Background: Exposure to heat is a growing health concern in the context of climate change. Older adults (people aged 600 years or older) are particularly vulnerable due to age-related physiological changes that compromise thermoregulation. Objective: To systematically review the evidence on thermoregulatory alterations in older adults exposed to heat and their association with adverse clinical outcomes. Methods: Following PRISMA guidelines, a systematic search was conducted in PubMed, Web of Science, ScienceDirect, and Scopus. Twenty-four original studies met the inclusion criteria, including experimental studies in controlled environments and epidemiological studies on heat-related outcomes. Data on study characteristics, thermophysiological responses, clinical outcomes, and methodological quality (assessed with JBI tools) were extracted and synthesized. Results: Experimental studies showed that older adults exhibit reduced sweating and cutaneous vasodilation, attenuated cardiovascular and autonomic adjustments, impaired hydration status, and altered thermal perception. These limitations resulted in greater heat storage, faster increases in core temperature, and a higher risk of dehydration and fatigue compared with younger adults. Epidemiological evidence confirmed a significant association between high ambient temperatures and increased hospitalizations and mortality among older populations, particularly at advanced ages, in women, and in those with comorbidities or socioeconomic vulnerability. Conclusions: Heat exposure and climatic conditions—particularly high ambient temperatures, humidity, and poor air quality—reduce thermoregulatory efficiency and increase risks of dehydration, cardiovascular strain, and mortality in older adults. Integrated public health actions addressing both environmental and physiological factors are essential for preventing heat-related illness among older adults.

Functionality after upper limb replantation is a decisive factor when considering the success of the intervention. Therefore, its evaluation is fundamental. The aim of this article was to conduct a systematic review of upper limb functions after replantation or reimplantation, seeking to identify reported functional outcomes as well as the level and mechanism of injury. To achieve this objective, a literature search was conducted in PubMed, ScienceDirect, Cochrane and Web of Science. Studies from the last 10 years which included patients with upper limb replantation and reported their functional outcomes were included. Out of 523 articles, 12 studies (n = 607) were finally included. DASH and CISS were the most commonly used assessments to report functional outcomes. In conclusion, functional outcomes after replantation are assessed using widely varying scales; therefore, due to this methodological variability, it is difficult to compare functional success between studies and further studies on functionality are needed to provide new data.

Purpose: Changes in voice and speech are characteristic symptoms of Huntington's disease (HD). Objective methods for quantifying speech impairment that can be used across languages could facilitate assessment of disease progression and intervention strategies. The aim of this study was to analyze acoustic features to identify language-independent features that could be used to quantify speech dysfunction in English-, Spanish-, and Polish-speaking participants with HD. Method: Ninety participants with HD and 83 control participants performed sustained vowel, syllable repetition, and reading passage tasks recorded with previously validated methods using mobile devices. Language-independent features that differed between HD and controls were identified. Principal component analysis (PCA) and unsupervised clustering were applied to the language-independent features of the HD data set to identify subgroups within the HD data. Results: Forty-six language-independent acoustic features that were significantly different between control participants and participants with HD were identified. Following dimensionality reduction using PCA, four speech clusters were identified in the HD data set. Unified Huntington's Disease Rating Scale (UHDRS) total motor score, total functional capacity, and composite UHDRS were significantly different for pairwise comparisons of subgroups. The percentage of HD participants with higher dysarthria score and disease stage also increased across clusters. Conclusion: The results support the application of acoustic features to objectively quantify speech impairment and disease severity in HD in multilanguage studies. Supplemental Material: https://doi.org/10.23641/asha.25447171

Background and Objetives: Currently, total knee arthroplasty is one of the most common surgeries, increasing with the increase in life expectancy. Whether or not to replace the patella has been a subject of debate over the years, remaining in controversy and without reaching a consensus. Over the years, different meta-analyses have been carried out in order to provide evidence on the subject, although, in recent times, there have not been many new studies in this regard. Therefore, it is considered necessary that the latest works form part of a new meta-analysis. Materials and Method: We searched the literature using PUBMED, SCOPUS, the Cochrane database and VHL from 2010 to 2020. The search terms used were “patellar” AND “resurfacing” OR “Replacement” and “no resurfacing” OR “no replacement”. A meta-analysis was performed with Stata software (Stata version 15.1). Forest plots were generated to illustrate the overall effect of knee arthroplasty interventions. Results: As a result, it was obtained that there is a significantly higher risk of suffering AKP in the non-resurfacing group, in addition to a significant increase in the risk of undergoing a reoperation in the non-resurfacing group. On the other hand, significant differences were obtained in favor of the resurfacing group in both the clinical and Feller KSS, with functional KSS being inconclusive. After analyzing different variables throughout the literature, it does seem clear that the non-resurfacing group may present a higher risk of reoperation than the resurfacing group. Conclusions: For all these reasons, we think that, although it does seem that not replacing the patella can precipitate a reoperation, it is not clear whether this reoperation is a direct consequence of not having replaced the patella. Therefore, in our opinion, the treatment must be individualized for each patient.

There are many studies whose results reveal possible risk factors for developing an infection after a total knee arthroplasty (TKA). The objective of this study is to analyse the risk factors that depend on the hospital and, especially, if the patellar replacement influences the appearance of periprosthetic infection. A retrospective study was performed, where data from the electronic registry of patients of people over 18 and who had undergone TKA, between the years 2015 and 2018, were reviewed. Dependent variables on the patients and the health care system were collected. The possible associations between the factors and the appearance of infection after TKA were studied using univariate and multivariate regression analyses. A total of 907 primary knee arthroplasties were included in the study. Those patients who had their patella replaced had a significantly higher risk of developing an infection (OR 2.07; 95% confidence interval 1.01–6.31). Likewise, patients who underwent surgery by surgeons with more than 10 years of experience were more than twice as likely to become infected than those operated on by younger surgeons (OR 2.64; 95%CI 1.01–6.97). Male patients were also found to be three times more likely to be infected than women (OR 2.99; 95%CI 1.32–5.74). Those interventions that were longer had a higher risk of infection. The same happened with patients who stayed in the hospital for a longer period of time. The rest of the variables did not show statistically significant results. In this study, it was found that the replacement of the patella may be a factor of infection, but it should be corroborated with randomized clinical trials. Furthermore, patients who underwent longer surgeries or those with prolonged hospital stays should be closely monitored to detect infection as soon as possible and establish the most appropriate treatment.

This systematic review explores interventions and technologies aimed at assessing or improving thermoregulation in older adults (≥60 years) across community, clinical, and institutional settings. Following PRISMA guidelines, a comprehensive search in PubMed, Scopus, Web of Science, and ScienceDirect (2010–2025) identified 449 records, of which nine studies met inclusion criteria. The evidence revealed that thermoregulation in older adults is influenced by complex interactions between environmental, physiological, behavioral, and cognitive factors. Predictive models based on skin or facial temperature, and supported by machine learning approaches, showed promising accuracy in estimating thermal sensation and core temperature. Active interventions, such as cooling devices, ventilated clothing, and microclimatic systems, demonstrated significant reductions in skin and core temperature, improving thermal comfort. Educational and community-based strategies also proved effective in reducing thermal risk perception and adverse events. However, despite the availability of wearable devices capable of continuous monitoring, no studies have reported their application in daily-life or environmental contexts for heatstroke prevention in older adults. This gap highlights a critical opportunity for integrating wearable technologies into preventive frameworks. Future research should focus on validating these approaches in ecological settings and tailoring strategies to individual vulnerabilities, thereby improving thermal safety, autonomy, and well-being in this vulnerable population.