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Background Dialysis modalities and their various treatment schedules result from complex compromises ('trade-offs') between medical, financial, technological, ergonomic, and ecological factors. This study targets summarizing the mutual influence of these trade-offs on (trans)portable, wearable, or even (partially) implantable haemodialysis (HD) systems, identify what systems are in development, and how they might improve quality of life (QoL) for patients with kidney failure. Methods HD as defined by international standard IEC 60601–2-16 was applied on a PUBMED database query regarding (trans)portable, wearable, and (partly) implantable HD systems. Out of 159 search results, 24 were included and scanned for specific HD devices and/or HD systems in development. Additional information about weight, size, and development status was collected by the internet and/or contacting manufacturers. International airplane hand baggage criteria formed the boundary between transportable and portable. Technology readiness levels (TRLs) were assigned by combining TRL scales from the European Union and NATO medical staff. Results The query revealed 13 devices/projects: seven transportable (six TRL9, one TRL5); two portable (one TRL6–7, one TRL4); two wearable (one TRL6, one frozen); and two partly implantable (one TRL4–5, one TRL2–3). Discussion Three main categories of technical approaches were distinguished: single-pass, dialysate regenerating, and implantable HD filter with extracorporeal dialysate regeneration (in climbing order of mobility). Conclusions Kidneys facilitate mobility by excreting strongly concentrated waste solutes with minimal water loss. Mimicking this kidney function can increase HD system mobility. Dialysate-regenerating HD systems are enablers for portability/wearability and, combined with durable implantable HD filters (once available), they may enable HD without needles or intravascular catheters. However, lack of funding severely hampers progress. [ABSTRACT FROM AUTHOR]

Featured Application: Motion comfort of automated driving and other transportation modes. In future automated vehicles we will often engage in non-driving tasks and will not watch the road. This will affect postural stabilization and may elicit discomfort or even motion sickness in dynamic driving. Future vehicles will accommodate this with properly designed seats and interiors, whereas comfortable vehicle motion will be achieved with smooth driving styles and well-designed (active) suspensions. To support research and development in dynamic comfort, this paper presents the validation of a multi-segment full-body human model, including visuo-vestibular and muscle spindle feedback, for postural stabilization. Dynamic driving is evaluated using a "sickening drive", including a 0.2 Hz 4 m/s2 slalom. Vibration transmission is evaluated with compliant automotive seats, applying 3D platform motion and evaluating 3D translation and rotation of pelvis, trunk and head. The model matches human motion in dynamic driving and reproduces fore–aft, lateral and vertical oscillations. Visuo-vestibular and muscle spindle feedback are shown to be essential, in particular, for head–neck stabilization. Active leg muscle control at the hips and knees is shown to be essential to stabilize the trunk in the high-amplitude slalom condition but not with low-amplitude horizontal vibrations. However, active leg muscle control can strongly affect 4–6 Hz vertical vibration transmission. Compared to the vibration tests, the dynamic driving tests show enlarged postural control gains to minimize trunk and head roll and pitch and to align head yaw with driving direction. Human modelling can enable the insights required to achieve breakthrough comfort enhancements, while enabling efficient developments for a wide range of driving conditions, body sizes and other factors. Hence, modelling human postural control can accelerate the innovation of seats and vehicle motion-control strategies for (automated) vehicles. [ABSTRACT FROM AUTHOR]

The relationship between the amplitude of motion and the accumulation of motion sickness in time is unclear. Here, we investigated this relationship at the individual and group level. Seventeen participants were exposed to four oscillatory motion stimuli, in four separate sessions, separated by at least 1 week to prevent habituation. Motion amplitude was varied between sessions at either 1, 1.5, 2, or 2.5 ms−2. Time evolution was evaluated within sessions applying: an initial motion phase for up to 60 min, a 10-min rest, a second motion phase up to 30 min to quantify hypersensitivity and lastly, a 5-min rest. At both the individual and the group level, motion sickness severity (MISC) increased linearly with respect to acceleration amplitude. To analyze the evolution of sickness over time, we evaluated three variations of the Oman model of nausea. We found that the slow (502 s) and fast (66.2 s) time constants of motion sickness were independent of motion amplitude, but varied considerably between individuals (slow STD = 838 s; fast STD = 79.4 s). We also found that the Oman model with output scaling following a power law with an exponent of 0.4 described our data much better as compared to the exponent of 2 proposed by Oman. Lastly, we showed that the sickness forecasting accuracy of the Oman model depended significantly on whether the participants had divergent or convergent sickness dynamics. These findings have methodological implications for pre-experiment participant screening, as well as online tuning of automated vehicle algorithms based on sickness susceptibility. [ABSTRACT FROM AUTHOR]

Worldwide, the number of people needing lifesaving kidney replacement therapy (KRT) steadily grows, but about two thirds of them lack access to KRT and thus die. Access to KRT depends on economic, social, infrastructural, ecological, and political factors. Current KRTs include kidney transplantation, peritoneal dialysis (PD) and hemodialysis (HD). Xenotransplantation recently is opening promising new perspectives but needs improvement. Unfortunately, not all patients are suitable for transplantation. PD and HD will remain important KRTs, but they are expensive and strongly depend on infrastructure, with little fundamental changes since the 1980s. The KRT field might learn from the African mobile phone revolution that beat infrastructural limitations, lowered costs, and increased access. We provide a non-exhaustive overview of promising ways to increase the mobility of technology-based KRTs by dialysate regeneration, chip-based nanoporous filters, bioreactor-enabling technologies and using the gut as a "third kidney". In 2018, the Kidney Health Initiative published a Roadmap for innovative KRTs composed by leading innovators, but the pace of innovation is slower than targeted. Ambitious political statements about realizing this roadmap can only succeed if the granted funding matches the targeted time scale. Patient-centered international coopetition (the act of cooperation between competing entities) seems to offer the quickest pathway to success., (Copyright © 2025. Published by Elsevier Inc.)