Esophageal adenocarcinoma is a major global health concern, primarily arising from gastroesophageal reflux disease, with Barrett's esophagus being its main precursor. Although proton pump inhibitors are commonly used to manage the symptoms from gastroesophageal reflux disease, their role in preventing esophageal adenocarcinoma progression remains uncertain. The aim of this review is to summarize the current advances in the diagnosis of Barrett's esophagus and its progression, as well as to critically evaluate and compare the impact of antireflux surgery on Barrett's esophagus and its potential role in preventing its progression to esophageal adenocarcinoma. In conclusion, surgical intervention, particularly antireflux surgery, has been associated with reduced esophageal adenocarcinoma risk in some studies, offering better long-term symptom control and possibly preventing cancer progression. However, other authors suggest that the cancer risk does not decrease significantly with surgery, highlighting the need for further investigation into its long-term preventive benefits. Several novel strategies have been established over the last few years that will facilitate an early diagnosis of Barrett's esophagus in the future.

Current interactive information visualization systems often fail to adequately incorporate cultural elements, limiting their effectiveness in cross-cultural communication and reducing user engagement across diverse global audiences. This research presents a comprehensive methodology that integrates artificial intelligence technologies with cultural elements to create more engaging and culturally appropriate interactive visualization systems. The proposed approach includes an intelligent cultural element identification algorithm achieving 91.2% recognition accuracy, an adaptive visualization generation framework that automatically incorporates cultural preferences, and real-time interface optimization mechanisms that dynamically adjust to user behavior patterns. Experimental validation with 600 participants from diverse cultural backgrounds demonstrated significant improvements: 23.5% increase in user satisfaction, 18.3% reduction in cognitive load, and 31.7% enhancement in user engagement compared to traditional visualization approaches. The multidimensional evaluation revealed superior performance across aesthetic appeal, functional usability, and cultural appropriateness metrics. This research contributes theoretical frameworks for understanding cultural influences on visualization perception and provides practical guidelines for implementing culturally informed, AI-driven design systems in multicultural environments.

Extreme weather can cause urban groundwater levels (GWLs) to rise sharply, making anti-uplift performance critical for underground structures. We present a drainage-pressure relief anti-uplift technique (DPRAT) that integrates the Dupuit circular island model, the Thiem equation, and GWL distribution assumptions into an intelligent control system. The system activates automatically when the measured water head exceeds a design threshold, draining groundwater to relieve hydrostatic pressure on buried structures. Tests and simulations in Chengdu's expansive soil areas confirm that anti-uplift failure results primarily from buoyant forces and soil expansion. To ensure adequate safety margins, the target drainage level is calibrated to maintain system inactivity approximately 80% of the time under normal conditions. Four years of field monitoring demonstrate that DPRAT effectively maintains GWLs below the design datum during extreme rainfall events. A 50-year life cycle assessment reveals that DPRAT reduces cradle-to-grave carbon emissions by up to 97.5% compared with conventional uplift anchors, representing a substantial shift from high-energy construction methods to low-carbon alternatives.

Loneliness is an aversive state that occurs at elevated rates among individuals with mental health disorders and may reciprocally exacerbate psychopathological processes. Individuals with personality disorders (PDs) appear particularly susceptible; however, knowledge regarding the relationship between loneliness and facets of personality functioning (PF) remains limited. Greater conceptual and empirical clarity is needed to elucidate the mechanisms linking loneliness with maladaptive self- and interpersonal functioning and to inform clinical practice. We examined the association between loneliness and PF in a longitudinal cohort of 87 inpatients undergoing psychotherapy programs. Loneliness was measured with the UCLA Loneliness Scale. PF was evaluated with the Semi-Structured Interview for Personality Functioning and the Level of Personality Functioning Scale. Baseline loneliness scores were positively associated with self-direction and intimacy, and changes in loneliness were correlated with changes in identity and intimacy. During treatment, significant changes were observed for loneliness and PF, particularly self-functioning, based on self- and clinician ratings. These findings indicate that loneliness is associated with dimensions of self- and interpersonal functioning cross-sectionally and longitudinally. Larger longitudinal studies are needed to elucidate how components of loneliness and PF are interconnected and to identify underlying mechanisms that may inform interventions aimed at reducing loneliness in individuals with PDs.

Conventional lower-limb exoskeletons often rely on lateral supports, which can shift the user's center of mass and induce gait asymmetry, thereby limiting practical deployment. This study preliminarily validated a rear-supported exoskeleton with a three-layer torque-impedance control strategy in healthy adults, providing initial evidence for potential rehabilitation applications. We designed the rear-supported lower-limb exoskeleton and evaluated its performance during level walking and on an 8.5° incline in six participants using synchronized surface electromyography and kinematic data. Results showed that rectus femoris root mean square of muscle activation decreased by 20.62% on level ground and 36.38% on the slope, while the Gait Symmetry Index improved by 8.82% and 14.37%, respectively. The combination of the rear-supported structure and hierarchical control reduced muscular demand and enhanced bilateral gait symmetry, suggesting a potential design paradigm for assistive walking and future rehabilitation.

Although musical experience has been linked to enhanced speech-in-noise (SIN) perception, the mechanisms underlying this relationship remain unclear. While previous studies have identified contributions from both auditory and cognitive skills, few have evaluated these contributions within an integrated framework. Furthermore, most studies have relied on binary comparisons between musicians and nonmusicians. Here, we assessed 62 young adults with normal hearing using a continuous measure of musical engagement (Goldsmiths Musical Sophistication Index) alongside tests of beat perception (Beat Alignment Test), pitch discrimination (frequency difference limen), auditory working memory (WAIS digit span), and subcortical pitch encoding (frequency-following response, FFR). SIN perception was measured with a spatialized two-talker masker task. Greater musical sophistication was associated with better SIN performance, stronger working memory, finer beat perception, and sharper pitch discrimination. Regression analyses identified working memory and beat perception as the strongest predictors, and mediation analyses indicatedthat these skills contributed to the association between musical sophistication and SIN performance, with working memory accounting for the most variance. In contrast, pitch discrimination and FFR precision were not significant predictors. Our findings clarify the cognitive and temporal foundations of the musician advantage and highlight the value of considering musical engagement as a continuous variable rather than categorical.

Dynamic obstacle avoidance remains a key challenge in robotic arm motion planning, as traditional algorithms struggle to balance adaptive decision-making with precise trajectory generation in unstructured environments. We present a hierarchical motion planning framework that combines proximal policy optimization (PPO) with rapidly exploring random tree star (RRT*), trained using a curriculum learning paradigm. PPO learns global obstacle avoidance strategies through progressively difficult training scenarios, while RRT* refines local trajectories to compensate for PPO's limitations in fine motor control. A multiobjective reward function-incorporating step-efficiency terms and artificial potential field principles-balances exploration and exploitation through tailored penalties and rewards. In dynamic obstacle scenarios, the proposed method achieves an 87.6% success rate, outperforming standalone PPO and existing hybrid reinforcement learning approaches. This framework offers a practical solution for dynamic obstacle avoidance with broader applicability to high-dimensional autonomous manipulation tasks.

The association between central sensitivity syndrome (CSS) and sensory processing sensitivity (SPS) demonstrates the need for assessment tools that quantify the physical and psychological alterations observed in these two conditions in order to generate multidisciplinary treatments and establish their effectiveness. This study aimed to identify and analyze validated CSS and SPS assessment methods and conduct an operational comparison of their parameters, content, methodological quality of their original validations, instructions, etc., in order to determine the best option. This systematic review (PRISMA) used PubMed, WoS, Scopus, Psycinfo, CINHAL, and manual searches until March 2025. A meta-analysis complemented the review. The main criteria selected for original validation studies of tools to assess CSS/SPS. Twenty-nine original validation studies with 29 assessment questionnaires/scales were selected. QUADAS-2 showed low risk of bias in all domains in recent validations. COSMIN-RB found that almost all domains in the post-2010 validations were adequate. The instruments included 78 variables grouped in the following categories: psychological, SPS, physical/psychosomatic aspects, intolerances, environmental sensitivity, and sensory modalities. The compilation and analysis of the assessment tools from the original validations associated with CSS and SPS provided scores and interpretations, locations, languages, etc., to select the most appropriate instrument in each context. The most recent validations had better methodological quality. The Central Sensitization Inventory Short Form scored the highest on QUADAS-2 and COSMIN-RB.

Rhythm organizes many human motor activities from before birth and continues to shape development throughout infancy. In this review, we examine the role of rhythmic processes in early vocal development, drawing on research from motor control, physiology, speech, and language acquisition. We propose that respiration functions as a crucial core of early rhythmic coordination, linking vocalizations and bodily movements into an integrated system. At present, we have an imprecise understanding of how infant breathing for speech develops during the first year of life. However, respiration, an inherently flexible and adaptive system, may provide a temporal framework within which speech articulation and motor actions become progressively aligned. During canonical babbling, a key milestone in language acquisition, repetitive adult-like syllables emerge from rhythmic motor actions. The advent of this behavior presumably reflects developing coordination among motor, respiratory, and vocal subsystems. This three-way coordination creates the multimodal foundation of language. In this perspective, the respiratory rhythm is fundamental to early vocal development. Along with reviewing past work and its limitations, we suggest directions for future work to better address how the respiratory rhythm subserves developing linguistic and nonlinguistic actions in infantdevelopment.

Stuttering is a developmental speech fluency disorder linked to timing deficits in speech motor control. Given the shared neural mechanisms between rhythmic timing and speech production, rhythm-based interventions may hold promise for stuttering. This proof-of-concept study evaluated the feasibility and potential benefits of a gamified rhythmic training program, Rhythm Workers (RW), in preadolescents who stutter. Twenty-one children (aged 9-12) were randomly assigned to RW or an active control game, which they played at home for 3 weeks. We assessed feasibility and potential training effects on rhythmic, cognitive, and speech-related abilities. Both games were well accepted, and compliance was moderate to high. Only participants trained on the rhythm game showed moderate enhancements in rhythmic synchronization, interference control, oromotor performance, and reduction of stuttering after training. The improvements (except for interference control) correlated with the training dose. Moreover, speech fluency gains were associated with improved rhythmic performance. While some effects did not reach statistical significance due to the limited sample size, the observed dose-response patterns and domain-specific improvements support the feasibility and promise of rhythmic gaming for young people who stutter. This study provides preliminary evidence that rhythm-based training can enhance speech and cognitive outcomes in preadolescents who stutter.