Search Results (224)

Background: The use of lower limb prosthesis can impact all aspects of daily life, activities and participation. Various studies have compared the microprocessor-controlled knee (MPK) to the non-microprocessor-controlled knee (NMPK) using a variety of different outcome measures, but results are inconsistent and raise the question of which type of knee is most effective. Therefore, we aimed to assess the effect of MPKs compared to NMPKs across all classified ICF domains in adult prosthesis users. Methods: Participants performed baseline measurements with the NMPK (T0). One week later, they started a four-to-six-week trial period with the MPK. Afterward, measurements were repeated with the MPK (T1). Functional tests (6MWT, TUG-test and activity monitor) and questionnaires (ABC, SQUASH, USER-P and PEQ) were used. For statistical analyses, paired t-tests, Wilcoxon signed-rank tests and Chi² test were applied. The Benjamini–Hochberg procedure was applied to correct for multiple testing. Results: Twenty-five participants were included. Using an MPK compared to an NMPK significantly resulted in improvements in balance and walking confidence, safety, walking distance and self-reported walking ability, as well as a decrease in number of stumbles and falls. Additionally, participants using an MPK were significantly more satisfied with their participation, experienced fewer restrictions, reported greater satisfaction with the appearance and utility of the MPK, experienced less social burden and reported better well-being, compared to using an NMPK. Conclusions: Using an MPK instead of an NMPK can lead to significant improvements in all classified ICF domains, such as improved walking ability, confidence and satisfaction and reduced fall risk. Full article

Electric buses are key in the strategy towards a greenhouse-gas-neutral fleet. However, their restrictions in terms of range and refueling as well as their increased price point present new challenges for public transport companies. This study aims to address, based on real-world operational data, how energy consumption and charging behavior affect battery aging and how operational strategies can be optimized to extend battery life under realistic conditions. This article presents an energy consumption analysis with respect to ambient temperatures and average vehicle speed based exclusively on real-world data of an urban bus fleet, providing a data foundation for range forecasting and infrastructure planning optimized for public transport needs. Additionally, the State of Charge (SOC) window during operation and vehicle idle time as well as the charging power were analyzed in this case study to formulate recommendations towards a more battery-friendly treatment. The central research question is whether battery-friendly operational strategies—such as reduced charging power and lower SOC windows—can realistically be implemented in daily public transport operations. The impact of the recommendations on battery lifetime is estimated using a battery aging model on drive cycles. Finally, the reduction in CO₂ emissions compared to diesel buses is estimated. Full article

Background/Objectives: Total knee arthroplasty (TKA) is commonly associated with postoperative muscle atrophy and weakness, while traditional rehabilitation is often limited by pain and patient compliance. Passive blood flow restriction (pBFR) training may offer a safe, low-threshold method to attenuate muscle loss in this early phase. This pilot study examined the feasibility, safety, and early effects of pBFR initiated during hospitalization on muscle mass, swelling, and functional recovery after TKA. Methods: In a prospective, single-blinded trial, 26 patients undergoing primary or aseptic revision TKA were randomized to either a control group (CON: sham BFR at 20 mmHg) or intervention group (INT: pBFR at 80% limb occlusion pressure). Both groups received 50 min daily in-hospital rehabilitation sessions for five consecutive days. Outcomes, including lean muscle mass (DXA), thigh/knee circumference, 6 min walk test (6 MWT), handgrip strength, and patient-reported outcomes, were assessed preoperatively and at discharge, six weeks, and three months postoperatively. Linear mixed models with Bonferroni correction were applied. Results: The INT group showed significant preservation of thigh circumference (p = 0.002), reduced knee swelling (p < 0.001), and maintenance of lean muscle mass (p < 0.01), compared with CON, which exhibited significant declines. Functional performance improved faster in INT (e.g., 6 MWT increase at T3: +23.7%, p < 0.001; CON: −7.2%, n.s.). Quality of life improved in both groups, with greater gains in INT (p < 0.05). No adverse events were reported. Conclusions: Initiating pBFR training on the first postoperative day is feasible, safe, and effective in preserving muscle mass and reducing swelling after TKA. These findings extend prior BFR research by demonstrating its applicability in older, surgical populations. Further research is warranted to evaluate its integration with standard rehabilitation programs and long-term functional benefits. Full article

The COVID-19 pandemic is considered a potentially traumatic event, as it introduced new challenges and threats to people around the world, disrupting daily life due to the restrictions imposed. The psychological defenses of individuals mobilized to deal with stress reactions are influenced by a set of factors, including previous traumatic experiences, which can amplify the current trauma. Recognizing that people exposed to adverse childhood experiences (ACEs) have increased risks of an array of adverse mental and physical health outcomes throughout life, the present study aimed to investigate the relationship between ACEs—more specifically, child abuse and child neglect—and PTSD symptoms in a sample of European adults during the pandemic. A sample of 8459 participants (67.1% female and 32.9% male, with a mean of 43.95 years old) was evaluated. The survey questionnaire included questions on sociodemographic and clinical characteristics, the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), and the Adverse Childhood Experiences (ACEs) questionnaire. According to our findings, younger women who have suffered from child abuse or child neglect are more likely to develop PTSD symptoms. The most significant factor influencing the PTSD risk was child neglect, contrary to many studies that indicate that child abuse is the most impactful adverse childhood experience. Full article

Complex walking tasks such as turning or walking with head movements are frequently used to assess dysfunction in an individual’s vestibular, nervous and musculoskeletal systems. Compared to other methods, wearable inertial measurement units (IMUs) allow quantitative analysis of these tasks in less restricted settings, allowing for a more scalable clinical measurement tool with better ecological validity. This study investigates the use of ear-worn IMUs to identify gait events during complex walking tasks, having collected data on 68 participants with a diverse range of ages and movement-related conditions. The performance of an existing gait event detection algorithm was compared with a new one designed to be more robust to lateral head movements. Our analysis suggests that while both algorithms achieve high initial contact sensitivity across all walking tasks, our new algorithm attains higher terminal contact sensitivity for turning and walking with horizontal head turns, resulting in more accurate estimates of stance and swing times. This provides scope to enable more detailed assessment of complex walking tasks during clinical testing and in daily life settings. Full article

Vehicle ride-sharing commute in smart cities is a service that has changed the way of citizens’ daily life and transportation schedule. Research in vehicle ride sharing aims to provide passengers with a comfortable living and well-being within the city. Ride sharing has a significant role in vehicle transportation services provided to passengers during their daily schedule from a certain origin to a desired destination within smart cities. Combining ride sharing with spatial, temporal, and social context has an impact on passenger satisfaction. In this paper, a vehicle ride-sharing algorithm is introduced, which incorporates certain spatial, temporal, and social behavior context restrictions that are able to provide a satisfactory routing trajectory that serves the daily needs of passengers in the smart city of Athens, Greece. Real data sources were exploited to evaluate certain spatial, temporal, and social matching distance functions, which define specific spatial, temporal, and social matching similarity thresholds of passengers’ social mobility behavior. The proposed algorithm is evaluated experimentally with real data based on specific evaluation metrics assessing its efficiency with regards to certain spatial, temporal, social, capacity, and satisfaction contexts. The evaluation process has an impact on the adoption of the proposed algorithm in vehicle ride-sharing commute in smart cities. Full article

Background/Objectives: The severity of autism spectrum disorder (ASD) is clinically assessed through a comprehensive evaluation of social communication deficits, restricted interests, repetitive behaviors, and the level of support required (ranging from level 1 to level 3) according to DSM-5 criteria. Along with its varied clinical manifestations, the neuroanatomy of ASD is characterized by heterogeneous abnormalities. Notably, brain MRI of children with ASD often reveals an increased number of perivascular spaces (PVSs) compared to typically developing children. Our recent findings indicate that enlarged PVSs (ePVSs) are more common in younger male patients with severe ASD and that specific ePVS locations are significantly associated with ASD symptoms. Methods: In this study, we mapped ePVSs across key regions of three major cognitive networks—the Default Mode Network (DMN), the combined Central Executive/Frontoparietal Network (CEN/FPN), and the Salience Network (SN)—in 36 individuals with different symptom severities and rehabilitation needs due to ASD. We explored how the number, size, and location of PVSs in these networks are related to specific ASD symptoms and the overall need for rehabilitation and support. Results: Our results suggest that ePVSs in the DMN, CEN/FPN, and SN are strongly correlated with the severity of certain ASD symptoms, including verbal deficits, stereotypies, and sensory disturbances. We found a mild association between ePVSs and the level of support needed for daily living and quality of life. Conclusions: Dysfunction in cognitive networks associated with the presence of ePVSs has a significant impact on the severity of ASD symptoms. However, the need for assistance may also be influenced by other comorbid conditions and dysfunctions in smaller, overlapping brain networks. Full article

Background: The COVID-19 pandemic has sparked the need for appropriate government responses in health-disaster situations worldwide. This study analyzes the impact of governments’ non-pharmaceutical measures on the number of deaths from COVID-19. In particular, it further analyzes how trust in government moderates government measures. Through this analysis, this study aims to explore the government’s appropriate role in overcoming future health disasters by understanding the effectiveness of government measures in response to the COVID-19 pandemic. Methods: This study collected and analyzed national data provided by various international organizations for countries of the Organization for Economic Co-operation and Development (OECD). To estimate the relationship between various policy measures and COVID-19 related deaths, it employed panel data analysis using random effects, since only three years of data, ranging from 2020 to 2022, were utilized. Results: The main findings of this study are as follows. First, suppression measures which include measures that place relatively stronger restrictions on people’s behavior were directly related to decreases in the number of total deaths. However, mitigation measures which consisted of weak-intensity measures were directly related to increases in the number of deaths. Second, higher levels of trust in government were directly related to decreased numbers of deaths. Finally, the moderating effect of government trust on suppression measures was not tested, but the moderating effect on mitigation measures was confirmed. Conclusions: This study presents the following implications. First, governments’ non-pharmaceutical measures in times of pandemic need to consider various environmental factors of the country. Second, trust in government can be an important environmental condition in overcoming health-disaster situations. In particular, trust in government weakens the side effects that can be caused by government measures. Third, suppression methods that directly affect people’s movement and daily life had a positive association with decreases in the number of total deaths, and the correlations of these measures in overcoming the health-disaster situation were confirmed. Full article

The co-occurrence of autism spectrum disorder (ASD) and epilepsy is a complex neurological condition that presents significant challenges for both patients and clinicians. ASD is a group of complex developmental disorders characterized by the following: (1) Social communication difficulties: challenges in understanding and responding to social cues, initiating and maintaining conversations, and developing and maintaining relationships. (2) Repetitive behaviors: engaging in repetitive actions, such as hand-flapping, rocking, or lining up objects. (3) Restricted interests: focusing intensely on specific topics or activities, often to the exclusion of other interests. (4) Sensory sensitivities: over- or under-sensitivity to sensory input, such as sounds, touch, tastes, smells, or sights. These challenges can significantly impact individuals’ daily lives and require specialized support and interventions. Early diagnosis and intervention can significantly improve the quality of life for individuals with ASD and their families. Epilepsy is a chronic brain disorder characterized by recurrent unprovoked (≥2) seizures that occur >24 h apart. Single seizures are not considered epileptic seizures. Epilepsy is often idiopathic, but various brain disorders, such as malformations, strokes, and tumors, can cause symptomatic epilepsy. While these two conditions were once considered distinct, growing evidence suggests a substantial overlap in their underlying neurobiology. The prevalence of epilepsy in individuals with ASD is significantly higher than in the general population. This review will explore the epidemiology of this comorbidity, delve into the potential mechanisms linking ASD and epilepsy, and discuss the implications for diagnosis, treatment, and management. Full article

Background: Total elbow arthroplasty (TEA) has evolved over time from a salvage procedure to a successful treatment of end-stage primary and secondary arthritis. However, the aseptic loosening and the associated reduced survival rate are still concerning. Thus, TEA is typically contraindicated in young and active patients where high-demand activities would promote aseptic loosening. For this reason, postoperative weightlifting limitations are often suggested, yet there is no consensus. The aim of this survey was to collect and analyze the current practice concerning the weightlifting restrictions following elbow arthroplasties among members of the Italian Society of Shoulder and Elbow Surgery (Società Italiana Chirurgia Spalla e Gomito, SICSeG). Methods: An online survey on the lifting restrictions after elbow arthroplasties was submitted to all members of the SICSeG. Results: In total, 36 members of the Italian society completed the survey. Only five consultants (13.8%) have experience with all the implants analyzed, of whom only three have experience with more than 10 implants per year. Concerning the comprehensive number of elbow arthroplasties performed per year, most of the respondents (45.7%) reported fewer than five surgeries per year, whereas only two surgeons claimed more than 20 procedures. Of the 36 respondents, 32 (88.9%) reported lifelong lifting limitations after linked TEA. In detail, these lifting restrictions were 10 lb in 14 responders (38.9%) and 5 lb in 15 responders (41.7%) performing linked TEA. A lifelong lifting limitation gradually decreased after unlinked TEA and hemiarthroplasty (HA) being advised by 82.8% (24/36) and 64.5% (20/36), respectively. Conclusions: To increase implant longevity, most Italian surgeons advise lifting restrictions after TEA. More than 80% of the responders agreed with suggesting lifelong limitations, but a greater variability was found in the amount of weight to which the patients are restricted. Currently, the lack of consensus on the optimal weightlifting restrictions after elbow replacements emphasizes the need for more studies focusing on elbow joint loading during different activities of daily life to improve implant survival rates. Full article

Objective: Since the lifting of the COVID-19 restrictions in China in November 2022, there has been a notable surge in the COVID-19 infection rate. Little is known about the prevalence of long COVID among the general adult population and its impact on COVID-19-related worries and behaviors after the policy change. Methods: This cross-sectional study recruited 1530 adults with prior COVID-19 infection in Guangzhou from February to March 2023. Logistic regression analyses and trend analyses were performed to investigate the associations between long COVID- and COVID-19-related worries and preventive behaviors. Results: The estimated prevalence of long COVID among adults in China was 18.0% (95% confidence interval: 16.1% to 20.0%). Common long COVID symptoms included cough (60.7%), fatigue (47.6%), dyspnea (34.5%), palpitation (26.2%), and insomnia (25.1%). Adjusted for background variables, individuals with long COVID exhibited higher level of COVID-19-related worries compared to those who had fully recovered from the infection (reference: without long COVID; adjusted odds ratios ranged from 1.87 to 2.55, all p values < 0.001). Participants primarily expressed worries regarding the potential for COVID-19 reinfection, the impact of the pandemic on daily life, the increasing number of COVID-19 cases and deaths, and the capacity of the healthcare system. While long COVID did not statistically significantly affect their preventive behaviors. Conclusions: Long COVID was prevalent among the general adult population in China after lifting the COVID-19 restrictions, and it had a significant impact on COVID-19-related worries. This study highlights the importance of monitoring the mental health of individuals with long COVID and developing targeted intervention strategies to improve their adherence to preventive measures. Full article

In Melbourne, Australia, strict ‘lockdowns’ were implemented in 2020 to suppress COVID-19, significantly disrupting daily life. Young people (<18 years) with medical conditions have an elevated risk of mental health problems and may have been disproportionately affected by the distress associated with the COVID-19 restrictions. To investigate this, we conducted a single-site, longitudinal cohort study involving the parents of 135 children and adolescents with medical conditions. Using an adapted version of the CoRonavIruS Health Impact Survey (CRISIS), parents rated their child’s mental health, activities and healthcare experiences pre-COVID-19 (retrospectively), during lockdown and 6 months post-lockdown. General linear mixed models revealed that mental health symptoms, including anxiety, fatigue, distractibility, sadness, irritability, loneliness and worry, were higher during lockdown compared to pre-COVID-19. Notably, anxiety, sadness and loneliness remained elevated 6 months post-lockdown. Covariates such as older child age, increased parent stress and child screen time contributed to greater mental health difficulties. While most mental health symptoms resolved post-lockdown, the persistence of anxiety, sadness and loneliness highlights the need for ongoing clinical monitoring for young people with medical conditions during periods of community stress and restrictions. Full article

Methionine is an amino acid necessary for the growth and development of all animals. Glutathione produced during methionine metabolism can reduce damage to cells caused by oxidative stress. Supplementing restricted amino acids in animals by scientific means will be beneficial to protein synthesis, which will affect the growth and development of animals and will bring huge economic benefits when applied to actual production and life. In this study, we collected three muscle tissues from 24 male Maiwa yaks, which were fattened for three months with different methionine concentrations in their diet. RNA-seq was performed to obtain expression reads. A total of 1116 editing sites were identified by at least two software; the editing site types were mainly T-to-C and A-to-G mutations. We found two significant RNA editing sites presenting high-risk editing types. One was located on the MSRA gene that regulates the reduction of methionine, and the other can make changes to the properties of encoded proteins. This provides further understanding of the mechanism of yak muscle tissue and regulation of gene expression after the addition of methionine to daily rations. Full article

Stroke is one of the leading causes of death and disability worldwide and poses a tremendous socioeconomic burden upon individuals, countries and healthcare systems. It causes debilitating symptoms and thus interferes with many aspects of the patient’s life, including physical functioning, cognition, emotional status, activities of daily living, social reintegration and quality of life. Post-stroke patients frequently experience functional motor disabilities of the upper limb, which restrict autonomy and self-efficacy and cause limitations in engagement with activities and social participation, as well as difficulties in performing important occupations. It is therefore not surprising that motor impairment or loss of motor function of the upper limb is one of the most devastating sequelae of stroke. On these grounds, achieving optimal functioning of the upper limb after stroke remains a fundamental goal of stroke rehabilitation. Mirror therapy (MT) represents one of the several rehabilitation techniques used for restoring the upper limb’s motor function after a stroke. However, conflicting results about the role of MT in the rehabilitation of the upper limb’s motor deficits have been reported in the literature. Accordingly, the aim of this narrative review is to summarize existing evidence regarding the effects of MT on the upper limb’s motor function in post-stroke patients and to further explore its role when applied in different phases of stroke. Full article

Wireless Fidelity (Wi-Fi) based positioning has gained popularity for accurate indoor robot positioning in indoor navigation. In daily life, it is a low-cost solution because Wi-Fi infrastructure is already installed in many indoor areas. In addition, unlike the Global Navigation Satellite System (GNSS), Wi-Fi is more suitable for use indoors because signal blocking, attenuation, and reflection restrictions create a unique pattern in places with many Wi-Fi transmitters, and more precise positioning can be performed than GNSS. This paper proposes a machine learning-based method for Wi-Fi-enabled robot positioning in indoor environments. The contributions of this research include comprehensive 3D position estimation, utilization of existing Wi-Fi infrastructure, and a carefully collected dataset for evaluation. The results indicate that the AdaBoost algorithm attains a notable level of accuracy, utilizing the dBm signal strengths from Wi-Fi access points distributed throughout a four-floor building. The mean average error (MAE) values obtained in three axes with the Adaptive Boosting algorithm are 0.044 on the x-axis, 0.063 on the y-axis, and 0.003 m on the z-axis, respectively. In this study, the importance of various Wi-Fi access points was examined with explainable artificial intelligence methods, and the positioning performances obtained by using data from a smaller number of access points were examined. As a result, even when positioning was conducted with only seven selected Wi-Fi access points, the MAE value was found to be 0.811 for the x-axis, 0.492 for the y-axis, and 0.134 for the Z-axis, respectively. Full article