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ROBOTIC AND EXOSKELETON-ASSISTED GAIT TRAINING IN POST-STROKE REHABILITATION: A SYSTEMATIC REVIEW
No full textRobotic and exoskeletal gait assistance systems are becoming an increasingly important part of post-stroke rehabilitation, offering the possibility of more intensive, repetitive and individualised locomotion training than traditional methods.
The review analysed 15 studies published between 2015 and 2024. The review included studies in which an exoskeleton or gait assistance robot was the main therapeutic intervention, and the analysis was narrative and systematic.
The results of the studies indicate that interventions using exoskeletons can lead to improvements in walking speed and quality, stride length, balance and lower limb motor function. The benefits were particularly evident in the subacute phase after stroke, and some of the studies also reported changes indicative of beneficial neurophysiological reorganisation. The therapy proved to be safe and well tolerated, and patients showed high acceptance and motivation to participate in the sessions. The limitations of the analysed studies included small sample sizes, varied treatment protocols and a lack of long-term follow-up.
The evidence suggests that robotic gait training is a valuable addition to conventional rehabilitation, but larger, well-designed studies are needed to more accurately assess the effectiveness and optimal use of these technologies. Designed studies are needed to more accurately assess the effectiveness and optimal use of these technologies.
Materials and Methods: A literature review was conducted using the PubMed database, covering publications from 2015 to 2024, a period of particularly dynamic development of robotic and exoskeletal methods of gait rehabilitation after stroke. Keywords were used in the search. Based on an analysis of titles and abstracts, studies on the use of exoskeletons in gait training in stroke patients were selected. Fifteen studies meeting the substantive criteria, including randomised controlled trials, pilot projects and feasibility studies, were included in the final review [10-24]. Data on population characteristics, the therapeutic protocol used, assessment tools, clinical outcomes, and information on the tolerance and safety of the therapy were obtained from each study. The review methodology was narrative and systematic; the aim was not to create a meta-analysis, but to provide a synthetic overview of the available results, compare the therapeutic approaches used, and identify research gaps. This allowed us to capture both the strengths of the technology, such as safety and high patient acceptance, and its limitations, including small study samples, heterogeneity of protocols, and lack of long-term data
THE ROLE OF THE MIRROR NEURON SYSTEM IN THE ACQUISITION OF EMERGENCY MEDICINE PROCEDURAL SKILLS: A COMPREHENSIVE NARRATIVE REVIEW
No full textBackground: Emergency medicine requires precise and rapid execution of high‑risk procedures in time-sensitive environments, leaving limited opportunities for safe supervised practice. Neuroscientific discoveries, particularly related to the mirror neuron system (MNS), suggest that observational learning may effectively enhance motor skill acquisition without risk to patients.
Aim: To comprehensively review the neurobiological foundations, educational applications, and practical implications of the MNS in emergency medicine procedural training.
Material and methods: Narrative review including PubMed, Scopus, Web of Science. Literature (2000–2024) concerning neuroscience, medical education, motor learning, and emergency medicine was analyzed.
Results: Studies demonstrate that the MNS supports imitation, enhances procedural memory formation, and strengthens early motor skill acquisition. Educational strategies such as expert modeling, action observation, motor imagery, and multimodal simulation appear aligned with MNS activation and may optimize procedural training.
Conclusions: The MNS offers a valuable, underutilized framework for optimizing procedural training in emergency medicine. Future research should integrate neurophysiological tools into educational research to directly examine the mechanisms by which observational learning enhances clinical performance
OBESITY AS A CHRONIC INFLAMMATORY DISEASE: ADIPOSE TISSUE PATHOPHYSIOLOGY, PHARMACOLOGICAL REVOLUTION, AND MULTIDISCIPLINARY TREATMENT STRATEGIES
No full textObesity is a global epidemic and a complex chronic neurohormonal disease, which is the main cause of lifestyle diseases. The aim of this review is to thoroughly collect and critically evaluate the latest information on the pathophysiology of obesity, including the importance of low-grade inflammation (meta-inflammation), as well as to analyze the effectiveness of breakthrough, multidirectional treatment methods. We conducted a narrative review of scientific literature from major medical databases, focusing on studies published between 2015 and 2025 that addressed pathogenesis, clinical consequences (cardiovascular disease, oncology), modern pharmacotherapy (GLP-1/GIP agonists), and bariatric surgery.
Obesity is driven by adipose tissue (endocrine organ) dysfunction and chronic inflammation (metaflammation), leading to insulin resistance and gut-brain axis dysregulation. Modern pharmacotherapy, in particular GLP-1/GIP agonists, achieves weight loss of 15-22% (in STEP/SURMOUNT studies), which is comparable to the effects of early bariatric surgery. Surgery remains the most effective method of weight reduction and remission of metabolic complications. Effective treatment of obesity requires a personalized approach in which new pharmacology, lifestyle modification, and bariatric surgery must be integrated. The need for continuous, long-term treatment is crucial for maintaining weight and combating weight regain
KNOWLEDGE SHARING AND ITS IMPORTANCE FOR UNIVERSITIES’ COMMUNICATION PRACTICES
No full textThis article examines how knowledge sharing underpins effective communicative practices in university institutions. Drawing on resource-based and stakeholder perspectives, it distinguishes tacit and explicit knowledge and outlines SECI dynamics to show how universities can convert individual know-how into organisational capability. The study identifies cultural, organisational, and technological enablers and barriers, emphasising the centrality of trust, cooperation, and performance systems, alongside digital tools such as LMS platforms and professional social networks. It argues that the strategic alignment of internal and external communication, along with tailored channels for diverse audiences, enhances reputation, innovation, and crisis readiness. The article concludes that cultivating a cooperative organisational culture and deploying well-designed mechanisms for knowledge circulation are strategic necessities for universities seeking quality, excellence, and sustainable development
EMERGING TECHNOLOGIES IN DIABETES MANAGEMENT: FROM CONTINUOUS GLUCOSE MONITORING (CGM) TO THE ARTIFICIAL PANCREAS (2015–2025)
No full textIntroduction: Over the past decade, diabetes care has undergone a profound technological transformation. Continuous glucose monitoring (CGM), intermittently scanned glucose monitoring systems (isCGM/flash), sensor-integrated insulin pumps, and hybrid closed-loop systems (“artificial pancreas”) have become central components of modern management of type 1 diabetes and are increasingly used in selected forms of insulin-treated type 2 diabetes.
Objective: To present a literature review from 2015–2025 on emerging technologies in diabetes treatment—from CGM to artificial pancreas systems—with particular emphasis on clinical effectiveness, psychosocial impact, and social and health-system implications.
Methods: A narrative review of the literature published between 2015 and 2025, identified through searches of PubMed/MEDLINE and the Cochrane Library, as well as leading diabetology and endocrinology journals. The review included randomized controlled trials, real-world observational studies, meta-analyses, systematic reviews, and position statements from scientific societies (ADA, EASD, ISPAD, ATTD).
Results: Compared with conventional self-monitoring of blood glucose (SMBG), CGM and isCGM systems significantly reduce HbA1c levels, time spent in hypoglycaemia, and glycaemic variability, while increasing time in range (TIR). Hybrid closed-loop systems further improve TIR (often exceeding 70–75%), reduce both hypo- and hyperglycaemia, and are associated with high patient satisfaction. Telemedicine and cloud-based platforms enable remote monitoring and support new models of care. Key barriers include cost, limited reimbursement, variability in digital literacy, and inequalities in access.
Conclusions: Emerging technologies—from CGM and isCGM to hybrid closed-loop systems—represent a major step toward individualized and partially automated diabetes management. To fully realize their potential, equitable access, adequate funding, structured education, and integration with digital health tools and psychosocial support are essential
GUSELKUMAB AS A NEW BIOLOGIC OPTION FOR THE MANAGEMENT OF ULCERATIVE COLITIS: A NARRATIVE REVIEW
No full textIntroduction: Ulcerative colitis (UC) is a chronic inflammatory bowel disease associated with substantial morbidity and an increasing global burden, for which durable disease control remains challenging despite advances in biologic and small-molecule therapies. Growing evidence implicates the interleukin-23 (IL-23) signaling axis as a key driver of UC pathogenesis, providing a strong biological rationale for selective IL-23 inhibition. This narrative review aims to synthesize the mechanistic basis, preclinical data, and emerging clinical evidence supporting the use of guselkumab, a fully human monoclonal antibody targeting the IL-23p19 subunit, in the treatment of UC.
Methods: A comprehensive literature search of the PubMed database was conducted to identify relevant preclinical, clinical, and translational studies evaluating guselkumab in UC, with a focus on pharmacology, efficacy, safety, and clinical positioning.
Results: Evidence from the phase 2 and phase 3 QUASAR clinical development program demonstrates that guselkumab provides statistically and clinically meaningful improvements in clinical remission, endoscopic outcomes, and steroid-free disease control in patients with moderately to severely active UC, including both biologic-naive and treatment-experienced populations. Preclinical and mechanistic studies further support its selective and potent inhibition of the IL-23/Th17 pathway, while clinical trials indicate a favorable and predictable safety profile.
Conclusions: In conclusion, current evidence positions guselkumab as an effective and well-tolerated advanced therapy for induction and maintenance of remission in moderate-to-severe UC. Ongoing real-world studies, longer-term follow-up, and comparative effectiveness research will be essential to further define its optimal role within evolving treatment algorithms
ADAPTIVE CHANGES IN THE CARDIOVASCULAR SYSTEM AND OVERTRAINING SYNDROME RESULTING FROM EXCESSIVE PHYSICAL ACTIVITY
No full textResearch objectives: Regular physical activity is widely recognized as a key component of a healthy lifestyle. While moderate effort brings numerous benefits, engaging in extreme physical activity introduces new challenges and risks. Intense exercise, despite its undeniable health benefits, can lead to unpredictable changes in the body. This paper identifies the possible adaptive changes of the cardiovascular system and the risk of developing overtraining syndrome as a result of long-term practice of intense exercise.
Methods and key findings: Two medical textbooks, thirty-eight scientific articles published between 2010 and 2024, and one article from 2005 were reviewed, with findings indicating that regular high-intensity training can lead to myocardial hypertrophy, reduced resting heart rate, and a smaller increase in heart rate in response to submaximal effort. An increased risk of arrhythmias and myocardial fibrosis has been observed in competitive athletes. Prolonged excessive exercise can result in overtraining syndrome, which may present as persistent fatigue, muscle and joint discomfort, and mood disturbances, among other symptoms.
Conclusions: The paper emphasizes the need to individualize training programs and proves the validity of regular monitoring of athletes' health. It also highlights the necessity for further research into overtraining syndrome and the adaptation of the cardiovascular system to intense exercise. Particular attention was paid to the diagnostic difficulties associated with overtraining syndrome due to the subjectivity of symptoms and the limited number of clinical studies. The significance of an interdisciplinary approach in understanding the body's adaptation to overload was emphasized, considering physiological, biochemical, and psychological factors
THE EFFECTIVENESS OF COGNITIVE BEHAVIORAL THERAPY (CBT) IN THE TREATMENT OF ALCOHOL USE DISORDER (AUD) – A COMPREHENSIVE REVIEW
No full textIntroduction: Alcohol use disorder (AUD) drives preventable illness and death worldwide, causing medical, mental health, and social harms that strain individuals and health systems. Cognitive behavioral therapy (CBT) targets maladaptive cognitions, conditioned cues, and high risk situations using functional analysis, coping skills training, and relapse prevention grounded in learning and cognitive theory. Relapse prevention frameworks emphasize high risk situations, coping responses, outcome expectancies, abstinence violation effects, and covert antecedents (e.g., urges) to enhance self efficacy and reduce relapse, with meta analyses showing benefits over minimal or non specific controls. Effects versus non specific therapies are small but significant early and generally attenuate over time, while head to head comparisons show comparable efficacy, highlighting maintenance care, treatment matching, and mechanism focused augmentation. Technology delivered CBT expands access and can reduce consumption and increase abstinence, with early trials suggesting noninferiority or advantages over clinician delivered CBT, warranting larger, longer evaluations and careful integration with pharmacotherapy in stepped care.
Study overview and methodology: This review examined randomized controlled trials evaluating CBT efficacy for substance use disorders, primarily alcohol. Studies compared CBT against three types of controls: minimal treatment, non-specific therapy, and specific evidence-based therapy. Effect sizes were pooled using inverse-variance weighting under random effects assumptions, with outcomes assessed at both early and late follow-up periods for frequency and quantity measures.
Conclusion: Cognitive behavioral therapy is a reliable, evidence-based option for alcohol use disorder that achieves meaningful reductions in drinking and supports maintenance of gains, performing on par with other established therapies; its emphasis on relapse prevention skills and flexible delivery, including effective digital formats, makes it well suited for integration into comprehensive, stepped-care models tailored to individual needs
HERITAGE AND TECHNOLOGY: THE CONTRIBUTION OF GIS TO THE MANAGEMENT AND ENHANCEMENT OF SETIF'S HISTORIC BUILDINGS
Get PDFIn today's global context, the preservation of architectural heritage is becoming a crucial challenge, particularly for buildings from the 19th and 20th centuries, which are often neglected or underestimated. This study focuses on the city of Setif, Algeria, where a rich architectural heritage bears witness to the region's historical and urban evolution. However, the lack of effective mechanisms for inventorying and promoting this heritage remains a major obstacle. The main objective of this research is to demonstrate the use of Geographic Information Systems (GIS) for the management and enhancement of the built heritage of Setif's historic center. The study explores the use of GIS to create a georeferenced database, facilitating the collection and consultation of detailed information on each building. The methodology includes document collection, georeferencing of buildings and their integration into QGIS software. The results show that such an interactive database enables more efficient management and better decision-making for heritage conservation. The case study of three representative buildings (Ibn Badis mosque, Kerouani high school, and Bank for agriculture and rural development) illustrates the application of GIS in the enhancement of architectural heritage. This approach contributes to the sustainable preservation of Setif's heritage and its integration into cultural development policies
REAL-WORLD APPLICATIONS OF DIGITAL TWIN TECHNOLOGY IN PERFORMANCE MANAGEMENT: LESSONS FROM GLOBAL HEALTHCARE CASE STUDIES
Get PDFDigital twin technology is revolutionizing healthcare by providing a real-time digital replica of hospital systems, enabling better decision-making and performance optimization. This study examines the implementation of digital twin models in healthcare through an analysis of four real-world case studies: The Moorfields Eye Hospital (UK), Singapore General Hospital, Duke Health (USA), and The Karolinska University Hospital (Sweden). By reviewing these cases, the study highlights their impact on operational efficiency, resource utilization, and patient care outcomes. Challenges faced during implementation and key lessons learned are discussed to guide future adoption of digital twin technology in healthcare