JMIR biomedical engineering最新文献

{"title":"Minimal Sensor Configuration for Human Activity Recognition in Patients With Hip Osteoarthritis: Proof-of-Concept Study.","authors":"Noor Alalem, Valérie Duay, Angelo Di Benedetto, Kevin Rose-Dulcina, Didier Hannouche, Stéphane Armand, Xavier Gasparutto","doi":"10.2196/95116","DOIUrl":"10.2196/95116","url":null,"abstract":"<p><strong>Background: </strong>Hip osteoarthritis (OA) impairs function during activities of daily living (ADL); however, objective functional assessment methods are lacking. Objectively measuring and characterizing functional deficits during ADL can help rehabilitation specialists target the activities in which patients experience the greatest difficulties. To characterize daily living function, ADL must first be accurately identified. Human activity recognition (HAR) models based on wearable sensor measurements, such as inertial measurement units (IMUs), have been implemented in individuals with various functional impairments but not yet in people with end-stage hip OA. In addition, the balance between HAR accuracy and wearability, which is crucial for patients' acceptance, remains unclear. Finally, to assess deficits of pathological populations, comparison with asymptomatic controls is necessary.</p><p><strong>Objective: </strong>This study aimed to evaluate the minimal accurate IMU configuration for HAR, from 8 to 1 IMU, in patients with hip OA and asymptomatic controls for mobility-related activities.</p><p><strong>Methods: </strong>Data from 20 patients and 9 controls were included. Participants completed a tour of ADL in the hospital vicinity while equipped with 8 IMUs. Activities included gait on flat ground, gait up and down a ramp, stair ascent/descent, turns, sitting up/down, and static sitting. Bidirectional gated recurrent unit models were trained to classify ADL based on 3D accelerations and angular velocities of multiple IMU configurations. Model accuracy was assessed on test sets of patient and control data using the Cohen Kappa( κ).</p><p><strong>Results: </strong>The resulting κ values were 0.95 for 8 IMUs, 0.93 for 4 IMUs, 0.90 for 2 IMUs, and 0.79 for 1 IMU. The accuracy was higher for controls than for patients. The best 2-IMU configurations were 2 shanks and 2 feet, and the best single-IMU configuration was the shank.</p><p><strong>Conclusions: </strong>Reducing the number of IMUs from 8 to 2 showed only a minimal decrease in κ, suggesting that minimal IMU setups could be as accurate as larger setups. Regarding gait detection, a single IMU was sufficient to reach very high accuracy (κ≥0.90). The single pelvic IMU showed the lowest accuracy for gait while still reaching high accuracy (κ>0.65). These results underline the potential of single-IMU or 2-IMU configurations to recognize mobility activities under semistandardized conditions. However, given the small sample size, these findings should be validated in larger and more heterogeneous hip OA cohorts before any clinical application can be considered.</p>","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"11 ","pages":"e95116"},"PeriodicalIF":0.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Electroencephalography in Hemodialysis: Scoping Review and Translational Framework.","authors":"Meng-Hsun Tsai, Cheng-Hsiung Chan","doi":"10.2196/94560","DOIUrl":"10.2196/94560","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cognitive impairment and cerebral dysfunction are common among patients with end-stage kidney disease undergoing maintenance hemodialysis. Repeated intradialytic hemodynamic stress, including reductions in cerebral blood flow and episodes of intradialytic hypotension, has been associated with adverse neurological outcomes. Quantitative electroencephalography (qEEG) offers a noninvasive approach for continuous assessment of cerebral activity; however, its potential role in dialysis monitoring remains unclear because of methodological heterogeneity and implementation challenges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This scoping review aimed to synthesize current evidence regarding qEEG alterations across the hemodialysis cycle and to evaluate the technical requirements for translating qEEG-derived features into future dialysis-related cerebral monitoring systems.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A structured literature search was conducted in PubMed/MEDLINE, Embase, and IEEE Xplore for studies published between January 2005 and February 2026. After removal of duplicates, 554 records were screened, and 70 full-text articles were assessed for eligibility. Sixty-two studies met the inclusion criteria and were included in the qualitative synthesis. Evidence was organized according to the 3 temporal domains of the hemodialysis cycle: predialysis baseline, intradialytic exposure, and postdialysis recovery. In addition to clinical findings, engineering-related evidence concerning electroencephalography hardware, electrode systems, signal processing pipelines, artifact mitigation, multimodal synchronization, edge computing, and digital biomarker validation was reviewed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Patients receiving maintenance hemodialysis consistently demonstrated baseline spectral slowing characterized by increased delta and theta activity, and reduced alpha power. During dialysis, multimodal imaging studies reported cerebral blood flow reductions of approximately 10% to 15%, accompanied by dynamic qEEG changes, including alterations in the alpha-delta ratio and slow wave activity. Connectivity and complexity measures provided complementary information regarding network-level and recovery-related responses but showed substantial variability across acquisition conditions and analytical pipelines. Major implementation challenges included electrical interference, motion artifacts, electrode instability, asynchronous physiological data streams, and limited standardization of preprocessing methods. Comparative analysis indicated that acquisition quality, artifact rejection performance, synchronization accuracy, and individualized baseline modeling are critical determinants of translational feasibility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Current evidence indicates that qEEG-derived measures have been reported in association with both chronic and intradialytic neurophysiological changes in patients undergoing hemodialysis. Howe","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"11 ","pages":"e94560"},"PeriodicalIF":0.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Glucose Monitoring Data Compression Using Peak-Nadir Encoding in Diabetes: Method Development and Evaluation.","authors":"Clara Bender, Line Davidsen, Søren Schou Olesen, Simon Cichosz","doi":"10.2196/91959","DOIUrl":"10.2196/91959","url":null,"abstract":"<p><strong>Background: </strong>Continuous glucose monitoring (CGM) generates high-frequency time-series data, creating challenges for efficient storage, transmission, and analysis.</p><p><strong>Objective: </strong>This study aimed to develop and evaluate a CGM-specific compression method that achieves high compression ratios while preserving signal fidelity and clinically relevant glycemic metrics.</p><p><strong>Methods: </strong>We introduce a content-based encoding approach (PN+) that represents CGM profiles using physiologically salient landmarks: glucose peaks and nadirs and a small set of optimally selected support points. Reconstruction is performed using piecewise cubic Hermite interpolation. PN+ was evaluated against peaks and nadirs only, uniform downsampling, piecewise aggregate approximation, and autoencoder-based compression. Performance was assessed across multiple compression ratios using 2 complementary datasets: 40,000 synthetic CGM profiles and real-world CGM data from a randomized crossover trial (558 days from 30 patients). Performance was evaluated using compression ratio, mean absolute error, and R2 between original and reconstructed CGM-derived clinical metrics.</p><p><strong>Results: </strong>At a compression ratio of 13 (22 points per 24-hour profile), PN+ achieved substantially lower reconstruction error than comparator methods (mean absolute error=0.77 vs 2.75-3.45) and consistently higher R2 values across glycemic metrics. Improvements were most pronounced for excursion-sensitive measures such as mean amplitude of glycemic excursions, where PN+ reduced error by more than 4-fold compared with downsampling, piecewise aggregate approximation, and autoencoders. These performance advantages were preserved in heterogeneous real-world data. Encoding and decoding required less than 0.2 seconds per profile, supporting practical scalability.</p><p><strong>Conclusions: </strong>PN+ enables robust CGM data compression by explicitly preserving physiologically meaningful glucose dynamics. The method outperforms generic compression techniques in reconstructing clinically relevant metrics while maintaining low computational overhead, making it well suited for large-scale CGM storage, interoperability, and downstream analytics.</p>","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"11 ","pages":"e91959"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fingerprint-Based Patient Identification Technology: Simulated Pilot Study on Technical Performance and Usability.","authors":"Ginger Schroers, Marta Del Rio Oliva, Jenny O'Rourke, Antxon Caballero, Luis Barata Gomes, Raquel Araújo","doi":"10.2196/88657","DOIUrl":"10.2196/88657","url":null,"abstract":"<p><strong>Unlabelled: </strong>This pilot study found that an artificial intelligence-supported fingerprint-based patient identification system demonstrated preliminary technical feasibility and user acceptability among healthcare workers in a simulated clinical environment, warranting further real-world evaluation.</p>","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"11 ","pages":"e88657"},"PeriodicalIF":0.0,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Spinal Orthosis With Leaf Spring and Programmable Local Vibration on Kyphosis Angle and Trunk Muscle Strength in Hyperkyphosis: Development and Feasibility Study.","authors":"Fatemeh Keshavarzi, Mokhtar Arazpour, Saeed Behzadipour","doi":"10.2196/82013","DOIUrl":"10.2196/82013","url":null,"abstract":"<p><strong>Background: </strong>The application of spinal orthoses and local vibration in the treatment of hyperkyphosis is a developing concept. Further research is needed to determine the impact of leaf springs and local vibration techniques on the neuromusculoskeletal system.</p><p><strong>Objective: </strong>This study aimed to evaluate the effect of the simultaneous application of a leaf spring and a programmed local vibration system in a spinal orthosis on thoracic kyphosis angle (TKA) and the function of trunk flexor and extensor muscles.</p><p><strong>Methods: </strong>We used a soft thoracolumbar orthosis as a base for 2 parallel leaf spring bars made from AISI (American Iron and Steel Institute) 1075 steel (45 cm × 2 cm × 2 mm each). We added 4 solenoid actuators (60 g each) housed in 2 units positioned 12 cm apart, generating 20 N vertical force at 8 Hz frequency with 10 mm free displacement. A programmable Arduino microcontroller delivered 10-second vibration bursts followed by 5-minute rest intervals, repeated for 12 cycles per session, applied every other day. One participant with hyperkyphosis (baseline TKA=47.24°) used this device for 4 weeks. Outcomes included TKA (measured by photogrammetry) and trunk muscle function (assessed under isometric, isotonic, and isokinetic conditions). Feasibility outcomes included adherence, wear time, and adverse events.</p><p><strong>Results: </strong>Bench testing confirmed an 8 Hz vibration frequency, a 10 mm free displacement, and an on-body contact pressure of 9.5 N/cm² (95 kPa). In the short-term assessment (N=10), mean acceptability scores were 7.95 (SD 0.83) for appearance and 7.6 (SD 0.07) for comfort, and no skin-related adverse events occurred. In the 4-week single-participant pilot (N=1), adherence was 100% (12/12 sessions completed), mean daily wear time was 1.4 (SD 0.3) hours, and no adverse events were reported. TKA decreased from 47.24° to 45.81° (change: -1.43°), which did not exceed the minimal detectable change (4.62°). Pre-post changes in muscle function outcomes are reported descriptively.</p><p><strong>Conclusions: </strong>A semirigid thoracolumbar orthosis with integrated programmable vibration (8 Hz, 20 N free force) is technically feasible, showing reliable bench performance. Short-term assessment in 10 participants indicated acceptable comfort and appearance with no immediate safety concerns. The 4-week single-participant pilot demonstrated 100% adherence and no adverse events. The observed 1.43° kyphosis reduction was not clinically meaningful (below minimal detectable change). Larger controlled studies are needed to determine whether this device improves muscle function or spinal alignment.</p>","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"11 ","pages":"e82013"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13299265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Stress in the Chinese Community: Speech Analytics Through Linguistic and Acoustic Fusion Using Machine Learning.","authors":"Amanda M Y Chu, Benson S Y Lam, Jenny T Y Tsang, Agnes Tiwari, Jacky N L Chan, Mike K P So","doi":"10.2196/91138","DOIUrl":"10.2196/91138","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers experience significant stress due to intensive caregiving activities, making them highly susceptible to adverse psychosocial health conditions. Early detection of this stress is crucial for timely interventions to prevent disease progression and long-term disability.</p><p><strong>Objective: </strong>This study aimed to develop and validate the Linguistic and Acoustic Speech Analytics Program, a novel machine learning approach capable of providing a fusion analysis of linguistic and acoustic speech features to enhance the effectiveness of psychosocial stress assessment.</p><p><strong>Methods: </strong>This quantitative study analyzed speech data collected from 100 Chinese family caregivers. Participants responded to 12 open-ended questions, and their voices were recorded for linguistic and acoustic feature extraction. Various machine learning classifiers, including support vector machine, were developed to process speech data. A key methodological step was the application of an orthogonalization procedure to decorrelate acoustic features from linguistic features before fusion analysis. The classifiers were then trained to evaluate psychosocial stress levels based on the processed and fused linguistic and acoustic speech features. Model performance was measured using receiver operating characteristic-area under the curve, F1-score, and accuracy.</p><p><strong>Results: </strong>The linear support vector machine model emerged as the top performer, achieving a receiver operating characteristic-area under the curve of 78.28%, an F1-score of 75.27%, and an accuracy of 73%. These results demonstrate the model's strong capability in identifying stressed participants based on their speech. Critically, the fusion of linguistic and acoustic features significantly outperformed models using either feature type alone. Furthermore, the orthogonalization procedure proved essential, as decorrelating features before fusion markedly enhanced classification accuracy compared to using non-orthogonalized features.</p><p><strong>Conclusions: </strong>This study demonstrates that fusion analysis of linguistic and acoustic features effectively identifies psychosocial stress among family caregivers. It also emphasizes the importance of proper feature processing when combining multiple features extracted from the same audio sample. These findings provide valuable insights for developing machine learning models for psychosocial stress assessment and addressing various psychosocial conditions in different contexts, supporting population mental health management.</p>","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"11 ","pages":"e91138"},"PeriodicalIF":0.0,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote Monitoring of Bioelectrical Impedance in Patients With Breast Cancer-Related Lymphedema: 1-Year Pilot Longitudinal Study.","authors":"Lori Bravi, Cheri Teranishi-Hashimoto, Elena A C MacDonald, Dayna Huntley, Samman Shahpar, Jami Fukui, Monica Padilla, Yoomi Heo, Linda A Koehler","doi":"10.2196/86624","DOIUrl":"10.2196/86624","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Breast cancer-related lymphedema (BCRL) is a chronic complication that impairs quality of life through persistent fluid accumulation. While clinical guidelines recommend longitudinal surveillance, implementation is often limited by the logistical challenges of frequent in-clinic visits. Bioelectrical impedance analysis (BIA), specifically the segmental extracellular water-to-total body water (ECW/TBW) ratio, offers a noninvasive method for tracking fluid status. However, the technical agreement between in-clinic and patient-led home-based BIA systems, as well as the feasibility of long-term self-monitoring in real-world settings, remains to be fully established.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Our primary objective was to evaluate the agreement between in-clinic and home-based BIA systems for key body composition and fluid-related parameters. Our secondary objective was to characterize longitudinal fluid patterns and diurnal variations in ECW/TBW ratios to assess the feasibility of home-based monitoring.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective, patient-driven, 12-month observational study enrolled breast cancer survivors at risk for lymphedema. Agreement between the in-clinic BIA system (InBody 770) and the home-based device (BWA ON) was assessed using Bland-Altman analysis, intraclass correlation coefficients (ICCs), and the Lin concordance correlation coefficient (CCC). Longitudinal home-based ECW/TBW measurements were analyzed using linear mixed-effects models to evaluate diurnal differences (before-noon vs after-noon) across groups defined by limb dominance and BCRL status (International Society of Lymphology [ISL] stage 0 vs stage 1).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Over 12 months, ECW/TBW ratios measured by the home-based device demonstrated strong agreement with in-clinic measurements, showing minimal bias and high ICC/CCC values. Longitudinal analysis revealed that ECW/TBW changes did not follow uniform patterns within ISL stage categories, showing substantial physiological heterogeneity even among clinically stable groups. Diurnal analysis identified a small but statistically significant decrease in ECW/TBW ratios in the afternoon (P&lt;.001). The magnitude of this decrease differed by limb dominance and BCRL status, with the most pronounced reduction observed in participants whose dominant arm was affected and who had a history of stage 1 lymphedema. ECW/TBW variability was driven more by within-individual factors (eg, measurement timing) than by between-individual differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Home-based segmental bioimpedance provides reliable longitudinal data and reveals granular fluid patterns not captured by conventional ISL staging alone. The significant impact of diurnal variation, particularly in relation to limb dominance, underscores the need for standardizing measurement protocols. Standardizing home-based measurements to a fixed monitoring time can minimize physiolo","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"11 ","pages":"e86624"},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Related Differences in Joint Kinematics and Spatiotemporal Parameters During Ramp Walking and Level Walking: Cross-Sectional Study.","authors":"Daiki Shimotori, Soshi Fujisawa, Masahiro Nishimura, Tatsuya Yoshimi, Kenji Kato","doi":"10.2196/86036","DOIUrl":"10.2196/86036","url":null,"abstract":"<p><strong>Background: </strong>Gait function is essential for mobility and independence in older adults. Although age-related gait decline on level walking has been studied extensively, there is less information on how aging affects gait during ramp walking, despite its relevance in daily life. Different biomechanical strategies are used during ramp ascent and descent; however, detailed joint kinematics remain unclear, particularly under real-world conditions.</p><p><strong>Objective: </strong>This study aims to investigate age-related differences in lower-limb joint angles and spatiotemporal parameters between level and ramp walking.</p><p><strong>Methods: </strong>Gait was assessed in 20 young (mean 31.3, SD 8.9 y) and 20 older (mean 64.2, SD 0.8 y) healthy adults using a markerless motion-capture system (Theia3D) in a living laboratory setting. Participants completed gait trials during level walking and on a 7° ramp (ascent and descent). Between-group comparisons of spatiotemporal parameters were performed using independent 2-tailed t tests, while joint angle data were analyzed using a linear mixed model with walking velocity as a covariate. Estimated marginal means were compared across age groups within each walking condition, and all P values were adjusted using the false discovery rate method. Effect sizes were calculated using Cohen d to examine whether between-group differences were more pronounced during ramp walking compared to level walking.</p><p><strong>Results: </strong>Ramp walking revealed multijoint kinematic alterations, while level walking showed limited differences (hip flexion and knee extension angles only). During ramp ascent, significant increases in knee flexion angle and reductions in ankle plantarflexion angle were observed. During ramp descent, multijoint changes were evident, including increased hip flexion and reduced knee extension and ankle plantarflexion angles. Effect sizes were particularly large during ramp walking (eg, knee flexion during ascent: |d|=2.37; knee extension during descent: |d|=1.87), while level walking showed large effect sizes for several parameters (eg, knee MaxExtStance: |d|=1.18; hip MaxFlexStance: |d|=1.17) despite reaching statistical significance for only a few parameters.</p><p><strong>Conclusions: </strong>In this cross-sectional sample, age-group differences in joint kinematics were more pronounced during ramp walking than during level walking, even after adjusting for walking velocity. This suggests that ramp walking may be a more sensitive task for detecting age-related adaptations compared to level walking. Markerless motion capture enables practical assessment in real-world settings. However, longitudinal studies are needed to determine whether these patterns predict functional decline.</p>","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"11 ","pages":"e86036"},"PeriodicalIF":0.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Safety and Efficacy of a Noninvasive Device in the Management of Musculoskeletal Pain Using Low-Level Light Therapy: Double-Blinded, Randomized, Placebo-Controlled, Multicentric Study.","authors":"Surya Prakash Maguluri, Vinod Kumar Penubakala, Sai Laxman Anne, Shankar A Navaladi, Chandrashekar P, Antony Leo Aseer, Ashok Kumar B K, Mohamed Sameer M, Radhika Soanker, Vikas Sharma","doi":"10.2196/87566","DOIUrl":"10.2196/87566","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal pain significantly impacts quality of life and daily functioning. Light-based therapies, including those using red and infrared wavelengths, have shown potential in pain management due to their anti-inflammatory and tissue healing properties. CURAPOD, a pain management device developed by Litemed, uses a combination of visible red and infrared light for noninvasive pain relief.</p><p><strong>Objective: </strong>This study aimed to assess the safety and efficacy of Litemed's pain management device (CURAPOD) in managing acute and chronic musculoskeletal pain at various pain sites, in comparison with a placebo, and to evaluate its efficacy across different skin types.</p><p><strong>Methods: </strong>In a double-blinded, randomized, placebo-controlled, multicentric study, 240 participants (aged 18-60 years) with acute or chronic musculoskeletal pain were enrolled and treated with either the test or control device for 30 minutes. The test device contains 7 LEDs designed to emit a combination of visible red and infrared radiation, while the control device emits visible light of the red spectrum. Pain intensity was subjectively measured at baseline, at 30 minutes after treatment, and at time windows of 8 to 12 hours and 21 to 24 hours after treatment.</p><p><strong>Results: </strong>A greater number of participants reported a reduction in pain (of up to 60%) in the treatment group than in the placebo group. Repeated measures ANOVA revealed significant effects of time (F3,684=282.37; P<.001) and treatment group (F1,228=662.12; P<.001), indicating that the relief experienced may be more sustained in the treatment group. No significant effects of pain site (F5,228=0.169; P=.97) or skin type (F5,228=0.8; P=.55) were observed, suggesting consistent action across anatomical locations and skin types. No significant adverse events were reported.</p><p><strong>Conclusions: </strong>The device appears to be safe and viable as a nonpharmacological adjunct for managing acute and chronic musculoskeletal pain. Treatment with the device showed short-term pain reduction, with reports of up to 60% pain reduction within 30 minutes of use and sustained self-reported relief in pain for up to 20 hours after treatment. No significant effects of pain sites or skin type on reduction in visual analog scale scores were observed, suggesting broad applicability. However, these results must be interpreted with caution while considering the limitations inherent to the study methodology and short-term follow-up. These findings should be interpreted as evidence of short-term analgesic response rather than definitive clinical effectiveness. Further investigation through rigorously designed randomized controlled trials and longitudinal studies is necessary to definitively establish the efficacy of the device, the durability of its action, and the potential integration of CURAPOD into pain management strategies.</p>","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"11 ","pages":"e87566"},"PeriodicalIF":0.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Large Language Model Accuracy for Care-Seeking Advice Using Prompts Reflecting Human Reasoning Strategies in the Real World: Validation Study.","authors":"Marvin Kopka, Markus A Feufel","doi":"10.2196/88053","DOIUrl":"10.2196/88053","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Current prompting techniques for large language models (LLMs), such as ChatGPT, mainly focus on well-structured, low-uncertainty problems; yet, many real-world tasks (eg, care-seeking decisions) are ill-defined and involve high uncertainty. Naturalistic decision-making (NDM) specifically analyzes how humans make accurate decisions in such settings, but NDM concepts have not yet been applied to LLM prompt engineering.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to determine whether prompting strategies inspired by NDM (specifically based on recognition-primed decision-making and the data-frame theory) could improve LLM performance in a real-world, high-uncertainty task, such as making care-seeking decisions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We evaluated 10 ChatGPT models (GPT-4o, GPT-4.1, GPT-4.1 mini, o3, o4 mini, o4 mini high, GPT-5.1 Instant, GPT-5.1 Thinking, GPT-5.2 Instant, and GPT-5.2 Thinking) using 3 prompting strategies: a default prompt solely asking the LLMs to classify the case vignettes, a recognition-primed prompt tasking the models to reason according to recognition-primed decision-making, and a data-frame prompt tasking the models to apply the data-frame theory. The task was taken from a standardized and validated evaluation framework and instructed the LLMs to advise on the appropriate care-seeking action for 45 real patient case vignettes across 3 urgency levels (emergency, nonemergency, and self-care). Each model-vignette-prompt combination was tested 10 times to assess and account for output variability. Accuracy was analyzed using mixed effects logistic regression. Additionally, we evaluated accuracy for each urgency level and examined output variability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Both NDM-inspired prompts increased overall model accuracy (recognition-primed: 67.6%; data-frame: 66.7%) compared to the default prompt (63.3%). The greatest improvements were observed for self-care recommendations, where accuracy increased from 13.4% (default prompt) to 29.8% (recognition-primed prompt) and 24.6% (data-frame prompt). Performance on 2 emergency and 30 nonemergency cases remained high across all prompts. Notably, NDM-inspired prompts made nonreasoning models start giving self-care advice, even though they rarely or never provided self-care advice with the default prompt. Output variability was similar across the 3 prompts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Using LLMs with prompts inspired by NDM, which are designed to reflect real-world human reasoning, improves the accuracy of LLMs in care-seeking tasks, particularly for self-care advice, without reducing performance in the included emergency or nonemergency cases. These findings indicate that NDM-inspired prompts can offer an advantage when LLMs are used for real-world decisions involving ambiguity and uncertainty. The impact of output that reflects real-world human reasoning on users' decision-making must be evaluated in future studie","PeriodicalId":87288,"journal":{"name":"JMIR biomedical engineering","volume":"11 ","pages":"e88053"},"PeriodicalIF":0.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}