity) and otolith function evaluations (subjective visual vertical, fundus photography, ocular/cervical vestibular-evoked myogenic potentials [oVEMPs/cVEMPs]). Additionally, static and dynamic posturography, as well as video-oculography (smooth-pursuit eye movements, saccades, nystagmus testing), were performed. The participant’s results were compared to established normative values. High-resolution diffusion tensor magnetic resonance imaging (DT-MRI) was utilized to assess motor tract integrity. Results: Semicircular canal testing revealed normal results except for a slightly reduced response to right-sided caloric irrigation (26% asymmetry ratio; cut-off = 25%). Otolith testing, however, showed marked asymmetry in oVEMP amplitudes, confirmed with two devices (37% and 53% weaker on the left side; cut-off = 30%). Bone-conducted cVEMP amplitudes were mildly reduced bilaterally. Posturography, video-oculography, and subjective visual vertical testing were all within normal ranges. Diffusion tensor MRI revealed no structural abnormalities correlating with the observed functional asymmetry. Conclusions: This professional tightrope walker’s exceptional balance skills contrast starkly with significant peripheral vestibular (otolithic) deficits, while MR imaging, including diffusion tensor imaging, remained normal. These findings highlight the critical role of central computational mechanisms in optimizing multisensory input signals and fully compensating for vestibular asymmetries in this unique case. Full article

Graves’ ophthalmopathy is the most common extrathyroidal manifestation of Graves–Basedow disease. Radiotherapy is effective especially when used in synergy with the administration of glucocorticoids. The aim of our study was to analyze the effectiveness and safety of radiotherapy, using different protocols, to improve ocular symptoms and quality of life. Methods: We retrospectively analyzed the clinical data of two-hundred and three patients treated with retrobulbar radiotherapy between January 2002 and June 2023. Ninety-nine patients were treated with a schedule of 10 Gy in 10 fractions and one-hundred and four were treated with 10 Gy in 5 fractions. Radiotherapy (RT) was administrated during the 12 weeks of pulse steroid therapy. Patients were evaluated with a clinical exam, orbital CT, thyroid assessment, and Clinical Activity Score (CAS). Results: The median follow-up was 28.6 months (range 12–240). Complete response was found in ninety-four pts (46.31%), partial response or stabilization in one hundred pts (49.26%), and progression in nine pts (4.43%). In most subjects, an improvement in visual acuity and a reduction in CAS of at least 2 points and proptosis by more than 3 mm were observed. Three patients needed decompressive surgery after treatment. Only G1 and G2 acute eye disorders and no cases of xerophthalmia or cataract were assessed. Conclusions: RT is an effective and well-tolerated treatment in this setting, especially when associated with the administration of glucocorticoids. Although the most used fractionation schedule in the literature is 20 Gy in 10 fractions, in our clinical practice, we have achieved comparable results with 10 Gy in 5 or 10 fractions with a lower incidence of toxicity. Full article

This paper introduces a fatigue detection model specifically designed for immersive virtual reality (VR) environments, aimed at facilitating upper limb rehabilitation for individuals with spinal cord injuries (SCIs). The model’s primary application centers on the Box-and-Block Test, providing healthcare professionals with a reliable tool to monitor patient progress and adapt rehabilitation routines. At its core, the model employs data fusion techniques via ordered weighted averaging (OWA) operators to aggregate multiple metrics captured by the VR rehabilitation system. Additionally, fuzzy logic is employed to personalize fatigue assessments. Therapists are provided with a detailed classification of fatigue levels alongside a video-based visual representation that highlights critical moments of fatigue during the exercises. The experimental methodology involved testing the fatigue detection model with both healthy participants and patients, using immersive VR-based rehabilitation scenarios and validating its accuracy through self-reported fatigue levels and therapist observations. Furthermore, the model’s scalable design promotes its integration into remote rehabilitation systems, highlighting its adaptability to diverse clinical scenarios and its potential to enhance accessibility to rehabilitation services. Full article

There has been long-standing debate as to whether Kami Fumi-e (paper images to be trampled on) had actually been used in image trampling sessions as part of the 250-year persecution of Christianity enforced by the Tokugawa Shogunate. Sacred images of Christianity officially recorded to have been trampled on are housed in the permanent collection of the Tokyo National Museum and are almost uniquely made of metal alloy. The controversy regarding paper images, apart from the medium being considered unsuitable for such extreme use, was fueled by the appearance of a significant number of them in museum collections and institutions worldwide in the 20th century. Most of the prints bear dates from different eras of the Edo period, sometimes hundreds of years apart; therefore, long-standing arguments regarding their authenticity marked the last century. In order to distinguish later copies from potentially original pieces, if ever existed, XRF, Raman, and FTIR analytical techniques were used to study the materials characterizing them. In addition, detailed observation of the main visual features (overall design composition, inscriptions, paper support, etc.) was carried out to highlight potential discrepancies that could pair with scientific evidence and lead to a definitive conclusion. Full article