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Abstract Background Various fixation devices are available for bunion osteotomy. In this study, we evaluated the radiographic outcomes, postoperative complications, and recurrence rate in a series of hallux valgus deformities treated with various osteotomy procedures using a pin for the fixation of the osteotomy. Methods Two-hundred forty-seven patients with hallux valgus deformity managed with a Simple, Effective, Rapid and Inexpensive (SERI) osteotomy, distal chevron osteotomy, or proximal crescentic osteotomy and K-wire fixation were included. The mean follow-up of the patients was 53.9 ± 8.9 months. Radiographic evaluations included the assessment of the Hallux valgus angle (HVA), intermetatarsal angle (IMA), and union. Clinical evaluations included the assessment of the range of motion, pain in the first metatarsophalangeal joint, and patient satisfaction. Results In the last visit, the mean improvement of HVA was 23.9 ± 9.1º (P

Abstract The importance of fuel mixing for the progress of the scramjet engine is indisputable. The present article shows the importance of the non-equal multi-injector system for effective fuel distribution and flame holding inside the combustion segment of a scramjet engine. The supersonic air and fuel jet flow in the non-equal nozzle arrangement is simulated via computational fluid dynamic technique. Two injector types of circular and rectangular nozzle have been analyzed to attain flow characteristics of hydrogen jets at supersonic cross flow. Mach contour is also analyzed for these jet arrangements to show the interface of the jet in the non-equal jet arrangement. Besides, addition of internal air jet is also simulated and evaluated in this research. Our investigation shows that the diffusion height of the fuel jet is higher when a rectangular non-equal nozzle is applied. The circular nozzle is more active in the spreading of the fuel in the combustor and the use of an internal air jet effectively increases fuel in a combustor of the scramjet.

Backgrounds: Many Speech and language pathologists (SLPs) are employed by Iran’s Ministry of Education, with services traditionally delivered through a pull-out model. However, alternative service delivery models (SDMs), such as classroom-based and consultant approaches, are also available for SLPs working in schools. While the advantages of these approaches have been established in other countries, their effectiveness in the Iranian context remains unexplored. This study sought to determine which SDM is more effective in enhancing language skills among Persian-speaking children with intellectual disability (ID) in Iran. Methods: This study employed a single-blind, randomized, controlled trial design. Twenty-one preschoolers, with a mental age of approximately 4:6, were randomly assigned to one of three groups (pull-out, classroom-based, and consultant) to receive speech therapy services. Language skills of all students were assessed by an experienced speech therapist using the Persian version of Test of Language Development-Persian:3 (TOLD-P:3), which has demonstrated favorable content validity and acceptable reliability. The language age of students on core subtests and their compositions were compared using the Kruskal-Wallis test. Results:Analyzing language areas and compositions revealed that speech therapy was effective across all delivery service models. However, notable changes were observed in students under the consultant model, particularly in their "Grammatical completion" score (p = 0.011). Additionally, significant improvements were noted in four other composition scores: 'spoken language' (p = 0.05), 'organizing' (p = 0.009), 'speaking' (p = 0.017), and 'syntax' (p = 0.055). Conclusion: The findings of this study demonstrate that speech therapy, irrespective of the service delivery models (SDMs), effectively improves language skills in children with ID. However, the consultant model emerged as the most effective among the three models (pull-out, classroom-based, and consultant) for children with ID.

Abstract Background Multiple sclerosis is a progressive neurological disease that affects the central nervous system, resulting in various symptoms. Among these, impaired mobility and fatigue stand out as the most prevalent. The progressive worsening of symptoms adversely alters quality of life, social interactions and participation in activities of daily living. The main objective of this study is to bring new insights into the impact of a multidisciplinary inpatient rehabilitation on supervised walking tests, physical activity (PA) behavior and everyday gait patterns. Methods A total of 52 patients, diagnosed with multiple sclerosis, were evaluated before and after 3 weeks of inpatient rehabilitation. Each measurement period consisted of clinical assessments and 7 days home monitoring using foot-mounted sensors. In addition, we considered two subgroups based on the Expanded Disability Status Scale (EDSS) scores: ‘mild’ (EDSS

Abstract The effective functioning and regulation of power systems crucially rely on the coordination of distance and directional overcurrent relays. Accurate fault detection and successful clearing sequences require support for each relay and the maintenance of the coordination time interval (CTI) between major distance relays, directional overcurrent relay support, and other relay zones. Efficiently initiating relays while adhering to complex coordination limitations poses a challenging task that demands innovative solutions. This study addresses the intricate problem of relay coordination by employing heuristic methods, specifically genetic algorithms (GA) and biogeography-based optimization (BBO), in both a 9-bus and 39-bus system. The primary objective is to determine the most efficient time setting factor (TSM) that minimizes the duration of relay operation. Additionally, the intelligent features of the overcurrent relay are carefully chosen to enhance the research's results. The integration of edge computing capabilities plays a significant role in advancing this coordination method. By incorporating advanced algorithms and communication technologies at the edge, the prompt activation of relays becomes possible, thereby meeting coordination demands. This study explores the combination of edge-based servers with genetic algorithms (GA) and biogeography-based optimization (BBO) techniques to enhance relay coordination. The findings indicate a notable enhancement compared to conventional approaches. However, comparative research suggests that BBO's performance is similar to GA, without a distinct advantage in achieving higher outcomes.

Objective Cerebral palsy (CP) is the most prevalent motor disability during childhood, characterized by a range of movement and posture disorders that result in activity limitations. In children with CP, abnormal walking patterns are observed due to spasticity and contractures in the lower limb muscles. Also, an excessive flexion gait pattern of the knee presents in 66% of spastic diplegic CP children aged from 5 to 21 years. Accordingly, reducing excessive knee flexion during walking may decrease secondary compensations and enhance walking performance and quality of life. This study aims to design and evaluate a novel dynamic orthosis along with its impact on functional parameters of walking and occupation performance in a child with spastic diplegia CP. Materials & Methods This research was a fundamental and applied study of the design and fabrication. The study plan is a single subject, interaction design, conducted in two stages and implemented as A-B-BC-A. After the initial orthosis design, a second and final iteration was developed to address the limitations observed in the preliminary design. The study participant included an 8-year-old boy with spastic diplegic CP, classified as level II (according to the gross motor function classification system expanded and revised), exhibiting a crouch gait pattern. Functional variables, such as speed, balance in walking, spasticity, and occupation performance, were assessed in the study phases. Results The advantages and disadvantages of the final design were identified. Changes were made regarding manufacturing in less time, the ability to adjust the circumferential measures, ease of wearing and removing, and issues related to toileting. In comparing the baseline with intervention phases one and two regarding balance, the intervention demonstrated effectiveness (percentage of non-overlapping data [PND]=70%). According to PND values, functional speed in the second intervention phase showed significant results (PND=75%). The hamstring muscle spasticity graph analysis during intervention phases exhibited a reduction of 1 or 2 units. The occupational performance score and satisfaction with the child’s performance increased significantly after the intervention phases. Conclusion According to the mechanism of dynamic movement orthoses, as long as they are worn during the day, they are effective in modulating the tonicity of spastic muscles by exerting pressure on hypertonic muscles. This modulation improves balance, movement speed, and overall task performance. Consequently, these findings suggest that dynamic orthotic interventions may enhance functional outcomes and occupational performance, and satisfaction in children with spastic diplegic CP.

Shell and spiral tube heat exchangers are widely favored in refrigeration and applications such as heat recovery systems, food processing, and heat storage. Researchers' primary focus is to discover a simple and cost-effective approach to improve the efficiency of heat exchangers. The research employed a specially designed shell and spiral tube heat exchanger to enhance efficiency. This research involved utilizing ANSYS FLUENT CFD software to analyze the thermodynamic efficiency and predict heat transfer in the specified converter. The analysis incorporated factors such as displacement velocity coefficient and friction coefficient. Researchers are focused on finding a simple and cost-effective approach to improve the efficiency of heat exchangers. Furthermore, the selection of nanohybrid fluids is a crucial factor influencing the thermohydraulic performance of shell and spiral tube heat exchangers. Among the three fluid nanohybrids chosen for simulation, the water nanohybrid exhibited superior temperature performance, surpassing all other liquids. Furthermore, the optimal thermal performance for the hybrid nanofluid was observed at φ1 = φ2 = 0.7.

Key Clinical Message This study presents a family with nine children, two of them diagnosed with RTS2 using genetic testing. The other siblings show some of the RTS2 criteria and are suggestive of the syndrome. Such reports help physicians be more alert in dealing with cases of rare syndromes. Timely initiation of genetic counseling and testing once the first child was diagnosed with the syndrome could have prevented the birth of affected siblings by RTS2. Since RTS2 patients could have a severe clinical manifestation as osteosarcoma which probably leads to death at a young age, the importance of genetic testing is even more underlined.

Three-dimensional (3D) motion analysis (MA) techniques are progressively being used in biomechanics research and for clinical applications to assess the risk of injuries. A marker-based 3D MA protocol has been developed to measure the upper and lower extremity (UE and LE) joints’ active and passive ranges of motion (AROM and PROM) in children. The joints that were included in this protocol are shoulder, elbow, wrist, hip, knee and ankle. The anatomical joint coordinate systems (JCS) have been defined for the upper and lower extremities to standardize reporting. A marker placement model was defined according to the International Society of Biomechanics (ISB) recommendations and used to develop the protocol. The proposed movements will be captured and analyzed using the Motion Analysis Corporations 3D MA system integrated with Cortex software. The movements adopted in this study have been selected from various sources to incorporate all joint rotations while ensuring the isolation of each joint motion during the movements. It is recommended that future studies utilize this protocol to draw a relationship between the joints’ range of motion (ROM) and the adjacent segments characteristics, i.e., segment length, joint stiffness, etc.

This paper aims to study of shape operator of an $ (n-1) $-dimensional distribution on an $ n $-dimensional smooth manifold. In this study firstly we state formulae for the shape operator and its symmetric and anti-symmetric components and in continuation we show their relationships with some notions such as integrability, totally umbilic and totally geodesic. Finally, by considering at most two eigenvalues for the shape operator, we classify this distribution and their foliations in simply connected space forms. 1. IntroductionThe study of surfaces in ordinary three-dimensional space was expanded by Gauss in the early 19th century by introducing the concepts of first and second fundamental forms and curvature. This approach was generalized by studying the submanifolds of a Riemannian manifold. Details of this matter in [10, 7, 11] have been studied. But other aspects need to be studied and in this paper, we intend to examine them. In differential geometry, a distribution on a manifold is an association of vector subspaces that have special properties, and often this distribution is a subbundle of a tangent bundle. The distributions that have the integrability condition create a foliation on the manifold, that is, they separate the manifold into smaller submanifolds. These concepts have many applications in different fields of mathematics, such as integrable systems, Poisson geometry, differential topology, etc [17, 2, 6]. The study of the geometry of regular distributions is a natural extension of the study of the geometry of submanifolds. The mode of integrable distributions is in accordance with the study of foliations. For more details we refer the reader to [16]. If the distribution is not integrable, then the tensor field of its shape operator, it is not symmetrical and its decomposition into symmetric and antisymmetric parts is related to the geometric properties of the distribution. The second fundamental form as well as the shape operator, is the main and basic tool which this research aims to study.We prove different properties of symmetric and antisymmetric components. Finally, by considering at most two eigenvalues for the shape operator, we classify the distribution and its foliations in simply connected space forms. 2. Main ResultsSuppose $ (M^n,g) $ be a Riemannian manifold, $ {\mathcal H}$ an $ (n-1) $-dimensional regular distribution (horizontal distribution) on $ M $ and $ {\mathcal V} $ the distribution of its orthogonal complement to the Riemannian metric $ g $ (vertical distribution). So $ TM= {\mathcal H}\oplus{\mathcal V}$. Let $ H $ and $ V $ be smooth $ (1,1) $-tensor fields that attribute to a vector field (to a vector) its horizontal and vertical parts, i.e. $ {H}(E)=E-\leftN $ and $ {V}(E)=\leftN $, where $ N $ is an unit vector field may be locally defined and it is perpendicular to the horizontal distribution. Here the symbol $ \left $ stands forthe inner multiplication of the metric $ g $, and the second fundamental form of $ {\mathcal H} $ is defined in the following form\begin{equation*}B^{{\mathcal H}}(E,F)={ V}(\nabla_{{ H}(E)}{{ H}(F)}),\end{equation*}where $ \nabla $ denotes the Levi-Civita connection of metric $ g $ and $ E,F\in {\mathcal X}(M)$. Definition 2.1. [12] Suppose $ N $ be an unit vertical vector field. The shape operator $ S $ obtained from $ N $, is given by the following relation\begin{equation*}\left=\left,\end{equation*}where $ X $, and $ Y $, are horizontal vector fields.The following proposition is similar to that in [12].Proposition 2.2. Shape operator specifies a linear operator $S:{\mathcal H}_p\rightarrow{\mathcal H}_p $, at any point $ p\in M $ and for each $ v\in {\mathcal H}_p $, $Sv=-\nabla_vN$. Remark 2.3. If the vertical vector field $ N $ (which may be locally defined) is replaced with $ -N $, then the sign of $ S $ changes. So even if $ M $ lacks a vector field that is vertical throughout, then the shape operator $ S $ is defined globally up to sign. The sign of ambiguity should be removed from the inherent formulas. Symmetric and antisymmetric components of $ B^{{\mathcal H}} $ which is denoted by $ B^{{\mathcal H}}_s $ and $ B^{{\mathcal H}}_a $, respectively are defined as follows:\begin{eqnarray*}B^{{\mathcal H}}_s(E,F)=\dfrac{1}{2}\left( B^{{\mathcal H}}(E,F)+B^{{\mathcal H}}(F,E)\right),\\\;B^{{\mathcal H}}_a(E,F)=\dfrac{1}{2}\left( B^{{\mathcal H}}(E,F)-B^{{\mathcal H}}(F,E)\right),\end{eqnarray*}where$ E,F\in {\mathcal X}(M)$. Therefore $ B^{{\mathcal H}}=B^{{\mathcal H}}_s+B^{{\mathcal H}}_a $. Motivated by this, we offer the following definition. Definition 2.4. Symmetric and antisymmetric components of $ S $, which is denoted by $ S_s $ and $ S_a $, respectively are defined by\begin{eqnarray*}\left=\left,\\\left=\left,\end{eqnarray*}where $ X $ and $ Y $, are horizontal vector fields. As a result $ S=S_s+S_a $, where\begin{eqnarray*}S_s=\frac{1}{2}\left(S+S^t\right),\\ S_a=\frac{1}{2}\left(S-S^t\right),\end{eqnarray*}and $S ^t $ denotes the transpose of $S$.Proposition 2.5. For each $ v\in {\mathcal H}_p $, the following relationships are established:\begin{align*}S_sv=&-\dfrac{1}{2}\left(\nabla_vN+{ H}((\nabla N)^tv)\right)\\=&-\frac{1}{2}\left(\nabla_vN+(\nabla N)^tv-\leftN\right),\end{align*}and\begin{align*}S_av=&-\dfrac{1}{2}\left(\nabla_vN-{ H}((\nabla N)^tv)\right)\\=&-\frac{1}{2}\left(\nabla_vN-(\nabla N)^tv+\leftN\right).\end{align*} Similar to what was stated in [3,12], we arrive at the following proposition. Proposition 2.6. For any horizontal vector field $ X, Y $, we have\begin{align*}\left&=\left\\&=-\frac{1}{2}({\mathcal L}_Ng)(X,Y).\end{align*}Definition 2.7. We call $ \mu^{\mathcal{H}}$ mean curvature and it is defined in the following form\begin{align*}\mu^{{\mathcal H}}=&\frac{1}{n-1}\mathrm{tr}B^{{\mathcal H}}\\=& \frac{1}{n-1}\mathrm{tr}B^{{\mathcal H}}_s\\=&\frac{1}{n-1}\sum_{i=1}^{n-1}B^{{\mathcal H}}_s (e_i,e_i),\end{align*}where $ \{e_i\}_{i=1}^{n-1} $ is a local orthogonal frame for $ \mathcal{H} $.Corollary 2.8. Thee mean curvature $ \mu^{{\mathcal H}} $ has the following properties(a)\begin{align*}\mu^{{\mathcal H}}&= \frac{1}{n-1}(\mathrm{tr}S)N\\&=-\frac{1}{2(n-1)}(\mathrm{tr}{\mathcal L}_Ng)N.\end{align*}(b)$ \mu^{{\mathcal H}}=0 $, if and only if $ \mathrm{tr}S=0 $, also $ \mathrm{tr}S=0 $ if and only if $ \mathrm{tr}{\mathcal L}_Ng=0 $.\end{enumerate} The following definition is similar to the definition which was stated in [3] Definition 2.9. Let $ \mathcal{H} $ be an $ (n-1) $-dimensional distribution.(a) We call $ \mathcal{H} $ totally umbilic if for all horizontal vector fields $ X,Y $, $$B^{{\mathcal H}}_s(X,Y)=\left\mu^{\mathcal{H}}.$$(b) We call $ \mathcal{H} $ totally geodesic if for all horizontal vector fields $ X,Y $, $$B^{{\mathcal H}}_s(X,Y)=0.$$(c) We call $ \mathcal{H} $ minimal if $$ \mu^{{\mathcal H}}=0.$$Based on the above definition, we conclude the following propositions.Proposition 2.10. The distribution $ {\mathcal H} $ is totally geodesic, if and only if it is totally umbilic and minimal. Proposition 2.11. The distribution $ {\mathcal H} $ is totally umbilic, if and only if for each selection $ N $, tensor $ S_s $ be a scalar. Especially $ {\mathcal H} $ it is totally geodesic If and only if for each selection $ N $, $ S_s=0 $. Proposition 2.12. Let $ W $ be a nowhere zero Killing vector field. Then the distribution $ {\mathcal H}=\left^{\bot} $ is totally geodesic and its symmetric shape operator is zero. A discussion similar to the proposition 2.11 and knowing that the integrability of a distribution is equivalent to the symmetry of its second fundamental form(see [12] for more details), will lead to the following proposition. Proposition 2.13. Let $ \mathcal{H} $ be an $ (n-1) $-dimensional distribution.(a) The distribution $ {\mathcal H}$ is integrable if and only if distribution shape operator, for each selection $ N $, be symmetrical. Hence $ S_s=S $ and $ S_a=0 $.(b) The distribution $ {\mathcal H}$ is totally umbilic and integrable if and only if the distribution shape operator, for each choice $ N $, be a scalar and therefore each leaf of its foliation is a totally umbilic hypersurface. In the following, we assume that the vertical vector field $ N $, be defined throughout manifold and therefore the shape operator obtained from $ N $, without sign of ambiguously defined throughout manifold. Let $ R^n(c) $ be a simply connected Riemannian space form with fixed sectional curvature $ c $ which is the Euclidean space $ \mathbb{R}^n $ for $ c=0 $, is the Euclidean sphere $ \mathbb{S}^n $ for $ c=1 $, and is the Hyperbolic space $ \mathbb{H}^n $ for $ c=-1 $. A hypersurface in $ R^n(c) $ is called an isoparametric if its principal curvatures are constant everywhere, counting multiplicities. In this case, we have the following proposition.Proposition 2.14. Let $ \mathcal{H} $ be an $ (n-1) $-dimensional distribution on $ R^n(c) $ and $ S=\alpha I $, where $\alpha$ is an arbitrary constant. Then either $ c=0 $ or $ c=-1 $ and $ {\mathcal H}$ is totally umbilic and integrable. If $ c=0 $, then $ \alpha=0$, the distribution is totally geodesic, and each leaf of its foliation is a hyperplane. If $ c=-1 $, then $ \alpha=\pm1$, the distribution is non-minimal and each leaf of its foliation is a parabolic hypersurface.Corollary 2.15. There is no $ (n-1) $-dimensional distribution which is integrable and totally geodesic on $ \mathbb{S}^n $ or $ \mathbb{H}^n $.Proposition 2.16. Let $ \mathcal{H} $ be an $ (n-1) $-dimensional distribution on $ R^n(c) $, with $ n>2 $, and $ S=f I $, in which $ f $ is a smooth function on $ R^n(c) $. Then either $ c=0 $ or $ c=-1 $, and $ {\mathcal H}$ is totally umbilic and integrable. If $c=0 $, then the distribution is totally geodesic and all leaves are hyperplanes and the function $ f $ is zero. If $ c=-1 $, then the distribution is non-minimal and each leaf is a hyperbolic or parabolic hypersurface. Also for all $ x\in \mathbb{H}^n $,non-zero vector $ a\in \mathbb{R}_1^{n+1} $, it is found that $ \left\in\{0,1\} $, and $ f(x)=-\frac{\left}{\sqrt{\left+\left^2}}$.Corollary 2.17. There is no $ (n-1) $-dimensional distribution which is integrable and totally umbilic on $ \mathbb{S}^n $, $ n>2 $.Proposition 2.18. There is no $ (n-1) $-dimensional distribution which is integrable on $ R^n(c) $ that its shape operator has only two distinct constant eigenvalues.Isoparameter hypersurfaces of $ \mathbb{R}^n $ and $ \mathbb{H}^n $ have at most two constant principal curvatures, and so, according to the propositions 2.14-2.18, we obtain the following result.Corollary 2.19. The only $ (n-1) $-dimensional distribution on $ \mathbb{R}^n $, which is integrable and all eigenvalues of its shape operator are constant, is generated by $ n-1 $ linearly independent constant vector fields and so the distribution is totally geodesic and every leaf of its foliation is a hyperplane and the distribution shape operator is zero.Corollary 2.20. There is no $ (n-1) $-dimensional distribution on $ \mathbb{H}^n $, which is integrable and all eigenvalues of its shape operator be constant and has at least two eigenvalues.3. ConclusionIn this paper, we studied the shape operator of a distribution and its properties, especially its decomposition into symmetric and antisymmetric parts. We showed that a distribution is totally umbilic if and only if the symmetric component of its shape operator is scalar, we also proved that it is totally geodesic if and only if the symmetric component of its form operator is zero. Finally, we considered the classification of $ {(n-1)} $-dimensional distributions and studied simply connected space forms with a shape operator having at most two eigenvalues.

The management of patients with severe aortic valve stenosis and an abdominal aortic aneurysm is a real therapeutic challenge. Minimally invasive treatment is more beneficial than open surgery for treating both aortic valve stenosis and abdominal aortic aneurysm. We present a case of a 77-year-old male initially treated with a 26 mm Sapien 3 transcatheter aortic valve replacement. Subsequently, using the same femoral access points, a custom fenestrated endoprosthesis and stents in digestive trunks and renal arteries were implanted. Follow-up imaging revealed no dysfunction of the valve, endoprosthesis, or stents.This is the first reported successful concomitant management of significant aortic valve stenosis and infrarenal abdominal aortic aneurysm through transcatheter aortic valve replacement and fenestrated endovascular aortic aneurysm repair.

Abstract Metabolic and bariatric surgery (MBS) is widely considered the most effective option for treating obesity, a chronic, relapsing, and progressive disease. Recently, the American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) issued new guidelines on the indications for MBS, which have superseded the previous 1991 National Institutes of Health guidelines. The aim of this study is to establish the first set of consensus guidelines for selecting procedures in Class I and II obesity, using an Expert Modified Delphi Method. In this study, 78 experienced bariatric surgeons from 32 countries participated in a two-round Modified Delphi consensus voting process. The threshold for consensus was set at an agreement or disagreement of ≥ 70.0% among the experts. The experts reached a consensus on 54 statements. The committee of experts reached a consensus that MBS is a cost-effective treatment option for Class II obesity and for patients with Class I obesity who have not achieved significant weight loss through non-surgical methods. MBS was also considered suitable for patients with Type 2 diabetes mellitus (T2DM) and a body mass index (BMI) of 30 kg/m2 or higher. The committee identified intra-gastric balloon (IGB) as a treatment option for patients with class I obesity and endoscopic sleeve gastroplasty (ESG) as an option for patients with class I and II obesity, as well as for patients with T2DM and a BMI of ≥ 30 kg/m2. Sleeve gastrectomy (1) and Roux-en-Y gastric bypass (RYGB) were also recognized as viable treatment options for these patient groups. The committee also agreed that one anastomosis gastric bypass (OAGB) is a suitable option for patients with Class II obesity and T2DM, regardless of the presence or severity of obesity-related medical problems. The recommendations for selecting procedures in Class I and II obesity, developed through an Expert Modified Delphi Consensus, suggest that the use of standard primary bariatric endoscopic (IGB, ESG) and surgical procedures (SG, RYGB, OAGB) are acceptable in these patient groups, as consensus was reached regarding these procedures. However, randomized controlled trials are still needed in Class I and II Obesity to identify the best treatment approach for these patients in the future.

Abstract The use of electrical stimulation devices to manage bladder incontinence relies on the application of continuous inhibitory stimulation. However, continuous stimulation can result in tissue fatigue and increased delivered charge. Here, we employ a real-time algorithm to provide a short-time prediction of urine leakage using the high-resolution power spectrum of the bladder pressure during the presence of non-voiding contractions (NVC) in normal and overactive bladder (OAB) cats. The proposed method is threshold-free and does not require pre-training. The analysis revealed that there is a significant difference between voiding contraction (VC) and NVC pressures as well as band powers (0.5–5 Hz) during both normal and OAB conditions. Also, most of the first leakage points occurred after the maximum VC pressure, while all of them were observed subsequent to the maximum VC spectral power. Kalman-Fuzzy method predicted urine leakage on average 2.2 s and 1.6 s before its occurrence and an average of 2.0 s and 1.1 s after the contraction started with success rates of 94.2% and 100% in normal and OAB cats, respectively. This work presents a promising approach for developing a neuroprosthesis device, with on-demand stimulation to control bladder incontinence.