In solid acid electrolytes CsH2PO4 and CsHSO4, the origin of fast proton conduction has long been debated, attributed either to local proton hopping or to polyanion rotation. However, the precise role of polyanion rotation and its interplay with proton hopping remains unresolved. Nanosecond-scale molecular dynamics simulations, driven by equivariant neural-network force fields, reveal a nuanced proton slingshot mechanism: a rotating polyanion first carries the proton, O-H bond reorientation then extends its displacement, and the combined motion enables long-range jumps. This mechanism refines the conventional Grotthuss-type picture, revealing that long-range transport arises from significant O-H bond reorientation assisted by only limited polyanion rotation. Despite their structural similarity, CsH2PO4 and CsHSO4 exhibit qualitatively different transport behavior associated with their distinct proton concentrations. In CsH2PO4, two rotation rates with different activation energies emerge, while CsHSO4 displays a single-rate process with faster productive polyanion dynamics. The higher proton concentration in CsH2PO4 is associated with greater rotational frustration and slower dynamics of PO4 compared with SO4 in CsHSO4. In CsH2PO4, we further identify a unique correlation between oxygen sharing and proton transport, arising from the extra proton per polyanion. Together, our findings establish a unified framework linking polyanion rotation, proton coordination, and long-range transport, and suggest that tuning proton concentration could accelerate rotation and enhance conductivity.

Simultaneously monitoring ammonia (NH3) leakage and human motion is desirable for safeguarding astronauts' safety in spacecraft equipped with NH3-driven propulsion, in which stable and selective NH3 sensing combined with reliable pressure detection is highly required. However, little is reported on a sensing material that synergistically presents the required NH3 and pressure sensing. Here, wearable NH3 and pressure sensing has been developed using PANI-wrapping carbon-intermixed Fe2O3 hierarchical microarchitectures (PANI@C-Fe2O3 HMAs), which have been synthesized by employing fern-shaped C-Fe2O3 HMAs with trunk/branches as structural precursors, followed by conformal PANI-wrapping. Beneficially, PANI@C-Fe2O3 HMAs present a wide detection range of 0.1 ppm-10 v/v%, 167-day-long stability and high selectivity toward NH3. Further, a pressure sensor prototype has been constructed by laminating PET tapes onto the HMAs-integrated flexible electrode, revealing an excellent pressure-dependent response and machine-learning-assisted human-motion recognition. Such superior dual sensing is attributed to the texturing behavior, in which conformal texturing of PANI along the hierarchical surface of C-Fe2O3 HMAs establishes heterojunctions with a built-in electric field to amplify resistance modulation, while fern-shaped HMAs with trunk/branches provide abundant active interfaces and electron transport pathways. Practically, a wearable dual-sensing device that integrates flexible NH3 and pressure sensor prototypes has been built with reliable dual-sensing responses.

High-energy bicondylar tibial plateau fractures of Schatzker types V and VI are conventionally managed, after open reduction and internal fixation, with 6-12 weeks of restricted weight-bearing, out of concern for loss of reduction and articular collapse. Emerging evidence questions whether this restriction is necessary. Reports of immediate weight-bearing specifically after fixation of these most unstable bicondylar patterns remain scarce, as most comparative studies pool this subtype within mixed cohorts. We present three consecutive patients (two men and one woman; mean age: 54 years; all of North Indian ethnicity) with closed, high-velocity Schatzker type V-VI tibial plateau fractures sustained in road traffic accidents. Each was treated with open reduction and internal fixation using a dual-plate or three-plate construct, with allograft impaction of the metaphyseal void created after the elevation of the depressed articular fragments. In departure from the conventional restricted protocol, each patient was mobilised to full weight-bearing as tolerated from the first postoperative day, using a walking aid for balance rather than for offloading, with early active range-of-motion exercises and no brace. At six weeks, all three patients had achieved independent ambulation with a walking aid, knee flexion beyond 90 degrees, no pain during activities of daily living, and a clinically acceptable gait. Follow-up radiographs showed no loss of fixation, screw cut-out, or articular collapse, and no patient sustained a wound complication, infection, or revision surgery. Immediate unrestricted full weight-bearing after stable plate fixation of Schatzker type V-VI tibial plateau fractures appears safe and may accelerate functional recovery. These observations are concordant with recent randomised and comparative literature and are underpinned by a coherent bone-biological rationale in which physiological loading promotes rather than jeopardises union. This report supports a considered shift away from routine prolonged non-weight-bearing towards individualised, stability-guided early mobilisation, even for the most unstable bicondylar patterns, provided the fixation construct is intraoperatively judged sound. Larger prospective comparative studies are needed to confirm these findings and refine patient selection.

Background Trigger finger (stenosing flexor tenosynovitis) is a common cause of hand pain and disability. Percutaneous release is a minimally invasive alternative to open surgery, but few guide-assisted, low-cost techniques have been described for resource-limited settings. This study evaluated the long-term outcomes, recurrence rate, safety, and patient satisfaction of a modified percutaneous trigger finger release using a custom-made Kirschner wire (K-wire) guide. Methods In this retrospective observational case series, 13 patients (26 trigger digits) treated between May 2016 and May 2026 at the Orthopedic Outpatient Clinic, Al-Shifa Medical Complex, Gaza City, Palestine, were reviewed. All procedures used a 16-18-gauge needle guided by a custom-made K-wire guide under local anesthesia in an outpatient setting. Outcomes assessed included immediate release, Quinnell grade, range of motion, Visual Analog Scale (VAS) pain score, recurrence, complications, and patient satisfaction. Results The mean age of patients was 50.5 ± 9.5 years (range 34-65 years); seven patients (53.8%) were male. Immediate release and complete resolution of triggering were achieved in all 26 digits (100%). At final follow-up (range: 3 months to 10 years), all digits demonstrated full range of motion, Quinnell grade 0, and a VAS score of 0. No recurrence, repeat procedure, or conversion to open surgery occurred. Overall patient satisfaction was 100% (11/13 very satisfied, 2/13 satisfied). Conclusions This modified percutaneous release technique using a custom-made K-wire guide demonstrated favorable long-term outcomes, with no recurrence and high patient satisfaction. It may represent a practical, minimally invasive, and resource-efficient outpatient technique for managing trigger finger, particularly in resource-limited settings.

Continuous non-invasive health monitoring requires wearable devices capable of capturing synchronized, multi-parametric physiological data without compromising user comfort or signal integrity. However, existing platforms often suffer from insufficient accuracy in complex modalities such bioimpedance. To address these limitations, this paper introduces the Multi-sensor Wearable Wristband Version 2.0 (MsW2-v2), an optimized, highly integrated platform designed for high-precision measurements. The methodology encompasses the hardware optimization of a previous prototype, integrating a low-leakage switching matrix and dual-bandwidth analog front ends to capture, in a quasi-simultaneous (time-multiplexed) manner, electrodermal activity (EDA) and bioimpedance (BiZ), as well as other physiological signals such as skin temperature, oxygen saturation, heart rate, and inertial motion. System validation was performed through rigorous laboratory calibration against reference impedances and subsequent in vivo testing on a human volunteer in an isolated room with no external stimuli whatsoever. The laboratory results indicated high-precision performance, with the mean absolute errors of the measurements being below 3 Ω in modulus and 0.2° in phase across a wide range of frequencies, from 1 kHz to 200 kHz. Preliminary in vivo benchmarks confirm the functionality of the device. These findings demonstrate that the MsW2-v2 successfully bridges the gap between high accuracy and wearable form factors, bringing us to the conclusion that this device could serve as a viable, scalable solution for real-time physiological measurements and biomedical signal monitoring.

Background Post-operative knee stiffness is a common complication following surgical fixation of fractures around the knee joint, leading to reduced range of motion, pain, and functional limitations. Early physiotherapy intervention is essential to restore mobility and improve function. Low-load long-duration stretch (LLLDS) is a prolonged stretching technique that enhances soft tissue extensibility and joint mobility with minimal discomfort. This study aimed to evaluate the effect of LLLDS on knee range of motion, pain, and functional outcomes in post-operative knee patients. Objectives To evaluate the effectiveness of low-load long-duration stretch on knee range of motion, pain reduction, and functional outcomes in post-operative knee conditions and to compare its effectiveness with conventional physiotherapy. Methods A randomized controlled experimental study was conducted at Krishna College of Physiotherapy, Karad, India. Thirty-six individuals were assessed for eligibility, of whom six were excluded before randomization. The remaining 30 participants were randomly allocated to the experimental group (n=15) and control group (n=15). Six participants were subsequently lost to follow-up or excluded after allocation, resulting in 24 participants (12 per group) completing the study. Participants aged 20-60 years who had undergone surgical fixation around the knee joint and completed six weeks of immobilization were included. They were randomly allocated to an experimental group (LLLDS with conventional physiotherapy) and a control group (conventional physiotherapy alone), with 12 participants in each group. Outcome measures included the Numerical Pain Rating Scale (NPRS), knee range of motion using a universal goniometer, and the Lysholm Knee Scoring Scale. Interventions were administered for four weeks. Paired t-test and unpaired t-test were used for statistical analysis. Results Both groups demonstrated statistically significant improvements in pain, knee range of motion, and functional outcomes following the four-week intervention (p<0.0001). The experimental group demonstrated lower post-intervention pain scores on the Numerical Pain Rating Scale (2.10±0.82 vs. 4.20±0.90; p=0.015), greater knee range of motion (106.33±2.93° vs. 103.50±2.68°; p=0.021), and higher Lysholm Knee Scoring Scale scores (88.75±6.40 vs. 84.10±6.85; p=0.039) compared with the control group. These findings suggest that adding LLLDS to conventional physiotherapy may provide additional benefits in reducing pain, improving knee mobility, and enhancing functional outcomes in post-operative knee conditions. Conclusion Low-load long-duration stretch combined with conventional physiotherapy is more effective than conventional physiotherapy alone in improving knee range of motion, reducing pain, and enhancing functional outcomes in post-operative knee conditions.

An 82-year-old woman presenting with an acute, 4-part proximal humerus fracture-dislocation after a ground-level fall was treated with reverse total shoulder arthroplasty using a novel FiberTape cerclage tuberosity fixation technique. Surgery was done within 24 hours of injury using a deltopectoral approach. The reconstruction technique incorporated a standard metaphyseal press-fit stem, autologous bone graft, and a modified Six-Tec-based suture tuberosity repair combined with a tension-band construct derived from a prophylactic humeral shaft FiberTape cerclage (Arthrex) anchored distal to fracture. The patient progressed from shoulder pendulums and active-assisted forward elevation in the scapular plane immediately postoperative to active range of motion at 6 weeks and removal of all restriction at 12 weeks. Simple Shoulder Test and QuickDASH scores were 10 and 9.09, respectively, at 96 weeks postoperatively with the patient reporting the ability to touch the back of her head and reach her buttock for self-hygiene. Active forward elevation was 140° at 1 year and 140° at 2.4 years with 30 degrees of external rotation. Tuberosity union was achieved by 3 months with minimal displacement. The patient did not experience any postoperative complications such as dislocation, implant failure, periprosthetic fracture, infection, humeral stem lucency, heterotopic ossification, or revision surgery.

On-body robots that travel around a human limb must keep a firm enough grip to avoid slipping or detaching, while never pressing hard enough to hurt-a balance that is hardest to strike precisely when the robot is orbiting the limb and gravity continually redistributes the contact loads. This paper presents an open, non-anthropomorphic robot that wraps around a compliant cylindrical surface with a three-contact grasp: a central traction module with two in-line driven wheels, and two lateral spring-loaded arms with distal wheels. Its central contribution is an actuation-space decomposition in which the two lateral wheel torques, expressed in a common-mode/differential basis, simultaneously drive the orbital motion and regulate the central normal force. We show that this basis diagonalises both the rolling kinematics and the static force balance, so the differential (grip-regulating) channel is provably orthogonal to the common-mode (propulsion) channel: a single pair of actuators perform both tasks without mutual interference and without a dedicated force mechanism. A model-based feedforward law derived from the static contact model, corrected by a PI term fed back from the compliant arms-which double as the force sensor-keeps the central force within a safe band; in a full-revolution simulation the differential command reverses sign to counteract the gravitational load swing while leaving the orbit undisturbed. The same compliant arms yield a closed-form estimate of the cylinder radius and contact geometry, accurate to below one millimetre across a 45-87 mm diameter range, from proprioception alone. Preliminary prototype tests reproduce the predicted behaviour, supporting the approach for future wearable and assistive applications.