Search Results (36)

Background: Lateral epicondylopathy is commonly approached as a tendinopathic disorder of the common extensor origin; however, persistent lateral elbow pain may also involve a superficial sensory nerve component related to the posterior antebrachial cutaneous nerve (PABCN). This proof-of-concept cadaveric anatomical feasibility study evaluated whether a single-window, humerus-parallel ultrasound-guided injectate pathway could simultaneously reach the superficial PABCN-related fascial plane and the common extensor origin. Methods: One fresh-frozen male cadaveric donor was used, and both elbows were injected under real-time ultrasound guidance. With the elbow flexed and the forearm pronated, the transducer was aligned parallel to the long axis of the humerus over the lateral epicondylar region. A 23-gauge, 6 cm needle was advanced in plane from distal to proximal over the common extensor aponeurosis, and 10 mL of 1% methylene blue was injected into each elbow. Layer-by-layer anatomical dissection was then performed by an anatomist who was not involved in the injection procedure. Gross linear dye spread was measured directly during dissection using the distal needle entry point as the reference point, and ruler-containing photographs were additionally reviewed using ImageJ software for supportive image-assisted assessment. Results: In both elbows, methylene blue stained the superficial PABCN-related fascial plane, including the anterior and posterior branches of the PABCN, and concomitantly covered the common extensor aponeurosis and lateral epicondylar enthesis. Dye spread measured approximately 10 cm proximally, 5 cm distally, and 4 cm anteriorly. No gross intra-articular dye deposition or focal intramuscular pooling was observed. Conclusions: This proof-of-concept cadaveric study demonstrates the anatomical plausibility of a single-window, enthesis-centered ultrasound-guided injectate pathway that includes both the superficial PABCN-related plane and the common extensor origin. These findings should be interpreted as descriptive anatomical feasibility observations and do not establish reproducibility across anatomical variants, clinical efficacy, safety, or procedural superiority. Full article

As Open Radio Access Network (O-RAN) deployments expand and adversaries adopt “store-now, decrypt-later” strategies, operators need empirical data on the cost of migrating critical control interfaces to post-quantum cryptography (PQC). This paper experimentally evaluates the impact of integrating a NIST-aligned Module-Lattice Key-Encapsulation Mechanism (ML-KEM) into IKEv2/IPsec, protecting the E2 interface between the 5G Node B (gNB) and the Near-Real-Time RAN Intelligent Controller (Near-RT RIC). Using an open-source testbed built from srsRAN, Open5GS, FlexRIC and strongSwan (with liboqs), we compare three configurations: no IPsec, classical Elliptic Curve Diffie–Hellman (ECDH)-based IPsec, and ML-KEM-based IPsec. This study focuses on IPsec tunnel-setup latency and the runtime behaviour of Near-RT RIC xApps under realistic signalling workloads. Results from repeated, automated runs show that ML-KEM integration adds a small overhead to tunnel establishment, which is approximately 2.7~4.7 ms in comparison to classical IPsec, while xApp operation and RIC control loops remain stable in our experiments. These findings, produced from an open, reproducible testbed, indicate that ML-KEM-based IPsec on the E2 interface is practically feasible and inform quantum-safe migration strategies for O-RAN deployments. Full article

Background/Objectives: Management of bipolar disorder is marked by variability in lithium response, with responders constituting a distinct clinical subgroup. Although pharmacogenetic studies implicate polymorphisms in neuroplasticity-related genes (BDNF) and hypothalamic–pituitary–adrenal (HPA) axis regulators (NR3C1), the underlying biophysical mechanisms remain poorly characterized. This study aims to bridge this structural–mechanistic gap by quantifying the atomic-level effects of key lithium-response polymorphisms on protein–protein interaction stability and conformational dynamics. Methods: Variant sequences for BDNF rs6265 and NR3C1 rs56149945 were generated and structurally modeled with SWISS-MODEL. Protein–protein interaction analyses focused on the BDNF–TrkB and NR3C1–FKBP5 systems. Structural alignment and conformational comparisons were performed with ChimeraX and US-align, while interaction energetics were evaluated with PRODIGY and HawkDock. Conformational flexibility was assessed using CABS-flex through RMSF analysis. Results: Structural validation showed acceptable model quality. Binding analyses indicated stronger interactions in the variant complexes. In the BDNF–TrkB complex, binding affinity shifted from −13.8 to −15.1 kcal/mol with an ~8.5-fold lower dissociation constant, while the NR3C1–FKBP5 variant complex shifted from −16.3 to −18.8 kcal/mol with an ~65-fold lower dissociation constant. MM/GBSA calculations supported increased stability, with binding energies changing from −61.98 to −83.91 kcal/mol (BDNF–TrkB) and from −18.88 to −31.25 kcal/mol (NR3C1–FKBP5). Structural superposition showed high conservation of global folds (pruned RMSD 0.779 Å and 0.310 Å; TM-scores 0.753 and 0.967). RMSF profiles were largely overlapping, indicating localized interface adjustments rather than global conformational changes. Conclusions: These findings suggest that lithium-response polymorphisms may modulate protein–protein interaction stability while preserving overall structure, providing a structural framework for exploring genetic influences on lithium treatment response. Full article

Background/Objectives: Choosing the best prosthetic foot for a patient is complicated by the many available options and limited evidence to distinguish them. This work aimed to clarify performance differences in the level-ground walking of K3-functional-level persons with amputations across a variety of prosthetic feet within the energy storage and return class. Methods: This clinical trial assessed 10 subjects fitted with the Ossur ProFlex foot (LP and XC) compared to their original foot after a 30-day adaptation period and careful prosthetic alignment matching. Multivariate data (walking performance, noise/play, balance and satisfaction) were collected in the gait laboratory. Results: Results were mixed across the cohort. MCID and statistical analysis were used to assess the magnitude and importance of the changes observed. Overall, the changes were small and not statistically significant. Conclusions: Our findings support that performance across a variety of measures for K3-level amputees walking over level ground is relatively insensitive to prosthetic foot componentry within the energy storage and return class. While functional performance is not the only metric that contributes to foot choice, it is an important one. This study helps to circumscribe its role in the larger decision-making framework for this class of componentry in persons with transtibial amputation. Full article

The increasing demand for sustainable polymer composites has driven the development of hybrid laminates that combine natural, recycled, and synthetic reinforcements while maintaining adequate mechanical performance. However, the combined influence of stacking sequence and mineral filler addition on the mechanical behavior of such sustainable hybrid systems remains insufficiently understood. In this study, sustainable hybrid laminated composites based on epoxy reinforced with glass fiber (G), bamboo fiber (B), and flex banner (F) were fabricated with varying stacking sequences and calcium carbonate (CaCO₃) filler contents (0 and 1 wt.%). A total of nine laminate configurations were produced and evaluated through flexural and impact testing. The results demonstrate that mechanical performance is strongly governed by laminate architecture and filler addition. The bamboo-dominant G/B/B/B/G laminate containing 1 wt.% CaCO₃ exhibited the highest flexural strength (191 MPa) and impact resistance (0.766 J/mm²), indicating a synergistic effect between reinforcement arrangement and CaCO₃-induced matrix strengthening. In contrast, the lowest performance was observed for the G/F/B/F/G configuration without filler. Overall, all hybrid composites outperformed neat epoxy, highlighting the potential of bamboo–flex banner hybrid laminates with CaCO₃ filler for sustainable composite applications requiring balanced mechanical properties. This work aligns with SDG 12 by promoting resource-efficient circular-economy practices through the utilization of flex banner material and natural fibers as reinforcements in epoxy-based hybrid composites. Full article

Lexicographic preference trees (LP-Trees) provide a compact and expressive representation for modeling complex decision-making scenarios, yet measuring similarity between complete or partial structures remains a challenge. This study introduces PLPSim, a novel metric for quantifying alignment between partial lexicographic preference trees (PLP-Trees) and develops three coalition formation algorithms—HRECS1, HRECS2, and HRECS3—that leverage PLPSim to group agents with similar preferences. We further propose ContractLex and PriceLex protocols (comprising CLF, CFB, CFW, CFA, CFP) for coalition-based contract and pricing strategies, along with a new evaluation metric, F@Lex, which is designed to assess satisfaction under lexicographic preferences. To illustrate the framework, we generate a synthetic dataset (PLPGen) contextualized in a hybrid renewable energy market, where consumers’ PLP-Trees are aggregated and matched with suppliers’ tariff contracts. Experiments across 162 market scenarios, evaluated using Normalized Discounted Cumulative Gain (nDCG), Davies–Bouldin dispersion, and F@Lex, demonstrate that PLPSim-based coalitions outperform baseline approaches. The combination HRECS3 + CFP yields the highest consumer satisfaction, while HRECS3 + CFB achieves balanced satisfaction for both consumers and suppliers. While electricity tariffs and renewable energy contracts—static and dynamic—serve as the motivating example, the proposed framework generalizes to diverse multi-agent systems, offering a foundation for preference-driven coalition formation, adaptive policy design, and sustainable market optimization. Full article

Background: The skin-to-transverse process distance (st) correlates with the skin-to-dural sac depth (d) and may be used to estimate optimal angles for perpendicular needle insertion using the formula inverse cosine d/√(1 + d²), as outlined in free visual guides. Objective: We aimed to analyze the relationship between the transverse process and dural sac depth at lumbar levels relevant to spinal anesthesia and to determine the range of planes where perpendicular paramedian needle insertion is feasible when midline access is not viable. Methods: Ten ex vivo trunks were flexed using an abdominal support, and CT scans were performed. Correlations between the transverse process and dural sac depth were evaluated from L3 to S1. Perpendicular planes at the level of needle paths were examined at L3–L4 and L4–L5. Median path viability was assessed. Results: The transverse process aligned with the dorsal dural sac at L3, the posterior third at L4, and the middle zone at L5 or S1. Median needle insertion was not viable in 20–30% of L4–L5 and L3–L4 levels, respectively. However, paramedian access was possible. The vertical range of viable paramedian planes was 8.7 ± 2.9 mm (L4–L5) and 7.9 ± 1.9 mm (L3–L4). Coronal reconstructions showed that the upper level of the transverse process correlates with the skin-perpendicular planes where insertion is likely to succeed. Conclusion: Many elderly spines lack viable midline paths. The superior aspect of the transverse process serves as a useful landmark for estimating dural sac depth, calculating paramedian angles, and identifying the plane for successful perpendicular needle insertion. Full article

Monitoring physiological activity and sleep states in real time is challenging, particularly for continuous assessment in daily life settings using wearable IoMT devices. We developed a 24 h wearable system that integrates electrocardiogram (ECG) electrodes for heart rate measurement and a glove-mounted flex sensor for motor responses, connected through an Internet of Medical Things (IoMT) platform. Flex signals were combined using principal component analysis (PCA) to generate a single kinematic channel, then standardized with heart rate. Time-series windows were embedded using TS2Vec and clustered with DBSCAN, while t-SNE was applied only for visualization. The framework identified four physiologically coherent states: (i) nocturnal sleep with the lowest heart rate and minimal motion, (ii) evening pre-sleep with low movement and moderately higher heart rate, (iii) daytime activity with variable motion and mid-range heart rate, and (iv) late-day high-intensity activity with the highest heart rate and increased motor responses. A few outliers were observed during transient body movements or sensor readjustments, which were identified and excluded during preprocessing to ensure stable clustering results. Across 24 h, heart rate ranged from 52 to 96 bpm (mean 77.4), while flexion spanned 0 to 165° (mean 52.5°), showing alignment between movement intensity and cardiac response. This integrated sensing and analytics pipeline provides an interpretable, subject-specific state map that enables continuous remote monitoring of physiological activity and sleep patterns. Full article

This study introduces a hybrid Brain–Computer (BCI) system with a robust and secure activation mechanism between sessions, aiming to minimize the negative effects of visual stimulus-based BCI systems on user eye health. The system is based on the integration of Electroencephalography (EEG) signals and Electrooculography (EOG) artefacts, and includes an LED stimulus operating at a frequency of 7 Hz for safe activation and objects moving in different directions. While the LED functions as an activation switch that reduces visual fatigue caused by traditional visual stimuli, moving objects provide command generation depending on the user’s intention. In order to evaluate the stability of the system against physiological and psychological conditions, data were collected from 15 participants in two different sessions. The Correlation Alignment (CORAL) method was applied to the data to reduce the variance between sessions and to increase stability. A Bootstrap Aggregating algorithm was used in the classification processes, and with the CORAL method, the system accuracy rate was increased from 81.54% to 94.29%. Compared to similar BCI approaches, the proposed system offers a safe activation mechanism that effectively adapts to users’ changing cognitive states throughout the day by reducing visual fatigue, despite using a low number of EEG channels, and demonstrates its practicality and effectiveness by performing on par or superior to other systems in terms of high accuracy and robust stability. Full article

The numerical analysis technique is one of the primary methods for the design and development of floating offshore wind turbines (FOWTs). This study presents a detailed investigation into the influences of fully coupled and decoupled numerical analysis methods on the dynamic responses of a floating offshore wind turbine. The fully coupled analysis is implemented via bidirectional FAST-OrcaFlex co-simulation, considering the dynamic interaction between rotor operation and platform motions. The decoupled analysis is conducted using OrcaFlex for wave-induced response analysis, incorporating unidirectional imported FAST-based thrust time series. First, the numerical tools used for simulating fully coupled numerical model of OC5 DeepCwind are verified against published model test data, including free-decay test, white noise wave test and working condition test. Then, the fully coupled and decoupled numerical models are compared under wind fields of different turbulence intensities and wind speeds to reveal the dynamic coupling effects. The results indicate that the predictions of the decoupled model are more aligned with the experimental data compared to those of the fully coupled model under conditions of combined wave and steady winds. The differences between the fully coupled and decoupled models are minor under wave-only condition. However, under turbulent condition, the decoupled model overestimates surge by up to 10% and mooring tension by less than 5%, while pitch deviations can reach 17%. These findings support the use of the decoupled method in preliminary design stages—especially for mooring system optimal design—to save computational cost and time. For detailed designs involving turbulent winds, low-frequency structure response analysis or pitch-sensitive performance, the fully coupled approach is recommended to ensure accuracy. This study could offer practical guidance for selecting suitable numerical methods in FOWT design and analysis. Full article

This article presents a novel methodology for evaluating the safety of forklift operations in intralogistics systems using a multi-user simulation model integrated with virtual reality (MUSM-VR). Set against the backdrop of persistent safety challenges in warehouse environments, particularly for inexperienced operators, the study addresses the need for proactive safety assessment tools. The authors develop a simulation framework within the FlexSim 24.2 environment, enhanced by proprietary VR and server integration libraries, enabling interactive, immersive testing of warehouse layouts and operational scenarios. Through literature review and analysis of risk factors, the methodology incorporates human, infrastructural, organizational, and technical dimensions of forklift safety. A case study involving inexperienced participants demonstrates the model’s capability to identify high-risk areas, assess operator behavior, and evaluate the impact of visibility and speed parameters on collision risk. Results highlight the effectiveness of MUSM-VR in pinpointing hazardous intersections and inform design recommendations such as optimal speed limits and layout modifications. The study concludes that MUSM-VR not only facilitates early-stage safety analysis but also supports ergonomic design, operator training, and iterative testing of preventive measures, aligning with Industry 4.0 and 5.0 paradigms. The integration of immersive simulation into design and safety workflows marks a significant advancement in intralogistics system development. Full article

This study explores virtual sensing techniques for the Eolink floating offshore wind turbine (FOWT), which features a pyramidal platform and a single-point mooring system that enables weathervaning to maximize power production and reduce structural loads. To address the challenges and costs associated with monitoring submerged components, virtual sensors are investigated as an alternative to physical instrumentation. The main objective is to design a virtual sensor of mooring hawser loads using a reduced set of input features from GPS, anemometer, and inertial measurement unit (IMU) data. A virtual sensor is also proposed to estimate the bending moment at the joint of the pyramid masts. The FOWT is modeled in OrcaFlex, and a range of load cases is simulated for training and testing. Under defined sensor sampling conditions, both supervised and physics-informed machine learning algorithms are evaluated. The models are tested under aligned and misaligned environmental conditions, as well as across operating regimes below- and above-rated conditions. Results show that mooring tensions can be estimated with high accuracy, while bending moment predictions also perform well, though with lower precision. These findings support the use of virtual sensing to reduce instrumentation requirements in critical areas of the floating wind platform. Full article

Road traffic accidents (RTAs) are a leading cause of physical injury worldwide, but they also frequently result in post-traumatic stress disorder (PTSD). This systematic review examines the prevalence, predictors, comorbidity, and treatment of PTSD among RTA survivors. Four electronic databases (PubMed, Scopus, EBSCO, and ProQuest) were searched following PRISMA 2020 guidelines. Articles were included if reporting on the presence of post-traumatic stress disorder as a result of a road traffic accident in adults aged 18 years and older. Including peer-reviewed journal articles and awarded doctoral theses across all publication years, and written in English, Macedonian, Serbian, Bosnian, Croatian, and Bulgarian, identified 259 articles, and using Literature Evaluation and Grading of Evidence (LEGEND) assessment of evidence 96 were included in the final review, involving 50,275 participants. Due to the heterogeneity of findings, quantitative data were synthesized thematically rather than through meta-analytic techniques. Findings are reported from Random Control Trial (RCT) and non-RCT studies. PTSD prevalence following RTAs ranged widely across studies, from 20% (using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5 criteria) to over 45% (using International Classification of Diseases, 10th Revision, ICD-10 criteria) within six weeks post-accident (non-RCT). One-year prevalence rates ranged from 17.9% to 29.8%, with persistence of PTSD symptoms found in more than half of those initially diagnosed up to three years post-RTA (non-RCTs). Mild or severe PTSD symptoms were reported by 40% of survivors one month after the event, and comorbid depression and anxiety were also frequently observed (non-RCTs). The review found that nearly half of RTA survivors experience PTSD within six weeks, with recovery occurring over 1 to 3 years (non-RCTs). Even minor traffic accidents lead to significant psychological impacts, with 25% of survivors avoiding vehicle use for up to four months (non-RCT). Evidence-supported treatments identified include Cognitive Behavioural Therapy (CBT) (RCTs and non-RCTs), Virtual Reality (VR) treatment (RCTs and non-RCTs), and Memory Flexibility training (Mem-Flex) (pilot RCT), all of which demonstrated statistically significant reductions in PTSD symptoms across validated scales. There is evidence for policy actions including mandatory and regular psychological screening post RTAs using improved assessment tools, sharing health data to better align early and ongoing treatment with additional funding and access, and support and interventions for the family for RTA comorbidities. The findings underscore the importance of prioritizing research on the psychological impacts of RTAs, particularly in regions with high incident rates, to understand better and address the global burden of post-accident trauma. Full article

Given the distinct operational features of flex-route transit (FRT) compared to conventional fixed-route systems, this study integrates FRT with urban rail transit and proposes a collaborative optimization approach for feeder flex-route operations and scheduling. The model incorporates path planning, timetable design, and vehicle scheduling to minimize travel costs, enhance operational efficiency, and improve service quality. A mixed-integer nonlinear programming method is applied to optimize scheduling while aligning with rail timetables and passenger transfer behavior. Simulation experiments based on realistic urban transit scenarios are conducted to validate the model, optimizing key operational parameters such as departure intervals, vehicle deployment, and stop selection. The results demonstrate that the proposed approach effectively adjusts schedules and vehicle assignments to accommodate fluctuating passenger demand. This study offers both a theoretical foundation and a practical framework for integrated scheduling of feeder flex-route services, with potential applications for improving coordination and performance in multimodal public transit systems. Full article

The digital transformation of manufacturing requires an accurate measurement and analysis of process parameters to optimize efficiency, quality and cost control. This paper introduces a structured sensor selection cycle, providing a systematic approach for identifying relevant metrics, evaluating sensor technologies and integrating them into existing production systems. The proposed methodology enables companies to enhance process transparency, leading to data-driven decision-making and more flexible production strategies. Developed within the ZuPro2Flex research project, this framework offers practical guidance for aligning sensor technology with business model requirements. Full article