Bioengineering最新文献

{"title":"Testing a Prespecified Matrix Transcriptional Programme in Myeloid Cells from Proliferative Vitreoretinopathy Membranes: A Donor-Aware Computational Single-Cell Study.","authors":"Georgios D Panos","doi":"10.3390/bioengineering13101185","DOIUrl":"https://doi.org/10.3390/bioengineering13101185","url":null,"abstract":"<p><p>Whether myeloid cells in proliferative vitreoretinopathy (PVR) membranes directly transcribe a coherent extracellular matrix (ECM) programme remains uncertain. We tested a prespecified seven-gene programme in a discovery cohort (GSE294329; five PVR donors) and an independent epiretinal PVR cohort (SCP2582; five donors), with GSE165784 (five public proliferative diabetic retinopathy [PDR] sample accessions of uncertain patient independence) providing separate disease context. Frozen cell states were evaluated using within-donor or within-accession summaries of rank scores, pseudobulk burden, detection, and ambient-corrected expression. In GSE294329, cluster 1 met the locked UCell discovery rule, but total ECM7 burden and detection were lower than in other myeloid cells in all five donors. Exact seven-gene replication was unevaluable because CCN2/CTGF was absent from the processed SCP2582 features; no eligible state passed the amended six-gene gate. In PDR, no myeloid state passed the direct-ECM gate, whereas stromal cells had higher ECM7 burden and detection in all five accessions. Secondary SAM-like states occurred in PDR clusters 1 and 6 only and did not rescue the direct-ECM result. An exploratory fixed-cell SCP2582 sensitivity analysis changed cluster membership, but no alternative donor-eligible cluster met the necessary raw gene-coherence criterion. An independently defined collagen-panel sensitivity yielded different patterns in the two PVR cohorts. These data do not demonstrate a reproducible ECM7-expressing myeloid state under the specified rules; small biological cohorts, a restricted gene panel, and indirect use of outcome genes during ambient correction limit broader exclusion.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Hybrid ViT-ECA-CF Framework with Adaptive Loss Reweighting for Imbalanced White Blood Cell Classification.","authors":"Fouzia Jabeen, Jamal Hussain Shah, Maira Afzal, Muhammad Awais","doi":"10.3390/bioengineering13101187","DOIUrl":"https://doi.org/10.3390/bioengineering13101187","url":null,"abstract":"<p><strong>Background: </strong>White blood cells (WBCs), also known as leukocytes, play a central role in immune defense, and accurate WBC classification is essential for a hematological assessment and computer-assisted diagnosis. However, a severe class imbalance remains a major challenge in deep-learning-based WBC classification, particularly when minority classes contain substantially fewer training samples. Although data augmentation is commonly used to address this issue, synthetic transformations may fail to capture the complex morphological and appearance variations of WBCs and may introduce redundant patterns and additional computational costs.</p><p><strong>Methods: </strong>This study proposes a hybrid ViT-ECA-CF framework with adaptive loss reweighting (ALR) for minority-class WBC classification without data augmentation. The framework integrates efficient channel attention (ECA) to enhance discriminative feature representations and color-feature fusion (CF) to jointly capture morphological and staining-related color information from WBC components, including the nucleus, cytoplasm, and granules. An adaptive loss-reweighting strategy dynamically adjusts class contributions according to class distribution, prediction loss, and prediction confidence, thereby directing model optimization toward challenging minority WBC classes.</p><p><strong>Results: </strong>On the evaluated WBC classification dataset, the proposed framework achieved a 90.00% accuracy, 94.49% macro-F1, and 93.98% balanced accuracy, with an F1-score of 96.43% for minority classes. The framework substantially reduced the majority-to-minority performance gap, achieving a minority-to-majority F1 balance ratio of 1.053, indicating a comparable recognition performance across classes despite the severe imbalance. The proposed approach was also evaluated on independent datasets and compared with a CNN baseline in terms of training time.</p><p><strong>Conclusions: </strong>The findings provide an effective strategy by combining transformer-based feature representation, ECA, color-feature fusion, and adaptive loss reweighting to improve minority-class WBC recognition without relying on synthetic data augmentation. The proposed approach offers a potential strategy for handling a severe class imbalance. Further validation on larger and multicenter datasets is required to establish the robustness and clinical applicability of the proposed framework.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CO₂ Self-Sufficiency in Renewable Methanol Production from Biomethane and Biohydrogen: Techno-Economic Assessment for Spain.","authors":"Arantza Rascón, José Ignacio Linares, Ana María Santos-Montes, Eva Arenas","doi":"10.3390/bioengineering13101183","DOIUrl":"https://doi.org/10.3390/bioengineering13101183","url":null,"abstract":"<p><p>Renewable methanol is commonly proposed either as biomethanol from biomass or biomethane reforming, or as e-methanol from CO₂ hydrogenation using electrolytic hydrogen. This work proposes a third concept: CO₂-self-sufficient biomethanol from biomethane, where biohydrogen and biogenic CO₂ are internally produced through biomethane reforming with carbon capture and utilisation. Four process routes are assessed for Spain, combining conventional CO/H₂ methanol synthesis and CO₂/H₂ hydrogenation. The proposed routes use biohydrogen rather than electrolytic hydrogen. In route 1 (baseline case), fossil methane and CO₂ in conventional methanol production are replaced by renewable alternatives. Route 2 produces hydrogen and CO₂ through steam biomethane reforming with carbon capture and utilisation, generating a CO₂ surplus. Route 3 uses a fraction of biomethane to produce CO₂ and biohydrogen, supplying the CO₂ required by route 1 and yielding excess hydrogen. Finally, route 4 integrates routes 1 and 2, using the CO₂ surplus from route 2 as feedstock for route 1. Routes 1 and 4 produce exclusively methanol and achieve the highest yields (108.6 t and 102.7 t per GWh-HHV of biomethane, respectively). All routes except route 1 are CO₂ self-sufficient. A detailed techno-economic assessment of routes 1 and 4 gives methanol costs of 403-817 €/t and 496-933 €/t, respectively.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization and Characterization of a Physicochemical Decellularization Protocol for Porcine Tracheal Scaffolds.","authors":"Elizabete Silva Dos Santos, Ronaldo Soares da Silva, Sabrina da Silva de Morais, Fabíola Matos da Cruz, Hector Fugihara Kroes, Marina Maizato, Idagene Aparecida Cestari, Paulo Manuel Pêgo-Fernandes, Aristides Tadeu Correia, Paulo Francisco Guerreiro Cardoso","doi":"10.3390/bioengineering13101181","DOIUrl":"https://doi.org/10.3390/bioengineering13101181","url":null,"abstract":"<p><p>Reconstruction of extensive tracheal defects remains a challenge, and the development of decellularized scaffolds represents a promising strategy for tissue engineering. This study aimed to optimize a porcine tracheal decellularization protocol using sodium deoxycholate (SDC), reducing detergent exposure time without compromising extracellular matrix (ECM) preservation or biomechanical properties. Ten decellularization cycles were evaluated by residual DNA quantification, histological analysis, and residual SDC quantification, and cycles 1, 2, and 10 were selected for ECM characterization, cytocompatibility assessment, and biomechanical analysis. The first cycle was effective for submucosal decellularization, although chondrocytes remained within the tracheal cartilage. ECM architecture and its biomechanical properties were preserved. Additional cycles provided no further benefit to decellularization and were associated with alterations in longitudinal biomechanical parameters. Residual SDC was detected in the scaffolds, and undiluted extracts showed cell viability below 70%. These results indicate that 24 h of SDC exposure achieved effective submucosal decellularization while chondrocytes remained in the cartilage regardless of the number of decellularization cycles. ECM characteristics and tissue biomechanical properties were preserved.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigation-Assisted and Robotic Total Hip, Knee, and Unicompartmental Arthroplasty: Reconciling Positioning Accuracy with Biomaterial Performance and Long-Term Implant Survival.","authors":"Yasaman Tavakoli, Fatemeh Kanaani Nejad, Kartik Varsani, Roshan Latifi, Mohammad Poursalehian, Jad Ismail, Robert A Sershon","doi":"10.3390/bioengineering13101182","DOIUrl":"https://doi.org/10.3390/bioengineering13101182","url":null,"abstract":"<p><p>Navigation-assisted and robotic systems improve component positioning in total hip (THA), total knee (TKA), and unicompartmental knee arthroplasty (UKA), but whether this improves biomaterial performance and implant survival is unclear. This structured narrative review asks for which bearing materials and fixation interfaces positioning accuracy plausibly alters the degradation and fixation pathways that govern survival, and how strong the evidence is for each link. We propose a conceptual model linking positioning to the local mechanical environment, material-specific degradation, biological response, and survival, and grade each link's evidence by study design. Enabling technologies consistently reduce outliers. Position-dependent degradation is well documented for conventional polyethylene, ceramic-on-ceramic, and metal-on-metal bearings, mainly from simulator, retrieval, and cohort studies. Highly cross-linked polyethylene appears to attenuate the wear penalty of malposition, although rim fatigue and impingement remain position-sensitive and vitamin E stabilization has no proven additional clinical benefit. In cementless TKA, varus alignment is associated with greater early tibial migration, a validated surrogate for loosening. Clinical translation remains limited: trials and registries show no consistent reduction in all-cause revision after TKA or THA, with lower dislocation after THA and a more favorable UKA signal as exceptions. Precision may matter most for position-sensitive bearings and cementless interfaces.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to Running After Extracorporeal Magnetotransduction and Electromagnetic Shockwave Therapy for Bone Stress Injuries: A Retrospective Case Series.","authors":"Ryan L Friedman, Violet E Sullivan, Logan W Gaudette, Amol Saxena, Michelle M Bruneau, Adam S Tenforde","doi":"10.3390/bioengineering13101176","DOIUrl":"https://doi.org/10.3390/bioengineering13101176","url":null,"abstract":"<p><p>Bone stress injuries (BSIs) are overuse injuries to bone that account for substantial time lost for athletes who are training and competing. Each injury varies in healing time based on factors including the Female and Male Athlete Triad (Triad), anatomical location, injury severity, and chronicity. While focused extracorporeal shockwave therapy (ESWT) has been evaluated for management of BSIs, extracorporeal magnetotransduction therapy (EMTT) has been proposed to have synergistic effects. We evaluated return to running in athletes with BSIs treated with combined ESWT and EMTT. Retrospective chart review identified 46 athletes with 50 BSIs (29 female, 17 male; mean age 30.5 ± 13.2 years; body mass index 22.0 ± 2.8 kg/m²). Each athlete was comprehensively evaluated and provided individualized management of all risk factors identified, including Triad, anatomical location, MRI grade, and chronicity (acute < 3 months; delayed/nonunion ≥ 3 months). Each athlete elected to receive weekly to biweekly focused electromagnetic ESWT and EMTT (mean values: 4.8 sessions; ESWT, 3424 pulses/session, mean energy flux density 0.41 mJ/mm²; EMTT: 80 mT, 8 Hz, 7826 pulses/session). Additional ESWT/EMTT were based on factors including persistent pain during return-to-run progression. Most BSIs were high grade (n=35); Triad risk was moderate in 21 athletes and high in 6. Forty athletes (87%) returned to pain-free running. Return to run was defined as the start of a patient-reported pain-free return-to-run progression. Among 39 athletes with documented dates, this occurred sooner for acute than delayed/nonunion BSIs (12.9 ± 5.8 vs. 23.8 ± 12.1 weeks, p=0.002). Differences by injury grade (p=0.18), Triad risk (p=0.97), and anatomical classification (p=0.26) were not statistically significant, although subgroup sizes were small. While we recognize limitations related to study design and the population studied, our findings suggest the addition of ESWT/EMTT combined with comprehensive management of athletes with BSI may allow for a high rate of return to running.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Explainable Deep Learning Framework for Musculoskeletal Abnormality Detection.","authors":"Saeed Ur Rehman, Muhammad Saad, Anwar Ali, Muhammad Awais","doi":"10.3390/bioengineering13101177","DOIUrl":"https://doi.org/10.3390/bioengineering13101177","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Accurate detection of musculoskeletal abnormalities from radiographs remains challenging because abnormal findings can be subtle and radiographic appearance may vary considerably across examinations. This study aimed to develop and systematically evaluate a deep learning framework incorporating Grad-CAM-based visual attribution for automated musculoskeletal abnormality detection using the publicly available Musculoskeletal Radiographs (MURA) dataset. Four transfer learning architectures, namely DenseNet201, EfficientNetV2-S, ConvNeXt Tiny, and Swin Transformer Tiny, were evaluated for musculoskeletal abnormality classification. The framework incorporated Grad-CAM-based attribution and activation-based weak localization to highlight image regions associated with model predictions without requiring bounding-box annotations during training and a sensitivity-oriented decision threshold to prioritize the detection of abnormal examinations. Model performance was assessed using recall, precision, F1-score, area under the receiver operating characteristic curve (AUC), and confusion matrix analysis. A targeted decision-threshold ablation analysis compared the sensitivity-focused threshold of 0.40 with the conventional 0.50 baseline using the same validation-set probabilities. Previously published results were reviewed to provide contextual information rather than establish comparative superiority. EfficientNetV2-S achieved the highest precision (0.925), F1-score (0.892), and AUC (0.956) on the internal validation set among the evaluated architectures. DenseNet201 achieved the highest recall of 0.876. Previously published performance metrics were reviewed to contextualize the results of the present study. However, differences in datasets, anatomical coverage, preprocessing procedures, and evaluation protocols preclude direct conclusions regarding comparative superiority. At the sensitivity-focused threshold of 0.40, EfficientNetV2-S obtained an accuracy of 0.896 and an F1-score of 0.892 on the internal validation set. Lowering the threshold to 0.40 improved sensitivity from 0.754 to 0.861 and decreased false-negative predictions from 1092 to 618 when compared to the traditional threshold of 0.50. Alongside this improvement, false-positive predictions increased from 150 to 307 and specificity decreased from 0.966 to 0.931. Grad-CAM visualizations and activation-derived bounding boxes provided qualitative information about spatial attribution. However, their correspondence with pathological findings was not independently validated using expert annotations or quantitative localization metrics. On the independent held-out test set, EfficientNetV2-S achieved a recall of 0.826, precision of 0.886, F1-score of 0.855, and AUC of 0.927. The independent evaluation demonstrated lower performance than the internal validation results, highlighting the importance of separating model optimization from final performance assessment. The findings demonstrate the feasi","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VesselRegNet: Multi-Scale Feature Fusion Network for Multi-Modal Joint Retinal Vessel Segmentation and Registration.","authors":"Anyu Cao, Maosong Jiang, Qinghong Gao, Xuelian Yang, Caiye Fan, Shu'an Liu, Zuoping Tan, Yuanyuan Wang","doi":"10.3390/bioengineering13101179","DOIUrl":"https://doi.org/10.3390/bioengineering13101179","url":null,"abstract":"<p><p>Multimodal retinal image registration remains challenging due to nonlinear intensity discrepancies and insufficient feature representation across modalities. To address these limitations, we propose VesselRegNet, a joint retinal vessel segmentation and registration framework based on multi-scale feature fusion. The model integrates a multi-scale semantic feature extraction module with a shared prediction head and rotation-equivariant constraints to enhance feature consistency. Unlike conventional approaches relying on binary segmentation masks, the proposed method utilizes dense semantic features to directly guide deformable registration. Experimental results demonstrate that VesselRegNet achieves an average Dice coefficient of 0.664 and SSIM of 0.645, achieving a relative improvement of 4.1% in Dice and 2.5% in SSIM over the strongest baseline (RetinaRegNet), and up to 11.9% improvement over general unsupervised registration frameworks. The proposed multi-scale fusion and joint learning strategy improves registration accuracy under complex retinal deformations.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical and Gravimetric Response of Surgical Suture Biomaterials to Commercial Mouthrinses During Static In Vitro Exposure.","authors":"Alicja Choszczyk, Anna Ciołko, Wiktoria Nowak, Leszek Szalewski, Ewelina Kosicka, Żaneta Anna Mierzejewska","doi":"10.3390/bioengineering13101178","DOIUrl":"https://doi.org/10.3390/bioengineering13101178","url":null,"abstract":"<p><p>Surgical sutures are temporary load-bearing biomaterials whose performance in the oral cavity may be altered by postoperative mouthrinses. Seven USP 4-0 suture materials were immersed in four commercial mouthrinses for 3, 7, 10, and 14 days in a balanced factorial design (<i>n</i> = 3 per condition), with artificial saliva as a time-matched reference. Maximum breaking force (Fmax), apparent wet-state mass change, and solution pH were evaluated, and Day 14 re-dried mass was determined in an additional cohort (<i>n</i> = 5). Fmax was significantly affected by material, mouthrinse, time, and all interaction terms (<i>p</i> < 0.001), with material showing the largest main effect (partial η² = 0.957). Mean Fmax decreased by 57.1% for PGA and 53.3% for PGLA between Days 3 and 14 when averaged across mouthrinses. PGLA also declined in artificial saliva (-49.1%), showing that temporal loss was not exclusive to mouthrinse exposure. Mean apparent wet-state mass change ranged from 85.1% for silk to 8.5% for nylon 66 and showed a weak pooled association with Fmax (r = -0.163, <i>p</i> = 0.086); suture-related pH shifts were small. Under static immersion, response was specific to the material-formulation pair and evolved with time. Continuous immersion without medium renewal or prior salivary conditioning does not reproduce intermittent clinical mouthrinse use.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fear of Falling and Its Association with Lower Limb Strength and Balance Control in Elderly Day-Care Center Users.","authors":"Jong-Seon Oh, Seong-Gil Kim","doi":"10.3390/bioengineering13101180","DOIUrl":"https://doi.org/10.3390/bioengineering13101180","url":null,"abstract":"<p><p>This cross-sectional study examined associations between lower limb strength, mobility, balance control, and fear of falling (FOF) among older adults attending community-based day-care centers. Seventy-three participants aged ≥65 years underwent assessments of knee extension strength (KES), Timed Up and Go (TUG), Functional Reach Test (FRT), and the Korean Falls Efficacy Scale-International (FES-I). Pearson correlation and simple linear regression analyses were performed. KES was negatively correlated with FES-I (r = -0.421, <i>p</i> < 0.01), TUG was positively correlated with FES-I (r = 0.394, <i>p</i> < 0.01), and FRT was negatively correlated with FES-I (r = -0.361, <i>p</i> < 0.01). Separate simple linear regression analyses likewise showed significant unadjusted associations of FES-I with KES, TUG, and FRT (all <i>p</i> < 0.01). These findings indicate that lower limb strength, mobility, and balance control are significantly associated with FOF. The results support the potential relevance of jointly assessing strength, mobility, balance control, and FOF in older adults attending day-care centers.</p>","PeriodicalId":8874,"journal":{"name":"Bioengineering","volume":"13 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}