Unilateral online ultrasound stimulation of early visual cortex suppresses responses to contralateral visual stimuli.

Introduction Flea infestation remains a major clinical and public health concern in cats due to its negative impact on animal welfare and its role in the transmission of zoonotic pathogens. Effective flea control under routine field conditions is essential for integrated parasite management in companion animals. The aim of this study was to evaluate the clinical performance of a topical formulation combining ivermectin, imidacloprid, and praziquantel for flea control in domestic cats under field conditions. Methods A total of 142 naturally infested cats of varying ages, sexes, and body conditions were included in the study. All animals received a single topical application of the evaluated formulation. Clinical and parasitological assessments were performed on Days 0, 1, 7, 14, and 30 post-treatment using standardized flea counts, pruritus scores, and dermatological lesion scores. Treatment effectiveness was assessed using within-subject pre–post comparisons. Effective flea control was defined as a marked reduction in the proportion of flea-positive cats relative to baseline, accompanied by concurrent clinical improvement. Results The proportion of cats free of detectable fleas exceeded 91% by Day 7 and approached 95% by Day 30 post-treatment. Significant clinical improvement was observed during the first two weeks, including reductions in pruritus intensity and dermatological lesion scores. Treatment response did not differ according to sex or age, indicating consistent clinical performance across diverse feline subpopulations. No adverse effects were reported throughout the study period. Discussion The findings indicate that the evaluated topical combination provides consistent and clinically meaningful flea control in domestic cats under routine field conditions, supporting its use as part of integrated parasite management strategies in companion animals. However, the absence of a negative control or active comparator group represents a limitation of the study; therefore, treatment effectiveness was assessed using within-subject comparisons rather than established regulatory efficacy benchmarks.

Recent evidence shows a strong correlative link between sleep disturbances and intrusive memories after traumatic events, presumably due to insufficient (nocturnal) memory integration. However, the underlying mechanisms of this link and the role of specific neural activities during sleep are poorly understood so far. Here, we investigated how the intra-individual affective response to an experimental trauma predicts changes in oscillatory activity during subsequent sleep and how these changes predict the processing of the experimental trauma. In a randomized within-subject comparison, twenty-two female, healthy participants (23.14 ± 2.46 years) watched a well-validated film clip including "traumatic" contents and a neutral film clip before bedtime on two separate nights. Heart rate was recorded during the film clips and nocturnal brain activity was recorded using 64-channel high-density EEG during subsequent nights. Intrusive memories were assessed via a six-day diary and negative affect was assessed using experimental trauma film reminders one week after the trauma film. An increased intra-individual heart rate during the trauma film predicted higher intra-individual sleep spindle envelope the following night. Increased theta activity (4.25 - 8 Hz) during rapid eye movement (REM) sleep after the trauma film predicted fewer trauma film related intrusive memories and negative affect. Likewise, an increase in sleep spindles after the trauma film predicted fewer trauma film related intrusive memories. Our findings suggest that an experience-dependent up-regulation of these nocturnal oscillatory activity patterns, which are known to be involved in adaptive memory consolidation processes, serves as a protective factor against trauma-related intrusive memory development. Particularly, increased theta activity during REM sleep and sleep spindle activity seem to be of importance here.

Effects of M-Cube Wave Versus Low-Frequency Neuromuscular Electrical Stimulation on the Strength and Thickness of the Quadriceps Muscles: A Within-Subject Comparison in Healthy Young Adults

High-resolution microbial changes in root caries revealed by Type IIB Restriction-site associated DNA for microbiome.

IntroductionInternet-based interventions are effective in the prevention of eating disorders (EDs) but are rarely translated from controlled study settings into practice. This study aimed to assess short- and long-term outcomes and adherence of a suite of internet-based screening and ED prevention programs.MethodsIn a 5-arm non-randomized dissemination trial, internet-based ED prevention interventions were offered to women recruited from the general population (N = 3,654). Each arm offered a different version of the ED prevention program, tailored for populations at different levels of risk. The interventions comprised 4 to 12 weekly modules based on cognitive-behavioral principles, including psychoeducation, exercises to promote body image and balanced eating, and—if applicable—to reduce ED symptoms. Primary outcome was the change in weight concerns from pre to post, using t-tests and completer data. Secondary outcomes included ED symptoms, eating habits, self-esteem and quality of life.ResultsPre-post within-subject comparisons in the completer sample showed significant reductions in weight concerns in 4 of 5 study arms (effect sizes between d = -0.45 and d = -0.94). ED symptoms were reduced and the ability to eat intuitively was improved in all study arms, with some effects persisting up to 12 months. Assessment drop-out ranged from 60.6% to 78.1% at post, and between 18.0% and 44.0% of participants completed the whole intervention.DiscussionThe trial demonstrates the feasibility of reaching different risk groups for prevention with a combined screening and tailored interventions as well as feasibility of larger scale dissemination of the interventions in the general population.Clinical trial registrationhttp://www.isrctn.org, identifier ISRCTN13716228.

BackgroundAccurate measurement of tibial rotation in anterior cruciate ligament (ACL) injury remains challenging because most devices rely on skin-referenced measurements and do not account for concurrent femoral rotation. Moreover, conventional assessments focus on central axial internal rotation (CAIR) rather than the more physiological medial pivotal rotation (MPR), which reflects the pivot-shift phenomenon. This study aimed to (1) develop a portable automated knee arthrometer to measure anterior translation (AT), CAIR, and MPR; (2) assess its reliability and validity in skin- and bone-referenced measurements; (3) investigate the skin-bone relationship considering concurrent femoral rotation; and (4) compare MPR with conventional CAIR for clinical utility.MethodsSix cadaveric lower limbs were evaluated under intact, ACL-sectioned, and combined ACL- and anterolateral ligament-sectioned conditions. AT was measured using a laser displacement sensor. Tibial and femoral rotations were measured using skin- and bone-referenced sensors. Intrarater and interrater reliability were assessed, and validity was evaluated by comparison with Lachmeter for AT and Mako for CAIR. The relationship between skin- and bone-referenced rotation was analyzed using regression, and the increase in rotation after ACL sectioning was compared between MPR and CAIR.ResultsThe arthrometer demonstrated excellent intrarater and interrater reliability for AT, CAIR, and MPR (ICCs > 0.90). It showed higher interrater reliability than the Lachmeter in injured knees (P = .004). Validity against reference devices was acceptable. Although skin- and bone-referenced rotational measurements differed significantly (P < .001), cadaver-wise regression showed strong correlation for net tibial rotation (R²: 0.833 for CAIR; 0.715 for MPR). The increase in MPR after ACL sectioning was significantly greater than that of CAIR (4.31° vs. 1.49° at 4 N·m, P < .001).ConclusionsThe arthrometer showed excellent reliability and acceptable validity for assessing AT, CAIR, and MPR. Although skin-referenced measurements differ from true osseous rotation, they may provide clinically meaningful assessments for within-subject comparisons. MPR increased more than CAIR after ACL sectioning, suggesting it may serve as a superior marker for ACL deficiency.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13018-025-06627-w.

BackgroundCaesarean section plays a crucial role in ensuring the health of both mother and newborn, especially when complications arise or are anticipated. However, the increasing global prevalence of caesarean section brings along significant postoperative challenges, notably pelvic adhesions, which can impact subsequent pregnancies and surgeries. Non-invasive preoperative assessment methods, such as ultrasonography, offer promise in enhancing surgical planning and patient outcomes.ObjectiveThis study aims to evaluate the accuracy of transabdominal and transvaginal sliding sign in detecting intraabdominal adhesions in third-trimester pregnant women with a history of caesarean section.MethodThis diagnostic study recruited 35 third-trimester pregnant women with a history of cesarean section undergoing scheduled repeat cesarean at a tertiary referral hospital. All participants underwent both via transvaginal (TV) and transabdominal (TA) ultrasound before surgery. The presence of a positive or negative sliding sign was recorded for each modality. Intra-abdominal adhesions were confirmed intraoperatively and used as the gold standard. Diagnostic accuracy was calculated for each modality. Comparative analysis was conducted across patient characteristics and outcomes.ResultAll 35 patients underwent both TA and TV ultrasound evaluations (within-subject design). The majority of participants were aged between 31 and 40 years (68.6%), were multigravida (65.7%), and had undergone two caesarean sections (51.4%). The sliding sign was negative in 18 (51.4%) and 17 (48.6%) patients using TA and TV approaches, respectively. Both modalities showed high sensitivity (93.75%) and specificity (84.21%) in detecting adhesions. There was no statistically significant difference between TA and TV sliding signs in relation to age or obstetric status. Comparative analysis of both modalities showed equivalent diagnostic performance.ConclusionBoth transabdominal and transvaginal sliding sign evaluations demonstrate high accuracy in detecting intra-abdominal adhesions in women undergoing repeat cesarean section. The within-subject comparison suggests either modality may be reliably used depending on clinical and logistic factors.

Large language models (LLMs) have the potential to scale assessment in medical education, but their psychometric equivalence to expert-written items and the detectability of their origin remain uncertain. In a preregistered, single-center, blinded observational, within-subject comparison, we evaluated 24 GPT-4o-generated versus 24 human-authored topic-matched multiple-choice questions (MCQs) across radiation oncology, radiology, and nuclear medicine. Medical students (n = 82) and physicians (n = 46) completed an identical 48-item formative mock examination, with item origin masked. Item difficulty (human: mean 0.65 [SD 0.22] vs LLM: 0.67 [0.20]) and discrimination (0.27 [0.12] vs 0.29 [0.12]) did not differ significantly; participants did not identify item origin above chance (0.50). Expert ratings of appropriateness and didactic quality showed low interrater agreement (ICC = 0.07-0.18). In this expert-reviewed, human-in-the-loop workflow, the item difficulty and discriminatory power of MCQs generated with GPT-4o did not differ significantly from those of expert-authored items, and were not reliably recognized as AI-generated by examinees. These findings delineate a feasible pathway for responsibly scaling formative assessment content in imaging-focused medical education, while underscoring the need for explicit educational policies regarding oversight, transparency, and fairness.

Multi-center imaging studies create large-scale data that are useful for identifying pathological patterns and robust training of deep learning models. However, variation due to site and scanner differences can confound analyses, emphasizing the need for harmonization. To evaluate scanner-related differences in T1w and T2-FLAIR images in the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset and assess the performance of publicly available image-level harmonization tools. Retrospective. Scanner group analysis: 1143 ADNI3 subjects (233 GE, 173 Philips, 250 Siemens, with 487 Siemens subjects used as an independent reference group). Within-subject comparison: paired multi-vendor scan sessions from 8 subjects. 3.0T, T1w, and T2-FLAIR MRI sequences. Gray/white matter contrast ratio (G/W ratio), white matter hyperintensity (WMH) volume, and image feature similarity metrics (Fréchet Inception Distance [FID], Learned Perceptual Image Patch Similarity [LPIPS]) were compared across scanner vendors before and after harmonization with statistical (ComBat) and deep learning (HACA3) algorithms. One-way ANOVA and post hoc Games-Howell tests were conducted to assess differences between scanner groups across image pipelines (baseline, post-harmonization). Repeated-measures ANOVA and post hoc paired t-tests with Bonferroni correction were used to evaluate similarity metric changes pre- and post-harmonization for multi-vendor subjects. We defined statistical significance as p < 0.05. At baseline, significant image differences in G/W ratio and WMH volumes between vendors were identified. Both ComBat and HACA3 harmonization improved G/W ratio consistency for T1w and T2-FLAIR imaging across vendors, particularly for GE T2-FLAIRs. HACA3 led to the best similarity between scanner datasets: mean FID T1w/T2-FLAIR: 10.45/14.62 (Baseline); 7.45/11.71 (ComBat); 5.60/8.91 (HACA3). Only HACA3 harmonization resulted in non-significant differences between vendors for WMH volume. HACA3 deep learning harmonization outperformed a statistical method, ComBat, improving MR contrast consistency and feature similarity across vendors. However, difficulties in harmonizing T2-FLAIRs highlight limitations in current multi-contrast MR harmonization tools. 3. Stage 1.

BackgroundThe impact of acute subdural hematoma (aSDH) on measures of glymphatic–meningeal lymphatic function has not previously been reported. We present a descriptive observational study including a small case series—one patient following unilateral aSDH, three following unilateral subarachnoid hemorrhage (SAH), and three control subjects—providing new insights into the differential effects of surface intracranial bleeds.MethodsThe magnetic resonance imaging (MRI) contrast agent gadobutrol (0.5 mmol), administered intrathecally, was used as a cerebrospinal fluid (CSF) tracer. Multiphase contrast-enhanced MRI was performed to assess glymphatic tracer enrichment. CSF tracer clearance to blood, serving as a proxy for dural lymphatic function, was estimated using population pharmacokinetic modeling. All hemorrhagic cases involved unilateral bleeds, allowing within-subject comparison between affected and unaffected hemispheres.ResultsThe series included one patient with aSDH (2.8 months post-event), three patients with unilateral SAH (mean 5.8 months post-event), and three age-matched, near-healthy reference subjects. Compared with controls, glymphatic tracer enrichment 24 h post-injection was slightly increased on the affected hemisphere in the aSDH case, whereas SAH patients showed markedly reduced enrichment on the affected side. Tracer distribution in controls was symmetrical. CSF clearance to blood was notably reduced in the aSDH case compared with references, suggesting impaired dural lymphatic function.ConclusionThis small descriptive series suggests that aSDH and SAH may differentially affect glymphatic and dural lymphatic functions. While glymphatic enrichment appeared only modestly altered after aSDH, it was severely impaired following SAH. In contrast, CSF clearance to blood was markedly reduced in the aSDH case, potentially reflecting compromised dural lymphatic drainage. The limited number of cases prevent broad generalization, but these findings offer novel hypothesis-generating observations that may inform future studies on the effects of surface intracranial hemorrhages on brain clearance pathways.

Robots navigating public spaces must move safely and intuitively. A key challenge in social navigation is conveying navigational intent that aligns with human expectations and situational dynamics. This study presents a real-world, within-subject comparison of five signaling strategies – no cue, sudden stop, speed reduction, trajectory shaping, and verbal announcement – to examine how different strategies influence pedestrian comfort, trust, predictability, clarity, and proxemics. Mixed subjective ratings and video-coded behavior from 15 participants across repeated hallway encounters show that trajectory-based signaling produced the smoothest and most confident responses, improving comfort, trust, and predictability by up to 40% and proxemic respect by nearly 90% over the no-cue baseline. It also significantly outperformed the verbal cue in comfort, trust, and proxemic respect and achieved the highest mean ratings across all five measures. These findings highlight lightweight motion shaping as a practical strategy for socially appropriate robot navigation.

To compare hearing preservation (HP) outcomes between ears for adult sequential bilateral cochlear implant (CI) recipients. Within-subject, retrospective cohort. Tertiary referral CI center. Sixty adults with preoperative functional acoustic hearing [low-frequency pure-tone average (LFPTA; 125, 250, and 500 Hz) ≤80 dB HL] were implanted with the same electrode array in both ears. Sequential bilateral cochlear implantation from 2012 to 2022. Initial (1mo) and long-term (12mo) HP outcomes between ears were assessed by comparing the LFPTA shift in the first and second implanted ear. Correlations between LFPTA shift in the first and second implanted ear at 1 month ( rs = 0.221, P = 0.090) and 12 months ( rs = 0.234, P = 0.123) were weak and nonsignificant. However, a multilevel linear mixed-effects model demonstrated greater LFPTA shifts in the second implanted ear when compared with the first, with a mean difference of 6.3 dB HL (95% CI: 0.2-12.4, P = 0.048). In addition, the model showed that HP declined during the first 12 months following implantation, and younger patients had greater LFPTA shifts over time ( p interaction = 0.012). There were no significant associations between LFPTA shift and preoperative LFPTA, biological sex, electrode array design, or postoperative steroid use. In the present sample, HP in the first implanted ear was poorly predictive of the outcome in the second ear. Substantial variability in outcomes between ears could indicate that subtle differences in surgical technique and insertion dynamics have a relatively larger impact on HP than patient-specific factors.

BackgroundIntimate partner violence (IPV) affects 2 in 5 women in Canada, leading to both physical and mental health consequences. Safety planning is a secondary prevention intervention designed to assist those experiencing IPV in taking steps to increase their safety and decrease contact with their abusive partner. Safety planning has been shown to help survivors mitigate the negative mental health effects of IPV and encourage actions to increase safety, but evaluation outside the United States remains limited.ObjectiveOur team plans to evaluate the use of single-case experimental design (SCED) to assess the effectiveness of a web-based safety planning app (WITHWomen Pathways) for women experiencing IPV in the Greater Toronto Area. The study also explores whether women can be safely engaged for intense follow-up.MethodsSCED evaluation will involve multiple baseline and postintervention assessments of a small number of women experiencing IPV (n=6). Participants will be recruited from IPV service organizations across the Greater Toronto Area. SCED will allow for rigorous within-subject comparison, using repeated measurements at multiple time points for 3 primary outcomes (decisional conflict, empowerment to take safety actions, and use of safety strategies) and 2 secondary outcomes (mental health and IPV recurrence). The evaluation will include 5 phases: recruitment, eligibility screening, multiple baseline interviews, intervention (web app delivery), and multiple postintervention assessments. In this paper, we also discuss the development of rigorous protocols for maintaining safety and flexible data collection methods (in person, via telephone, or online).ResultsRecruitment began on July 3, 2024. As of December 2025, a total of 4 participants have been recruited and have completed multiple baseline assessments. Data analysis has been completed for 4 participants, and results are expected to be published in spring 2026.ConclusionsThe SCED approach may offer a novel and ethical evaluation method for IPV interventions. If effective, the WITHWomen Pathways web app could significantly improve help-seeking and safety planning among women experiencing IPV in the GTA. This study may serve as a model for future IPV intervention evaluations, demonstrating robust evaluation data and participant safety.

How the presence of a dog and types of interaction affect physiological responses to experimental heat pain induction in healthy humans - a randomized controlled study.

Out-of-reach interaction in virtual reality has primarily relied on raycasting (selection using the laser pointer metaphor). However, as bare-hand tracking becomes increasingly prevalent, there is a growing need to explore and optimize hand-based out-of-reach interaction techniques. To address this, we introduce Hand Gliding and Laser Gliding, novel out-of-reach interaction techniques that use velocity-to-velocity mapping to control virtual hands through physical movements, and implement Go-Go and HOMER, position-to-position methods. First, a pilot study evaluated the feasibility of Hand Gliding. Next, we conducted a within-subject comparison of the four interaction techniques using selection and translation tasks while assessing speed, comfort, and subjective responses. The best results were achieved with both raycasting-aided techniques (HOMER, Laser Gliding) in terms of both performance and user comfort. Position-to-position mapping performed slightly better in tasks requiring rapid selection, while velocity-to-velocity techniques facilitated interaction at greater distances. The feasibility of velocity-to-velocity approaches to out-of-reach interaction was confirmed by this study. Due to their simple implementation (compared to position-based techniques, they do not require torso tracking data), velocity-based interaction methods have the potential for wide adoption in current VR systems.

ABSTRACT Bioequivalence studies play a pivotal role in drug development by establishing the clinical equivalence of two drug formulations. These studies often utilize crossover designs to facilitate within-subject treatment comparisons, optimizing statistical power with fewer subjects. However, uncertainty regarding the variance of a new drug or formulation during planning presents a challenge for sample size determination. While adaptive designs offer a potential solution, their application in crossover studies is less explored compared to group sequential designs, and many existing adaptive methods require data unblinding during the trial. Only two blinded sample size re-estimation approaches have been developed in crossover settings to date. In this paper, we propose a novel method for blinded within-subject variance estimation at interim analysis and re-estimate the sample size to achieve the desired power. We thoroughly investigate its analytical properties and introduce a refined, unbiased estimator. Through extensive simulation studies, our method shows comparable performance to existing blinded approaches and offers a distinct advantage in scenarios with small treatment differences and large subject variances.

Stress can significantly alter decision-making, often promoting riskier choices. While prior research suggests a link between acute stress and increased risk-taking, the specific contributions of cortisol and noradrenaline-two key neuroendocrine stress mediators-remain unclear. Investigate how the pharmacological manipulation of two key neuroendocrine stress mediators (cortisol and noradrenaline) influences risk-taking behavior in healthy individuals. In a double-blind, randomized study, we examined the individual and combined effects of hydrocortisone (20mg) and yohimbine (20mg; an α₂-adrenergic receptor antagonist) on risky decision-making in 96 healthy adults (48 women, 48 men). Participants completed the Balloon Analogue Risk Task (BART) before and after drug administration, allowing for within-subject comparisons relative to individual baselines. While the pharmacological manipulation effectively elevated cortisol concentration and salivary alpha amylase activity (as proxy for noradrenaline levels), no substantial effects on risk-taking behavior emerged, contrasting with some earlier findings. Exploratory analyses of associations with personality traits (anxiety, aggression, sensation seeking) and baseline levels of testosterone and estradiol revealed only weak and inconsistent relationships. These findings underscore the complexity of stress effects on decision-making and suggest that pharmacological activation of stress systems may not straightforwardly mimic psychosocial stress. Methodological factors such as timing, dosage, receptor specificity, and task familiarity likely play critical roles in modulating these effects.

The pre-ejection period (PEP) is a widely used cardiac parameter in psychophysiology that reflects the duration between the onset of ventricular depolarization and the opening of the aortic valve. PEP is often used as a marker of cardiac sympathetic nervous system (SNS) activity, particularly in within-subject comparisons under similar hemodynamic conditions. While many algorithms for automated PEP extraction from electrocardiography (ECG) and impedance cardiography (ICG) signals (more precisely, its first derivative, dZ/dt) have been proposed in literature, they have not been systematically benchmarked. This lack of standardized algorithm comparisons originates from the absence of open-source algorithms and annotated datasets for evaluating PEP extraction algorithms. To address this issue, we introduce PEPbench, an open-source Python package with different Q-peak and B-point detection algorithms from literature that can be combined to create comprehensive PEP extraction pipelines, and a standardized framework for evaluating PEP extraction algorithms. We use PEPbench to systematically compare 108 different algorithm combinations. All combinations are evaluated on two datasets with manually annotated Q-peaks and B-points, which we make publicly available as the first datasets with reference PEP annotations. Our results show that the algorithms can differ vastly in their performance and that B-point detection algorithms introduce a considerable amount of error. Thus, we suggest that automated PEP extraction algorithms should be used with caution on a beat-to-beat level as their error rates are relatively high. This highlights the need for open and reproducible benchmarking frameworks for PEP extraction algorithms to improve the quality of research findings in the field of psychophysiology. With PEPbench, we aim to take a first step toward this goal and encourage other researchers to engage in the evaluation of PEP extraction algorithms by contributing algorithms, data, and annotations. We hope to establish a community-driven platform, fostering innovation and collaboration in the field of psychophysiology and beyond.

Symptom Relief From Tub Bathing in Terminal Cancer: A Multicenter, Controlled Observational Study.