Stroke is the third leading cause of disability in the world, and effective rehabilitation is needed to improve lost functionality post-stroke. In this regard, robot-assisted therapy (RAT) and transcranial direct current stimulation (tDCS) are promising rehabilitative approaches that have been shown to be effective in motor recovery. In the past decade, they have been combined to study whether their combination produces adjuvant and greater effects on stroke recovery. The aim of this study was to estimate the effectiveness of the combined use of RATs and tDCS in the motor recovery of the upper extremities after stroke. After reviewing 227 studies, we included nine randomised clinical trials (RCTs) in this study. We analysed the methodological quality of all nine RCTs in the meta-analysis. The analysed outcomes were deficit severity, hand dexterity, spasticity, and activity. The addition of tDCS to RAT produced a negligible additional benefit on the effects of upper limb function (SMD −0.09, 95% CI −0.31 to 0.12), hand dexterity (SMD 0.12, 95% CI −0.22 to 0.46), spasticity (SMD 0.04, 95% CI −0.24 to 0.32), and activity (SMD 0.66, 95% CI −1.82 to 3.14). There is no evidence of an additional effect when adding tDCS to RAT for upper limb recovery after stroke. Combining tDCS with RAT does not improve upper limb motor function, spasticity, and/or hand dexterity. Future research should focus on the use of RAT protocols in which the patient is given an active role, focusing on the intensity and dosage, and determining how certain variables influence the success of RAT.

(1) Background: The increasing life expectancy brings an increase in geriatric syndromes, specifically frailty. The literature shows that exercise is a key to preventing, or even reversing, frailty in community-dwelling populations. The main objective is to demonstrate how an intervention based on multicomponent exercise produces an improvement in frailty and pre-frailty in a community-dwelling population. (2) Methods: a prospective observational study of a multicomponent exercise program for geriatric revitalization with people aged over 65 holding Barthel Index scores equal to, or beyond, 90. The program was developed over 30 weeks, three times a week, in sessions lasting 45–50 min each. Frailty levels were registered by the Short Physical Performance Battery, FRAIL Questionnaire Screening Tool, and Timed “Up & Go” at the beginning of the program, 30 weeks later (at the end of the program), and following 13 weeks without training; (3) Results: 360 participants completed the program; a greater risk of frailty was found before the program started among older women living in urban areas, with a more elevated fat percentage, more baseline pathologies, and wider baseline medication use. Furthermore, heterogeneous results were observed both in training periods and in periods without physical activity. However, they are consistent over time and show improvement after training. They show a good correlation between TUG and SPPB; (4) Conclusions: A thirty-week multicomponent exercise program improves frailty and pre-frailty status in a community-dwelling population with no functional decline. Nevertheless, a lack of homogeneity is evident among the various tools used for measuring frailty over training periods and inactivity periods.

Background/Objectives: This study aimed to determine the effects of weight gain and fatigue on nursing students performing high-fidelity cardiopulmonary resuscitation (CPR) simulation. Methods: A simulation-based research study (with or without a vest) was performed at the Faculty of Health Sciences, University of Castilla la Mancha (Spain), with volunteer nursing students. Vital signs, pain scale, pupillary sizes, analytical parameters, and lifestyle habits were evaluated before, during, and after CPR. The differences between groups were assessed by ANOVA for time and group factors. Results: A total of 31 participants met the inclusion criteria, 15 subjects without a vest and 16 subjects with a vest. The ANOVA results revealed that all the variables presented statistically significant time effects, except for glucose. For the group effect, heart rate, lactate, and cortisol presented statistically significant differences between subjects with and without vests. Conclusions: Vital signs and physiological variables increased during CPR with vests. This could negatively impact the CPR procedure. The implementation of physical training programs aimed at improving the performance of future health professionals during CPR should be studied.

Background: Schizophrenia is a serious mental health condition that usually begins in adolescence and often progresses to become a chronic and disabling illness. Difficulties in communication and anomalous language are considered core elements of the disorder. Several studies have demonstrated the presence of semantic deficits in individuals with schizophrenia, suggesting that these deficits may constitute a core feature of the disorder. However, research in this area remains limited, particularly among individuals at high risk of developing the disorder. The central hypothesis of this study is that individuals with schizophrenia exhibit semantic processing deficits, even when cognitive function, psychopathology, and medication are controlled for. We also hypothesize that similar, albeit milder, deficits can be observed in individuals at high risk of developing the condition. Methods: This cross-sectional study included 155 participants divided into three groups: 46 with schizophrenia, 42 at high risk due to factors like substance use and high psychopathology, and 67 controls matched by sex, age, and education. Semantic processing was assessed using the semantic relations subtest from the BETA, controlling for medication and cognitive performance as possible confounding factors. Results: the results revealed significant differences among the three groups (F = 28.543; p < 0.001); the schizophrenia group performed poorly, followed by the high-risk group, and then the control group, which showed no deficits. Error patterns were also analyzed to assess group differences, revealing that the schizophrenia group had the lowest scores and the most specific deficits. These findings highlight the relevance of semantic evaluation in schizophrenia and, more importantly, in individuals at high risk of developing the disorder, as such deficits may serve as early biomarkers. Additionally, significant correlations were found between semantic performance and variables such as medication (r = −0.342; p = 0.020), cognition (r = −0.259; p = 0.001), and psychopathology (r = −0.566; p < 0.001). Conclusions: This emphasizes the need to control these factors to avoid misinterpreting semantic deficits in both schizophrenia and high-risk groups. The present research is not without limitations; for example, the study design does not allow for conclusions of causality but rather of correlation.

Background/Objectives: Differences between rural and urban settings, as well as between emergency medical service (EMS) systems, may influence short-term mortality among patients attended in the prehospital setting. The aim of this study was to determine the associations of rurality and the US and Spanish EMS health systems with patient mortality. Methods: This was a multicenter, EMS-based, observational study involving a prospective dataset, the Salud de Castilla y Leon dataset (SACYL) from Spain, and a retrospective dataset, the National Emergency Medical Services Information System (NEMSIS) from the US. All consecutive EMS activations of adult patients (≥18 years) requiring high-priority transport to emergency departments were included in the analysis. The collected variables included demographic characteristics, EMS transport characteristics, case characteristics, and rural or urban origin. The primary outcome was 2-day, short-term mortality. Results: A total of 54,981 EMS activations were considered from both datasets. The mortality rate was 8.47% for rural areas and 11.8% for urban areas (p < 0.001). Multivariable analyses showed that mortality patterns differed according to geographic setting and EMS system. Male sex and the use of advanced life support were associated with higher odds of mortality in several models, while prehospital time intervals and call characteristics showed context- and system-dependent associations, including protective effects in specific subgroups. Conclusions: Short-term mortality differed between rural and urban settings, with heterogeneous patterns across EMS systems. These findings highlight the importance of considering both geographic context and system-level organizational characteristics when evaluating prehospital care and mortality outcomes.