Search Results (700)

This paper presents the design and evaluation of a lightweight, minimally actuated lower limb exoskeleton that emphasizes hip–knee coordination for natural and efficient gait assistance. The system adopts a hip-only motorized actuation strategy in combination with an electromagnetically controlled knee locking mechanism, ensuring rigid stability during stance while providing compliant assistance during swing. To support sit-to-stand transitions, a gas spring–ratchet mechanism is integrated, which remains disengaged in the seated position, delivers assistive torque during rising, and provides cushioning during the descent to enhance safety and comfort. The control framework fuses foot pressure and thigh-mounted IMU signals for finite state machine (FSM)-based gait phase detection and employs a fuzzy PID controller to achieve adaptive hip torque regulation with coordinated hip–knee control. Preliminary human-subject experiments demonstrate that the proposed design enhances lower-limb coordination, reduces muscle activation, and improves gait smoothness. By integrating a minimal-actuation architecture, a practical sit-to-stand assist module, and an intelligent control strategy, this exoskeleton strikes an effective balance between mechanical simplicity, functional support, and gait naturalness, offering a promising solution for everyday mobility assistance in elderly or mobility-impaired users. Full article

Background: Physical frailty is a prevalent and clinically important manifestation of COPD. While the ERS/ATS recommends the Short Physical Performance Battery (SPPB), handgrip strength (HGS), 30 s sit-to-stand (30secSTS), and Timed-Up-and-Go (TUG) as frailty screening tools, their agreement and predictive performance remain unclear. Furthermore, the trajectory of frailty is poorly understood in patients who decline pulmonary rehabilitation (PR). Objective: To assess the prevalence of and change in physical frailty and its association with 12-month all-cause hospitalizations and mortality. Secondarily, to assess the agreement and predictive value (positive; PPV/negative; NPV) of recommended screening tests in COPD patients declining PR. Methods: In this prospective cohort study, 102 patients with COPD (61 females, mean ± SD age 70 ± 9 years, FEV₁ 34 ± 11%, SPPB 8.0 ± 3.2 points, CAT 19 ± 7) underwent repeated frailty assessments at baseline and after 12 months using the SPPB (reference), TUG, 30secSTS, and HGS. Results: At baseline, 39% were physically frail (SPPB ≤ 7). Frailty persisted in 86%, and 23% had died at 12 months. Baseline age-adjusted physical frailty was not statistically associated with 12-month all-cause hospitalization (OR 1.79 [0.61–5.24]) or mortality (OR 3.54 [0.95–13.16]). Agreement with SPPB was moderate for TUG (κ = 0.53) and fair for 30secSTS (κ = 0.38) and HGS (κ = 0.26), with similar findings at 12 months. TUG had the highest PPV/NPV (0.85/0.71). Conclusions: Physical frailty is prevalent and persistent in patients with severe COPD who decline PR. ERS/ATS-recommended tools showed fair to moderate agreement and predictive value. TUG was the most robust proxy, though tool selection should be guided by clinical context and purpose. Full article

Prolonged poor sitting posture increases the risk of musculoskeletal disorders and chronic diseases. We developed a smart cushion system that integrated pressure sensing and machine learning for posture recognition. Nine FSR406 sensors were used to measure pressure distribution on the system. A calibration and normalization process improves data consistency, and a heatmap visualizes the result. Among the five machine learning models evaluated, the narrow neural network achieved the best performance, with a validation accuracy of 97.63% and a test accuracy of 91.73%. When body mass index (BMI) was included as an additional input feature, the test accuracy improved to 95.49%, indicating that BMI positively impacts recognition performance. Full article

Background: Exercise is known to help with the effects of the menopause, but women from low socioeconomic status (SES) tend to exercise less at this stage of life. Therefore, this study aimed to investigate the physical and psychological effects of a Zumba Gold^® community-based intervention in postmenopausal women from low SES. Methods: Forty-three women were divided into a Zumba Gold^® (ZG) and control (C) group, and participated in pre- and post-testing sessions, separated by a 12-week intervention period. The outcomes measured were: body composition, sit-to-stand (STS), six-minute walk test (6MWT), balance, Short Form Health Survey (SF-12), Multidimensional Fatigue Index (MFI-20), Self-Efficacy for Exercise (SEE), Behavioral Regulations in Exercise (BREQ-2), Hospital Anxiety and Depression Scale (HADS), and Social Connectedness questionnaires. Semi-structured interviews were also performed on 15 ZG participants. Results: The results showed significant improvements in the ZG group only for STS, 6MWT, mental health, fatigue (general, physical, and mental), social connectedness score, and a significantly lower level of amotivation. Zumba Gold^® had positive effects on four main themes: belonging, non-judgmental place, psychological motivational factors, and mind–body connection. Conclusions:This is the first study to show that ZG is beneficial for this population and encourages similar studies on other aspects of the menopause. Full article

To prepare for a boosted sterile insect technique (SIT) field trial in Saint-Joseph, Reunion island, we compared the attractiveness of two adult mosquito traps for Aedes albopictus and Aedes aegypti. In addition, we explored the co-occurrence of these species in their usual larval habitats. Two traps were compared with two conditions each using a Latin square design: BG Sentinel trap baited with carbon dioxide (CO₂) with/without addition of BG Lure and ovi-sticky trap with/without hay. The ovi-sticky traps proved ineffective. For both Aedes species, CO₂-baited traps were equally effective at catching females when baited with the lure or not. In contrast, they were more attractive to males than for females with the lure. Aedes aegypti larvae were found in four of six vacoas (Pandanus utilis), and one of four anthropogenic breeding sites. In vacoas, the densities of Aedes albopictus and Aedes aegypti larvae were negatively correlated, whereas the correlation was positive between chironomids and Aedes aegypti. The abundance of adults and larvae varied according to weather conditions. Finally, CO₂-baited traps were used without lure for the entomological monitoring to assess the effectiveness of the area-wide boosted SIT intervention to reduce costs and logistics. Full article

Objectives: The central nervous system plays a fundamental role in chronic pain; however, its behavior in this condition remains unclear, especially when associated with interventions such as kinesiotaping (KT). This study aimed to analyze the effects of KT on the somatosensory cortex of women with chronic low back pain. Methods: This case series involved 15 women with chronic low back pain. Participants underwent a progressive-tension KT protocol for 8 weeks, and electroencephalogram recordings were performed in two positions, namely sitting and standing while load bearing (10% of body weight), in the first and eighth weeks. The following instruments were employed: Oswestry lumbar disability index, fear avoidance beliefs questionnaire, and the numerical pain intensity scale. Results: All participants showed significant pain improvement and a reduction in Oswestry disability index scores from moderate to minimal. Additionally, activity in the alpha band within the somatosensory cortex and insula (central region—represented by the electrode Cz) decreased. This was confirmed by reduced power spectral density, indicating diminished cortical activity in these regions. Conclusions: KT positively affects women with chronic low back pain, providing pain reduction and improved functional capacity, as indicated by the fear avoidance beliefs questionnaire and numerical pain intensity scale. Moreover, KT reduces cortical activity in the somatosensory cortex, which is related to the progression of painful sensations, described above after the intervention. Full article

Background and Objectives: Urinary incontinence (UI) is a prevalent issue among older adults and may require urodynamic studies (UDSs) for accurate diagnosis. However, these procedures can be uncomfortable and time-consuming, especially in a geriatric population, where certain practical restrictions may apply. This study examines whether posture of filling cystometry during UDSs in an older patient group affects diagnostic outcomes and whether a single UDS in one posture is sufficient for a reliable diagnosis or if multiple postures provide added value. Materials and Methods: This is a secondary analysis of the Think Dry: Optimalisation of Diagnostic Process of Urinary Incontinence in Older People study (NCT04094753), a prospective observational cohort study. Each patient underwent both sitting and standing filling cystometry during UDS. The final diagnosis was determined by the referring urologist by integrating results from both the sitting and standing groups alongside all available clinical data. Subsequently, each separate UDS was reviewed independently by a second, blinded, urologist, and a diagnosis was established based on a single UDS. The agreement between these independent diagnoses and the final diagnosis was then evaluated using Cohen’s kappa coefficient (κ). Results: Results from the UDS with the standing filling cystometry had an almost perfect agreement (κ = 0.92) with the final diagnosis, compared to only a moderate agreement (κ = 0.42) while sitting. Conclusions: UDS with standing filling cystometry may be sufficient for an accurate diagnosis, potentially eliminating the need for additional filling cystometry in the sitting position. By streamlining the diagnostic process, this approach could enhance efficiency, reduce patient burden, and optimize resource utilization in older adults. Full article

16S rRNA next-generation sequencing (NGS) has significantly advanced cervicovaginal microbiome profiling, offering insights into the relationship between vaginal dysbiosis and HPV-associated carcinogenesis. However, reliance on a limited set of 16S hypervariable regions introduces inherent biases that impact results. This study developed standardized workflows for 16S/ITS NGS, with a focus on identifying methodological biases that influence microbial abundance and taxonomic specificity. Commercial NGS tools were employed, including the 16S/ITS QIAseq V1–V9 screening panel, ATCC vaginal microbial standard, and CLC Genomics Workbench integrated with a customized database (VAGIBIOTA) for analysis. The microbial communities of 66 cervical cytology samples were characterized. Among the regions tested, V3V4 exhibited the least quantitative bias, while V1V2 offered the highest specificity. Microbial profiles and Community State Types (CST) (I–V) were broadly consistent with prior studies, with Lactobacillus abundance clustering into three states: L.-dominant (CST I–III, V), L.-diminished (CST IV-A), and L.-depleted (CST IV-B). Differential abundance analysis revealed that anaerobic opportunistic pathogens dominant in CST IV-B (dysbiosis) were also enriched in HSIL and HPV-16 positive samples. Our findings revealed distinct differences in species identification across 16S rRNA hypervariable regions, emphasizing the importance of region selection in clarifying microbial contributions to HPV-associated carcinogenesis. Full article

Background/Objectives: Persons with Parkinson’s disease (PD) are at elevated risk of falling due to deficits in postural control, lower limb strength, and sensory integration. While community-based boxing programs (CBPs) have shown promise in improving strength and balance, their feasibility and potential role in addressing fall risk remain unclear. This preliminary, prospective cohort study explored the feasibility of a CBP enhanced with individualized balance training tailored to somatosensory deficits and explored early indications of potential impact on fall risk and related outcomes. Methods: Twenty individuals with mild-to-moderate PD participated in a 12-week exercise program consisting of group-based boxing, functional circuit training, and one-on-one balance training based on the Modified Clinical Test of Sensory Interaction in Balance. Self-reported falls were collected at baseline and 3 months post-intervention. Secondary outcomes included standard measures of balance, gait, and functional mobility. Results: Participants demonstrated significant improvements in balance and functional mobility including the Timed Up and Go (F(2, 40.85) = 24.83, p < 0.001, η² = 0.580), Five Times Sit-to-Stand Test (F(2, 78.13) = 50.22, p < 0.001, η² = 0.736), and Berg Balance Scale (F(2, 193.39) = 12.72, p < 0.001, η² = 0.414), among others. 4 participants experienced a decrease in falls, 2 experienced an increase, and the remainder had no change. Conclusions: These preliminary findings suggest that integrating individualized balance training with a CBP is feasible and may positively influence functional mobility and balance in persons with PD. However, effects on fall reduction remain inconclusive. These results should be interpreted as exploratory and used to inform the design of future structured clinical trials. Full article

The half-sitting posture is essential for many functional tasks performed by industrial workers. Thus, passive lower-limb exoskeletons, known as wearable chairs, are increasingly used to relieve lower-limb loading in such scenarios. However, although these devices lighten muscle effort during half-sitting tasks, they can disrupt walking mechanics and balance. Moreover, rigorous biomechanical data on joint moments and contact forces during walking with such a device remain scarce. Therefore, this study conducted a biomechanical evaluation of level walking with a wearable chair to quantify its effects on gait and joint loading. Participants performed walking experiments with and without the wearable chair. An optical motion capture system and force plates collected kinematic and ground reaction data. Six-axis force sensors measured contact forces and moments. These measurements were fed into a Newton–Euler inverse dynamics model to estimate lower-limb joint moments and assess joint loading. The contact measurements showed that nearly all rotational load was absorbed at the thigh attachment, while the ankle attachment served mainly as a positional guide with minimal moment transfer. The inverse dynamics analysis revealed that the wearable chair introduced unintended rotational stresses at lower-limb joints, potentially elevating musculoskeletal risk. This detailed biomechanical evidence underpins targeted design refinements to redistribute loads and better protect lower-limb joints. Full article

This case report investigated the cause of visual impairment at night in Beagle dogs in a family of 12 individuals. Four related adult male Beagles with impaired night vision and eight related Beagles (three females, five males) underwent a complete ophthalmological examination at the ophthalmology service. Electroretinography was performed on four dogs with impaired night vision after dark adaptation to evaluate retinal function. Retinoscopy was performed in 12 dogs in a standing or sitting position to assess refraction. Axial globe measurements were conducted using B-scan ultrasonography in nine dogs. In total, twelve adult Beagles (nine males, three females) from four generations were evaluated, with nine dogs showing impaired night vision. Ophthalmic examinations revealed no abnormalities that could explain the visual impairment. Electroretinography showed normal retinal function. In total, 83.3% (10/12) of the dogs were myopic, with refractive errors ranging from −1.25 to −6.25 diopters (D). All dogs with night vision impairment were significantly more myopic (median: −4.88 D) than those without impairment (median: −1.25 D). In two myopic dogs, the insertion of contact lenses improved navigation in the dark maze test. Myopic dogs showed a significantly greater vitreous body depth (10.1 mm; range 9.7–10.3 mm) compared to emmetropic dogs (9.5 mm; range: 9.4–9.6 mm). These findings suggest that in dogs with night vision impairment, retinoscopy should be included in the ophthalmological exam to exclude myopia as a potential cause. Further research is needed to determine the cause of myopia in the tested Beagles and to investigate possible genetic factors. Full article

Background: Emerging parameters, such as the spino-pelvic unit and the combined sagittal index (CSI), are gaining importance in evaluating and optimizing implant positioning in total hip arthroplasty (THA). Our institution adopts the “femur first” technique to achieve the desired combined anteversion (CA). The purpose of this study is to evaluate the role of the ‘femur first’ technique and spinopelvic characteristics in achieving the CSI_standing ‘safe zone’ in primary THA. Methods: Consecutive patients undergoing primary THA were included in the present retrospective study. All patients underwent radiographic assessments in the standing position with the EOS 2D/3D radiography system. Results: Forty patients (40 hips) were enrolled. Of these, 34 patients fell inside the CSI_standing “safe zone” (205–245°). When considering the restricted CSI_standing “safe zone” for patients at high risk for adverse spinopelvic characteristics (215–245°), only 16 patients fell inside the range. We demonstrated a positive linear correlation between CSI_standing and CA (p < 0.0001). Pelvic tilt (PT) showed a positive correlation both in standing and relaxed sitting positions, (p < 0.001). Sacral slope (SS) showed a significant positive correlation in the relaxed sitting (p = 0.003) position but not in the standing position (p = 0.34). The correlation analysis between CSI_{relaxed-sitting} and ΔSS showed a positive correlation (p = 0.003). Conclusions: The “femur first” technique is able to achieve the CSI “safe zone” in most patients; however, it seems insufficient in those with adverse spinopelvic characteristics, who are at higher risk of dislocation. Moreover, the CA, the position of the pelvis in space (PT), and its mobility (ΔSS) greatly influence the CSI “safe zone” in patients undergoing primary THA. Full article

Background/Objectives: Aging is associated with a gradual decline in physical capabilities, often leading to impaired balance and reduced functional status, which are major contributors to falls in older adults. Although many studies have assessed these variables independently, a limited amount of research has explored the direct relationship between balance and functional status in a healthy geriatric population. The aim of this study was to investigate the relationship between balance and functional capacity and to assess the influence of demographic factors such as age, comorbidities, smoking status, and history of falls. Methods: A sample of community-dwelling older adults (19 women, 16 men) (n = 35), aged 60 years and above (M = 78 years; SD = 9.23) from Sparta, Greece, took part in the present study. Participants were assessed using three validated tools: (a) the Five Times Sit-to-Stand test, (b) the Timed Up-and-Go test, and (c) the Berg Balance Scale. Spearman’s rank correlation coefficient was used for statistical analysis (α = 0.05). Results: Age was positively correlated with poorer performance in the Five Times Sit-to-Stand (r = 0.40; p < 0.01) and the Timed Up-and-Go test (r = 0.47; p < 0.01) and negatively correlated with Berg Balance Scale scores (r = −0.51; p < 0.01). Comorbidities and smoking were also associated with the Berg Balance Scale. A strong negative correlation was observed between balance and the other two functional tests (Five Times Sit-to-Stand: r = −0.51; Timed Up-and-Go: r = −0.66; both p < 0.01). Conclusions: The findings highlight the importance of evaluating both balance and functional capacity in older adults as interrelated factors that can significantly influence quality of life and fall risk. Future research with larger and more diverse populations is recommended to confirm the present findings and to use exercise programs to prevent falls in the geriatric population. Full article

Background: This study examines balance, flexibility and self-esteem among healthy individuals who engage in surfing compared to those who do not surf. Methods: A cross-sectional study design was conducted with 124 participants divided into the following groups: Group 1: Surfers n = 42; Group 2: individuals performing over 3 h of physical activity per week n = 43; and Group 3: individuals performing fewer than 3 h of physical activity per week n = 39. To assess balance, the Star Excursion Balance Test (SEBT) and the Flamenco Test (FBT) were used, the sit-and-reach test (SRT) was used to measure hamstring extensibility, the Rosenberg Scale was used to measure self-esteem, and the International Physical Activity Questionnaire (IPAQ) was used to measure physical activity levels. Results: Regarding descriptive characteristics, G1 participants were significant older than those of G2 and G3 (p < 0.05 and p < 0.001, respectively). Moreover, there was a higher proportion of females in G3 than in G1 and G2 (p < 0.05). The results revealed significant differences in balance between the surfers and those engaging in fewer than 3 h of activity per week (p < 0.05). G1 obtained significantly higher results in SEBT-left leg than G2 and G3 (p < 0.001) and higher result in SEBT-right leg and FBT than G3 (p < 0.05) but no significant differences in self-esteem were found. Significant differences in flexibility were observed between males and females (p < 0.001). Conclusions: This result suggests that surfing could have a positive effect on balance. Full article

Graphene quantum dots (GQDs) obtained by microwave-induced pyrolysis of glutamic acid and triethylenetetramine (trien) are fairly stable, emissive, water-soluble, and positively charged nano-systems able to interact with negatively charged meso-tetrakis(4-sulfonatophenyl) porphyrin (TPPS₄). The stoichiometric control during the preparation affords a supramolecular adduct, GQDs@TPPS₄, that exhibits a double fluorescence emission from both the GQDs and the TPPS₄ fluorophores. These supramolecular aggregates have an overall negative charge that is responsible for the condensation of cations in the nearby aqueous layer, and a three-fold acceleration of the metalation rates of Cu²⁺ ions has been observed with respect to the parent porphyrin. Addition of various metal ions leads to some changes in the UV/Vis spectra and has a different impact on the fluorescence emission of GQDs and TPPS₄. The quenching efficiency of the TPPS₄ emission follows the order Cu²⁺ > Hg²⁺ > Cd²⁺ > Pb²⁺ ~ Zn²⁺ ~ Co²⁺ ~ Ni²⁺ > Mn²⁺ ~ Cr³⁺ >> Mg²⁺ ~ Ca²⁺ ~ Ba²⁺, and it has been related to literature data and to the sitting-atop mechanism that large transition metal ions (e.g., Hg²⁺ and Cd²⁺) exhibit in their interaction with the macrocyclic nitrogen atoms of the porphyrin, inducing distortion and accelerating the insertion of smaller metal ions, such as Zn²⁺. For the most relevant metal ions, emission quenching of the porphyrin evidences a linear behavior in the micromolar range, with the emission of the GQDs being moderately affected through a filter effect. Deliberate pollution of the samples with Zn²⁺ reveals the ability of the GQDs@TPPS₄ adduct to detect sensitively Cu²⁺, Hg^2+, and Cd²⁺ ions. Full article