Search Results (255)

Background/Objectives: Right vertical infra-axillary thoracotomy to repair ventricular septal defects (VSDs) and atrial septal defects (ASDs) is less invasive than conventional surgical repair via median sternotomy. However, right vertical infra-axillary thoracotomy (RVIAT) may result in unilateral lung injury, a serious postoperative complication requiring extracorporeal circulation and unilateral lung collapse. The aim of this study was to evaluate whether repeated lung recruitment provides enhanced respiratory compliance and lung oxygenation in children who have undergone right vertical infra-axillary thoracotomy (RVIAT) to correct a congenital heart defect. Methods: Eligible participants were children with a common congenital heart defect corrected via RVIAT. Seventy-seven children were randomly classified into two groups. In group A (n = 39), an alveolar recruitment maneuver (ARM) was performed immediately after cardiopulmonary bypass. Children in group C (n = 38) did not receive any additional interventions during surgery. Results: The ARM group tolerated open lung ventilation without significant hemodynamic instability. Compared to controls, intraoperative PaO₂, PaO₂/FiO₂ and lung compliance (Com_dyn) improved in group A (p < 0.05), who also showed a significantly lower IL-6 (p < 0.05). In addition, group A had a lower incidence of lung injury and lung atelectasis than Group C at specific post CPB time points. Conclusions: Our findings provide some indication that the application of ARM could effectively improve the oxygenation profile, reduce postoperative pulmonary complications, and attenuate the postoperative inflammatory response in children with a common congenital heart defect corrected via the RVIAT technique. Full article

Artificial intelligence (AI) is increasingly transforming spine surgery, with expanding applications in diagnostics, intraoperative imaging, and surgical navigation. As the field advances toward greater precision and safety, machine learning (ML) and deep learning technologies are being integrated to augment surgeon expertise and optimize operative workflows. In particular, AI-driven innovations in image acquisition and navigation are reshaping intraoperative decision-making and technical execution. This narrative review provides an overview of AI applications relevant to intraoperative imaging and navigation in spine surgery. We begin by defining key concepts in AI, ML, and deep learning and briefly outline the historical evolution of AI within spine practice. We then examine current capabilities in image recognition and automated pathology detection, emphasizing their clinical relevance. Given the central role of imaging accuracy in modern navigation-assisted procedures, we review conventional acquisition platforms, including intraoperative computed tomography (CT) systems (e.g., O-arm, GE, Airo), surface-based registration to preoperative CT (Stryker, Medtronic), and optical surface mapping technologies (e.g., 7D Surgical). Emerging AI-optimized advancements are subsequently discussed, including low-dose intraoperative CT protocols, expanded scan windows, metal artifact reduction algorithms, integration of 2D fluoroscopy with preoperative CT datasets, and 3D reconstruction derived from 2D imaging. These developments aim to improve image quality, reduce radiation exposure, and enhance navigational accuracy. By synthesizing current evidence and technological progress, this review highlights how AI-enhanced imaging systems are redefining intraoperative spine surgery and shaping the future of precision-based care. The primary purpose of this review is to outline the applications of AI and its potential for perioperative and intraoperative optimization, including radiation exposure reduction, workflow streamlining, preoperative planning, robot-assisted surgery, and navigation. The secondary purpose is to define AI, machine learning, and deep learning within the medical context, describe image and pathology recognition, and provide a historical overview of AI in orthopedic spine surgery. Full article

Background and Objectives: The authors aimed to describe their experience performing frameless stereotactic biopsies using an Autoguide Robotic Platform and to compare the outcomes with a frame-based stereotactic technique. We would like to emphasize the importance of this study, as it is the first in the literature to use sodium fluorescein for confirmation in intracranial biopsies taken with a Stealth Autoguide Robotic Platform. Materials and Methods: We retrospectively evaluated 30 patients who underwent a stereotactic intracranial biopsy between June 2018 and March 2024. The patients were divided into two groups: The robotic biopsy group (n = 15) underwent a frameless image-guided stereotactic intracranial biopsy with a Stealth Autoguide Robotic Platform and optical neuronavigation system (Stealth-Station S8, Medtronic, Minneapolis, MN, USA) using intraoperative sodium fluorescein. The frame-based (Integra, CRW, New Jersey, USA) stereotactic biopsy group (n = 15) underwent a stereotactic biopsy with the use of a stereotactic planning system (Atlas Integra Software, NJ, USA and Brainlab AG, Munich, Germany) without sodium fluorescein. Preoperative MRI and CT scans were performed in all the patients. Their external cranial anatomy was registered using either facial tracing or O-Arm (Medtronic Sofamor Danek, Inc., Memphis, TN, USA). Results: The robotic biopsy group demonstrated a diagnostic yield of 93.3% (14/15), while the frame-based group achieved 100% (15/15), with no significant difference (p = 0.609). The mean calculated tip error in the robotic biopsy group was 0.42 ± 0.19 mm (range: 0.1–0.7 mm) and the postoperative targeting accuracy in the frame-based biopsy group was 0.51 ± 0.23 mm (range: 0.2–0.9 mm), with no significant difference (p = 0.287). The robotic biopsy group demonstrated a significantly shorter mean surgical time (40.26 ± 6.13 vs. 52.47 ± 8.92 min, p = 0.002). Conclusions: Both frame-based and robotic-assisted stereotactic biopsy techniques achieve comparable diagnostic accuracy and targeting precision. However, a robotic biopsy significantly reduces the surgical time compared to a frame-based technique. The use of intraoperative sodium fluorescein is a valuable adjunct method for confirming that biopsy specimens are obtained from the intended target site. Full article

Background/Objectives: Positive end-expiratory pressure (PEEP) is a standardized component of the invasive mechanical ventilation (IMV) settings to improve oxygenation; however, its physiological effects in patients with no documented prior lung disease remain poorly defined. This study evaluated the impact of moderate PEEP variations on macrohemodynamic parameters, gas exchange, and driving pressure (ΔP). Methods: This single-arm, non-randomized, crossover study included adult intensive care unit (ICU) patients with no documented prior lung disease during the early phase of IMV. Sequential PEEP levels of 6, 8, and 10 cmH₂O were applied for 30 min each within the first 24 h of ICU admission, while all other ventilatory parameters were kept constant. Arterial blood gases [partial pressure of oxygen (PaO₂), partial pressure of carbon dioxide (PaCO₂), and arterial oxygen saturation (SaO₂)], oxygenation index [PaO₂/fraction of inspired oxygen (FiO₂)], systolic, diastolic, and mean arterial pressures, ΔP, and static compliance (Cstat) were measured. Friedman and Mann–Whitney U tests were used, with adjustment for multiple comparisons. Results: A total of 150 patients were enrolled (64.7% male). The observed mortality rate was 53.3%; however, mortality was not defined as a primary or secondary outcome, and was used only as a grouping variable for comparative analyses. Intraindividual comparison across PEEP levels of 6, 8, and 10 cmH₂O showed small but significant reductions in systolic and mean arterial pressure at higher PEEP (p-value < 0.05), with Bonferroni-adjusted significance for PEEP 6 vs. 10. No significant differences were observed in oxygenation (SaO₂, PaO₂, and PaO₂/FiO₂), PaCO₂, ΔP, or Cstat. These results suggest that moderate PEEP changes produced limited macrohemodynamic effects without relevant impact on gas exchange or respiratory mechanics. Overall, no clinically relevant or statistically significant differences were observed in gas exchange, macrohemodynamic parameters, ΔP, or Cstat across PEEP levels when mortality was used as the grouping variable. Among survivors, higher PEEP was associated with modest reductions in systolic and mean arterial pressures and higher PaCO₂ values; however, these findings did not translate into consistent physiological benefits. Conclusions: In mechanically ventilated patients with no documented prior lung disease, PEEP may exert divergent effects on macrohemodynamics, gas exchange, and ΔP, supporting a cautious and individualized approach to PEEP selection in this population. Full article

We present a modular building block strategy for synthesizing phosphonated polyaromatic systems as an alternative to the conventional late-stage phosphonation of prefabricated aromatic scaffolds, which often requires harsh conditions and has limited tolerance for functional groups. A monophosphonated biphenyl building block was obtained via nickel-catalyzed phosphonation of dibromobiphenyl at 170 °C for three hours. This synthesis is more economical and milder than typical high-temperature palladium systems. In parallel, a borated pyrene derivative was prepared by Suzuki–Miyaura borylation. The final palladium-catalyzed Suzuki cross-coupling reaction produced the target compound, octaethyl(pyrene-tetrakis(biphenyl))tetrakis(phosphonate), Et₈-PyTPPE. Single-crystal X-ray diffraction reveals a centrosymmetric molecule that crystallizes in the triclinic space group P–1, with the inversion center located at the central C–C bond of the pyrene core. The pyrene unit is essentially planar, while the biphenylphosphonate arms are highly twisted relative to the core and to each other. The crystal packing is dominated by weak intermolecular interactions, and no significant π–π stacking is observed. Hirshfeld surface analysis shows that H···H (60.5%) and C···H (22.5%) contacts predominate, while O···H interactions (14.4%) with phosphoryl oxygen atoms represent the most relevant directed contacts. From photophysical investigations, Et₈-PyTPPE exhibits blue fluorescence (λ_em. = 452 nm) in solution and aggregation-induced red-shifted emission with nanosecond lifetimes in the solid state, confirming purely fluorescent behavior. Full article

Background: Oral leukoplakia (OL) with oral epithelial dysplasia (OED) carries an increased risk of malignant transformation and typically requires active management and long-term surveillance. Surgical excision remains the gold standard, yet recurrence is common and morbidity may be substantial, particularly in extensive or multifocal disease. Photodynamic therapy using 5-aminolevulinic acid (ALA-PDT) has emerged as a minimally invasive alternative. However, its effectiveness in dysplastic OL has not been quantified systematically. Methods: A systematic review and meta-analysis were conducted according to a prospectively registered protocol (PROSPERO: CRD420251249586) and reported in line with PRISMA 2020. PubMed, Scopus, and Web of Science were searched from inception to 15 December 2025 for clinical studies evaluating ALA-PDT as primary treatment for OL with histopathologically confirmed OED. Single-arm prospective or retrospective studies reporting clinical response were eligible. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Case Series. Pooled overall response rate (ORR) and complete response (CR) were estimated as proportions using random-effects models. Recurrence and malignant transformation were summarized as incidence rates per 100 person-years. Results: Six single-arm clinical studies including 109 patients with dysplastic oral leukoplakia treated with 5-ALA-mediated photodynamic therapy were eligible for quantitative synthesis. The pooled overall response rate was 0.85 (95% CI 0.74–0.93), whereas the pooled complete response rate reached 0.34 (95% CI 0.18–0.53), with moderate to substantial heterogeneity. Recurrence and malignant transformation outcomes were limited and analyzed descriptively, suggesting low but persistent long-term risk. The overall certainty of the evidence was rated as very low according to GRADE. Conclusions: 5-ALA-mediated photodynamic therapy appears to be an effective and minimally invasive treatment option for oral leukoplakia with epithelial dysplasia; however, the very low certainty of evidence, lack of standardized protocols, and persistent risk of recurrence and malignant transformation highlight the need for well-designed controlled studies and long-term clinical surveillance. Full article

Octopus mimus aquaculture has gained relevance owing to its commercial potential; however, optimization of its reproductive and growth conditions in captivity requires further study. The objective of this study was to evaluate the reproductive conditioning, morphometric growth, and water quality of this species in a controlled system. To do this, adult O. mimus were selected and kept in circular tanks with controlled temperature, dissolved oxygen, pH, and salinity. Weight, total length (TL), mantle length (ML), and arm length (AL) measurements were made, in addition to monitoring seawater quality throughout the conditioning cycle. Paralarvae hatching productions were recorded, and Fulton’s condition index (k) was calculated to assess octopus health. The results showed that larger females produced more paralarvae, and that temperature significantly influenced the incubation period. The morphometric relationships between TL, ML, and LA were highly correlated, particularly in females. The seawater quality, with temperatures close to 22 °C, dissolved oxygen between 7.8 and 9.2 mg/L, 7.1–8.0 pH, and salinity around 35.3 PSU, was optimal for the welfare and reproduction of octopuses. This study provides keys to the effective management of O. mimus in aquaculture, with an emphasis on the importance of proper water quality management and the selection of larger broodstock. Full article

In recent years, autonomous liquid pouring systems have gained more relevance, with applications from daily service tasks to complex industrial operations. While seemingly simple for humans, this task poses major challenges for automated systems, as it requires precise control and adaptation to varying container geometries, liquid properties, and environmental conditions. This review examines the state-of-the-art on liquid pouring through five research questions: (1) What are the characteristics of the liquids used in the experiments? (2) What are the characteristics of the containers used in the experiments and how do they affect the performance of the pouring tasks? (3) What techniques are used to control liquid pouring (i.e., to control the robotic arm or device)? (4) What metrics are used to assess the methods for pouring liquid? (5) What devices are used to measure poured volume? This scoping review follows the Arksey and O’Malley framework, and uses the PRISMA-ScR protocol to filter the articles. A total of 285 studies published between 2018 and 2025 were screened from IEEE Xplore, SpringerLink, ScienceDirect, Web of Science, and EBSCOhost, of which 23 met the inclusion criteria. Results showed that the most widely used methods for autonomous liquid pouring were classical control methods—PID, PD (30.4% of the studies). Conversely, the least widely used methods for autonomous liquid pouring were learning, imitation learning, and probabilistic models (15% of the studies). Full article

(1) Background: Evidence on the clinical accuracy of wireless photoplethysmography (PPG)-based vital sign monitoring is limited. This study evaluated the accuracy, technical performance, and patient comfort of a novel PPG-based earsensor for measuring oxygen saturation (SpO₂), pulse rate (PR), and respiratory rate (RR) in postoperative patients. (2) Methods: In this observational method comparison study, SpO₂, PR, and RR were simultaneously recorded using the earsensor and compared with continuous monitoring in patients admitted overnight to the post-anesthesia care unit. Outcome measures were bias, 95% limits of agreement (LoA), and average root mean square (ARMS). Technical performance was evaluated by data loss and data gap duration. Patient comfort was assessed using a questionnaire. (3) Results: Twenty-one patients contributed to 264 h of data. Bias was 1.7% for SpO₂ (ARMS 2.4%; LoA −1.8% to 5.1%), 1.2 bpm for PR (ARMS 3.9 bpm; LoA –6.1 to 8.4 bpm), and 0.3 brpm for RR (ARMS 4.4 brpm; LoA –8.4 to 8.9 brpm). Overall, data loss was 42% for SpO₂, 33% for RR, and 29% for PR; most data gaps were under 30 min. Patient-reported comfort was high (77%). (4) Conclusions: The earsensor accurately measured SpO₂ and PR. RR accuracy was outside the predefined criteria. Despite substantial data loss, patient comfort was high, supporting the potential of PPG-based sensors for unobtrusive vital sign trend monitoring in low-acuity settings. Full article

Tungiasis, caused by the sand flea Tunga penetrans, results in itching and pain. Effective treatments, such as dimeticones, are often unaffordable. A 3% phenothrin lotion has shown safety and efficacy in Kenyan trials. This study compared the cure rate and safety of 3% phenothrin lotion (as the intervention) and 0.05% potassium permanganate (KMnO₄; as the standard-care comparator) over 14 days. This parallel-group, three-arm, non-blinded, randomised comparative trial was conducted in Vihiga County, Kenya. Participants aged ≥2 years with ≥1 viable flea on each foot were allocated (2:1:1) to KMnO₄, single-dose 3% phenothrin, or two-dose 3% phenothrin groups. Overall, 415 fleas from 79 participants were followed up to day 14 (KMnO₄, 213; single-dose, 129; two-dose, 73). On days 4 and 7, the single-dose phenothrin showed significantly higher cure rates (11.6% and 21.7%) than KMnO₄ (0.9% and 11.7%) (p < 0.001 and p = 0.013). The differences diminished by days 10 and 14 because of spontaneous flea death. The cure rate of the two-dose group on day-7 (8.2%) was lower than that of the single-dose group. Single-dose 3% phenothrin improved early cure rates compared to KMnO₄, but not by days 10–14; two-dose phenothrin showed no benefit compared with single dose from day 7 onwards. Full article

Glycosylation depends on luminal nucleotide sugars delivered by solute carrier 35 (SLC35) transporters. SLC35A3 is a uridine diphosphate N-acetylglucosamine (UDP-GlcNAc) transporter. In humans, biallelic mutations in SLC35A3 cause arthrogryposis, mental retardation, and seizures (AMRS). To define how loss of SLC35A3 function reshapes the neural glycome, we profiled N-, O-, and glycosaminoglycans (GAGs) in Slc35a3 knockout mouse brains. N- and O-glycans were analyzed by MALDI-TOF MS, and GAG disaccharides were quantified by anion-exchange HPLC. Knockout mouse brains exhibited attenuation of complex-type N-glycans with a reciprocal rise in high-mannose species, as revealed by MALDI-TOF MS profiling. In contrast, ConA lectin blotting showed no significant change, consistent with its preferential detection of mannose-rich glycans. Branching analysis revealed loss of tri- and tetra-antennary structures compared with biantennary species. O-glycan profiling showed core-2-type species (Hex₂HexNAc₂ backbone) decreased. The dominant disialyl core-1 remained stable. Total GAG output (chondroitin/dermatan sulfate, heparan sulfate, and hyaluronan) was preserved. These findings support a microdomain model in which SLC35A3 acts as a locally effective supplier of UDP-GlcNAc to MGAT4 (branching N-acetylglucosaminyltransferase that installs the β1,4-GlcNAc arm) in the brain, while alternative routes buffer UDP-GlcNAc delivery for GAG and mucin-type O-glycan biosynthesis. Accordingly, AMRS may be attributed to impaired higher-order N-glycan branching in the brain. Full article

This study presents a novel modified polylactic acid (PLA) composite material engineered to simultaneously achieve enhanced mechanical performance, crystallinity, degradability, and antibacterial activity through the incorporation of multi-arm Zn/CFR-PLA modifiers, derived from ZnO-loaded phenolic resin microspheres. The modifiers were synthesized via ring-opening polymerization (ROP) of lactide, initiated by phenolic resin microspheres with multiple surface hydroxyl groups, where multi-arm architecture was tailored to improve compatibility and interfacial bonding with PLA matrices. Mechanical characterization revealed significant reinforcement and toughening effects: the (Zn/CFR₂-PLLA)₂/PLLA composite exhibited an elongation at break of 102.7% (≈13-fold higher than pristine PLA) and a tensile strength of 19.6 MPa, alongside markedly improved impact strength. Notably, the Zn/CFR₂-PDLA/PLLA composite, leveraging stereocomplex formation between PDLA and PLLA, achieved a higher tensile strength of 27.2 MPa with an elongation at break of 47.3%. Furthermore, the release of zinc ions from the modifiers endowed the composites with exceptional antibacterial activity, achieving more than 98% inhibition against Escherichia coli and Staphylococcus aureus. The composites also demonstrated degradability and processability, as melt-spun PLA fibers derived from them exhibited enhanced modulus (up to 4.51 GPa) and moisture-wicking capability. The composites can serve as potential candidates for biodegradable packaging films, antibacterial textiles for medical or hygienic uses, and sustainable materials for consumer products. Full article

Development of rapid, precise and fieldable detection methods for foodborne pathogens is one of the essential requirements in food safety and public health. In this research, the single-nucleotide polymorphisms (SNPs) in the eae gene of Escherichia coli O157:H7 are well visually identified with the designed amplification refractory mutation system–polymerase chain reaction (ARMS-PCR) mediated lateral flow strip (LFS). Allele-specific primers were designed and optimized to discriminate the mutant-type genes from wild-type genes with single-nucleotide resolution in a simple visual format. The single-nucleotide variation in the eae gene could be easily differentiated by the observation of an optical signal on the T line of the LFS without any devices. Assay performance results show that it has a high sensitivity and specificity with the single-nucleotide differentiation ratio as low as 0.1%. This genetic polymorphisms screening performance could enumerate complex genetic variation into a simple and direct yes/no readout, highlighting the ultra-easy SNP screening mode and the simplicity of the result output for practical applications. This ARMS-PCR mediated LFS offers a straightforward, swift, and economical strategy for SNP identification with great potential for use in evolution of bacterial resistance genes and viral evolution under different environmental stresses. Full article

Rapid urbanization and anthropogenic activities have led to a significant deterioration of air quality, adversely affecting human health and ecosystems. The study of transboundary river basins, where air pollution is exacerbated by political and socio-economic factors, is of particular relevance. This paper presents the results of an analysis of the spatiotemporal distribution of pollutants (Aerosol Index (AI), Methane (CH₄), Carbon Monoxide (CO), Formaldehyde (HCHO), Nitrogen Dioxide (NO₂), Ozone (O₃), Sulfur Dioxide (SO₂)) in the ambient air within the Orontes River basin across Lebanon, Syria, and Turkey for the period 2019–2024. The research is based on satellite monitoring data (Copernicus Sentinel-5P), processed using the Google Earth Engine (GEE) cloud-based platform and GIS technologies (ArcGIS 10.8). The dynamics of population density (LandScan) and the impact of military operations in Syria on air quality were additionally analyzed using media content analysis. The results showed that the highest concentrations of pollutants were recorded in Syria, which is associated with the destruction of infrastructure, military operations, and unregulated emissions. The main sources of pollution were: explosions, fires, and destruction during the conflict (aerosols, CO, NO₂, SO₂); methane (CH₄) leaks from damaged oil and gas facilities; the use of low-quality fuels and waste burning. Atmospheric circulation contributed to the eastward transport of pollutants, minimizing their spread into Lebanon. Population density dynamics are related to changes in concentrations of pollutants (e.g., nitrogen dioxide). The results of the study highlight the need for international cooperation to monitor and reduce air pollution in transboundary regions, especially in the context of armed conflicts. The obtained data can be used to develop measures to improve the environmental situation and protect public health. Full article

Background/Objectives: Evidence on pulmonary rehabilitation (PR) in paediatric post-COVID-19 condition (PPCC) is scarce. This study aimed to evaluate the association of a PR programme with changes in physical and mental health and quality of life in PPCC over a 12-month follow-up. Methods: A quasi-experimental pre–post single-arm study was conducted, with no control group, in PPCC patients attending an outpatient PR unit. The primary outcome was change in exercise capacity (6 min walk test, 6MWT). Secondary outcomes included inspiratory and peripheral muscle strength, quadriceps muscle morphology by ultrasound, fatigue, physical activity, quality of life, and psychiatric symptoms, assessed using validated paediatric instruments. Results: A total of 115 PPCC patients (mean age 13.3 years; 66.1% female) completed the PR. 6MWD distance increased from 509 ± 87 to 546 ± 86 (+37 m; p < 0.001; D: 0.50). Handgrip strength increased by 2.4 kg, maximal inspiratory pressure increased by 15 cmH₂O, physical activity increased by 2.4 points, fatigue score improved by 9.3 points, and quality of life improved by 11 points (all p < 0.001). Rectus femoris thickness increased by 0.56 mm (p = 0.005), psychiatric symptom scores decreased by 4.5 points (p < 0.001), and rectus femoris echo-intensity decreased (p = 0.003). Conclusions: Multidisciplinary PR appears feasible and potentially effective in improving physical function, psychological well-being, and quality of life in PPCC, supporting the need for evidence-based paediatric rehabilitation. Full article