Search Results (8,727)

Background and Objectives: Hysterectomy is a common non-obstetric procedure. Minimally invasive techniques, such as laparoscopy and robot-assisted surgery, have replaced open surgery for benign gynecologic conditions. Robotic surgery offers reduced blood loss and shorter hospital stays but is limited by high costs. Articulating laparoscopic instruments aim to replicate robotic dexterity cost-effectively. However, comparative data on these two approaches in hysterectomy are limited. Materials and Methods: This multicenter study analyzed the outcomes of hysterectomies for benign gynecological diseases using articulating laparoscopic instruments (prospectively recruited) and robot-assisted surgery (retrospectively reviewed). The surgeries were performed by minimally invasive gynecological surgeons in South Korea, Japan, and Taiwan. The baseline characteristics, operative details, and outcomes, including operative time, blood loss, complications, and hospital stay, were compared. Statistical significance was set at p < 0.05. Results: A total of 151 patients were analyzed, including 67 in the articulating laparoscopy group and 84 in the robot-assisted group. The operating times were comparable (114.9 vs. 119.9 min, p = 0.22). The articulating group primarily underwent dual-port surgery (79.1%), whereas the robot-assisted group required four or more ports in 71.4% of the cases (p < 0.001). Postoperative complications occurred in both groups, without a significant difference (9.0% vs. 3.6%, p = 0.17). No severe complications or significant differences in the 30-day readmission rates were observed. Conclusions: Articulating laparoscopic instruments provide outcomes comparable to robot-assisted surgery in hysterectomy while reducing the number of ports required. Further studies are needed to explore the learning curve and long-term impact on surgical outcomes. Full article

Degradable fluorescent sensors present a promising portable approach for heavy metal ion detection, aiming to prevent secondary environmental pollution. Additionally, the excessive intake of ferric ions (Fe³⁺), an essential trace element for human health, poses critical health risks that urgently require effective monitoring. In this study, we developed a thermally degradable fluorescent hydrogel sensor (Eu-CDs@DPPG) based on europium-doped carbon dots (Eu-CDs). The Eu-CDs, synthesized via a hydrothermal method, exhibited selective fluorescence quenching by Fe³⁺ through the inner filter effect (IFE). Embedding Eu-CDs into the hydrogel significantly enhanced their stability and dispersibility in aqueous environments, effectively resolving issues related to aggregation and matrix interference in traditional sensing methods. The developed sensor demonstrated a broad linear detection range (0–2.5 µM), an extremely low detection limit (1.25 nM), and rapid response (<40 s). Furthermore, a smartphone-assisted LAB color analysis allowed portable, visual quantification of Fe³⁺ with a practical LOD of 6.588 nM. Importantly, the hydrogel was thermally degradable at 80 °C, thus minimizing environmental impact. The sensor’s practical applicability was validated by accurately detecting Fe³⁺ in spinach and human urine samples, achieving recoveries of 98.7–108.0% with low relative standard deviations. This work provides an efficient, portable, and sustainable sensing platform that overcomes the limitations inherent in conventional analytical methods. Full article

Due to increased precipitation intensity and sea-level rise, low-lying coastal roads are increasingly vulnerable to subbase saturation. Widely applied lumped hydrological approaches cannot accurately represent time and space-varying groundwater levels in some highly conductive coastal soils, calling for more sophisticated tools. This study assesses the suitability of the Gridded Surface Subsurface Hydrologic Analysis model (GSSHA) for representing hydrological processes and groundwater dynamics in a unique coastal roadway setting in Alabama. A high-resolution model was developed to assess a 2 km road segment and was calibrated for hydraulic conductivity and aquifer bottom levels using observed groundwater level (GWL) data. The model configuration included a fixed groundwater tidal boundary representing Mobile Bay, a refined land cover classification, and an extreme precipitation event simulation representing Hurricane Sally. Results indicated good agreement between modeled and observed groundwater levels, particularly during short-duration high-intensity events, with NSE values reaching up to 0.83. However, the absence of dynamic tidal forcing limited its ability to replicate certain fine-scale groundwater fluctuations. During the Hurricane Sally simulation, over two-thirds of the segment remained saturated for over 6 h, and some locations exceeded 48 h of pavement saturation. The findings underscore the importance of incorporating shallow groundwater processes in hydrologic modeling for coastal roads. This replicable modeling framework may assist DOTs in identifying critical roadway segments to improve drainage infrastructure in order to increase resiliency. Full article

Ujimqin sheep, known for its distinctive multi-vertebrae phenotypes (T13L7, T14L6, and T14L7) and economic value, has garnered significant attention. However, conventional phenotypic detection methods suffer from low efficiency and high costs. In this study, based on a key SNP locus (ABCD4 gene, Chr7:89393414, C > T) identified through a genome-wide association study (GWAS), a TaqMan-MGB (minor groove binder) genotyping system was developed. the objective was to establish a high-throughput and efficient molecular marker-assisted selection (MAS) tool. Specific primers and dual fluorescent probes were designed to optimize the reaction system. Standard plasmids were adopted to validate genotyping accuracy. A total of 152 Ujimqin sheep were subjected to TaqMan-MGB genotyping, digital radiography (DR) imaging, and Sanger sequencing. the results showed complete concordance between TaqMan-MGB and Sanger sequencing, with an overall agreement rate of 83.6% with DR imaging. For individuals with T/T genotypes (127/139), the detection accuracy reached 91.4%. This method demonstrated high specificity, simplicity, and cost-efficiency, significantly reducing the time and financial burden associated with traditional imaging-based approaches. the findings indicate that the TaqMan-MGB technique can accurately identify the T/T genotype at the SNP site and its strong association with the multi-vertebrae phenotypes, offering an effective and reliable tool for molecular breeding of Ujimqin sheep. Full article

Urban green infrastructure plays a vital role in the sustainable development of cities. As urban areas expand, green spaces are increasingly affected. The pressure from new developments leads to a reduction in vegetation and raises new public health risks. Addressing this challenge requires effective planning, maintenance, and continuous monitoring. To enhance traditional approaches, remote sensing is becoming a vital tool for city-wide observations. Publicly available large-scale data, combined with machine learning models, can improve our understanding. We explore the potential of Sentinel-2 to classify and extract meaningful features from urban landscapes. Using advanced machine learning techniques, we aim to develop a robust and scalable framework for classifying urban environments. The proposed models will assist in monitoring changes in green spaces across diverse urban settings, enabling timely and informed decisions to foster sustainable urban growth. Full article

Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi. Methods: A mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions. Results: Between September 2023 and February 2025, 77 virtual learning sessions were conducted, engaging 2445 unique participants from hospital-based AMS committees and health professionals across the three countries. Participants reported significant knowledge gain, and data showed facility improvements in two core AMS areas, including the implementation of multidisciplinary ward-based interventions/communications and enhanced monitoring of antibiotic resistance patterns. Along those lines, participants reported that the program assisted them in improving prescribing and culture-based treatments, and also evidence-informed antibiotic selection. The evidence of implementing ward-based interventions was further stressed in focus group discussions, as well as other strengthened practices like point-prevalence surveys, and development or revision of stewardship policies. Substantial improvements in microbiology services were also shared by participants, particularly in Malawi. Other practices mentioned were strengthened multidisciplinary communication, infection prevention efforts, and education of patients and the community. Conclusion: Our findings suggest that a virtual case-based learning educational intervention, providing structured and tailored AMS capacity building, can drive behavior change and strengthen healthcare systems in low resource settings. Future efforts should aim to scale up the engagements and sustain improvements to further strengthen AMS capacity. Full article

In cognitive science and education research, learning has been described to occur at surface and deep levels. Learners are thought to orient more toward one of these approaches to learning versus the other. In cognitive science, this has been assessed with a concept-building framework using objective function learning tasks to classify students as exemplar (surface) or abstraction (deep) learners. In education, the student approach to learning (SAL) framework has used self-report survey measures to classify learners as relying on surface approaches or deep approaches to learning. In two studies, we directly compared these two frameworks using self-report data from the Modified Approaches and Study Skills Inventory (M-ASSIST) and the Revised Study Process Questionnaire (R-SPQ-2F) along with objectively determined concept-building classifications from a computer-based function learning task. Potential links between exemplar learning and surface approaches and between abstraction learning and deep approaches were not found. We discuss possible explanations for the absence of empirical links, including inaccuracies in students’ metacognitions regarding their learning, the measures, and possible differences between learning-content-dependencies of the survey responses versus content neutrality of the concept-building task. We conclude by suggesting directions for future work in assessing and comparing surface and deep learning across frameworks. Full article

Background/Objectives: Nowadays, intravascular lithotripsy (IVL) has emerged as a novel technique for treatment of vascular calcifications, first in coronary and then in peripheral arteries. In the current literature there is little evidence that describes IVL as an effective and safe solution in treating severe aortic and aorto-iliac calcifications. The aim of this study is to report current available data about the use of IVL in treating aortic and aorto-iliac calcified lesions and its application in facilitating other endovascular procedures. Methods: the present review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Guidelines. Preliminary searches were conducted on MEDLINE and Pubmed from January 2015 to February 2025. Studies were divided into 3 main categories depending on the location of calcifications and the type of treatment: IVL in visceral and infrarenal obstructive disease (group 1), IVL in aorto-iliac obstructive disease (group 2), IVL used to facilitate other endovascular procedures. Main primary outcomes in the perioperative period were technical and clinical successes and perioperative complications. Primary outcomes at 30 days and mid-term (2 years) were overall survival, limb salvage rate, primary patency, primary assisted patency, secondary patency, and residual stenosis. Results: Sixteen studies were identified for a total of 1674 patients. Technical and clinical successes were 100%, with low rates of perioperative complications. Dissection rate reaches up to 16.1% in some studies, without any differences compared to plain old balloon angioplasty (POBA) alone (22.8%; p = 0.47). At 30 days, limb salvage and survival rates were 100%. At 2 years, primary patency, assisted primary patency, and secondary patency were 95%, 98%, and 100%, respectively, with no difference compared to IVL + stenting. Conclusions: IVL has emerged as a novel approach to treat severe calcified lesions in visceral and aorto-iliac atherosclerotic disease and to facilitate other endovascular procedures. This technique seems to offer satisfactory early and mid-term outcomes in terms of primary, primary assisted patency, and secondary patency with low complication rates. Full article

Adverse drug events (ADEs) significantly impact patient safety and health outcomes. Manual ADE detection from clinical narratives is time-consuming, labor-intensive, and costly. Recent advancements in large language models (LLMs), including transformer-based architectures such as Bidirectional Encoder Representations from Transformers (BERT) and Generative Pretrained Transformer (GPT) series, offer promising methods for automating ADE extraction from clinical data. These models have been applied to various aspects of pharmacovigilance and clinical decision support, demonstrating potential in extracting ADE-related information from real-world clinical data. Additionally, chatbot-assisted systems have been explored as tools in clinical management, aiding in medication adherence, patient engagement, and symptom monitoring. This narrative review synthesizes the current state of LLMs in ADE detection from a clinical perspective, organizing studies into categories such as human-facing decision support tools, immune-related ADE detection, cancer-related and non-cancer-related ADE surveillance, and personalized decision support systems. In total, 39 articles were included in this review. Across domains, LLM-driven methods have demonstrated promising performances, often outperforming traditional approaches. However, critical limitations persist, such as domain-specific variability in model performance, interpretability challenges, data quality and privacy concerns, and infrastructure requirements. By addressing these challenges, LLM-based ADE detection could enhance pharmacovigilance practices, improve patient safety outcomes, and optimize clinical workflows. Full article

The search for the biomarkers of Alzheimer’s disease (AD) may prove essential in the diagnosis and prognosis of the pathology, and the differential expression of key proteins may assist in identifying new therapeutic targets. In this proof-of-concept (POC) study, a new approach of data mining and matching combined with the biochemical analysis of proteins was applied to AD investigation. Three influential online open databases (UniProt, AlzGene, and Allen Human Brain Atlas) were explored to identify the genes and encoded proteins involved in AD linked to mitochondrial and iron dysmetabolism. The databases were searched using specific keywords to collect information about protein composition, and function, and meta-analysis data about their correlation with AD. The extracted datasets were matched to yield a list of relevant proteins in AD. The biochemical analysis of their amino acid content suggested a defective synthesis of these proteins in poorly oxygenated brain tissue, supporting their relevance in AD progression. The result of our POC study revealed several potential new markers of AD that deserve further molecular and clinical investigation. This novel database search approach can be a valuable strategy for biomarker search that can be exploited in many diseases. Full article

Background/Objectives: Artificial intelligence (AI) is rapidly emerging as a transformative force in healthcare education, including orthodontics. This systematic review and meta-analysis aimed to evaluate the integration of AI into orthodontic training programs, focusing on its effectiveness in improving diagnostic accuracy, learner engagement, and the perceived quality of AI-generated educational content. Materials and Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Embase through May 2025. Eligible studies involved AI-assisted educational interventions in orthodontics. A mixed-methods approach was applied, combining meta-analysis and narrative synthesis based on data availability and consistency. Results: Seven studies involving 1101 participants—including orthodontic students, clinicians, faculty, and program directors—were included. AI tools ranged from cephalometric landmarking platforms to ChatGPT-based learning modules. A fixed-effects meta-analysis using two studies yielded a pooled Global Quality Scale (GQS) score of 3.69 (95% CI: 3.58–3.80), indicating moderate perceived quality of AI-generated content (I² = 64.5%). Due to methodological heterogeneity and limited statistical reporting in most studies, a narrative synthesis was used to summarize additional outcomes. AI tools enhanced diagnostic skills, learner autonomy, and perceived satisfaction, particularly among students and junior faculty. However, barriers such as limited curricular integration, lack of training, and faculty skepticism were recurrent. Conclusions: AI technologies, especially ChatGPT and digital cephalometry tools, show promise in orthodontic education. While learners demonstrate high acceptance, full integration is hindered by institutional and perceptual challenges. Strategic curricular reforms and targeted faculty development are needed to optimize AI adoption in clinical training. Full article

The sharing economy is considered to be a potentially efficacious approach for promoting sustainable production and consumption (SPC). This study utilizes dockless bike sharing (DBS) in Beijing as a case study to examine how sharing economy policies and business practices advance SPC. It also dynamically quantifies the environmental and economic performance of DBS practices from a life cycle perspective. The findings indicate that effective SPC practices can be achieved through the collaborative efforts of multiple stakeholders, including the government, operators, manufacturers, consumers, recycling agencies, and other business partners, supported by regulatory systems and advanced technologies. The SPC practices markedly improved the sustainability of DBS promotion in Beijing. This is evidenced by the increase in greenhouse gas (GHG) emission reduction benefits, which have risen from approximately 35.81 g CO₂-eq to 124.40 g CO₂-eq per kilometer of DBS travel. Considering changes in private bicycle ownership, this value could reach approximately 150.60 g CO₂-eq. Although the economic performance of DBS operators has also improved, it remains challenging to achieve profitability, even when considering the economic value of the emission reduction benefits. In certain scenarios, DBS can maximize profits by optimizing fleet size and efficiency, without compromising the benefits of emission reductions. The framework of stakeholder interaction proposed in this study and the results of empirical analysis not only assist regulators, businesses, and the public in better understanding and promoting sustainable production and consumption practices in the sharing economy but also provide valuable insights for achieving a win-win situation of platform profitability and environmental benefits in the SPC practice process. Full article

Automated movement intention is crucial for brain–computer interface (BCI) applications. The automatic identification of movement intention can assist patients with movement problems in regaining their mobility. This study introduces a novel approach for the automatic identification of movement intention through finger tapping. This work has compiled a database of EEG signals derived from left finger taps, right finger taps, and a resting condition. Following the requisite pre-processing, the captured signals are input into the proposed model, which is constructed based on graph theory and deep convolutional networks. In this study, we introduce a novel architecture based on six deep convolutional graph layers, specifically designed to effectively capture and extract essential features from EEG signals. The proposed model demonstrates a remarkable performance, achieving an accuracy of 98% in a binary classification task when distinguishing between left and right finger tapping. Furthermore, in a more complex three-class classification scenario, which includes left finger tapping, right finger tapping, and an additional class, the model attains an accuracy of 92%. These results highlight the effectiveness of the architecture in decoding motor-related brain activity from EEG data. Furthermore, relative to recent studies, the suggested model exhibits significant resilience in noisy situations, making it suitable for online BCI applications. Full article

Accurate semantic segmentation of indoor architectural elements, such as staircases and elevators, is critical for safe and efficient robotic navigation, particularly in complex multi-floor environments. Traditional fusion methods struggle with occlusions, reflections, and low-contrast regions. In this paper, we propose a novel feature fusion module, Skip-Connection Fusion (SCF), that dynamically integrates RGB (Red, Green, Blue) and depth features through an adaptive weighting mechanism and skip-connection integration. This approach enables the model to selectively emphasize informative regions while suppressing noise, effectively addressing challenging conditions such as partially blocked staircases, glossy elevator doors, and dimly lit stair edges, which improves obstacle detection and supports reliable human–robot interaction in complex environments. Extensive experiments on a newly collected dataset demonstrate that SCF consistently outperforms state-of-the-art methods, including PSPNet and DeepLabv3, in both overall mIoU (mean Intersection over Union) and challenging-case performance. Specifically, our SCF module improves segmentation accuracy by 5.23% in the top 10% of challenging samples, highlighting its robustness in real-world conditions. Furthermore, we conduct a sensitivity analysis on the learnable weights, demonstrating their impact on segmentation quality across varying scene complexities. Our work provides a strong foundation for real-world applications in autonomous navigation, assistive robotics, and smart surveillance. Full article

Wheelchair-mounted assistive robotic manipulators can provide reach and grasp functions for power wheelchair users. This in-lab study evaluated a vision-guided shared control (VGS) system with twelve users completing two multi-step kitchen tasks: a drinking task and a popcorn making task. Using a mixed methods approach participants compared VGS and manual joystick control, providing performance metrics, qualitative insights, and lessons learned. Data collection included demographic questionnaires, the System Usability Scale (SUS), NASA Task Load Index (NASA-TLX), and exit interviews. No significant SUS differences were found between control modes, but NASA-TLX scores revealed VGS control significantly reduced workload during the drinking task and the popcorn task. VGS control reduced operation time and improved task success but was not universally preferred. Six participants preferred VGS, five preferred manual, and one had no preference. In addition, participants expressed interest in robotic arms for daily tasks and described two main operation challenges: distinguishing wrist orientation from rotation modes and managing depth perception. They also shared perspectives on how a personal robotic arm could complement caregiver support in their home. Full article