Soft and continuum robots have unique advantages and capabilities useful in medical applications and confined environments due to their highly flexible structure. However, their underactuation and theoretically infinite degrees-of-freedom present significant challenges, particularly in control and state estimation. Prior work showed that a 2D discrete rod mechanics model, derived from the continuous partial differential equations of a Kirchhoff rod and expressed in maximal coordinates, can facilitate continuum robot state estimation and feedback-linearization-based control without conversion to a classical minimal robot dynamics form. We here extend that maximal-coordinate modeling approach to 3D, in a symmetric, constrained-Lagrangian form, using quaternions and Baumgarte constraint stabilization. We also formulate a physically intuitive, model-based observer to estimate the full state of a continuum robot by introducing virtual forces and moments. We validate both the open-loop model and the observer through optical tracking in experiments on a large tendon-driven continuum robot prototype, demonstrating the ability to accurately estimate the robot’s dynamic state during actuation.
The study "Urinary extracellular proteome in diabetic kidney disease: associations with albuminuria and treatment response" by van Heugten et al. profiles the urinary extracellular vesicle proteome in diabetic patients treated with 4 different therapies. This is an important advance in the field because it demonstrates the utility of such an approach to understand prognosis and responses to therapy in patients with chronic kidney diseases.
Electronic health record (EHR) data are increasingly used for case-control investigations. Using multiple control groups in de-identified EHR-data we evidence how conditioning on imaging (descendent of a collider: symptomology) can perturb exposure estimations enough to reverse conclusions. Because imaging is often required for rotator cuff tear diagnosis, some argue imaging should be required for control selection. We constructed two control groups (with vs. without imaging) to evaluate selection bias through collider stratification involving metabolic exposures-body mass index (BMI), type 1 diabetes (T1D), and type 2 diabetes (T2D)-and rotator cuff tears. Cases and controls were identified using validated algorithms. We compared baseline characteristics and performed multivariable logistic regression across designs. Cases were older and more likely to have arthritis (57%), ligamentous disease (9%), and prior shoulder injury (99%) than controls. Controls requiring imaging more closely resembled cases, with more arthritis (9% vs. 1%), ligamentous disease (6% vs. 2%), and prior shoulder injury (54% vs. 7%). T1D prevalence was 3% in cases, 4% in controls-with-imaging, and 1% in controls-without, compared to ~1% nationally. T1D was positively associated with tears using controls-without-imaging (aOR=1.78; 95% CI: 1.64-1.92), but inversely using controls-with-imaging (aOR=0.75; 0.57-0.97).
Background/Objectives: The purpose of this nursing-led quality-improvement initiative was to strengthen organizational culture, support staff well-being, and improve patient safety by implementing an evidence-based collaboration model that redefined registered nurse (RN) and unlicensed assistive personnel (UAP) teamwork in acute care settings. Methods: Guided by transformational leadership principles, Nursing Professional Development (NPD) practitioners, nurse directors and managers, and frontline staff collaboratively redesigned communication and workflows. After piloting the process change, expansion occurred across acute care and step-down units through leader-supported team training alongside ongoing rounding, observations, and feedback cycles. The four phases of the EPIS framework of implementation science were used to implement the initiative, and data were collected via direct observation, anonymous staff surveys, and organizational retention and quality reports. Results: Across the seven units in Cluster 1 of the expansion, 335 RNs and 180 UAPs participated. Standardized communication using a structured handover tool increased from 18% to 95% with corresponding improvements in discussions of quality-related measures such as fall risk, turn schedules, and toileting. Patient safety measures exceeded threshold goals for fiscal year (FY) 2026 across falls with harm, pressure injuries, and catheter-associated urinary tract infections (CAUTI). RN and UAP retention demonstrated overall improvement, with RNs exceeding their retention goal and UAPs exceeding their goal by removing a single outlier unit. Perceptions of overall team communication throughout the shift increased for both RNs and UAPs. Conclusions: This initiative exemplifies how uniting transformational leadership with frontline staff empowerment supports inclusion, improved quality measures, and strengthened workforce resilience. This scalable framework for nurse-led transformation fosters belonging, safety, and shared outcomes across organizations.
BACKGROUND:Long-term outcomes of femoroacetabular impingement (FAI) surgery, particularly survivorship, are critical to guide treatment decision-making and patient counseling, yet only a limited number of studies have reported mid- to long-term survivorship. The purpose of this study was to report survivorship rates at a mean 10-year follow-up in a large, multicenter FAI surgery cohort and to identify clinical predictors of survivorship. METHODS:A prospective, multicenter cohort study assessed patients treated for FAI with hip arthroscopy or surgical dislocation from 2008 to 2012. At a minimum of 8 years, 362 hips (80.1%) had follow-up that permitted assessment of total hip arthroplasty (THA)-free survivorship. A Cox proportional-hazards model was developed to identify risk factors for THA. RESULTS:tThe cohort included 362 hips with a mean patient age of 32.1 years; 53% were in females, and 95.6% were in Caucasian patients. The THA-free survivorship of the cohort was 90.6% at a mean of 10.4 ± 1.6 years postoperatively. Risk factors for THA were older age at surgery (p = 0.01), male sex (p = 0.02), body mass index of ≥30 kg/m 2 (p = 0.009), and femoral head chondromalacia (p < 0.001). CONCLUSIONS:This study demonstrates that FAI surgery yielded durable 10-year THA-free survivorship of 90.6%. Older age at surgery, obesity, male sex, and femoral head chondromalacia were key predictors of conversion to THA. LEVEL OF EVIDENCE:Therapeutic Level II . See Instructions for Authors for a complete description of levels of evidence.
