Search Results (3,516)

Background: Accurate assessment of volume status remains a central challenge in hemodialysis (HD). Although bioimpedance spectroscopy (BIS) can quantify fluid compartments, it is time-consuming and requires a lot of personnel. Modern HD machines provide continuous relative blood volume (RBV) monitoring. We examined whether intradialytic RBV dynamics reflect pre-dialysis extracellular fluid (ECW) status to inform personalized fluid management. Methods: In an ancillary, monocentric, prospective study of the SkInDialysis trial (DRKS00036332), 11 maintenance-HD patients underwent three standardized dialysis sessions with simultaneous measurement of RBV and BIS. BIS was performed at five time points per session (pre-HD; 20, 80, and 160 min after the start of HD; and post-HD). Ultrafiltration (UF), RBV, total body water (TBW), ECW, and intracellular water (ICW) were recorded. Results: Mean total UF was 2809 ± 894 mL/session. RBV declined to 94.7 ± 3.1% at 20 min and to 87.6 ± 5.5% by the end of the session. TBW decreased by 2.9 ± 2.7%, driven by ECW reduction (−3.15 ± 2.9%) over ICW (−1.1 ± 1.65%). Cumulative UF correlated with declines in TBW (R² = 0.18; p = 0.02) and ECW (R² = 0.23; p = 0.01) and more modestly with ICW (R² = 0.16; p = 0.04). In contrast, ΔRBV (pre- vs. post-HD) did not correlate with UF, weight loss, or compartmental water changes. Early steady-state RBV at 80 min correlated with pre-HD ECW (R² = 0.19; p = 0.02) and more strongly with the pre-HD ECW/ICW ratio (R² = 0.34; p = 0.001). Conclusions: In this small, repeated-measures cohort, absolute early steady state RBV levels were associated with pre-dialysis ECW and the ECW/ICW ratio, whereas RBV change (ΔRBV) did not track absolute fluid removal. Our data support a time-anchored RBV level as a pragmatic, device-embedded indicator of the pre-dialysis extracellular reservoir. Full article

Purpose: Decentralized hearing care models facilitated by community health workers (CHWs) can improve access to care in low-income settings. Preset hearing aids, which offer user-selectable pre-developed amplification programs, may support such models, but little is known about their real-world use and alignment with clinical recommendations. Method: This longitudinal study formed part of a feasibility project implementing the World Health Organization’s (WHO’s) hearing aid service delivery approach in three low-income South African communities. Adults (≥18 years) with confirmed moderate-to-severe bilateral hearing loss were fitted with preset hearing aids by trained CHWs. Devices offered four preset amplification programs. Participant-driven selections were recorded at four distinct time points: fitting and follow-ups at 2 weeks, 2 months, and 6 months post-fitting. Results: In total, 36 participants (mean age = 76 years, SD = 8.9, range 50–96) were fitted with devices. Although over half (right: 52.8%, left: 58.3%) presented with high-frequency loss, only 34% initially selected the corresponding program. Most participants (80.6%, n = 29) changed their selections at least once over the six months. Significant associations between hearing loss configuration and selection occurred at some time points only in the left ear, but agreement with clinically recommended programs declined from 42% at baseline to 28% at six months. Conclusions: CHW-facilitated hearing aid delivery supports user autonomy in low-resource settings. However, frequent changes and divergence from clinically recommended programs suggest reliance on user-driven trial-and-error adjustments rather than audiometric fit, which may limit long-term benefit. Ongoing, person-centred guidance is needed for the effective use of preset hearing aids. Full article

Particulate matter (PM2.5) is a critical indicator of air quality and has significant health implications. This study presents the development and evaluation of a custom-built PM2.5 device, named the P-Tracker, designed to offer an accessible alternative to commercially available air quality monitors. This paper presents the design framework used to address the requirements of a low-cost, accessible device which meets the performance of existing commercial systems. Step-by step build instructions are provided for hardware and software development and connection to the P-tracker open access website which displays the data and interactive map. To demonstrate the performance, the P-Tracker was compared against leading consumer devices, including the AtmoTube Pro by AtmoTech Inc., Flow by Plume Labs, View Plus by Airthings, and the Smart Citizen Kit 2.1 by Fab Lab Barcelona, across four controlled tests. The tests included: (1) a controlled paper combustion test in which all devices were exposed to combustion aerosols in a sealed environment alongside the DustTrak 8530 (TSI Incorporated, Shoreview, MN, USA), used as the gold standard reference, where the P-Tracker achieved a Pearson correlation of 0.99 with DustTrak over the final measurement period; (2) an outdoor test comparing readings with a stationary reference sensor, Osiris (Turnkey Instruments Ltd., Rudheath, UK), where the P-Tracker recorded a mean PM2.5 concentration of 3.08 µg/m³, closely aligning with the Osiris measurement of 3.53 µg/m³ and achieving a Pearson correlation of 0.77; (3) a controlled indoor air quality assessment, where the P-Tracker displayed stable readings with a standard deviation of 0.11 µg/m³, comparable to the AtmoTube Pro; and (4) a real-world kitchen environment test, where the P-Tracker effectively captured fluctuations in PM2.5 levels due to cooking activities, maintaining a consistent response with the DustTrak reference. The results indicate varied degrees of agreement across devices in different conditions, with the P-Tracker demonstrating strong correlation and low error margins in high-pollution and controlled scenarios. This research underscores the potential of open-source, low-cost, custom-built air quality sensors which may be developed and deployed by communities to provide hyperlocal measurements of air pollution. Full article

This study proposes a Personalized Deep Learning-Based Sleep Recommendation System Using Lifelog Data (PDSRS-LD). Traditional sleep research primarily relies on bio signals such as EEG and ECG recorded during sleep but often fails to sufficiently reflect the influence of daily activities on sleep quality. To address this limitation, we collect lifelog data such as stress levels, fatigue, and sleep satisfaction via wearable devices and use them to construct individual user profiles. Subsequently, real sleep data obtained from an AI-powered motion bed are incorporated for secondary training to enhance recommendation performance. PDSRS-LD considers comprehensive user data, including gender, age, and physical activity, to analyze the relationships among sleep quality, stress, and fatigue. Based on this analysis, the system provides personalized sleep improvement strategies. Experimental results demonstrate that the proposed system outperforms existing models in terms of F1 score and Average Precision (mAP). These results suggest that PDSRS-LD is effective for real-time, user-centric sleep management and holds significant potential for integration into future smart healthcare systems. Full article

A new energy storage unit, which is fed by a piezoelectric wind energy harvester, is explored. The outputs of a three-phase piezoelectric wind energy device have been initially recorded from the laboratory experiments. Following the records of voltage outputs, the power ranges of the device were measured at several hundred microwatts. The main issue of piezoelectric voltage generation is that voltage waveforms of piezoelectric materials have high total harmonic distortion (THD) with incredibly high subharmonics and superharmonics. Therefore, such a material reply causes a certain power loss at the output of the wind energy generator. In order to fix this problem, we propose a combination of a rectifier and a storage system, where they can operate compatibly under high THD rates (i.e., 125%). Due to high THD values, current–voltage characteristics are not linear-dependent; indeed, because of capacitive effect of the piezoelectric (i.e., lead zirconium titanite) material, harvested power from the material is reduced by nearly a factor of 20% in the output. That also negatively affects the storage on the Li-based battery. In order to compensate, the output waveform of the device, the waveforms, which are received from the energy-harvester device, are first rectified by a full-wave rectifier that has a maximum power point tracking (MPPT) unit. The SOC values prove that almost 40% of the charge is stored in 1.2 s under moderate wind speeds, such as 6.1 m/s. To conclude, a better harvesting performance has been obtained by storing the energy into the Li-ion battery under a current–voltage-controlled boost converter technique. Full article

Adolescents’ increasing screen time has been linked to poor sleep quality, which may, in turn, affect their academic performance. This study aimed to examine screen time patterns among Jordanian adolescents and assess their associations with sleep quality and academic achievement. A descriptive correlational study was conducted among 477 students aged 12–14 years from four randomly selected schools in northern Jordan. Participants completed the validated Questionnaire for Screen Time of Adolescents (QueST) and the Adolescent Sleep–Wake Scale–Short Version (ASWS-S), while academic performance was assessed using GPA from school records. Results showed that average screen time was 9.13 h per day. Weekend screen time emerged as a significant negative predictor of sleep quality (β = –0.27, p = 0.016). Gender and school type were also significant predictors. Adolescents with screen devices in their bedrooms and those with chronic medical conditions reported higher screen time. Although total screen time did not significantly predict academic achievement, it showed a moderate negative correlation with sleep quality (r = –0.18, p < 0.01). These findings suggest that excessive screen use, particularly on weekends, may impair sleep quality among adolescents. Interventions targeting screen habits could help enhance sleep and potentially benefit academic performance. Full article

Basketball is a high-intensity, intermittent sport in which physical demands fluctuate depending on different contextual variables. Most studies addressed these demands in isolation without integrative approaches. Therefore, the present study aimed to identify key variables explaining players’ physical workload across game quarters and playing positions through principal component analysis (PCA). Ninety-four elite U18 male basketball players were registered during the EuroLeague Basketball ANGT Finals using WIMU PRO™ multi-sensor wearable devices that integrate local positioning systems (LPS) and microelectromechanical systems (MEMS). From over 250 recorded variables, 31 were selected and analyzed by PCA for dimensionality reduction, analyzing the effects of game quarter and playing position. Five to eight principal components explained 61–73% of the variance per game quarter, while between four and seven components explained 64–69% per playing position. High-intensity variables showed strong component loadings in early quarters, with explosive distance (loading = 0.898 in total game, 0.645 in Q1) progressively declining to complete absence in Q4. Position-based analysis revealed specific workload profiles: guards required seven components to explain 69.25% of the variance, with complex movement patterns, forwards showed the highest explosive distance loading (0.810) among all positions, and centers demonstrated concentrated power demands, with PC1 explaining 34.12% of the variance, dominated by acceleration distance (loading = 0.887). These findings support situational and individualized training approaches, allowing coaches to design individual training programs, adjust rotation strategies during games, and replicate demanding scenarios in training while minimizing injury risk. Full article

Background: This study aimed to evaluate the influence of scleral contact lens (SCL) wear on optical coherence tomography (OCT) scan quality and structural measurements in patients with keratoconus. Methods: This retrospective observational study included 28 eyes of 28 keratoconus patients. All participants underwent a comprehensive ophthalmologic evaluation, including corneal topography and spectral-domain OCT (Optopol REVO 60). Two OCT measurement sessions were performed on the same day: one without SCLs and one after a 30–75 min adaptation period with Mini Misa^® scleral lenses. Recorded parameters included corneal and epithelial thicknesses, ganglion cell–inner plexiform layer (GCIPL) thickness, retinal nerve fiber layer (RNFL) thickness, and device-reported quality index (QI). Correlation analyses between topographic values, age, and OCT parameters were also conducted. Results: The mean age of participants was 32.96 ± 13.72 years. SCL wear significantly decreased anterior segment QI (6.76 ± 1.73 vs. 5.57 ± 2.34, p = 0.019) but improved posterior segment QI in both the ganglion (2.52 ± 1.03 vs. 5.76 ± 2.17, p < 0.001) and disc (2.82 ± 0.94 vs. 4.39 ± 1.87, p < 0.001) modules. Central corneal thickness remained stable, while central epithelial thickness decreased slightly (50.53 ± 6.66 µm vs. 47.59 ± 7.20 µm, p = 0.007). RNFL and GCIPL thicknesses showed no significant changes, except for minor sectoral variations. Steeper keratometry values correlated with lower QI in both conditions. Conclusions: SCLs enhanced posterior OCT scan quality while reducing anterior segment image clarity. These findings suggest that SCLs not only provide visual rehabilitation but also facilitate more reliable posterior segment imaging in keratoconus patients, despite mild interference with anterior segment OCT metrics. Further prospective studies are warranted to validate these results. Full article

The completeness and integrity of multimodal medical data are critical determinants of surgical success and postoperative recovery. However, because of issues such as poor sensor contact, small vibrations, and device discrepancies during signal acquisition, there are frequent missing values in patients’ medical data. This issue is especially prominent in rare or complex cases, where the inherent complexity and sparsity of multimodal data limit dataset diversity and degrade predictive model performance. As a result, clinicians’ understanding of patient conditions is restricted, and the development of robust algorithms to predict preoperative, intraoperative, and postoperative disease progression is hindered. To address these challenges, we propose Med-Diffusion, a diffusion-based generative framework designed to enhance sensor data by imputing missing multimodal clinical data, including both categorical and numerical variables. The framework integrates one-hot encoding, simulated bit encoding, and feature tokenization to improve adaptability to heterogeneous data types, utilizing conditional diffusion modeling for accurate data completion. Med-Diffusion effectively learns the underlying distributions of multimodal datasets, synthesizing plausible data for incomplete records, and it mitigates the data sparsity caused by poor sensor contact, vibrations, and device discrepancies. Extensive experiments demonstrate that Med-Diffusion accurately reconstructs missing multimodal clinical information and significantly enhances the performance of downstream predictive models. Full article

Multisensory behavioral research is increasingly aiming to move beyond traditional laboratories and into real-world settings. Smartphones offer a promising platform for this purpose, but their use in psychophysical experiments requires rigorous validation of their ability to precisely present multisensory stimuli and record reaction times (RTs). To date, no study has systematically assessed the feasibility of conducting RT-based multisensory paradigms on smartphones. In this study, we developed a reproducible validation method to quantify smartphones’ temporal precision in synchronized auditory–tactile stimulus delivery and RT logging. Applying this method to five Android devices, we identified two with sufficient precision. We also introduced a technique to enhance RT measurement by combining touchscreen and accelerometer data, effectively doubling the measure resolution—from 8.33 ms (limited by a 120 Hz refresh rate) to 4 ms. Using a top-performing device identified through our validation, we conducted an audio–tactile RT experiment with 20 healthy participants. Looming sounds were presented through headphones during a tactile detection task. Results showed that looming sounds reduced tactile RTs by 20–25 ms compared to static sounds, replicating a well-established multisensory effect linked to peripersonal space. These findings present a robust method for validating smartphones for cognitive research and demonstrate that high-precision audio–tactile paradigms can be reliably implemented on mobile devices. This work lays the groundwork for rigorous, scalable, and ecologically valid multisensory behavioral studies in naturalistic environments, expanding participant reach and enhancing the relevance of multisensory research. Full article

Background/Objectives: In view of demographic change and the increase in chronic illnesses, home care poses a considerable challenge. Telemedical technologies offer considerable potential for improving the quality of care and relieving the burden on family caregivers. With this study, we aim to develop appropriate training strategies for the use of telemedical applications in home care, focusing on the specific requirements of patients with dementia, heart failure, diabetes mellitus, chronic obstructive pulmonary disease, and stroke. Methods: A comprehensive survey was conducted among 31 family caregivers to record their experience with digital technologies and to analyze caregiver acceptance of these technologies and barriers to their use. The survey comprised 29 questions, including a mix of multiple-choice, Likert scale, and open-ended questions. The internal consistency of the questionnaire was high (Cronbach’s alpha = 0.8876). Results: The results show that although 32% of respondents already use digital technologies, there is a significant need for training and support. Key barriers identified include a lack of technical skills (cited by 45% of respondents), limited access to suitable devices (38%), and privacy concerns (35%). In addition, 90% of respondents expressed a willingness to participate in training programs. Conclusions: Based on the survey results, evidence-based recommendations are provided for the design of training programs tailored to the individual needs of family caregivers. Through a targeted combination of e-learning modules, webinars, and practical exercises, family caregivers can be empowered to take full advantage of telemedical technologies and thus significantly improve the quality of care at home. The results underscore the importance of overcoming technical barriers and providing comprehensive training to ensure the effective use of telemedicine in home care. Full article

Background: Despite the high prevalence of anterior cruciate ligament (ACL) surgeries, standardized, evidence-based rehabilitation protocols remain lacking. Digital medical devices (DMDs) like the “Orthelligent” system have gained relevance as adjuncts to traditional physiotherapy, offering continuous, objective monitoring of functional recovery. Methods: A retrospective cohort analysis included 335 patients who underwent ACL reconstruction and used the “Orthelligent home” system between August 2022 and December 2024. In total, 5675 recorded test and exercise events were analyzed. Functional recovery was assessed using the Limb Symmetry Index (LSI) across five defined rehabilitation phases (0–4). All patients followed a structured rehabilitation program aligned with current clinical practice guidelines, supplemented by Orthelligent as a home-based digital tool for daily monitoring. Results: Significant functional improvement was observed during early rehabilitation phases, with the LSI increasing from 0.64 ± 0.02 in phase 0 to 0.81 ± 0.01 in phase 2 (p < 0.001). Time since surgery was a significant positive predictor (p = 0.034), while pain showed a strong negative impact on performance (p < 0.001). Anthropometric factors had no significant effect. Exercises associated with high rates of drop-out, pain, or difficulty were identified and linked to specific rehab phases. Conclusions: This study demonstrates that digital rehabilitation monitoring can reliably reflect patient progress after ACL reconstruction. The early postoperative period (first 3 months) is critical for functional gains, highlighting the need for individualized, pain-sensitive rehabilitation strategies. Full article

Background/Objectives: Joint arthroplasty revision and comorbidities are considered two increased risk factors for periprosthetic joint infection (PJI), a complication that may lead to prolonged hospital stay, continued antibiotic therapy, and serious consequences, including amputation and, in extreme cases, death of the patient. DAC^® is an absorbable barrier in the form of a gel that, when applied as a coating, protects implants from bacterial colonization. The aim of this case–control study was to explore whether the device could decrease the risk of PJI in a cohort of patients who underwent arthroplasty revision and were affected by comorbidities. Methods: We carried out a retrospective 1:1-matched case–control investigation in 96 patients who underwent arthroplasty revision between January 2023 and December 2024; these patients had at least 6 months of follow-up, had comorbidities, and were treated with DAC^® gel. The control group consisted of 96 subjects who received standard of care. Demographics, comorbidities, type of arthroplasty, adverse event onset, and incidence of PJI were recorded for all patients. Results: No significant differences in relevant demographics, type of arthroplasty revision, or number or type of comorbidities, except for smoking, were observed between the two groups. At 6-month follow-up, no PJIs were recorded in the DAC^® treatment group, whereas five (5.2%) PJIs were observed in the control group (p = 0.0235). No adverse event or impairment of implant osseointegration related to the use of DAC^® was observed. Conclusions: The DAC^® bioabsorbable hydrogel acts as a physical barrier when applied over an arthroplasty revision implant, protecting it from bacterial adhesion and preventing biofilm formation. Full article

Objective: To explore the lived experiences of type 2 diabetes mellitus (T2DM) patients undergoing peritoneal dialysis (PD) or hemodialysis (HD) using continuous glucose monitoring (CGM). Research Design and Methods: A qualitative phenomenological study was conducted with 50 adult T2DM patients on PD or HD who used CGM for at least 14 days. Semi-structured interviews were audio-recorded and transcribed verbatim. A thematic analysis framework was applied to identify major themes regarding insulin management, CGM utilization, and emotional and social dimensions. Results: Four main themes emerged, each with multiple subthemes. PD patients emphasized enhanced autonomy and frequent insulin adjustments due to dialysate glucose absorption. Conversely, HD patients reported severe post-dialysis fatigue, emotional distress, and limited social engagement often associated with intra-dialytic hypoglycemia. CGM was valued by 85% of participants for improving metabolic awareness and self-management. However, 15% reported barriers such as device cost and technical difficulties. The insights clearly distinguish the differential impact of dialysis modality on daily glucose control and patient well-being. Conclusions: These findings underscore the critical need for patient-centered care incorporating access to CGM and tailored insulin regimens. Equitable implementation of CGM in dialysis settings could significantly enhance glycemic control, emotional resilience, and overall quality of life. Full article

Can brightness illusions modulate ocular accommodation? Previous studies have shown that brightness illusions can influence pupil size as if caused by actual luminance increases. However, their effects on other ocular responses—such as accommodative or focusing dynamics—remain largely unexplored. This study investigates the influence of brightness illusions, under two ambient lighting conditions, on accommodative and pupillary dynamics (physiological responses), and on perceived brightness and visual comfort (subjective responses). Thirty-two young adults with healthy vision viewed four stimulus types (blue bright and non-bright, yellow bright and non-bright) under low- and high-contrast ambient lighting while ocular responses were recorded using a WAM-5500 open-field autorefractor. Brightness and comfort were rated after each session. The results showed that high ambient contrast (mesopic) and brightness illusions increased accommodative variability, while yellow stimuli elicited a greater lag under photopic condition. Pupil size decreased only under mesopic lighting. Perceived brightness was enhanced by brightness illusions and blue color, whereas visual comfort decreased for bright illusions, especially under low light. These findings suggest that ambient lighting and visual stimulus properties modulate both physiological and subjective responses, highlighting the need for dynamic accommodative assessment and visually ergonomic display design to reduce visual fatigue during digital device use. Full article