The ABCD2 score is widely used for early stroke risk stratification following transient ischemic attack (TIA); however, a critical limitation is that low-risk scores may still fail to identify patients with treatable high-risk conditions, leading to missed opportunities for urgent intervention. This raises ongoing concerns about its predictive accuracy, applicability across diverse clinical settings, and the added value of incorporating neuroimaging or expanded clinical variables. A PRISMA-guided systematic review was performed, evaluating nine studies investigating the predictive performance and limitations of the ABCD2 score and its variants for early and late stroke risk, as well as their ability to distinguish TIA from mimics. Across 6,111 TIA patients and additional suspected-TIA cohorts, findings were heterogeneous. Several studies demonstrated only modest predictive accuracy, with the score performing best at identifying low-risk patients rather than reliably detecting those at highest risk. Importantly, multiple studies showed that patients with ABCD2 <4 still experienced clinically significant short-term stroke risk when underlying etiologies such as carotid stenosis or cardioembolism were present. Imaging-augmented variants (e.g., ABCD2-I, ABCD3-I) provided inconsistent or minimal incremental value. Moreover, up to 20% of suspected TIAs were mimics, and the ABCD2 score showed poor discriminatory ability in distinguishing them from true events. Although the ABCD2 score remains a practical initial tool for TIA triage, its limitations—including inconsistent predictive accuracy, inability to reliably identify all high-risk patients, and poor performance in differentiating mimics—underscore the need for comprehensive clinical assessment beyond simple scoring. Future large-scale prospective studies are required to validate augmented models and refine individualized risk-stratification strategies.

This study aims to examine the effect of plyometric training on leg muscle strength, kicking speed, and agility of pencak silat athletes. The background of this study is based on the need to improve athlete performance through effective training methods. Plyometric training is known for its explosive movements that can increase muscle strength and speed. This research method involved a sample of pencak silat athletes who underwent a plyometric training program for eight weeks. Leg muscle strength measurements were carried out using a vertical jump test, kicking speed was assessed based on the number of kicks per minute, and agility was evaluated through a shuttle run test. The results showed a significant increase in both performance metrics. After eight weeks, there was a significant increase in leg muscle strength as measured by vertical jump height (sig = 0.001). In addition, kicking speed also increased significantly in the right leg (sig = 0.001) and left leg (sig = 0.041), as seen from the higher number of kicks per minute. However, athlete agility showed no significant improvement (sig = 0.71). Based on the results of special agility training. In conclusion, plyometric training has been shown to be an effective training method to improve key athletic attributes in pencak silat athletes. These significant increases in leg muscle strength, kicking speed, and agility contributed to improvements in the athletes’ overall performance. These findings emphasize the importance of incorporating plyometric training into the routine training regimen of martial arts athletes to achieve optimal athletic development and better competitive performance.

The purpose of this study was to measure the effectiveness of the punch and kick speed training models developed in karate athletes. The development of the model is based on the characteristics of martial arts taking into account the age of the athlete 15-17 years. The research method only used one group of pretest posttests, which tested the training model that had been developed to prove its effectiveness in increasing the speed of punches and kicks. The instrument developed by the author measures the speed of martial arts punches and kicks. Involving all athletes aged 15-17 years with a sample of 65 male athletes. The results of the study proved that there was an increase in the average speed of punches and kicks with a significance of p < 0.05, and there was an increase in the average speed of punches and kicks with a minimum pretest score of 1.04 seconds and a maximum score of 0.55 seconds. Meanwhile, the results of the minimum postest value are 0.64 seconds and the maximum value is 0.23 seconds. So it can be concluded that the development of a punch and kick speed training model can increase movement speed, so that it can be an alternative applied in the training process for athletes aged 15-17 years.

Acute pancreatitis (AP) is a frequent gastroenterological emergency with a highly diverse clinical progression, varying from a self-resolving condition to a potentially fatal disease involving multi-organ failure. Precise early risk assessment is essential for enhancing results and efficiently distributing resources. This exhaustive review seeks to critically integrate the present status of prognostic forecasting in AP. It examines existing clinical scoring systems, new biomarkers, and the growing significance of Artificial Intelligence (AI) and Machine Learning (ML) to suggest a comprehensive framework for assessing severity. A narrative review of the scientific literature were performed. A comprehensive search of databases such as PubMed and Scopus was conducted utilizing keywords like "acute pancreatitis," "severity prediction," "biomarkers," and "machinelearning." Research offering quantitative information on predictive effectiveness (e.g., sensitivity, specificity, AUC) was prioritized for examination. Defined scores (Ranson, APACHE II, BISAP, CTSI) continue to be significant but have constraints regarding their timing and intricacy. Easily obtainable biomarkers such as C-reactive Protein (CRP), Procalcitonin (PCT), and the Neutrophil-to-Lymphocyte Ratio (NLR) offer important real-time prognostic information. New elements like visceral fat (VAI, LAP) and a lack of Vitamin D are significant, independent indicators of severity. Crucially, early research on AI and machine learning models (like Random Forest and XGBoost) demonstrates a significant enhancement in predictive accuracy, frequently surpassing traditional measures for severe AP, complications, and mortality in retrospective studies. The future of acute pancreatitis management is in a combined, multifaceted strategy. This approach ought to integrate the advantages of quick clinical assessments, real-time biomarker tracking, and AI-improved predictive analysis. Shifting from a universal model to this customized, stratified approach is essential for enhancing precision medicine and boosting patient results in acute pancreatitis.

This study aims to develop and validate an interactive digital learning media for Pencak Silat instruction using the Articulate Storyline platform. The research employed the Research and Development (R&D) method based on the Borg and Gall model, integrated with the Multimedia Development Life Cycle (MDLC) framework consisting of six stages: concept, design, material collection, assembly, testing, and distribution. Data were collected through expert validation, teacher practicality assessment, and student response questionnaires. The validation results showed an average score of 92.63%, categorized as very valid, while the practicality test obtained an average score of 91.13%, classified as excellent. These findings indicate that the developed media effectively integrates cultural elements, interactive features, and pedagogical accuracy. The multimedia—comprising text, animation, narration, and video—successfully enhanced student motivation, engagement, and psychomotor understanding in performing Pencak Silat movements. This research contributes to digital transformation in Physical Education by providing accessible, culturally grounded, and sustainable learning innovations that align with SDG 4 (Quality Education) and SDG 11 (Sustainable Cities and Communities). The Articulate Storyline-based media offers an effective model for developing interactive learning resources that preserve cultural heritage while enhancing 21st-century competencies.

This study seeks to evaluate the impact of Anaerobic Soccer Training (AnST) utilizing a weight vest on body composition, encompassing variables such as Body Fat Mass (BFM), Fat Free Mass (FFM), Body Fat Percentage (PBF), Visceral Fat Level (VFL), Body Weight (BW), Body Mass Index (BMI), Total Body Water (TBW), and Skeletal Muscle Mass (SMM). Twenty-one amateur soccer players (mean age: 20 ± 0.81 years) were randomly allocated into two groups: experimental (n=11) and control (n=10). Data were evaluated using paired t-tests for normally distributed vari-ables, whereas Wilcoxon tests were used for non-normally distributed variables. The experi-mental group exhibited reductions in body fat mass (BFM) and body fat percentage (PBF), and an increase in fat-free mass (FFM), alongside an increase in visceral fat (VFL). Furthermore, body weight (BW), body mass index (BMI), total body water (TBW), and skeletal muscle mass (SMM) exhibited relative consistency. The control group exhibited stability, characterized by minor fluctuations, including a slight rise in FFM and BFM, while PBF, VFL, BW, BMI, and TBW re-mained generally constant. There was an augmentation in SMM. In conclusion, the short training duration, limited recovery, and poor nutrition likely prevented the weight vest AnST program from producing significant improvements in body composition.

Affective inversion, defined as a paradoxical reversal of emotional attachment into hostility or fear, represents a core yet understudied dynamic within severe psychotic disorders. This case se-ries examines five patients diagnosed across schizophrenia subtypes, exploring how disintegra-tion of adaptive mechanisms shapes affective and relational pathology. Using the CARE (CAse REport) framework, each case was analyzed through clinical observation, psychodynamic inter-pretation, and contextual family assessment. The results reveal that affective inversion frequent-ly emerges as a maladaptive form of psychotic adaptation, transforming dependency into perse-cution and love into aggression. These reversals were consistently directed toward primary caregivers, reflecting unresolved trauma, disrupted attachment, and transgenerational repetition of affective conflict. Pharmacological treatment alone proved insufficient, as improvement in positive symptoms did not restore relational coherence or emotional regulation. Integrating psychotherapy, family involvement, and structured containment was essential to achieve partial stabilization and re-establish minimal affective reciprocity. The findings suggest that affective inversion constitutes both a clinical marker and a defense mechanism against unbearable de-pendency and identity fragmentation. Understanding this process through a psychodynamic and systemic lens enhances diagnostic precision and informs comprehensive therapeutic strategies that address not only symptom remission but also the reconstruction of relational meaning and adaptive resilience.

Thalassotherapy, which utilises seawater, marine mud, and a coastal climate for therapeutic purposes, has gained increasing recognition as a complementary method in physical and rehabilitation medicine. Its combined mechanical, thermal, and biochemical actions may stimulate tissue regeneration, reduce inflammation, and improve functional outcomes. The present study aimed to assess the clinical and biochemical effects of a two-week thalassotherapy program compared with standard rehabilitation in post-traumatic patients. A prospective, non-randomized, matched-controlled, comparative cohort study was carried out at the Corpore Sano Sanatorium, Techirghiol, Romania, including 140 patients with musculoskeletal post-traumatic conditions. Participants were divided into two equal groups: the thalassotherapy group underwent daily seawater baths, peloid applications, marine aerosol exposure, and hydrokinetic exercises, while the control group received conventional physiotherapy and electrotherapy sessions. Clinical and laboratory evaluations included pain intensity (measured using the Visual Analogue Scale, VAS), joint mobility, serum C-reactive protein (CRP), and interleukin-6 (IL-6), all of which were assessed before and after treatment. Functional status and quality of life were measured using the SF-36 questionnaire. After 14 days, patients in the thalassotherapy group demonstrated significantly greater improvement in mobility (increase of 25.6 ± 7.1%; p < 0.01) and pain reduction (VAS 3.4 ± 1.5 vs. 6.2 ± 1.8; p < 0.01). CRP and IL-6 levels decreased more prominently in the thalassotherapy group (CRP 4.3 ± 1.9 mg/L vs. 6.1 ± 2.5 mg/L; IL-6 5.6 ± 1.8 pg/mL vs. 7.9 ± 2.0 pg/mL; p < 0.05). Quality-of-life scores improved by 29% compared to 17% in the control group. Thalassotherapy yielded superior outcomes compared to conventional rehabilitation, improving both physical recovery and systemic inflammatory balance. These results support its inclusion as a practical complementary approach in post-traumatic rehabilitation strategies.

We present a case of a young patient with severe myopathy and repeated episodes of lower limb paralysis. The patient was diagnosed as having primary hypertension and because of severely increased blood pressure he received four hypo-tensive drugs including a diuretic. Laboratory analyses indicated severe hypokalemia and increased creatin kinase. The association of resistant hypertension with hypokalemia suggested primary hyperaldosteronism (PA) confirmed by the increased values of aldosterone and suppression of renin. Abdominal computed tomography identified an adrenal ade-noma as being the cause of increased aldosterone concentration. Even though muscle weakness is frequently associated in PA, paralytic hypokalemic myopathy with rhabdomyolysis is a rare finding, imposing a differential diagnosis with other causes of myositis. In our patient, muscular symptoms have remitted after hypokalemia correction. Surgical re-moval of adrenal adenoma significantly reduced arterial pressure values and persistently normalized serum potassium. Conclusion. In patients with arterial hypertension, muscle weakness may be a sign of hypokalemic myopathy suggest-ing PA. The administration of diuretics in these patients may aggravate hypokalemia and its unfavorable clinical con-sequences including severe rhabdomyolysis.

Long COVID is frequently associated with emotional disturbances such as anxiety and depression, which may persist beyond the acute phase and significantly affect quality of life and social reintegration. This retrospective study aimed to investigate the effect of a structured physical therapy program on anxiety and depression symptoms in long COVID patients referred to the Colentina Rehabilitation Department. Thirty-three patients were enrolled and completed ten sessions of kinesiotherapy; high-intensity laser therapy was added in cases with musculoskeletal comorbidities. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), corroborated by clinical interview and patient-reported perception, at admission, discharge, and one month post-discharge. At baseline, all patients exhibited anxiety symptoms and 24 showed signs of depression, mostly in the mild-to-moderate range. By discharge, a significant improvement was observed in both dimensions, with continued progress at one-month follow-up. Statistical analysis revealed significant differences between the three evaluations. Improvements in anxiety and depression scores were positively correlated with enhanced 6-Minute Walk Test (6MWT) performance. Moreover, depression scores were positively associated with elevated blood glucose levels, while anxiety scores demonstrated a negative correlation with serum 25-hydroxy vitamin D. These correlations emphasize the complex interplay between emotional, physical, and metabolic factors in long COVID recovery and highlight the multidimensional benefits of rehabilitation.