Search Results (304)

The objective of the project was to develop a hybrid rocket with a recovery system that would facilitate reuse. The rocket was successfully developed, launched and recovered. A two-stage parachute deployment system was developed and utilized, incorporating a non-pyro separation and a low-shock device. Notably, the non-pyro separation device plays a pivotal role in enabling the successful separation of a hybrid rocket, thereby ensuring its operation is free from explosive hazards. The launch took place on 14 December 2024, and all equipment was successfully recovered, except for the nose cones, the antenna-deployable GPS beacon and the motor case. The Ti-6Al-4V oxidizer tank, an important part that can be reused, was recovered with damage only to the outlet fitting. The tank was successfully repaired and passed a pressure test. This marks the first step in creating a reusable hybrid rocket. Full article

Antimicrobial stewardship (AMS) is often framed as a set of prescribing-focused interventions aimed at optimizing antibiotic selection, dose, route of administration, and duration. In practice, AMS also functions as a systems discipline. Embedded within governance and regulatory frameworks, diagnostic capacity, antimicrobial consumption and use patterns, and surveillance infrastructure, AMS operates within real-world structural and economic constraints, such as resource limitations, conflicting pharmaceutical market incentives, and health system fragmentation. In lower- and middle-income countries, variation in regulatory enforcement, prescribing patterns, diagnostic limitations, and surveillance infrastructure can undermine otherwise well-designed stewardship policies. This paper frames AMS as a systems governance function and proposes the Aligned AMS Systems Governance framework, comprising four core AMS functions—governance and regulation, antimicrobial consumption and antimicrobial use measurement, diagnostic stewardship, and antimicrobial resistance (AMR) surveillance and reporting—within four broader enabling domains: infection prevention and control, public engagement and awareness, environmental stewardship, and One Health coordination. This paper is an analytical narrative review of peer-reviewed literature, global policy frameworks, and implementation guidance. Using India as an illustrative example, we show that inconsistent regulatory enforcement, non-prescription antibiotic access, diagnostic constraints, and pharmaceutical market dynamics interact to complicate stewardship implementation despite the presence of national policies. Effective AMS requires deliberate alignment of these multiple functions and domains through defined responsibilities, routine data collection and sharing across AMS functions, and continuous feedback loops linking findings to coordinated action and subsequent reassessment. Reframing AMS as systems governance clarifies actionable leverage points for implementation and supports more practical, scalable approaches to mitigating AMR across diverse health system contexts. Full article

Planetary sample return missions can impose extreme mechanical forces on both spacecraft and the returned samples collected from a planetary surface that they contain. The chain of custody phases from entry/descent/landing to curation each present distinct vibration, shock, and dynamic loads that may compromise sample integrity. Interplanetary sample return missions, from the Apollo program to Stardust, Hayabusa, Hayabusa2, and OSIRIS-REx (Origins, Spectral Interpretation, Resource Identification, and Security—Regolith Explorer), have refined capsule design to ensure sample integrity. While much attention has understandably been paid to contamination control, thermal control, and mechanical shock at impact, the role of vibrational monitoring on the sample container itself is less frequently explored; yet, it merits attention. Here, we combine a review of vibration sensor aspects relevant to planetary sample return with a Monte Carlo analysis of how capsule-level vibration may propagate into representative lunar sample types. Using Apollo-derived sample container geometries and a representative multi-frequency capsule vibration environment, we show that sample archetypes can exhibit substantially different dynamic responses to the same vibration input. These results illustrate the value of vibration measurements at or near the sample container for documenting the mechanical environment experienced by returned material and interpretation of potential scientific losses during transport and curation. Full article

Chronic musculoskeletal pain remains a leading cause of disability worldwide, driven by progressive degeneration of cartilage, bone, tendon, intervertebral discs, and peripheral nerves. Conventional interventional approaches primarily address symptoms without restoring structural integrity or tissue homeostasis. Regenerative strategies, including platelet-rich plasma, mesenchymal stem cells, and biomaterials, have demonstrated potential but are limited by variability in outcomes, poor cellular survival, and lack of standardization. Exosomes and extracellular vesicles are key mediators of intercellular communication in tissue repair, reproducing many of the paracrine effects of parent cells while offering improved safety and scalability. These nano-sized vesicles regulate inflammation, angiogenesis, extracellular matrix remodeling, and cell survival across musculoskeletal and neural tissues. Importantly, growing evidence suggests that mechanical cues such as compression, shear stress, and tensile loading not only regulate cellular behavior but also shape exosome biogenesis, cargo composition, and functional effects through mechanotransduction pathways involving integrins, ion channels, and YAP/TAZ signaling. This mechanobiology–exosome interface is particularly relevant in interventional pain medicine, where therapeutics are delivered into mechanically active environments such as joints, discs, tendons, and perineural spaces. Mechanical loading conditions may therefore modulate therapeutic efficacy by shaping both endogenous repair processes and the behavior of administered exosomes. The present investigation reviews the current literature and knowledge on mechanotransduction pathways and exosome biology, with a focus on their intersection in musculoskeletal regeneration. We further examine preclinical and clinical evidence supporting exosome-based therapies in osteoarthritis, degenerative disc disease, tendon and ligament injuries, and neuropathic pain states, alongside key translational challenges including heterogeneity in exosome isolation, dosing, biodistribution, and clinical standardization. Finally, we discuss future directions in mechanobiology-guided exosome engineering and their potential integration into interventional pain practice. Full article

People living with HIV (PLHIV) are at an increased risk of progressing from Mycobacterium tuberculosis (TB) infection to TB disease. Tuberculosis preventive treatment (TPT) is recommended for PLHIV; however, its uptake remains suboptimal. In Zimbabwe, three months of weekly rifapentine and isoniazid (3HP) and six months of daily isoniazid (6H) are the most commonly prescribed TPT regimens. We explored barriers to TPT uptake among PLHIV from the perspective of healthcare workers (HCWs) in Zimbabwe. Facility nurses who had been implementing TPT for at least six months were invited to participate in in-depth interviews and/or focus group discussions conducted in March 2023. Audio recordings were transcribed into English, coded using NVivo 12 (QSR International), and analyzed thematically. Eleven HCWs participated in in-depth interviews and 15 in focus group discussions. Barriers were categorized as person- and health system-related. Person-related barriers included misconceptions about TPT, fear of adverse events, and pill burden. Health system barriers included stock-outs of TPT medications, limited HCW knowledge and skills to promote TPT, limited expertise in initiating TPT among children under five years of age, and limited access to chest radiography. Barriers to TPT uptake and completion remain in Zimbabwe and contribute to missed opportunities for TB prevention among PLHIV. TPT implementation could be strengthened through an uninterrupted supply of TPT medications, continuous training and mentorship of HCWs, and community engagement to improve awareness of the benefits and risks of TPT. Full article

Monocular 3D lane detection faces challenges due to the loss of directional detail in distant markings during feature downsampling and geometric ambiguity between lateral curvature and road elevation under single-view projection. R-A3D addresses both issues through frequency-aware Riemannian anchor learning in an anchor-regression pipeline. A Haar-based feature pyramid retains four frequency subbands before learned channel projection, strengthening thin and low-contrast lane responses. Each evolving 3D anchor is summarized in the lateral-elevation plane by Gaussian mean and covariance statistics, embedded in a symmetric positive-definite matrix, and mapped to a tangent-space feature with the Log-Euclidean metric. This Riemannian anchor feature is residually fused with anchor-aligned visual evidence and recomputed after each cascade stage. On OpenLane, the ResNet-50 model achieves 64.9% F1, 94.1% category accuracy, and far-range lateral and vertical errors of 0.215 m and 0.081 m at 23.5 frames/s; the ResNet-18 model reaches 63.0% F1 at 53.2 frames/s. Across the three ApolloSim subsets, R-A3D improves F1 over the reproducible Anchor3DLane baseline by 1.4–4.3 percentage points and reduces far-range lateral error by 18.7–23.2%. These results indicate complementary benefits from frequency-preserving visual evidence and proposal-dependent Riemannian geometry within the evaluated settings. Full article

Long-term LiDAR maps support urban remote sensing, infrastructure inventories, change analysis, digital twins, and map-based localization. Most map-cleaning pipelines, however, output a single retained map, forcing transient observed-dynamic artifacts and movable but currently stationary scene content into the same keep/remove decision. This paper formulates layer assignment within long-term LiDAR map maintenance as a layered representation problem. The resulting output comprises a long-term static (LTS) layer, a potentially dynamic (PD) layer, and a removed observed-dynamic (OD) set. For geometry-only accumulated maps with per-frame semantic predictions, the proposed layer-assignment framework combines map-to-scan geometric inconsistency, dual-timescale map-side semantic memory, PD admission, and PD-preserving recovery within the geometric rejection set. Geometric evidence first identifies OD candidates and rejection regions, while semantic memory converts framewise class predictions into map-side movability evidence for LTS/PD assignment. Experiments on SemanticKITTI under a controlled in-sequence LTS/PD/OD protocol show that this framework maintains high LTS-layer retention, improves PD retention, and reduces PD over-cutting while maintaining competitive OD suppression with predicted semantic input. Mechanism analyses further show that the dual-timescale semantic memory helps preserve PD evidence under conflicting or temporally sparse semantic predictions, while PD-preserving recovery provides boundary compensation with an explicit OD-suppression trade-off. Collapsing the output to a single retained map also improves the balance between static and PD retention relative to single-layer cleaning baselines. Qualitative Apollo SouthBay transfer observations further indicate that the same configuration can produce a three-layer map output without retuning, with binary annotations used only to support map-quality checks. Full article

Alzheimer’s disease (AD) is a multifactorial neurodegenerative disorder characterized by impaired glucose metabolism, mitochondrial dysfunction, inflammation, oxidative stress, and progressive cognitive decline. Because currently available pharmacological therapies provide only modest symptomatic benefit, nutrition-based interventions are increasingly being explored as complementary strategies for supporting brain metabolism and cognitive resilience. The KetoFLEX 12/3 dietary pattern, developed within the ReCODE (Reversal of Cognitive Decline) program, is a plant-rich, mildly ketogenic nutrition and lifestyle framework that integrates low-glycemic nutrition, time-restricted eating, and personalized metabolic optimization. The diet emphasizes deeply pigmented non-starchy vegetables, extra-virgin olive oil, nuts and seeds, omega-3-rich seafood, and minimally processed foods while limiting refined carbohydrates, sugars, processed foods, and selected grains and dairy products. Emerging mechanistic and clinical evidence suggests that KetoFLEX 12/3 may influence several pathways relevant to AD pathophysiology, including insulin signaling, mitochondrial bioenergetics, neuroinflammation, oxidative stress, autophagy, detoxification pathways, and gut–brain axis function. Observational findings from ReCODE-related studies have reported improvements in metabolic parameters, mood-related outcomes, cognitive measures, and brain volumetrics in participants adhering to multimodal precision-medicine interventions incorporating the KetoFLEX principles. Compared with traditional dietary models such as the Mediterranean or MIND diets, KetoFLEX 12/3 places greater emphasis on mild nutritional ketosis, meal timing, and metabolic personalization based on factors such as ApoE genotype and insulin sensitivity. The objective of this Perspective is to examine the mechanistic rationale, emerging evidence, limitations, and future research priorities for KetoFLEX 12/3 as a precision-nutrition framework for cognitive health in AD. Although much of the current evidence remains mechanistic, observational, or derived from multimodal intervention studies, the framework offers a biologically plausible precision-nutrition model that may inform future research and clinical investigation in cognitive decline. Full article

Background: Acute exacerbation of obstructive airway disease (AEOAD) is a major cause of hospitalization, morbidity, and premature mortality in India. Hospitalized patients for the same are predominantly treated with short-acting bronchodilators, which require frequent administration and are associated with systemic adverse effects. Despite the availability of nebulized long-acting muscarinic antagonists (LAMAs) with quick onset of action, such as glycopyrronium, their role in acute care remains unclear in India. Methods: A pan-India expert opinion-building initiative was conducted among 220 pulmonologists across Tier I–II cities through 13 structured advisory meetings between April 2025 and July 2025. The final expert perspectives were then categorized into recurrent insights, raised in 75% or more meetings, and variable insights, raised in <75% of all meetings. Results: Experts reported that AEOAD management commonly involved initial stabilization with SABA/SAMA followed by transition to triple therapy with nebulized glycopyrronium, formoterol, and budesonide. Nebulized glycopyrronium was perceived to provide rapid and sustained bronchodilation with fewer cardiovascular side effects compared to short-acting agents. Benefits were reported in patients with frequent exacerbations, high sputum burden, and bronchiectasis. Operational advantages included reduced dosing frequency and nursing workload. Experts also noted potential improvements in hospital stay and readmissions; however, these observations were based on clinical experience rather than controlled data. Conclusions: Indian pulmonologists agreed that early initiation of nebulized glycopyrronium (with formoterol and budesonide) in hospitalized AEOAD may improve symptom control, lower exacerbation burden, reduce reliance on short-acting bronchodilators and corticosteroids, and shorten hospital stays. Full article

Background: No preferred treatments for melasma are known, owing to its underlying complicated pathomechanisms; microneedle radiofrequency (MRF) has recently been used to treat melasma. Objectives: We aimed to investigate the effects and pathomechanisms of melasma treated by MRF and identify the possible determining factors for good response. Methods: Therapeutic outcomes were measured using the Melasma Area and Severity Index (MASI) and artificial intelligence-assisted optical coherence tomography (OCT) evaluation for collagen and pigmentation at baseline and 2 months after each treatment. Participants were divided into good- (≥25% reduction in MASI) and poor-response (<25% reduction in MASI) groups after the last MRF treatment. Results: Two patients achieved fair response and three patients achieved poor response. Overall OCT analysis showed that the confetti/granular melanin ratios (melanin aggregation index) decreased, the distance between melanosomes increased, and the size of melanin decreased. The number of dendritic cells (DCs) decreased. In subgroup analysis, the continuity of the basement membrane was improved in the fair-response group, and the melanin aggregation index and the number of DCs were decreased in the poor-response group. A higher baseline confetti/granular melanin ratio trended towards poorer therapeutic response. Conclusions: This pilot study used OCT to assess the therapeutic efficacy of MRF for melasma and identify the characteristics of individuals for whom MRF is effective. The statistical results were exploratory and descriptive. Further large-scale, randomized controlled studies are required to prove the efficacy of MRF in treating melasma and the feasibility of OCT in investigating the treatment response of melasma. Full article

Mobility hubs promise to reduce car dependence and make multimodal travel work in practice, yet behavioural evidence remains limited when hub improvements coexist with easier car access. This article examines the tension at Rome Trastevere, an urban rail node that gradually acquires mobility-hub functions while facing improved parking access near Piazza della Radio. The empirical analysis combines a pilot survey of 83 users with an on-site stated preference survey of 204 valid respondents. The stated preference instrument uses a route-based feasible-choice design with nine choice sets per experiment: respondents evaluate alternatives among bikes, walking, e-scooters, e-mopeds, public transport, private cars, and shared cars under variations in travel time, travel cost, and search time. The paper estimates a multinomial logit model in Apollo and uses sample enumeration, supported by Monte Carlo simulation, to assess four parking and shared-mobility scenarios and produce confidence intervals around predicted probabilities. Results show that users respond to time, monetary cost, and search friction in coherent and policy-relevant ways. Setting the car parking search time to zero increases predicted car probability only marginally, by about 0.9% relative to the baseline. By contrast, a EUR 1/h increase in parking cost reduces predicted car probability by about 14.7%, while a EUR 1.5/h increase reduces it by about 22.4%. A coordinated scenario combining higher parking cost and lower shared-mode search time produces the lowest predicted car probability and strengthens e-scooter and e-moped alternatives, while public transport remains the dominant option. Findings indicate that parking pricing steers behaviour more clearly than parking convenience destabilizes it in the tested range. The paper shows that mobility-hub performance depends on coordinated access management, including parking regulation, shared-service reliability, and legible multimodal transfer. Full article

Future planetary exploration missions are expected to employ increasingly sophisticated aerial, ground, and hybrid robotic systems that must interact directly with extraterrestrial regolith during landing, takeoff, mobility, anchoring, sampling, and subsurface investigation activities. Consequently, understanding the mechanical behavior of lunar and Martian regolith is essential for the design and reliable operation of autonomous exploration platforms. This review examines drone–regolith interaction from a system-level perspective by integrating knowledge of regolith mechanical properties with findings from penetration mechanics, anchoring technologies, mobility studies, numerical modelling, and in situ mission observations. Key differences between lunar and Martian regolith are identified, highlighting the predominantly friction-driven behavior of lunar soils and the combined frictional–cohesive response frequently observed in Martian regolith. Lessons learned from planetary missions, particularly the Apollo and Mars InSight programs, demonstrate how system–soil mismatch can significantly affect penetration, stabilization, and surface-operation performance. The review further discusses the implications of regolith mechanics for landing stability, rotor–surface interaction, anchoring efficiency, subsurface access, and future drone-assisted exploration concepts. Finally, current challenges in experimental validation and numerical modelling are assessed, emphasizing the need for integrated approaches that combine soil mechanics, robotic system design, and environmental constraints to enable reliable autonomous operations on the Moon and Mars. Full article

Background: Flexible bronchoscopy (FB) has long been integral to pulmonology, but its bedside role in the intensive care unit (ICU) is expanding. Despite a lack of high-level evidence, FB remains a pivotal tool for airway visualization, sampling, and selected interventions in critically ill patients. Objective: This meta-narrative review critically appraises the clinical use, evolving indications, safety profile, and emerging controversies of FB in ICU settings, particularly regarding the role of non-pulmonologist intensivists. Methods: A structured literature search was conducted using PubMed, Scopus, and Google Scholar for studies published in the past 15 years. Emphasis was placed on observational studies, meta-analyses, and guidelines relevant to FB in ICU patients. Key controversies were grouped under thematic questions based on clinical relevance. Results: A total of 84 articles were retrieved, of which 47 met the predefined inclusion criteria. Seven key thematic domains were synthesized regarding the use of flexible bronchoscopy (FB) in the intensive care unit (ICU) setting. FB performed by trained intensivists was found to be safe and diagnostically effective across a range of ICU populations, including elderly and non-intubated patients. Although procedure-related hypoxemia was reported, it was largely manageable with appropriate precautions. FB demonstrated critical utility in the management of acute respiratory failure (ARF), acute respiratory distress syndrome (ARDS), and sepsis, particularly through bronchoalveolar lavage (BAL), airway secretion clearance, and, selectively, bronchoscopic lung biopsy. The adoption of disposable bronchoscopes may reduce infection risk and economic burden. Furthermore, the integration of advanced techniques such as endobronchial ultrasound (EBUS) and transbronchial cryobiopsy is emerging, although application in the critical care environment remains cautious and selective. Conclusions: With structured training and careful patient selection, FB is an adaptable and often underutilized tool in ICU medicine. Multidisciplinary competency development and institutional protocols can enhance its safe integration. Full article

Sickle Cell Disease (SCD) is a pervasive monogenic disorder characterized by chronic hemolytic anemia, unpredictable vaso-occlusive crises, and progressive multi-organ damage, representing a significant global health burden. Driven by a point mutation in the β-globin gene, the resulting abnormal Hemoglobin S (HbS) polymerizes under deoxygenated conditions, leading to erythrocyte sickling and systemic endothelial dysfunction. While supportive therapies such as hydroxyurea and transfusions manage symptoms, the mandate for definitive curative therapies is urgent. Historically, allogeneic hematopoietic stem cell transplantation (HSCT) utilizing matched sibling donors (MSD) has been the sole curative option, offering high survival rates but constrained by limited donor availability and the risk of graft-versus-host disease (GVHD). Consequently, alternative donor sources, including matched unrelated donors, umbilical cord blood, and haploidentical donors, have expanded patient access, particularly with the integration of post-transplant cyclophosphamide (PTCy) to mitigate alloreactivity. Concurrently, the advent of autologous gene therapy, encompassing lentiviral gene addition (Lyfgenia) and CRISPR-Cas9 gene editing (Casgevy) offers a revolutionary donor-independent approach that eliminates GVHD risk. Lyfgenia employs a lentiviral vector to introduce an anti-sickling βT87Q hemoglobin variant into autologous hematopoietic stem cells, while Casgevy employs CRISPR-Cas9 to disrupt the erythroid-specific enhancer of the BCL11A transcription factor, derepressing γ-globin expression and elevating fetal hemoglobin. This review synthesizes the pathophysiological mechanisms of SCD, evaluates the clinical outcomes and limitations of both allogeneic HSCT and autologous gene therapies, and outlines the clinical decision-making paradigms and future innovations required to achieve equitable global access to these transformative treatments. Full article

Spatial intelligence in autonomous driving requires object-level 3D geometry, yet existing monocular mesh reconstruction methods usually operate with a fixed inference path and a single mesh parameterization, which limits their flexibility under heterogeneous resource constraints. To address this issue, we propose DyPRSI, a dynamic-parameterized framework for monocular vehicle 3D reconstruction that provides multiple predefined accuracy–latency operating points within a single model. DyPRSI inserts two early exits into a shared Res2Net–BiFPN trunk and associates each exit with an exit-specific mesh specification, forming a coarse-to-fine reconstruction hierarchy across network depth. To better match the efficiency requirements of shallow branches, DyPRSI adopts lightweight coordinate-classification keypoint decoding for EE1 and EE2, while retaining a heatmap-regression keypoint head in the Main branch to preserve the upper bound of reconstruction accuracy. Experiments on ApolloCar3D show that DyPRSI-Main achieves competitive reconstruction performance, whereas EE1 and EE2 substantially reduce end-to-end inference latency and provide useful alternatives under different resource requirements. Ablation studies further show that the speedup mainly comes from the lightweight branch-specific keypoint heads, while the exit-specific mesh settings help organize stable coarse-to-fine reconstruction behavior across branches. These results indicate that DyPRSI is a practical monocular vehicle reconstruction framework for resource-aware spatial intelligence. Full article