Search Results (5,328)

Background/Objectives: The adoption of artificial intelligence (AI) in healthcare, particularly in high-stakes environments such as operating rooms (ORs), is expanding rapidly. While AI has the potential to enhance patient safety and clinical efficiency, it may also trigger anxiety among healthcare professionals due to uncertainties around job displacement, ethical concerns, and system reliability. This study aimed to examine the relationship between AI-related anxiety and patient safety attitudes among OR professionals. Methods: A descriptive, cross-sectional research design was employed. The sample included 155 OR professionals from a university and a city hospital in Turkey. Data were collected using a demographic questionnaire, the Artificial Intelligence Anxiety Scale (AIAS), and the Safety Attitudes Questionnaire–Operating Room version (SAQ-OR). Statistical analyses included t-tests, ANOVA, Pearson correlation, and multiple regression. Results: The mean AIAS score was 3.25 ± 0.8, and the mean SAQ score was 43.2 ± 10.5. Higher AI anxiety was reported by males and those with postgraduate education. Participants who believed AI could improve patient safety scored significantly higher on AIAS subscales related to learning, job change, and AI configuration. No significant correlation was found between AI anxiety and safety attitudes (r = −0.064, p > 0.05). Conclusions: Although no direct association was found between AI anxiety and patient safety attitudes, belief in AI’s potential was linked to greater openness to change. These findings suggest a need for targeted training and policy support to promote safe and confident AI adoption in surgical practice. Full article

Hand hygiene is a key measure to prevent healthcare-associated infections (HAIs), yet compliance remains low in Sub-Saharan Africa (SSA), due to limited resources, insufficient training, and behavioral challenges. Simulation-based education offers a promising approach to enhance technical and non-technical skills in safe learning environments, promoting behavioral change and patient safety. This study aimed to develop and pilot a contextually adapted hand hygiene simulation-based learning scenario for nursing students in SSA. Grounded in the Medical Research Council (MRC) Framework and Design-Based Research principles, a multidisciplinary team from European and African higher education institutions (HEIs) co-created this scenario, integrating international and regional hand hygiene guidelines. Two iterative pilot cycles were conducted with expert panels, educators, and students. Data from structured observation and post-simulation questionnaires were analyzed using descriptive statistics. The results confirm the scenario’s feasibility, relevance, and educational value. The participants rated highly the clarity of learning objectives (M = 5.0, SD = 0.0) and preparatory materials (M = 4.6, SD = 0.548), reporting increased knowledge/skills and confidence and emphasizing the importance of clear roles, structured facilitation, and real-time feedback. These findings suggest that integrating simulation in health curricula could strengthen HAI prevention and control in SSA. Further research is needed to evaluate long-term outcomes and the potential for wider implementation. Full article

Because of their substantial weight and high centers of gravity, commercial vehicles require braking systems that ensure maximum performance and safety. Accurate braking control is vital for preserving safe vehicle dynamics by preventing lateral instability due to excessive deceleration or rear-wheel lock-up. Considering the growing demand for safety in medium-duty commercial vehicles, we introduce a rule-based dynamic braking controller for pneumatic electronic parking brake (EPB) systems. The proposed system is established using a model-based design (MBD) framework involving a V-cycle development process. The rule-based controller is designed to control the braking force based on wheel slip, thereby ensuring both adequate braking distance and lateral stability during emergency braking. Simulations and real-vehicle tests confirmed that the proposed control strategy can maintain lateral stability across varying loading and road-surface conditions. The results highlight the dynamic braking capability of the proposed pneumatic EPB system and its feasibility as an emergency braking solution. The effectiveness of the proposed controller in preventing wheel lock supports the use of MBD for developing safety-aware controllers. Full article

Background/Objectives: Hypodermoclysis has gained increasing recognition as a safe, effective, and minimally invasive method for administering medication and fluids in palliative care. Despite its advantages, its adoption remains limited, primarily due to a lack of structured training resources for healthcare professionals. This study aimed to develop and validate an educational tool for training clinical nurses in hypodermoclysis administration in palliative care. Methods: This is a methodological study with a multi-methods approach. Study development involved a needs assessment with 48 professionals, a literature review, and the creation of a manual enriched with visual aids. Results: The material was validated by expert judges, technical reviewers, and the target audience. Organized into 21 chapters, the manual comprehensively addresses technical, theoretical, and ethical dimensions of the practice. Content validation by 14 experts yielded an outstanding global Content Validity Index (CVI) of 0.95. An independent evaluation of visual design by four communication specialists produced consistently high scores (91–96%), classifying the material as “superior” in quality. Feedback from target users (12 nurses) highlighted the manual’s clarity, applicability, and relevance. All constructive suggestions were incorporated into the final version. Conclusions: The resulting manual demonstrates strong validity as an educational resource, with significant potential to standardize and enhance hypodermoclysis training in palliative nursing, promoting both safety and humanized care. Full article

This review explores the therapeutic promise of natural compounds in modulating 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), a key enzyme in cholesterol synthesis. HMGCR dysregulation is implicated in dyslipidemia, cardiovascular disease, and cancer, conditions linked to oxidative stress. While statins inhibit HMGCR, their side effects necessitate exploring alternatives. The review highlights various natural compounds—flavonoids, phenolic acids, stilbenes, and herbal formulations—with HMGCR-modulating and antioxidant capabilities. In vitro and in vivo studies suggest these compounds offer a promising avenue for treating HMGCR-related conditions. Synergistic effects are observed when combining natural products with statins, hinting at combination therapies that could lower statin dosages and reduce adverse effects. Natural HMGCR modulators hold therapeutic promise but face hurdles like limited in vivo data, regulatory issues, variability in composition, potential drug interactions, and safety concerns. Future research must prioritize comprehensive mechanistic studies, standardized preparations, and well-designed clinical trials. Overcoming these challenges through rigorous science is essential for integrating natural HMGCR modulators into clinical practice and improving patient outcomes in a safe and effective manner. Specifically, clinical trials should consider combination therapies and comparison with standard treatments like statins. More research is also needed on optimal dosages and treatment regimens. Full article

Objectives: Anagrelide, an oral phosphodiesterase-3 inhibitor, is widely used to treat thrombocythemia. Evaluating the bioequivalence of low-dose formulations is essential to ensure consistent therapeutic outcomes while minimizing adverse effects, particularly cardiovascular events such as palpitations, tachycardia, and potential arrhythmias, which are known concerns with anagrelide therapy. This study aimed to compare the pharmacokinetics and bioavailability of a newly developed 0.5 mg anagrelide capsule with the reference product under fasting conditions y. Materials and Methods: In a randomized, open-label, two-period crossover design, 42 healthy Turkish male volunteers received a single oral dose (0.5 mg) of either the test or reference anagrelide capsule, with a seven-day washout period between treatments. Serial blood samples were collected over a 10 h post-dose period. Plasma concentrations of anagrelide were analyzed using a validated LC-MS/MS method. Key pharmacokinetic parameters (AUC₀–t, AUC₀–∞, Cmax, tmax, λz, t½, AUC–extrapol) were calculated and subjected to ANOVA-based bioequivalence analysis. Results: A total of 42 healthy male participants (mean age: 34.1 ± 8.9 years; BMI: 25.7 ± 2.9 kg/m²) completed the study without any protocol deviations. Pharmacokinetic analysis demonstrated that the test and reference formulations of anagrelide 0.5 mg were bioequivalent. The mean AUC₀–t values were 4533.3 ± 2379.3 pg·h/mL for the test formulation and 4515.0 ± 2392.3 pg·h/mL for the reference (p > 0.05), while the mean Cmax values were 1997.1 ± 1159.2 pg/mL and 2061.3 ± 1054.0 pg/mL, respectively (p > 0.05). The 90% confidence intervals for the geometric mean ratios of AUC₀–t (94.09–104.75%), Cmax (85.62–104.03%), and AUC₀–∞ (94.50–105.10%) were all within the predefined bioequivalence range of 80–125%, with corresponding point estimates of 99.28%, 94.37%, and 99.66%, respectively. Intra-subject variability was 14.68% for AUC₀–t and 26.98% for Cmax. No statistically significant differences were observed between the formulations for any of the primary or secondary pharmacokinetic parameters (ANOVA, p > 0.05). Regarding safety, 13 treatment-emergent adverse events were reported in 11 participants (26.2%), mostly moderate-intensity headaches, all of which resolved without complications. No serious adverse events occurred, confirming the tolerability of both formulations. Conclusions: This study demonstrates that the test and reference formulations of low-dose 0.5 mg anagrelide are bioequivalent under fasting conditions, with similar safety and tolerability profiles. The findings support the use of the test product as a safe and effective alternative. Full article

Artificial intelligence (AI) is playing an increasingly important role in driving sustainable change across coastal and marine environments. Artificial intelligence offers strong support for environmental decision-making by helping to process complex data, anticipate outcomes, and fine-tune day-to-day operations. In busy coastal zones such as the Mediterranean where tourism and boating place significant strain on marine ecosystems, AI can be an effective means for marinas to reduce their ecological impact without sacrificing economic viability. This research examines the contribution of artificial intelligence toward the development of environmental sustainability in marina management. It investigates how AI can potentially reconcile economic imperatives with ecological conservation, especially in high-traffic coastal areas. Through a focus on the impact of social and technological context, this study emphasizes the way in which local conditions constrain the design, deployment, and reach of AI systems. The marinas of Ibiza and Monaco are used as a comparative backdrop to depict these dynamics. In Monaco, efforts like the SEA Index^® and predictive maintenance for superyachts contributed to a 28% drop in CO₂ emissions between 2020 and 2025. In contrast, Ibiza focused on circular economy practices, reaching an 85% landfill diversion rate using solar power, AI-assisted waste systems, and targeted biodiversity conservation initiatives. This research organizes AI tools into three main categories: supervised learning, anomaly detection, and rule-based systems. Their effectiveness is assessed using statistical techniques, including t-test results contextualized with Cohen’s d to convey practical effect sizes. Regression R² values are interpreted in light of real-world policy relevance, such as thresholds for energy audits or emissions certification. In addition to measuring technical outcomes, this study considers the ethical concerns, the role of local communities, and comparisons to global best practices. The findings highlight how artificial intelligence can meaningfully contribute to environmental conservation while also supporting sustainable economic development in maritime contexts. However, the analysis also reveals ongoing difficulties, particularly in areas such as ethical oversight, regulatory coherence, and the practical replication of successful initiatives across diverse regions. In response, this study outlines several practical steps forward: promoting AI-as-a-Service models to lower adoption barriers, piloting regulatory sandboxes within the EU to test innovative solutions safely, improving access to open-source platforms, and working toward common standards for the stewardship of marine environmental data. Full article

Spatially intersecting roadways in mines are prone to stress concentration due to disturbances during mining operations, which significantly affects the stability of the inter-roadway surrounding rock between the roadways. Analyzing the stability of underlying roadways under the influence of disturbances from overlying roadways, as well as enhancing the stability of the inter-roadway surrounding rock, is critical for ensuring safe and efficient mining operations. Based on the geological conditions at the spatial intersection of the 5⁻¹ Coal Auxiliary Transportation Roadway and the 5⁻² Coal Auxiliary Transportation Roadway in the Hengliao Coal Mine, this study investigates the deformation and failure characteristics of the surrounding rock between roadways under dynamic loading. A stability criterion equation for the inter-roadway surrounding rock is established using the limit equilibrium method. Furthermore, numerical simulations are conducted to analyze the stress–strain distribution in the surrounding rock and supporting structures at the intersection area of the 5⁻¹ roadway under the dynamic loading conditions induced by trackless rubber-tired vehicle operation in the 5⁻² roadway. Field applications demonstrate that the proposed combined support scheme effectively controls roadway deformation and ensures the stability of the rock mass between roadways. This study provides valuable insights for stability assessment and support design of spatially intersecting roadways. Full article

This study proposes an equivalent furniture fire model based on standard combustible assembly and verifies its feasibility as a substitute for real furniture through full-scale experiments and numerical simulations. Experiments show that the peak heat release rate and total heat release of the standard combustible assembly are highly consistent with those of the single-seat sofa. The numerical model has been verified by experimental data. The dynamic characteristics of the heat release rate (HRR) curve are consistent with the temperature evolution process, confirming its reliability for the numerical model. The research on optimizing fire extinguishing parameters is carried out based on this numerical simulation. The results show that the response time of the horizontal sprinkler is 22 s shorter than that of the vertical sprinkler, and the fire extinguishing efficiency is improved. Reducing the sprinkler height to 3 m can accelerate activation and reduce CO₂ release. A flow rate of 91.4 L/min can effectively control the fire, but when it exceeds 150 L/min, the fire extinguishing efficiency is significantly reduced. The low response time index sprinkler starts up 88 s faster than the standard type, significantly enhancing the initial fire suppression capability. This scheme provides a safe, economical, and repeatable standardized combustible assembly for fire training and offers theoretical support for the parameter design of intelligent fire extinguishing systems. Full article

Background: Temporomandibular joint (TMJ) injections and arthrocentesis are commonly used minimally invasive methods for treating temporomandibular disorders (TMDs). Although considered safe, they can cause neurological complications. The aim of this systematic review was to synthesize all identified evidence for neurological adverse events following intra-articular TMJ interventions. Methods: This review was based on a systematic search with BASE, DOAJ, PubMed, SciELO, and Semantic Scholar on 28 May 2025. It included primary studies involving patients diagnosed with TMDs who underwent intra-articular injections into the TMJ or were treated with arthrocentesis, and in whom neurological adverse effects associated with the intra-articular intervention were reported. Studies reporting non-specific symptoms or unrelated systemic conditions were excluded. The risk of bias was assessed using the Joanna Briggs Institute’s critical appraisal tools. Results were presented in summary tables. Results: The search yielded five eligible studies comprising 319 patients, of whom 320 neurological adverse events were reported. Included studies comprised a randomized controlled trial, two retrospective studies, and two case reports. Four studies had a low risk of bias, and one had a moderate risk of bias according to the Joanna Briggs Institute appraisal tools. The proportion of patients affected ranged from 14% to 65% depending on the study design and intervention type. The most common adverse event was transient facial nerve (cranial nerve VII) paralysis, mainly involving the temporal and zygomatic branches. Less commonly reported complications involved the trigeminal nerve branches (V1, V3). There is also a single case of epidural hematoma with palsy of the oculomotor nerve (III). Most symptoms resolved spontaneously within a few hours to a few days. The use of local anesthesia and large volumes of irrigation (60 mL) during arthrocentesis increases the risk of complications. Attempts to explain the mechanisms of complications include local anesthetic diffusion, compression neuropraxia due to lavage fluid leakage, and corticosteroid neurotoxicity. One of the limitations of the study is the scarcity of data. Conclusions: Although most adverse events are mild and reversible, these findings highlight that precise, real-time guided injection and careful control of lavage volumes can minimize extra-articular spread of anesthetics or fluids, thereby reducing the likelihood of neurological complications. This study received no funding. PROSPERO ID number: CRD420251088170. Full article

The design of automatic control systems is critical for ensuring safety in gas field surface engineering production. However, over-reliance on standardized design approaches within the context of automation technology can compromise system flexibility and neglect individualized cost-effectiveness considerations. This paper identifies a comprehensive evaluation method as the preferred approach for assessing station control systems by comparing the advantages and disadvantages of various common evaluation techniques. We propose an integrated semi-quantitative and quantitative evaluation method designed to comprehensively and accurately assess the effectiveness of station automatic control systems. For the semi-quantitative framework, we first establish a specific indicator system for the control system and employ the Analytic Hierarchy Process (AHP) to determine indicator weights tailored to different station types, achieving a scientific quantification of evaluation criteria. Additionally, we utilize quantitative calculation methods, specifically reliability and availability analyses, to evaluate the station’s automatic control system. Differential research is conducted to customize the evaluation based on the distinct process characteristics of various gas field stations. Differential design calculations and analyses were performed for a single station, improving the economy and adaptability of the automatic control system design. The proposed comprehensive evaluation method ensures the safe and stable operation of control system designs and provides a new approach for the automation and intelligent transformation of gas field surface engineering. Full article

When a building normally used for exhibitions is converted into a Fangcang shelter hospital in emergency situations, its original space combination, functional flow line, and safety exits are significantly changed. When the building becomes densely populated, if an accident such as a fire, explosion, or earthquake occurs, then safe evacuation will be a serious challenge. This study systematically considers the characteristics of the building space and functional flow line after the conversion of an exhibition building to a Fangcang shelter hospital. Pathfinder software was used to simulate representative scenarios of a Fangcang shelter hospital and to analyze the main spatial factors affecting evacuation efficiency in terms of evacuation time, spatial congestion characteristics, and the exits used by personnel. Then, a targeted design optimization strategy was proposed based on the accessibility of safety exits and the internal space layout of the building. Finally, a simulation was used to verify the effectiveness of the design strategy. The results of this study provide solid theoretical support and methodological guidance for the spatial arrangement of exhibition buildings converted into Fangcang shelter hospitals so as to effectively improve the efficiency of safe evacuation and promote the resilience and safety of exhibition buildings. Full article

With growing global attention on animal welfare and food safety, humane and efficient slaughtering methods in the poultry industry are in increasing demand. Traditional manual inspection methods for stunning broilers need significant expertise. Additionally, most studies on electrical stunning focus on white broilers, whose optimal stunning conditions are not suitable for red-feathered Taiwan chickens. This study aimed to implement a smart, safe, and humane slaughtering system designed to enhance animal welfare and integrate an IoT-enabled vision system into slaughter operations for red-feathered Taiwan chickens. The system enables real-time monitoring and smart management of the poultry stunning process using image technologies for dynamic object tracking recognition. Focusing on red-feathered Taiwan chickens, the system applies dynamic tracking objects with chicken morphology feature extraction based on the YOLO-v4 model to accurately identify stunned and unstunned chickens, ensuring compliance with animal welfare principles and improving the overall efficiency and hygiene of poultry processing. In this study, the dynamic tracking object recognition system comprises object morphology feature detection and motion prediction for red-feathered Taiwan chickens during the slaughtering process. Images are firsthand data from the slaughterhouse. To enhance model performance, image amplification techniques are integrated into the model training process. In parallel, the system architecture integrates IoT-enabled modules to support real-time monitoring, sensor-based classification, and cloud-compatible decisions based on collections of visual data. Prior to image amplification, the YOLO-v4 model achieved an average precision (AP) of 83% for identifying unstunned chickens and 96% for identifying stunned chickens. After image amplification, AP improved significantly to 89% and 99%, respectively. The model achieved and deployed a mean average precision (mAP) of 94% at an IoU threshold of 0.75 and processed images at 39 frames per second, demonstrating its suitability for IoT-enabled real-time dynamic tracking object recognition in a real slaughterhouse environment. Furthermore, the YOLO-v4 model for poultry slaughtering recognition in transient stability, as measured by training loss and validation loss, outperforms the YOLO-X model in this study. Overall, this smart slaughtering system represents a practical and scalable application of AI in the poultry industry. Full article

The accelerating threat of antimicrobial resistance (AMR) demands transformative strategies that go beyond conventional antibiotic therapies. Nanoparticles (NPs) have emerged as versatile antimicrobial agents, offering a combination of physical, chemical, and immunological mechanisms to combat multidrug-resistant (MDR) pathogens. Their small size, surface tunability, and ability to disrupt microbial membranes, generate reactive oxygen species (ROS), and deliver antibiotics directly to infection sites position them as powerful tools for infection control. This narrative review explores the major classes, mechanisms of action, and biomedical applications of antimicrobial NPs—including their roles in wound healing, implant coatings, targeted drug delivery, inhalation-based therapies, and the treatment of intracellular infections. We also highlight the current landscape of clinical trials and evolving regulatory frameworks that govern the translation of these technologies into clinical practice. A distinctive feature of this review is its focus on the interplay between NPs and the human microbiota—an emerging frontier with significant implications for therapeutic efficacy and safety. Addressing this bidirectional interaction is essential for developing microbiota-informed, safe-by-design nanomedicines. Despite promising advances, challenges such as scalability, regulatory standardization, and long-term biosafety remain. With interdisciplinary collaboration and continued innovation, antimicrobial NPs could reshape the future of infectious disease treatment and help curb the growing tide of AMR. Full article

Background/Objectives: Lower urinary tract symptoms (LUTSs) due to benign prostatic obstruction (BPO) represent a common condition affecting aging men. Transurethral resection of the prostate represents the gold standard surgical treatment but is not without complications such as retrograde ejaculation, bleeding and urinary retention. The temporary implantable nitinol device (iTIND) is considered a minimally invasive surgical technique, designed to treat LUTS while preserving erectile and ejaculatory function. Herein we report the results of a multi-center, real-world assessment of the iTIND procedure. Methods: Data from five international centers treating LUTS with the iTIND device were collected. We recorded changes through an International Prostatic Symptom Score (IPSS) questionnaire with Quality of Life (QoL), International Index of Erectile Function (IIEF5) questionnaire, antegrade ejaculatory function, maximum flow (QMax), post voiding residual volume (PVR) and freedom from repeat intervention. Results: A total of 74 subjects were enrolled; median follow-up was 12 months. IPSS and QoL changed from a median of 23 and 4 points at baseline to 11 and 2 points, respectively, at the last follow-up. A mean improvement in Qmax and PVR from 9 mL/s and 56 mL at baseline to 13 mL/s and 40 mL was noticed at the last follow-up. Total median operative time was 10 min, and the median time of iTIND indwell time was 7 days. The median device removal time was 5 min. There were no changes in IIEF5 scores and antegrade ejaculation rate. No intraoperative complications were reported, and non-serious postoperative complications occurred in six patients (two urinary retention, two mild haematuria, two urinary tract infection). Finally, four patients underwent reoperation during the follow-up period. All procedures were performed as outpatient day cases. Conclusions: Our results confirms that treatment with the iTIND is effective and safe in terms of improving urinary symptoms and quality of life without impacting sexual function. Longer follow-up is required to better define the durability of this minimally invasive procedure. Full article