Search Results (1,190)

Objectives: We assessed the difference between quiet stance and gait in the spatial distribution and intensity of foot plantar pressures and whether it is possible to estimate the distribution during gait from data obtained during stance. Methods: A total of 60 healthy subjects with a mean age of 31.0 ± 9.4 years performed two trials for quiet stance and four trials for gait on a baropodometric walkway with their eyes open. Foot plantar pressures were recorded from 10 areas of the foot sole. Results: During quiet stance, the highest plantar pressure occurred at metatarsal heads (M2 to M4) and the medial (MH) and lateral halves of the heel (LH). During gait, the profile of plantar pressure values was like that during stance, but significantly higher. The differences concentrated at the big toe (T1), M2 to M4, MH, and LH, whilst toes (T2,3,4,5) and midfoot (MF) showed the smallest difference. A significant positive correlation was found between the corresponding areas of foot pressure during gait and stance. Conclusions: During quiet stance and gait, the overall profile of plantar pressure distribution was similar. During quiet stance, the subjects loaded more on the heels, in keeping with the known position of the center of pressure just in front of the ankles. During gait, higher pressures on the metatarsal areas are related to the forward propulsion of the center of mass. The correlation between the corresponding areas of foot pressure during gait and stance suggests that the pressure distribution during gait can partly be estimated from that during stance. This finding might be useful in most clinical settings when a single sensorized platform rather than a complete walkway is available. Full article

Bioinspired soft adhesive systems capable of stable and intelligent object manipulation are critical for next-generation robotics. In this study, a soft gripper combining an octopus-inspired suction mechanism with a frog-inspired hexagonal friction pattern was developed to enhance adhesion performance under diverse surface conditions and orientations. The hexagonal pattern, inspired by frog toe pads, contributed to improved stability against tilting and shear forces. The integrated strain gauge enabled real-time monitoring of gripping states and facilitated the detection of contact location and changes in load distribution during manipulation. The system demonstrated robust adhesion under both dry and wet conditions, with adaptability to various object geometries and inclinations. These results suggest broad potential for bioinspired gripping platforms in fields such as collaborative robotics, medical tools, and underwater systems. Full article

Background: Gait kinematics address the analysis of joint angles and segment movements during walking. Although there is work in the literature to solve the problems of forward (FK) and inverse kinematics (IK), there are still problems related to the accuracy of the estimation of Cartesian and joint variables, singularities, and modeling complexity on gait analysis approaches. Objective: In this work, we propose a framework for two-dimensional gait analysis addressing the singularities in the estimation of the joint variables using quaternion-based kinematic modeling. Methods: To solve the forward and inverse kinematics problems we use the dual quaternions’ composition and Damped Least Square (DLS) Jacobian method, respectively. We assess the performance of the proposed methods with three gait patterns including normal, toe-walking, and heel-walking using the RMSE value in both Cartesian and joint spaces. Results: The main results demonstrate that the forward and inverse kinematics methods are capable of calculating the posture and the joint angles of the three-DoF kinematic chain representing a lower limb. Conclusions: This framework could be extended for modeling the full or partial human body as a kinematic chain with more degrees of freedom and multiple end-effectors. Finally, these methods are useful for both diagnostic disease and performance evaluation in clinical gait analysis environments. Full article

Background and Clinical Significance: Angioleiomyoma (ALM) is a benign tumor that generally presents as a single lesion and, according to the updated WHO classification, includes the following three histological subtypes: solid (or capillary), cavernous, and venous. Typically, ALMs are described as well-defined nodules in the lower extremities but are unusually located in the acral locations and toes. We summarize two cases of ALM and perform a systematic review to provide foot surgeons with the most up-to-date and useful information on the epidemiological aspects, anatomical distribution, and specific histological subtypes of ALM in the foot. Materials and Methods: A systematic review was carried out according to the criteria of a PICO framework, and a systematic search and data processing were carried out according to the PRISMA guidelines. We analyzed patient demographics, clinical characteristics, diagnostic workup, treatment, and clinical outcomes. Each one of the included articles was independently assessed for methodological quality and risk of bias by an independent evaluator. The risk of bias of the included studies was assessed based on their characteristics. Results: This systematic review included 14 case series with 172 reported cases of ALM. One hundred and seventy-two (18.57%) were cases of ALM located on foot, excluding the ankle region. The female-to-male ratio was 1.48. The most common location was the hindfoot (41.5%), followed by the forefoot (20.2%) and the midfoot (8.9%). In 29.4% of cases, the location of the lesions could not be determined. The most frequent location of the lesions was subcutaneous (69%), followed by subaponeurotic (16.5%) and skin (14.5%) locations. The most frequent histological presentation was the solid histologic subtype (65%), followed by the venous subtype (21%) and the cavernous subtype (14%), respectively. Of the total reported cases of ALM located in foot, 63.1% presented as solid painful lesions. Calcified presentations occurred in 7% of cases, with more than half of the cases located in the hindfoot. Surgical excision was the treatment of choice in the two herein reported cases of solid ALM located in the hindfoot, one of them with a calcified presentation. No recurrence was observed in either case after two and five years of follow-up, respectively. All cases reviewed after surgical excision showed a low recurrence rate with a favorable prognosis regardless of the histological subtype and a very rare tendency toward malignancy. Conclusions: ALMs of the foot present as well-defined, painful nodules in the subcutaneous tissue of middle-aged women. Solid histological subtypes are the most prevalent. Histopathological analysis is usually essential for confirmation. Treatment consists primarily of direct excision, with remarkably low recurrence rates. Full article

Hospitals rank among the most energy-intensive public building typologies and offer substantial potential for carbon mitigation. However, their construction phase has received limited scholarly attention within China’s ‘dual carbon’ agenda. To address this research gap, this study develops and empirically validates an integrated Technology Acceptance Model and Technology-Organization-Environment framework tailored for hospital construction projects. The study not only identifies 12 critical adoption factors but also offers recommendations and discusses the relevance to multiple Sustainable Development Goals. This research provides both theoretical and practical insights for promoting sustainable hospital construction practices. Full article

There is limited knowledge about the benefits of functional textile in arthritis management. This study aimed to evaluate the effect of wearing functional socks in patients with rheumatoid or psoriatic arthritis. Patients were randomized into an experimental group (n = 23) and control group (n = 18). The intervention involved wearing functional textile socks for 12 weeks. Sock composition was analyzed using X-ray fluorescence spectrometry and scanning electron microscopy. Outcome measures included the Numeric Rating Scale, Health Assessment Questionnaire–Disability Index (HAQ-DI), and RAND-36 (Estonian version). At week 12, the experimental group showed significantly lower metatarsophalangeal and toe joint pain (p = 0.001), stiffness (p = 0.005), and ankle stiffness (p = 0.017) scores than the control group. Improvements were also observed in HAQ-DI reaching (p = 0.035) and activity (p = 0.028) scores. RAND-36 scores were higher in physical functioning (p = 0.013), social functioning (p = 0.024), and bodily pain (p = 0.006). Role limitations due to physical problems improved in the experimental group but worsened in the control group (p = 0.029). In conclusion, wearing functional socks led to some statistically significant improvements in foot and ankle pain and stiffness, physical function, and health-related quality of life. However, the effect sizes were small, and the clinical relevance of these findings should be interpreted with caution. Full article

Inherited epidermolysis bullosa (EB) is a heterogeneous clinical entity that includes over 30 phenotypically and/or genotypically distinct inherited disorders, characterized by mechanical skin fragility and bullae formation. Junctional EB (JEB) is an autosomal recessive disease characterized by an intermediated cleavage level within the skin layers, commonly at the “lamina lucida”. Laryngo-onycho-cutaneous syndrome (LOC) is an extremely rare variant of JEB, characterized by granulation tissue formation in specific body sites (skin, larynx, and nails). Although most cases of JEB are caused by pathogenic variants occurring in the genes encoding for classical components of the lamina lucida, such as laminin 332 (LAMA3, LAMB3, LAMC2), integrin α6β4 (ITGA6, ITGB4), and collagen XVII (COL17A1), other variants have also been described. We report the case of a 4-month-old male infant who presented with recurrent bullous and erosive lesions from the first month of life. At the first dermatological evaluation, the patient was agitated and exhibited hoarse breathing, a clinical sign suggestive of laryngeal involvement. Multiple polygonal skin erosions were observed on the cheeks, along with similar isolated, roundish lesions on the scalp and legs. Notably, nail dystrophy and near-complete anonychia were evident on the left first and fifth toes. Due to the coexistence of skin erosions and nail dystrophy in such a young infant, a congenital bullous disorder was suspected, prompting molecular analysis of all potentially involved genes. In the patient’s DNA, clinical exome sequencing (CES) identified a pathogenic variant, apparently in homozygosity, in the exon 1 of the LAMA3 gene (18q11.2; NM_000227.6): c.47G > A;p.Trp16*. The presence of this variant was confirmed, in heterozygosity, in the genomic DNA of the patient’s mother, while it was absent in the father’s DNA. Subsequently, trio-based SNP array analysis was performed, revealing a paternally derived pathogenic microdeletion encompassing the LAMA3 locus (18q11.2). To our knowledge, this is the first reported case of JEB with a LOC-like phenotype caused by a maternally inherited monoallelic nonsense mutation in LAMA3, unmasked by an almost complete deletion of the paternal allele. The combined use of exome sequencing and SNP array is proving essential for elucidating autosomal recessive diseases with a discordant segregation. This is pivotal for providing accurate genetic counseling to parents regarding future pregnancies. Full article

Fatigue damage in steel–concrete composite structures frequently initiates at welded joints due to stress concentrations and inherent defects. This study investigates the stress intensity factors (SIFs) associated with fatigue cracks in the welds of steel longitudinal beams, employing the FRANC3D–ABAQUS interactive technique. A finite element model was developed and validated against experimental data, followed by the insertion of cracks at both the weld root and weld toe. The influences of stud spacing, initial crack size, crack shape, and lack-of-penetration defects on Mode I SIFs were systematically analyzed. Results show that both weld root and weld toe cracks are predominantly Mode I in nature, with the toe cracks exhibiting higher SIF values. Increasing the stud spacing, crack depth, or crack aspect ratio significantly raises the SIFs. Lack of penetration defects further amplifies the SIFs, especially at the weld root. Based on the computed SIFs, fatigue life predictions were conducted using a crack propagation approach. These findings highlight the critical roles of crack geometry and welding quality in fatigue performance, providing a numerical foundation for optimizing welded joint design in composite structures. Full article

Rainfall infiltration is a key factor affecting the stability of the slope. To study the impact of rainfall on the instability mechanism and stability of slopes, this paper employs numerical simulation to establish a rainfall infiltration slope model and conducts a saturated–unsaturated slope flow and solid coupling numerical analysis. By combining the strength reduction method with the calculation of slope stability under rainfall infiltration, the safety factor of the slope is obtained. A comprehensive analysis is conducted from the perspectives of the seepage field, displacement field and other factors to examine the impact of heavy rainfall patterns and rainfall intensities on the instability mechanism and stability of the slope. The results indicate that heavy rainfall causes the transient saturation zone within the landslide body to continuously move upward, forming a continuous sliding surface inside the slope, which may lead to instability and sliding of the soil in the upper part of the slope toe. The heavy rainfall patterns significantly affect the temporal and spatial evolution of pore water pressure, displacement and safety factors of the slope. Pore water pressure and displacement show a positive correlation with the rainfall intensity at various times during heavy rainfall events. The pre-peak rainfall pattern causes the largest decrease in the safety factor of the slope, and the slope failure occurs earlier, which is the most detrimental to the stability of the slope. The rainfall intensity is inversely proportional to the safety factor. As the rainfall intensity increases, the decrease in the slope’s safety factor becomes more significant, and the time required for slope instability is also shortened. The results of this study provide a scientific basis for analyzing rainfall-induced slope instability and failure. Full article

Background and Objectives: Toe walking (TW) is frequently observed in children with Autism Spectrum Disorder (ASD), yet its clinical significance and association with comorbid conditions remain poorly understood. This study aimed to examine the prevalence of TW in a large Italian cohort of children with ASD and to explore its association with ASD severity, sleep disturbances, feeding behaviors, and gastrointestinal symptoms. Materials and Methods: A total of 289 children with ASD and 289 typically developing controls (TDC), matched for age and sex, were evaluated in a multicentric observational study. TW was assessed during neurodevelopmental evaluations. Sleep quality was assessed using the Sleep Disturbance Scale for Children (SDSC), feeding behaviors via the Brief Autism Mealtime Behavior Inventory (BAMBI), and gastrointestinal symptoms through clinical reporting. Statistical analyses included Chi-square tests, Mann–Whitney U tests, Spearman correlations, and logistic regressions. Results: TW was significantly more prevalent in the ASD group (27.3%) than in TDC (5.5%, p < 0.0001). Within the ASD group, TW occurred in 50.5% of children with Level 3 severity but was absent in Levels 1 and 2 (p < 0.0001). Males exhibited TW more frequently than females. Children with TW had higher SDSC scores (ρ = 0.33, p < 0.0001), though no subscale independently predicted TW. Constipation was reported in 100% of children with Level 3 ASD and was strongly correlated with SDSC total scores (ρ = 0.58, p < 0.0001). The Disorders of Arousal (DA) subscale emerged as an independent predictor of constipation (β = 0.184, p = 0.019). Conclusions: TW in ASD appears to be a marker of greater neurodevelopmental severity and is associated with sleep disturbances and gastrointestinal dysfunction. These findings support the hypothesis that TW may reflect broader dysfunctions involving the gut–brain axis, sensory processing, and motor control. The routine clinical assessment of TW should include the evaluation of sleep and somatic symptoms to better understand the multisystemic nature of ASD phenotypes. Full article

Background: Hemiparetic gait is characterized by reduced limb shortening during swing, increasing the risk of tripping and leading to compensatory strategies. Despite 3D gait analysis being the gold standard for gait assessment, there is no consensus on relevant kinematic biomarkers for limb shortening and compensatory movements. Methods: Systematic review querying five databases (PubMed, Cochrane, Scopus, PEDro, and Web of Science). We included articles that described at least one kinematic biomarker of the lower limb in the sagittal plane and at least one biomarker of the lower limb or pelvis in the transversal or frontal plane, or pelvis in the sagittal plane. Then, we collected kinematic biomarkers from these studies and identified those that seemed relevant to describe limb shortening and compensatory movements during the swing phase. Results: We included 40 studies and collected 385 biomarkers. Among them, 15 described limb shortening, 22 compensations, and 3 toe clearance. Analysis of 12 interventional studies showed that some biomarkers of shortening and compensation were more sensitive to change than others. Conclusions: This review highlights the lack of standardized description for limb shortening and compensatory movements in hemiparetic gait. A set of 13 relevant biomarkers is proposed to improve the interpretation of gait analysis and support consistent evaluation of therapeutic interventions. Full article

Water migration occurs in unsaturated loess subgrade due to extreme rainfall, making it prone to subgrade subsidence and other water damage disasters, which seriously impact road safety and sustainable development of the Loess Plateau. The study performed a rainfall test using a compacted loess subgrade model based on a self-developed water migration test device. The effects of extreme rainfall on the water distribution, wetting front, and infiltration rate in the subgrade were systematically explored by setting three rainfall intensities (4.6478 mm/h, 9.2951 mm/h, and 13.9427 mm/h, namely J1 stage, J2stage, and J3 stage), and a lateral water migration model was proposed. The results indicated that the range of water content change areas constantly expands as rainfall intensity and time increase. The soil infiltration rate gradually decreased, and the ratio of surface runoff to infiltration rainfall increased. The hysteresis of lateral water migration refers to the physical phenomenon in which the internal water response of the subgrade is delayed in time and space compared to changes in boundary conditions. The sensor closest to the side of the slope changed first, with the most significant fluctuations. The farther away from the slope, the slower the response and the smaller the fluctuation. The bigger the rainfall intensity, the faster the wetting front moved horizontally. The migration rate at the slope toe is the highest. The migration rate of sensor W3 increased by 66.47% and 333.70%, respectively, in the J3 stage compared to the J2 and J1 stages. The results of the model and the measured data were in good agreement, with the R² exceeding 0.90, which verifies the reliability of the model. The study findings are important for guiding the prevention and control of disasters caused by water damage to roadbeds in loess areas. Full article

E36 steel, widely used in shipbuilding and offshore structures, offers moderate strength and excellent low-temperature toughness. However, its welded joints are highly susceptible to fatigue failure. Cracks typically initiate at weld toes or within the heat-affected zone (HAZ), severely limiting the fatigue life of fabricated components. Traditional life prediction methods are complex, inefficient, and lack accuracy. This study proposes a machine learning (ML) framework for efficient fatigue life prediction of E36 welded joints. Welded specimens using SQJ501 filler wire on prepared E36 steel established a dataset from 23 original fatigue test data points. The dataset was expanded via Z-parameter model fitting, with data scarcity addressed using SMOTE. Pearson correlation analysis validated data relationships. After grid-optimized training on the augmented data, models were evaluated on the original dataset. Results demonstrate that the machine learning models significantly outperformed the Z-parameter formula (R² = 0.643, MAPE = 16.15%). The artificial neural network (R² = 0.972, MAPE = 4.45%) delivered the best overall performance, while the random forest model exhibited high consistency between validation (R² = 0.888, MAPE = 6.34%) and testing sets (R² = 0.897), with its error being significantly lower than that of support vector regression. Full article

Advanced technologies, such as robotic process automation, blockchain, and machine learning, increase audit efficiency. Nonetheless, some Supreme Audit Institutions (SAIs) have not undergone digital transformation. This research aimed to develop a comprehensive framework for supreme audit institutions to adopt and integrate emerging technologies into their auditing processes using a hybrid theoretical approach based on the TAM (Technology Acceptance Model) and TOE (Technology–Organisation–Environment) models. The framework was informed by insights from nineteen highly experienced experts in the field from eight countries. Through a two-round Delphi questionnaire, the experts provided valuable input on the key factors, challenges, and strategies for successful technology adoption by public sector audit organisations. The findings of this research reveal that technology adoption in SAIs starts with solid management support led by the chief technology officer. They must evaluate the IT infrastructure and readiness for advanced technologies, considering the budget and funding. Integrating solutions like the SAI of Ghana’s Audit Management Information System can significantly enhance audit efficiency. Continuous staff training is essential to build a positive attitude toward new technologies, covering areas like data algorithm auditing and big data analysis. Assessing the complexity and compatibility of new technologies ensures ease of use and cost-effectiveness. Continuous support from technology providers and monitoring advancements will keep SAIs aligned with technological developments, enhancing their auditing capabilities. Full article

Biallelic pathogenic variants in DHCR7 result in decreased activity of 7-dehydrocholesterol (7-DHC) reductase, which converts 7-DHC to cholesterol, and causes Smith–Lemli–Opitz syndrome (SLOS). Elevated serum 7-DHC levels are indicative of SLOS as are intellectual disability (ID), growth retardation, microcephaly, craniofacial anomalies, and 2–3 toe syndactyly. Additional congenital malformations may be present in SLOS, and broad clinical variability has been recognized in SLOS. Rarely, biallelic pathogenic DHCR7 variants were reported with low-normal and normal intelligence quotient (IQ) and development. We report here a pair of siblings with mild global developmental delay, infrequent epileptic seizures, and elevated serum 7-DHC levels, associated with the homozygous DHCR7 variant c.988G>A (p.Val330Met). Remarkably, neither sibling displayed congenital anomalies nor dysmorphisms. Quattro-exome sequencing performed for global delay and mild ID in both siblings did not identify other ID causes. c.988G>A affects a highly conserved amino acid and displays a relatively high global population allele frequency of 0.04%, with absence of homozygotes from the population database gnomADv4.1.0. Our observation leads us to suggest that DHCR7 variant c.988G>A and other DHCR7 variants might be generally considered as underlying non-syndromic ID. Full article