Search Results (633)

Focal chondral defects of the knee are a common cause of pain and functional limitation in active individuals and may predispose to early degenerative joint changes. Given the limited regenerative capacity of hyaline cartilage, biologically based surgical strategies have emerged to promote tissue repair and restore joint function. This narrative review critically examines current treatment approaches that rely on autologous cell sources and scaffold-supported regeneration. Particular emphasis is placed on techniques that stimulate endogenous repair or support chondrocyte-based tissue restoration through the use of autologous biomaterial constructs. The influence of lesion morphology, joint biomechanics, and patient-specific variables on treatment selection is discussed in detail, focusing on the differences between tibiofemoral and patellofemoral involvement. Biologically driven approaches have shown promising mid- to long-term outcomes in selected patients, and are increasingly favoured over traditional methods in specific clinical scenarios. However, the literature remains limited by heterogeneity in study design, follow-up duration, and outcome measures. This review aims to provide an evidence-based, morphology-informed framework to support the clinical decision-making process in the management of knee cartilage defects. Full article

Neuromuscular hip dysplasia (NHD) is a common deformity in children with cerebral palsy (CP). Although some predictive factors of NHD are known, the prediction of NHD is in its infancy. We present a Clinical Decision Support System (CDSS) designed to calculate the probability of developing NHD in children with CP. The system utilizes an ensemble of three machine learning (ML) algorithms: Neural Network (NN), Support Vector Machine (SVM), and Logistic Regression (LR). The development and evaluation of the CDSS followed the DECIDE-AI guidelines for AI-driven clinical decision support tools. The ensemble was trained on a data series from 182 subjects. Inclusion criteria were age between 12 and 18 years and diagnosis of CP from two specialized units. Clinical and functional data were collected prospectively between 2005 and 2023, and then analyzed in a cross-sectional study. Accuracy and area under the receiver operating characteristic (AUROC) were calculated for each method. Best logistic regression scores highlighted history of previous orthopedic surgery (p = 0.001), poor motor function (p = 0.004), truncal tone disorder (p = 0.008), scoliosis (p = 0.031), number of affected limbs (p = 0.05), and epilepsy (p = 0.05) as predictors of NHD. Both accuracy and AUROC were highest for NN, 83.7% and 0.92, respectively. The novelty of this study lies in the development of an efficient Clinical Decision Support System (CDSS) prototype, specifically designed to predict future outcomes of neuromuscular hip dysplasia (NHD) in patients with cerebral palsy (CP) using clinical data. The proposed system, PredictMed-CDSS, demonstrated strong predictive performance for estimating the probability of NHD development in children with CP, with the highest accuracy achieved using neural networks (NN). PredictMed-CDSS has the potential to assist clinicians in anticipating the need for early interventions and preventive strategies in the management of NHD among CP patients. Full article

Background/Objectives: Diabetic retinopathy is a leading cause of vision impairment worldwide, and the development of reliable automated classification systems is crucial for early diagnosis and clinical decision-making. This study presents a comprehensive comparative evaluation of two state-of-the-art deep learning families for the task of classifying diabetic retinopathy using retinal fundus images. Methods: The models were trained and tested in both binary and multi-class settings. The experimental design involved partitioning the data into training (70%), validation (20%), and testing (10%) sets. Model performance was assessed using standard metrics, including precision, sensitivity, specificity, F1-score, and the area under the receiver operating characteristic curve. Results: In binary classification, the ResNeXt101-64x4d model and RegNetY32GT model demonstrated outstanding performance, each achieving high sensitivity and precision. For multi-class classification, ResNeXt101-32x8d exhibited strong performance in early stages, while RegNetY16GT showed better balance across all stages, particularly in advanced diabetic retinopathy cases. To enhance transparency, SHapley Additive exPlanations were employed to visualize the pixel-level contributions for each model’s predictions. Conclusions: The findings suggest that while ResNeXt models are effective in detecting early signs, RegNet models offer more consistent performance in distinguishing between multiple stages of diabetic retinopathy severity. This dual approach combining quantitative evaluation and model interpretability supports the development of more robust and clinically trustworthy decision support systems for diabetic retinopathy screening. Full article

Natural fiber-based biocomposites are rapidly gaining traction in sustainable manufacturing. However, their supply chain (SC) designs at the feedstock pre-processing stage often lack robust multicriteria decision-making evaluations, which can impact downstream processes and final product quality. This case study proposes a sustainability-driven multicriteria decision-making framework for selecting pre-processing equipment configurations within a hemp-based biocomposite SC. Using a cradle-to-gate system boundary, four alternative configurations combining balers (square vs. round) and hammer mills (full-screen vs. half-screen) are evaluated. The analytical network process (ANP) model is used to evaluate alternative SC configurations while capturing the interdependencies among environmental, economic, social, and technical sustainability criteria. These criteria are further refined with the inclusion of sub-criteria, resulting in a list of 11 key performance indicators (KPIs). To evaluate ranking robustness, a non-linear programming (NLP)-based sensitivity model is developed, which minimizes the weight perturbations required to trigger rank reversals, using an IPOPT solver. The results indicated that the Half-Round setup provides the most balanced sustainability performance, while Full-Square performs best in economic and environmental terms but ranks lower socially and technically. Also, the ranking was most sensitive to the weight of the system reliability and product quality criteria, with up to a 100% shift being required to change the top choice under the ANP model, indicating strong robustness. Overall, the proposed framework enables decision-makers to incorporate uncertainty, interdependencies, and sustainability-related KPIs into the early-stage SC design of bio-based composite materials. Full article

Despite rapid advances in robot learning, the coordination of closed-loop manipulation in cluttered environments remains a challenging and relatively underexplored problem. We present a novel two-level hierarchical architecture for a depth vision-equipped robotic arm that integrates pushing, grasping, and high-level decision making. Central to our approach is a prioritised action–selection mechanism that facilitates efficient early-stage learning via behaviour cloning (BC), while enabling scalable exploration through reinforcement learning (RL). A high-level decision neural network (DNN) selects between grasping and pushing actions, and two low-level action neural networks (ANNs) execute the selected primitive. The DNN is trained with RL, while the ANNs follow a hybrid learning scheme combining BC and RL. Notably, we introduce an automated demonstration generator based on oriented bounding boxes, eliminating the need for manual data collection and enabling precise, reproducible BC training signals. We evaluate our method on a challenging manipulation task involving five closely packed cubic objects. Our system achieves a completion rate (CR) of 100%, an average grasping success (AGS) of 93.1% per completion, and only 7.8 average decisions taken for completion (DTC). Comparative analysis against three baselines—a grasping-only policy, a fixed grasp-then-push sequence, and a cloned demonstration policy—highlights the necessity of dynamic decision making and the efficiency of our hierarchical design. In particular, the baselines yield lower AGS (86.6%) and higher DTC (10.6 and 11.4) scores, underscoring the advantages of content-aware, closed-loop control. These results demonstrate that our architecture supports robust, adaptive manipulation and scalable learning, offering a promising direction for autonomous skill coordination in complex environments. Full article

Background: Artificial intelligence (AI) and machine learning (ML) have been reshaping maternal, fetal, neonatal, and reproductive healthcare by enhancing risk prediction, diagnostic accuracy, and operational efficiency across the perinatal continuum. However, no comprehensive synthesis has yet been published. Objective: To conduct a scoping review of reviews of AI/ML applications spanning reproductive, prenatal, postpartum, neonatal, and early child-development care. Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, and Scopus through April 2025. Two reviewers independently screened records, extracted data, and assessed methodological quality using AMSTAR 2 for systematic reviews, ROBIS for bias assessment, SANRA for narrative reviews, and JBI guidance for scoping reviews. Results: Thirty-nine reviews met our inclusion criteria. In preconception and fertility treatment, convolutional neural network-based platforms can identify viable embryos and key sperm parameters with over 90 percent accuracy, and machine-learning models can personalize follicle-stimulating hormone regimens to boost mature oocyte yield while reducing overall medication use. Digital sexual-health chatbots have enhanced patient education, pre-exposure prophylaxis adherence, and safer sexual behaviors, although data-privacy safeguards and bias mitigation remain priorities. During pregnancy, advanced deep-learning models can segment fetal anatomy on ultrasound images with more than 90 percent overlap compared to expert annotations and can detect anomalies with sensitivity exceeding 93 percent. Predictive biometric tools can estimate gestational age within one week with accuracy and fetal weight within approximately 190 g. In the postpartum period, AI-driven decision-support systems and conversational agents can facilitate early screening for depression and can guide follow-up care. Wearable sensors enable remote monitoring of maternal blood pressure and heart rate to support timely clinical intervention. Within neonatal care, the Heart Rate Observation (HeRO) system has reduced mortality among very low-birth-weight infants by roughly 20 percent, and additional AI models can predict neonatal sepsis, retinopathy of prematurity, and necrotizing enterocolitis with area-under-the-curve values above 0.80. From an operational standpoint, automated ultrasound workflows deliver biometric measurements at about 14 milliseconds per frame, and dynamic scheduling in IVF laboratories lowers staff workload and per-cycle costs. Home-monitoring platforms for pregnant women are associated with 7–11 percent reductions in maternal mortality and preeclampsia incidence. Despite these advances, most evidence derives from retrospective, single-center studies with limited external validation. Low-resource settings, especially in Sub-Saharan Africa, remain under-represented, and few AI solutions are fully embedded in electronic health records. Conclusions: AI holds transformative promise for perinatal care but will require prospective multicenter validation, equity-centered design, robust governance, transparent fairness audits, and seamless electronic health record integration to translate these innovations into routine practice and improve maternal and neonatal outcomes. Full article

The integration of Life Cycle Assessment (LCA) into Building Information Modeling (BIM) processes is becoming increasingly important for enhancing the environmental performance of construction projects. This scoping review examines how LCA methods and environmental data are currently integrated into BIM workflows, focusing on automation, data standardization, and visualization strategies. We selected 43 peer-reviewed studies (January 2010–May 2025) via structured searches in five major academic databases. The review identifies five main types of BIM–LCA integration workflows; the most common approach involves exporting quantity data from BIM models to external LCA tools. More recent studies explore the use of artificial intelligence for improving automation and accuracy in data mapping between BIM objects and LCA databases. Key challenges include inconsistent levels of data granularity, a lack of harmonized EPD formats, and limited interoperability between BIM and LCA software environments. Visualization methods such as color-coded 3D models are used to support early-stage decision-making, although uncertainty representation remains limited. To address these issues, future research should focus on standardizing EPD data structures, enriching BIM objects with validated environmental information, and developing explainable AI solutions for automated classification and matching. These advancements would improve the reliability and usability of LCA in BIM-based design, contributing to more informed decisions in sustainable construction. Full article

Background/Objectives: Melanoma is an aggressive type of skin cancer that poses serious health risks if not detected in its early stages. Although early diagnosis enables effective treatment, delays can result in life-threatening consequences. Traditional diagnostic processes predominantly rely on the subjective expertise of dermatologists, which can lead to variability and time inefficiencies. Consequently, there is an increasing demand for automated systems that can accurately classify melanoma lesions and retrieve visually similar cases to support clinical decision-making. Methods: This study proposes a transfer learning (TL)-based deep learning (DL) framework for the classification of melanoma images and the enhancement of content-based image retrieval (CBIR) systems. Pre-trained models including DenseNet121, InceptionV3, Vision Transformer (ViT), and Xception were employed to extract deep feature representations. These features were integrated using a weighted fusion strategy and classified through an Ensemble learning approach designed to capitalize on the complementary strengths of the individual models. The performance of the proposed system was evaluated using classification accuracy and mean Average Precision (mAP) metrics. Results: Experimental evaluations demonstrated that the proposed Ensemble model significantly outperformed each standalone model in both classification and retrieval tasks. The Ensemble approach achieved a classification accuracy of 95.25%. In the CBIR task, the system attained a mean Average Precision (mAP) score of 0.9538, indicating high retrieval effectiveness. The performance gains were attributed to the synergistic integration of features from diverse model architectures through the ensemble and fusion strategies. Conclusions: The findings underscore the effectiveness of TL-based DL models in automating melanoma image classification and enhancing CBIR systems. The integration of deep features from multiple pre-trained models using an Ensemble approach not only improved accuracy but also demonstrated robustness in feature generalization. This approach holds promise for integration into clinical workflows, offering improved diagnostic accuracy and efficiency in the early detection of melanoma. Full article

When emergency incidents, such as bridge damage, abruptly occur on highways and lead to traffic disruptions, the multidimensionality and complexity of driver behaviors present significant challenges to the design of effective emergency response mechanisms. This study introduces a multi-level collaborative emergency mechanism grounded in driver behavior characteristics, aiming to enhance both traffic safety and emergency response efficiency through hierarchical collaboration and dynamic optimization strategies. By capitalizing on human drivers’ perception and decision-making attributes, a driver behavior classification model is developed to quantitatively assess the risk response capabilities of distinct behavioral patterns (conservative, risk-taking, and conformist) under emergency scenarios. A multi-tiered collaborative framework, comprising an early warning layer, a guidance layer, and an interception layer, is devised to implement tailored emergency strategies. Additionally, a rear-end collision risk propagation model is constructed by integrating the risk field model with probabilistic risk assessment, enabling dynamic adjustments to interception range thresholds for precise and real-time emergency management. The efficacy of this mechanism is substantiated through empirical case studies, which underscore its capacity to substantially reduce the occurrence of secondary accidents and furnish scientific evidence and technical underpinnings for emergency management pertaining to highway bridge damage. Full article

Technological roadmaps are essential tools for managing and planning complex projects, especially in the rapidly evolving field of space exploration. Defined as dynamic schedules, they support strategic and long-term planning while coordinating current and future objectives with particular technology solutions. Currently, the available methodologies are mostly built on experts’ opinions and in just few cases, methodologies and tools have been developed to support the decision makers with a rational approach. In any case, all the available approaches are meant to draw “ideal” maturation plans. Therefore, it is deemed essential to develop an integrate new algorithms able to decision guidelines on “non-nominal” scenarios. In this context, Politecnico di Torino, in collaboration with the European Space Agency (ESA) and Thales Alenia Space–Italia, developed the Technology Roadmapping Strategy (TRIS), a multi-step process designed to create robust and data-driven roadmaps. However, one of the main concerns with its initial implementation was that TRIS did not account for time and budget estimates specific to the space exploration environment, nor was it capable of generating alternative development paths under constrained conditions. This paper discloses two main significant updates to TRIS methodology: (1) improved time and budget estimation to better reflect the specific challenges of space exploration scenarios and (2) the capability of generating alternative roadmaps, i.e., alternative technological maturation paths in resource-constrained scenarios, balancing financial and temporal limitations. The application of the developed routines to available case studies confirms the tool’s ability to provide consistent planning outputs across multiple scenarios without exceeding 20% deviation from expert-based judgements available as reference. The results demonstrate the potential of the enhanced methodology in supporting strategic decision making in early-phase mission planning, ensuring adaptability to changing conditions, optimized use of time and financial resources, as well as guaranteeing an improved flexibility of the tool. By integrating data-driven prioritization, uncertainty modeling, and resource-constrained planning, TRIS equips mission planners with reliable tools to navigate the complexities of space exploration projects. This methodology ensures that roadmaps remain adaptable to changing conditions and optimized for real-world challenges, supporting the sustainable advancement of space exploration initiatives. Full article

This study proposed an online early lameness detection method for dairy cow health management to overcome the inability of wearable sensor-based methods for online detection and low sensitivity to early lameness. Wearable IMU sensors collected acceleration data in stationary and moving states; a threshold discrimination module using variance of motion-direction acceleration was designed to distinguish states within 2 s, enabling rapid data screening. For moving-state windowed data, the InceptionTime network was modified with YOLOConv1D and SeparableConv1D modules plus Dropout, which significantly reduced model parameters and helped mitigate overfitting risk, enhancing generalization on the test set. Typical gait features were fused with deep features automatically learned by the network, enabling accurate discrimination among healthy, mild (early) lameness, and severe lameness. Results showed that the online detection model achieved 80.6% dairy cow health status detection accuracy with 0.8 ms single-decision latency. The recall and F1 score for lameness, including early and severe cases, reached 89.11% and 88.93%, demonstrating potential for early and progressive lameness detection. This study improves lameness detection efficiency and validates the feasibility and practical value of wearable sensor-based gait analysis for dairy cow health management, providing new approaches and technical support for monitoring and early intervention on large-scale farms. Full article

The complexity of assessment is a significant problem in designing renewable energy source (RES) products, especially when one wants to take into account their various aspects, e.g., technical, environmental, or social. Hence, the aim of the research is to develop a model supporting the decision-making process of RES product development based on meeting the criteria of quality, environmental impact, and social responsibility (QES). The model was developed in four main stages, implementing multi-criteria decision support methods such as DEMATEL (decision-making trial and evaluation laboratory) and TOPSIS (Technique for Order Preference by Similarity to an Ideal Solution), as well as criteria for social responsibility and environmental impact from the ISO 26000 standard. The model was tested and illustrated using the example of photovoltaic panels (PVs): (i) five prototypes were developed, (ii) 30 PV criteria were identified from the qualitative, environmental, and social groups, (iii) the criteria were reduced to 13 key (strongly intercorrelated) criteria according to DEMATEL, (iv) the PV prototypes were assessed taking into account the importance and fulfilment of their key criteria according to TOPSIS, and (v) a PV ranking was created, where the fifth prototype turned out to be the most advantageous (QES = 0.79). The main advantage of the model is its simple form and transparency of application through a systematic analysis and evaluation of many different criteria, after which a ranking of design solutions is obtained. QES ensures precise decision-making in terms of sustainability of new or already available products on the market, also those belonging to RES. Therefore, QES will find application in various companies, especially those looking for low-cost decision-making support techniques at early stages of product development (design and conceptualization). Full article

This study explores the application of Eye-Tracking technology for the ergonomic evaluation of assistive device usability. Sixty-four participants evaluated six jar-opening devices in a two-phase study. First, the participants’ gaze was recorded while they viewed six rendered pictures of assistive devices, each shown in two different versions: with and without rubber in the grip area. Second, the participants physically interacted with the devices in a hands-on usability task. In both phases, participants rated the devices according to six usability affordances: robustness, comfort, easiness to grip, lid slippery, effort level, and easiness to use. Eye-Tracking metrics (fixation duration, number of fixations, and visit duration) correlated with the on-screen ratings, which aligned with ratings after using the physical devices. High ratings in comfort and effort level correlated with more visual attention to the grip area, where the rubber acted as key signifier. Heatmaps revealed the grip area as important for comfort and easiness to use and the lid area for robustness and slipperiness. These findings demonstrate the potential of Eye Tracking in usability studies, providing valuable insights for the ergonomic evaluation of assistive devices. Moreover, they highlight the suitability of Eye Tracking for early-stage design evaluation, offering objective metrics to guide design decisions and improve user experience. Full article

Background/Objectives: The RTK-RAS signaling cascade is a central axis in colorectal cancer (CRC) pathogenesis, governing cellular proliferation, survival, and therapeutic resistance. Somatic alterations in key pathway genes—including KRAS, NRAS, BRAF, and EGFR—are pivotal to clinical decision-making in precision oncology. However, the integration of these genomic events with clinical and demographic data remains hindered by fragmented resources and a lack of accessible analytical frameworks. To address this challenge, we developed AI-HOPE-RTK-RAS, a domain-specialized conversational artificial intelligence (AI) system designed to enable natural language-based, integrative analysis of RTK-RAS pathway alterations in CRC. Methods: AI-HOPE-RTK-RAS employs a modular architecture combining large language models (LLMs), a natural language-to-code translation engine, and a backend analytics pipeline operating on harmonized multi-dimensional datasets from cBioPortal. Unlike general-purpose AI platforms, this system is purpose-built for real-time exploration of RTK-RAS biology within CRC cohorts. The platform supports mutation frequency profiling, odds ratio testing, survival modeling, and stratified analyses across clinical, genomic, and demographic parameters. Validation included reproduction of known mutation trends and exploratory evaluation of co-alterations, therapy response, and ancestry-specific mutation patterns. Results: AI-HOPE-RTK-RAS enabled rapid, dialogue-driven interrogation of CRC datasets, confirming established patterns and revealing novel associations with translational relevance. Among early-onset CRC (EOCRC) patients, the prevalence of RTK-RAS alterations was significantly lower compared to late-onset disease (67.97% vs. 79.9%; OR = 0.534, p = 0.014), suggesting the involvement of alternative oncogenic drivers. In KRAS-mutant patients receiving Bevacizumab, early-stage disease (Stages I–III) was associated with superior overall survival relative to Stage IV (p = 0.0004). In contrast, BRAF-mutant tumors with microsatellite-stable (MSS) status displayed poorer prognosis despite higher chemotherapy exposure (OR = 7.226, p < 0.001; p = 0.0000). Among EOCRC patients treated with FOLFOX, RTK-RAS alterations were linked to worse outcomes (p = 0.0262). The system also identified ancestry-enriched noncanonical mutations—including CBL, MAPK3, and NF1—with NF1 mutations significantly associated with improved prognosis (p = 1 × 10⁻⁵). Conclusions: AI-HOPE-RTK-RAS exemplifies a new class of conversational AI platforms tailored to precision oncology, enabling integrative, real-time analysis of clinically and biologically complex questions. Its ability to uncover both canonical and ancestry-specific patterns in RTK-RAS dysregulation—especially in EOCRC and populations with disproportionate health burdens—underscores its utility in advancing equitable, personalized cancer care. This work demonstrates the translational potential of domain-optimized AI tools to accelerate biomarker discovery, support therapeutic stratification, and democratize access to multi-omic analysis. Full article

Patient involvement in health technology assessment (HTA) processes is increasingly recognized as pivotal for informed, equitable, and patient-relevant health care decision-making. With the implementation of Joint Scientific Consultations (JSCs) and Joint Clinical Assessments (JCAs) under Regulation (EU) 2021/2282, the European Union has a unique opportunity to design harmonized mechanisms that reflect best practices from established HTA systems. This article, drawing on the Acute Leukemia Advocates Network (ALAN)’s comparative analysis of HTA practices across seven countries (Canada, England, Scotland, France, Germany, Spain, and Italy), examines how current patient involvement processes can inform the JCA framework. It identifies opportunities to replicate effective practices and proposes strategies to embed patient voices meaningfully into the JCA process. By prioritizing robust and inclusive patient involvement, the EU can establish a global benchmark for impactful and consistent HTA processes. By leveraging lessons from international HTA systems and prioritizing clear frameworks, early involvement, and capacity building, the EU can set a global standard for meaningful patient participation in HTA processes. ALAN is an independent global network of patient organizations dedicated to improving outcomes for patients with acute leukemia. Full article