Search Results (1,623)

Firmware forms the persistent software layer controlling embedded and Internet-of-Things (IoT) devices, industrial controllers, automotive systems, and cyber-physical infrastructure. Vulnerabilities in firmware enable remote compromise, supply-chain attacks, and long-lived implants that survive operating-system reinstallation. This review synthesises 118 works published from 2014 to 2026—comprising 78 primary research studies; 23 surveys and systematisations of knowledge; and 17 benchmarks, tools, and background references—covering the full firmware reverse engineering (FRE) pipeline: physical acquisition (including fault injection and side-channel extraction), format analysis and unpacking, static analysis (binary code similarity detection, protocol reverse engineering, and patch diffing), dynamic analysis and hardware emulation, fuzzing-based vulnerability discovery, and artificial intelligence (AI) and large language model (LLM)-assisted analysis. Three additional dimensions are surveyed: digital twin-assisted firmware security testing; secure boot, trusted execution environment (TEE), and over-the-air (OTA) update security; and firmware rootkit and implant detection. Coverage spans two axes—the firmware class (Linux-based IoT, microcontroller-unit bare-metal, RTOS, UEFI/BIOS, PLC/ICS, and automotive ECU) and analysis depth (surface scanning to exploit-validated vulnerability chains). We identify ten structural gaps, including the absence of unified evaluation benchmarks, fragmented peripheral modelling, the scalability–fidelity trade-off in re-hosting, and insufficient grounding of LLM tools in firmware-specific realities. We conclude with six research directions for trustworthy, scalable, and infrastructure-aware firmware analysis. Full article

Background: Inverted-bearing reverse total shoulder arthroplasty (rTSA), using a polyethylene glenosphere with a metal humeral liner, may reduce polyethylene wear, osteolysis, and scapular notching. This study evaluated long-term survivorship, complications, radiographic findings, and clinical outcomes of a large-glenosphere inverted-bearing rTSA design. Methods: A retrospective single-surgeon cohort included 394 primary rTSAs (363 patients; mean age 73.8 ± 8.5 years) performed between 2006 and 2018 using the same implant system. Clinical follow-up was available for 123 patients at a mean of 9.4 years. Outcomes included ASES, Oxford Shoulder Score (OSS), Subjective Shoulder Value (SSV), and pain VAS. Radiographs obtained at ≥8 years were assessed for scapular notching, glenoid loosening, and humeral osteolysis/stress shielding. Kaplan–Meier survival analysis was performed. Results: Thirty of the 257 rTSAs with revision follow-up (11.7%) underwent revision, most commonly for glenoid loosening or instability. Among patients with long-term radiographs, scapular notching occurred in 8.3% of all-polyethylene glenospheres and was limited to grade 1. Humeral osteolysis/stress shielding was present in 36%, although no humeral components were revised for loosening. Median final follow-up PROMs were ASES 75.8, OSS 42, SSV 78, and pain VAS 1. Conclusions: Large-glenosphere inverted-bearing rTSA demonstrated satisfactory long-term outcomes, low notching rates, and acceptable survivorship. The favourable notching profile should be interpreted in the context of the larger eccentric glenosphere design, which precludes attribution of this finding to bearing material alone. Full article

Current airway stents, including silicone and metallic devices, remain associated with important complications such as migration, restenosis, mucus retention and the need for repeated interventions. Biodegradable stents offer a promising alternative by providing temporary mechanical support while avoiding the long-term presence of a permanent implant. However, the influence of stent geometry and material properties on their mechanical performance and interaction with airway tissue is still not fully understood. This study presents a computational framework integrating computer-aided design and finite element analysis to investigate the mechanical behaviour of biodegradable tracheobronchial stents. Two stent architectures (X-pattern and W-pattern) were analysed over a range of wire thicknesses using two biodegradable materials: a PLA/PCL; 70/30 wt.% blend and AZ31 magnesium alloy. Radial compression, diameter recovery after radial compression and stent–tissue interaction simulations were performed to evaluate the influence of geometry, material selection and design parameters on device performance. The results suggested that both stent geometry and material properties strongly influence the mechanical behaviour of biodegradable airway stents, although they affect different aspects of the stent–tissue interaction. The X-pattern consistently exhibited greater resistance to radial compression, lower elastic diameter recovery after radial compression and improved maintenance of the expanded lumen compared with the W-pattern. Material properties primarily affected the magnitude of the mechanical response, as further confirmed by the quantitative contact-pressure analysis, with AZ31 providing greater radial support, while the spatial distributions of stress and strain within the tracheal wall were mainly governed by the stent architecture. Based on the computational analyses, X-pattern stents manufactured from the PLA/PCL; 70/30 wt.% blend were selected for in vivo evaluation in a rabbit model. Endoscopic observations revealed tissue features that were qualitatively consistent with the mechanical patterns predicted by the numerical simulations, although no direct causal relationship can be established from the available observations. These findings support the ability of the proposed framework to represent the principal aspects of stent–tissue interaction. The proposed computational framework provides a practical tool for the rational design and mechanical assessment of biodegradable airway stents and may facilitate the future development of customised airway prostheses. Full article

Patients with implanted cardiac devices are a rapidly growing imaging population, and electrocardiogram-gated cardiac computed tomography (CT) is increasingly used to characterize device geometry, multi-device relationships, and dynamic behavior across the cardiac cycle. Cinematic rendering (CR) is a photorealistic three-dimensional (3D) visualization technique for cardiac CT whose established contribution in this population is communicative: it conveys 3D device geometry and material distinctions within a single rendered volume. We describe a demonstrative case series extending CR across the cardiac cycle—time-resolved “4D cine” CR—to depict dynamic device behavior and time-resolved multi-device interaction in a single volume; this is an illustrative technical experience rather than a systematic evaluation of diagnostic performance. Illustrative examples include an EVOQUE transcatheter tricuspid valve rendered together with concurrent surgical mitral and transcatheter aortic valves, a left atrial appendage occlusion device, a normally positioned Impella catheter, and a HeartMate 3 left ventricular assist device (LVAD). Across cases, 4D cine CR feasibility scaled inversely with metallic burden—the aggregate volume and radiodensity of metallic device components within the scan field—with renderings informative for low-metal nitinol and catheter devices but substantially degraded by streak artifact in high-metal LVAD housings. This relationship was observed qualitatively in a small selected series and is offered as an initial observation rather than an established characteristic of the technique. We discuss current limitations and emerging directions such as photon-counting detector CT, metal artifact reduction, and artificial-intelligence-assisted post-processing that may extend 4D cine CR in this population. Full article

Micromachined ultrasonic transducers (MUTs) represent a notable advance in miniaturized sensing, enabling compact, low-power, and complementary metal-oxide-semiconductor (CMOS)-integrated platforms that extend ultrasonic capabilities into wearable, implantable, and edge-computing domains. The integration of artificial intelligence (AI) has introduced new approaches for signal interpretation, adaptive control, and data-driven optimization, enhancing performance in specific areas such as compressed sensing, neural beamforming, and learned image enhancement that complement conventional signal processing. Meanwhile, sensor fusion strategies that combine ultrasonic data with complementary modalities have improved robustness, contextual awareness, and diagnostic accuracy across applications ranging from industrial monitoring to clinical diagnostics. This review provides a comprehensive analysis of this active research area, systematically covering transducer hardware platforms, design methodologies, and intelligent signal processing frameworks. While traditional bulk piezoelectric transducers remain the benchmark for high-power applications, capacitive and piezoelectric micromachined variants offer superior acoustic impedance matching and monolithic CMOS compatibility essential for portable systems. We examine the evolution from deterministic analytical and numerical modeling toward AI-powered inverse design, which enables the discovery of non-intuitive, high-performance geometries beyond human intuition. Furthermore, the integration of machine learning (ML) for signal recovery, image enhancement, and multi-modal sensor fusion is discussed as a pathway to compensate for hardware constraints such as limited aperture, sparse sampling, and low signal-to-noise ratio (SNR), while pointing out that AI technology cannot overcome fundamental physical limits including acoustic attenuation, thermal noise floors, and transduction efficiency boundaries. By synthesizing recent advancements, this review demonstrates how the convergence of classical acoustic physics and data-driven intelligence is guiding the development of of intelligent ultrasonic systems. Full article

Biodegradable magnesium (Mg)-based implants represent a paradigm shift in orthopedic biomaterials, offering temporary mechanical support, inherent osteogenic bioactivity, and elimination of hardware removal surgery. These properties are particularly attractive for sports orthopedic applications, including anterior cruciate ligament (ACL) reconstruction, rotator cuff repair, meniscal fixation, and osteochondral fragment refixation, where young, active patients demand rapid return to function and where permanent metallic hardware poses long-term risks of stress shielding, imaging artifact, and reoperation. Despite extensive preclinical evidence demonstrating that Mg-based interference screws promote fibrocartilaginous enthesis regeneration, attenuate peri-tunnel bone loss, and achieve biomechanical fixation comparable to titanium, no human clinical trial has yet evaluated Mg fixation devices for soft-tissue reconstruction in sports medicine. Meanwhile, clinical fracture fixation data from over 468 patients across multiple trials and a meta-analysis confirm complication rates equivalent to those of titanium. This narrative review synthesizes the current evidence on Mg alloy design, surface engineering strategies, preclinical sports medicine applications, clinical translation in fracture fixation, imaging compatibility, and the remaining barriers to clinical adoption in sports orthopedic surgery. By mapping the translational gap between promising animal data and the absence of clinical sports medicine trials, this review aims to guide future research priorities and accelerate the pathway toward clinical application of Mg-based devices in sports orthopedics. Full article

Bacterial colonization and biofilm formation on orthopedic and dental implants remain major clinical complications, while conventional systemic antibiotics are often limited by poor penetration into biofilms and infected bone. These limitations have motivated the development of biomaterials with intrinsic antibacterial activity. Hydroxyapatite (HA), a major inorganic component of bone and teeth, possesses excellent biocompatibility, osteoconductivity, and bone-bonding ability but exhibits limited inherent antibacterial activity. Incorporation of therapeutic metal ions, including Ag⁺, Cu²⁺, Zn²⁺, Ti⁴⁺, Co²⁺, Ga³⁺, Sr²⁺, and Ce³⁺, has therefore emerged as a promising strategy for developing multifunctional HA-based biomaterials. This review critically examines the crystal-chemical basis of metal-ion incorporation into HA and discusses how ionic radius, oxidation state, charge-compensation mechanisms, dopant concentration, and synthesis conditions influence lattice occupancy, physicochemical properties, and biological performance. The antibacterial activity of metal-substituted and metal-modified HA systems generally involves interconnected mechanisms, including bacterial membrane damage, intracellular metabolic disruption, interference with enzymes and nucleic acids, reactive oxygen species (ROS)-mediated oxidative stress, and inhibition of bacterial adhesion and biofilm formation. Ag-, Cu-, Zn-, and Ga-containing HA systems show the most consistently reported antibacterial effects, although their efficacy and cytocompatibility depend strongly on dopant concentration and ion-release kinetics. Co-substituted HA may combine antibacterial activity with angiogenic and osteogenic stimulation, whereas Sr-substituted HA is primarily osteogenic and anti-resorptive, with variable antibacterial performance. Ti-modified HA and TiO₂/HA composites exhibit predominantly photoactive antibacterial behavior, while Ce-substituted HA shows concentration-, oxidation-state-, and synthesis-dependent biological effects. The review also evaluates protein adsorption, osteogenic and angiogenic signaling, macrophage-mediated immunomodulation, biological safety, and representative commercial and translational applications. Overall, metal-substituted HA represents a versatile platform for infection-resistant and regenerative hard-tissue biomaterials, provided that composition, phase structure, ion release, antibacterial efficacy, and cytocompatibility are systematically co-optimized before clinical translation. Full article

Implantable neural probes that can simultaneously possess biocompatibility, electrochemical stability, and high signal fidelity are the core devices in neuroelectrophysiological research. In this article, AlGaN/GaN heterojunction field-effect transistors are used instead of traditional metal microelectrodes to prepare brain nerve probes. By photoelectrochemical etching and optimization of sensing area size, the probes have the maximum transconductance value, i.e., the highest sensitivity, under no gate control. After digital filtering processing, the neural probe achieved a signal-to-noise ratio of 8.04 dB on biological analog signals as low as 50 µV, confirming its ability to detect microvolt-level signals. The ex vivo recording of the bullfrog sciatic nerve further validated its biosensing performance, demonstrating the selective capture of composite action potentials from active neural tissue. Full article

The rapid development of implantable medical electronics requires robust biocompatible coatings capable of ensuring long-term stability in aggressive physiological environments. Although Grade 1 titanium is widely used for its excellent mechanical properties and corrosion resistance, active implants require defect-free insulating coatings to prevent electrical leakage and metal ion release. This study presents a systematic evaluation of Parylene C (P-C) thin films deposited by the Gorham chemical vapor deposition (CVD) process onto implant-grade titanium substrates. Four coating thicknesses (1, 5, 10, and 20 µm) were deposited and characterized using complementary chemical, morphological, optical, and mechanical techniques. Contact-angle measurements confirmed uniform hydrophobicity (90.56 ± 1.86°), while FTIR and EDX verified the characteristic chemical composition of P-C. Reflectometry, ellipsometry, and interferometry demonstrated excellent thickness control and deposition reproducibility. Pull-off testing showed high initial mechanical integrity, with detachment forces ranging from 52 to 73 N. However, accelerated PBS ageing (21 days at 90 °C) induced significant degradation, particularly for thicker coatings, reducing pull-off forces to 19–42 N. Likewise, thermal-shock cycling (−80 °C to +220 °C) caused severe interfacial damage, decreasing the required detachment force to approximately 5.5 N for 20 µm coatings because of extensive cracking and delamination. These results demonstrate that Parylene C provides excellent conformal coverage and chemical stability on titanium but that its durability is significantly affected by prolonged hydrothermal ageing and extreme thermal loading. This study provides practical guidelines for the design of reliable encapsulation systems for active implantable medical devices and highlights the need for improved interfacial engineering through optimized adhesion-promoting layers or hybrid protective architectures. Full article

Bioresorbable stents (BRS) have been explored in cardiovascular intervention to provide temporary mechanical support while reducing long-term foreign material. The coronary experience has shown both the potential and the limitations of this strategy. First-generation polymeric stents demonstrated feasibility but were limited by thick struts, insufficient radial strength, delayed healing, and increased scaffold thrombosis. In contrast, metallic bioresorbable platforms improved mechanical performance, but each material system still faces trade-offs between strength, degradation rate, and biological response. Transcatheter pulmonary valve replacement (TPVR) may represent a clinically meaningful setting for renewed BRS development. Patients with congenital heart disease often require repeated pulmonary valve interventions over a lifetime, and permanent metallic frames may increase cumulative implant burden and complicate future treatment. However, TPVR imposes distinct requirements, including large-diameter expansion, stable anchoring, fatigue resistance, controlled degradation, and leaflet-frame integration. This review summarizes the lessons learned from coronary BRS, discusses material considerations for TPVR-oriented stent design, and evaluates current preclinical evidence for bioresorbable and regenerative pulmonary valve platforms. Particular attention is given to magnesium–zinc alloys as a tunable material strategy for future bioresorbable TPVR frames. Although direct evidence for fully bioresorbable metallic TPVR devices remains limited, this approach provides a rational framework for next-generation pulmonary valve intervention. Full article

Oral diseases, such as periodontitis, remain a major global concern due to their high incidence and significant morbidity. The principal drivers are bacterial overgrowth and associated inflammation. Bioactive glass of the 45S5 Bioglass^® composition (BG) is known for its remineralising, osteogenic and antibacterial effects via ion release, but its application has been limited in oral environments. In this study, a photocurable GelMA hydrogel was developed as a carrier matrix for BG (1–15% w/v) to obtain synergy between the adhesive properties of the GelMA and the bioactivity of the glass. Incorporation of 10% w/v BG improved ultimate tensile strength (97 kPa) compared to pure GelMA (58 kPa) and reduced swelling by 18%. The composites showed ~60% higher adhesive strength on collagen sheets than GelMA alone. Tensile bonding strengths reached 54 kPa on collagen sheets and 23 kPa on tooth sections. Lap-shear adhesive strengths were 44 kPa on collagen and 18 kPa on implant metal. In vitro studies confirmed the composite’s biocompatibility with dental pulp stem cells and antibacterial activity against Escherichia coli and methicillin-resistant Staphylococcus aureus. Overall, the GelMA/BG composite presents a multifunctional platform for dental remineralisation with promising mechanical, adhesive and antibacterial performance. Full article

Introduction: One of the fundamental principles of modern medicine, including dentistry, is prevention. However, if treatment is not initiated, tooth loss can occur, necessitating the use of dental prostheses to restore the function and aesthetics of the stomatognathic system. The oral microbiome is a complex ecosystem that is sensitive to external factors, including the biomaterials used to manufacture dental prostheses. Objectives: This narrative literature review aims to identify and compare the effects of various metal alloys used in dentistry, specifically high-precious (gold), precious (silver–palladium) and base (cobalt–chromium and nickel–chromium) alloys, as well as titanium, on the balance of the oral microbiome and biofilm formation. Results: The analysis indicates that gold, silver and palladium alloys demonstrate the most favourable biocompatibility and antibacterial properties, significantly reducing biofilm accumulation. Titanium and titanium-based alloys generally exhibit neutral properties under healthy conditions, although their biocorrosion products can alter the microbial environment in pathological states such as peri-implantitis. In contrast, base metal alloys (cobalt–chromium and nickel–chromium) are highly susceptible to biocorrosion in acidic environments, which can encourage the growth of bacteria that cause tooth decay and inflammation, potentially exacerbating oral dysbiosis. Conclusions: The selection of materials plays a critical role in maintaining oral microbial homeostasis and preventing plaque-related diseases. High-noble alloys and titanium are more biocompatible than base metal alloys. However, further long-term clinical trials and multi-species biofilm models are needed to fully understand these interactions between materials and microbes. Full article

Background and Clinical Significance: Implant rehabilitation of patients with acquired maxillofacial defects remains challenging, particularly following high-energy war-related trauma. Gunshot and mine blast injuries frequently result in extensive hard and soft tissue loss, often requiring complex reconstructive procedures. Although cortically anchored implants have been successfully used in patients with severe maxillary atrophy and selected traumatic defects, evidence supporting their use for the immediate rehabilitation of critical-size war-related maxillary defects remains limited. Cortically anchored single-piece implants used in conjunction with an immediate loading protocol may provide an alternative rehabilitation strategy for selected patients who decline, or are unsuitable for, conventional implants and bone-grafting procedures. Case Presentation: Two patients with critical-size maxillary defects (approximately 3 cm) resulting from gunshot and mine blast injuries are presented. Treatment consisted of extraction of non-restorable teeth, placement of cortically anchored single-piece implants, including tubero-pterygoid implants, followed by immediate loading with fixed hybrid metal–acrylic hybrid prostheses. Clinical and radiological evaluation was performed using panoramic radiography and cone-beam computed tomography. Conclusions: Successful implant-supported prosthetic rehabilitation was achieved in both patients. Cortically anchored implants engaging the basal bone of the maxilla provided stable support for immediately loaded fixed prostheses despite substantial hard and soft tissue loss. Functional and aesthetic outcomes were satisfactory. Immediate prosthetic rehabilitation was successfully completed in both patients. A 12-month clinical and radiographic follow-up was available for one patient and demonstrated stable implant function without biological or prosthetic complications. Long-term follow-up of the second patient was not available because of active military service. Cortically anchored implant-supported hybrid prostheses may represent a viable treatment option for selected patients with critical-size maxillary defects resulting from gunshot or mine blast injuries, enabling rapid restoration of oral function and facial aesthetics while avoiding extensive bone-grafting procedures. Full article

Two design solutions such as modular and mono-block Ti6Al4V porous implants for femoral defect repair were implemented and compared. Static stress analysis on each model was performed via finite element analysis to investigate potential critical elements that might cause system failure under physiological loads. Prior to calculations, a mesh convergence study was realized by varying the minimum element sizes. The entire bone–prosthetic system was modeled, and design optimization was performed. For mono-block implants, a less stressed configuration was found by changing the plate design. Comparison of the maximum Von Mises stress ${\sigma }_{max}$ and equivalent strain ${\epsilon }_{eq}$ between the models allowed for an understanding of the distribution of the loads and identify areas with critical stress concentration. The modular implant appeared to be highly solicited with stress shielding on epiphyses due to enhanced rigidity at the metal/bone interface. Finally, a study of the deformation on cancellous and cortical bone suggested that a more elastic junction with balanced strain delivery to the bone might improve tissue regeneration when using a mono-block implant. Full article

Titanium remains the gold standard in dental implantology; however, its clinical drawbacks, such as hypersensitivity reactions, metallic particle release, and aesthetically compromising discoloration, have driven interest in metal-free alternatives. Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) has emerged as a promising bioceramic candidate, offering favorable aesthetics, mechanical strength, and reduced bacterial plaque affinity. Its pristine surface is nonetheless bioinert, prompting extensive research into surface modification strategies, including sandblasting, acid-etching, femtosecond laser texturing, and bioactive coatings, to enhance osteoconductivity. This comprehensive narrative review synthesizes in vitro evidence on the behavior of key host cell populations—macrophages, mesenchymal stem cells, osteoblasts, fibroblasts, and epithelial cells in response to Y-TZP surface and its modifications, relevant to osseointegration and soft-tissue sealing. A literature search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library, supplemented by Google Scholar, concluding in March 2026. By integrating findings across multiple cell lineages, this review aims to clarify how engineered zirconia topographies modulate cell-specific pathways, thereby informing the development of next-generation implants optimized for biological integration. Full article