Search Results (5,937)

Background/Objectives: this study describes the development of a novel three-dimensional electrogoniometer for the quantitative assessment of knee mobility and stability during gait. The primary objective is to determine whether real-time measurements obtained during dynamic activity provide more clinically relevant information than traditional static assessments. Methods: the device employs angular position encoders to capture knee joint kinematics—specifically flexion, extension, rotation, and tibial translation—during locomotion. Data are transmitted in real time to an Android-based application, enabling immediate graphical visualization. A descriptive observational study was conducted involving healthy participants and individuals with anterior cruciate ligament (ACL) injuries to evaluate the device’s performance. Results: results showed that the electrogoniometer captured knee flexion-extension with a range of up to 90°, compared to 45° typically recorded using conventional systems. The device also demonstrated enhanced sensitivity in detecting variations in tibial translation during gait cycles. Conclusions: this electrogoniometer provides a practical tool for clinical assessment of knee function, enabling real-time monitoring of joint behavior during gait. By capturing functional mobility and stability more accurately than static methods, it may enhance diagnostic precision and support more effective rehabilitation planning in orthopedic settings. Full article

Background: Sleep plays a crucial role in the health of older adults, and its quality is influenced by multiple physiological and functional factors. However, the relationship between sleep quality and physical fitness, body composition, and metabolic markers remains unclear. This exploratory study aimed to investigate the associations between sleep quality and physical, metabolic, and body composition variables in older adults, and to evaluate the preliminary performance of a logistic regression model in classifying sleep quality. Methods: A total of 32 subjects participated in this study, with a mean age of 69. The resting arterial pressure (systolic and diastolic), resting heart rate, anthropometrics (high waist girth), body composition (by bioimpedance), and physical fitness (Functional Fitness Test) and sleep quality (Pitsburg sleep-quality index) were evaluated. Group comparisons, associative analysis and logistic regression with 5-fold stratified cross-validation was used to classify sleep quality based on selected non-sleep-related predictors. Results: Individuals with good sleep quality showed significantly better back stretch (t = 2.592; p = 0.015; η² = 0.239), lower limb strength (5TSTS; t = 2.564; p = 0.016; η² = 0.476), and longer total sleep time (t = 6.882; p < 0.001; η² = 0.675). Exploratory correlations showed that poor sleep quality was moderately associated with reduced lower-limb strength and mobility. The logistic regression model including 5TSTS and TUG achieved a mean accuracy of 0.76 ± 0.15, precision of 0.79 ± 0.18, recall of 0.83 ± 0.21, and AUC of 0.74 ± 0.16 across cross-validation folds. Conclusions: These preliminary findings suggest that physical fitness and clinical variables significantly influence sleep quality in older adults. Sleep-quality-dependent patterns suggest that interventions to improve lower limb strength may promote better sleep outcomes. Full article

In this study, we successfully prepared silver electrodes through a silver mirror reaction. By carefully regulating the amount of ammonia complexing agent in the silver–ammonia solution, we effectively suppressed the decomposition of the plating solution while reducing the surface roughness of silver films from 9.22 nm to 4.42 nm. The electrical conductivity of our solution-processed silver layers was nearly one order of magnitude higher than that of conventional inkjet-printed silver electrodes. When applied as source-drain electrodes in organic field-effect transistors (OFETs), these electrodes enabled devices with an average mobility of 0.13 cm²/(V·s) and remarkably low mobility variation of only 8.7%. Furthermore, we modified the silver electrodes through chemical platinum plating, achieving a significant 0.74 eV alteration in work function, which demonstrates the great potential of chemical plating for surface functionalization in solution-processed organic electronic devices. Full article

Understanding the molecular structure and water transport behavior in anion-exchange membranes (AEMs) is essential for advancing efficient and cost-effective alkaline fuel cells. In this study, large-scale all-atom molecular dynamics simulations of QPAF-4, a promising AEM material, were performed at multiple water uptakes (λ = 2, 3, 6, and 13). The simulated systems comprised approximately 1.4 to 2.1 million atoms and spanned approximately 26 nm, thus enabling direct comparison with both wide-angle X-ray scattering (WAXS) and small-angle X-ray scattering (SAXS) experiments. The simulations successfully reproduced experimentally observed structure factors, accurately capturing microphase-separated morphologies at the mesoscale ($~$8 nm). Decomposition of the SAXS profile into atom pairs suggests that increasing water uptake may facilitate the aggregation of fluorinated alkyl chains. Furthermore, the calculated pair distribution functions showed excellent agreement with WAXS data, suggesting that the atomistic details were accurately reproduced. The water dynamics exhibited strong dependence on hydration level: At low water uptake, mean squared displacement showed persistent subdiffusive behavior even at long timescales ($~$200 ns), whereas almost normal diffusion was observed when water uptake was high. These results suggest that water mobility may be significantly influenced by nanoconfinement and strong interactions exerted by polymer chains and counterions under dry conditions. These findings provide a basis for the rational design and optimization of high-performance membrane materials. Full article

Background and Objectives: Aging is associated with heterogeneous declines in cognitive and physical functions, yet little is known about how baseline functional levels influence the effectiveness of intervention programs. This study analyzed the effects of a psychomotor intervention program on cognitive and physical functions in community-dwelling older adults, considering their baseline functional levels. Materials and Methods: Fifty-one participants (75.4 ± 5.6 years) were divided into an experimental group, which underwent the intervention, and the control group. The experimental group was further divided into lower-functioning (LFG) and higher-functioning (HFG) subgroups based on baseline assessments. Participants were assessed at baseline, 24-week post-intervention, and after a 12-week follow-up. Results: Significant improvements were observed in both experimental subgroups, particularly LFG, in processing speed, executive functions, reaction time, attention, lower-body strength, balance, and mobility (p < 0.05). Cognitive gains persisted post-follow-up, while physical gains were reversed, especially in LFG (p < 0.05). Effect sizes ranged from medium to large in both lower- and higher-functioning groups. Discussion: The intervention improved cognitive and physical functions in both lower- and higher-functioning groups. Although older and less educated, the lower-functioning group showed greater gains but also more decline after follow-up. These findings emphasize that older adults with diverse baseline functional levels can improve substantially, highlighting the need for tailored psychomotor interventions to maximize benefits and address individual variability. The study was registered at ClinicalTrials.gov (NCT03446352). Full article

Background: Diabetic foot ulcers (DFUs) in patients with peripheral artery disease (PAD) are difficult to treat and associated with poor healing outcomes. Photobiomodulation therapy (PBMT) and exercise have shown individual benefits, but evidence on their combined effects is limited. Objective: To evaluate whether PBMT combined with resistance exercise improves wound healing and walking ability in patients with DFU and PAD. Methods: In this pilot randomized trial, 11 patients with DFU and PAD were allocated to either PBMT plus supervised exercise or exercise alone for 4 weeks. Outcome measures included wound size, skin temperature, and 6-min walking distance. Results: PBMT combined with exercise improved wound healing and walking capacity compared with baseline; however, no significant between-group differences were observed. A positive correlation was observed between post-PBMT plantar skin temperature and percentage of wound reduction. Conclusions: PBMT combined with resistance exercise may enhance wound healing and functional mobility in patients with DFU and PAD. Full article

Limb amputation causes significant challenges for patients in achieving effective mobility and functionality through prosthetic limbs. The prosthetic socket plays a pivotal role in the success of rehabilitation. This review explores the current advancements in prosthetic socket design and fabrication, focusing on traditional techniques like casting and lamination, and emerging technologies such as 3D printing and computer-aided design (CAD). By comparing these methods, this review highlights the advantages, limitations, and suitability for different clinical needs. This article discusses the importance of pressure distribution in socket design, emphasizing the need to relieve pressure in sensitive areas to prevent skin complications. It also examines the materials used in socket fabrication, from high-density polymers to advanced composites, assessing their impact on patient comfort and prosthetic performance. Additionally, we discuss the challenges practitioners face in prosthetic care, particularly in low-resource settings, and propose potential solutions through innovative techniques and materials. Advancements in computational modeling improved socket design and validation, enhancing patient comfort and improving the overall biomechanical interaction between the prosthesis and the user. The manuscript concludes by identifying future research opportunities, particularly in personalized prosthetic design and the integration of smart materials, to further enhance the comfort, functionality, and accessibility of prosthetic sockets. Full article

Introduction: Craniotomy, a common neurosurgical procedure, is frequently associated with substantial perioperative challenges and delayed recovery. While Enhanced Recovery After Surgery (ERAS) protocols have demonstrated clear benefits in multiple surgical fields, their application in neurosurgery, particularly elective craniotomy, remains emerging. Objective: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of ERAS protocols in adult patients undergoing elective craniotomy, focusing on key outcomes such as length of hospital stay (LOS), postoperative pain, complications, and functional recovery. Methods: Following PRISMA guidelines, a comprehensive search was conducted in PubMed, Embase, Scopus, Web of Science, and the Cochrane Library up to June 2025. Eligible studies included adult patients (≥18 years) undergoing elective craniotomy and compared ERAS protocols to conventional perioperative care. Primary outcomes were LOS, postoperative complications, pain, early oral intake, and early mobilization. Data extraction and risk of bias assessment (RoB 2.0) were independently performed by two reviewers. Results: Nine randomized controlled trials (RCTs), totaling 1453 patients, were included. Meta-analysis showed that ERAS protocols significantly reduced length of hospital stay (mean difference: −2.17 days; 95% CI: −2.92 to −1.42; p < 0.00001) and decreased the incidence of postoperative nausea and vomiting (odds ratio [OR]: 0.29; 95% CI: 0.19 to 0.44; I² = 0%). ERAS protocols were associated with higher odds of early mobilization (OR: 6.88; 95% CI: 3.46 to 13.68) and early oral intake (OR: 14.04; 95% CI: 7.80 to 25.26). Postoperative complications were significantly reduced in the ERAS group (OR: 0.49; 95% CI: 0.24 to 0.99; p = 0.048; I² = 0%). While early urinary catheter removal showed a favorable trend (OR: 13.48), high heterogeneity (I² = 95.7%) limits interpretability. Postoperative pain on day 1 did not differ significantly between groups (mean difference: −0.37; 95% CI: −2.38 to 1.63; p = 0.72). The overall risk of bias was rated low to moderate across studies. Conclusions: ERAS protocols in elective craniotomy are associated with shorter hospital stays, lower complication rates, reduced PONV, and earlier return to function, without increasing adverse events. These findings support broader implementation of ERAS in neurosurgical practice. Further multicenter RCTs are warranted to standardize and refine ERAS components for craniotomy. Full article

Background: Severe glenoid bone loss presents a major challenge in both primary and revision reverse shoulder arthroplasty (RSA). Standard implants often fail to achieve reliable fixation in these cases. Custom-made, 3D-printed glenoid components have emerged as a potential solution, offering anatomically tailored fit and fixation. This study evaluates the clinical and radiographic outcomes of custom-made glenoid implants in managing severe glenoid bone loss. Methods: A retrospective, multicenter study was conducted on 23 shoulders (11 primary and 12 revision RSAs) that received a custom-made glenoid component using the Enovis ProMade System (San Daniele del Friuli, Udine, Italy) between 2017 and 2022, with a minimum follow-up of 24 months. Preoperative planning utilized CT-based 3D modeling to design implants with patient-specific instrumentation. Clinical outcomes (ROM, pain, Constant–Murley score) and radiographic results were assessed. Statistical comparisons were made between primary and revision groups. Results: Both groups demonstrated significant improvements in shoulder mobility, pain relief, and Constant–Murley scores (all p < 0.001), with no significant differences between primary and revision groups in delta scores. Radiographically, no loosening was observed, with minimal radiolucent lines and low complication rates. Four cases of instability occurred, all in the revision group, with only one requiring conversion to hemiarthroplasty. No differences in radiographic outcomes were observed between groups. Conclusions: Custom-made glenoid implants provide a reliable solution for severe glenoid bone loss in both primary and revision RSA, yielding consistent functional improvement and implant stability. Further prospective studies with larger cohorts and long-term follow-up are warranted to confirm these findings and assess cost-effectiveness. Full article

This paper presents the design and implementation of an Intelligent Home Energy Management System in a smart home. The system is based on an economically decentralized hybrid concept that includes photovoltaic technology, a proton exchange membrane fuel cell, and a hydrogen refueling station, which together provide a reliable, secure, and clean power supply for smart homes. The proposed design enables power transfer between Vehicle-to-Home (V2H) and Home-to-Vehicle (H2V) systems, allowing electric vehicles to function as mobile energy storage devices at the grid level, facilitating a more adaptable and autonomous network. Our approach employs Double Deep Q-networks for adaptive control and forecasting. A Multi-Agent System coordinates actions between home appliances, energy storage systems, electric vehicles, and hydrogen power devices to ensure effective and cost-saving energy distribution for users of the smart grid. The design validation is carried out through MATLAB/Simulink-based simulations using meteorological data from Tunis. Ultimately, the V2H/H2V system enhances the utilization, reliability, and cost-effectiveness of residential energy systems compared with other management systems and conventional networks. Full article

Population aging intensifies the demand for rehabilitation services, which are already suffering from staff shortages. In response to this challenge, the implementation of new technologies in physiotherapy is needed. For such a task, rehabilitation exoskeletons can be used. While designing such tools, their functionality and safety must be ensured. Therefore, simulations of their strength and kinematics must meet set criteria. This paper aims to present a methodology for simulating the dynamics of rehabilitation exoskeletons during activities of daily living and determining the reactions in the construction’s joints, as well as the required driving torques. The methodology is applied to the SmartEx-Home exoskeleton. Two versions of a multibody model were developed in the Matlab/Simulink environment—a rigid-only version and one with deformable components. The kinematic chain of construction was reflected with the driven rotational joints and modeled passive sliding open bearings. The simulation outputs include the driving torques and joint reaction forces and the torques for various input trajectories registered using IMU sensors on human participants. The results obtained in the investigation show that in general, to mobilize shoulder flexion/extension or abduction/adduction, around 30 Nm of torque is required in such a lightweight exoskeleton. For elbow flexion/extension, around 10 Nm of torque is needed. All of the reactions are presented in tables for all of the characteristic points on the passive and active joints, as well as the attachments of the extremities. This methodology provides realistic load estimations and can be universally used for similar structures. The presented numerical results can be used as the basis for a strength analysis and motor or force sensor selection. They will be directly implemented for the process of mass minimization of the SmartEx-Home exoskeleton based on computational optimization. Full article

Shoulder pain, subluxation, and displacement of the body’s center of gravity due to hemiplegia negatively affect patients’ balance, gait, and functionality post-stroke. This study aimed to investigate the effect of a shoulder orthosis on balance and functional mobility in patients post-stroke. This cross-over clinical study was conducted in rehabilitation centers within the Attica Region and included 26 patients in the subacute phase following a stroke. Outcome measures included dynamic balance and functional mobility, assessed through the Timed Up and Go (TUG) test, the Functional Reach Test (FRT), and the modified Four-Square Step Test (mFSST). Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 29.0.10, with a significance level set at p < 0.05. The results showed significant improvements in patient performance with the shoulder orthosis in the FRT (p = 0.049, d = 0.406), TUG (p = 0.023, d = 0.446), and (mFSST) (p = 0.004, d = 0.565). In addition, correlations were observed between Brunnstrom stages, Functional Ambulation Category (FAC) scores, and performance on the dynamic balance and functional mobility tests. Gender, functional status and hemiplegia side did not have a significant effect on the study outcomes. The use of a shoulder orthosis has a positive effect on dynamic balance and functional mobility in patients in the subacute phase post-stroke. Full article

The safety-critical functions of autonomous drones heavily rely on Positioning, Navigation and Timing (PNT) information provided by Global Satellite Navigation Systems (GNSSs). This makes GNSS technology a critical element as the PNT solution can be affected by several threats, mostly in urban and suburban environments. In order to evaluate safe and reliable GNSS-based solutions in Urban Air Mobility (UAM) scenarios, a proper GNSS security impact simulator is needed. In this context, the present work details the design, implementation and testing of a GNSS Threat Simulator (GTS) capable of reproducing typical issues within a GNSS system in a UAM environment, such as satellite visibility (i.e., the actual visibility condition of the receiver’s antenna with respect to terrain and ground obstacle), multipath, electromagnetic interference, cyber threats (i.e., spoofing and jamming) and satellites failures. The GTS elaborates and modifies dual-frequency multi-constellation GNSS observables in order to inject the desired threats. The effectiveness of the proposed simulator has been demonstrated through both fast-time and real-time simulations, in which the GTS was used to validate a hybrid navigation unit installed on a drone operating in a representative urban scenario. Full article

Human methyltransferase-like protein 16 (METTL16) installs N⁶-methyladenosine on U6 small nuclear RNA (snRNA) and other RNAs. Multiple X-ray crystal structures of METTL16 have been published; however, we do not yet fully understand the structure–function relationships of specific residues. We designed 38 mutants, including seven cancer-associated mutants, and used electrophoretic mobility shift assays and single-turnover kinetic assays to better understand the functional roles of specific domains and amino acid residues in binding to U6 snRNA, formation of the METTL16•U6 snRNA•S-adenosylmethionine (SAM) complex, and the rate of methylation. While point mutations in the methyltransferase domain mildly weaken the binding of METTL16 to U6 snRNA, the C-terminal vertebrate conserved regions (VCRs), particularly the arginine-rich region (R382 to R388), mediate cooperative binding and contribute more to RNA binding. All METTL16 K-loop mutants displayed tighter SAM binding, suggesting that the K-loop blocks SAM binding. In addition, residues E133 and F227 are critical for stabilizing SAM binding. Mutations in the ₁₈₄NPPF₁₈₇ catalytic core and R282A abolished methyltransferase activity. Two METTL16 somatic cancer-associated mutants (G110C and R241Dfs*2) displayed reduced methylation activity. This mutational analysis expands our understanding of how specific domains and residues contribute to substrate-binding activity and methylation of U6 snRNA catalyzed by METTL16. Full article

Infrared video imaging is an cornerstone technology for environmental perception, particularly in drone-based remote sensing applications such as disaster assessment and infrastructure inspection. Conventional systems, however, rely on bulky optical architectures that limit deployment on lightweight aerial platforms. Computational imaging offers a promising alternative by integrating optical encoding with algorithmic reconstruction, enabling compact hardware while maintaining imaging performance comparable to sophisticated multi-lens systems. Nonetheless, achieving real-time video-rate computational image restoration on resource-constrained unmanned aerial vehicles (UAVs) remains a critical challenge. To address this, we propose Mobile Wavelet Restoration-Net (MWR-Net), a lightweight deep learning framework tailored for real-time infrared image restoration. Built on a MobileNetV4 backbone, MWR-Net leverages depthwise separable convolutions and an optimized downsampling scheme to minimize parameters and computational overhead. A novel wavelet-domain loss enhances high-frequency detail recovery, while the modulation transfer function (MTF) is adopted as an optics-aware evaluation metric. With only 666.37 K parameters and 6.17 G MACs, MWR-Net achieves a PSNR of 37.10 dB and an SSIM of 0.964 on a custom dataset, outperforming a pruned U-Net baseline. Deployed on an RK3588 chip, it runs at 42 FPS. These results demonstrate MWR-Net’s potential as an efficient and practical solution for UAV-based infrared sensing applications. Full article