Search Results (2,053)

Background and Objectives: Massive extremity haemorrhage remains the leading cause of preventable death on the battlefield and among trauma victims in civilian settings. Tourniquets are an effective, low-cost tool used to rapidly control bleeding. However, the availability of certified tourniquet models during a full-scale armed conflict can be significantly limited. This favours the emergence of locally manufactured devices. The aim of this study was to compare the effectiveness of the DNIPRO Gen 2 and SICH tourniquets with the CAT Gen 7 and SOFTT W Gen 4 tourniquets recommended by the Committee on Tactical Combat Casualty Care. Materials and Methods: The study included 51 Ukrainian medics experienced in prehospital care. Application speed was measured with a stopwatch, and occlusion success was confirmed by Doppler ultrasound. Pain was measured using the NRS, and participants were also able to provide subjective comments regarding the ergonomics and design of the tourniquets. Results: The four tourniquets tested demonstrated different occlusion success rates in arm and leg application. In upper extremity application, the SICH had the highest success rate (98.0%) and was associated with higher odds of successful application compared with the SOFTT-W Gen 4 (OR 25.14). In lower extremity application, the CAT Gen 7 had the highest rate of success (94.1%) and was 7.5 times more likely to achieve occlusion than the SOFTT-W Gen 4 (OR 7.54). The DNIPRO Gen 2 was rated most painful (Median 6), with significantly lower pain levels reported for the SICH (Median 4), the CAT Gen 7 (Median 5), and the SOFTT-W Gen 4 (Median 4). Conclusions: The DNIPRO Gen 2 and SICH tourniquets demonstrated high occlusion success rates, comparable to the CAT Gen 7 and superior to the SOFTT-W Gen 4. These findings suggest that Ukrainian-manufactured tourniquets may demonstrate comparable performance to CoTCCC-recommended tourniquets in a simulated prehospital setting. Full article

HRC is increasingly adopted in industrial and logistics environments, while workforce preparation often remains constrained by instructional approaches that provide limited embodied understanding of safety and ergonomics. This study examines the architectural design and system integration of a modular, human-centred XR platform intended to support safe and ergonomics-aware collaboration within smart logistics contexts. The proposed system integrates XR training scenarios deployed on consumer-grade hardware and follows a structured pedagogical progression from conceptual familiarisation through experiential task execution to reflective ergonomic evaluation. Multimodal feedback mechanisms based on posture-oriented guidance, attention-aware interaction design, and context-sensitive safety cues are incorporated without reliance on intrusive sensing technologies. A structured evaluation framework is defined to examine usability, task performance, and ergonomics-aligned posture indicators using standardised instruments and system-generated telemetry. The architectural design indicates that the framework supports scalable deployment, consistent interaction fidelity, and privacy-conscious data handling across educational and vocational settings. The proposed framework suggests that human-centred XR architectures can strengthen safety-oriented and ergonomically informed HRC within Industry 4.0 logistics environments. Full article

Background: Informal sewing workers are widely exposed to ergonomic and workload-related risks but remain largely excluded from formal occupational health protection, particularly in low- and middle-income countries. This study evaluated integrated physical and mental workload risks associated with WMSDs among informal sewing workers to develop contextually feasible preventive guidelines based on the Hierarchy of Ergonomic Control. Methods: A mixed-methods study was conducted among 150 informal sewing workers in Ubon Ratchathani Province, Thailand. Quantitative data were collected using a structured questionnaire, the Rapid Upper Limb Assessment (RULA), the Nordic Musculoskeletal Questionnaire (NMQ), and the NASA Task Load Index (NASA-TLX). Associations between sociodemographic characteristics, ergonomic risks, and WMSDs were analyzed using chi-square tests and correlation analysis. Qualitative data were obtained through a focus group discussion with key stakeholders to develop ergonomic control strategies guided by the HEC framework. Results: The majority of participants were female and middle-aged, with widespread exposure to high-risk ergonomic conditions, including prolonged sitting, repetitive tasks, and awkward postures. A high prevalence of WMSDs was observed, particularly in the neck, shoulders, and back. Younger workers and those with lower educational attainment experienced significantly higher ergonomic risk exposure and WMSD prevalence. NASA-TLX results indicated that physical demand and performance pressure were the main contributors to overall workload. Application of the HEC framework showed that elimination and substitution controls were the most effective strategies for reducing ergonomic risks, followed by engineering controls, while administrative measures and personal protective equipment were less effective. Conclusions: Informal sewing workers face substantial ergonomic and mental workload risks that contribute to a high burden of WMSDs. Prioritizing higher-order ergonomic controls, integrating workload management, and implementing community-based ergonomic interventions are essential to improving occupational health and reducing inequities among informal workers. Full article

Continuous monitoring of sitting posture is crucial for ergonomic assessment and fatigue prevention, yet many existing approaches rely on vision-based systems or single-modality sensing that are limited in capturing spatial and temporal biomechanical dynamics. This paper presents a multimodal smart-skin sensing system for spatial and temporal ergonomic fatigue analysis in sitting postures. The proposed platform integrates 42 distributed pressure, temperature, and vibration sensors arranged in 14 trimodal sensing nodes embedded across anatomical seating and back regions to enable real-time multimodal acquisition of human–chair interaction patterns. The study introduces an analytical framework combining anatomical heatmap visualization, temporal evolution analysis, delta pressure mapping, fatigue intensity estimation, and hotspot detection to characterize dynamic pressure redistribution during prolonged sitting. Experimental evaluations were conducted using a biomechanical mannequin and a single human participant with identical anthropometric characteristics (165 cm height and 62 kg body mass) across nine seated conditions, including neutral sitting, reclining, leaning, periodic shifting, and vibration-induced motion. Each posture condition was recorded as a time-series session and segmented into temporal phases to analyze fatigue evolution during prolonged sitting. Statistical analysis of pressure redistribution dynamics indicates significantly higher pressure drift in human measurements compared with the mechanically stable mannequin baseline (p < 0.001). The proposed framework provides a scalable sensing approach for ergonomic monitoring, intelligent seating systems, and human–machine interface applications. Full article

Background: Work-related musculoskeletal disorders (WMSDs) are common among surgeons. The objective was to study how economic, demographic, and quality-of-life indicators influence the WMSD prevalence among European surgeons. Methods: A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three open databases were scanned without a date limit to extract the overall WMSD prevalence and by body area. Results: Among the 11,814 articles, 25 were included, with a total of 5174 surgeons. The overall prevalence was pooled at 75.8% (95% CI: 68.6–83.1%). The most affected areas were lower back (52.1%, 95% CI: 43.1–61.0%), neck (51.2%, 95% CI: 43.7–58.9%), shoulder (43.1%, 95% CI: 36.4–49.8%) and upper back (34.2%, 95% CI: 24.2–44.1%). Surgeons aged over 45 with more than 10 years’ experience had a higher prevalence of WMSDs in the neck, hip, upper and lower back. The overall and lower back prevalence was higher among surgeons in countries where the surgery-by-surgeon ratio was greater than 125. A negative correlation was observed between the Human Development Index and the lower back prevalence. Conclusions: Further research is needed to strengthen ergonomics programs, knowledge, and organizational work strategies to effectively reduce WMSD prevalence among European surgeons. Full article

This paper presents a methodological framework for integrating UAV-based photogrammetry and GIS technologies to generate a high-accuracy digital elevation model (DEM) for urban land-use planning. The study was conducted in an urbanized area characterized by heterogeneous topography, mixed vegetation cover, and fragmented land use, which complicate high-resolution terrain modeling. UAV surveys were performed using multiple photogrammetric blocks with centimeter-level ground sample distance and a dense ground control network supported by geoid-based height corrections. The resulting DEM was independently validated using control points derived from large-scale topographic data. The achieved vertical accuracy (RMSE ≈ 0.25 m) confirms the applicability of UAV-derived DEMs for large-scale mapping (1:1000–1:2000) and urban spatial analysis. Unlike studies focused on runoff simulation, this work emphasizes the accuracy-controlled generation and validation of DEMs as a primary spatial dataset for urban planning applications. The results demonstrate that DEM accuracy depends strongly on flight planning, ground control distribution, and hybrid automatic–manual point cloud refinement. Full article

Industrial metaverse systems enable shared, immersive environments for coordinating complex, data-intensive industrial workflows; however, ensuring effective and usable interaction remains a key barrier to professional adoption. This study examines immersive point cloud- and CAD-based inspection tasks in an industrial metaverse context using a mixed-methods evaluation that combines perceived usability ratings, cognitive workload assessment (NASA-TLX), validated presence and flow instruments, qualitative interviews, and structured observation. The results indicate that users generally experienced smooth navigation, manageable cognitive workload, and a meaningful sense of spatial presence, supporting focused and task-oriented engagement. At the same time, execution-level challenges—particularly related to tool discoverability, annotation flexibility, system feedback clarity, and interaction ergonomics—introduced workflow friction for some users. By triangulating quantitative, qualitative, and observational evidence, the study derives actionable design recommendations, including adaptive onboarding, improved feedback mechanisms, and refinements to interaction design. Overall, the findings provide empirical insight into how usability, cognitive workload, presence, and flow jointly shape user experience in industrial metaverse inspection environments and inform the development of more robust, user-centered industrial systems. Full article

This study investigates the development of workwear designed to withstand harsh conditions and support physically demanding tasks. Its central aim is to create garments that enhance workers’ comfort and mobility by optimizing ergonomic and anthropometric factors. First of all, expert surveys were collected, and the importance of posture adaptability and material comfort was highlighted. To investigate realistic body–garment interactions, the 3D body scans of the upper body from 34 participants in common working poses were captured. These scans revealed the zones of high deformation, guiding the placement of elastic inserts to improve flexibility in targeted areas. The redesigned garments underwent a two-stage evaluation process. First, Clo3D virtual fittings provided qualitative insights into overall jacket fit and movement behavior. Next, stress and strain mapping offered quantitative validation, showing that fabric stress levels remained below 120 kPa, providing evidence that the added elasticity effectively reduced mechanical load and improved wearability. Expert reviewers confirmed the enhanced fit and functional performance. Overall, the study demonstrates an integrated design strategy that unites textile behavior, body dimensions and biomechanics. This approach not only improves workwear but also offers a transferable framework for developing specialized clothing across other physically intensive professions. Full article

Background: Posterior approaches to intramedullary spinal cord tumors traditionally rely on bilateral laminotomy or laminoplasty to ensure adequate midline exposure and contralateral dissection. Unilateral approaches are seldom applied in this context, due to concerns regarding insufficient visualization and limited working angles across the midline. Objective: To describe a modified hemilaminectomy technique designed to achieve safe midline myelotomy and bilateral tumor dissection through a unilateral corridor, preserving the structural and clinical benefits of minimally invasive posterior access. Methods: Fourteen patients with intramedullary spinal cord tumors underwent resection via a refined hemilaminectomy technique, which incorporated systematic thinning of the spinous process and strategic dural suspension. Pre- and postoperative neurological status was assessed using the modified McCormick scale. Surgical parameters, postoperative outcomes, and radiological follow-up were retrospectively collected. Results: Gross total resection was achieved in 13 of 14 patients (92.9%), with no new permanent neurological deficits. The mean surgical duration was 194.8 ± 55.9 min, and mean hemoglobin decrease was 1.47 ± 0.94 g/dL. Early postoperative improvement in McCormick grade was observed in 50% of cases, with statistically significant overall functional recovery (p = 0.013). No cases of postoperative cord tethering were identified on follow-up magnetic resonance imaging. The approach was technically reproducible and ergonomically favorable, with a shallow learning curve in surgeons experienced with conventional hemilaminectomy. Conclusions: The modified hemilaminectomy technique enables effective bilateral exposure and safe midline myelotomy through a unilateral approach, achieving high resection rates with minimal morbidity. It represents a feasible and reproducible alternative to bilateral approaches and warrants prospective validation. Full article

Computational simulation is a valuable tool for advancing personalized ergonomics. This study evaluated the ability of musculoskeletal simulation to estimate individual lumbar loading during manual lifting tasks representative of construction activities. Fifty-six Colombian adults were recruited to reflect national anthropometric distributions and grouped by BMI and stature. Participants performed two standardized lifting tasks with a 10 kg load: symmetric lifting from the floor to xiphoid height and lateral lifting from a 0.40 m surface to shoulder height with contralateral transfer. Whole-body kinematics and ground reaction forces were processed in OpenSim software using the validated model to estimate L5–S1 compression and shear forces. Results showed a moderate association between lumbar compression and body weight, while shear forces exhibited low correlations with kinematic variables. Subject-specific scaled models revealed substantial inter-individual differences in lumbar loading related to lifting technique and anthropometric characteristics, highlighting the potential of musculoskeletal simulation for personalized risk assessment in construction. Full article

Background/Objectives: Hand loss or severe impairment significantly reduces quality of life by restricting essential daily activities and professional tasks. Despite advances in prosthetics, challenges remain in affordability, accessibility, and usability. This study aimed to design and develop a low-cost, ergonomic bionic hand prototype that integrates sustainable fabrication, intuitive control, and modular electronics. Methods: A user-centred design process guided by iterative prototyping, anatomical modelling, and functional validation. The prototype was manufactured using 3D printing techniques and assembled with modular electronic components. The design included segmented fingers, independent thumb articulation, and a tendon-like actuation system driven by micro-motors. Control was implemented through an ESP32-based board and a Bluetooth-enabled mobile application. Durability was preliminarily assessed through 500 grasp–release cycles. Results: Experimental validation confirmed the feasibility of both precision and power grips. The pinch grip successfully lifted objects to 120 g, and the power grip up to 85 g, corresponding to effective output forces of approximately 1.2 N and 0.83 N, respectively. The final prototype weighed ~350 g and maintained reliable performance during 500 grasp–release cycles. Conclusions: The developed bionic hand demonstrates that an affordable, ergonomic, and functional prosthetic can be achieved through sustainable 3D printing and accessible electronics. Future work will focus on enhancing actuation strength, long-term durability, and integration of sensory feedback, with the long-term objective of clinical testing and scalable production. Full article

Modern manufacturing enterprises strive to increase process efficiency while simultaneously reducing resource consumption and improving the working conditions of operators. In this context, the importance of digital tools supporting the design and analysis of production processes is growing, such as computer simulations and virtual reality (VR) technologies, which enable the evaluation of designed solutions even before their implementation. The article presents the possibilities of using VR technology in the analysis and optimization of a production process based on a case study. The applied methodology included defining evaluation indicators, developing a simulation model in the FlexSim environment, verifying the functioning of the process using computer simulation and immersive VR, and then introducing improvements followed by a re-analysis of the process. The evaluation included indicators of process efficiency, operator utilization, transport distances, electricity consumption, and qualitative observations concerning ergonomics and work organization. The applied approach made it possible to increase process efficiency, improve operator utilization, and reduce transport distances while simultaneously improving work organization. The results confirm the validity of using simulation supported by immersive techniques as a tool for supporting the design and optimization of production processes and for identifying problems that are difficult to detect using classical simulation methods. Full article

Background: Pumping in Laser-class sailing is a dynamic propulsion technique used in marginal wind conditions and characterized by repetitive, coordinated oscillations of the sailor–sail system. Despite its practical relevance, its biomechanical and ergonomic demands remain insufficiently characterized. Methods: A mixed-methods framework was applied combining questionnaire data, kinematic analysis, ergonomic assessment, and musculoskeletal modelling. Thirty-six competitive Laser sailors completed a Borg CR-10-based questionnaire on perceived discomfort/fatigue across body regions at predefined time points (during pumping, immediately after training, and the following day). A controlled land-based multi-angle video acquisition was used to reconstruct a standardized pumping posture and parameterize a digital human model in DELMIA^® for postural/kinematic analysis. Ergonomic risk was assessed using REBA, and muscle activity was estimated using the AnyBody^® Modeling System (simulation-derived normalized muscle activity across 129 muscles). Results: the simulation identified high neuromuscular demand in the trunk and shoulder complex, with several deep trunk stabilizers and the left latissimus dorsi reaching 100% modeled normalized muscle activity. Marked lateral asymmetry was observed, with right-sided trunk dominance and left-sided shoulder dominance. Kinematic analysis showed substantial joint excursions, with large lumbar motion amplitudes, while REBA yielded a score of 11 (Very-High Risk). Questionnaire data indicated a high prevalence of pumping-related musculoskeletal discomfort (72.2%), most frequently involving the lower back, shoulders, and knees. A dissociation was observed between modeled muscle activity and perceived fatigue, with the lower limbs rated as most fatigued despite lower modeled activation than the trunk. Conclusions: Findings identify the deep trunk stabilizers, latissimus dorsi, and lower extremities as key regions involved in pumping, with marked lateral asymmetry and high ergonomic risk. They support targeted training, injury-prevention, and ergonomic strategies to improve performance and reduce injury risk in competitive sailing. Full article

Ensuring accessibility for wheelchair users is essential in promoting inclusivity and equal opportunities, yet challenges remain, especially regarding infrastructure and public furniture. One common issue is the incompatibility of standard public tables with wheelchair heights, which often results in discomfort or discourages use. While various wheelchair trays have been introduced, many lack stability, ergonomic design, and ease of attachment. To address these shortcomings, we developed AdjusTABLE—a portable, height-adjustable, and foldable tray designed with ergonomic comfort and user convenience. Using empathy maps and focus group discussions, we created a tray that holds drinks, pens, phones, and personal belongings, improving usability and independence. Full article

Background: Fibromyalgia (FM) and eating disorders (ED) represent distinct clinical entities traditionally managed within separate medical specialties, yet emerging evidence suggests significant comorbidity and potential shared pathophysiological mechanisms. Both conditions disproportionately affect women, involve complex multifactorial etiologies and substantially impair quality of life. Despite documented clinical overlaps, the mechanistic connections linking these conditions remain poorly characterized, and integrated treatment approaches are lacking. Objective: This narrative review examines the role of oxidative stress and nuclear factor erythroid 2-related factor 2 (Nrf2) pathway dysfunction as a unifying molecular mechanism connecting fibromyalgia and eating disorders, with emphasis on implications for integrated rehabilitation strategies. Methods: We synthesized current evidence on oxidative stress pathophysiology in fibromyalgia and eating disorders, focusing on Nrf2-Keap1 pathway function, clinical comorbidity patterns and rehabilitation interventions targeting antioxidant defense mechanisms. In PubMed, representative search strings included “(fibromyalgia [MeSH] OR fibromyalgia [Title/Abstract]) AND (“eating disorders” [MeSH] OR “anorexia nervosa” [MeSH] OR “bulimia nervosa” [MeSH])” and “fibromyalgia AND (“oxidative stress” OR Nrf2 OR “redox”)”. Articles in English published through December 2025 were considered, with additional records identified by manually screening reference lists. Results: Fibromyalgia patients exhibit elevated oxidative stress markers, impaired antioxidant enzyme function and compromised Nrf2 activity correlating with disease severity, with studies reporting approximately 30–50% reductions in coenzyme Q10 levels compared with healthy controls. Similarly, eating disorders demonstrate mitochondrial dysfunction and oxidative stress dysregulation, though patterns differ across eating disorder phenotypes. Nrf2 serves as the master regulator of cellular antioxidant defense, coordinating expression of over 500 genes involved in detoxification, cytoprotection, inflammation modulation and metabolic regulation. Evidence suggests Nrf2 activity is regulated by energy balance, potentially linking nutritional status with cellular stress responses. Rehabilitation interventions, including graduated exercise and nutritional optimization with Nrf2-activating foods (cruciferous vegetables, polyphenols, omega-3 fatty acids), offer mechanism-based therapeutic approaches through hormetic Nrf2 activation and direct Keap1 modification. Conclusions: Multidisciplinary rehabilitation programs integrating physical therapy, exercise prescription and nutritional strategies targeting Nrf2 activation offer evidence-based, mechanism-driven approaches to address shared oxidative stress pathophysiology. Nrf2 pathway dysfunction represents a promising and biologically plausible molecular target that may help to unify our understanding of fibromyalgia and eating disorders pending confirmation from prospective clinical studies in comorbid populations. Future research should prioritize prospective clinical trials testing Nrf2-targeted interventions in comorbid populations and collaborative patient-centered care models. Full article