Search Results (95)

Background and Objectives: Heart failure (HF) represents a major public health challenge worldwide, with rising prevalence, high morbidity and mortality rates, and substantial healthcare costs. Non-invasive telemonitoring has emerged as a promising adjunct in HF management, yet its clinical effectiveness remains unclear. Materials and Methods: In this systematic review, we summarize randomized controlled trials (RCTs) between 2004 and 2024 examining the efficacy of non-invasive telemonitoring on mortality, readmission, and quality of life (QoL) in HF. In addition, we characterize the heterogeneity of features of different telemonitoring interventions. Results: In total, 32 RCTs were included, comprising 13,294 participants. While some individual studies reported benefits, non-invasive telemonitoring demonstrated mixed effects on mortality, readmission rates, and QoL. The most common modality for interfacing with patients was by mobile application (53%), followed by web portals (22%), and stand-alone devices (19%). Periodic feedback (63%) was more common than continuous feedback (31%) or on-demand feedback (6%). Clinician reviews of patient telemonitoring data was event-triggered (44%) more commonly than based on a prespecified timeline (38%). In most designs (90%), patients played a passive role in telemonitoring. Conclusions: Non-invasive telemonitoring interventions for HF exhibited considerable variation in duration and system design and had a low rate of patient engagement. Future work should focus on identifying telemonitoring-responsive subgroups and refining telemonitoring strategies to complement traditional HF care. Full article

This review provides a comprehensive analysis of recent advancements in lower limb exoskeleton systems, focusing on applications, control strategies, hardware architecture, sensing modalities, human-robot interaction, evaluation methods, and technical innovations. The study spans systems developed for gait rehabilitation, mobility assistance, terrain adaptation, pediatric use, and industrial support. Applications range from sit-to-stand transitions and post-stroke therapy to balance support and real-world navigation. Control approaches vary from traditional impedance and fuzzy logic models to advanced data-driven frameworks, including reinforcement learning, recurrent neural networks, and digital twin-based optimization. These controllers support personalized and adaptive interaction, enabling real-time intent recognition, torque modulation, and gait phase synchronization across different users and tasks. Hardware platforms include powered multi-degree-of-freedom exoskeletons, passive assistive devices, compliant joint systems, and pediatric-specific configurations. Innovations in actuator design, modular architecture, and lightweight materials support increased usability and energy efficiency. Sensor systems integrate EMG, EEG, IMU, vision, and force feedback, supporting multimodal perception for motion prediction, terrain classification, and user monitoring. Human–robot interaction strategies emphasize safe, intuitive, and cooperative engagement. Controllers are increasingly user-specific, leveraging biosignals and gait metrics to tailor assistance. Evaluation methodologies include simulation, phantom testing, and human–subject trials across clinical and real-world environments, with performance measured through joint tracking accuracy, stability indices, and functional mobility scores. Overall, the review highlights the field’s evolution toward intelligent, adaptable, and user-centered systems, offering promising solutions for rehabilitation, mobility enhancement, and assistive autonomy in diverse populations. Following a detailed review of current developments, strategic recommendations are made to enhance and evolve existing exoskeleton technologies. Full article

Background: Newly arrived migrants are at increased risk for vaccine-preventable and communicable diseases due to low immunization coverage, poor access to healthcare, and challenging migration trajectories. This study describes the implementation and outcomes of a one-stop public health intervention focused on serological screening and accelerated vaccination in recently arrived migrants in Galicia, Spain. Methods: We conducted a cross-sectional descriptive study in July and August 2024 involving 335 adult migrants from sub-Saharan Africa with irregular administrative status and asylum applications. A centralized mobile health unit provided point-of-care screening for immunity against measles, mumps, rubella, varicella, and hepatitis A, alongside testing for active infections, including hepatitis B and syphilis. Sociodemographic and clinical data were collected, and individuals were offered vaccination according to an accelerated immunization schedule. Results: Of 336 migrant adults invited to participate in the study, only 1 individual declined to participate (participation rate: 99.7%). Therefore, 335 migrants were assessed. A significant proportion of participants were susceptible to at least one vaccine-preventable disease, particularly hepatitis B (36.4%, 95% CI 31.3–41.6), measles (22.7%, 95% CI 18.2–27.2), and varicella (16.4%, 95% CI 12.5–20.4). Active infections were detected in 12.9% (95% CI 9.3–16.4) of individuals, including hepatitis B (9.9%, 95% CI 6.7–13.0) and syphilis (3.0%, 95% CI 1.2–4.8). The intervention allowed for timely vaccination and linkage to care, minimizing dependence on passive healthcare access. Conclusions: This study highlights substantial immunization gaps and the presence of undiagnosed infections in vulnerable migrant populations. Centralized and culturally adapted screening programs, combined with accelerated vaccination strategies, are feasible and effective. These findings support the integration of structured protocols into national health systems to ensure equity, reduce transmission risk, and align with WHO and ECDC public health frameworks. Full article

Wireless electric vehicle charging (WEVC) is rapidly advancing as an enabling technology for convenient electrified transportation. The trend toward high-power WEVC systems is accelerating, which not only enhances charging speed and user convenience but also introduces new and complex safety challenges. These challenges are particularly acute at the coupler level, where electrical, thermal, and magnetic risks often interact. This review offers a comprehensive analysis of safety management technologies that are specific to WEVC, with an exclusive focus on coupler-related risks. System-level and coupler-level hazards associated with high-power operation are first examined, followed by an in-depth discussion of recent progress in passive safety materials, such as insulation, thermal dissipation, and electromagnetic shielding. Active safety management strategies are also reviewed in detail, including foreign object detection, live body detection, misalignment detection, and multifunctional detection schemes that integrate these capabilities. Emphasis is placed on the ongoing rapid iteration of safety technologies as power levels increase and on the necessity for solutions that are comprehensive, precise, orderly, and reliable. This review concludes by highlighting future research directions, such as data-driven safety management, intelligent sensor integration, regulatory evolution, and user-centered system design, aiming to support the safe and scalable deployment of WEVC in next-generation mobility. Full article

As a core technology emerging from the convergence of Network Function Virtualization (NFV) and Software-Defined Networking (SDN), Service Function Chaining (SFC) enables the dynamic orchestration of Virtual Network Functions (VNFs) to support diverse service requirements. However, in dynamic network environments, SFC faces significant challenges, such as resource fluctuations, user mobility, and fault recovery. To ensure service continuity and optimize resource utilization, an efficient migration mechanism is essential. This paper presents a comprehensive review of SFC migration research, analyzing it across key dimensions including migration motivations, strategy design, optimization goals, and core challenges. Existing approaches have demonstrated promising results in both passive and active migration strategies, leveraging techniques such as reinforcement learning for dynamic scheduling and digital twins for resource prediction. Nonetheless, critical issues remain—particularly regarding service interruption control, state consistency, algorithmic complexity, and security and privacy concerns. Traditional optimization algorithms often fall short in large-scale, heterogeneous networks due to limited computational efficiency and scalability. While machine learning enhances adaptability, it encounters limitations in data dependency and real-time performance. Future research should focus on deeply integrating intelligent algorithms with cross-domain collaboration technologies, developing lightweight security mechanisms, and advancing energy-efficient solutions. Moreover, coordinated innovation in both theory and practice is crucial to addressing emerging scenarios like 6G and edge computing, ultimately paving the way for a highly reliable and intelligent network service ecosystem. Full article

Background/Objectives: Myokines can modulate organ function and metabolism, offering a protective profile against ICU complications beyond preventing local muscle wasting. This scoping review aims to explore and summarize the evidence regarding the secretion of myokines and their potential local or systemic effects in critically ill patients. Methods: A scoping review following Joana Briggs Institute recommendations was conducted. A systematic search of MEDLINE (Ovid), Embase (Ovid), CENTRAL, CINAHL (EBSCOhost), WoS, and Scopus was conducted from inception to February 2023. We included primary studies evaluating myokine secretion/concentration in critically ill adults undergoing physical rehabilitation interventions. Two independent reviewers performed study selection and data extraction. Results: Seventeen studies published between 2012 and 2023 were included. Most were randomized clinical trials (47%). Physical rehabilitation interventions included electrical muscle stimulation, as well as passive and active mobilization, delivered alone or combined, in single or daily sessions lasting 20–60 min. Twelve studies (70%) evaluated interleukin-6, while interleukin-10, tumour necrosis factor-α, Interleukin-8, and myostatin were also commonly studied. Thirteen studies (76%) reported changes in myokine secretion or gene expression, although no clear concentration change pattern emerged. Myokines involved in muscle protein synthesis and breakdown may protect against muscle waste and weakness. Conclusions: The study of myokine dynamics in critically ill patients highlights the systemic impact of physical rehabilitation. This emerging field has grown in interest over the past decade, offering significant research potential. However, challenges such as study design, small sample sizes, and variability in physical therapy protocols hinder a comprehensive understanding of myokine responses. Full article

Modern cellular systems rely on high-capacity and low-latency optical networks to meet ever-increasing data demands. Centralized Radio Access Network (C-RAN) architectures offer a cost-effective approach for deploying mobile infrastructures. In this work, we propose a flexible and cost-efficient fronthaul topology that combines Wavelength Division Multiplexing (WDM) passive optical networks (PONs) with free-space optical (FSO) links. To enhance overall system performance, we introduce Low-Density Parity Check (LDPC) decoding, which provides robust error-correction capabilities against atmospheric turbulence and noise. Our system transmits 20 Gbps, 16-QAM intensity-modulated orthogonal frequency-division multiplexing (OFDM) signals, achieving a substantial reduction in bit error rate (BER). Numerical results show that the proposed WDM-PON-FSO architecture, augmented with LDPC decoding, maintains reliable transmission over 2 km under strong turbulence conditions. Full article

The assessment of joint ranges is an essential component of the physical examination, enabling monitoring and follow-up. Additionally, it is a key component of muscle mobility assessment. Smartphone applications for range-of-motion assessments offer a cost-effective alternative to traditional measurement tools, reducing the need for expensive equipment while maintaining accuracy. Their portability and ease of use provide significant advantages in clinical settings, allowing for quicker assessments. This, in turn, can enhance patient care by enabling more frequent monitoring and timely interventions, ultimately improving treatment outcomes. This study evaluated the validity and reliability of the PhysioMaster application in measuring knee range of motion. Twenty-nine participants performed passive knee extensions, with data collected simultaneously through the application and video recordings for posterior angle calculations. The application demonstrated excellent validity, with intraclass correlation (ICC = between 0.729 and 0.814) and the Pearson correlation values ranging from r = 0.908 to 0.974. For inter-rater reliability, ICC was 0.898 and Pearson correlation coefficient r = 0.82. Additionally, the coefficient of variation was 5.18%, and the measurement error was 0.82°. The results showed that the PhysioMaster application is a valid and reliable tool for assessing passive knee extension in clinical environments, supporting efficient and accurate patient evaluations. Full article

Background: Rotator cuff-related shoulder pain (RCRSP) is a prevalent musculoskeletal issue, encompassing various shoulder conditions. While exercise typically forms the foundation of conservative treatment, there exists ongoing discourse regarding the effectiveness and role of passive treatments. International guidelines recommend initial conservative management, with surgery considered only after failed conservative treatment. However, recent studies reveal discrepancies between recommended practices and actual clinical management. The aim of the study was to assess current practices in managing RCRSP among Greek physiotherapists, with a focus on understanding the alignment of these practices with international guidelines for conservative treatment. Methods: A cross-sectional survey was conducted among Greek physiotherapists to assess current practices in managing RCRSP. The survey, adapted from previous studies, collected demographic data and assessed clinical reasoning through a vignette-based approach. Responses were analyzed for alignment with guideline-recommended care. Results: Out of over 9000 contacted physiotherapists, 163 responded. A majority expressed a specific interest in shoulder pain (85%). Patient education (100%) and exercise (100%) were widely endorsed, with limited support for imaging (44%), injection (40%), and surgery (26%). Younger respondents were less inclined towards surgical referral (p = 0.001). Additionally, adjunctive interventions like mobilization (66%) and massage therapy (58%) were commonly employed alongside exercise and education. Treatment duration typically ranged from 6 to 8 weeks, with exercises reviewed weekly. Conclusions: The study highlights a consistent preference for conservative management among Greek physiotherapists, aligning with international guidelines. However, there are variations in practice, particularly regarding adjunctive interventions and exercise prescription parameters. Notably, there is a disparity between recommended and actual use of certain modalities. Full article

Thermal coating paints offer a passive strategy to reduce heat gain in buildings, improve ventilation, and lower energy consumption. This study investigates the effectiveness of these technologies by comparing different housing structures and environmental conditions. Specifically, it examines thermal envelope solutions for cool roofs in homes along the Colombian Caribbean Coast. We quantify the thermal impacts using experimental data collected from 120 houses across eight municipalities in the Magdalena Department, Colombia. The research details the technology and analytical methods employed, focusing on thermal reductions achieved through thermal coatings to potentially reduce energy demand. A comprehensive measurement system, incorporating temperature and humidity sensors, is developed to assess the impact of the coatings. Thermal comfort is evaluated according to the ASHRAE 55 standard, with temperature reductions calculated for each house treated with thermal coatings. A methodology is applied to evaluate the thermal reduction between a house with a coating solution versus a house without it. The results show a temperature reduction on a house-by-house basis, from 1.5% to 16%. On average, the results yield a significant 7% reduction in thermal load. Additionally, a mobile application is developed to disseminate the results of this research, promoting the social appropriation of science among the involved communities. Full article

Tourism and recreation managers rely on spatial-temporal data to measure visitors’ behavior for gauging carrying capacity and sustainable management. Location-based service (LBS) data, which passively record location data based on mobile devices, may enable managers to measure behaviors while overcoming constraints in labor, logistics, and cost associated with in-person data collection. However, further validation of LBS data at more refined spatial and temporal scales within tourism attractions is needed. We compared observations of salient spatial–temporal measures from a stratified sample of onsite visitors’ GPS traces in a popular U.S. National Park during peak season over two years with a sample of visitors’ traces collected during the same period by a third-party LBS data provider. We described trip characteristics and behaviors within 34 points of interest (POIs) and then pre-processed both datasets into weighted, directed networks that treated POIs as nodes and flow between POIs as edges. Both datasets reported similar proportions of day-use visitors (~79%) and had moderate-to-strong correlations across networks depicting visitor flow (r = 0.72–0.85, p < 0.001). However, relative to the onsite data, LBS data underestimated the number of POIs the visitors stopped by and differed in its rank of popular POIs, underestimating the length of time visitors spent in POIs (z = 1, p ≤ 0.001) and overestimating visitation to the most popular POIs (z = 180, p = 0.044). Our findings suggest that LBS data may be helpful for identifying trends or tracking tourist movement in aggregate and at crude spatial and temporal scales, but they are too sparse and noisy to reliably measure exact movement patterns, visitation rates, and stay time within attractions. Full article

Background: Lung cancer is an oncological threat worldwide, including in Italy. New organizational approaches based on a network of cancer centers and multidisciplinary and technological innovation are required. The experience in the Liguria region, in northwestern Italy, in the management of lung cancer is presented with a focus on the organizational model. Methods: A retrospective observational analysis was conducted for the period from January 2019 to December 2023 using administrative regional data. Results: Of the total surgery treatments in Liguria, most were carried out at the IRCCS San Martino (about 47%), which is the hub’s center. Most cases involved males aged ≥65 years (p < 0.001). Passive mobility showed a decrease in recent years. Considering the type of access to clinical structures, almost all that were finalized to receive chemotherapy were from the day hospital regimen (99%). Conclusion: A comprehensive approach must be carried out for cancer patients to maintain high levels of care quality. In this challenging context, the Liguria region has implemented new organizational approaches based on the networking of cancer centers and multidisciplinary and technological innovation. Full article

Community mobility, encompassing both active (e.g., walking) and passive (e.g., driving) transport, plays a crucial role in maintaining autonomy and social interaction among older adults. This study aimed to quantify community mobility in older adults and explore the relationship between GPS- and accelerometer-derived metrics and fall risk. Methods: A total of 129 older adults, with and without a history of falls, were monitored over an 8 h period using GPS and accelerometer data. Three experimental conditions were evaluated: GPS data alone, accelerometer data alone, and a combination of both. Classification models, including Random Forest (RF), Support Vector Machines (SVMs), and K-Nearest Neighbors (KNN), were employed to classify participants based on their fall history. Results: For GPS data alone, RF achieved 74% accuracy, while SVM and KNN reached 67% and 62%, respectively. Using accelerometer data, RF achieved 95% accuracy, and both SVM and KNN achieved 90%. Combining GPS and accelerometer data improved model performance, with RF reaching 97% accuracy, SVM achieving 95%, and KNN 87%. Conclusion: The integration of GPS and accelerometer data significantly enhances the accuracy of distinguishing older adults with and without a history of falls. These findings highlight the potential of sensor-based approaches for accurate fall risk assessment in community-dwelling older adults. Full article

Recent advancements in mobile health (mHealth) technology and the ubiquity of wearable devices and smartphones have expanded a market for digital health and have emerged as innovative tools for data collection on individualized behavior. Heterogeneous levels of device usage across users and across days within a single user may result in different degrees of underestimation in passive sensing data, subsequently introducing biases if analyzed without addressing this issue. In this work, we propose an unsupervised 2-Stage Pre-processing Algorithm for Passively Sensed mHealth Data (2SpamH) algorithm that uses device usage variables to infer the quality of passive sensing data from mobile devices. This article provides a series of simulation studies to show the utility of the proposed algorithm compared to existing methods. Application to a real clinical dataset is also illustrated. Full article

A family of TiHfZrNb high-entropy alloys has been considered novel biomaterials for high-performance, small-sized implants. The present work evaluates the role of niobium on passivation kinetics and electrochemical characteristics of passive film on TiHfZrNb alloys formed in Hanks’ simulated body fluid by analyzing electrochemical data with three analytical models. Results confirm that higher niobium content in the alloys reinforces the compactness of the passive film by favoring the dominance of film formation and thickening mechanism over the dissolution mechanism. Higher niobium content enhances the passivation kinetics to rapidly form the first layer, and total surface coverage reinforces the capacitive-resistant behavior of the film by enrichment with niobium oxides and reduces the point defect density and their mobility across the film, lowering pitting initiation susceptibility. With the high resistance to dissolution and rapid repassivation ability in the aggressive Hanks’ simulated body fluid, the TiHfZrNb alloys confirm their great potential as new materials for biomedical implants and warrant further biocompatibility testing. Full article