Search Results (1,329)

Embedded systems increasingly require on-device deep learning, yet their processors must simultaneously handle real-time sensing, networking administration, and data control. Existing Field-Programmable Gate Array (FPGA) accelerators typically target peak per-operator throughput without addressing concurrent execution demands of real-time embedded platforms. This paper presents a systolic array-based accelerator prototype implemented on the Zynq-7000 SoC integrated directly into PyTorch, enabling dense linear algebra to be delegated to the FPGA chip while Cortex-A9 continues executing the software stack uninterrupted. Unlike traditional accelerators optimized for peak per-operator speed, this design prioritizes asynchronous co-executionbetween the processing system (PS, the dual-core Cortex-A9) and the programmable logic (PL): The PL performs tiled matrix multiplication, while the PS executes preprocessing, orchestration, and I/O data concurrently, increasing effective end-to-end throughput regardless of the relative isolated performance of CPU and FPGA. The proposed module includes high-level-synthesis (HLS)-based matrix multiplication, activation functions, and Advanced eXtensible Interface (AXI)-Stream Direct Memory Access (DMA) interfaces, wrapped as custom PyTorch kernels under the PetaLinux operating system. The results obtained on the PYNQ-Z2 board show that, once the DMA transfer time is included in the measurement, the FPGA path does not surpass Cortex-A9 in isolated per-operator latencies across the evaluated range; the benefit lies instead in delegating the matrix compute to the fabric at low incremental power while the host CPU cores stay available for concurrent tasks. A concurrent workload sweep across matrix sizes from $8\times 8$ to $256\times 256$ confirms that the co-execution mode sustains 98–99% of available PS compute throughput compared with a constant ≈50% in single-core blocking mode; the difference is statistically significant for all evaluated sizes (see Mann–Whitney U: $U=25$, $p=3.97\times {10}^{-3}$, perfect discrimination, $n=5$). A fair dual-core CPU-only baseline attains comparable PS availability, so this figure reflects the dual-core scheduling that co-execution enables rather than a per-operator advantage of the fabric; the accelerator’s distinct role is to perform the matrix arithmetic off the general-purpose cores at low incremental power. The design occupies only 8% of available look-up tables (LUTs) and 5% of digital signal processing (DSP) blocks, maintains 1.69 W power with a junction temperature of 44.5 °C, and achieves 96.10% MNIST accuracy under fixed-point arithmetic. Full article

Background: Concurrent use of acetylcholinesterase inhibitors (AChEIs) and medicines with anticholinergic activity is a clinically important medication safety concern in dementia care because these medicines may pharmacologically oppose dementia treatment and increase the risk of avoidable harm. This review systematically synthesised evidence on the prevalence, patterns, predictors and clinical consequences of concurrent use of anticholinergic and anti-dementia drugs (ADDs) in older adults with dementia. Methods: A PRISMA-informed systematic review was conducted employing Ovid MEDLINE, Embase and PsycINFO from January 2010 to April 2026. Observational studies were eligible if they included older adults with dementia and reported concurrent exposure to at least one anticholinergic medicine and an ADD, defined as AChEIs and/or memantine. Study quality was appraised using the Newcastle–Ottawa Scale. Results: Twenty-eight studies were included, spanning community, outpatient memory-clinic, acute hospital, long-term care and population-based settings. Two distinct exposure constructs were identified: (1) temporal co-prescribing and (2) cumulative anticholinergic burden among ADD users. Reported prevalence varied markedly according to the exposure definition and setting. Concurrent use was lowest in studies limited to bladder antimuscarinic overlap, generally around 5–13%,but increased to 20–45% when broader anticholinergic definitions were used. In long-term care and institutional cohorts, concurrent exposure reached 61–67%. Recurring predictors included polypharmacy, fragmented care or multiple prescribers, urinary symptoms, behavioural and psychological symptoms of dementia, Parkinson’s disease and non-geriatric prescribing. One large population-based study reported that high anticholinergic burden was associated with treatment modification of AChEIs (aHR 1.12), delirium (aHR 1.52), and two-year mortality (aHR 1.23). Additional studies reported associations with longer hospital stays or readmission. Conclusions: Concurrent use of anticholinergic medicines and ADDs is a common, clinically important and potentially modifiable medication-safety problem in dementia care. Full article

Objectives: The present study was designed to repurpose aripiprazole (AR) as an antifungal drug for the management of topical candidiasis using a bioadhesive sponge incorporating a hyaluronic acid (HA)-, ceramide-, and terpene-based vesicular nanosystem (HCT-NS). Methods: AR-loaded HCT-NS were formulated by the modified ethanol injection method with varying amounts of HA, ceramide, and two types of terpenes. The formulation optimization of AR-loaded HCT-NS was carried out by a full factorial design. The responses evaluated were zeta potential (ZP), particle size (PS), and entrapment efficiency (EE). Results: The optimized AR-loaded HCT-NS has 5 mg of HA, 10 mg of ceramide, and fenchone, which showed spherical vesicles with EE of 81.21 ± 0.01%, PS of 223.25 ± 11.25 nm, polydispersity index (PDI) of 0.492 ± 0.003, and ZP of −27.74 ± 0.04 mV. The optimum HCT-NS showed a greater drug release in comparison to the AR suspension. In addition, the selected HCT-NS exhibited good bioadhesive characteristics and stayed stable during storage. Confocal laser scanning microscopy confirmed the penetration of the fluorescently optimized HCT-NS via the skin. Further, the scanning electron microscope image indicates the porous structure of the formed sponge. In vivo evaluations for the optimum HCT-NS sponge showed a good antifungal impact against Candida albicans. The safety of topical treatment was confirmed by histopathological examination. Conclusions: Taken together, the results here suggest that the AR-loaded HCT-NS sponge showed potent antifungal activity against Candida albicans fungal infection. Full article

We present a neuro-fuzzy digital twin for cardiac disease recognition on the PTB-XL dataset that keeps the accuracy of a strong convolutional model while exposing its reasoning as readable fuzzy rules. The key design choice is to separate the two jobs instead of forcing one network to do both. A convolutional backbone (xresnet1d101 with cross-lead attention) is trained first and acts as the predictor. A second phase then freezes the backbone and trains a five-expert mixture of interval Type-2 Adaptive Neuro-Fuzzy Inference Systems as an interpretation layer, attached through a learnable trust gate. Four experts read complementary signal streams (the raw 12-lead waveform, a Fourier–Bessel Series Expansion, a Tunable-Q Wavelet Transform, and a morphogram); a fifth reads 22 clinical and demographic descriptors. A concept bottleneck maps the backbone embedding to eight named clinical concepts (ST elevation, T inversion, QT prolongation, Sokolov–Lyon and Cornell voltages, RVH, axis deviation, QRS widening), so the downstream rules read in clinical language. Two genetic-algorithm stages keep the model compact: NSGA-II selects the clinical features, and a multi-objective rule-pruning search trades macro-F1 and hypertrophy recall against the number of active rules. On the official test fold the twin reaches a macro-F1 of 0.751 (bootstrap 95% CI 0.740 to 0.767), a macro-AUC of 0.928, a Matthews correlation coefficient of 0.672, and a macro expected calibration error of 0.021, which is above the Strodthoff xresnet1d101 baseline of 0.74 and well below the calibration error of our earlier coupled design. Because the fuzzy layer is attached as a trust-gated residual and the best epoch is chosen on threshold-optimized validation F1, the interpretable twin matches the backbone within about 0.004 (twin 0.751 versus backbone 0.754) rather than paying the usual “interpretability tax”. The fuzzy mixture on its own still reaches a macro-F1 of 0.69, so the rules carry real diagnostic signal. Subgroup macro-F1 stays within about 0.045 across sex, age, and body-mass groups. A concept-level intervention simulator estimates how cardioactive drug classes would shift a patient’s risk by perturbing the named concepts and re-running the same twin. Full article

Background/Objectives: Children with cancer admitted to the pediatric intensive care unit (PICU) are at increased risk for post-intensive care syndrome (PICS-p) due to prolonged immobility, deep sedation, and severe illness. The ABCDEF bundle offers a framework for enhancing ICU care and patient recovery, but implementing all components in pediatric oncology patients is challenging. This study assesses the development and implementation of the BRAVE (Beginning Restorative Activities Very Early) initiative, specifically BRAVE2, to integrate the comprehensive ABCDEF bundle and a nurse-led mobility program, in collaboration with rehabilitation specialists, within a pediatric oncology intensive care unit. Methods: BRAVE2 was a quality improvement project conducted in a single pediatric ICU from 2022 to 2023. We analyzed ICU data to assess patient demographics, frequency of physical and occupational therapy (PT/OT) consultations, time to initial mobilization, and delirium screening rates (CAPD score of 9 or higher) for patients with ICU stays over 48 h. BRAVE2 addressed all elements of the ABCDEF bundle, including regular pain assessments, evaluation of spontaneous breathing readiness, sedation adjustments, delirium screening, early mobilization, and family engagement. Outcomes were monitored using statistical process control methods. Results: Of 140 patients, 117 (84%) remained in the ICU for more than 48 h. The delirium screening rate was 15.5%, consistently below the target of 30%. PT/OT consultations within 72 h occurred in 80.7% of patients, and early mobilization in 49.7% of patients, both below the 80% goal. However, 90.4% of patients with tracked mobility were able to ambulate during their ICU stay. No mobility-related safety incidents were reported. Conclusions: Rolling out a full ICU liberation plan in a pediatric oncology ICU is possible, and implementing a comprehensive one is feasible and sustainable despite challenges. Although therapist-led early mobilization did not meet targets, incorporating nurse-led mobility strategies and routine delirium screening has established a scalable model to enhance ICU care and support long-term recovery for these patients. Full article

Facility Layout Planning (FLP) remains a complex task for manufacturers seeking to improve productivity, reduce daily operating costs, and stay competitive in fast-changing markets. Traditional methods such as Systematic Layout Planning (SLP) offer useful guidelines for designing department layouts but still rely heavily on judgment and experience. At the same time, modern optimization and simulation techniques provide valuable quantitative insights. These techniques are often used separately rather than as part of an integrated process. In this work, a hybrid layout-planning approach that combines these techniques is developed and validated through an industrial case study, providing a practical decision-support process for facility layout planning. The process starts with SLP, which develops an initial layout using activity relationship charts, material-flow analysis, and handling-cost estimates. A simulation model then evaluates throughput, machine utilization, and work-in-progress, providing early indications of the layout’s real-world performance. A Genetic Algorithm (GA) is used to find improved configurations that reduce distances and costs. The optimized layouts are further tested through simulation. To demonstrate practical use, the framework was applied at a transformer manufacturing plant. It resulted in an approximately 35% reduction in material-handling costs. The results show that the optimized layout reduced material-handling costs from 7062.5 to approximately 4560 L.E. per transformer while increasing monthly throughput by 2.46% (approximately 11 transformers per month). Additionally, a what-if analysis was performed to identify opportunities for improvement, such as increasing production by using an automatic laser-cutting machine. The findings support data-driven decisions in facility layout design and long-term operational planning. Full article

Experience has become a central source of competitiveness in wellness tourism, yet natural features in resorts often remain passive scenery rather than deliberately designed service content. This prospective, four-group randomised controlled service-evaluation study examined whether brief nature-based wellness micro-interventions developed from natural elements already present in a coastal health and wellness resort were associated with more favourable immediate evaluations of experience quality, satisfaction, perceived innovativeness, added value, and recommendation intention. Of 120 adult hotel guests randomly allocated in equal proportions to cloud noticing, forest therapy elements, active control, or standard stay, 114 completed the final evaluation. A contextually adapted 22-item instrument based on service-performance logic and tourism-experience research was used. The forest-therapy-elements and cloud-noticing conditions showed the most favourable overall evaluation profiles, followed by active control and standard stay. The clearest differentiation concerned perceived innovativeness, while recommendation intention was most strongly associated with perceived added value and satisfaction. These findings are relevant to wellness-tourism development because they indicate that natural elements already present in a resort may acquire additional perceived service value when translated into structured, facilitated, and place-sensitive guest activities. Because outcomes were immediate self-reports obtained in a single resort and participants and facilitators could not be blinded, the findings should not be interpreted as proof of lasting behavioural effects. They suggest a promising low-infrastructure service-development pathway whose effects on actual recommendation, repeat visitation, willingness to pay, loyalty, and destination outcomes require confirmation in multi-site and longitudinal research. Full article

Background: Modern intensive care paradigms prioritize optimal analgesia over heavy sedation. While morphine, fentanyl, and remifentanil are widely used, sufentanil is relatively unknown in several countries. Aimed primarily at intensive care physicians, this narrative review evaluates the utilization of sufentanil in critically ill adult patients across four fundamental dimensions: (1) translational pharmacology (chemical structure, pharmacokinetics, pharmacodynamics, and pharmacogenomics); (2) indications and safety precautions; (3) clinical evidence in ICU patients; and (4) therapeutic positioning in contemporary ICU analgosedation and future research directions. Methods: A comprehensive literature search was conducted in PubMed/MEDLINE focusing on the translational pharmacology, safety parameters, and clinical studies of sufentanil critically ill adults. The synthesis was structured according to SANRA principles for high-quality narrative reviews and includes articles published up to February 2026. Results: Sufentanil exhibits an exceptionally high affinity for the µ-opioid receptor, providing a potency 10-fold greater than fentanyl and 1000-fold greater than morphine. It has an experimental therapeutic index (LD50/ED50) nearly two orders of magnitude wider than that of fentanyl, enabling safe, highly granular bedside titration. Unlike morphine, hepatic CYP3A4 biotransformation yields completely inactive metabolites, preventing toxic accumulation during acute kidney injury. Furthermore, receptor-binding dynamics suggest a lower propensity for recruiting β-arrestins and activating NMDA pathways, potentially reducing opioid-induced hyperalgesia (OIH). Clinically, pilot trials in neurocritical cohorts demonstrate that sufentanil maintains reliable cerebral hemodynamic stability. In postoperative cardiac surgery and large ICU registries, sufentanil may reduce the mechanical ventilation duration, accelerate extubation, and shorten ICU length of stay. Conclusions: For critically ill adults, sufentanil is an excellent alternative to traditional opioids because it offers high-precision titratability, potent analgesia, and a safer metabolic profile. Full article

The growth in the number of half-marathon participants reflects a transformation from performance-centred participation towards sporting experiences of a social and hybrid nature, with a great capacity to generate tourism flows. This study examines the social motivational structure of participants in the Bidasoa Half Marathon and identifies distinct profiles based on their social motivations. In this event, with a strong tourism appeal, 59.15% of respondents reside outside the Bidasoa region, a characteristic already recognised by the organisers, who promote parallel social activities aimed at enhancing the participant experience and encouraging overnight stays. A self-administered questionnaire was distributed to all runners registered for the 2025 edition (N = 1496), yielding 284 valid responses (an 18.98% response rate). The instrument measured three specific dimensions: event inclusivity, face-to-face socialisation, and digital interaction/validation. Exploratory and Confirmatory Factor Analyses validated a robust three-dimensional model explaining 85.04% of the total variance, with adequate reliability and convergent and discriminant validity indices. Inclusivity emerged as the primary motivational driver, followed by digital interaction and physical socialisation. Furthermore, cluster analysis identified three segments: the Inclusive Runner (38.03%), characterised by a high valuation of inclusivity and low digital interest; the Connected Runner (31.34%), with high and balanced scores across the three dimensions and a peak score in digital interaction; and the Autonomous Runner (30.63%), displaying low levels across all social dimensions. Significant associations with age, gender, and educational attainment evidence the inherent heterogeneity of the participants. Consequently, the findings extend traditional models by integrating social and digital dimensions, thereby providing strategic implications for the contemporary management of sporting events. Full article

Background/Objectives: Despite the increasing rates of disability associated with aging, obesity, and osteoarthritis requiring surgery, optimizing rehabilitation after hospital discharge remains a major challenge and a key determinant of care safety, quality, and sustainability. The aim of this exploratory study is to evaluate the predictive performance of machine learning (ML) models for predicting Inpatient Rehabilitation Length Of Stay (IRLOS), Function in the Activities of Daily Living (FADL) and discharge destination (DD) in patients who underwent total joint replacement for hip and knee osteoarthritis, using Real-World Data routinely collected in a tertiary orthopedic hospital. Methods: 2103 patients were included and temporally split into a development cohort (2019; n = 1711) and a temporal validation cohort (2018; n = 392). A total of 73 routinely collected perioperative variables were used to train multiple ML models, including both black-box and transparent methods. IRLOS and FADL were modeled as regression tasks, while DD was treated as a binary classification task. Model development followed a rigorous pipeline with feature selection, cross-validation, and hyperparameter tuning. Performance was assessed using appropriate metrics and evaluated across joint type (hip/knee) and via temporal validation. Model interpretability was examined using SHAP and model-specific analyses, further supported by clinical analysis. Results: In temporal validation, models achieved modest performance for IRLOS (R² = 0.17; MAE = 2.52 days) and FADL (R² = 0.25; MAE = 2.25 days), with no significant performance degradation over time. DD prediction showed good discrimination (AUC = 0.85; balanced accuracy = 0.80) despite outcome imbalance, with high sensitivity (0.92) and negative predictive value (≈1.00), but low positive predictive value (0.09). Performance was stable across hip and knee subgroups. The interpretability analysis further highlighted several key predictors related to perioperative complexity (e.g., surgical duration and transfusion), baseline functional status, and social factors (e.g., living situation and employment), confirming that rehabilitation outcomes are multidimensional and influenced by both medical and non-medical determinants. Conclusions: The analysis identified several relevant predictors related to perioperative complexity, baseline functional status, and social context. The models showed stable behavior across intervention type and across time through temporal validation, suggesting that they capture relevant patterns in rehabilitation pathways, although predictive performance was moderate. Full article

Gelatin-based hydrogels are promising matrices for wound management, but their direct application is constrained by insufficient structural stability and lack of intrinsic antimicrobial activity. Porcine and fish gelatin hydrogels were photochemically crosslinked with menadione sodium bisulfite (MSB), a water-soluble hemostatic derivative of vitamin K3, and characterized by ATR-FTIR and ¹H NMR spectroscopy, together with antimicrobial testing against Staphylococcus aureus, Candida albicans, Escherichia coli, and Salmonella enterica. FTIR analysis showed that MSB crosslinking retards the thermal disruption of collagen-like triple helices in both gelatins, with the effect being more pronounced in porcine gelatin owing to its higher imino acid content and more developed collagen-like network. NMR measurements confirmed that crosslinking increases the bound-water fraction approximately threefold in porcine and twofold in fish gelatin, while the bulk water mobility stays unchanged. MSB crosslinking enhanced antimicrobial activity against S. aureus and C. albicans by up to 5.6-fold relative to non-crosslinked controls and additionally conferred activity against E. coli, while S. enterica remained resistant in all variants. MSB, thus, simultaneously serves as a structural crosslinker and imparts intrinsic antimicrobial activity to the resulting hydrogels, making them a promising basis for multifunctional wound-healing materials. Full article

Background/Objectives: Obesity is extremely common among patients with end stage renal disease (ESRD) due to shared metabolic risk factors. Renal transplantation is the gold standard treatment for ESRD, however obesity is a major barrier due to increased anaesthetic risks, surgical complications and poorer graft outcomes. The aim of this study was to assess ESRD patients referred for metabolic bariatric surgery (MBS) in Scotland. Methods: Data from all adult patients with ESRD who were referred for MBS in Scotland from January 2014 to August 2025 were obtained retrospectively. Categorical data are presented as number and percentage; non-parametric continuous data are presented as median and inter-quartile range. A focused review of comparable published cohorts was performed for context. Results: A total of 9 patients with ESRD were referred for MBS over the study period; of these, 5 patients went on to have MBS. Of the patients who underwent MBS, the median age at referral was 47 years, 3 of 5 were female and the median starting weight and body mass index (BMI) were 131 kg and 49 kg/m² respectively. Four patients underwent laparoscopic sleeve gastrectomy, and 1 patient underwent one-anastomosis gastric bypass. The median length of hospital stay was 2 days. The median total percentage weight loss was 33.5% (range 27.7% to 48.1%). Four of the five patients were able to be activated on the transplant waiting list after successfully achieving their target weight after a median of 8.4 months. Of the 4 listed patients, 3 were transplanted with no post-operative complications, and 1 remains active on the waiting list. Across seven comparable cohorts (19 to 198 operated patients), all single- or two-centre, ours had the only national coverage. Listing and transplantation outcomes (4 of 5 listed, 3 of 5 transplanted) were broadly consistent with the range reported in these cohorts, although the small sample precludes formal comparison. Conclusions: In this small case series and review, MBS appeared safe and feasible in a highly selected group of patients with obesity and ESRD. MBS facilitates access to renal transplant but is under-utilised in Scotland. We plan to formalise a national treatment pathway to streamline access to bariatric services for patients with ESRD and enable more patients to undergo renal transplantation. Full article

How can one test for a multiplicative topological difference between two structured network populations whose fixed-scale additive Betti summaries agree? We model each population as a probability law over finite graphs, considered up to isomorphism, and read each graph through its clique complex. At the working scale, the ordinary summary is the joint Betti vector $B=(b_0,b_1,b_2)$, recording connected components, loops, and voids. The comparison is deliberately single scale: B is the vector of Betti counts at a fixed working scale, not the full persistence diagram of a filtration. We show that this additive summary can be identical under two non-degenerate graph laws while a multiplicative cohomology-ring statistic differs: the cup product, a multiplicative operation recording when two one-dimensional cohomology classes have a nonzero product in degree two, occurs with different frequency under the two laws. Consequently any procedure whose input is only this single-scale B-summary has no power beyond its size against the constructed alternatives, while a simple cup-product statistic separates them. We define a ring-frequency distance, prove finite-sample concentration for its plug-in estimator, and give a consistent two-sample test. The theory is aimed at structured, ring-rich graph complexes—surface-like meshes and coverage complexes—where the cup product is active; we give a deterministic mechanism under which it is vacuous, together with numerical evidence that it can be uninformative in generic random-graph regimes. Numerical illustrations confirm that the ring test detects the difference while calibrated B-only tests stay blind; those same B-only tests have power when the Betti law itself changes. Real-data case studies on surface meshes and nanoporous frameworks illustrate, respectively, the intended ring-rich regime and a cup-vacuous scope boundary. Full article

Background/Objectives: Preoperative anxiety is a common issue among patients undergoing third-molar surgery, significantly impacting physiological stability, surgical outcomes, and recovery, highlighting the need for effective non-pharmacological interventions. This systematic review was performed to delineate the current literature regarding non-pharmacological interventions aimed at alleviating preoperative anxiety in patients undergoing an odontectomy. Methods: A comprehensive search was performed across major databases, including Cochrane, EMBASE, MEDLINE, PubMed, Scopus, and Web of Science, for studies published between 2011 and 2026. The inclusion criteria comprised original research, reviews, and clinical trials focused on non-pharmacological approaches to alleviating anxiety in patients undergoing an odontectomy. Results: A total of 28 studies were found via an electronic search. After screening, 11 studies were eligible for systematic review. This study demonstrates that preoperative anxiety is common in odontectomies, impacting both psychological and physiological stability. Instruments such as VAS, STAI, and MDAS demonstrate elevated anxiety levels prior to surgical procedures. This anxiety induces physiological responses that affect stability. Music therapy effectively lowers anxiety, as indicated by reduced VAS scores (F = 4.226, p < 0.05) and improved emotional well-being and parasympathetic activity. Conclusions: This review highlights both subjective and objective instruments for measuring anxiety as well as non-pharmacological approaches to mitigating preoperative anxiety in patients undergoing an odontectomy. While non-pharmacological interventions show potential, there is a lack of protocols and specific evidence, highlighting the need for integrated, culturally adapted strategies and regular anxiety screening. Full article

Microscopic magnetic stimulation (MSTI) induces electric fields without direct charge injection and can shape localized field gradients with asymmetric micro-coils. Most demonstrations still rely on external drivers, off-chip hardware, or separated coil validation, so the CMOS integration boundary remains poorly characterized. This work presents a fabricated $2\times 1 {\mathrm{mm}}^2$ $0.18 \mathsf{\mu }\mathrm{m}$ CMOS magnetic-stimulation SoC that co-integrates ASK-compatible command decoding, FSM and register-based parameter control, a programmable current–voltage–current triangular driver, and a bent top-metal micro-coil, and it characterizes the on-chip driver-to-coil path together with a substrate-aware field model. Sensing-load reconstruction confirms command-to-waveform programmability, including duration-window decoding, burst-count control, and polarity reversal, with measured slew targets that give a peak current of $I_{\mathrm{pk}}=3.72$–$21.6 \mathrm{mA}$. A quantitative comparison contrasts the current-mode triangular driver with conventional electrode stimulators, a coil-impedance measurement shows the coil stays resistive across 1 to 10 MHz, and the measured total SoC power is about 41 mW. Substrate-aware simulation at a $15 \mathsf{\mu }\mathrm{m}$ target plane shows that the grounded p-substrate retains $35.1$–$40.5\%$ of the no-substrate peak x-directed field-gradient metric. The prototype establishes this electrical programmability and the substrate-aware gradient-transfer loss as a compact design-margin metric for CMOS-integrated magnetic stimulation. Direct biological activation is not claimed and is left to future in vitro validation. Full article