Search Results (197)

Remand custody has received little academic or policy attention, despite being a form of punishment that removes an individual immediately into prison for an unknown duration. While there has been growing international attention on prisoners’ children and families, the punitive impact of remand is ‘still forgotten’. Responding to this gap, 61 semi-structured interviews were conducted with loved ones (i.e., partners, parents, and friends) supporting a person in prison on remand in England and Wales. Data collected in 2018 and 2019 were then coded and thematically analysed. This paper focuses specifically on the juggling act that 16 mothers and grandmothers (as maternal figures) undertook as they engaged in ‘family practices’ to balance their own needs against those of other family members, including those in the community and their remanded adult (grand)children. Four subthemes exploring prison conditions and healthcare, violence, mental health, and supporting other family members are discussed, which sit within an overarching theme that found disrupted maternal practices and a lack of control. This article concludes that because remand is distinct, so are the experiences of maternal figures, necessitating nuanced support and further research and policy attention, so that remand experiences are no longer forgotten. Full article

Background: Lower limb (LL) and low back Radicular Syndromes (RSs) may result from discopathy of the lumbo-sacral spine. Consistent benefits are reported from Epidural Adhesiolysis (EA). Aim: To evaluate clinical and European Quality of Life items (EQ-5D) of Peri-Neural Release interventions (PNR, a modified approach and terminology for EA) among patients diagnosed with lumbo-sacral discopathy associated radicular syndromes. Methods: A retrospective study was conducted by retrieving records of patients e treated by PNR for low back and lower limbs pain between January 2018 and December 2024. Eligible patients were adults who were diagnosed with lumbo-sacral discopathy, stenosis, or Post Lumbar Surgery Syndrome (PLSS). Data on Patient-Reported Outcome Measures (PROMs) adopting the European Quality of Life five items (Euro-QoL 5D) that includes self-ratings of mobility, active daily living, self-care, pain and discomfort, anxiety and depression) was collected before the procedure and on subsequent follow-up visits. Other clinical outcomes included numerical pain rating scales (NRSs), sleep quality, time to pain during activity, and self-reported health scores. Results: A total of 221 patients were included in this analysis. Of these, 56.6% were female, with a mean age of 45.1 ± 14.7 years. In total, 50.2% of patients underwent PNR alone, followed by 28.1% who underwent PNR balloon decompression neuroplasty. Of the remaining patients, 7.2% underwent epiduroscopic PNR, 6.3% PNR combined with annuloplasty (biacuplasty) and 8.1% underwent PNR combined with nucleoplasty. Significant improvements were observed across all EQ-5D and NRS (p < 0.001) at follow-up assessments without major complications. The interventions were associated with a decrease in NRS from 7.9 to 3.1, and an increase in the duration of pain-free activity (walking, standing, sitting) (p < 0.001). Self-reported overall health scores improved from 53.9 ± 18.4 to 81.1 ± 15.1. In terms of complications, two patients reported post-operative headache. The remaining side effects included coccydynia at the site of intervention, resolving with application of non-steroid anti-inflammatory topicals and self-resolving lower limb numbness in five cases. Conclusions: The presented data suggest that PNR—whether performed alone or in combination with adjunctive intradiscal procedures—is a safe intervention, and is associated, in the majority of patients, with substantial pain relief and improvement in EQ-5D both in the short- and long-term follow-up. Full article

Type 2 diabetes mellitus and prediabetes often develop silently and may remain undiagnosed for years. This is particularly relevant in regions where laboratory-based screening is not always readily accessible. Against this background, the present work explores whether multilead electrocardiography can provide physiologically meaningful markers potentially associated with disturbances in glucose metabolism. We developed and tested an upgraded wearable 12-lead ECG system capable of synchronized multichannel recording under controlled conditions. ECG signals were acquired in sitting and standing positions, with a sampling frequency of 500 Hz and a recording duration of one minute per posture. The hardware architecture included a high resolution analog front-end and wireless data transmission; the accompanying software provided acquisition control, preprocessing, visualization, and data storage within a unified framework. Signal processing focused on the extraction of rhythm-related and morphological parameters, with particular attention to ventricular repolarization indices. QT interval, heart rate–corrected QT (QTc), and QT dispersion (QTd) were calculated across leads, as these parameters are known to reflect heterogeneity of repolarization and autonomic influences on myocardial electrophysiology. The analysis was structured to ensure reproducible boundary detection and systematic feature formation rather than isolated parameter measurement. The study had a pilot character and included a limited and unbalanced sample (healthy n = 10; prediabetes n = 1; T2DM n = 1). For this reason, the results are presented descriptively and should be regarded as preliminary observations. In representative cases, differences in QT-related indices were noted between categories of glycemic status; however, the potential influence of age, sex, and other confounders cannot be excluded. A pilot expert comparison of T-wave end detection demonstrated close agreement between the automated algorithm and cardiologist assessment (mean Δ$T_{end}$ approximately −1 to −2 ms; MAE 10–24 ms). Diagnostic performance metrics such as ROC/AUC, sensitivity, and specificity were not calculated at this stage, as validation in a larger cohort with biochemical confirmation (HbA1c, OGTT) is required. The study demonstrates the technical feasibility of combining synchronized 12-lead wearable acquisition with structured multilead repolarization analysis. The proposed system should therefore be considered a research platform intended to support further clinical validation and methodological development rather than a finished screening solution. Full article

Background: Smoking adversely affects pulmonary function and systemic health; however, its impact on diaphragm muscle morphology and its relationship with functional capacity and psychosocial outcomes in individuals without clinically diagnosed respiratory disease remain unclear. This study aimed to evaluate diaphragm muscle thickness in smokers and to investigate its associations with pulmonary function, functional capacity, sleep quality, and depression. Methods: This cross-sectional observational study included 20 smokers and 20 age-matched never-smokers. Pulmonary function was assessed using spirometry. Functional capacity was evaluated with the 6-Minute Walk Test (6 MWT) and the 30 s sit-to-stand test (30 s STST). Sleep quality and depression were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Inventory (BDI). Inspiratory and expiratory diaphragm muscle thicknesses were measured by ultrasonography. Between-group comparisons and correlation analyses were performed. Results: Smokers exhibited significant impairments in all assessed parameters except expiratory diaphragm thickness compared with controls (p < 0.05). Large to very large effect sizes were observed for FEV₁, FEF_25–75%, functional capacity, and inspiratory diaphragm thickness. Inspiratory diaphragm thickness showed moderate to strong positive correlations with pulmonary function parameters and a very strong positive correlation with functional capacity, while strong negative correlations were observed with sleep quality and depression (p < 0.05). Smoking duration was strongly associated with poorer functional and psychosocial outcomes. Conclusions: Smoking is associated with early and multidimensional impairments in diaphragm muscle morphology, pulmonary function, functional capacity, and psychosocial status, even in individuals without overt respiratory disease. Reduced inspiratory diaphragm thickness may represent an early and clinically meaningful marker of smoking-related respiratory muscle dysfunction. Full article

This article presents PrevOccupAI-HAR, a new publicly available dataset designed to advance smartphone-based human activity recognition (HAR) in office environments. PrevOccupAI-HAR comprises two sub-datasets: (1) a model development dataset collected under controlled conditions, featuring 20 subjects performing nine sub-activities associated to three main activity classes (sitting, standing, and walking), and (2) a real-world dataset captured in an unconstrained office setting captured from 13 subjects carrying out their daily office work for six hours continuously. Three machine learning models—namely, k-nearest neighbors (KNN), support vector machine (SVM), and Random Forest (RF)—were trained on the model development dataset to classify the three main classes independently of sub-activity variation. The KNN, SVM, and RF models achieved accuracies of 90.94%, 92.33%, and 93.02%, respectively, on the development dataset. When deployed on the real-world dataset, the models attained mean accuracies of 69.32%, 79.43%, and 77.81%, reflecting performance degradations between 21.62% and 12.90%. Analysis of sequential predictions revealed frequent short-duration misclassifications, predominantly between sitting and standing, resulting in unstable model outputs. The findings highlight key challenges in transitioning HAR models from controlled to real-world contexts and point to future research directions involving temporal deep learning architectures or post-processing methods to enhance prediction consistency. Full article

Background/Objectives: One of the topics of electrocardiographic risk factor studies is investigations of beat-to-beat QT interval variability. The seminal study that reported QT variability as a prognostic risk factor introduced the so-called QT variability index (QTVi). QTVi quantification relies not only on the variance of QT intervals but also on correction factors, including RR interval variance, heart rate, and overall QT interval duration. This study investigated the influence of all the measured factors on QTVi values. Methods: Long-term electrocardiograms (ECGs) were obtained from 251 healthy subjects (mean age 33.6 ± 9.1 years, 108 females) during repeated postural tests that involved supine, sitting, and standing positions maintained for 10 or 15 min. During each position, a 5-min ECG segment with a stable heart rate and without any ectopic disturbances was found. In these segments, standard deviations of normal-to-normal RR (NN) interval durations (SDNN) and of beat-to-beat QT interval durations (SDQT) were measured together with the means of NN and QT intervals. QTVi was subsequently calculated. For each subject, results obtained during each postural position were averaged. Results: In multivariable regression models, evaluated separately in female and male sex-subgroups of the population, QTVi values were significantly dependent on SDQT, SDNN, and mean NN intervals (all p < 0.001) but practically independent of mean QT interval durations. Conclusions: QTVi is significantly influenced by factors that are unrelated to the beat-to-beat changes in QT interval durations. This needs to be considered when interpreting QTVi values. In future studies, multivariable statistical models are needed to ensure that QTVi findings are independent of associated heart rate variability indices. Full article

Background/Objectives: Healthy lifestyle behaviors are major contributors to overall health and disease prevention. This cross-sectional study aimed to assess attitude toward a healthy lifestyle and its associations with lifestyle behaviors, body mass index (BMI), excess body weight, sociodemographic characteristics, and self-rated health in adults. Methods: The Attitudes toward a Healthy Lifestyle Questionnaire was administered to 570 Croatian adults between November and December 2025. Multiple linear and binary logistic regression models were used to examine associations between lifestyle behaviors (number of daily meals, sitting time, sleep duration), smoking and e-cigarette use, alcohol consumption, BMI, self-rated health, and attitude toward a healthy lifestyle. Results: The median attitude toward a healthy lifestyle score was 52.0 (IQR = 10), corresponding to 62% of the maximum possible score. A more positive attitude toward a healthy lifestyle was associated with a higher number of daily meals (β = 0.16, p = 0.001), longer sleep duration (β = 0.17, p < 0.001), lower sitting time (β = −0.11, p = 0.010), and lower BMI (β = −0.24, p < 0.001). Smoking was negatively associated with attitude toward a healthy lifestyle (β = −0.18; p < 0.001), while e-cigarette use was associated with fewer daily meals (β = −0.10; p = 0.025). Longer sleep duration increased the odds of excellent self-rated health (OR = 1.31, p = 0.014), and a more positive attitude toward a healthy lifestyle was associated with lower odds of excess body weight (OR = 0.92, p < 0.001). Conclusions: Attitude toward a healthy lifestyle is significantly associated with lifestyle behaviors, BMI, excess body weight, and self-rated health, highlighting the importance of psychological factors in promoting sustainable healthy lifestyles. Full article

The aim of the study was to determine the effects of sprint interval training (SIT) on anaerobic and aerobic performance in young physically active men, as assessed by maximal power (Pmax), maximal oxygen uptake (VO₂max), and the second ventilatory threshold (VT2). The data obtained were presented against the background of the effects of aerobic interval training. Participants (n = 45) aged 19–27 years were recruited into three groups of 15 participants each. The first group performed SIT, the second performed aerobic interval training (AIT), and the third group was without any intervention (control—CON). In each study group, participants performed somatic measurements twice (before and after the exercise intervention), the Wingate test (assessing peak anaerobic power (PP)), and a graded exercise test assessing aerobic performance. The training intervention in the SIT and AIT groups lasted 6 weeks, with three training sessions per week. The duration of a single session in AIT was constant throughout the intervention and lasted 60 min, while in SIT it lasted 17 min (first session), and the longest training session lasted 30 min. Training in the SIT group resulted in a significant increase in absolute anaerobic peak power (p < 0.001, ES = 0.36), while no significant change in PP was observed after AIT (p = 0.13, ES = 0.24). Both training protocols (SIT and AIT) significantly improved VO₂max (p = 0.03, ES = 0.39 and p = 0.02, ES = 0.55, respectively) and absolute Pmax (p < 0.001, ES = 0.68 and p = 0.02, ES = 0.36). Only in the AIT group were statistically significant changes related to VT2 observed: after training, oxygen uptake at VT2 increased significantly (p = 0.04, ES = 0.64). The SIT protocol improved both aerobic (VO₂max) and anaerobic (PP) performance, but did not affect the VT2 level. The data indicate that SIT can be used for training in sports disciplines requiring aerobic and anaerobic performance. Full article

This pilot study examined the feasibility, usability, and physiological effects of a high-intensity exercise program delivered through immersive virtual reality (IVR) in adults with Down syndrome (DS). Twenty participants (mean age: 29.85 ± 9.37 years) completed a 12-week intervention using the FitXR exergame on Meta Quest 3, with two sessions per week. Usability, safety, and personal experiences were assessed via the System Usability Scale (SUS), Simulator Sickness Questionnaire (SSQ), and Game Experience Questionnaire (GEQ), while body composition and strength were measured using bioelectrical impedance analysis and standardized tests (handgrip dynamometry, Five Sit-to-Stand Test). Results indicated excellent usability (SUS: 92.88–95.03/100), minimal cybersickness (SSQ: 2.12 → 1.98/48), and high adherence (90%). Positive experiences increased significantly, with no negative experiences reported. Lower-limb strength has been considered as a primary outcome, which has shown to improve significantly (p = 0.018; Cohen’s d = 0.89), whereas upper-limb strength and body composition changes were minimal. These findings suggest that IVR-based exercise is a safe, engaging, and feasible strategy for promoting physical activity and enhancing functional strength in adults with DS. Further controlled trials with longer duration and nutritional strategies are warranted to optimize body composition outcomes. Full article

Background/Objectives: Parkinson’s disease is the second most common neurodegenerative disorder, affecting patients’ daily lives in multiple domains, including functional status, health-related quality of life, and psychological well-being. This study examined the relationship between self-reported global activity level, functional status, Health Related QoL (HRQoL), and psychological state among patients with Parkinson’s disease in Greece. Methods: Thirty volunteers (mean age = 69.07, SD = 11.24), members of the Greek Parkinson’s Patients and Caregivers Association, completed (a) the Parkinson’s Disease Questionnaire to evaluate HRQoL and (b) the Hospital Anxiety and Depression Scale (HADS) to assess psychological state. Participants then performed (a) the Five Times Sit to Stand Test (FTSST) and (b) the Berg Balance Scale (BBS) to evaluate functional status. All questionnaires and the test used in the present study have been validated in Greek. Correlation analysis with Spearman r tests with Bonferroni correction was performed between the above variables. Subsequent linear regression models were used to identify independent predictors of HRQoL and balance using SPSS 29.0.2.0. Results: Participants reported elevated anxiety (M = 9.67, SD = 4.44) and depressive symptoms (M = 8.97, SD = 4.08), alongside relatively high HRQoL scores (M = 40.09, SD = 18.40). Impaired functional performance was observed, with 22 participants failing to complete the FTSST within 16 s and 16 scoring below 40 on the BBS. Functional status was strongly correlated with HRQoL (r = −0.696, p < 0.001) and activity level (r = −0.521, p < 0.008). Depression was also significantly associated with poorer HRQoL (r = 0.618, p < 0.008) and lower activity levels (r = −0.545, p < 0.008). Regression analyses revealed that balance (β = −0.526), disease duration (β = 0.437), anxiety (β = 0.411), and lower limb function (β = −0.351) were significant independent predictors of HRQoL (R² = 0.785; F(9, 20) = 12.69; p < 0.001), while HRQoL (β = −0.738) and lower limb function (β = −0.391) independently predicted balance (R² = 0.699; F(9, 20) = 4.72; p = 0.002), suggesting a bidirectional relationship between physical function and subjective well-being. Conclusions: Activity level, HRQoL, functional status, and psychological state in patients with Parkinson’s disease are interrelated factors. Increased levels of anxiety and depression, as well as reduced HRQoL, were observed. The findings point to a potentially reinforcing cycle between poor balance and diminished quality of life, with anxiety and age playing key roles. Overall, the results illustrate that functional, psychological, and HRQoL measures interact in complex ways, emphasizing the multidimensional profile of patients with Parkinson’s disease. Further studies with larger samples are required to confirm these findings. Full article

Background: Socioeconomic factors significantly influence health outcomes in older adults, yet their impact on specific aspects of mobility remains unclear. This study investigates the relationship between area-level socioeconomic disadvantage and mobility health in older adults. Methods: We conducted a cross-sectional study of 110 community-dwelling older adults recruited and collected using voluntary response sampling at eight health fairs across rural Southeast Alabama in 2022–2024 (60 ± 16 years, 80% female). Area-level socioeconomic status was measured using the Area Deprivation Index (ADI), a validated composite measure of neighborhood disadvantage. Mobility was assessed using the Instrumented Timed Up and Go (iTUG) test and the Instrumented Five Times Sit-to-Stand (i5TSTS) test. Kruskal–Wallis tests and general linear models in SAS 9.4 analyzed the relationship between ADI and mobility measures. Results: Higher ADI scores were significantly associated with poorer performance on the i5TSTS test (p = 0.0004). While overall iTUG duration did not differ significantly across ADI groups, the sit-to-stand phase of the iTUG showed a significant relationship with ADI (p = 0.0026). These associations remained significant after adjusting for age, weight, race, and education level. Conclusions: These findings suggest that neighborhood context plays a crucial role in mobility health, particularly in functions related to postural transitions. Clinicians should consider area-level disadvantage when screening for mobility limitations and may need to prioritize sit-to-stand interventions for patients living in high-deprivation areas. Full article

Background: Sitting and standing with conventional hip–knee–ankle–foot (HKAF) prostheses are demanding tasks for hip disarticulation (HD) amputees due to the passive nature of current prosthetic hip joints that cannot assist with moment generation. This study developed a sitting and standing control strategy for a motorized hip joint and evaluated whether providing active assistance reduces the intact side demand of these activities. Methods: A dedicated control strategy was developed and implemented for a motorized hip prosthesis (Power Hip) compatible with existing prosthetic knees, feet, and sockets. One HD participant was trained to perform sitting and standing tasks using the Power Hip. Its performance was compared with the participant’s prescribed passive HKAF prosthesis through measurements of ground reaction forces (GRFs), joint moments, and activity durations. GRFs were collected using force plates, kinematics were captured via Theia3D markerless motion capture, and joint moments were computed in Visual3D. Results: The Power Hip enabled more symmetric limb loading and faster stand-to-sit transitions (1.22 ± 0.08 s vs. 2.62 ± 0.41 s), while slightly prolonging sit-to-stand (1.69 ± 0.49 s vs. 1.22 ± 0.40 s) compared to the passive HKAF. The participant exhibited reduced intact-side loading impulses during stand-to-sit (4.97 ± 0.78 N∙s/kg vs. 15.06 ± 2.90 N∙s/kg) and decreased reliance on upper-limb support. Hip moment asymmetries between the intact and prosthetic sides were also reduced during both sit-to-stand (−0.18 ± 0.09 N/kg vs. −0.69 ± 0.67 N/kg) and stand-to-sit transitions (0.77 ± 0.20 N/kg vs. 2.03 ± 0.58 N/kg). Conclusions: The prototype and control strategy demonstrated promising improvements in sitting and standing performance compared to conventional passive prostheses, reducing the physical demand on the intact limb and upper body. Full article

People with Parkinson’s disease (PD) experience mobility impairments that impact daily functioning, yet conventional clinical assessments provide limited insight into real-world mobility. This study evaluated motor-state classification and the concurrent validity of mobility metrics derived from augmented-reality (AR) glasses against a markerless motion capture system (Theia3D) during gamified AR exercises. Fifteen participants with PD completed five gamified AR exercises measured with both systems. Motor-state segments included straight walking, turning, squatting, and sit-to-stand/stand-to-sit transfers, from which the following mobility metrics were derived: step length, gait speed, cadence, transfer and squat durations, squat depth, turn duration, and peak turn angular velocity. We found excellent between-systems consistency for head position (X, Y, Z) and yaw-angle time series (ICC_(c,1) > 0.932). The AR-based motor-state classification showed high accuracy, with F1-scores of 0.947–1.000. Absolute agreement with Theia3D was excellent for all mobility metrics (ICC_(A,1) > 0.904), except for cadence during straight walking and peak angular velocity during turns, which were good and moderate (ICC_(A,1) = 0.890, ICC_(A,1) = 0.477, respectively). These results indicate that motor states and associated mobility metrics can be accurately derived during gamified AR exercises, verified in a controlled laboratory environment in people with mild to moderate PD, a necessary first step towards unobtrusive derivation of mobility metrics during in-clinic and at-home AR neurorehabilitation exercise programs. Full article

Background/Objectives: The benefits of physical activity (PA) do not depend on the PA level alone but also on sedentary behavior (SB). The interaction between PA and SB (i.e., PA–SB interplay) is important to determine one’s health status. This study explored the effect of PA–SB interplay on balance and gait in healthy young adults. Methods: Healthy young adults (n = 133, 18–35 yrs) were placed in four PA–SB interplay groups (according to their sitting duration and physical activity duration) using the American College of Sports Medicine PA guidelines (i.e., sedentary active [>6 h/day, >150 min/week], sedentary inactive [>6 h/day, <150 min/week], physically active [<6 h/day, >150 min/week], and physically inactive [<6 h/day, <150 min/week]). In this cross-sectional study, participants’ balance and gait were assessed with inertial measurement units placed on seven bodily sites. In this exploratory study, significance level was set at p < 0.1. Results: Sway acceleration RMS during the eyes closed on stable surface balance test showed a statistically significant difference among the PA–SB interplay groups (p = 0.055) which was found between sedentary active and physically inactive (p = 0.066). Anticipatory postural adjustment (APA) duration during gait showed a statistically significant difference (p = 0.010) which was found between sedentary inactive and physically active (p = 0.019) and between sedentary active and physically active (p = 0.026). Conclusions: PA–SB interplay influences static (sway acceleration RMS) and dynamic (APA duration) balance of healthy young adults. Findings suggest that somatosensory processing during balance and gait initiation are significantly impacted by PA–SB interplay. Full article

Spontaneous rhythmic performance is a fundamental feature of human movement, well established in biomechanical models (EBMs) but less understood in complex physical fitness exercises (PFEs). This study examined the task dependency of spontaneous rhythmic performance across three EBMs (walking, hopping, finger tapping) and seven PFEs (hip abduction, back extension, sit-up, push-up, shoulder abduction, squat, lunge). A total of 15 men and 15 women performed each task at a self-selected pace while wearing inertial sensors. Measures included spontaneous motor tempo (SMT), temporal structure metrics, and their within- and between-trial individual variability (%CV) (ANOVA, SPSS 28.0, p ≤ 0.05). SMT was task-dependent, with EMB tasks being near ~2 Hz (walking: 1.82 ± 0.10 Hz; hopping: 2.08 ± 0.22 Hz; finger tapping: 1.89 ± 0.43 Hz) and PFEs being slower (0.36–0.68 Hz). Temporal structure mirrored these differences with shorter cycle and phase durations in EBM than PFE tasks, with relative phase durations consistently at about a 1:1 ratio. Τhe overall low %CV indicated stable performance (within-trial: 1.4–7.5%; between-trial: 0.5–7.8%). The results highlight the task dependency of SMT and temporal structure, as well as the robustness of an overarching internal timing framework supporting rhythmic motor control across diverse movement contexts. Full article