Search Results (137)

Purpose: Sarcopenia has emerged as a potential prognostic factor for postoperative complications, functional recovery, patient-reported outcomes, and healthcare costs in patients undergoing total knee arthroplasty (TKA). This systematic review aimed to evaluate its impact on these outcomes following primary TKA. Methods: A systematic review was conducted according to PRISMA guidelines and prospectively registered in PROSPERO (CRD420261320013). PubMed/MEDLINE, EMBASE, and Cochrane Library were searched up to 1 December 2025. Comparative clinical studies including sarcopenic and non-sarcopenic patients undergoing primary TKA and reporting postoperative outcomes were included. Methodological quality was assessed using the MINORS tool. Due to heterogeneity in study design, diagnostic criteria, and outcome measures, a narrative synthesis was performed. Results: Nine studies including more than 93,000 patients were analyzed. Sarcopenia prevalence ranged from 7.7% to 25%. Sarcopenic patients demonstrated higher rates of postoperative complications, including medical events, blood transfusion, falls, fractures, reoperations, and implant-related complications. Functional recovery was delayed, particularly in patients with sarcopenic obesity, with slower improvements in range of motion and gait speed. Although both groups improved after TKA, short- to mid-term patient-reported outcomes were often inferior in sarcopenic patients, while long-term differences were less consistent. Sarcopenia was also associated with longer hospital stay and increased healthcare costs. Conclusions: Sarcopenia is associated with worse postoperative outcomes following primary TKA and may represent a modifiable risk factor for perioperative optimization. Full article

In the context of subtropical cities, the slow-moving environment of HOD (Hospital-Oriented Development) faces the dual challenges of spatial fragmentation and an extreme hot and humid climate, which also restricts the outdoor space’s thermal environment performance. Taking the Macau Light Rapid Transit (LRT) Union Hospital Station as an example, this study constructs a “topology-climate” dual quantitative assessment framework that integrates space syntax and parametric universal thermal climate index (UTCI) simulation. In response to the current problems of mixed pedestrian and vehicular traffic and high-intensity heat radiation, a comprehensive intervention strategy combining three-dimensional stitching and spatial optimization is proposed. The results show that: (1) The implantation of three-dimensional corridors improved the spatial integration of the core area of the site by 67.0%, significantly optimizing network connectivity. (2) During the extreme high-temperature period of daytime (9:00–18:00) in summer and autumn, the intervention strategy precisely opened up a continuous low-heat-stress linear shade zone through the synergistic mechanism of building projection shadows, physical shading of connecting corridors, (landscape shading effect, original evaporation removed). (3) The study confirms that landscape-coupled shading layout is the most effective method, reducing potential pedestrian heat exposure across the entire area, while the three-dimensional connecting corridors precisely control the thermal environment of core walkways. Together, these two elements construct a “topology-climate” optimization framework, achieving a synergistic improvement in spatial accessibility and simulated thermal comfort performance under standard meteorological input and quantitatively verifying the optimization effectiveness of the tiered intervention scheme. This study provides a data-driven decision-making basis for optimizing potential walking thermal conditions for vulnerable groups and reshaping the space’s potential to improve microclimate via shading design of medical hub areas and also provides a scientific paradigm for TOD microclimate planning focused on shading-based thermal environment optimization. Full article

Background/Objectives: The rapid growth of the global aging population, projected to reach 2.1 billion older adults by 2050, presents major challenges for pharmacotherapy and drug delivery. Age-related physiological changes affecting pharmacokinetics and pharmacodynamics, widespread polypharmacy, and functional impairments such as dysphagia, cognitive decline, and sensory or motor limitations reduce the effectiveness and safety of conventional “one-size-fits-all” medication approaches. This review aimed to evaluate the major barriers to effective drug delivery in older adults and to assess emerging patient-centered and technology-driven drug delivery systems designed to improve medication adherence, safety, and therapeutic outcomes in geriatric populations. Methods: A comprehensive narrative review of current literature was conducted focusing on geriatric pharmacotherapy, age-related barriers to medication administration, and advanced drug delivery technologies. The review analyzed evidence regarding modified oral formulations, transdermal systems, long-acting injectables, implantable devices, nanotechnology-based platforms, digital health integrations, pharmacogenomics, biomarker-guided therapy, and deprescribing strategies including STOPP/START criteria and Beers Criteria. Studies addressing polypharmacy, medication adherence, and personalized medicine in older adults were also evaluated. Results: Evidence indicates that older adults experience significant medication-related challenges due to multimorbidity, polypharmacy, and functional decline. Dysphagia affects more than half of nursing home residents, while polypharmacy prevalence reaches up to 86.6% in some populations. Emerging drug delivery technologies demonstrated potential to improve adherence, dosing precision, and patient convenience. Personalized approaches incorporating pharmacogenomics, biomarker-guided treatment, and AI-assisted dosing showed promise for optimizing therapy. However, major limitations remain, including underrepresentation of older adults in clinical trials, limited high-quality evidence supporting many polypharmacy interventions, and insufficient implementation of advanced drug delivery systems in routine clinical practice. Conclusions: Current evidence supports a transition from standardized medication approaches toward flexible, individualized, and patient-centered drug delivery strategies for older adults. Advanced delivery technologies and personalized pharmacotherapy may improve medication safety, adherence, and quality of life in aging populations, although stronger clinical evidence and broader implementation are still needed. Future progress will require interdisciplinary care models, improved geriatric representation in clinical research, and regulatory reforms supporting the integration of innovative drug delivery systems into routine healthcare practice. Full article

Background: Despite the widespread clinical use of dental implants, research in implant dentistry remains active, aiming to develop new materials, designs, and surface morphologies, as well as to better understand the biological mechanisms underlying the pathophysiology of certain diseases to improve patient outcomes. In this context, preclinical animal models provide an essential opportunity to explore and validate new technologies and protocols before their application in humans. Although large vertebrate species have historically been preferred due to their biological similarity to humans, small animal models such as rats offer significant advantages. Additionally, they allow researchers to work with larger sample sizes, improving the statistical power of experimental outcomes. This scoping review aimed to analyze the current literature on intraoral rat surgical models in the field of implant dentistry. Methods: We included the preclinical studies using rat models focused on implant placement in the oral cavity and published in English. We excluded all studies that involved animal models other than rats or used implant placements in anatomical sites different from the target region. An electronic search was conducted in the PubMed and Scopus databases. From an initial 1032 results, 680 articles remained after duplicate removal. A first screening retained 191 articles, and after full-text review, 98 studies were ultimately included. The selection process was conducted using the software Rayyan. Data were extracted and analyzed across nine domains: Publication metadata, Focused Research Questions, Animal specificities, Study Design, Surgical Protocol Features, Medications Administered to Establish the Experimental Model, Timing of Euthanasia, Characterization methods, and Drop-Out Information. Results: The evaluation of the selected literature revealed a lack of standardization in study design. There is no consensus regarding the rat species used, the age at the time of implant placement, the anatomical site, or the implant morphology. Even more concerning is the presence of methodological deficiencies in the reporting of study design and outcome measures. Conclusions: By summarizing the available data, this review proposes the most commonly used features across preclinical trials in rats. Moreover, it offers a comprehensive overview of the current scientific landscape in this field, enabling researchers to compare different study designs and more easily access relevant information. Full article

This is a narrative review that explores the development of non-implantable vestibular devices designed to address postural instability, particularly in aging populations and patients with vestibular hypofunction. It establishes that balance relies on complex sensory integration and that the functional decline of this system creates a significant medical need. Three principal technological strategies are examined: sensory substitution devices, galvanic vestibular stimulation (GVS), and immersive visual feedback systems. Sensory substitution devices, which convert balance data into auditory, tactile, or electrotactile cues, demonstrate significant promise. Examples like vibrotactile belts provide feedback that reduces postural sway, enhancing stability and patient confidence. Parallel to this, GVS—using electrical currents applied to the mastoids—emerges as a potent non-invasive method to modulate vestibular pathways, improving balance control and even inducing neuroplastic changes, especially with stochastic “noisy” signals. The most recently developed devices include augmented and virtual reality technologies that offer innovative visual feedback, creating enriched rehabilitation environments that accelerate recovery by promoting sensory reweighting and neural adaptation. This review concludes that while implantable prostheses are advancing, non-invasive devices offer versatile, affordable, and complementary solutions for balance restoration. The future success of non-invasive alternatives hinges on developing more sophisticated stimulation protocols that account for the complexity of natural movement and individual patient contexts, expanding therapeutic options for vestibular disorders. Full article

This research presents an artificial intelligence (AI)-driven 3D scanning and printing system for the fabrication of personalized dental prosthetics, implants, and orthodontic appliances. The proposed system integrates high-resolution intraoral scanning, AI-based data analysis, and additive manufacturing to enhance precision, customization, and treatment efficiency. Patient-specific anatomical data and medical history are incorporated to optimize implant design, material selection, and functional performance. Nano-enhanced biocompatible materials are utilized to improve mechanical strength, durability, and antibacterial properties. Specifically, these materials demonstrate a 30% increase in overall precision and a 50% improvement in durability compared to traditional dental materials. In addition, the system adopts a zero-waste manufacturing strategy by recycling excess materials, supporting sustainable dental practices. The results demonstrate significant improvements in accuracy, patient comfort, and environmental responsibility in modern digital dentistry. Full article

Nanotechnology has emerged as a key driver in radioisotope batteries, which offer unique advantages for long-term, maintenance-free energy supply in deep space exploration, medical implants, and nuclear waste utilization. This review summarizes recent progress in applying nanomaterials and nanostructures to overcome the limitations of nuclear batteries, including low energy conversion efficiency and poor stability. The main content focuses on the three primary conversion mechanisms of thermoelectric, radio-voltaic, and radio-photovoltaic batteries, discussing high-performance thermoelectric nanomaterials such as SiGe alloys, wide-bandgap semiconductors including diamond and SiC for enhanced carrier collection, and nanoscale radionuclide ources to mitigate self-absorption losses. This review further elaborates on how nanostructure regulation and interface engineering have significantly improved carrier collection efficiency and device stability. These advances have enabled notable civilian applications, such as the BV100 and “Zhulong No.1” nuclear batteries. Despite this progress, challenges remain in ensuring long-term material stability under extreme environments, maintaining performance consistency during macroscopic device integration, and addressing the high fabrication costs. The review concludes by outlining future research directions, including the development of novel nanomaterial systems, innovative nanostructure designs, scalable manufacturing processes, and enhanced device stability and safety, to further advance next-generation radioisotope batteries. Full article

Cranial cruciate ligament rupture is a common orthopedic condition in dogs, and tibial tuberosity advancement is a well-established surgical treatment. The aim of this retrospective study was to evaluate the short-term clinical and radiographic outcomes of a cageless tibial tuberosity advancement technique in small-breed dogs. Medical records of 63 dogs (77 stifles) treated using this technique were reviewed. Fixation was achieved using three construct types: a screw–pin construct (the majority of cases), a screw-only construct, or a screw combined with two pins. Due to small subgroup sizes, fixation-type outcomes were primarily analyzed descriptively. Clinical and radiographic evaluations were performed immediately after surgery and at eight weeks postoperatively. Clinical outcomes were graded based on limb function, and radiographic bone healing was scored using a standardized scale. Postoperative complications were recorded and analyzed in relation to patient and procedural variables. No intraoperative complications were observed, while postoperative complications occurred in 27% of dogs and were predominantly minor and implant-related. Lameness scores improved significantly over the follow-up period. All treated stifles demonstrated stable implants, maintained advancement, and satisfactory bone healing. The use of bone graft material appeared to be associated with fewer complications and more favorable clinical outcomes; however, this observation should be interpreted with caution given the retrospective and non-randomized design of the study. In this retrospective case series, cageless tibial tuberosity advancement using screw-based fixation (predominantly screw–pin constructs) was associated with favorable short-term clinical and radiographic outcomes. These findings should be considered preliminary and limited to short-term evaluation, given the retrospective design, absence of a control group, and relatively short follow-up period. Further prospective studies with larger populations, standardized outcome measures, and longer follow-up are warranted to confirm these findings. Full article

Orthopaedic plates are long-established medical devices conventionally manufactured from metals, most notably titanium alloys. The introduction of Additive Manufacturing (AM) has created new opportunities to design implants with complex internal architectures, enabling precise control over infill patterns and densities that directly influence mechanical properties and fatigue performance. Biodegradable polymers such as polylactic acid (PLA) have attracted growing interest in biomedical engineering, potentially reducing the need for secondary implant-removal surgery if degradation rates are carefully controlled and clinically approved. Additionally, AM offers the ability to customise internal structure for improved mechanical performance and load-bearing, while also providing the possibility of integrating advanced functionalities, such as controlled drug delivery. Building on previous work by our research group at the University of Belgrade, this study investigates the fatigue behaviour of the best-performing AM-optimised orthopaedic plate design. Numerical models incorporating honeycomb infill structures with the full range of achievable densities were developed to assess structural integrity under fatigue loading. Fatigue crack growth was simulated in ANSYS Mechanical (ANSYS Inc., Canonsburg, PA, USA) software, employing a four-point bending configuration in accordance with the ASTM F382 standard. A validated PLA material model was implemented at a reduced load level (10%) relative to previous studies. Direct comparison with titanium plates was avoided due to fundamentally different material properties, focusing instead on infill architecture to identify optimal AM design strategies for orthopaedic plates. Full article

Additive manufacturing has been adopted in several industries including the medical field to develop new personalised medical implants including tissue engineering scaffolds. Custom patient-specific scaffolds can be additively manufactured to speed up the wound healing process. The aim of this study was to design, fabricate, and evaluate a range of materials and scaffold architectures for 3D-printed wound dressings intended for soft tissue applications, such as skin repair. Multiple biocompatible polymers, including polylactic acid (PLA), polyvinyl alcohol (PVA), butenediol vinyl alcohol copolymer (BVOH), and polycaprolactone (PCL), were fabricated using a material extrusion additive manufacturing technique. Eight scaffolds, five with circular designs (knee meniscus angled (KMA), knee meniscus stacked (KMS), circle dense centre (CDC), circle dense edge (CDE), and circle no gradient (CNG)), and three square scaffolds (square dense centre (SDC), square dense edge (SDE), and square no gradient (SNG), with varying pore widths and gradient distributions) were designed using an open-source custom toolpath generator to enable precise control over scaffold architecture. An in vitro degradation study in phosphate-buffered saline demonstrated that PLA exhibited the greatest material stability, indicating minimal degradation under the tested conditions. In comparison, PVA showed improved performance relative to BVOH, as it was capable of absorbing a greater volume of exudate fluid and remained structurally intact for a longer duration, requiring up to 60 min to fully dissolve. Tensile testing of PLA scaffolds further revealed that designs with increased porosity towards the centre exhibited superior mechanical performance. The strongest scaffold design exhibited a Young’s modulus of 1060.67 ± 16.22 MPa and withstood a maximum tensile stress of 21.89 ± 0.81 MPa before fracture, while maintaining a porosity of approximately 52.37%. This demonstrates a favourable balance between mechanical strength and porosity that mimics key properties of engineered tissues such as the meniscus. Overall, these findings highlight the potential of 3D-printed, patient-specific scaffolds to enhance the effectiveness and customisation of tissue engineering treatments, such as meniscus repair, offering a promising approach for next-generation regenerative applications. Full article

This study, based on the specifications of implantable medical devices for wireless power transfer, presents a bootstrap-comparator rectifier circuit design characterized by high voltage conversion efficiency, high power conversion efficiency, and improved reliability. The design is implemented using a 0.18 µm process to achieve superior VCE and PCE performance. The input signal is a 2 MHz, 3.3 V sine wave, producing an output voltage of 2.94 V with a maximum operating current of 5 mA. At an output load of $R_L=8\mathrm{k}\Omega$, the maximum voltage conversion efficiency (VCE) reaches 89.02%, while the maximum power conversion efficiency (PCE) is 84.73% at $R_L=500\Omega$. The temperature rise ($\Delta T$) is 0.22–0.45 °C. Full article

Contemporary advances in bioengineering and materials science have substantially improved the viability of medical implants. The demand for optimized implant technologies has led to the development of advanced coatings that enhance biocompatibility, antimicrobial activity, and durability. Implant manufacturers and surgeons must anticipate both biological and mechanical challenges when implementing devices for patient use. Key areas of concern include infection, corrosion, wear, immune response, and implant rejection; regulatory and economic considerations must also be addressed. Materials science developments are optimizing the integration of established materials such as biometrics, composites, and nanomaterials, while also advancing fabrication-based innovations including plasma functionalization, anodization, and self-assembled monolayers. Emerging smart and stimuli-responsive surface technologies enable controlled drug delivery and real-time implant status communication. These innovations enhance osseointegration, antimicrobial performance, and overall device functionality across orthopedic, dental, and cardiovascular applications. As implant design continues to shift toward personalized, responsive systems, advanced coating technologies are poised to deliver significantly improved long-term clinical outcomes for patients. Full article

Recent studies show that titanium (Ti)-based alloys combine established mechanical strength, corrosion resistance, and biocompatibility with emerging electrical and electrochemical properties relevant to bioelectronics. The main goal of the present manuscript is to give a wide-ranging overview on the use of Ti-alloys in electronics and biomedicine, focusing on a comprehensive analysis and synthesis of the existing literature to identify gaps and future directions. Concurrently, the identification of possible correlations between the effects of the manufacturing process, alloying elements, and other degrees of freedom influencing the material characteristics are put in evidence, aiming to establish a global view on efficient interdisciplinary efforts to realize high-added-value smart devices useful in the field of biomedicine, such as, for example, implantable apparatuses. This review mostly summarizes advances in surface modification approaches—including anodization, conductive coatings, and nanostructuring that improve conductivity while maintaining biological compatibility. Trends in applications demonstrate how these alloys support smart implants, biosensors, and neural interfaces by enabling reliable signal transmission and long-term integration with tissue. Key challenges remain in balancing electrical performance with biological response and in scaling laboratory modifications for clinical use. Perspectives for future work include optimizing alloy composition, refining surface treatments, and developing multifunctional designs that integrate mechanical, biological, and electronic requirements. Together, these directions highlight the potential of titanium alloys to serve as foundational materials for next-generation bioelectronic medical technologies. Full article

Magnetic localization technology plays a significant role in medical device navigation and human–computer interaction. However, existing localization methods based on local optimization suffer from poor initial solutions and slow convergence. To address the aforementioned challenges, this paper presents a hybrid localization approach, referred to as the Improved Artificial Lemming Algorithm (IALA) Integrated with Levenberg–Marquardt (LM) Optimization. Building upon the Artificial Lemming Algorithm (ALA), the proposed method incorporates an adaptive Gaussian–Lévy hybrid mutation strategy designed to enhance search performance through improved exploration–exploitation dynamics, as quantitatively demonstrated by the diversity-based analysis where IALA maintains higher exploration percentages on multimodal functions while achieving superior optimization results on high-dimensional problems. By introducing a competitive foraging mechanism inspired by the aggressive behavior of the Tasmanian Devil Optimization (TDO) algorithm, it enhances population diversity and search initiative. Furthermore, a time-varying tracking and escape strategy is adopted to improve dynamic optimization performance in complex solution spaces. The proposed method leverages IALA to generate high-quality initial solutions, significantly accelerating the convergence speed and stability of the LM algorithm, thereby improving the overall performance of the permanent magnet localization system. The experimental results show that, using a horizontal test platform of 60 mm × 60 mm with 41 uniformly distributed test points, and acquiring data at vertical heights ranging from 15 mm to 65 mm in 5 mm increments for two distinct orientations of the permanent magnet, the IALA-LM algorithm achieves an average localization success rate of 96.9% over 902 trials, with a mean position error of 1.1 mm and a mean orientation error of 0.17°. Compared with the standard LM algorithm, the proposed IALA-LM algorithm reduces the position error by approximately 66.7% (from 3.3 mm to 1.1 mm) and the orientation error by approximately 94.3% (from 3.0° to 0.17°). Consequently, the proposed method enables high-precision, high-stability, and high-efficiency localization of permanent magnets. It can provide reliable spatial pose estimation support for demanding applications such as miniature implantable or ingestible medical devices (e.g., capsule endoscopy, intramedullary nail fixation, and tumor localization), human–computer interaction, and industrial inspection. Full article

Glaucoma is recognized as the second leading cause of blindness globally and a primary cause of irreversible blindness, estimated to affect over 80 million patients worldwide, including 4.5 million in the United States. Though the disease is multifactorial, the primary cause is elevated intraocular pressure (IOP), which damages the optic nerve fibers that connect the eye to the brain, thus interfering with the quality of vision. Current treatments have evolved, which consist of medications, laser therapies, and surgical interventions such as filtering procedures, glaucoma drainage devices (GDDs), and current innovations of minimally invasive glaucoma surgeries (MIGS). This paper aims to discuss the history and evolution of the design and biomaterials employed in GDDs and MIGS. Through a comprehensive review of the literature, we trace the development of these devices from early concepts to modern implants, highlighting advancements in materials science and surgical integration. This historical analysis, ranging from the mid-19th century, reveals a trend towards enhanced biocompatibility, improved efficiency in IOP reduction, and reduced complications. We conclude that the ongoing evolution of GDDs and MIGS underscores a persistent commitment to advancing patient care in glaucoma, paving the way for future device innovations and therapeutic trends to treat glaucoma. Full article