Search Results (142)

Background: Acute cholecystitis affects approximately 200,000 hospitalizations annually in the United States, and emergency cholecystectomy is its definitive treatment. Whether weekend hospital admission, which is often associated with reduced staffing and diagnostic resources, adversely affects surgical outcomes in this population is unclear. We evaluated the association between weekend hospital admission and in-hospital mortality and key secondary outcomes following emergency cholecystectomy. Methods: This retrospective cohort study used the National Inpatient Sample (NIS) from January 2018 through December 2022. Adults (≥18 years) with acute cholecystitis (identified by ICD-10-CM codes) who underwent nonelective cholecystectomy (identified by ICD-10-PCS codes) were included; elective admissions, pediatric patients, and admissions with missing discharge weights were excluded. The analytic cohort comprised 194,787 unweighted admissions, representing a weighted national estimate of approximately 973,935 hospitalizations. Weekend admission was defined as admission on Saturday or Sunday (vs. Monday through Friday). The primary outcome was in-hospital mortality. Secondary outcomes, defined from secondary (not principal) diagnosis fields and interpreted as coded in-hospital diagnoses, included prolonged length of stay (>75th percentile), sepsis, surgical site infection, bile duct injury, venous thromboembolism, respiratory failure, acute kidney injury, blood transfusion, and cardiac complications. Multivariable logistic regression with hospital-year cluster-robust standard errors was used, adjusting for pre-exposure patient and hospital characteristics; the Benjamini–Hochberg false discovery rate was applied across secondary outcomes. Results: Among 194,787 admissions (weekday, 73.2%; weekend, 26.8%), in-hospital mortality was 0.62% in weekday and 0.53% in weekend patients. After adjustment, weekend admission was not associated with in-hospital mortality (aOR 0.87; 95% CI, 0.75–1.00; p = 0.06). Weekend admission was associated with modestly lower odds of prolonged length of stay (aOR 0.90; 95% CI, 0.88–0.93; p < 0.001). Weekend admission was not associated with sepsis (5.3% vs. 5.3%; aOR 1.01; 95% CI, 0.96–1.06; p = 0.65), respiratory failure (aOR 1.05; 95% CI, 1.00–1.10; p = 0.06), overall complications, or the remaining secondary outcomes after correction for multiple comparisons. Findings were consistent across design-based survey-weighted, inverse-probability-weighted, transfer-excluded, and principal-diagnosis sensitivity analyses. Conclusions: Weekend admission was not associated with higher in-hospital mortality or with a higher risk of sepsis following emergency cholecystectomy in the United States; weekend patients had modestly shorter hospital stays. These findings provide no evidence of higher coded in-hospital mortality or coded in-hospital complications among weekend admissions in contemporary US practice. Full article

Cardiovascular disease remains the leading global health challenge, claiming approximately 19.8 million lives annually. The convergence of wearable technology and artificial intelligence represents a transformative shift in cardiovascular healthcare, enabling continuous real-time monitoring beyond conventional clinical settings. This narrative review synthesises current evidence on integrating consumer-grade and medical-grade wearable devices with AI algorithms for continuous cardiovascular monitoring applications, with particular attention to real-world translational applicability and global health equity. This review examined the technological landscape of wearable cardiovascular monitoring devices, including smartwatches with photoplethysmography and electrocardiogram capabilities, continuous cardiac monitoring patches, and emerging biosensor technologies. Also, the review explored AI methodologies, particularly machine learning and deep learning architectures, employed in processing complex physiological data streams from these devices. Clinical applications demonstrate impressive capabilities: arrhythmia detection with sensitivity rates exceeding 98%, continuous blood pressure monitoring through cuffless technologies, heart failure decompensation prediction, and cardiovascular risk stratification. However, substantial challenges persist, including data quality assurance, algorithm interpretability, regulatory compliance, and seamless clinical workflow integration. Privacy concerns, health disparities in algorithm performance, and the need for robust validation across diverse populations remain critical considerations. AI-enhanced wearable systems hold considerable potential for shifting cardiovascular care from reactive treatment paradigms towards predictive, preventive, and precision medicine approaches. Future directions include edge computing architectures, federated learning approaches, personalised AI models, enhanced interoperability with electronic health records, and expansion to resource-limited settings, ultimately improving patient outcomes whilst reducing healthcare costs. Full article

Background: Respiratory failure (RF) is a frequently fatal complication of chronic liver disease (CLD), yet population-level data on RF-related mortality trends among adults with CLD are lacking. This study characterized temporal trends and demographic disparities in RF-related mortality among U.S. adults with CLD from 1999 to 2024. Methods: Death certificate data were obtained from the CDC WONDER database for adults aged ≥25 years with both RF (ICD-10: J96) and CLD (ICD-10: K70–K76) listed as an underlying or contributing cause of death. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Joinpoint regression identified temporal inflection points and annual percentage change (APC). Results: Among 241,075 deaths, the overall AAMR increased 3.2-fold from 2.237 (1999) to 7.162 (2021) per 100,000, then declined to 6.132 by 2024. Joinpoint analysis identified four segments: moderate increase (1999–2006; APC +2.40%), accelerated increase (2006–2018; APC +5.37%), late acceleration period (2018–2021; APC +13.10%), and post-pandemic decline (2021–2024; APC −4.32%; all p < 0.001). The 2024 AAMR remained 174.2% above baseline. The male-to-female rate ratio narrowed from 2.02 to 1.50, with females showing steeper acceleration (+14.38% vs. +12.36%). American Indian or Alaska Native individuals had the highest AAMRs and the most dramatic surge (APC +26.90%). Rural areas surpassed urban AAMRs by 2020, with steeper post-2007 acceleration (+8.74% vs. +5.51%). The Western U.S. consistently had the highest regional rates. Younger adults aged 25–34 and 35–44 showed 2.96-fold and 2.37-fold increases in crude mortality rates, respectively. Approximately 80% of deaths occurred in inpatient settings. Conclusions: RF-related mortality among U.S. adults with CLD increased more than threefold from 1999 to 2021, with a dramatic surge followed by incomplete decline. Persistent disparities by sex, race/ethnicity, urbanization, and region highlight the need for targeted interventions, including expanded screening for alcohol-associated and metabolic liver disease and improved access to hepatology services in underserved communities. Full article

Electric vehicle (EV) transport by ship is expanding beyond industrial logistics centred on automobile production, trade, and pure car and truck carriers (PCTCs) into daily transportation for island tourism, commuting, and essential mobility. According to Korea Maritime Transportation Safety Authority (KOMSA) vessel status data as of March 2026, 104 of 146 domestic passenger ships were car-ferry passenger ships, accounting for 71.2% of the fleet and operating on 75 of 99 designated routes nationwide. Korea Shipping Association (KSA) operational records show that the EV transport rate on these routes increased from 0.76% in 2024 to 1.21% in 2025, with some routes exceeding 2.0–4.7%. Unlike enclosed multi-deck PCTC vehicle spaces, Korean coastal car-ferry passenger ships generally have single-tier open vehicle decks and bow ramp gates. Crosswinds on open decks may reduce smoke detector activation probability by 60–75%. Although Article 97 of the Standard for Ship Fire-Fighting Appliance newly requires dedicated EV fire-fighting equipment for car-ferry ships, it remains primarily equipment-prescriptive and does not yet provide open-deck-specific performance requirements for wind-resistant detection, fixed EV-zone cooling, EV-designated stowage arrangements, or passenger–operator safety management obligations. This study applies the five-step International Maritime Organization (IMO) Formal Safety Assessment (FSA) procedure to support improvements to EV fire-fighting equipment standards for coastal car-ferry passenger ships. Hazard identification (HAZID) was conducted with a 15-member advisory panel, and probability elicitation was performed through a Delphi survey with 10 core experts, showing strong consensus (Kendall’s W = 0.74, p < 0.01). Fault tree analysis (FTA) and event tree analysis (ETA) probabilities were derived from the Delphi results and the international literature. H-07, representing wind-induced smoke dilution, was identified as the dominant single-point vulnerability within the detection-failure branch. Monte Carlo-based FTA–ETA analysis (n = 10,000) estimated annual fire frequencies of 5.9 × 10⁻², 1.8 × 10⁻¹, and 2.9 × 10⁻¹ yr⁻¹ at EV loading ratios of 10%, 30%, and 50%, respectively, with 2.47 expected fatalities per fire. Risk entered the IMO ALARP band above a 30% EV loading ratio and exceeded the maximum tolerable crew risk above 50%. The combined application of risk control options (RCOs) 2, 3, and 4 reduced annual expected fatalities by 85.6%. Based on these results, six RCOs and institutional recommendations are proposed, including strengthened safety management obligations for passenger ship operators. Full article

Neospora caninum is a major cause of reproductive failure in cattle, responsible for epidemic abortion outbreaks that inflict annual billion-dollar losses on the global livestock industry. In water buffaloes (Bubalus bubalis), however, a phylogenetically close relative often raised in the same environments, the same parasite typically establishes a subclinical persistent infection with markedly lower rates of clinical abortion. This review inverts the traditional narrative by arguing that the key to next-generation control strategies lies in understanding the tolerant host (buffalo) rather than solely the susceptible host (cattle). By dissecting this “Neospora paradox”, we explore the molecular and immunological crosstalk that dictates pregnancy outcomes. We examine the parasite’s invasion proteins, revealed by CRISPR-Cas9 screens, and the maternal–fetal interface, where the balance between immune tolerance and parasite control determines the fate of pregnancy. We also compare N. caninum with the related zoonotic parasite Toxoplasma gondii to highlight how differential host immune recognition shapes infection outcomes. Finally, we propose that deciphering the buffalo’s successful equilibrium with N. caninum can illuminate novel pathways for vaccines and immunotherapeutic strategies, transforming the management of neosporosis worldwide. Full article

Tailings storage facility (TSF) failures have caused severe casualties and economic losses. This study used Enhanced Small Baseline Subset InSAR (E-SBAS-InSAR) and 88 Sentinel-1A images to retrieve the 2022–2024 surface deformation time series of the Shiguilong TSF, located in the Fe–Cu polymetallic metallogenic belt of the middle–lower Yangtze River. The reliability of the results was assessed through consistency comparisons with Small Baseline Subset InSAR (SBAS-InSAR) and Persistent Scatterer InSAR (PS-InSAR). A time-series decomposition model was applied to extract seasonal deformation components and analyze their lagged responses to temperature and intense rainfall events. The results show that: (1) E-SBAS-InSAR achieved a monitoring-point density nearly 7 times higher than SBAS-InSAR, enabling dense and long-term deformation characterization; (2) subsidence at Shiguilong continued to increase, with cumulative subsidence reaching −76.8 mm and a maximum annual mean subsidence rate of −22.78 mm/yr; (3) deformation was mainly controlled by long-term consolidation of loose tailings and creep of dam–tailings materials, while seasonal factors induced stage-dependent fluctuations; (4) seasonal deformation showed lagged responses of 6 days to temperature variations and 2 days to intense rainfall events, with rainfall exerting a more pronounced influence. This work is significant for TSFs monitoring under complex surface conditions. Full article

Background/Objectives: the study aims to evaluate early outcomes of endovascular aneurysm repair (EVAR) using the ultra-low-profile Minos^TM Abdominal Aortic Stent-Graft in elective and emergent infrarenal abdominal aortic aneurysm (AAA), and compare its performance with established EVAR devices. Methods: This retrospective single-centre study included 79 patients treated with the Minos stent-graft between September 2020 and August 2024. Primary endpoints were 30-day mortality and major adverse events (MAEs). Secondary outcomes included technical success, endoleak rates, sac dynamics, reintervention rates, and stent-graft patency. Imaging follow-up was performed on day 1, at 4–6 weeks, at 6–12 months, and annually thereafter. Results: The cohort (mean age 74.6 ± 8.2 years; 83.5% male) included 60 elective and 19 emergent cases, with high cardiovascular comorbidity and challenging anatomy (48.1% with iliac diameters < 7 mm and 16.5% < 5 mm; 20.3% hostile necks). Technical success rate was 93.7% (elective: 95.0%; emergent: 89.5%). Persistent endoleaks occurred in 14.0% of patients (type II 12.7%, type I 1.3%). Clinical success was achieved in 88.6% (elective: 90.0%; emergent: 84.2%). Six-month survival was 96.1% in the elective and 89.5% in the emergent cohort. MAEs were more frequent in emergent cases: acute kidney failure (31.6% vs. 3.3%; p = 0.004) and pneumonia (31.6% vs. 0.0%; p < 0.001). Mean follow-up was 12.5 ± 9.9 months (median 9.3). Reinterventions were required in 16.5% within 30 days, more frequently in emergent cases (31.6% vs. 11.7%, p = 0.041). Sac regression ≥5 mm occurred in 43.0%. No stent-graft migrations or infections were reported. Conclusions: Minos demonstrated reliable performance and safety in elective and emergent EVAR with excellent anatomical applicability due to its ultra-low-profile design. Full article

Software aging and the corresponding need for system rejuvenation are well-established concepts in computer science. As virtualization technologies are increasingly adopted within electric power utility infrastructures, early investigation into Software Aging and Rejuvenation (SAR) models, aging indicators, and empirical data collection becomes essential. Given the critical role of the electric power grid and the high dependability requirements of the protection and control systems that support its operation, proactive research in this area is timely and necessary. Motivated by this need, this work proposes a hierarchical framework that integrates an SAR model into the Reliability Block Diagram (RBD) representation of a Digital Substation Automation System (DSAS). The analysis shows that, for the selected parameter set, incorporating SAR into the VPAC reliability model results in higher estimated failure rates and increased annual downtime relative to hardware-only models. When combined with substation primary system indices, however, the overall reliability indices remain largely unchanged, aside from reduced outage duration attributed to improved switching performance enabled by the DSAS architecture. Further examination reveals that the limited influence of SAR is primarily due to the lack of historical failure-mode data for the secondary system. Availability of such empirical data is expected to significantly affect combined reliability indices and improve the accuracy of reliability evaluations. This highlights the importance of systematic data collection and aging-indicator analysis as utility infrastructures transition toward virtualized and software-dependent architectures. Full article

Articular cartilage defects affect millions of patients annually and pose one of the most persistent challenges in orthopedic surgery, owing to the tissue’s inherent avascular and alymphatic nature. Current surgical approaches, microfracture, autologous chondrocyte implantation (ACI/MACI), and osteochondral grafting, share a common failure mode: inadequate adhesion between repair constructs and surrounding native cartilage, contributing to deterioration rates of 15–75% at five-year follow-up across all techniques. This review repositions adhesion not as a supplementary material property but as the central determinant of clinical success in cartilage repair. We systematically evaluate the biomechanical demands imposed by the joint environment and define clinically relevant adhesion thresholds. Adhesive hydrogel strategies are categorized by surgical context: microfracture augmentation, ACI/MACI enhancement, osteochondral graft integration, and standalone repair platforms. Material platforms are analyzed across catechol/dopamine systems, NHS ester chemistry, photocrosslinkable hydrogels, supramolecular approaches, and multi-mechanism hybrids. Injectable formulations for arthroscopic delivery are critically examined alongside key translational barriers, including fatigue durability, biocompatibility–adhesion trade-offs, sterilization compatibility, batch variability, and regulatory classification ambiguity. Future directions encompass 4D bioprinting, AI-guided formulation optimization, and stimuli-responsive reversible adhesion systems. Adhesive hydrogels represent the missing link that current cartilage repair paradigms require. Full article

Iron ore mining requires the surrounding rock to be excavated, and the beneficiation process generates tailings. When used as construction aggregates, these materials can cause concrete to crack due to the presence of pyrite. Currently, there are no established technical methods to prevent damage caused by pyrite, which limits the resource recovery of such solid waste. In this study, we selected the surrounding rock and tailings to serve as coarse or fine aggregates for C50 concrete based on standard engineering mix proportions. We found that surface-exposed pyrite on aggregates oxidizes first to form ettringite, triggering expansion, with the expansion rate positively correlated with the surface-exposed pyrite content. The deformation process was quantitatively characterized using the Arrhenius equation and by analyzing the acceleration effect of temperature on expansion, yielding an apparent activation energy of 8.28–9.47 kJ/mol. Using a 0.04% expansion value as the failure criterion, the results indicate that at an annual average temperature of 20 °C, C50 concrete with surface-exposed pyrite introduced by concrete aggregates exceeding 20 kg/m³ will fail within its service life. Full article

Transcatheter Aortic Valve Replacement (TAVR) has transformed aortic stenosis management across the full risk spectrum, but expansion into younger populations makes valve failure and reintervention central to lifetime planning. There are two pathways to follow when TAVR fails: redo transcatheter implantation and surgical explantation with surgical aortic valve replacement (SAVR), termed TAVR-SAVR. This narrative review synthesizes evidence from four studies (35,677 patients, 2011–2024) examining the association between prior valve type and redo SAVR outcomes versus redo SAVR after prior surgical prosthesis (SAVR-SAVR). TAVR-SAVR volume grew at up to 144.6% annually, projected to surpass SAVR-SAVR by approximately 2029 based on linear extrapolation from limited registry and single-center data. Operative mortality was 12.3–17% in TAVR-SAVR versus 1.1–9% in SAVR-SAVR, persisting after propensity matching in both comparative studies (11.3% vs. 6.7%, OR 1.7; and 12.0% vs. 1.1%, OR 12.5). Observed-to-expected mortality ratios exceeded 1.0 across all risk strata, including low-risk patients (O/E up to 5.48), while SAVR-SAVR demonstrated a remarkably low ratio of 0.22–0.33. Renal failure, failure to rescue, and prolonged ventilation were significantly higher following TAVR-SAVR; stroke and pacemaker rates were comparable. Paradoxically, shorter bypass and cross-clamp times in TAVR-SAVR despite worse outcomes are consistent with cumulative organ injury, rather than operative complexity, as a predominant contributor to excess mortality, though this mechanistic explanation remains hypothetical. STS risk models, developed for standard surgical populations, showed limited applicability in this population, with observed mortality consistently exceeding predicted values. These findings raise important considerations regarding TAVR-first strategies in operable patients aged 65–80 years, although causality cannot be established from observational data alone. In the era of expanding TAVR indications, the legacy of the first valve cannot be ignored. Full article

Objectives: To evaluate the effectiveness and durability of matrix-associated autologous chondrocyte implantation with periosteal flap (pMACI) in treating knee cartilage defects using clinical scores and MRI evaluations. Methods: Data were collected from 37 knees of 17 patients, with a mean follow-up of 5 years (range: 0.1–20 years). Clinical outcomes were assessed using the Lysholm Knee Scoring Scale (LKS) and Knee Injury and Osteoarthritis Outcome Score (KOOS). Tissue quality was quantitatively evaluated using MRI T1ρ and T2 mapping (biochemical) and MR observation of cartilage repair tissue: MOCART 2.0 (morphological). A linear mixed model was used to identify factors affecting outcomes, including etiology (trauma, OCD, OA), graft site, and defect size. Results: At the 20-year follow-up, clinical scores remained significantly improved from baseline (mean LKS: 55.6 to 86.5; KOOS: 37.8 to 70.8). The biochemical MRI parameters (T1ρ and T2 values) stabilized at levels comparable to native cartilage across all etiologies and sites (p = 0.326 and 0.412, respectively), indicating stable long-term tissue quality. In contrast, the MOCART 2.0 scores significantly declined over time (annual rate: −1.14 points; p < 0.001). Etiology was a significant factor; the OA group showed significantly lower clinical and MOCART scores compared to the trauma/OCD groups (p < 0.05). However, no significant differences were found in LKS and KOOS based on graft site (p = 0.489) or defect size (p > 0.05). Conclusions: pMACI may be a highly durable treatment capable of maintaining biological tissue quality and providing clinical benefits for two decades. The observed morphological deterioration after 20 years likely reflects joint-wide aging—especially in OA cases—rather than graft failure, highlighting the importance of long-term MRI monitoring. Full article

Seismic collapse can cause catastrophic losses, and acceptable annual collapse probability with its CMR target is a core metric in performance-based design. Existing ATC-63-based CMR research mainly addresses non-damped systems and often uses a single lumped dispersion, obscuring damper-reliability contributions and hindering alignment with CECS 392 limits. This study proposes a unified, code-consistent decision framework for acceptable annual collapse probability and CMR that jointly accounts for seismic hazard and damper-related uncertainty. The total collapse dispersion is decomposed as ${\sigma }_{\mathrm{total},\mathrm{damp}}^2={\sigma }_{\mathrm{base}}^2 +{ \sigma }_{\mathrm{damper}}^2$, where ${\sigma }_{\mathrm{b}\mathrm{a}\mathrm{s}\mathrm{e}}$ represents background dispersion independent of dampers and ${\sigma }_{\mathrm{d}\mathrm{a}\mathrm{m}\mathrm{p}\mathrm{e}\mathrm{r}}$ captures incremental uncertainty induced by degradation and partial failure. A code-designed viscous-damped RC frame is evaluated under three scenarios (nominal damping, 20% damping-coefficient reduction, and 7% random damper failures). Using the same 14 records and $\mathrm{S}\mathrm{a}\left({\mathrm{T}}_1,5\%\right)$ as the intensity measure, multi-stripe IDA and Probit-based lognormal fragility fitting yield median collapse intensities $\mathrm{S}\mathrm{c}\approx 2.18-2.24 \mathrm{g}$, with only ~2–3% reduction under mild degradation/failure. A random-effects variance decomposition identifies σ_damper ≈ 0, indicating a limited marginal contribution of damper-related uncertainty within the degradation range considered in this study. Closed-form relationships between annual collapse rate, $\mathrm{S}\mathrm{c}$, and ${\sigma }_{\mathrm{t}\mathrm{o}\mathrm{t}\mathrm{a}\mathrm{l},\mathrm{d}\mathrm{a}\mathrm{m}\mathrm{p}}$ are then derived under a power-law hazard model and inverted to generate acceptable-risk intervals and CMR target curves/matrices. Results show that higher design intensity and larger ${\sigma }_{\mathrm{t}\mathrm{o}\mathrm{t}\mathrm{a}\mathrm{l},\mathrm{d}\mathrm{a}\mathrm{m}\mathrm{p}}$ demand substantially higher CMR, highlighting potential risk underestimation when relying solely on nominal CMR. The framework enables explicit identification of damper-related uncertainty from limited collapse data and provides a practical workflow for collapse-prevention design and post-assessment under explicitly defined scenario conditions, with a clear pathway for extension to broader scenario spaces. Full article

This paper investigates the optimization of maintenance strategies to improve the reliability of equipment at the Kapshagay Hydropower Plant (HPP), located in Kazakhstan. Operational data for the period 2020–2025 were analyzed to evaluate the effectiveness of existing maintenance systems. The analysis showed that the failure frequency of the main equipment averaged 3.8–4.2 events per year, while annual unplanned downtime reached 80–100 h, resulting in electricity generation losses of 2.5–3.2%. In addition, total maintenance costs were approximately 150 million KZT per year, with about 40% related to unplanned repairs. A reliability-centered maintenance model was developed using mathematical modeling and simulation tools such as Python 3.11 and SMath Solver 0.99.7920. The study integrates reliability theory, exponential failure modeling, and statistical performance analysis based on operational data from the Kapshagay HPP. Simulation-based validation was performed to compare baseline and optimized maintenance strategies under real operating conditions. After implementing the proposed model, equipment failure probability decreased by 15%, failure rate decreased by 28%, the mean time between failures increased from 120 days to 165 days, and repair duration decreased from 6 days to 4 days. Additionally, failure probability decreased from 0.10 to 0.07, while annual downtime decreased from 6.2 days to 4.1 days. Electricity generation losses decreased by approximately 18–22 GWh per year, while the annual economic benefit was estimated at 320–480 million KZTn. The results demonstrate that reliability-centered maintenance can increase equipment reliability by 20–30%, reduce maintenance costs by 10–12%, and improve electricity generation efficiency by 1.8–2.4%. The obtained results have practical significance for improving the technical and economic performance of hydropower plants. Full article

Background/Objectives: Deep endometriosis is a chronic inflammatory disease that significantly affects fertility. The objective was to evaluate the magnitude of the effect of minimally invasive nerve-sparing complete excision of endometriosis on natural conception rate in women with documented infertility. Methods: This pre-planned interdisciplinary retrospective observational study included 45 patients who wished to conceive naturally (spontaneous pregnancy) and were followed for 12 months after surgery. Results: The spontaneous conception rate was 33.3% (95% CI: 20.0–46.7) and the mean time to conception was 6.7 months. Age, body mass index, and history of infertility showed no significant differences between the success and failure spontaneous pregnancy groups, but annual income was positively associated with reproductive success (p = 0.022). None of the procedures needed to be converted to open surgery, required colostomy/ileostomy, blood transfusion or abdominal drains. No cases of urinary retention were observed across different levels of nerve preservation. In addition, the absence of serious surgical complications (Clavien–Dindo III/IV) supports the safety of this intervention for infertile patients. Conclusions: The absence of serious surgical complications in this cohort supports the concept that minimally invasive nerve-sparing complete excision of endometriosis is a safe intervention when performed by an experienced team. The results underscore the importance of exploring socioeconomic-related factors through an individualized assessment of patients who wish to conceive naturally after minimally invasive nerve-sparing surgery. Future studies focusing on personalized management of endometriosis should attempt to identify socioeconomic-related covariates that influence natural conception. Full article