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Objective. Knee osteoarthritis (KOA) is a progressive joint disorder that significantly impairs patients’ quality of life. Effective long-term management of KOA remains challenging due to limited pharmacological options and associated adverse effects. This monocentric, retrospective observational study evaluated the efficacy and safety of a fixed-dose tramadol/paracetamol combination (75/650 mg) in alleviating pain in patients with grade I-II KOA according to the Kellgren-Lawrence classification. Methods. A total of 30 patients treated for 15 days were assessed using the Numerical Rating Scale for pain, the Western Ontario and McMaster Universities Osteoarthritis Index for functional impairment, and the Pittsburgh Sleep Quality Index for sleep quality. Results. Results showed a 30% and 50% pain reduction in 86% and 43% of patients, respectively, alongside significant improvements in functional mobility and sleep quality. Adverse events, including nausea, itching, and sleepiness, occurred in 10% of patients and did not necessitate treatment discontinuation. Efficacy was consistent across demographic and clinical subgroups, possibly suggesting broad treatment applicability. Conclusions. While the findings could support tramadol/paracetamol as a safe and effective first-line therapy for KOA, reinforcing its role in optimizing KOA management strategies, limitations such as the small sample size and lack of a control group highlight the need for further research.

Background and Objectives: Osteoporosis is a prevalent skeletal disorder characterized by decreased bone mass and compromised bone microarchitecture, leading to an elevated risk of fractures and significant morbidity, particularly among aging populations. Early diagnosis and personalized management are critical to reducing fracture incidence and associated healthcare burdens. Recent advances in artificial intelligence (AI) and machine learning (ML) have led to potential improvements in enhancing osteoporosis care by enabling accurate diagnostic imaging analysis, robust fracture risk prediction, and personalized therapeutic strategies. Materials and Methods: We performed a narrative review to summarize and critically evaluate the current literature on AI and ML applications in osteoporosis diagnosis and management. We searched relevant literature from inception to January 2025 to provide a comprehensive perspective, focusing on key themes, methodological approaches, and clinical implications. Results: Deep learning models, especially convolutional neural networks, facilitate rapid and accurate bone mineral density assessment from routine radiographs, expanding screening capabilities beyond conventional dual-energy X-ray absorptiometry (DXA). Machine learning algorithms harness clinical and demographic data to generate fracture risk models that often outperform traditional tools, enabling timely identification of high-risk individuals. Furthermore, AI-driven analyses of historical treatment responses coupled with real-time monitoring through wearable technologies and mobile applications allow for personalized therapeutic optimization and enhance patient engagement. Despite these promising advances, challenges remain regarding ethical considerations, data privacy, legal liability, incomplete model validation, lack of standardization, and the need for critical appraisal of real-world clinical efficacy for widespread clinical adoption. Conclusions: This narrative review indicates that AI and ML hold significant promise to revolutionize osteoporosis management by enabling early detection, precise risk stratification, and tailored interventions. However, the current evidence is heterogeneous, often lacking robust external validation and quantitative synthesis. Critical gaps include insufficient evaluation of model robustness across diverse populations, discussion of negative or conflicting results, and a comprehensive assessment of the limitations inherent in current AI evidence. Strategic efforts to validate, regulate, and critically integrate these technologies into routine clinical workflows are essential to realize their full potential and address the growing burden of osteoporosis worldwide.

Background: Frozen shoulder (FS) is a painful condition characterized by progressive loss of shoulder function with passive and active range of motion reduction. To date, there is still no consensus regarding its rehabilitative treatment for pain management. Purpose: The aim of this umbrella review of systematic reviews was to analyze the literature, investigating the effects of non-surgical and rehabilitative interventions in patients suffering from FS. Patients and Methods: A review of the scientific literature was carried out from 2010 until April 2020 using the following search databases: PubMed, Medline, PEDro, Scopus and Cochrane Library of Systematic Reviews. A combination of terms was used for the search: frozen shoulder OR adhesive capsulitis AND systematic review OR meta-analysis AND rehabilitation NOT surgery NOT surgical intervention. We included systematic reviews that specifically dealt with adults with FS, treated with non-surgical approaches. All the systematic reviews and meta-analyses included in the study that met the inclusion criteria were assessed using the Assessment of Multiple Systematic Reviews as a quality assessment tool. Results: Out of 49 studies, only 14 systematic reviews respected the eligibility criteria and were included in this study. Their results showed an important heterogeneity of the studies and all of them agree on the lack of high-quality scientific work to prove unequivocally which rehabilitative treatment is better than the other. Due to this lack of gold standard criteria, there may be also a heterogeneity in the diagnosis of the reviews analyzed. Conclusion: Non-surgical and rehabilitative interventions are undoubtedly effective in treating FS, but there is no evidence that one approach is more effective than the other regarding the methods reported. Future high-quality RCTs are needed to standardize the treatment modalities of each physiotherapy intervention to provide strong recommendations in favor. Keywords: adhesive capsulitis, frozen shoulder, pain control, pain management, rehabilitation, non-surgical interventions

We illustrate an application of graph neural networks (GNNs) to predict the pressure, temperature and velocity fields induced by a sudden explosion. The aim of the work is to enable accurate simulation of explosion events in large and geometrically complex domains. Such simulations are currently out of the reach of existing CFD solvers, which represents an opportunity to apply machine learning. The training dataset is obtained from the results of URANS analyses in OpenFOAM. We simulate the transient flow following impulsive events in air in atmospheric conditions. The time history of the fields of pressure, temperature and velocity obtained from a set of such simulations is then recorded to serve as a training database. In the training simulations we model a cubic volume of air enclosed within rigid walls, which also encompass rigid obstacles of random shape, position and orientation. A subset of the cubic volume is initialized to have a higher pressure than the rest of the domain. The ensuing shock initiates the propagation of pressure waves and their reflection and diffraction at the obstacles and walls. A recently proposed GNN framework is extended and adapted to this problem. During the training, the model learns the evolution of thermodynamic quantities in time and space, as well as the effect of the boundary conditions. After training, the model can quickly compute such evolution for unseen geometries and arbitrary initial and boundary conditions, exhibiting good generalization capabilities for domains up to 125 times larger than those used in the training simulations.

Genetic contributions to autism are extremely heterogeneous and may involve synaptic formation and maturation. [...]multiple genes involved in the formation, specification, and maintenance of synapses have been identified as risk factors for ASD development (Hahn et al., 2013). [...]transcranial ultrasonography deserves more attention as a harmless and low-cost means of evaluating CSF fluid volumes and stratifying ASD children potentially at-risk for chronic CNS inflammatory disorders. Transcranial ultrasonography enables reproducible evaluation of EAF by measuring the distances between the arachnoid membrane and the cortical pia layer (subarachnoid space), and may thus help establishing the degree of meningeal lymphatic drainage deficit. Since the measures can be easily repeated, the technique could be used for monitoring the progression of the disease or for objectively assessing the efficacy of treatments. [...]the observation by Louveau et al.

This Editorial elaborates on innovative concepts presented at the 2nd European Conference of Biomedical Research and Treatments for autism held in Bari, Italy, in November 2017. We discuss the recent publication of a paper describing how relativistic time dilation at the DNA level can lead to novel approaches in disease prevention and cure, and we elaborate on the role of the human microbiota in restoring quantum entanglement at the DNA level. According to this hypothesis, microbial degradation of a glycosaminoglycan, chondroitin sulfate, leads to restauration of gene expression, induces general and sequence-specific relativistic time dilation, restores DNA quantum entanglement, and improves the ability of DNA to retain, process and transmit information both at the biochemical and the quantum levels. It can be argued that these processes played a role in the evolution of the human brain and consciousness. Fermented aliments that today would be defined as “probiotics” were the first processed foods eaten by early humans, and it is conceivable that the effects of the microbes in those aliments on the chondroitin sulfate, coming from cartilage of animals hunted or scavenged, may have led to the biochemical, relativistic and quantum effects responsible for human evolution. Finally, we discuss the implications in the field of autism where the theory of consciousness based on quantum biology presents exciting and innovative perspectives for prevention and cure.

Background. Disability (both temporary and transitory, or definitive) might occur for the first time in a given patient after an acute clinical event. It is essential, whenever indicated, to undergo a Physical Medicine and Rehabilitation assessment to detect disability and any need for rehabilitation early. Although access to rehabilitation services varies from country to country, it should always be governed by a PRM prescription. Objective. The aim of the present observational retrospective study is to describe consultancy activity performed by PRM specialists in a university hospital in terms of requests’ typology, clinical questions, and rehabilitation setting assignment. Methods. Multiple parameters were analyzed (clinical condition, patient’s socio-family background, and rehabilitation assessment scale scores) and a correlation analysis was performed between the analyzed characteristics and both the different clinical conditions and the assigned rehabilitation setting. Results. PRM evaluations of 583 patients from 1 May 2021 to 30 June 2022 were examined. Almost half of the total sample (47%) presented disability due to musculoskeletal conditions with a mean age of 76 years. The most frequently prescribed settings were home rehabilitation care, followed by intensive rehabilitation and long-term care rehabilitation. Conclusions. Our results suggest the high public health impact of musculoskeletal disorders, followed by neurological disorders. This is, however, without forgetting the importance of early rehabilitation to prevent other types of clinical conditions such as cardiovascular, respiratory, or internal diseases from leading to motor disability and increasing costs.

Background/Objectives: Abaloparatide is an osteoanabolic therapy used in patients at high risk of fracture; however, the breadth of evidence across routes, comparators, and sequential strategies has not yet been comprehensively summarized. This study aimed to evaluate the efficacy and safety of abaloparatide for reducing fractures and improving bone mineral density (BMD) in adults with osteoporosis. Methods: Following PRISMA 2020, we searched PubMed, Embase, CENTRAL, and Web of Science (2016–2024) for randomized controlled trials and comparative real-world studies. Additional meta-analyses and network meta-analyses were included as contextual evidence but not pooled to avoid double-counting. Primary outcomes were vertebral, non-vertebral, and hip fractures; secondary outcomes included percentage change in BMD and safety endpoints. Random-effects models were used; heterogeneity, influence analyses, and prediction intervals were examined. Risk of bias was assessed using RoB 2 and AMSTAR 2. Results: Nine quantitative evidence sources met the criteria. Abaloparatide reduced vertebral fractures (RR 0.13–0.21) and showed moderate reductions in non-vertebral fractures. Lumbar spine BMD increased substantially, while hip and femoral neck gains were smaller and heterogeneous. Hypercalcemia risk was consistently lower compared to teriparatide. Transdermal delivery was less effective, and sequential abaloparatide → antiresorptive therapy further reduced fractures. Serious adverse events were not increased. Conclusions: Abaloparatide provides strong vertebral protection, significant BMD improvement, and shows a favorable calcemic profile, with moderate certainty for non-vertebral effects. Evidence in men and long-term safety remains limited.

Background/Objectives: Cervical facet joint syndrome (CFJS) is a frequent cause of neck pain and motor disability. Among the available therapies for CFJS, ultrasound (US)-guided injections are becoming more and more widespread, but the evidence about their accuracy and effectiveness is still debated in the scientific literature. The aim of this systematic review is to assess efficacy, accuracy and feasibility of US-guided cervical facet injections for the related chronic neck pain treatment. Methods: This review was conducted following the preferred reporting items for systematic reviews and meta-analysis 2020 (PRISMA) statement guidelines. The scientific articles were identified through the PubMed, Google Scholar and Cochrane Library databases. Qualitative assessment of the selected studies was carried out using the modified Oxford quality scoring system. Nine studies with a total of 958 patients were included in this review. The risk of bias was assessed using the Cochrane Collaboration tool. The protocol was registered at PROSPERO 2024 (n°CRD42024512214). Results: The results of this review suggest that the US-guided cervical facet injection for CFJS treatment is an effective technique in terms of accuracy (using the lateral technique it ranges from 92% to 98%), and efficiency (it grants pain relief with a decrease in the procedure time and fewer needle passes in comparison with the X-ray-guided technique, which also involves radiation exposure). Conclusions: US-guided injections are a safe and effective method to treat this musculoskeletal disease, granting a high functional recovery and long-lasting pain relief, net of the used drugs. However, these procedures are strictly operator-dependent and require important training to acquire good expertise.