Perceptions of the complete eradication of vaccine-preventable diseases such as measles, mumps, and rubella (MMR) may foster complacency and compromise vaccination efforts. Decreased measles vaccination rates during the COVID-19 pandemic have heightened the risk of outbreaks, even in adequately vaccinated populations. To address this, we have aligned with ECDC recommendations, leveraging previous cross-border sero-epidemiological assessments between Pécs, Hungary, and Osijek, Croatia, to identify latent risk groups and uncover potential parallels between our nations. Testing 2680 Hungarian and 1764 Croatian serum samples for anti-MMR IgG via ELISAs revealed anti-measles seropositivity ratios below expectations in Croatian cohorts aged ~20–30 (75.7%), ~30–40 (77.5%) and ~40–50 years (73.3%). Similarly, Hungarian samples also showed suboptimal seropositivity ratios in the ~30–40 (80.9%) and ~40–50 (87.3%) age groups. Considering mumps- and rubella-associated seropositivity trends, in both examined populations, individuals aged ~30–50 years exhibited the highest vulnerability. Additionally, we noted congruent seropositivity trends across both countries, despite distinct immunization and epidemiological contexts. Therefore, we propose expanding research to encompass the intricate dynamics of vaccination, including waning long-term immunity. This understanding could facilitate targeted interventions and bolster public awareness. Our findings underscore persistent challenges in attaining robust immunity against measles despite vaccination endeavors. Full article

The pneumatic centralized fertilizer discharge system is an important part of pneumatic fertilization machinery and mainly includes a fertilizer discharge device, an air–fertilizer mixing device and a pneumatic distribution device. In this paper, the mechanical structure, key parameters and research methods of pneumatic centralized discharge devices, air–fertilizer mixing devices and pneumatic distribution devices at home and abroad are briefly analyzed. The advantages and disadvantages of these existing devices are summarized, the existing problems are discussed and improvement methods are put forward. In this paper, the structural adaptability, uniformity and stability of the fertilizer discharge of different types of fertilizer discharge devices, such as external groove wheel types, spiral types and centrifugal types, are comprehensively analyzed. The working principle of air–fertilizer mixing devices using the Venturi effect to achieve the uniform mixing of fertilizer and airflow is expounded. The effects of air–fertilizer mixing devices with different structural forms and parameters on mixing performance and the motion characteristics of air–solid two-phase flows are analyzed. The influence of the internal structure, key parameters and distribution mode of pneumatic distribution devices on the uniformity and accuracy of fertilizer distribution are analyzed. This paper focuses on how to improve the uniformity, stability and consistency of discharge across rows provided by the pneumatic centralized fertilizer discharge system. The research status and progress made regarding the core components of the pneumatic centralized fertilizer discharge system at home and abroad are summarized. Based on different research results, the key factors and methods for improving the uniformity of fertilizer discharge are discussed. Full article

In industrial applications, local exhaust systems have been used extensively for capturing and confining contaminants at their source. The present study investigates the efficacy of these systems in mitigating the spread of exhaled pollutants by combining them with mixing and displacement ventilation. Experiments were conducted in a simulated meeting room with six closely situated workstations, featuring five exposed persons (simulated with heated dummies) and one infected person (simulated with a breathing manikin). Six overhead local exhaust units, merged with panels, corresponding to workstations, were installed using a lowered false ceiling. Additionally, a table plenum setting for air inlets was introduced to enhance displacement ventilation effectiveness along with local exhaust systems. Results from 16 experimental cases are presented, using the local air quality index and ventilation effectiveness in the breathing zone. The local exhaust system improved the local air quality at the measuring locations closest to the infector in almost all test scenarios. The improvement, particularly significant with displacement ventilation, marked a maximum 35% increase in the local air quality index adjacent to the infector and 25% in the entire breathing zone of the tested meeting room. Moreover, the table plenum settings, coupled with displacement ventilation, further enhanced conditions in the breathing zone. Under the specific conditions of this investigation, the number of operational local exhausts had a marginal impact on mixing ventilation but a significant one on displacement ventilation tests. The efficacy of local exhaust systems was also influenced by the levels of heat gains present in the room. Overall, the study aims to contribute to ongoing efforts to identify sustainable solutions to mitigate indoor airborne diseases with a combination of supply and local exhaust units. Full article

This paper describes the procedure for creating a electronic simulation model of a solenoid power electronic driver with a nonlinear inductive load. Furthermore, it discusses the electromagnetic interaction between the driver and the load example electromagnetic valve. The consideration of nonlinear effects in the power electronic components MOSFET and diode is particularly important to distinguish their effects from the nonlinear behaviour of the inductive load. Full article

Despite coordinated efforts at global level, through the Global Polio Eradication Initiative (GPEI), poliomyelitis disease (Polio) is still a major public health issue. The wild poliovirus type-1 (WPV1) is still endemic in Afghanistan and Pakistan, and new circulations of the WPV1 were confirmed in southeast Africa in 2021, in Malawi and Mozambique. The circulating vaccine derived polioviruses (cVDPV) are also causing outbreaks worldwide. The Task Force for Global Health (TFGH)’s Polio Surge Capacity Support Program, established in 2019, is an effort to reinforce the existing partnership with the GPEI to strengthen countries’ capacities for polio outbreak preparedness and response. In four years, its coordinated efforts with GPEI partners have resulted in a remarkable improvement in the early detection of poliovirus circulation and reducing the missed children gaps in many countries. However, these encouraging results cannot hide an increasingly complex programmatic environment with numerous funding and operational challenges. Full article

Motivated by the recent observation of Klein tunneling in 8-Pmmn borophene, we delve into the phenomenon in β₁₂ borophene by employing tight-binding approximation theory to establish a theoretical mode. The tight-binding model is a semi-empirical method for establishing the Hamiltonian based on atomic orbitals. A single cell of β₁₂ borophene contains five atoms and multiple central bonds, so it creates the complexity of the tight-binding model Hamiltonian of β₁₂ borophene. We investigate transmission across one potential barrier and two potential barriers by changing the width and height of barriers and the distance between two potential barriers. Regardless of the change in the barrier heights and widths, we find the interface to be perfectly transparent for normal incidence. For other angles of incidence, perfect transmission at certain angles can also be observed. Furthermore, perfect and all-angle transmission across a potential barrier takes place when the incident energy approaches the Dirac point. This is analogous to the “super”, all-angle transmission reported for the dice lattice for Klein tunneling across a potential barrier. These findings highlight the significance of our theoretical model in understanding the complex dynamics of Klein tunneling in borophene structures. Full article

This work presents two mixed-integer programming models that intend to minimize the costs of the picking and storage operation through better planning and organization of the places occupied by the products in the warehouse. A large customer that stores frozen goods in a Portuguese cold chain logistics company was selected for the analysis of the allocation of the products in the warehouse and of the corresponding outbound movements. Data with 8525 movements that occurred during 2021 were collected for 228 different product references. For this case study, the products that had a picking place in the initial scenario now have pallets with all the goods in the reserve area, and vice versa. The mathematical models were permitted to obtain savings for the logistics operator costs of around 30.9%. The proposed models can, in the future, be applied in other warehouse scenarios to companies in completely different sectors of activity. Full article

Parkinson’s disease (PD) is a slowly progressing neurological disorder with symptoms that overlap with those of other conditions, making early detection and accurate diagnosis vital for effective treatment and a patient’s quality of life. Symptoms such as tremors, stiffness, slow movements, and balance issues, along with psychiatric manifestations, are typical of PD. This study introduces a groundbreaking approach to PD diagnosis, utilizing a multimodal machine learning framework that integrates Electroencephalography (EEG) and Magnetic Resonance Imaging (MRI) data. Focusing on the early detection and accurate classification of PD, the proposed research leverages the distinct yet complementary nature of EEG and MRI datasets to enhance diagnostic precision. We employed a robust algorithmic strategy, including LightGBM and machine learning techniques, to analyze the complex patterns inherent in neurological data. The key steps of the proposed research are preprocessing and feature extraction from both EEG and MRI modalities, followed by their fusion using Principal Component Analysis (PCA) for dimensionality reduction. The fused dataset was then analyzed using a LightGBM model and validated through a 10-fold cross-validation process to ensure reliability and stability. The model’s efficacy was further tested on independent datasets, demonstrating its robustness across diverse patient demographics. The obtained results showcased an accuracy of 97.17%, sensitivity of 96.58%, and specificity of 96.82% in PD classification, outperforming traditional multimodal as well as single-modality diagnostic methods. The integration of EEG and MRI data provided a more comprehensive view of the neurophysiological and neuroanatomical changes associated with PD. Additionally, the use of advanced machine learning algorithms allowed for a nuanced analysis, capturing subtle patterns indicative of early PD stages. Full article

T-2 toxin (T-2), an A-type mono mycotoxin produced by various Fusarium species, disrupts DNA/RNA and protein synthesis upon entering the body, resulting in pathological conditions in various tissues/organs and posing a significant threat to human and animal health. However, the mechanisms underlying its toxicity remain unclear. With the goal of learning how T-2 affects reproduction in animals, we utilized primary porcine ovarian granulosa cells (pGCs) as a carrier in vitro and constructed concentration models for analyzing cell morphology and RNA-sequencing (RNA-seq). Our findings showed that T-2 could influence pGCs morphology, induce cell cycle arrest, and promote apoptosis in a dose-dependent manner. The results of RNA-seq analyses indicated that a total of 8216 genes exhibited significant differential expression (DEG) following T-2 treatment, of which 4812 were observed to be down-regulated and 3404 were up-regulated. The DEGs following T-2 toxin treatment of pGCs had a notable impact on many metabolic pathways such as PI3K-Akt, Ras, MAPK, and apoptosis, which in turn altered important physiological processes. Gene set enrichment analysis (GSEA) indicated that the differences in the harmful effects of T-2 might be caused by the varying control of cellular processes and the pathway responsible for steroid metabolism. These results present further insights regarding the mechanism of T-2 action on sow reproductive toxicity, enhance our understanding of T-2 reproductive toxicological effects, and lay a theoretical foundation for the judicious prevention of T-2-induced reproductive toxicity. Full article

Background: Little is known about morphogenetic changes in the umbilical cord during the maturation process. Extracellular matrix remodeling, angiogenesis, progenitor activity, and immunomodulation are represented by specific markers; therefore, the aim of this study was to determine the expression of matrix metalloproteinase-2 (MMP2), tissue inhibitor of metalloproteinases-2 (TIMP2), CD34, vascular endothelial growth factor (VEGF), and human β-defensin 2 (HBD2) in preterm and full-term human umbilical cord tissue. Methods: Samples of umbilical cord tissue were obtained from 17 patients and divided into two groups: very preterm and moderate preterm birth umbilical cords; late preterm birth and full-term birth umbilical cords. Routine histology examination was conducted. Marker-positive cells were detected using the immunohistochemistry method. The number of positive structures was counted semi-quantitatively using microscopy. Statistical analysis was carried out using the SPSS Statistics 29 program. Results: Extraembryonic mesenchyme cells are the most active cell producers, expressing MMP2, TIMP2, VEGF, and HBD2 at notable levels in preterm and full-term umbilical cord tissue. Statistically significant differences in the expression of CD34, MMP2, and TIMP2 between the two patient groups were found. The expression of VEGF was similar in both patient groups, with the highest number of VEGF-positive cells seen in the extraembryonic mesenchyme. The expression of HBD2 was the highest in the extraembryonic mesenchyme and the amniotic epithelium, where mostly moderate numbers of HBD2-positive cells were detected. Conclusions: Extracellular matrix remodeling in preterm and term umbilical cords is strongly regulated, and tissue factors MMP2 and TIMP2 take part in this process. The expression of VEGF is not affected by the umbilical cord’s age; however, individual patient factors can affect the production of VEGF. Numerous CD34-positive cells in the endothelium of the umbilical arteries suggest a significant role of progenitor cells in very preterm and moderate preterm birth umbilical cords. Antimicrobial activity provided by HBD2 is essential and constant in preterm and full-term umbilical cords. Full article

China faces a significant population of individuals with disabilities, and the aging demographic exacerbates this challenge. There is an urgent need for accessible environments for vulnerable groups such as persons with disabilities, the elderly, and pregnant women. Consequently, this study aimed to explore the factors influencing satisfaction with accessible travel in old communities in Nanchang City. Adopting a perspective encompassing vulnerabilities across all age groups, we employed interviews, on-site surveys, questionnaires, and literature reviews to construct a model of satisfaction with accessible travel. This model comprises five evaluation dimensions: pedestrian pathways, public spaces, signage guidance, social support, and software provision, encompassing twenty-seven influencing factors. Structural equation modeling (SEM) was utilized to validate the model. The research findings indicated that social support (0.697), pedestrian pathways (0.480), and public spaces (0.291) exerted a significant overall effect on satisfaction within the model, whereas the influence of software provision (0.225) and signage guidance (0.249) was comparatively smaller. Vulnerable groups within the community prioritized operational maintenance (0.818) and cultural advocacy (0.791) within social support. They also emphasized aspects of pedestrian pathways such as elevation treatment (0.809) and pavement design (0.803), as well as rest facilities (0.804) and service facilities (0.790) within public spaces. Finally, based on the weighted ranking of factors among latent variables, we propose corresponding optimization strategies and development proposals. This paper contributes to providing theoretical, practical, and technical support for the design of community accessibility that caters to socially vulnerable groups across “universal and all-ages” groups. It plays a proactive role in enhancing the quality of life for these vulnerable groups and promoting the improvement of accessibility environments in old communities. Full article

Bio-based polymers are attracting increasing interest as alternatives to harmful and environmentally concerning non-biodegradable fossil-based products. In particular, bio-based polymers may be employed as ligands for the preparation of metal nanoparticles (M(0)NPs). In this study, chitosan (CS) was used for the stabilization of Ru(0) and Rh(0) metal nanoparticles (MNPs), prepared by simply mixing RhCl₃ × 3H₂O or RuCl₃ with an aqueous solution of CS, followed by NaBH₄ reduction. The formation of M(0)NPs-CS was confirmed by Fourier Transform Infrared Spectroscopy (FT-IR), Differential Scanning Calorimetry (DSC), Thermal Gravimetric Analysis (TGA), Scanning Electron Microscopy (SEM), Energy-Dispersive X-ray Analysis (EDX), Transmission Electron Microscopy (TEM) and X-ray Diffraction (XRD). Their size was estimated to be below 40 nm for Rh(0)-CS and 10nm for Ru(0)-CS by SEM analysis. M(0)NPs-CS were employed for the hydrogenation of (E)-cinnamic aldehyde and levulinic acid. Easy recovery by liquid-liquid extraction made it possible to separate the catalyst from the reaction products. Recycling experiments demonstrated that M(0)NPs-CS were highly efficient up to four times in the best hydrogenation conditions. The data found in this study show that CS is an excellent ligand for the stabilization of Rh(0) and Ru(0) nanoparticles, allowing the production of some of the most efficient, selective and recyclable hydrogenation catalysts known in the literature. Full article

Background and Objectives: Sarcopenic obesity, a clinical condition coexisting with obesity and sarcopenia, is associated with a high risk of functional impairment, reduced quality of life, and increased mortality. A decline in age-related free testosterone (FT) levels has been reported to be associated with decreased muscle mass and muscle strength and increased fat mass. However, the association between low FT levels and risk of sarcopenic obesity has not been well studied. This study aimed to investigate the direct association between low FT levels and sarcopenic obesity. Materials and Methods: This cross-sectional study used data of 982 community-dwelling men aged 70–84 years from the Korean Frailty and Aging Cohort Study. Sarcopenia was defined according to the criteria of the Asian Group for Sarcopenia (AWGS) 2019. Obesity was defined as a body fat mass ≥28.3%. Participants who met both sarcopenia and obesity criteria were defined as having sarcopenic obesity. Low FT levels were defined as FT levels <17.35 pmol/L according to the Endocrine Society Clinical Practice Guidelines. Results: The prevalence of sarcopenia, obesity, and sarcopenic obesity was significantly higher in the low-FT group than in the normal-FT group. Low FT levels were significantly associated with a higher risk of obesity (odds ratio [OR], 2.09, 95% confidence interval [CI], 1.11–3.92), sarcopenia (2.57, 95% CI 1.08–6.10), and sarcopenic obesity (3.66, 95% CI 1.58–8.47) compared with the healthy control group. The risk of low appendicular skeletal muscle mass index (ASMI) (1.78, 95% CI 1.04–3.02) and high fat mass (1.92, 95% CI 1.12–3.31) was significantly higher in the low-FT group than in the normal-FT group. Conclusions: This study showed that low FT levels were associated with a higher risk of sarcopenic obesity. Low FT levels were mainly related to body composition parameters such as low ASMI and high fat mass. Full article

In adapting to the demands of this modernized landscape, a conventional human-operated forklift within an industrial or warehouse setting falls short. However, the adoption of autonomous forklifts remains a distant prospect for many companies, primarily due to the formidable implementation and switching costs associated with artificial intelligence and complex control mechanisms. To bridge this gap, we present the development of a teleoperated forklift utilizing mecanum wheels for enhanced maneuverability. A key contribution of this work lies in the design of a novel synchronization method for the precise position control of the pallet carriers. This method surpasses the conventional independent and master–slave approaches, demonstrably achieving superior tracking and synchronization performance. Also, a model-based velocity control algorithm was designed for the mecanum wheels to facilitate the mobility of the system. The forklift was successfully able to carry a maximum load of 300 kg. For the comparison of the tracking and synchronization performance, the independent and master–slave methods were also applied to the system. The proposed method showed better performance compared to other structures. Full article

The murine model of experimental cerebral malaria (ECM) induced by Plasmodium berghei ANKA was used to investigate the relationship among pro-inflammatory cytokines, alterations in renal function biomarkers, and the induction of the TRAIL apoptosis pathway during malaria-associated acute kidney injury (AKI). Renal function was evaluated through the measurement of plasma creatinine and blood urea nitrogen (BUN). The mRNA expression of several cytokines and NaPi-IIa was quantified. Kidney sections were examined and cytokine levels were assessed using cytometric bead array (CBA) assays. The presence of glomerular IgG deposits and apoptosis-related proteins were investigated using in situ immunofluorescence assays and quantitative real-time PCR, respectively. NaPi-IIa downregulation in the kidneys provided novel insights into the pathogenesis of hypophosphatemia during CM. Histopathological analysis revealed characteristic features of severe malaria-associated nephritis, including glomerular collapse and tubular alterations. Pro-inflammatory cytokines, such as TNF-α, IL-1β, and IL-6, were upregulated. The TRAIL apoptosis pathway was significantly activated, implicating its role in renal apoptosis. The observed alterations in renal biomarkers and the downregulation of NaPi-IIa shed light on potential mechanisms contributing to renal dysfunction in ECM. The intricate balance between pro- and anti-inflammatory cytokines, along with the activation of the TRAIL apoptosis pathway, highlights the complexity of malaria-associated AKI and provides new therapeutic targets. Full article

Most of the responses present in animals when exposed to stressors are mediated by the autonomic nervous system. The sympathetic nervous system, known as the one responsible for the “fight or flight” reaction, triggers cardiovascular changes such as tachycardia or vasomotor alterations to restore homeostasis. Increase in body temperature in stressed animals also activates peripheral compensatory mechanisms such as cutaneous vasodilation to increase heat exchange. Since changes in skin blood flow influence the amount of heat dissipation, infrared thermography is suggested as a tool that can detect said changes. The present review aims to analyze the application of infrared thermography as a method to assess stress-related autonomic activity, and their association with the cardiovascular and heart rate variability in domestic animals. Full article

This study aimed to develop and implement a nanotechnology-based alternative to traditional tracers used in the oil and gas industry for assessing interwell connectivity. A simple and rapid hydrothermal protocol for synthesizing carbon quantum dots (CQDs) using agroindustry waste was implemented. Three commercial CQDs were employed (CQDblue, CQDgreen, and CQDred); the fourth was synthesized from orange peel (CQDop). The CQDs from waste and other commercials with spherical morphology, nanometric sizes less than 11 nm in diameter, and surface roughness less than 3.1 nm were used. These tracers demonstrated high colloidal stability with a negative zeta potential, containing carbonyl-type chemical groups and unsaturations in aromatic structures that influenced their optical behavior. All materials presented high colloidal stability with negative values of charge z potential between −17.8 and −49.1. Additionally, individual quantification of these tracers is feasible even in scenarios where multiple CQDs are present in the effluent with a maximum percentage of interference of 15.5% for CQDop in the presence of the other three nanotracers. The CQDs were injected into the field once the technology was insured under laboratory conditions. Monitoring the effluents allowed the determination of connectivity for five first-line producer wells. This study enables the application of CQDs in the industry, particularly in fields where the arrangement of injector and producer wells is intricate, requiring the use of multiple tracers for a comprehensive description of the system. Full article

Lower back pain, a common issue among pregnant women, often complicates daily activities like standing up from a chair. Therefore, research into the standing motion of pregnant women is important, and many research studies have already been conducted. However, many of these studies were conducted in highly controlled environments, overlooking everyday scenarios such as using a desk for support when standing up, and their effects have not been adequately tested. To address this gap, we measured multimodal signals for a sit-to-stand (STS) movement with hand assistance and verified the changes using a t-test. To avoid imposing strain on pregnant women, we used 10 non-diseased young adults who wore jackets designed to simulate pregnancy conditions, thus allowing for more comprehensive and rigorous experimentation. We attached surface electromyography (sEMG) sensors to the erector spinae muscles of participants and measured changes in muscle activity, skeletal positioning, and center of pressure both before and after wearing a Maternity-Simulation Jacket. Our analysis showed that the jacket successfully mimicked key aspects of the movement patterns typical in pregnant women. These results highlight the possibility of developing practical strategies that more accurately mirror the real-life scenarios met by pregnant women, enriching the current research on their STS movement. Full article

Weight loss solutions are on the rise, and there is growing interest in natural alternatives to the pharmaceuticals in the market, which are not devoid of relevant side effects. To this end, the objective of the current study was to assess the effects of a botanical-based blend comprised of lemon verbena and hibiscus extracts on weight management, body fat, appetite, lipid, and glucose profiles in an overweight population for 90 days. The volunteers presented significant weight loss in absence of diet (approximately 3 kg, −3.4% total body weight), which coincided with decreased body fat (−1.7%, equivalent to an almost 6% decrease compared to initial value). Body fat was assessed by anthropometry, electrical bioimpedance and DEXA scans. Cholesterol levels were also significantly decreased (approximately 7% decrease). Satiety assessment revealed that the product contributed to increased feeling of fullness and satisfaction after a meal compared to the placebo group, which could contribute to the weight loss observed. Blood glucose and blood pressure levels remained unchanged, which was expected as the volunteers were normoglycemic and their blood pressure was in the healthy range. In conclusion, daily supplementation of a botanical-based blend contributes to weight loss in overweight individuals in absence of diet, while not affecting other parameters that are in the healthy range. This product could be a candidate alternative or add-on to other weight loss products as part of a healthy lifestyle. Full article

This study layed the groundwork for the creation of haploid and triploid celestial goldfish, presenting essential data derived from preliminary investigations. The research delved into three main areas: the short-term preservation of celestial goldfish gametes, the interaction between oocytes and foreign sperm, and the effects of temperature on fertilized eggs concerning hatching rates and late-stage ocular development. Initially, the study explored the optimal semen dilution ratio for celestial goldfish under microscopic examination. And the hybridization of the largemouth bass and celestial goldfish was investigated: largemouth bass sperm was crossbred with celestial goldfish eggs, and it was found that their sperm could not stimulate the development of celestial eye eggs. At last, celestial goldfish fertilized eggs were stimulated at 4 °C and −20 °C, respectively, to observe their impact on the hatching rate and later celestial eye rate. The results revealed no significant differences in hatching rate and celestial eye rate between the cold stimulus groups and the control group, but numerically, the 4 °C cold stimulation reduced the celestial eye rate of celestial goldfish fertilized eggs. The research provided fundamental data for artificial breeding and hybridization experiments in celestial goldfish. Full article

Background: Established barriers to general exercise and physical activity among individuals with head and neck cancer include dry mouth, difficulty eating, weight loss, fear of injury, comorbidities, and treatment-related symptoms of pain and fatigue. Methods/Design: A 12-week pragmatic randomized controlled trial was conducted followed by an optional supported exercise transition phase. Eligible participants were individuals with head and neck cancers who had undergone surgery and/or radiation therapy to lymph node regions in the neck. Participants were randomized to a comparison group involving a shoulder and neck physiotherapeutic exercise protocol, or to a combined experimental group comprising the shoulder and neck physiotherapeutic exercise protocol and lower-body resistance exercise training. The primary outcome of this study was fatigue-related quality of life. Results: Sixty-one participants enrolled, 59 (97%) completed the randomized trial phase, 55 (90%) completed the 24-week follow-up, and 52 (85%) completed the one-year follow-up. Statistically significant between-group differences were found in favor of the combined experimental group for the fatigue-related quality of life, fitness outcomes, and overall physical activity. Paired comparisons confirmed significant within-group improvements for both groups from baseline to one-year follow-up across most outcomes. Discussion: A group-based combined physiotherapeutic and lower-body resistance exercise program was feasible and effective. Findings are limited to individuals who had undergone a surgical neck dissection procedure. Given the complexity of head and neck cancer, further pragmatic interdisciplinary research is warranted. Full article