Search Results (5,168)

The Jinsha River Basin on the eastern margin of the Qinghai–Xizang (Tibetan) Plateau is one of the most landslide-prone regions globally. The Batang reach (from Suwalong Township to Changbo Township) lies in the core of the Jinsha River Suture Zone, characterized by complex geological conditions and frequent landslide disasters. To address the limitations of traditional monitoring methods—including difficulty in full-area coverage, high costs, and low efficiency in mountainous canyon terrain—a systematic study of landslide monitoring was conducted using Sentinel-1A SAR data and Interferometric Synthetic Aperture Radar (InSAR) technology. The results demonstrate that SBAS-InSAR, via short-baseline combinations, achieves a monitoring point density of 697 points/km² (6.28 times that of PS-InSAR), offering significant advantages in mountainous canyon areas with dense vegetation and fragmented rock masses. Using this technical framework, a total of 38 active landslides were identified in the study area, including 5 newly detected rapidly deforming hazards, 17 with river blockage risk, and 10 with the potential to bury buildings. The maximum downslope deformation rate reaches −89.56 mm/yr for the landslide near Suwalong Hydropower Station. Landslides are concentrated within 500 m of faults, in weak rock zones, on steep slopes with gradients greater than 30°, and near road-cutting projects. Temporally, landslide deformation shows an evident correlation with rainfall; approximately 70% of annual cumulative deformation occurs within the rainy season. Engineering activities including hydropower station impoundment appear to be associated with elevated deformation rates of local landslides. This study provides a scientific basis for the safety of major infrastructure corridors (e.g., the Sichuan–Tibet Railway) and regional disaster prevention and mitigation. Full article

Background: Patients with end-stage renal disease (ESRD) undergoing radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) represent a uniquely high-risk population. While prior studies have demonstrated worse postoperative outcomes among dialysis-dependent patients, no study has systematically compared oncological outcomes between peritoneal dialysis (PD) and hemodialysis (HD) modalities following RNU. This multicenter study evaluates whether dialysis modality (peritoneal dialysis versus hemodialysis) acts as an independent prognostic factor following radical nephroureterectomy. Methods: Using the Taiwan UTUC Collaboration Group Registry—a multicenter, nationwide database comprising 21 tertiary and regional medical centers —we identified 350 ESRD patients who underwent RNU for UTUC between September 1988 and December 2023. Patients were categorized by dialysis modality at the time of surgery: 310 on HD and 40 on PD. Propensity score overlap weighting was applied to account for baseline differences. Multivariate Cox proportional hazards and Fine-Gray competing risk regression models were utilized to evaluate overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), and non-UTUC mortality. Results: After overlap weighting, PD was independently associated with significantly worse OS (HR = 2.34, 95% CI 1.29–4.25, p = 0.005) and PFS (HR = 2.06, 95% CI 1.16–3.66, p = 0.013) compared to HD and exhibited a trend toward worse CSS in univariate analysis (log-rank p = 0.094). Survival curve divergence between PD and HD was most pronounced from 12 to 24 months post-surgery onward. Notably, this survival disadvantage persisted despite PD patients being significantly younger (mean age 58.8 vs. 65.1 years) and receiving adjuvant chemotherapy more frequently (20.0% vs. 6.5%). PD was also independently associated with higher non-UTUC mortality on multivariate competing risk analysis (sHR = 2.17, 95% CI 1.22–3.88, p = 0.009). Conclusions: In this first multicenter systematic comparison of PD versus HD patients undergoing RNU for UTUC, PD modality was independently associated with worse OS and PFS and exhibited a trend toward worse CSS in univariate analysis, compared to HD. This survival disadvantage persists despite favorable baseline characteristics and higher rates of adjuvant chemotherapy. We hypothesize these outcomes may be driven by a dual vulnerability: impaired systemic tumor control and elevated non-cancer mortality following surgical disruption of the peritoneal environment. To mitigate these risks, prioritizing minimally invasive or retroperitoneal surgical approaches to preserve peritoneal integrity, combined with modality-specific multidisciplinary surveillance, is recommended. Full article

Background: Patients with end-stage kidney disease commonly develop hyperparathyroidism, which may impair muscle strength and physical function. Elevated parathyroid hormone (PTH) levels have been associated with weakness and poor Timed Up and Go (TUG) test performance. We hypothesized that elevated PTH at kidney transplantation would correlate with worse TUG performance and poorer post-transplant outcomes. Methods: We performed a retrospective cohort study of 226 kidney transplant recipients (2015–2023) at a single transplant center with documented TUG testing and PTH levels. Patients were divided into normal PTH (≤600 pg/mL, nPTH) and high PTH (>600 pg/mL, hPTH) groups. Demographics, clinical characteristics, and transplant outcomes, including graft and patient survival, were analyzed. Results: The hPTH group (n = 16) was younger than the nPTH group (41.8 vs. 55.4 years, p < 0.001) and more likely to have English as a second language (62.5% vs. 35.6%, p = 0.032). They also had lower estimated post-transplant survival scores (29.3 vs. 52.0, p = 0.003) and higher rates of hyperphosphatemia (18.8% vs. 4.3%, p = 0.044). TUG pass rates, acute rejection, delayed graft function, and patient survival were similar between groups. However, the hPTH group demonstrated shorter mean graft survival (6.6 vs. 7.7 years, p = 0.022). On multivariable Cox regression, elevated PTH at transplantation remained independently associated with graft failure (adjusted hazard ratio 20.6, 95% CI 1.91–222). Conclusions: Elevated PTH at transplant was associated with poorer graft survival despite similar rejection rates and patient survival. Although not directly measured in this study, high PTH may reflect increased medical complexity or adherence-related challenges. Full article

Background: It is well documented that Black and African American (AA) patients have the highest risk of recurrence of breast cancer. However, less is known about racial differences in gene expression profiling tests such as Oncotype DX that predicts cancer recurrence. This study aimed to assess the predictive differences in Oncotype DX scores for breast cancer outcomes between Black/AA and non-Hispanic White patients. Methods: We identified Oncotype DX testing status in patients ages 18–75 years who were newly diagnosed with breast cancer, assessed race and other factors among patients with different testing statuses, and described the distribution of the Oncotype DX score. Additionally, we assessed treatment, and multifactorial impact on outcomes by Oncotype DX score, including: receipt of chemotherapy, endocrine therapy, stage, and disease-related recurrence and mortality. Results: We identified 2577 eligible patients for the analysis. Black/AA patients had a 49% greater risk/hazard of mortality than non-Hispanic White (NHW) patients (multivariable model p-value 0.0444). Oncotype DX score differences were associated with mortality in the overall sample (multivariable model, p-value = 0.0281). Specifically, in the Oncotype DX-specific models, Black/AA patients with an Oncotype DX score of 0–16 had 73% greater risk of mortality than NHW patients (multivariable model p-value 0.0409). While all other Oncotype DX score categories showed elevated risks of mortality, they were not statistically significant. The Oncotype DX-specific multivariable models showed that, compared to NHW patients, recurrence was lower for Black/AA patients in the lower categories and higher in the upper categories, but results were not statistically significant. Conclusions: This study assessed recurrence and mortality outcomes by the recurrence score and found significantly higher rates of mortality among Black/AA patients in the lowest recurrence score category. Other studies have shown that recurrence scores add prognostic value during diagnosis. However, examining performance of these tools among diverse populations is imperative. Full article

Background: Advances in neonatal intensive care have improved survival in congenital diaphragmatic hernia (CDH), shifting the clinical focus toward long-term complications such as feeding difficulties. Initiation of enteral feeding varies across centers, with evidence suggesting that intra-abdominal pressure (IAP) may influence time to feeding and clinical decision-making. We explored associations of early postoperative heart rate (HR), recorded Apgar score, and intra-abdominal pressure (IAP) with time to enteral trophic feeding. Methods: We retrospectively evaluated 28 consecutive neonates undergoing CDH repair at a national referral center between January 2022 and June 2025. Trophic enteral feeding (≥10 mL/kg/day for ≥24 h) was the primary endpoint. Aalen–Johansen estimates and two parsimonious Fine–Gray models (HR plus Apgar; IAP plus Apgar) were primary analyses and cause-specific Cox models were sensitivity analyses. Results: Within 30 postoperative days, trophic enteral feeding was achieved in 21 cases, six patients died before feeding, and one did not achieve feeding before censoring. Each 10 bpm higher HR was associated with lower feeding incidence (subdistribution HR 0.62, 0.46–0.85; p = 0.003); the cause-specific point estimate was also below 1 (HR 0.65, 0.47–0.89; p = 0.007). Mean IAP was not clearly associated with feeding incidence (subdistribution HR 1.01 per mmHg, 0.82–1.25; p = 0.925). Both Cox models failed global proportional-hazards tests. Conclusions: Each 10 bpm increase in HR was associated with a longer time to trophic enteral feeding, and the cause-specific sensitivity analysis pointed in the same direction. Because both estimates derive from the same 28 infants, their agreement is expected rather than corroborative. These findings are exploratory and do not establish causality, individual predictive value, or superiority of HR over IAP. Prospective multicenter studies with adequate sample sizes are needed to confirm these findings. Full article

Background: Despite Rwanda’s achievement of the UNAIDS 95–95–95 targets, national evidence on virological failure (VF) and mortality after transition to second- or third-line antiretroviral therapy (ART) remains limited. We estimated the incidence of these outcomes and examined associated factors among people living with HIV (PLWH) transitioned to second- or third-line ART in Rwanda between 2019 and 2025. Methods: We conducted a retrospective cohort study using Rwanda’s national HIV case-based surveillance (CBS) system. PLWH aged ≥15 years who transitioned to second- or third-line ART between 1 January 2019 and 31 December 2025 were followed from transition until the first recorded outcome, last clinical contact, or administrative censoring. The primary operational VF endpoint was the first viral load >1000 copies/mL recorded ≥180 days after transition; a prespecified sensitivity analysis required two consecutive measurements >1000 copies/mL. We used Kaplan–Meier estimation and facility-clustered Cox regression for the composite outcome of VF or death, and Aalen–Johansen cumulative incidence functions and Fine–Gray regression for VF with death treated as a competing event. Results: Among 778 PLWH followed for 3564 person-years (median follow-up, 60.0 months), 81 (10.4%) met the primary operational VF endpoint, and 13 (1.7%) had death recorded as the first event. The composite incidence rate was 2.64 per 100 person-years (95% CI 2.10–3.17). In adjusted Cox regression, a PI-based regimen (adjusted hazard ratio [aHR] 2.14, 95% CI 1.37–3.36), WHO stage III (aHR 1.92, 95% CI 1.10–3.34), and WHO stage IV (aHR 3.59, 95% CI 1.61–8.02) were associated with the composite outcome. In Fine–Gray analysis, a PI-based regimen (subdistribution hazard ratio [sHR] 3.37, 95% CI 1.96–5.78) and WHO stage IV (sHR 4.44, 95% CI 1.91–10.4) were associated with VF. Conclusions: PI-based regimen use and advanced WHO clinical stage were associated with poorer outcomes after ART line transition. These findings support intensified viral load monitoring, adherence and resistance assessment, and individualized regimen review for patients receiving PI-based therapy, together with systematic implementation of the WHO advanced HIV disease package for patients with stage III or IV disease. Full article

Background and Objectives: This study investigated the association between periodontal procedure intensity, serving as an indirect proxy for periodontal disease burden, and incident tinnitus in Korean adults. Materials and Methods: Using the Korean National Health Insurance Service–National Health Screening Cohort (2002–2019), we included adults aged ≥40 years who had a diagnosis of periodontal disease (International Classification of Diseases, 10th Revision [ICD-10] code K05), had undergone relevant periodontal treatment, and had available health-screening data. Because direct clinical periodontal measures were unavailable, participants were classified according to treatment intensity into: a mild procedure group (scaling or root planing only) and a moderate-to-severe procedure group (subgingival curettage, extraction, periodontal flap surgery, bone grafting, or guided tissue regeneration). Incident tinnitus was defined as an ICD-10 H93.1 diagnosis recorded during two or more outpatient visits to a neurology or otolaryngology department to improve diagnostic specificity. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models adjusted for demographic, socioeconomic, cardiometabolic, and behavioral factors. Results: Among 132,808 participants (76,844 mild; 55,964 moderate-to-severe), the incidence rate of tinnitus was higher in the moderate-to-severe group than in the mild group (4.38 vs. 3.87 per 1000 person-years). After adjustment, the moderate-to-severe group showed a significantly higher risk of tinnitus (HR 1.24, 95% CI 1.17–1.30). These associations were consistent across sex- and age-stratified analyses and in sensitivity analyses using stricter tinnitus definitions. Conclusions: Greater periodontal procedure intensity was associated with a modestly higher incidence of tinnitus in this nationwide cohort. Because procedure intensity serves only as an indirect surrogate for periodontal disease burden, and because auditory confounders and short-term procedure-related factors were unavailable, causality and a specific inflammatory mechanism cannot be established. Further studies incorporating direct periodontal measurements, audiological data, and prespecified lag-time analyses are warranted to confirm these findings. Full article

Sea fog that lowers horizontal visibility below 1 km is a recurrent hazard to port operations and near-shore navigation, yet its objective, continuous short-range warning remains difficult. Using a microwave radiometer and a 35 GHz millimeter-wave cloud radar co-located at the Xiaoyangshan station near the Yangshan deep-water port, eastern China, supervised by a continuous minute-resolution visibility ground truth (about 0.65 million records, 2025–2026), we develop a calibrated probabilistic sea-fog nowcasting model for lead times of 0–3 h. Under strict date-grouped cross-validation—in which neither the input window nor any forecast label crosses a fold boundary—and at the operationally realistic fog base rate of ∼1.9%, the model attains a fog-state ROC-AUC of 0.95–0.96 across lead times and an onset-AUC of about 0.94 at the 3 h lead. After out-of-group isotonic calibration the output probabilities are reliable (expected calibration error 0.007), and a single-stage alarm reaches an event hit rate of 0.84 over the 2026 hold-out period—a figure that is unchanged under a strictly out-of-time protocol in which the model, the calibrator, and the alarm parameters are all frozen on data through 2025—with a median first alert about 3.1 h before fog onset. A compact near-surface scalar model already saturates discrimination; adding vertical profiles and radar microphysics through a mask-aware fusion network yields only a small, statistically non-significant gain, indicating that independent fog events, not model capacity, limit further improvement. The scheme is lightweight, locally deployable, and can be re-evaluated as observations accumulate. Full article

Heavy metal pollution is a serious environmental concern worldwide. Cadmium is one of the most common and hazardous heavy metals and is known to impair intestinal barrier integrity. Therefore, this study was designed to evaluate the protective effects of Lactobacillus plantarum against cadmium chloride (CdCl₂)-induced toxicity in chickens. A total of 120 one-day-old Arbor Acres broiler chickens were randomly divided into four equal groups (n = 30 birds/group). Following a 4-day acclimation period, the chickens were subjected to a 28-day feeding trial. The control group (CON) received a standard basal diet, the probiotic group (LB) received L. plantarum at 1 × 10⁸ CFU/mL via oral gavage, the co-treatment group (LC) received L. plantarum at 1 × 10⁸ CFU/mL together with CdCl₂ at 80 mg/kg, and the toxin group (CD) received CdCl₂ at 80 mg/kg. Cadmium exposure markedly increased mortality, reduced survival rates, elevated serum liver enzyme activities (p < 0.0001), increased cadmium accumulation in tissues (p < 0.05), and decreased body weight gain in chickens (p < 0.0001). Moreover, cadmium exposure was associated with altered tissue Ca²⁺ homeostasis, upregulation of PIEZO1 expression and impairment of the epithelial tight-junction proteins, including ZO-1, occludin, and claudin-1. In contrast, L. plantarum supplementation improved intestinal barrier integrity and restored intestinal morphology, including villus height and crypt depth, which were adversely affected by cadmium exposure. Collectively, L. plantarum supplementation attenuated cadmium-induced systemic and intestinal toxicity, as evidenced by multiple protective mechanisms, such as reduced mortality, decreased tissue cadmium accumulation (p < 0.05), improved biochemical parameters, and preservation of intestinal morphology and tight-junction integrity. These findings suggest that L. plantarum may provide a potential dietary strategy for mitigating cadmium toxicity in broiler chickens. Full article

Balanced joint adaptive progressive Type-II censoring (B-JAPC) is developed for two independent Lomax populations with a common shape parameter and population-specific scale parameters. Classical and Bayesian inference methods are constructed for the model parameters, survival functions, and hazard rates. To address the exponential scale–shape ridge where standard maximum likelihood estimates often fail to converge, a constrained maximum likelihood estimator (CMLE) with parametric bootstrap confidence intervals is established. A partially conjugate Bayesian framework under a Beta–Gamma prior is also implemented via a Metropolis-within-Gibbs algorithm. Monte Carlo simulations demonstrate that the proposed adaptive design substantially reduces the mean test duration compared to non-adaptive schemes while maintaining high inferential accuracy. The methodology is successfully applied to randomized cloud-seeding rainfall data, confirming its practical utility and quantifying the sensitivity of lifetime inference to shape regularization. Full article

Coal–rock cutting state recognition is essential for adaptive cutting and intelligent speed regulation in shearers. To address the limited representational capability of individual signals, the confusion between adjacent gangue-bearing cutting conditions, and the domain discrepancy between simulation and experimental data, a vibration–current multimodal fusion method based on CORRECT-Net is proposed. First, an EDEM–RecurDyn–MATLAB/Simulink co-simulation system was developed to generate cutting records for four coal–rock states. After screening for physical equivalence and label conflicts, 158 valid records were retained and grouped into 150 physical-condition groups, which were partitioned at the group level into training, validation, and test sets. Subsequently, SincNet was employed to extract frequency-band-constrained features, a Transformer was used to model long-range temporal dependencies, and a residual importance-guided GATv2 module was introduced to perform cross-modal fusion of vibration-impact and current-load features. On 2500 test windows, CORRECT-Net achieved an accuracy of 96.20% ± 0.11%, a macro-F1 score of 95.14% ± 0.21%, and a hazardous-condition miss rate of 0.58% ± 0.13%. Compared with the multimodal 1D-CNN, TCN, and Bi-LSTM models, CORRECT-Net improved the accuracy by 8.80, 4.00, and 2.08 percentage points, respectively. In the progressive ablation study, the accuracy increased from 87.40% ± 0.26% to 96.20% ± 0.11%, while the macro-F1 score increased from 84.57% ± 0.34% to 95.14% ± 0.21%. Under Gaussian noise with a standard deviation of 0.05, the model retained an accuracy of 92.76% ± 0.24%. When the vibration and current modalities were separately unavailable, the corresponding accuracies were 86.56% ± 0.37% and 92.44% ± 0.25%, respectively. A five-fold simulation-to-experiment transfer evaluation was further conducted at the independent-run level using five experimental records per class. Without adaptation using experimental samples, the model achieved an accuracy of 91.33% ± 5.19%. When 20% and 50% of the experimental windows were used for adaptation, the accuracy increased to 96.33% ± 0.75% and 98.67% ± 1.39%, respectively. These results demonstrate that CORRECT-Net effectively integrates mechanical vibration responses and motor-load information and, under the present simulation and experimental conditions, achieves high recognition accuracy, a low hazardous-condition miss rate, and effective adaptability to the experimental domain. Full article

Background: Chronic obstructive pulmonary disease (COPD) and acute myocardial infarction (AMI) frequently coexist and share several biological pathways and risk factors. Although COPD is associated with worse outcomes after AMI, the prognostic value of objective pulmonary function has not been well characterized. The aim of this study was to evaluate the association between airflow-obstruction severity and five-year all-cause mortality after AMI among patients with COPD. Methods: This single-center retrospective cohort study was restricted to adult post-AMI patients (2002–2017) with a background diagnosis of COPD and documented spirometry; therefore, the final cohort represents a selected subgroup of the source COPD-AMI population. Airflow obstruction was categorized according to forced expiratory volume in one second (FEV1) as Mild, Moderate, Severe, or Very Severe (according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD)). The outcome was all-cause mortality during up to five years of follow-up. Results: Among 1594 patients hospitalized with AMI and a COPD diagnosis, 169 patients with available spirometry were included in this selected analytical cohort (mean age 66.76 ± 9.86 years, 76.9% male). During follow-up, 65 patients died, corresponding to an overall five-year mortality rate of 38.5%. Mortality increased progressively across obstruction categories: 19.0%, 33.3%, 40.0%, and 70.8% in Mild, Moderate, Severe, and Very Severe, respectively (p for trend <0.001). In multivariable analysis, adjusted hazard ratios for mortality were: 2.49 (95% CI 0.86–7.24), 3.38 (95% CI 1.09–10.46), and 5.23 (95% CI 1.62–16.89) for Moderate, Severe, and Very Severe, compared with Mild obstruction. Conclusions: Among patients with COPD who survived hospitalization for AMI, more severe airflow obstruction was associated with substantially higher five-year all-cause mortality. These findings support the potential role of spirometry-based risk stratification and highlight the need for integrated cardiopulmonary follow-up after AMI. Full article

Power cable tunnels are typical enclosed cable-routing spaces in which cable overheating, insulation aging, and partial discharge may gradually develop into fire hazards. During the early stage of cable fires, abnormal sensor responses are often weak, localized, and continuously evolving, which increases the difficulty of early warning based on a single sensor or a single temporal feature. Motivated by cable fire early warning in power cable tunnels, this study uses cable-fire records from a publicly available indoor EN 54 fire-test-room dataset with distributed multi-sensor nodes to evaluate the proposed model under controlled laboratory conditions. In monitoring scenarios with fixed sensor nodes, temporal-only modeling methods often struggle to simultaneously characterize short-term variations, temporal evolution, and spatial differences in node responses. To address this limitation, this study proposes a multi-sensor spatiotemporal feature fusion model that integrates a gated recurrent unit (GRU), a Modern Temporal Convolutional Network (ModernTCN), and an enhanced graph convolutional network (GCN+). The proposed model adopts the ModernTCN as the temporal modeling backbone. A GRU module is introduced at the front end to encode local fluctuations and short-term continuous changes between consecutive time steps, while GCN+ is embedded at the intermediate feature stage of the backbone to model spatial correlations and cross-node coordinated responses among fixed sensor nodes. Experimental results show that the proposed model achieves strong classification performance in the cable fire early warning discrimination task, with a test accuracy of 0.9884 and a false negative rate (FNR) reduced to 0.0150. The comparative experimental results indicate that the proposed model achieves better overall performance than typical temporal baseline models. The ablation study further shows that, under the experimental settings of this study, the introduction of GRU and GCN+ leads to overall improvements in the main evaluation metrics, suggesting that both modules provide a certain enhancement to the cable fire early warning discrimination performance of the ModernTCN backbone. Full article

Background/Objectives: The goal of the study is to examine associations of baseline residential elevation with blood biomarkers and newly reported multisystem chronic diseases among middle-aged and older adults, and to explore whether routine blood indicators may lie on these pathways. Methods: We analyzed 2011, 2015, and 2018 data from the China Health and Retirement Longitudinal Study (CHARLS). Wave 1 provided residential elevation, covariates, and 14 biomarkers; Wave 3 provided intermediate biomarkers; and Wave 4 identified 13 chronic disease outcomes based on participants’ reports of having received a physician diagnosis. High elevation was defined as ≥1500 m. Baseline and longitudinal samples included 11,371 and 9270 participants. Analyses used multivariable linear regression, attrition-weighted Cox models, logistic sensitivity models, restricted cubic splines, and exploratory mediation analysis. Results: High-elevation residence was associated with 9 of 14 biomarkers. Among 182 biomarker–disease Cox models, 35 associations had false-discovery-rate-adjusted q < 0.05, including 32 involving outcomes with at least 50 newly reported cases in the high-elevation group. Direct multiple-imputation inverse-probability-weighted (MI-IPW) Cox models showed that high-elevation residence was associated with higher estimated hazards over the interview interval for newly reported lung disease, kidney disease, arthritis, and hypertension; the first three associations remained significant in weighted logistic models. MI-IPW sensitivity analyses retained 31 of the 32 event-reliable biomarker–disease findings. No indirect effect survived multiple-comparison correction, including after excluding participants who had reported the relevant disease by Wave 3. Among the eight outcomes examined using restricted cubic splines, only kidney disease showed nominal evidence of nonlinearity (p = 0.017). Conclusions: Baseline residential elevation was associated with distinct biomarker patterns and heterogeneous disease risks. Routine blood biomarkers were prospectively associated with later disease reporting but did not provide stable evidence of mediation. These observational findings support cautious, disease-specific interpretation and further prospective and mechanistic research. Full article

The modern agricultural sector faces a multidimensional crisis, mainly consisting of an aging workforce, labor shortages, exhausting working conditions, and high rates of work-related accidents. In response, the authors carried out a systematic literature review (SLR), to explore the latest research on smart agricultural technologies, their effects on occupational safety, ergonomics, and worker health, and pinpoint obstacles to sustainable adoption. A thorough search was performed solely in the Scopus database, covering peer-reviewed publications from 2020 to 2026, strictly following the PRISMA 2020 guidelines. Based solely on Scopus, this study provides a focused synthesis, with the results suggesting that hazards such as chemical exposure and musculoskeletal strain are significantly reduced with the use of innovations such as unmanned vehicles, exoskeletons, and collaborative robots. These technologies also show great promise in cutting down resource waste, helping farmers practice sustainable agriculture. However, a recurring gap between research and real-life deployment exists, as adoption is hindered by cost considerations, reliability issues, and ergonomic problems. To achieve a sustainable technological transition in agriculture, it is necessary to simultaneously bridge three critical gaps: technological (ensuring robust field performance), ergonomic (design and testing processes based on real end-users and their needs), and socio-economic (addressing adoption barriers). Full article