Gait asymmetrical evaluation of lower limb amputees using wearable inertial sensors.

This study presents an analysis and evaluation of gait asymmetry (GA) based on the temporal gait parameters identified using a portable gait event detection system, placed on the lateral side of the shank of both lower extremities of the participants. Assessment of GA was carried out with seven control subjects (CS), one transfemoral amputee (TFA) and one transtibial amputee (TTA) while walking at different speeds on overground (OG) and treadmill (TM). Gait cycle duration (GCD), stance phase duration (SPD), swing phase duration (SwPD), and the sub-phases of the gait cycle (GC) such as Loading-Response (LR), Foot-Flat (FF), and Push-Off (PO), Swing-1 (SW-1) and Swing-2 (SW-2) were evaluated. The results revealed that GCD showed less asymmetry as compared to other temporal parameters in both groups. A significant difference (p < 0.05) was observed between the groups for SPD and SwPD with lower limb amputees (LLA) having a longer stance and shorter swing phase for their intact side compared to their amputated side, resulting, large GA for TFA compared to CS and TTA. The findings could potentially contribute towards a better understanding of gait characteristics in LLA and provide a guide in the design and control of lower limb prosthetics/orthotics.

Enhanced photocatalytic and electrochemical performance of hydrothermally prepared NiO-doped Co nanocomposites.

In this study, we synthesize nanostructured nickel oxide (NiO) and doped cobalt (Co) by combining nickel(II) chloride hexahydrate (NiCl2.6H2O) and sodium hydroxide (NaOH) as initial substances. We analyzed the characteristics of the product nanostructures, including their structure, optical properties, and magnetic properties, using various techniques such as x-ray diffraction (XRD), scanning electron microscopy (SEM), ultraviolet absorption spectroscopy (UV-Vis), Fourier transform infrared (FTIR) spectroscopy, and vibrating sample magnetometers (VSM). The NiO nanoparticles doped with Co showed photocatalytic activity in degrading methylene blue (MB) dye in aqueous solutions. We calculated the degradation efficiencies by analyzing the UV-Vis absorption spectra at the dye's absorption wavelength of 664 nm. It was observed that the NiO-doped Co nanoparticles facilitated enhanced recombination and migration of active elements, which led to more effective degradation of organic dyes during photocatalysis. We also assessed the electrochemical properties of the materials using cyclic voltammetry (CV) and impedance spectroscopy in a 1 mol% NaOH solution. The NiO-modified electrode exhibited poor voltammogram performance due to insufficient contact between nanoparticles and the electrolyte solution. In contrast, the uncapped NiO's oxidation and reduction cyclic voltammograms displayed redox peaks at 0.36 and 0.30 V, respectively.

Role of virtual reality in examining the effect of fear of falling (FOF) on postural stability in individuals without and with Parkinson's disease in Egypt: a mixed-methods feasibility study protocol.

BACKGROUND: Falls are common in older people and individuals with neurological conditions. Parkinson's disease (PD) is known for postural instability causing mobility disabilities, falls and reduced quality of life. The fear of falling (FOF), a natural response to unstable balance, can worsen postural control problems. Evaluating FOF relies largely on affected persons' subjective accounts due to limited objective assessment methods available. The aim of this mixed-methods feasibility study is to develop an assessment method for FOF while in motion and walking within virtual environments. This study will assess a range of FOF-related responses, including cognitive factors, neuromuscular response and postural stability. METHODS AND ANALYSIS: This feasibility study will consist of four phases: the first two phases will include people without PD, while the other two will include people diagnosed with PD. Participants will be assessed for direct and indirect responses to real life, as well as virtual environment walking scenarios that may induce FOF. Data from questionnaires, different neurophysiological assessments, movement and gait parameters, alongside evaluations of usability and acceptability, will be collected. Semistructured interviews involving both participants and research assistants shall take place to elicit their experiences throughout different phases of the assessments undertaken. Demographic data, the scores of assessment scales, as well as feasibility, usability and acceptability of the measurement methods, will be illustrated via descriptive statistics. Movement and gait outcomes, together with neurophysiological data, will be extracted and calculated. Exploring relationships between different factors in the study will be achieved using a regression model. Thematic analysis will be the approach used to manage qualitative data. ETHICS AND DISSEMINATION: This feasibility study was approved by the Ethics Committee of the Faculty of Physical Therapy, Kafr El Sheikh University, Egypt (number: P.T/NEUR/3/2023/46). The results of this study will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT05931692).

3D-printed titanium alloy cage in anterior and lateral lumbar interbody fusion for degenerative lumbar spine disease.

Background: The most commonly used cages for intervertebral disc replacement in lumbar fusion procedures are made predominantly from polyetheretherketone (PEEK). There is sufficient data studying their subsidence and failure rates from a variety of approaches. A novel implant is now available for commercial use, 3D-printed porous titanium (3DppTi) alloy cages, which have recently become available for use in spinal procedures. They have been shown in ovine models to have superior efficacy and fusion rates compared to traditional cages. However, there is limited data on their use in clinical practice and long-term outcomes associated with them. Methods: A retrospective chart review was performed, of all patients in a single institution who underwent lumbar spine fusion surgery via an anterior or lateral approach with a 3D-printed titanium alloy cage, between January 2020 and February 2021. Clinic letters, imaging and operation reports were independently reviewed to assess for fusion, or evidence of subsidence on follow-up. Results: Fifty patients were identified as meeting inclusion criteria, with a total of 66 operative levels. Of these operative levels, 32 were via an anterior approach and 34 via a lateral approach. One patient demonstrated a Marchi grade 0 subsidence, with recurrence of radiculopathy 2 months after an anterior approach, requiring posterior decompression and stabilization. A second patient demonstrated a Marchi grade 1 subsidence after a lateral approach, but did not require further surgery as they were asymptomatic at 2 years of follow-up. This study demonstrated an overall subsidence rate of 3.03%. There was a median follow-up time of 11.3 months for all patients. Conclusions: 3D-printed titanium alloy cages demonstrate a lower subsidence rate compared to historically published rates for alternative intervertebral cages, in anterior and lateral lumbar spine fusion surgery.

Electrochemical investigations and antimicrobial activity of Au nanoparticles photodeposited on titania nanoparticles.

Titanium oxide nanopowder (TiO2 NPs) was synthesized via anodization in 0.7 M perchloric acid then annealed in nitrogen at 450 °C for 3 h to prepared the Titanium Oxide Nitrogen annealed nanoparticles (TiO2 NPs-N2) powder as catalytic support. Using a photodeposition process, gold was added with isopropanol as a sacrificial donor and H[AuCl4] acid, producing gold nanoparticles on nitrogen-annealed titanium oxide nanoparticles (Au-NPs on TiO2-NPs-N2). The mass loading of Au NPs was 2.86 × 10-4 (g/cm2). TEM images of Au NPs on TiO2-NPs-N2 suggest circular particles with a tendency to agglomerate. Cyclic voltammetry (CV) was used to investigate the electrocatalytic performance of the Au NPs/TiO2-NPs-N2 catalysts in ferrocyanide, KOH, and H2SO4, and the results were compared to those of a polycrystalline Au electrode that is readily accessible in the market. In KOH, H2SO4, and (2 M KOH + 0.1 M glycerol) solutions, the Au NPs/TiO2-NPs-N2 electrode displayed a startlingly high electrocatalytic performance. Using CV, the electrocatalytic oxygen reduction reaction (ORR) of Au NPs/TiO2-NPs-N2 and Au-NPs against glycerol oxidation in basic media was studied. The results indicated that Au NPs/TiO2-NPs-N2 is a promising support material for improving the electrocatalytic activity for acidic and basic oxidation. The electrode made of Au NPs/TiO2-NTs-N2 has steady electrocatalytic activity and may be reused repeatedly. TiO2 NPs and Au NPs/TiO2NPs-N2 showed satisfactory antibacterial activity against some human pathogenic bacteria using the disc diffusion method.

Performance evaluation of PSO-PID and PSO-FLC for continuum robot's developed modeling and control.

Continuum robots are complex structures that require sophisticated modeling and control methods to achieve accurate position and motion tracking along desired trajectories. They are highly coupled, nonlinear systems with multiple degrees of freedom that pose a significant challenge for conventional approaches. In this paper, we propose a system dynamic model based on the Euler-Lagrange formulation with the assumption of piecewise constant curvature (PCC), where we accounts for the elasticity and gravity effects of the continuum robot. We also develop and apply a particle swarm optimization (PSO) algorithm to optimize the parameters of our developed controllers: an inverse dynamic proportional integral derivative (PID) controller and an inverse dynamic fuzzy logic controller (FLC), where we use the integral time of absolute error (ITAE) as the objective function for the PSO algorithm. We validate our proposed model and optimized controllers through different designed trajectories, simulated using our developed unique animated MATLAB simulation. The results show that the PSO-PID controller improves the rise time, overshoot percentage, and settling time by 16.3%, 31.1%, and 64.9%, respectively, compared to the PID controller without PSO. The PSO-FLC controller shows the best performance among all controllers, with a settling time of 0.7 s and a rise time of 0.4 s, leading to the highest level of precision in trajectory tracking. The ITAE error for the PSO-FLC controller is 11.4% and 29.9% lower than that of the PSO-PID and FLC controllers, respectively.

Optimizing power consumption and position control in an electro-hydraulic system with cylinder bypass and NN-MPC.

This study introduces an innovative approach to enhance the energy efficiency and position control performance of electro-hydraulic systems, employing a comprehensive comparative analysis. It presents and evaluates three control techniques: Proportional-Integral-Derivative (PID) control, Model Predictive Control (MPC), and Neural Network Model Predictive Control (NN-MPC). These methods are systematically assessed across varying load conditions. Notably, our research unequivocally establishes the exceptional performance of the NN-MPC approach, even when confronted with load variations. Furthermore, the study conducts an exhaustive examination of energy consumption by comparing a conventional system, where a flow control valve is not utilized as a hydraulic cylinder bypass, with a proposed system that employs a fully open Flow Control Valve (FCV). The results underscore the remarkable energy savings achieved, reaching up to 9% at high load levels.

Self-Medication Related Knowledge, Attitudes, and Practices among Residents of Riyadh, Saudi Arabia: A Community-Based Cross-Sectional Study.

Rational and responsible self-medication (SM) is an essential core element for better health outcomes. It is influenced mainly by the level and adequacy of knowledge, attitude, and appropriateness of practice (KAP) towards SM. The present study explored the level and adequacy of KAP among residents of Riyadh city, Saudi Arabia. A convenient snowball sampling method was utilized to recruit the study participants. Data were analyzed using SPSS version 27. Six hundred and eleven participants completed the questionnaire. Residents with good knowledge, positive attitude, and proper practice were 43.7%, 33.1%, and 90.0%, respectively. The level of KAP was significantly influenced by the participant's occupation, age, gender, nationality, marital status, presence of chronic disease, and COVID-19 infection status. The mean knowledge, attitude, and practice scores observed were 5.11 (SD = 1.27), 22.28 (SD = 2.6) and 5.20 (SD = 1.29), respectively. Pearson correlation and scattered plot matrix analysis revealed a significant positive weak correlation among KAP, indicating that residents with good knowledge possess better attitude (r = 0.142, p < 0.001) and follow the proper practice (r = 0.256, p < 0.001) towards SM. Multivariate linear regression revealed a significant (p < 0.001) negative (ß = -0.059) influence of occupation, family members working in the health sector (p = 0.046, ß= -0.426), Body Mass Index (p = 0.019, ß = -0.049), and physical activity (p = 0.018, ß = -0.292) on the overall KAP score. Understanding the residents' level of KAP towards SM would enable the health care system to identify the gap and develop a mechanism to educate the people and make them knowledgeable about SM and self-care.

The Co-Existence of Patent Omphalomesenteric Duct and Omphalocele in Patau's Syndrome in Saudi Arabia: A Case Report.

The pathophysiology of Patau's syndrome involves the triplication of chromosomes, leading to multiple comorbidities. An omphalocele is characterized by a protrusion of abdominal contents from the base of the umbilical cord through the peritoneum. An omphalomesenteric duct remnant occurs when there is a failure of duct closure that results in a diverticulum extending from the fetal midgut to the yolk sac. While congenital defects rarely occur simultaneously in patients with Patau's syndrome, this case report describes a newborn with Patau syndrome who presented with both an omphalocele and an omphalomesenteric duct remnant. The newborn exhibited various congenital abnormalities such as coloboma, microphthalmia, broad nasal bridge, cleft lip, cleft palate, low-set ears, systolic murmur, omphalocele, intestinal umbilical fistula (omphalomesenteric continuous vitelointestinal duct remnant), polydactyly, rocker-bottom feet, left-sided clubbed foot, and ruptured myelomeningocele. Imaging revealed additional complications such as a large patent ductus arteriosus, hypoplastic distal arch, markedly dilated right atrium and left ventricle, and cerebellar hypoplasia. Chromosomal analysis confirmed the diagnosis of Patau's syndrome. Given the untreatable medical condition, the patient was placed under "Do Not Resuscitate," and palliative care was initiated. The simultaneous appearance of an omphalocele and an omphalomesenteric continuous vitelointestinal duct is rare, and surgical intervention is the standard of care if the patient is deemed suitable for surgery. However, in cases where surgery is not feasible, palliative care is initiated. Regardless of the outcome, genetic counseling is essential and should include a discussion on paternal autonomy, understanding the disorder, suggesting alternative management methods, and making crucial decisions concerning future family care and planning.

Non-operative treatment for simple acute appendicitis (NOTA) in children during the COVID-19 era: new lessons from the pandemic.

Coronavirus (COVID-19) was a pandemic disease that was affecting our medical and surgical daily practice badly. The surgical management of acute appendicitis was the gold standard, but new studies suggest the safety of antibiotic treatment alone. Non-operative treatment for simple acute appendicitis (NOTA) avoids surgery, the risks of general anesthesia, and long hospital stays. It also decreases the risk of exposure to coronavirus. We aimed to study the cost-effectiveness and outcome of NOTA during the COVID-19 pandemic and compared it to single-incision pediatric endo-surgery appendectomy (SIPESA). A prospective cohort study for NOTA of patients from 6 to 12 years old in the COVID-19 pandemic period from April 1st, 2020, to April 30th, 2021, patients were divided into two groups: Group S was managed by SIPESA, and Group N was managed by NOTA. Family education and assurance with detailed explanation were done for early detection of any complications, and we continue monitoring the patients until their complete recovery. Group S had 24 cases (40%), mean age 9.3 years. Group N had 36 cases (60%), mean age 9.1 years. Six cases (17%) in group N were converted to surgical management in the first 6 months of the study. The mean cost dropped from $2736/day to $400/day. The mean psychological stress for the children improved from 4.4 in April to 2 in September. The mean follow-up was 3.5 months. NOTA is a feasible, cost-effective approach, and we recommend it, as we have learned this lesson during the COVID-19 pandemic days.

A conceptual design of circular adaptive façade module for reuse.

Climate change has an impact on the ecosystem, and subsequently, it affects the built environment. Building envelope has a vital role in controlling the integration between indoor and outdoor environmental quality. The responsivity of the façade has proven its efficiency in optimizing the global energy performance of buildings. Adaptive façades are multifunctional reconciling envelope dynamic systems that improve sustainability with the purpose of utilizing environmental parameters. This paper tackles the research gap in integrating façades circularity, adaptive envelopes, and design for disassembly. The research investigates the merge between biodegradability, circularity of adaptive façades components, and interior space micro-climate control for energy efficiency. This paper presents a proof of concept for a circular adaptive façade during two phases in its life cycle: operation and reuse phases. A scientific quantitative method took place which is based on a hybrid method; computational simulation, smart control, and an up-scale model. Adaptability is investigated through the façade life cycle from design to disassembly instead of demolition and consequent waste production, by exploiting sustainable materials. As a result, an empirical prototype is constructed. The prototype provides 3 levels of adaptability across the design, operation, and disassembly for reuse. Subsequently, this work proposes an up-scale physical model that can help in mitigating the climate change effects.

Localization of composite prosthetic feet: manufacturing processes and production guidelines.

Amputation levels in Egypt and the surrounding neighborhood require a state intervention to localize the manufacturing of prosthetic feet. Amputations are mainly due to chronic diseases, accidents, and hostilities' casualties. The prosthetic foot type is traditionally classified according to the number of axial rotational movements, and is recently classified according to the energy activeness of the foot. The localization of this industry needs a preliminary survey of the domestic technological levels with respect to the foot type. Upon the results of this survey, the energy storage response foot has appealing metrics to proceed with its manufacturing. A prototype manufacturing chain is designed and a set of these feet with a certain commercial size of 27 is manufactured. Resin impregnation technology for carbon fiber composites is followed in this work. The feet are tested according to ISO 22,675. Based on the dimensional and mechanical results, a manufacturing value chain is proposed with the prospective resin transfer molding technology. This value chain will guarantee the required localization as well as the natural growth of this value chain with all related activities like accreditation of practices as well as manpower certification.

Nonconventional Tether Structure for Quality Factor Enhancement of Thin-Film-Piezoelectric-on-Si MEMS Resonator.

This article presents a new design of supporting tethers through the concept of force distribution. The transmitted force applied on tethers will be distributed on the new tether design area, resulting in low acoustic energy transferred to anchor boundaries and stored energy enhancement. This technique achieves an anchor quality factor of 175,000 compared to 58,000 obtained from the conventional tether design, representing a three-fold enhancement. Furthermore, the unloaded quality factor of the proposed design improved from 23,750 to 27,442, representing a 1.2-fold improvement.

Recent Advances in Bimetallic Catalysts for Methane Steam Reforming in Hydrogen Production: Current Trends, Challenges, and Future Prospects.

As energy demand continues to rise and the global population steadily grows, there is a growing interest in exploring alternative, clean, and renewable energy sources. The search for alternatives, such as green hydrogen, as both a fuel and an industrial feedstock, is intensifying. Methane steam reforming (MSR) has long been considered a primary method for hydrogen production, despite its numerous advantages, the activity and stability of the conventional Ni catalysts are major concerns due to carbon formation and metal sintering at high temperatures, posing significant drawbacks to the process. In recent years, significant attention has been given to bimetallic catalysts as a potential solution to overcome the challenges associated with methane steam reforming. Thus, this review focuses on the recent advancements in bimetallic catalysts for hydrogen production through methane steam reforming. The review explores various aspects including reactor type, catalyst selection, and the impact of different operating parameters such as reaction temperature, pressure, feed composition, reactor configuration, and feed and sweep gas flow rates. The analysis and discussion revolve around key performance indicators such as methane conversion, hydrogen recovery, and hydrogen yield.

The Epidemiological Pattern of Skin Cancer from 2011 to 2022 among the Population of the Aseer Region, Kingdom of Saudi Arabia.

The overall risk of developing cancer before the age of 75 years in the Kingdom of Saudi Arabia is 9.9%. We aimed to explore the pattern of skin cancer, specifically among the Saudi population residing in the Aseer region. We obtained data from the medical records of Aseer Central Hospital regional histopathological laboratory considering surgical pathology reports from 2011 to 2021. The 61-80-year-old age group represented most of the cases (41.4%), followed by the 41-60-year-old group at 24.1%. Men made up the majority of the cases (59.4%). Furthermore, the dataset predominantly consisted of Saudi nationals (94.3% of the sample). The percentage of cases diagnosed each year relative to the cumulative number of skin cancer cases varied each year, ranging from 1.6% in 2011 to 11.6% in 2017. The most common diagnoses were squamous cell carcinoma (SCC) with 230 cases (41.1%) and basal cell carcinoma (BCC) with 147 cases (26.3%). The majority of cases occurred in the head and neck region (55.4%), followed by the lower limb (16.6%), trunk (13.6%), upper limb (8.2%), and pelvis (2.3%). There was a significant variation in the type of skin cancer across the age groups (p < 0.001) and across different body parts (p < 0.001). The incidence of skin cancer exhibited variability throughout the study period. The predominant diagnoses observed were SSC and BCC. Among the affected areas, the head and neck region displayed the highest prevalence, followed by the lower limb, trunk, upper limb, and pelvis.

Reem-Shape Phononic Crystal for Q Anchor Enhancement of Thin-Film-Piezoelectric-on-Si MEMS Resonator.

This paper proposes a reem-shaped phononic crystal for the performance enhancement of TPoS resonators. The proposed phononic crystal offers an ultra-wide acoustic band gap that prevents energy leakage through the supporting substrate upon its placement at the anchoring boundary, resulting in significant improvements in the resonator quality factor. Simulated results show reem-shape phononic crystals generate a band gap up to 175 MHz with a BG of 90% and enhance the anchor quality factor from 180,000 to 6,000,000 and the unloaded quality factor from 133,000 to 160,000, representing 33.3-fold and 1.2-fold improvements, respectively.

Clean hands, safe care: how knowledge, attitude, and practice impact hand hygiene among nurses in Najran, Saudi Arabia.

Introduction: Healthcare-acquired infections are infections that patients acquire while receiving treatment for a medical or surgical condition and can occur in all care facilities. Hospital-acquired infections and the spread of antimicrobial resistance can be reduced by implementing proper preventive measures, including hand hygiene. Aim: This study aimed to assess nurses' knowledge and attitudes toward hand hygiene guidelines in Najran city, determine compliance levels, identify factors contributing to non-compliance, and provide recommendations for interventions to improve hand hygiene practices and reduce healthcare-associated infections risk. Subject and methods: This cross-sectional study was conducted among nurses working in the selected government hospitals in Najran City, Saudi Arabia. A self-administered questionnaire was distributed among the targeted nurses using an online survey. The questionnaire includes socio-demographic characteristics such as age, gender, and marital status. The questionnaire had 25 items to measure knowledge, 10 to measure attitude, 6 to measure practices, and 4 to measure the impact of COVID-19 on hand hygiene practices. Results: Among the 386 nurses recruited, 88.3% were females, and 25.6% were aged between 31 to 35 years old. Overall, good knowledge, positive attitude, and good practice levels were found in 42.5, 48.4, and 94%, respectively. The common factor influencing hand hygiene practice was the prevention of cross-infection (88.1%). The total knowledge score mean was 18 ± 3.4 (highest possible score: 25). The total attitude score mean was 37.5 ± 6.1 (highest possible score: 50). The total practice score mean was 26.9 ± 2.8 (highest possible score: 30). A higher score indicates higher KAP of hand hygiene. Factors associated with increased KAP were being older in age (Z = 6.446; p < 0.001), gender female (Z = 9.869; p < 0.001), being a Filipino nurse (H = 117.8; p < 0.001), working in a surgery department (H = 28.37; p < 0.001), having more than 10 years of experience (Z = 6.903; p < 0.001), living in shared accommodation (H = 87.22; p < 0.001), having associated chronic disease (Z = 4.495; p < 0.001), and receiving formal training in hand hygiene (Z = 2.381; p = 0.017). There was a positive highly statistically significant correlation between knowledge score and attitude score (r = 0.556), between knowledge score and practices score (r = 0.303), and between attitude score and practices score (r = 0.481). Conclusion: In light of the results, we can say that the nurses' knowledge, attitude, and practice in regards to hand hygiene were deemed acceptable. We noticed that female nurses who were older and had more experience, as well as those who had received formal hand hygiene training, displayed better KAP compared to their counterparts. Moreover, we found a significant and positive correlation between the scores for knowledge, attitude, and practice. Nonetheless, additional research is necessary to establish the extent of KAP concerning hand hygiene.

An Improved Approach for Grasp Force Sensing and Control of Upper Limb Soft Robotic Prosthetics.

The following research proposes a closed loop force control system, which is implemented on a soft robotic prosthetic hand. The proposed system uses a force sensing approach that does not require any sensing elements to be embedded in the prosthetic's fingers, therefore maintaining their monolithic structural integrity, and subsequently decreasing the cost and manufacturing complexity. This is achieved by embedding an aluminum test specimen with a full bridge strain gauge circuit directly inside the actuator's housing rather than in the finger. The location of the test specimen is precisely at the location of the critical section of the bending moment on the actuator housing due to the tension in the driving tendon. Therefore, the resulting loadcell can acquire a signal proportional to the prosthetic's grasping force. A PI controller is implemented and tested using this force sensing approach. The experiment design includes a flexible test object, which serves to visually demonstrate the force controller's performance through the deformation that the test object experiences. Setpoints corresponding to "light", "medium", and "hard" grasps were tested with pinch, tripod, and full grasps and the results of these tests are documented in this manuscript. The developed controller was found to have an accuracy of ±2%. Additionally, the deformation of the test object increased proportionally with the given grasp force setpoint, with almost no deformation during the light grasp test, slight deformation during the medium grasp test, and relatively large deformation of the test object during the hard grasp test.