Search Results (37)

Background: Falls are common among individuals with multiple sclerosis (MS), yet standard clinical mobility assessments—such as the Timed Up and Go (TUG)—may not fully capture the complexities of real-world ambulation, leading to suboptimal fall identification. There is a critical need to evaluate the ecological validity of these assessments and identify alternative tests that better reflect real-world mobility and more accurately detect falls. This study examined the ecological validity of the TUG and novel dual-task clinical assessments by comparing laboratory-based gait metrics to community ambulation in individuals with MS and evaluated their ability to identify fallers. Methods: Twenty-seven individuals with MS (age 59.11 ± 10.57) completed the TUG test and three novel dual-task mobility assessments (TUG-extended, 25-foot walk and turn, and Figure 8 walk), each performed concurrently with a phonemic verbal fluency task. After lab assessments, the participants wore accelerometers for three consecutive days. Gait speed and stride regularity data was collected during both the in-lab clinical assessments and identified walking bouts in the community. The participants were stratified as fallers or non-fallers based on self-reported fall history over the previous six months. Findings: Significant differences were observed between the TUG and real-world ambulation for both gait speed (p < 0.01) and stride regularity (p = 0.04). No significant differences were found in gait metrics between real-world ambulation and both the 25-foot walk and turn and TUG-extended. Intraclass correlation coefficient analysis demonstrated good agreement between the 25-foot walk and turn and real-world ambulation for both gait speed (ICC = 0.75) and stride regularity (ICC = 0.81). When comparing the TUG to real-world ambulation, moderate agreement was observed for gait speed (ICC = 0.56) and poor agreement for stride regularity (ICC = 0.41). The 25-foot walk and turn exhibited superior predictive ability of fall status (AUC = 0.76) compared to the TUG (AUC = 0.67). Conclusions: The 25-foot walk and turn demonstrated strong ecological validity. It also exhibited superior predictive ability of fall status compared to the TUG. These findings support the 25-foot walk and turn as a promising tool for assessing mobility and fall risk in MS, warranting further study. Full article

After the fall of communism, Romania embarked on a comprehensive land restitution process through Law No. 18/1991, aiming to re-establish private ownership rights, particularly for agricultural and forestry lands. Divergent historical legacies across regions have resulted in heterogeneous land administration systems, contributing to inconsistencies, overlapping claims, and prolonged legal disputes. To address these challenges, the Romanian government introduced the National Cadastre and Land Registration Program, which promotes systematic property registration across the country. Keeping in mind the fact that there is no integrated study that analyses national challenges from multiple dimensions such as history, law, institutions, technology, and socioeconomics and proposes systematic optimization strategies, this article provides a critical analysis of the legal and institutional framework governing land restitution and cadastral reform, highlighting the influence of historical administrative structures and the adoption of modern geospatial technologies such as Geographic Information Systems (GISs) and Unmanned Aerial Vehicles (UAVs). By adopting a qualitative and document-based research approach, focusing on the analysis of legislative frameworks, institutional procedures, and technical instruments used in systematic land registration in Romania, this study emphasizes the benefits of systematic registration, including increased legal certainty, investment stimulation, improved access to credit, and better planning and taxation. Despite progress, implementation remains uneven, hindered by documentation gaps, institutional capacity limitations, and administrative obstacles. Recent legislative adjustments and the integration of advanced geospatial tools aim to improve data quality and accelerate the registration process. Ultimately, the integration of legal, institutional, and geospatial components is essential for achieving transparent and accountable land governance, efficient resource management, and sustainable rural development in Romania. Full article

Background/Objectives: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of a multidisciplinary, multifactorial approach in managing high fall risk in an older adult with diabetes, hypertension, and osteoporosis. Methods: A 72-year-old woman with a recurrent history of falls participated in an 8-week intervention as part of the American Physical Therapy Association (APTA) balance and falls prevention credential program. This study was conducted in Virginia Beach, USA, at the participant’s residence. A single-subject design investigation was conducted, measuring outcomes including the Balance Evaluation Systems Test (BESTest), gait speed, Timed Up and Go (TUG), fear of falling, and balance confidence at baseline and post-intervention. Results: The participant had impaired baseline values across various variables and was classified as a recurrent high-risk faller. After 8 weeks of intervention, clinically meaningful improvements with large effect sizes were observed: self-selected gait speed improved by 25%, BESTest scores improved by 50%, Falls Efficacy—International (FES I) scores improved by 26%, and Activity Balance Confidence (ABC) scores improved by 26%. No falls or adverse events occurred during the intervention period, and the patient reported enhanced mobility and safety at home. Conclusions: A tailored multidisciplinary approach effectively addressed the physical, psychological, and environmental factors contributing to high fall risk. This highlights the importance of patient-centered interventions in managing fall risk and promoting safe aging in place. Continued education, environmental adaptations, and regular follow-up are essential for long-term fall prevention. Full article

Background: The role of the periarticular muscles of the knee joint in ensuring body balance is still ambiguous. Therefore, we conducted clinical and biomechanical assessments on 52 older adults (36 women and 16 men, age of 67.58 ± 7.30 years, body weight of 75.10 ± 13.42 kg, and height of 163.92 ± 8.80 cm) to determine the role of the knee muscles in balance maintenance. Methods: The clinical examination included the Dizziness Handicap Inventory (DHI), the Geriatric Depression Scale (GDS), the Performance-Oriented Mobility Assessment (POMA), the Functional Reach Test (FRT), the Falls Efficacy Scale—International (FES-I), and bioimpedance parameters (skeletal muscle mass—SMM—and its derived parameter—Diff SMM). The biomechanical assessment involved parameters that characterize muscle torques of knee joint extensors and flexors in isokinetic and isometric conditions, as well as changes in the centre of pressure (COP) position while standing with eyes open and closed. Results: Based on treatment history and DHI results (>10 points), 26 participants were identified as having balance disorders, while the remaining participants formed the control group. Statistical analysis was performed to determine differences between the groups. The groups significantly differed in terms of the results obtained from the DHI (p < 0.001) and GDS (p = 0.04) questionnaires as well as FES-I (p < 0.001) and POMA (p = 0.002) tests. While SMM (p = 0.012) was similar in the groups, Diff SMM (p = 0.04) significantly differed. The multiple regression analysis confirmed the knee joint extensor parameters’ significant role in predicting the COP path (p = 0.03 and p = 0.04 for two assumed models). Conclusions: The obtained results proved that the muscle torques of knee extensors can be used in the diagnostic process of older patients with balance disorders, indicating possible rehabilitation directions. Full article

In the whole service life of building clusters, they will encounter multiple hazards, including the disaster chain of earthquakes and building debris. The falling debris may block the post-earthquake roads and even severely affect the evacuation, emergency, and recovery operations. It is of great significance to develop a surrogate model for predicting seismic responses of building clusters as well as a prediction model of post-earthquake debris. This paper presents a general methodology for developing a surrogate model for rapid seismic responses calculation of building clusters and probabilistic prediction model of debris width. Firstly, the building cluster is divided into several types of representative buildings according to the building function. Secondly, the finite element (FE) method and discrete element (DE) method are, respectively, used to generate the data pool of structural floor responses and debris width. Finally, with the structural response data of maximum floor displacement, a surrogate model for rapidly calculating seismic responses of structures is developed based on the XGBoost algorithm, achieving R² > 0.99 for floor displacements and R² = 0.989 for maximum inter-story drift ratio (MIDR) predictions. In addition, an unbiased probabilistic prediction model for debris width of blockage is established with Bayesian updating rule, reducing the standard deviation of model error by 60% (from σ = 10.2 to σ = 4.1). The presented models are applied to evaluate the seismic damage of the campus building complex in China University of Mining and Technology, and then to estimate the range of post-earthquake falling debris. The results indicate that the surrogate model reduces computational time by over 90% compared to traditional nonlinear time-history analysis. The application in this paper is helpful for the development of disaster prevention and mitigation policies as well as the post-earthquake rescue and evacuation strategies for urban building complexes. Full article

Insects often encounter starvation stress, especially during invasion spread or population outbreaks. The fall webworm, Hyphantria cunea (Drury) (Lepidoptera: Arctiidae), is an important invasive pest in China, and the starvation resistance of its larvae determines population spread and resulting outbreak threat. In this study, we investigated the starvation resistance of H. cunea larvae and the effects of starvation stress on their life history and adult fitness. Larval starvation resistance increased along with the instar stage, and the second-day sixth instar molt was critical for starvation resistance. The response to starvation stress was reflected in multiple biological indicators observed in H. cunea. Complete food deprivation reduced the pupation survival rate of sixth instar larvae, prolonged their developmental duration, reduced pupal and adult body mass, shortened adult forewing length and lifespan, and reduced female egg production. The sixth instar larvae showed a certain ability to recover after refeeding. However, negative impacts of the starvation period on larval life history traits, such as pupation survival rate, pupal and adult body mass, adult longevity, and fecundity, were still observed even after refeeding, and the effects of refeeding were affected by larval starvation duration and refeeding mode. These results suggested that H. cunea larvae were highly resistant to starvation, that starvation stress negatively affected their larval life history and adult fitness, and that the pattern of the effects of post-starvation refeeding on larval and adult fitness was related to the duration of starvation and the refeeding mode. The results of this study offer important insights into understanding the physiological response mechanisms of invasive insects under starvation stress. Full article

Multiple forms of endemic malaria existed in the Mediterranean Basin from the 3rd millennium BCE until eradication regimes were imposed in the 20th century, with major societal health impacts across the history of the region. Little attention has been paid to the role endemic malaria played during the high medieval period, especially during the Crusades, when large Christian armies transited the Mediterranean to conquer the Levant, forging new states, trade lanes and pilgrimage routes in the process. This study utilizes a recent GIS-enabled malaria risk model validated for the pre-modern Mediterranean to re-evaluate contemporary accounts of illness and epidemics in the Crusader Levant. While medieval sources often provide ambiguous descriptions of disease, careful consideration of these accounts in light of the demonstrable spatial and temporal risk of malaria infection provides substantial evidence of these kinds of epidemics. The resulting evidence suggests that several malaria species, either on their own or in concert with other pathogens, afflicted numerous Crusade campaigns in low-lying landscapes during the warmest periods of the summer and fall in the Levant. In turn, these malaria epidemics had a major impact on the history of the Crusades and the Crusader States. Full article

Background/Objectives: Childhood hemophilia, a hereditary bleeding disorder predominantly affecting males, arises due to gene mutations encoding clotting factors VIII or IX. Intracranial hemorrhage represents a significant and life-threatening complication in pediatric patients with hemophilia. The incidence of intracranial hemorrhage in children with hemophilia, although relatively low, is notably higher compared to the general pediatric population. Methods: In this study, the objective is to examine patients with hemophilia who have experienced intracranial hemorrhage retrospectively. This study is a multicenter, retrospective analysis using data from three tertiary care centers in a provincial city in Turkey. Data were obtained from the participants’ hospital records. The presence of inhibitors against FVIII in the participants and the prophylaxis used against them were included in the analysis. Trauma history was queried, with types of traumas examined, including traffic accidents, falls, and a traumatic vaginal delivery. The duration and causes of complaints among the participants were investigated. The causes of complaints were categorized as fever, hematoma, convulsions, loss of consciousness, and hemiparesis. The participants’ Physical Examination Findings were classified as fever, hematoma, and loss of consciousness. The duration of hospital stays was evaluated. The hemorrhage location was classified into five groups: parenchymal, subdural, scalp, subarachnoid, and multiple hemorrhagic foci. The recurrence of bleeding, the need for transfusion, surgical intervention, and mortality were also examined. Results: A significant difference was identified between the participants’ survival rates and age variables, as well as transfusion in <36 months. A total of 9 participants had spontaneous intracranial bleeding, 2 experienced cranial trauma as a result of traffic accidents, and 25 participants were exposed to head trauma due to falls. Of the remaining individuals, one suffered head trauma from a severe impact, and one had cranial trauma following a traumatic vaginal delivery. Fourteen participants required transfusion, and three underwent surgical intervention. Conclusions: According to the results of the statistical analyses, the variables Factor Level, Physical Examination Findings, Transfusion, Recurrent Bleeding, Inhibitor, and Prophylaxis were found to affect survival significantly. No significant relationship was determined between the other analyzed variables and survival. During our study, five of the participants examined died. Accordingly, the mortality rate identified in our study is 13.1%. Full article

Death from falls accounts for a significant number of injuries and fatalities globally, often linked to suicides, workplace accidents, or substance abuse, and rarely to homicidal causes. Injuries from falls vary based on height, impact point, and surface struck, with severe trauma often seen, including visceral ruptures, organ lacerations, and complex fractures. Even minimal external injuries can mask severe internal damage, such as multiple organ ruptures, organ tears, and large vessel lacerations. Blunt cardiac injuries, which occur in 5% to 50% of falls, are significant, especially in falls over 6 m. In 70% of the cases, cardiac rupture is observed at the level of the posterior wall of the heart and occurs due to a contusive action on the heart during the diastolic filling phase. We report a case of a 29-year-old man (weight 95 kg) who died from an 11-meter fall. He had a history of cardiac surgery for the transposition of the great vessels, and an autopsy revealed extensive cardiac rupture, likely worsened by fibrotic adhesions anchoring the heart to the pericardium. Toxicological investigations on peripheral blood showed BAC > 2.58 g/L. Heart scars, macro- and microscopically as a deposit of fibrous tissue, due to previous surgery, may have contributed to the extent of the lesion, suggesting the need for further study on post-operative tissue changes and their effects on trauma from falls. Full article

Background/Objectives: In recent decades, the number of patients with chronic cardiovascular diseases (CVDs) has increased, and CVD survivors are more likely to be old and frail and to have multiple comorbidities. A better understanding of geriatric conditions and their prevalence would help improve the management of older patients with CVDs. The main objective of this study is to estimate the association of myocardial infarction (MI) history with geriatric syndromes (GSs) in people 65 years of age and older. Methods: The cross-sectional study EVKALIPT included patients who were 65 years of age and older. All patients underwent a comprehensive geriatric assessment. The presence of MI history was assessed by medical records. Results: A total of 4295 participants were included. The prevalence of MI history was 12.6%. According to univariate regression analysis, MI history was associated with an increase in the odds of 12 GSs by 1.3–2.4 times. Multivariate regression analysis showed that male sex and four GSs (impairment in basic and instrumental activities of daily living, depression, falls) were independently associated with a history of MI, with the odds ratio ranging from 1.28 to 1.86. Conclusions: This study showed the association between MI history and GSs. Full article

Falls among older adults represent a critical global public health problem, as they are one of the main causes of disability in this age group. We have developed an automated approach to identifying fall risk using low-cost, accessible technology. Trunk movement patterns were collected from 181 older people, with and without a history of falls, during the execution of the Mini-BESTest. Data were captured using smartphone sensors (an accelerometer, a gyroscope, and a magnetometer) and classified based on fall history using deep learning algorithms (LSTM). The classification model achieved an overall accuracy of 88.55% a precision of 90.14%, a recall of 87.93%, and an F1 score of 89.02% by combining all signals from the Mini-BESTest tasks. The performance outperformed the metrics we obtained from individual tasks, demonstrating that aggregating all cues provides a more complete and robust assessment of fall risk in older adults. The results suggest that combining signals from multiple tasks allowed the model to better capture the complexities of postural control and dynamic gait, leading to better prediction of falls. This highlights the potential of integrating multiple assessment modalities for more effective fall risk monitoring. Full article

Academics often comment that their teaching affects their research, but how this manifests is often implicit. In this essay, I explicitly explore the artistic, scholarly, and curatorial research instantiated by an undergraduate class titled “Transgender Studies meets Art History,” which I taught during the fall of 2022. Alongside personal anecdotes—both personal and connected to the class—and a critical reflection on my pedagogy, I discuss the artwork and public programming connected to a curatorial project, “Forever Becoming: Decolonization, Materiality, and Trans* Subjectivity, I organized at UrbanGlass, New York City in 2023. The first part of the article I examine how “trans” can be applied to thinking about syllabus construction and re-thinking canon formation for a class focused on transgender studies’ relationship to art history. In the second half, I theorize trans joy as a felt vibration between/across multiplicity and singularity, belonging and unbelonging, and world-making and world-unmaking. Overall, I consider trans as a lived experience and its utility as a conceptual tool. As a coda, I consider the precarity of teaching this course in the current political climate of the United States. Full article

Aerial manipulators have seen a rapid uptake for multiple applications, including inspection tasks and aerial robot–human interaction in building and construction. Whilst single degree of freedom (DoF) and multiple DoF rigid link manipulators (RLMs) have been extensively discussed in the aerial manipulation literature, continuum manipulators (CMs), often referred to as continuum robots (CRs), have not received the same attention. This survey seeks to summarise the existing works on continuum manipulator-based aerial manipulation research and the most prevalent designs of continuous backbone tendon-driven continuum robots (TDCRs) and multi-link backbone TDCRs, thereby providing a structured set of guidelines for fabricating continuum robots for aerial manipulation. With a history spanning over three decades, dominated by medical applications, CRs are now increasingly being used in other domains like industrial machinery and system inspection, also gaining popularity in aerial manipulation. Fuelled by diverse applications and their associated challenges, researchers have proposed a plethora of design solutions, primarily falling within the realms of concentric tube (CT) designs or tendon-driven designs. Leveraging research works published in the past decade, we place emphasis on the preparation of backbones, support structures, tendons, stiffness control, test procedures, and error considerations. We also present our perspectives and recommendations addressing essential design and fabrication aspects of TDCRs in the context of aerial manipulation, and provide valuable guidance for future research and development endeavours in this dynamic field. Full article

Meals comprising a staple grain, a main, and side dishes (SMS meals) promote good dietary intake, yet limited studies have examined their multifactorial relationship with dietary intake. We investigated how demographic characteristics, lifestyle, and dietary habits affect the relationship between SMS meal frequency and nutrient intake adequacy. This cross-sectional study analyzed survey data from 331 Japanese adults (208 men and 123 women) aged 30–69 years in February 2019. SMS meal frequency was evaluated according to respondents’ answers to how many days a week they consumed ≥2 daily SMS meals. Dietary intake was evaluated using the brief self-administered diet history questionnaire. Differences in nutrient intake adequacy among groups according to SMS meal frequency were determined using multiple logistic regression. Less frequent SMS meals correlated with a lower intake of protein, water-soluble vitamins, and certain minerals, with more individuals falling below the estimated average requirement for nutrient intake. However, no relationship was found between SMS meal frequency and nutrient intake concerning tentative dietary goals for preventing lifestyle-related diseases. Our findings indicate that adopting SMS meals could achieve adequate intake of some nutrients and enhance overall diet quality among Japanese adults. Full article

Falling is inevitable for legged robots when deployed in unstructured and unpredictable real-world scenarios, such as uneven terrain in the wild. Therefore, to recover dynamically from a fall without unintended termination of locomotion, the robot must possess the complex motor skills required for recovery maneuvers. However, this is exceptionally challenging for existing methods, since it involves multiple unspecified internal and external contacts. To go beyond the limitation of existing methods, we introduced a novel deep reinforcement learning framework to train a learning-based state estimator and a proprioceptive history policy for dynamic fall recovery under external disturbances. The proposed learning-based framework applies to different fall cases indoors and outdoors. Furthermore, we show that the learned fall recovery policies are hardware-feasible and can be implemented on real robots. The performance of the proposed approach is evaluated with extensive trials using a quadruped robot, which shows good effectiveness in recovering the robot after a fall on flat surfaces and grassland. Full article