Simulation-Based Design of a Cam-Driven Hydraulic Prosthetic Ankle

Background/Objectives: A cam-driven hydraulic prosthetic ankle was designed to overcome the weaknesses of commercial prostheses and research prototypes, which largely fail to mimic the energy-recycling behaviour of an intact ankle, resulting in poor walking performance for lower-limb prosthesis users. Methods: This novel device exploits miniature hydraulics to capture the negative work performed during stance, prior to push-off, in a hydraulic accumulator, and return positive work during push-off for forward body propulsion. Two cams are used to replicate intact ankle torque profiles based on experimental data. The design process for the new prosthesis used a design programme, implemented in MATLAB, based on a simulation of the main components of the prosthetic ankle. Results: In this paper, we present the design programme and explain how it is used to determine the cam profiles required to replicate intact ankle torque, as well as to size the cam follower return springs. Moreover, a constraint-based preliminary design investigation is described, which was conducted to size other key components affecting the device’s size, performance, and energy efficiency. Finally, the feasible design alternatives are compared in terms of their energy losses to determine the best design with regard to minimising both energy losses and device size. Conclusions: Such a design approach not only documents the design of a particular novel prosthetic ankle, but can also provide a systematic framework for decomposing complex design challenges into a series of sub-problems, providing a more effective alternative to heuristic approaches in prosthetic design

Analysing the effectiveness of digital escape rooms on enhancing student experience and knowledge acquisition – A microbiology-based case

Active and gamified teaching methods, such as digital escaperooms, effectively enhance student outcomes. However, current work in this areais highly specialised and lacks translational capability across sectors, withlimited data associated with key higher education impact measures. This studyaimed to design a central platform for developing digital escape rooms andevaluate their pedagogical impact using a microbiology-based example.A university-wide platform for the design and delivery ofdigital escape rooms and an exemplar microbiology-based room were developedutilising WordPress with specialist plugins. The study cohort was comprised of17 students from a range of biology, biomedicine and chemical scienceprogrammes. Quantitative surveys were then completed to understand how digitalescape rooms impacted key pedagogical metrics with further stratification basedon socioeconomic factors.Overall feedback was positive with students reporting apositive experience (100 %), the escape room was well developed (88.2 %),increased their knowledge (82.4 %) and added value to their degrees (70.6 %).These data show the positive pedagogical impacts of digital escape rooms inhigher education

Perceived bioethical issues in cancer rehabilitation: a qualitative study among Italian physiotherapists

Introduction: Literature on bioethics in physiotherapy, particularly in cancer management, is limited. This study explores the perceived bioethical issues in cancer rehabilitation by Italian physiotherapists.Participants: Thirty-one physiotherapists (Age: 42 ± 10.5 years; 20 women, 11 men) with expertise in cancer rehabilitation were purposefully selected.Data Collection: Six online focus groups were conducted, guided by a focus group guide based on existing literature and refined by experts in cancer rehabilitation and bioethics.Data Analysis: Sessions were recorded, transcribed, and analyzed using Braun and Clarke’s ‘Reflexive Thematic Analysis’.Results: Four primary themes emerged: 1) Challenges of (Non)-Disclosure in Diagnosis and Prognosis – ethical difficulties around withholding diagnosis or prognosis information; 2) Balancing Hope and Realism in Patient and Caregiver Expectations – navigating hope versus realistic rehabilitation goals; 3) Weighing Efficacy and Safety in Cancer Rehabilitation – balancing treatment outcomes with patient safety; 4) Decisions on Withdrawing Treatment – ethical considerations in discontinuing treatment.Discussion: These themes highlight common ethical dilemmas faced by physiotherapists in cancer rehabilitation, mirroring broader healthcare challenges. Addressing them requires a nuanced understanding of ethical principles within the cancer rehabilitation context.Conclusions: The study provides insights into the bioethical issues in cancer rehabilitation, stressing the need for a patient-centered approach to navigate these challenges effectively

Phylogenetic Signal in Primate Tooth Enamel Proteins and its Relevance for Paleoproteomics

Ancient tooth enamel, and to some extent dentin and bone, contain characteristic peptides that persist for long periods of time. In particular, peptides from the enamel proteome (enamelome) have been used to reconstruct the phylogenetic relationships of fossil taxa. However, the enamelome is based on only about 10 genes, whose protein products undergo fragmentation in vivo and post mortem. This raises the question as to whether the enamelome alone provides enough information for reliable phylogenetic inference. We address these considerations on a selection of enamel-associated proteins that has been computationally predicted from genomic data from 232 primate species. We created multiple sequence alignments for each protein and estimated the evolutionary rate for each site. We examined which sites overlap with the parts of the protein sequences that are typically isolated from fossils. Based on this, we simulated ancient data with different degrees of sequence fragmentation, followed by phylogenetic analysis. We compared these trees to a reference species tree. Up to a degree of fragmentation that is similar to that of fossil samples from 1-2 million years ago, the phylogenetic placements of most nodes at family level are consistent with the reference species tree. We tested phylogenetic analysis on combinations of different enamel proteins and found that the composition of the proteome can influence deep splits in the phylogeny. With our methods, we provide guidance for researchers on how to evaluate the potential of paleoproteomics for phylogenetic studies before sampling valuable ancient specimens

Validity and Inter‐Device Reliability of an Artificial Intelligence App for Real‐Time Assessment of 505 Change of Direction Tests

The present study aimed to explore the validity and inter‐device reliability of a novel artificial intelligence app (Asstrapp) for real‐time measurement of the traditional (tra505) and modified‐505 (mod505) change of direction (COD) tests. Twenty‐five male Sports Science students (age, 23.5 ± 3.27 years; body height, 178 ± 9.76 cm; body mass, 79.4 ± 14.7 kg) completed 12 trials each, consisting of six tra505 and six mod505 trials. Completion times were simultaneously recorded via single‐beam electronic timing gates (ETG) and two different iPhones (APP1 and APP2). In total 300 trials were collected across the two tests, using all three devices, to establish the reliability and validity of the app. The coefficient of variation indicated a similar level of dispersion between the ETG (≤ 2.73%), APP1 (≤ 2.39%) and APP2 (≤ 2.52%). Intraclass correlation coefficients (ICC) revealed excellent reliability among the three timing devices (ICC ≥ 0.99) and Asstrapp relative reliability was excellent for both APP1 (ICC ≥ 0.91) and APP2 (ICC ≥ 0.91). There was a practically perfect correlation and agreement between ETG and Asstrapp (APP1: r = 0.97; APP2: r = 0.97) for both COD tests. However, small but significant differences were found between smartphones and ETG for tra505 (ES ≤ 0.33; p < 0.05). Collectively, these findings support the use of Asstrapp for real‐time assessment of both 505 COD tests

Adversarial attacks on artificial Intelligence of Things-based operational technologies in theme parks

Theme parks represent a popular, yet vulnerable aspect of life, where large unsuspecting crowds gather and interact with technology. Artificial intelligence (AI), computer vision, and the Internet of Things (IoT) are transforming theme parks by revolutionizing various aspects. This research study is the first to identify critical components of theme parks that can be optimized, and comprehensively maps them onto emerging AI/IoT applications, often powered by machine learning or deep learning models. Additionally, the study sheds light on adversarial attacks targeting vulnerable smart surveillance systems, which generate a very large volume of video stream data. These systems serve as a prominent example of AIoT-based operational technologies (AIoT-OT) responsible for critical alerts and actions. Rigorous experimentation, involving a novel hybrid multi-pixel deception attack technique, demonstrates that advanced adversarial attack methods can significantly degrade the performance of detection systems. The performance metrics and attack success rate were measured by accuracy, precision, recall, F1-score, and AUC score. Before attack, the accuracy rates of 87. 45%, 83. 17% and 81. 40% were achieved for the EfficientNet, ResNet and MobileNet models, respectively. However, after applying the proposed MPD attack, the performance of each model declined significantly. The accuracy dropped to 61.23% for EfficientNet (with an attack success rate of 29.10%), 59.12% for ResNet (with success rate of 30.20%), and 55.17% for MobileNet (with success rate of 32.50%). This study signifies the need for a strategic plan of action and the development of robust methods for the proactive security of AIoT in theme parks

Revitalizing Pastoral Care: Leveraging Stupa Learning Management System in Diocese of Maumere

The Catholic Church of the Diocese of Maumere is developing a learning management system (LMS) for its pastoral training program called the Weekend Pastoral Study, which is also abbreviated in Indonesian as Stupa. The aim of this LMS development is to enhance access and flexibility in pastoral education. Utilizing Design science research methodology (DSRM), the LMS was designed and developed using the Moodle platform along with various technologies such as PHP, MariaDB with MySQLi extension, HTML, CSS, and JavaScript. The performance of the Stupa LMS was evaluated through Black Box Testing based on ISO 25010 standards, focusing on pastoral ministers as the end users. The research findings indicate that this LMS has the potential to enrich spiritual experiences and enhance the effectiveness of learning for pastoral ministers at Diocese of Maumere, helping the Catholic Church address challenges in the digital era

Enhancing Laboratory Education through Collaborative Online International Learning: A Case Study between USA and UK Students

Collaborative Online International Learning (COIL) has emerged in recent years as an effective and viable alternative to increase the international opportunities within taught curricula. Through recent innovations in online collaboration tools, and elevated demand for international opportunities, there has been a global increase in the development of COIL opportunities across a range of health aligned disciplines. This style of learning has been described to positively develop student’s internationality and enhance their transferable skills. However, there have been no reported COIL opportunities described in the fields of laboratory medicine and biomedicine, likely due to the emphasis on practical techniques associated with the subjects making them difficult to disseminate virtually. This study therefore aimed to develop a COIL project that incorporates practical laboratory elements and evaluates the efficacy of this teaching and learning approach. A laboratory-based COIL was developed and delivered across two days between the University of Salford, United Kingdom, and Wayne State University, United States of America. Day one was composed of asynchronous livestreamed laboratory demonstrations, micro-teaching sessions of practical activities, with day two focused on the completion of a time-dependent team-based task. The pedagogical impact of this laboratory-based COIL was evaluated through 1) pre and post surveys and 2) an overall survey utilising Likert scales to evaluate experience, transferable skill enhancement and international development. The laboratory-based COIL was well received among students with most students stating they enjoyed the session (94.1%) and learnt a lot by participating in it (94.1%). COIL learning opportunity also produced highly positive benefits to student confidence (97.1%), teamworking (100%), and communication (97.1%). Pre and Post-analysis revealed significant enhancement of students’ international medical practice knowledge (p<0.0001), cultural intelligence (p<0.0001), social initiative (P=0.0373), and work-based flexibility (P=0.0047). Further stratification based on participants’ international institution revealed significant differences in questions relating to cultural intelligence (P=0.0062) and their confidence of working with cultures unfamiliar to themselves (P=0.0390). We are the first to report that implementation of laboratory-based COIL opportunities enhances students' international, cultural and transferable competencies within medical laboratory and biomedicine education. These data suggest that practical-based COIL is an effective method for preparing students to thrive in a globalized healthcare environment

Exploring the Presence and Impact of Advanced Nursing Roles in Care Homes and Charitable Organisations: An International Systematic Scoping Review

Introduction: Investing in advanced nursing roles (AN) in social care is a strategic priority to address workforce challenges, create new career pathways, improve outcomes and future‐proof the sector. However, there is limited understanding of these roles globally. This systematic scoping review maps the international presence and impact of post‐qualification advanced practice roles for registered nurses (RNs) working in care homes and charitable organisations. Design: This review was conducted following the methodology established by the JBI and adhered to the PRISMA extension for scoping reviews checklist. Methods: Studies were included if (1) they included RNs working in care homes, charities or not‐for‐profit health centres, (2) the RN was in a specialist, enhanced or advanced practice role and (3) if role details were provided. Studies were limited to those published in the English language between 2014 and 2024. Evidence was gathered from a comprehensive search of electronic databases (CINAHL, MEDLINE, Scopus, PubMed and Web of Science), grey literature, relevant webpages, and reference lists. Expert consultations were also conducted. Eligible full texts were reviewed in Covidence software by two independent researchers. Results: The search yielded 575 records, and 89 were taken forward for full‐text screening. A total of 20 met the inclusion criteria: 19 were concerned with AN roles in care homes, and one focused on a charitable organisation. The majority of these studies (n = 12) were conducted in North America. Conclusion: The literature on AN roles in care homes and charitable organisations is notably sparse. Despite this, the available evidence highlights substantial benefits, including improved care quality, enhanced resident outcomes and positive impacts on team dynamics. This review identifies four key themes: scope of practice, positive impacts, influencing factors and barriers, which provide a framework for policymakers, healthcare leaders and educators to optimise the contributions of this group within the evolving global social care sector. Public or Patient Contribution: Not undertaken because of the nature of scoping reviews. Clinical Relevance: This review highlights the crucial role of advanced nurses in enhancing care quality, resident outcomes, and workforce sustainability in care homes and charitable organisations. The findings provide direction for policymakers and health and social care leaders to further develop the role of nursing in social care settings globally