Search Results (12,210)

The increase in the elderly population globally reflects a change in the population’s mindset regarding preventive health measures and necessitates a rethinking of healthcare strategies. The integration of machine learning (ML)-type algorithms in geriatrics represents a direction for optimizing prevention, diagnosis, prediction, monitoring, and treatment. This paper presents a systematic review of the scientific literature published between 1 January 2020 and 31 May 2025. The paper is based on the applicability of ML techniques in the field of geriatrics. The study is conducted using the Web of Science database for a detailed discussion. The most studied algorithms in research articles are Random Forest, Extreme Gradient Boosting, and support vector machines. They are preferred due to their performance in processing incomplete clinical data. The performance metrics reported in the analyzed papers include the accuracy, sensitivity, F1-score, and Area under the Receiver Operating Characteristic Curve. Nine search categories are investigated through four databases: WOS, PubMed, Scopus, and IEEE. A comparative analysis shows that the field of geriatrics, through an ML approach in the context of elderly nutrition, is insufficiently explored, as evidenced by the 61 articles analyzed from the four databases. The analysis highlights gaps regarding the explainability of the models used, the transparency of cross-sectional datasets, and the validity of the data in real clinical contexts. The paper highlights the potential of ML models in transforming geriatrics within the context of personalized predictive care and outlines a series of future research directions, recommending the development of standardized databases, the integration of algorithmic explanations, the promotion of interdisciplinary collaborations, and the implementation of ethical norms of artificial intelligence in geriatric medical practice. Full article

(1) Virtual reality (VR) technologies have shown significant potential for diagnosing and treating vision-related impairments. This rapid review evaluates and characterizes the existing literature on VR technologies for diagnosing and treating vision-based diseases. (2) Methods: A systematic search was conducted across Ovid MEDLINE, Ovid Embase, the Cochrane Database of Systematic Reviews (Ovid), and the Cochrane Central Register of Controlled Trials (Ovid). Abstracts were screened using Rayyan QCRI, followed by full-text screening and data extraction. Eligible studies were published in peer-reviewed journals, written in English, focused on human participants, used immersive and portable VR devices as the primary intervention, and reported on the clinical effectiveness of VR for therapeutic, diagnostic, or screening purposes for vision or auditory–visual impairments. Various study characteristics, including design and participant details, were extracted, and the MMAT assessment tool was used to evaluate study quality. (3) Results: Seventy-six studies met the inclusion criteria. Among these, sixty-four (84.2%) were non-randomized studies exploring VR’s effectiveness, while twenty-two (15.8%) were randomized-controlled trials. Of the included studies, 38.2% focused on diagnosing, 21.0% on screening, and 38.2% on treating vision impairments. Glaucoma and amblyopia were the most commonly studied visual impairments. (4) Conclusions: The use of standalone, remotely controlled VR headsets for screening and diagnosing visual diseases represents a promising advancement in ophthalmology. With ongoing technological developments, VR has the potential to revolutionize eye care by improving accessibility, efficiency, and personalization. Continued research and innovation in VR applications for vision care are expected to further enhance patient outcomes. Full article

Background: Mediastinal staging plays a critical role in guiding treatment decisions for non-small cell lung cancer (NSCLC). While mediastinoscopy has been the gold standard for assessing mediastinal lymph node involvement, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a minimally invasive alternative with comparable diagnostic accuracy. This systematic review evaluates the diagnostic performance, safety, cost-effectiveness, and feasibility of EBUS-TBNA versus mediastinoscopy for mediastinal staging. Methods: A systematic literature review was conducted in accordance with PRISMA guidelines, including searches in Medline, Scopus, EMBASE, and Cochrane databases for studies published from 2010 onwards. A total of 1542 studies were identified, and after removing duplicates and applying eligibility criteria, 100 studies were included for detailed analysis. The extracted data focused on sensitivity, specificity, complications, economic impact, and patient outcomes. Results: EBUS-TBNA demonstrated high sensitivity (85–94%) and specificity (~100%), making it an effective first-line modality for NSCLC staging. Mediastinoscopy remained highly specific (~100%) but exhibited slightly lower sensitivity (86–90%). EBUS-TBNA had a lower complication rate (~2%) and was more cost-effective, while mediastinoscopy provided larger biopsy samples, essential for molecular and histological analyses. The need for general anaesthesia, longer hospital stays, and increased procedural costs make mediastinoscopy less favourable as an initial approach. Combining both techniques in select cases enhanced overall staging accuracy, reducing false negatives and improving diagnostic confidence. Conclusions: EBUS-TBNA has become the preferred first-line mediastinal staging method due to its minimally invasive approach, high diagnostic accuracy, and lower cost. However, mediastinoscopy remains crucial in cases requiring posterior mediastinal node assessment or larger tissue samples. The integration of both techniques in a stepwise diagnostic strategy offers the highest accuracy while minimizing risks and costs. Given the lower hospitalization rates and economic benefits associated with EBUS-TBNA, its widespread adoption may contribute to more efficient resource utilization in healthcare systems. Full article

Avocado (Persea americana), originally from Mesoamerica, has emerged as a focus of intense scientific and industrial interest due to its unique combination of nutritional richness, bioactive potential, and technological versatility. Its pulp, widely consumed across the globe, is notably abundant in monounsaturated fatty acids, especially oleic acid, which can comprise over two-thirds of its lipid content. In addition, it provides significant levels of dietary fiber, fat-soluble vitamins such as A, D, E and K, carotenoids, tocopherols, and phytosterols like β-sitosterol. These constituents are consistently associated with antioxidant, anti-inflammatory, glycemic regulatory, and cardioprotective effects, supported by a growing body of experimental and clinical evidence. This review offers a comprehensive and critical synthesis of the chemical composition and functional properties of avocado, with particular emphasis on its lipid profile, phenolic compounds, and phytosterols. It also explores recent advances in environmentally sustainable extraction techniques, including ultrasound-assisted and microwave-assisted processes, as well as the application of natural deep eutectic solvents. These technologies have demonstrated improved efficiency in recovering bioactives while aligning with the principles of green chemistry. The use of avocado-derived ingredients in nanostructured delivery systems and their incorporation into functional foods, cosmetics, and health-promoting formulations is discussed in detail. Additionally, the potential of native cultivars and the application of precision nutrition strategies are identified as promising avenues for future innovation. Taken together, the findings underscore the avocado’s relevance as a high-value matrix for sustainable development. Future research should focus on optimizing extraction protocols, clarifying pharmacokinetic behavior, and ensuring long-term safety in diverse applications. Full article

This research advances the integration of terrestrial laser scanning (TLS) in heritage documentation, targeting the development of holistic and practical guidance for practitioners to adopt the technology effectively. Acknowledging the pivotal role of TLS in capturing detailed and accurate representations of cultural heritage, the study emerges against a backdrop of technological progression and the evolving needs of heritage conservation. Through a comprehensive literature review, critical case studies of heritage sites in the U.S., expert interviews, and the development of a TLS for Heritage Documentation Best Practice Guide (the guide), the paper addresses the existing gaps in streamlined practices in the domain of TLS’s applications in heritage documentation. While recognizing and building upon foundational efforts such as international guidelines developed over the past decades, this study contributes a practice-oriented perspective grounded in field experience and case-based analysis. The developed guide seeks to equip practitioners with structured methods and practical tools to optimize the use of TLS, ultimately enhancing the quality and accessibility of heritage documentation. It also sets a foundation for integrating TLS datasets with other technologies, such as Building Information Modeling (BIM), virtual reality (VR), and augmented reality (AR) for heritage preservation, tourism, education, and interpretation, ultimately enhancing access to and engagement with cultural heritage sites. The paper also critically situates this guidance within the evolving theoretical discourse on digital heritage practices, highlighting its alignment with and divergence from existing methodologies. Full article

The classical V-Model has served as the foundational framework for aerospace systems engineering, but its scope terminates upon aircraft certification, creating a significant gap in addressing reliability degradation during operational service. This study introduces the W-model framework—a comprehensive lifecycle management approach that extends the V-Model to systematically integrate reliability-centered component modifications with established aerospace development practices. The W-model incorporates a structured six-phase reliability-centered modification methodology that transforms operational data into certified design improvements through systematic reliability monitoring, candidate selection, design reviews, development, and certification processes. A detailed case study on the aviation pneumatic bypass valve demonstrates the methodology. Application of the W-model resulted in a 36% improvement in the mean time between failures and a significant reduction in unscheduled removals. The W-model represents a paradigm shift from reactive maintenance strategies to proactive, data-driven reliability enhancement, providing a systematic approach that maintains the rigor and traceability required for commercial aviation while enabling continuous reliability growth throughout the complete aircraft lifecycle. Full article

This study aims to evaluate the level of awareness and practical adoption of green wall systems in the Nigerian construction industry. It seeks to examine the current state of green wall implementation and recommend strategies to enhance their integration into construction practices among Nigerian construction professionals. A thorough review of the existing literature was conducted to identify different types of green wall systems. Insights from this review informed the design of a structured questionnaire, which was distributed to construction professionals based in Lagos State. The data collected were analyzed using statistical tests. The study reveals that while there is generally high awareness of green wall systems among Nigerian construction professionals, the practical use remains low, with just 8 out of the 18 systems being actively implemented, eclipsing the mean value of 3.0. The findings underscore the need for targeted education, industry incentives, and increased advocacy to encourage the use of green wall systems in the Nigerian construction sector. The results have significant implications for the Nigerian construction industry. The limited awareness and adoption of green wall systems highlight the need for strategic actions from policymakers, industry leaders and educational institutions. Promoting the use of green walls could drive more sustainable building practices, improve environmental outcomes and support the broader goals of decarbonization and circularity in construction. This research adds to the body of knowledge on sustainable construction by offering a detailed evaluation of green wall awareness and adoption within the Nigerian context. While green wall systems have been studied globally, this research provides a regional perspective, which in this case focuses on Lagos State. The study’s recognition of the gap between awareness and implementation highlights an important area for future research and industry development. Full article

The development of Industry 4.0 has accelerated the adoption of sophisticated technologies, including Digital Twins (DTs), Artificial Intelligence (AI), and cybersecurity, within Additive Manufacturing (AM). Enabling real-time monitoring, process optimization, predictive maintenance, and secure data management can redefine conventional manufacturing paradigms. Although their individual importance is increasing, a consistent understanding of how these technologies interact and collectively improve AM procedures is lacking. Focusing on the integration of digital twins (DTs), modular AI, and cybersecurity in AM, this review presents a comprehensive analysis of over 137 research publications from Scopus, Web of Science, Google Scholar, and ResearchGate. The publications are categorized into three thematic groups, followed by an analysis of key findings. Finally, the study identifies research gaps and proposes detailed recommendations along with a framework for future research. The study reveals that traditional AM processes have undergone significant transformations driven by digital threads, digital threads (DTs), and AI. However, this digitalization introduces vulnerabilities, leaving AM systems prone to cyber-physical attacks. Emerging advancements in AI, Machine Learning (ML), and Blockchain present promising solutions to mitigate these challenges. This paper is among the first to comprehensively summarize and evaluate the advancements in AM, emphasizing the integration of DTs, Modular AI, and cybersecurity strategies. Full article

Openings in two-way reinforced concrete (RC) slabs are frequently incorporated for architectural and functional purposes, such as providing pathways for mechanical, electrical, and plumbing services. While necessary, these openings can significantly compromise the structural performance of slabs, particularly by reducing their capacity to resist punching shear, an effect that is especially critical when the openings are located near column–slab connections. This paper provides a detailed review of the existing research, examining how various opening parameters such as their size, shape, and position affect key structural performance metrics including their stiffness, ductility, and failure modes. The findings highlight that opening geometry is a major determinant of a slab’s overall behavior. Notably, the proximity of openings to column faces is identified as a critical factor that can substantially influence the extent of strength degradation and failure mechanisms. Furthermore, this review identifies a significant research gap concerning the behavior of slabs with openings under non-standard loading conditions, such as seismic activity, blasts, and impact loads. It also emphasizes the need for further investigation into the long-term performance of such slabs under adverse environmental influences, including elevated temperatures, corrosion, and material degradation. By consolidating the current knowledge and identifying unresolved challenges, this review aims to guide engineers and researchers in developing more robust design strategies and performance-based solutions for RC slabs with openings, ultimately contributing to safer and more resilient structural systems. Full article

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

A brief review of various existing mathematical formulations of the uncertainty relations in quantum mechanics, containing variances of two or more non-commuting operators, is given. In particular, inequalities for the products of higher-order moments of a coordinate and a momentum are considered, as well as inequalities making the uncertainty relations more accurate when additional information about a quantum system is available (for example, the correlation coefficient or the degree of mixing of a quantum state characterized by the trace of the squared statistical operator). The special cases of two, three, and four operators are discussed in detail. Full article

Multiple sclerosis (MS) and allergic diseases, traditionally considered immunologically opposing entities, may share pathogenic mechanisms rooted in immune dysregulation. While MS is predominantly mediated by Th1 and Th17 responses and allergies by Th2 responses, emerging evidence suggests overlapping immunological pathways, including the involvement of histamine, regulatory T cells, and innate lymphoid cells. This review synthesizes current knowledge on the epidemiological and immunopathological associations between MS and allergies. Epidemiological studies have yielded inconsistent results, with some suggesting a protective role for respiratory and food allergies against MS onset, while others find no significant correlation. Clinical studies indicate that food allergies in adults may be associated with increased MS inflammatory activity, whereas childhood atopy might exert a protective effect. In addition, we review hypersensitivity reactions to disease-modifying treatments for MS, detailing their immunological mechanisms, clinical presentation, and management, including desensitization protocols where applicable. Finally, we explore how treatments for allergic diseases—such as clemastine, allergen immunotherapy, montelukast, and omalizumab—may modulate MS pathophysiology, offering potential therapeutic synergies. Understanding the interplay between allergic and autoimmune processes is critical for optimizing care and developing innovative treatment approaches in MS. Full article

Background and Clinical Significance: Brugada syndrome (BrS) is a rare inherited cardiac channelopathy, often associated with SCN5A loss-of-function mutations. Clinical presentations range from asymptomatic to malignant arrhythmias and sudden cardiac death. Physiological and pharmacological stressors affecting sodium channel function—such as pyrexia, certain medications, and possibly pregnancy—may unmask or exacerbate arrhythmic risk. However, there is limited information regarding pregnancy and obstetric outcomes. Obstetric management remains largely informed by isolated case reports and small case series. A literature review was conducted using OVID Medline and Embase, identifying case reports, case series, and one retrospective cohort study reporting clinical presentation, obstetric management, and outcomes in maternal BrS. A case is presented detailing coordinated multidisciplinary input, antenatal surveillance, and intrapartum and postpartum care to contribute to the growing evidence base guiding obstetric care in this complex setting. Case Presentation: A 30-year-old G2P0 woman with asymptomatic BrS (SCN5A-positive) was referred at 31 + 5 weeks’ gestation for multidisciplinary antenatal care. Regular review and collaborative planning involving cardiology, anaesthetics, maternal–fetal medicine, and obstetrics guided a plan for vaginal delivery with continuous cardiac and fetal monitoring. At 38 + 0 weeks, the woman presented with spontaneous rupture of membranes and underwent induction of labour. A normal vaginal delivery was achieved without arrhythmic events. Epidural block with ropivacaine and local anaesthesia with lignocaine were well tolerated, and 24 h postpartum monitoring revealed no abnormalities. Conclusions: This case adds to the limited but growing literature suggesting that with individualised planning and multidisciplinary care, pregnancies in women with BrS can proceed safely and without complication. Ongoing case reporting is essential to inform future guidelines and optimise maternal and fetal outcomes. Full article

One major challenge in cellular neuroscience is to elucidate how the accurate alignment of presynaptic release sites with postsynaptic densely clustered ligand-gated ion channels at chemical synapses is achieved upon synapse assembly. The clustering of neurotransmitter receptors at postsynaptic sites is a key moment of synaptogenesis and determinant for effective synaptic transmission. The number of the ionotropic neurotransmitter receptors at these postsynaptic sites of both excitatory and inhibitory synapses is variable and is regulated by different mechanisms, thus allowing the modulation of synaptic strength, which is essential to tune neuronal network activity. Several well-regulated processes seem to be involved, including lateral diffusion within the plasma membrane and local anchoring as well as receptor endocytosis and recycling. The molecular mechanisms implicated are numerous and were reviewed recently in great detail. The role of pre-synaptically released neurotransmitters within the complex regulatory apparatus organizing the postsynaptic site underneath presynaptic terminals is not completely understood, even less for inhibitory synapses. In this mini review article, we focus on this aspect of synapse formation, summarizing and contrasting findings on the functional role of the neurotransmitters glycine and γ-aminobutyric acid (GABA) for initiation of postsynaptic receptor clustering and regulation of Cl⁻ channel receptor numbers at inhibitory synapses gathered over the last two decades. Full article

Implementing nature-based solutions (NbSs) for wildfire risk management and other hazards has been challenging in emerging economies due to the high costs, the lack of immediate returns on investment, and stringent inclusion criteria set by organizations like the IUCN and domain experts. To address these challenges, this exploratory study proposes a new concept: green/blue initiatives. These initiatives represent intermediate steps, encompassing small-scale, community-driven activities that can evolve into recognized NbSs over time. To explore this concept, experiences related to wildfire prevention in the Biobío region of Chile were analyzed through primary and secondary source reviews. The analysis identified three initiatives qualifying as green/blue initiatives: (1) goat grazing in Santa Juana to reduce fuel loads, (2) a restoration prevention farm model in Florida called Faro de Restauración Mahuidanche and (3) the Conservation Landscape Strategy in Nonguén. They were examined in detail using data collected from site visits and interviews. In contrast to Chile’s prevailing wildfire policies, which focus on costly, large-scale fire suppression efforts, these initiatives emphasize the importance of reframing wildfire as a manageable ecological process. Lastly, the challenges and enabling factors for adopting green/blue initiatives are discussed, highlighting their potential to pave the way for future NbS implementation in central Chile. Full article