Search Results (852)

Background: Neurogenic bladder (NB) in children may lead to recurrent urinary tract infections (UTIs), renal deterioration, and a reduced quality of life. Clean intermittent catheterization (CIC) is the standard of care, but in some patients, CIC may be unfeasible due to anatomical, sensory, or compliance issues. Button cystostomy (BC) has emerged as a minimally invasive, bladder-preserving alternative. This study aimed to assess the feasibility, safety, and outcomes in the long-term of BC in pediatric NB patients. Methods: Retrospective analysis was conducted on children with NB who underwent endoscopic BC placement between January 2020 and December 2024 in a tertiary pediatric center. Demographic data, operative time, complications, and follow-up outcomes were collected. All procedures used an endoscopic approach with cystoscopic guidance for safe device placement. Results: Thirty-three patients (25 males; median age 7.96 years) underwent BC placement. Most had spinal dysraphism (63.6%). The mean operative time was 48.5 ± 6 min. During a mean follow-up of 2.1 ± 1.4 years, five patients (15.2%) had febrile UTIs and two had minor leakage. No major complications occurred. Four buttons were removed due to clinical improvement (N = 1), the fashioning of a continent derivation (N = 1) and implantation of a sacral neuromodulator (N = 2); two patients accepted CIC. Satisfaction was reported by 93.9% of families. Conclusions: BC is an effective, minimally invasive alternative for urinary drainage in children with NB, even when compared to continent diversion techniques such as the Mitrofanoff, due to its lower invasiveness, greater feasibility, and lower complication rate. Broader adoption may be warranted, but prospective studies are needed to confirm long-term outcomes. Full article

This study presents an advanced framework for fabric texture classification by leveraging macro- and micro-texture extraction techniques integrated with deep learning architectures. Co-occurrence histograms, local binary patterns (LBPs), and albedo-dependent feature maps were employed to comprehensively capture the surface properties of fabrics. A late fusion approach was applied using four state-of-the-art convolutional neural networks (CNNs): InceptionV3, ResNet50_V2, DenseNet, and VGG-19. Excellent results were obtained, with the ResNet50_V2 achieving a precision of 0.929, recall of 0.914, and F1 score of 0.913. Notably, the integration of multimodal inputs allowed the models to effectively distinguish challenging fabric types, such as cotton–polyester and satin–silk pairs, which exhibit overlapping texture characteristics. This research not only enhances the accuracy of textile classification but also provides a robust methodology for material analysis, with significant implications for industrial applications in fashion, quality control, and robotics. Full article

The purpose of this study is to synthesize existing peer-reviewed literature on fashion renting and provide insights into its role within the broader framework of sustainable consumption and business practices within different cultural contexts, while also guiding future research efforts. This review includes only peer-reviewed journal articles and book chapters in English, with the search conducted up to 31 March 2025. A total of 95 academic papers published between 2010 and 2025 were analyzed to explore the evolving landscape of fashion rental consumption and business practices. NVivo 14 was used for the analysis of the collected literature. The findings revealed six key motivating benefits and six significant barriers that influence consumer participation in fashion renting. Additionally, five success factors and four critical challenges were identified as shaping the development of the fashion rental market. This research represents the first attempt to synthesize literature from both the consumer and business perspectives of fashion renting. The findings provide a comprehensive understanding of market dynamics related to fashion rental consumption and business practices, shedding light on the key factors that support the sustainability of fashion rental businesses as well as the challenges they face. Both theoretical and practical implications are discussed, offering valuable guidance for researchers and fashion industry stakeholders. Full article

Design and use of wearable technology have grown exponentially, particularly in consumer products and service sectors, e.g., healthcare. However, there is a lack of a comprehensive understanding of wearable technology in consumer acceptance. This systematic review utilized a PRISMA on peer-reviewed articles published between 2014 and 2024 and collected on WoS, Scopus, and ScienceDirect. A total of 38 full-text articles were systematically reviewed and analyzed using bibliometric, thematic, and descriptive analysis to understand the technical functions of digital wearable products (DWPs) in consumer acceptance. The findings revealed four key functions: (i) wearable technology, (ii) appearance and design, (iii) biomimetic innovation, and (iv) security and privacy, found in eight types of DWPs, among them smartwatches, medical robotics, fitness devices, and wearable fashions, significantly predicted the customers’ acceptance moderated by the behavioral factors. The review also identified five key outcomes: health and fitness, enjoyment, social value, biomimicry, and market growth. The review proposed a comprehensive acceptance model that combines biomimetic principles and AI-driven features into the technical functions of the technical function model (TAM) while addressing security and privacy concerns. This approach contributes to the extended definition of TAM in wearable technology, offering new pathways for biomimetic research in smart devices and robotics. Full article

Daoist robes in the Ming Dynasty literature underwent a marked transformation from exclusive religious vestments to widespread secular attire. Originally confined to Daoist priests and sacred rites, these garments began to appear in everyday work, entertainment, and ceremonies across social strata. Drawing on a hand-coded corpus of novels that yields robe related passages, and by analyzing textual references from Ming novels, Daoist canonical works, and visual artifacts, and applying clothing psychology and semiotic theory, this study elucidates how Daoist robes were re-coded as secular fashion symbols. For example, scholar-officials donned Daoist robes to convey moral prestige, laborers adopted them to signal upward mobility, and merchants donned them to impersonate the educated elite for commercial gain. By integrating close textual reading with cultural theory, the article advances a three-stage model, sacred uniform, ritual costume, and secular fashion, that clarifies the semantic flow of Daoist robes. In weddings and funerals, many commoners flaunted Daoist robes despite sumptuary laws, using them to assert honor and status. These adaptations reflect both the erosion of Daoist institutional authority and the dynamic process of identity construction through dress in late Ming society. Our interdisciplinary analysis highlights an East Asian perspective on the interaction of religion and fashion, offering historical insight into the interplay between religious symbolism and sociocultural identity formation. Full article

Background/Objectives: The aim of this systematic review was to identify the role of orthodontics in patients undergoing tumor-ablative surgery, in collaboration with maxillofacial prosthodontic rehabilitation in a multidisciplinary fashion. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42024582050). The focused question was constructed using the PICO (participant, intervention, comparison, and outcome) approach. A three-stage search was performed in PubMed, Scopus, and Web of Science using Medical Subject Heading (MeSH) terms. To assess the risk of bias, the National Institute of Health (NIH) “Quality Assessment Tool for case series/reports” was used. All data was synthesized qualitatively, according to the Synthesis Without Meta-analysis (SWiM) reporting guideline. Results: The initial search yielded 624 articles, of which 22 met the inclusion criteria after screening and eligibility assessment, with most being single-patient case reports and one case series involving 12 patients. The included studies primarily involved tumors in the mandible (64.5%) and maxilla (32.3%). Orthodontic treatment was initiated at various time points, ranging from one month pre-surgery to 19 years post-surgery, primarily utilizing fixed appliances (77.8%). In some studies, orthodontic appliances were used to enhance the stability of maxillofacial prostheses. The results of this study indicate that orthodontic treatment may facilitate prosthetic rehabilitation by improving conditions prior to prosthetic intervention and increasing the retention of the obturator prosthesis. Conclusions: Orthodontic treatment can enhance maxillofacial prosthetic rehabilitation after tumor-ablative surgery by optimizing jaw growth, improving occlusion, and facilitating prosthetic retention or space creation. Further research is needed to establish treatment guidelines. Orthodontic miniscrews may improve temporary prosthesis retention before final implant placement, when indicated. Full article

This study conducts a comparative assessment of the environmental, social, and governance (ESG) integration strategies of three leading companies in Hong Kong—H&M Group, China Gas Company Limited (Towngas), and MTR Corporation Limited (MTR)—each operating in distinct sectors with unique sustainability challenges and opportunities. The analysis adopts the Challenge–Evaluation–Planning–Action–Review (CEPAR^®) framework developed by the International Chamber of Sustainable Development to examine how these companies identify and evaluate ESG-related risks, formulate action plans, implement sustainability initiatives, and refine their strategies. The findings reveal H&M’s strong emphasis on sustainable fashion, with a target of using 100% sustainable materials by 2030 and reducing greenhouse gas emissions by 56%. Towngas faces the complex challenge of transitioning from fossil fuels to cleaner energy and is investing in zero-carbon technologies to meet regulatory standards and stakeholder expectations. MTR focuses on sustainable urban development and efficient mass transit, prioritizing community engagement and reducing environmental impact. This study underscores the importance of sector-specific ESG approaches tailored to a company’s operational context. It also demonstrates how ESG integration is enhanced by proactive planning, transparent reporting, and alignment with long-term corporate values. By showcasing both successful practices and areas requiring further attention, this research contributes to the broader discourse on sustainable business practices in Hong Kong. Moreover, it provides actionable policy implications for government agencies and regulatory bodies. The insights gained can inform strategic decision-making across sectors and support the development of a more sustainable, resilient, and inclusive economy aligned with Hong Kong’s long-term climate and governance goals. Full article

Background/Objective: Hypertrophic cardiomyopathy (HCM) often presents later in the disease course, with frequent misdiagnoses and population-level underdiagnoses. Underserved patients may have even greater diagnostic delays. We aimed to test the hypothesis in a retrospective cohort that artificial intelligence analysis of ECGs (AI-ECG) could have afforded the opportunity for earlier diagnosis of HCM in one health system. Methods: We collected all available ECGs from patients referred to an HCM Center of Excellence over 15 years, both before and after HCM diagnosis. We applied AI-ECG to each ECG in a blinded fashion to predict the probability of HCM. We calculated the time between each patient’s AI-ECG diagnosis and clinical diagnosis. We examined the sensitivity and specificity of AI-ECG for all patients, and by septal subtype and genetic test result. Results: 3499 ECGs were analyzed in 404 patients (age 56 ± 18 years, 52% female). AI-ECG correctly identified HCM in 155 patients with a sensitivity of 67%, specificity of 95%, positive predictive value of 94%, and a negative predictive value of 69%. The AUC was similar using mean probability from all ECGs for each patient (AUC 0.91 [0.88, 0.94]) or using probability from the first ECG (AUC 0.91 [0.87,0.93]). AI-ECG diagnosed 27 patients over 1 year before clinical diagnosis, and up to 16.3 years early. Black patients were more likely than White patients to have an AI-ECG diagnosis before a clinical diagnosis (p = 0.005). Conclusions: AI-ECG offers the potential for advanced HCM diagnosis. Differences in identification timing between subgroups highlight inequities in current care and show the potential of AI-ECG for the greatest benefit in underserved ethnic groups. Full article

This paper examines the strategic decisions of fashion brands to develop and sell non-fungible tokens (NFTs) within the metaverse. We construct two operational models based on whether NFTs are adopted: the traditional fashion model without NFT (Scenario T) and the digital fashion model with NFT (Scenario D). By comparing the equilibrium outcomes of fashion brands in Scenarios T and D, we derive valuable insights into the implementation of digital strategies in the fashion industry. Our analysis reveals three key findings. First and foremost, the proportion of fashion customers to conventional customers, as well as the digital value and cost of NFTs, are direct factors influencing the adoption of digital strategies by fashion brands. Secondly, opportunistic pricing by manufacturers is an indirect factor influencing fashion brands’ strategic choices, and a fixed production price contract can effectively avoid this case. Finally, we find that personalized pricing and a free NFT strategy are effective tools to boost fashion brands’ digital revenues. Full article

Pulmonary neuroendocrine proliferations and neoplasms represent a broad spectrum of diseases, ranging from neuroendocrine cell hyperplasia and tumorlets to carcinoid tumors. Carcinoid tumorlets are most commonly located in the peripheral airways and are often incidentally detected as pulmonary micronodules on chest CT. We report the radiological, bronchoscopic, and pathological findings of a case of carcinoid tumorlets presenting as endobronchial nodules in the left main bronchus. The patient had previously undergone a left lower lobectomy five years earlier for a typical carcinoid tumor. Follow-up imaging revealed new endobronchial nodules, which were subsequently confirmed as carcinoid tumorlets through histopathologic analysis. This case highlights the rare presentation of carcinoid tumorlets in the central airways, emphasizing the importance of recognizing their potential for late recurrence and atypical localization. It underscores the necessity for physicians to be aware that pulmonary neuroendocrine tumors can recur over the long term and may present in a multicentric fashion within the disease spectrum. Full article

Steroids are found in bacteria and eukaryotes, and genes potentially encoding steroid metabolic enzymes have also been identified in giant viruses. For decades, hydroxylated steroids have been utilized in medicine to treat various human diseases. The hydroxylation of steroids can be achieved using microbial enzymes, especially cytochrome P450 monooxygenases (CYPs/P450s) and is well documented. Understanding the structural determinants that govern the regio- and stereoselectivity of steroid hydroxylation by P450s is essential in order to fully exploit their potential. Herein, we present a comprehensive analysis of the steroid-hydroxylating CYP109 family across the domains of life and delineate the structural determinants that govern steroid hydroxylation. Data mining, annotation, and phylogenetic analysis revealed that CYP109 family members are highly populated in bacteria, and indeed, these members passed from bacteria to archaea by horizontal gene transfer, leading to the evolution of P450s in archaea. Analysis of twelve CYP109 crystal structures revealed large, flexible, and dynamic active site cavities that can accommodate multiple ligands. The correct positioning and orientation of the steroid in the active site cavity and the nature of the C17 substituent on the steroid molecule influence catalysis. In an analogous fashion to the CYP107 family, the amino acid residues within the CYP109 binding pocket involve hydrophilic and hydrophobic interactions, influencing substrate orientations and anchoring and determining the site of hydroxylation and catalytic activity. A handful of amino acids, such as Val84, Val292, and Ser387 in CYP109B4, have been found to play a role in determining the catalytic regiospecificity, and a single amino acid, such as Arg74 in CYP109A2, has been found to be essential for the enzymatic activity. This work serves as a reference for the precise understanding of CYP109 structure–function relationships and for P450 enzymes in general. The findings will guide the genetic engineering of CYP109 enzymes to produce valuable steroid molecules of medicinal and biotechnological importance. Full article

In this study, we present a comparative analysis of gradient descent-based optimizers frequently used in Convolutional Neural Networks (CNNs), including SGD, mSGD, RMSprop, Adadelta, Nadam, Adamax, Adam, and the recent EVE optimizer. To explore the interaction between optimization strategies and activation functions, we systematically evaluate all combinations of these optimizers with four activation functions—ReLU, LeakyReLU, Tanh, and GELU—across three benchmark image classification datasets: CIFAR-10, Fashion-MNIST (F-MNIST), and Labeled Faces in the Wild (LFW). Each configuration was assessed using multiple evaluation metrics, including accuracy, precision, recall, F1-score, mean absolute error (MAE), and mean squared error (MSE). All experiments were performed using k-fold cross-validation to ensure statistical robustness. Additionally, two-way ANOVA was employed to validate the significance of differences across optimizer–activation combinations. This study aims to highlight the importance of jointly selecting optimizers and activation functions to enhance training dynamics and generalization in CNNs. We also consider the role of critical hyperparameters, such as learning rate and regularization methods, in influencing optimization stability. This work provides valuable insights into the optimizer–activation interplay and offers practical guidance for improving architectural and hyperparameter configurations in CNN-based deep learning models. Full article

Background: While magnetic resonance imaging (MRI) is commonly used to identify meniscal tears, intraoperative assessment typically dictates repairability. This study evaluated whether a simplified MRI-based scoring system could reliably predict meniscal repair versus meniscectomy. Methods: Patients who underwent meniscectomy or meniscal repair between 2010 and 2018 were retrospectively identified. Preoperative MRIs were independently reviewed in a blinded fashion by two radiologists and one orthopedic sports surgeon. Reviewers scored images based on four arthroscopic criteria for tear repairability, with one point awarded for each of the following criteria—(1) proximity within 4 mm of the meniscosynovial junction, (2) length > 10 mm, (3) presence of intact inner meniscal segment, and (4) >50% meniscal thickness. Tears scoring four points were considered repairable. Accuracy, sensitivity, and positive and negative predictive values were calculated against the actual procedure performed. Inter- and intraobserver reliability were evaluated using kappa statistics. The predictive performance of each individual criterion was also analyzed. Results: A total of 202 meniscal tears were included (134 meniscectomies and 68 repairs). Reviewer accuracy in predicting repairability ranged from 48% to 76%. Intraobserver reliability was moderate to substantial (κ = 0.42–0.66), whereas interobserver reliability was poor to moderate (pairwise κ = 0.07–0.43; Fleiss’ κ = 0.11). Analysis of individual MRI criteria demonstrated limited predictive value, with most criteria achieving less than 50% accuracy across reviewers. Conclusions: MRI-based prediction of meniscal repairability using arthroscopic criteria demonstrated limited accuracy and poor interobserver reliability. Overall predictive reliability remains insufficient for clinical decision-making. Further investigation, integrating advanced imaging techniques and artificial intelligence, may improve the preoperative assessment of meniscal repairability. Full article

This study focuses on the shift to a circular economy (CE) in the textile, apparel, and fashion (TAF) sectors, which generate tons of waste annually. Thus, embracing CE practices is essential for contributing to UN Sustainable Development Goals. This study employs a mixed-methods approach, integrating PRISMA for systematic literature selection, BERTopic modeling and AI-driven SDG mapping, and case study analysis to explore emerging CE themes, implemented circular practices, and systemic barriers. Machine-learning-based SDG mapping reveals strong linkages to SDG 9 and SDG 12, emphasizing technological advancements, industrial collaborations, and circular business models. Moderately explored SDGs, namely, SDG 8, SDG 6, and SDG 7, highlight research on labor conditions, water conservation, and clean energy integration. Reviewing 655 peer-reviewed papers, the BERTopic modeling extracted six key themes, including sustainable recycling, circular business models, and consumer engagement, whereas case studies highlighted regulatory frameworks, stakeholder collaboration, and financial incentives as critical enablers. The findings advance institutional theory by demonstrating how certifications, material standards, and regulations drive CE adoption, reinforcing SDG 12 and SDG 16. The natural resource-based view is extended by showing that technological resources alone are insufficiently aligned with SDG 9. Using the Antecedents–Decisions–Outcomes framework, this study presents a structured, AI-driven roadmap for scaling CE in the TAF industry, addressing systemic barriers, and supporting global sustainability goals, highlighting how multistakeholder collaboration, digital traceability, and inclusive governance can improve the impact of CE. The results recommend that CE strategies should be aligned with net-zero targets, carbon credit systems, and block-chain-based supply chains. Full article

This study examines the symbolic ambiguity of Buddhist robes in the Heian period, focusing particularly on their representation in The Tale of Genji. While Buddhist monastic garments traditionally signify religious renunciation, they also functioned as fashion items regulated by strict social norms. Through an analysis of Heian-era dress codes and deviations from them, as well as literary portrayals of robes associated with ordination scenes, this study reveals that robes embodied not only religious aspirations but also worldly attachments. Literary depictions highlight the tension between formal religious identity and persistent human desires, demonstrating how Buddhist robes served not only as religious symbols but also as mediators between spiritual ideals and secular emotions. By examining robes as visual and emotional media within a broader cultural and historical framework, this paper argues that Buddhist robes during the Heian period symbolized the complex intersection of salvation and desire. Ultimately, this study sheds light on how religious symbols, rather than representing pure spiritual transcendence, reveal the enduring contradictions inherent in human nature. Full article