Search Results (7,782)

This review summarizes the base materials, joining methods, filler materials, and principal technical challenges in endoscope joining fabrication, and proposes practical strategies to improve joint reliability under clinical constraints. We conducted a comprehensive search in multiple databases, including Web of Science, Google Scholar, patent databases, Scopus databases, and Medline (via PubMed), for articles on the joining for precision endoscope fabrication, covering the period from 1950 to 2026. We employed the combinations of keywords, “endoscopy”, “minimally invasive surgery”, “welding”, “joining”, “sealing”, “soldering”, “bonding”, and “brazing”. Approximately 500 references were retrieved. After excluding duplicates and irrelevant studies, 158 publications met the inclusion criteria. Data on base materials, joining, processes, filler materials, and technical issues related to sterilization, corrosion, and microstructural evolution were extracted and analyzed. Endoscopes are multi-material systems, involving metallic biomaterials (stainless steels (SSs), titanium alloys, nickel-based alloys, etc.), optical functional materials (glass, sapphire, quartz, etc.), engineering plastics, ceramics, composite materials, and coatings. Joining, sealing, and functional integration have been achieved via adhesive bonding, laser soldering, laser brazing, wave soldering, reflow soldering, fusion welding, and other joining techniques. The main challenges include how to reliably join highly mismatched dissimilar materials, how to fabricate low-residual-stress joints, and how to increase the long-term resistance to sterilization-induced degradation and thermal aging over repeated 100–200 °C thermal cycles. Conventional joining techniques struggle to balance mechanical integrity, joint hermeticity, and long-term stability under such harsh cyclic conditions. The resulting joints may suffer surface yellowing, interfacial debonding, microcracking, delamination, or progressive property degradation during service. We propose the following three strategies to achieve reliable, low-residual-stress, and sterilization-resistant joining of dissimilar materials for endoscopes: (1) A synergistic design that combines thin-film engineering (including evaporation, sputtering, and electroplating) with silver anti-oxidation layers is proposed to reduce residual stresses and to enhance the joint hermeticity. (2) To develop principles for the selection of multi-joining processes to achieve the multi-material integration and functional assembly of dissimilar material components. (3) To develop the laser-based joining methods (fusion, brazing, or braze-welding) for precision control of heat input, bonding quality, and the least damage to the heat-sensitive components. Full article

Energy efficiency and sustainability are core issues in the modern design and management of industrial machinery and plants. These concerns are reflected and reinforced by the Sustainable Development Goal 9 of the United Nations (SDG9), “Industry, innovation and infrastructure”, which enshrines efficiency and optimized energy use as key features of sustainable production systems. As the engineering of industrial machinery reorients itself towards energy sustainability, attention is naturally shifting to actuators, since these components unavoidably waste part of the considerable amount of energy they absorb to execute their functions. Hydraulic actuation systems, while uniquely suited to heavy-duty applications, are particularly affected by poor energy conversion efficiency, in part due to their intrinsic properties but also because of outdated yet still common industrial practices. Consequently, for this actuation technology, there are wide margins for improvement in terms of energy waste reduction and increased environmental sustainability. This paper, therefore, investigates new applications for a management and control method conceived by the authors to drastically and systematically reduce the energy consumption of hydraulic actuators. The method is easily retrofittable to existing plants, being based on the unconventional and non-invasive deployment of a continuous-control electrohydraulic valve (CCEV) to control the supply pressure, whose required value is estimated according to the instantaneous load demands. Through the simulation of several industrial processes characterized by process parameters of varying orders of magnitude, this paper demonstrates that this innovative use of a CCEV for supply pressure regulation is an effective and widely applicable solution for energy savings and CO₂ footprint reduction in production systems that rely on hydraulic servo axes. Full article

Mangroves are important coastal wetland ecosystems with high ecological service values and strong carbon sequestration capacity, serving as a crucial barrier for coastal ecological security. However, current afforestation efforts often ignore environmental suitability differences among mangrove species, while the applicability value and ecological risks of exotic species (Laguncularia racemosa and Sonneratia apetala) for restoration remain poorly understood. Five native and two exotic mangrove species along China’s coasts were selected in this study. Using the MaxEnt model, we identified key environmental factors governing their distribution, predicted their current and future suitable habitats (under the SSP245 scenario in the 2070s), and quantified niche overlap between native and exotic mangroves. The results showed that temperature-related factors (air and sea temperature) are the core climatic drivers shaping the typical mangrove distribution, followed by sea surface salinity, with precipitation contributing little. Currently, niche overlap between native and the two exotic species is low (D.overlap: 0.129–0.340), indicating certain niche differentiation. Under the SSP245 scenario in the 2070s, except for Rhizophora stylosa, other studied species appear to experience expanded suitable habitat areas and a northward latitudinal distribution shift. Compared with Sonneratia apetala, Laguncularia racemosa exhibits a more pronounced expansion of suitable habitats in the future, with its overall suitable area second only to the native Kandelia obovata, indicating its stronger adaptive potential to climate change. Clarifying niche differentiation and constructing species-specific management frameworks may facilitate biological invasion control, mangrove restoration, and species diversity improvement. Full article

Listeria monocytogenes (Lm) is an important zoonotic foodborne pathogen that causes severe rhombencephalitis in ruminants. The trigeminal ganglion is a critical node for Lm invasion of the central nervous system via neural pathways. However, the roles of key virulence factors InlA, InlB, and LLO from ovine-derived Lm in trigeminal ganglion neuron infection remain unclear. In this study, LM90SB2, an ovine-derived Lm strain isolated from a sheep with encephalitis in Xinjiang, China, was used as the wild type, and its ΔInlAB double-gene deletion and ΔInlABO triple-gene deletion mutants were constructed. Primary mouse trigeminal ganglion cells (TGCs) were infected with these strains, and cell-association and invasion assays, bacterial colonization analysis, cell scratch tests, Western blotting, and qRT-PCR were performed to explore the effects of InlA, InlB, and LLO on Lm infection of TGCs and their regulatory roles in host adhesion molecules N-cadherin and NCAM1. The results showed that the wild-type LM90SB2 had significantly stronger cell-association, invasion, and colonization abilities in TGCs than the ΔInlAB and ΔInlABO mutants (p < 0.01 or p < 0.0001). LM90SB2 infection significantly upregulated the mRNA and protein expression levels of N-cadherin and NCAM1 in TGCs and enhanced TGC migration, while these effects were gradually attenuated with the sequential deletion of InlA, InlB and LLO. This study clarifies the synergistic roles of InlA, InlB, and LLO in mediating the infection of trigeminal ganglion neurons by ovine-derived Lm and reveals the molecular mechanism by which Lm promotes neural invasion by regulating the expression of host cell adhesion molecules. Our findings provide important experimental data for elucidating the neural invasion pathway of Lm in ruminants and lay a theoretical foundation for the development of targeted prevention and control strategies for ruminant listeriosis in veterinary clinical practices. Full article

Background and Objective: Transurethral resection of bladder tumor (TURBT) is the standard for non-muscle-invasive bladder cancer (NMIBC), yet recurrence rates remain high. This study evaluates the safety, tolerability, and efficacy of neoadjuvant intravesical mitomycin C (neoMMC) before TURBT in reducing recurrence and improving surgical outcomes. Methods: This randomized phase III trial enrolled patients with primary or recurrent NMIBC. Participants were randomized 1:1 to a neoadjuvant group receiving two instillations of MMC (day −14 and −7) before TURBT, or a control group undergoing standard TURBT without neoadjuvant treatment. The primary endpoint was 12-month recurrence-free survival (RFS). Secondary endpoints included surgical quality (complete resection, cauterization only, absence of residual tumor) and safety. Exploratory endpoints included histopathologic response and time to recurrence. Key Findings and Limitations: Among 95 patients (48 neoMMC, 47 controls), baseline characteristics were balanced. After a median follow-up of 19.4 months, recurrences occurred in 9 StA and 4 NeoA patients, with one progression to MIBC in the NeoA arm. RFS did not differ significantly between groups at 12 or 18 months. Neoadjuvant MMC was well tolerated, with only grade 1–2 AEs. Exploratory microbiota analyses suggested that neoadjuvant MMC modulated urinary microbial diversity and was associated with a microbiota profile more similar to that observed in non-recurrent patients. Limitations include single-center design and relatively short follow-up. Conclusions and Clinical Implications:Neoadjuvant intravesical MMC before TURBT was feasible and well tolerated in patients with NMIBC, with no unexpected safety signals. In this prematurely terminated and underpowered trial, no significant improvement in RFS was observed. Larger adequately powered studies are needed to clarify the oncologic efficacy of this approach. Full article

Parkinson’s disease (PD) is a progressive neurodegenerative disorder primarily caused by the degeneration of dopamine-producing neurons in the substantia nigra, leading to characteristic motor symptoms such as tremors, rigidity, and bradykinesia, as well as non-motor manifestations including depression, sleep disturbances, and speech impairments. Among these symptoms, speech abnormalities affect approximately 90% of individuals with PD, making acoustic analysis a promising non-invasive cue for early detection. However, subtle speech variations are often imperceptible to the human ear, and speech-only analysis may overlook complementary visual manifestations, such as hypomimia—reduced facial expressivity commonly observed in PD patients. To address these limitations, we propose Parkinson’s Detection via Attentional Fusion Network (PDAF-Net), a novel multimodal deep learning framework for early PD detection that jointly models acoustic and facial dynamic features in a binary classification setting. The proposed architecture consists of a Dual-Stream Feature Encoder (DSFE), with an audio branch based on a one-dimensional convolutional neural network (1D-CNN) and bidirectional long short-term memory (BiLSTM), and a visual branch built upon a two-dimensional convolutional neural network (2D-CNN) and a Transformer encoder. Multimodal integration is achieved through a Cross-Attention-guided Attentional Feature Fusion (CA-AFF) module, which explicitly models bidirectional cross-modal interactions and performs adaptive feature recalibration via an iterative attentional fusion mechanism. We conducted experiments on a self-collected Chinese multimodal dataset comprising 100 PD patients and 100 healthy controls. Although the data are balanced at the subject level, sliding-window segmentation introduces sample-level imbalance; to address this issue, a class-balanced focal loss is employed. Model performance was evaluated using subject-wise five-fold cross-validation. The results demonstrate that PDAF-Net consistently outperforms unimodal baselines across multiple evaluation metrics, achieving an accuracy of 89.3%, an F1-score of 0.884, and an AUC of 0.916. These findings highlight the effectiveness of explicit cross-modal interaction modeling and adaptive feature fusion for improving automated early PD screening in real-world clinical settings. Full article

High litter moisture content (LMC) in poultry houses is a primary driver of footpad dermatitis, elevated ammonia emissions, and bacterial proliferation. These conditions directly compromise broiler welfare and productivity. Existing monitoring methods, including oven-drying, contact-based sensors, and near-infrared spectroscopy, suffer from invasiveness, single-point limitation, or surface-only measurement. This study investigates ultra-wideband (UWB) impulse radar as a non-contact sensing modality for estimating the LMC of cedar wood shaving bedding under controlled laboratory conditions. A four-phase experimental program was conducted. Phases 1–3 characterized signal–moisture relationships across 0–50% LMC, manure simulant contamination, and bedding structural changes (loose, compacted, caked). Phase 4 tested whether UWB radar can estimate litter LMC when a stationary broiler body obstructs the beam under combined contamination and structural conditions. A progressive feature engineering approach and an SVC-gated mixture-of-experts regression architecture were used to address each confounding factor. Full technical details are provided in the Methods Section. Under clean conditions, the baseline model achieved $R^2=0.97$ and RMSE = 2.48% LMC. Under combined realistic conditions (manure contamination, caked bedding, centered carcass), the full pipeline achieved $R^2=0.91$ and RMSE = 4.53% LMC, with 98.8% bird detection accuracy from the radar signal alone. These laboratory findings suggest that the UWB radar can sense litter moisture through a stationary broiler body. The results support its potential as the sensing core of a non-contact monitoring system for precision poultry farming. Full article

Advanced glycation end products (AGEs) accumulate under chronic inflammation and metabolic stress and may contribute to long-term tissue damage. Skin autofluorescence (SAF) enables non-invasive assessment of tissue AGE accumulation, but data in inflammatory rheumatic diseases remain limited. The present study evaluated AGE-SAF levels in patients with seropositive rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and investigated their associations with disease activity, inflammatory markers, metabolic parameters, and comorbidities. Patients with RA and AS, along with healthy controls, were included. AGE-SAF was measured non-invasively. Disease activity was assessed using the Disease Activity Score in 28 joints (DAS28) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Between-group comparisons were performed both crudely and after multivariable adjustment for age, sex, and body mass index (BMI). Logistic regression and receiver operating characteristic (ROC) analyses were used to describe the exploratory discriminative performance of AGE-SAF, and propensity score analyses were conducted as sensitivity analyses to address baseline imbalance. In crude comparisons, AGE-SAF levels were higher in RA than in AS and controls, and higher in AS than in controls (p < 0.001). After adjustment for age, sex, and BMI, AGE-SAF remained significantly elevated in both RA (β = 0.440, 95% CI 0.298–0.583, p < 0.001) and AS (β = 0.304, 95% CI 0.183–0.425, p < 0.001) compared with controls; however, the difference between RA and AS was no longer statistically significant (β = 0.136, 95% CI −0.051 to 0.323, p = 0.154). Exploratory ROC analyses showed good discrimination for RA versus controls (AUC = 0.851) and moderate discrimination for AS versus controls (AUC = 0.695), whereas discrimination between RA and AS was limited (AUC = 0.670). In overlap-weighted sensitivity analysis, the RA-AS difference remained non-significant (β = 0.161, p = 0.293). AGE-SAF is elevated in inflammatory rheumatic diseases compared with healthy controls, and this elevation persists after adjustment for age, sex, and BMI. Although crude AGE-SAF values were higher in RA than in AS, this difference attenuated after confounder adjustment, indicating that a substantial part of the between-disease difference is attributable to demographic and treatment-related imbalance. AGE-SAF may therefore reflect cumulative disease-related and vascular–metabolic burden across both diseases rather than a disease-specific phenomenon. Full article

The modulation of the tumour microenvironment represents a pivotal step in tumorigenesis and metastasis and results from direct and paracrine cellular interactions. The innate immune Toll-like receptor 4 (TLR4) controls immune and inflammatory signalling in the tumour microenvironment. A growing body of evidence shows that TLR4 activation in cancer, immune and stromal cells upregulate gelatinase expression and activity, linking innate immune responses to extracellular matrix (ECM) remodelling. Gelatinases, or matrix metalloproteinases (MMP2) and (MMP9) play a pivotal role in tumour matrix degradation, thereby facilitating invasion, angiogenesis and metastasis. Interestingly, although TLR4 signalling in cancer cells and tumour-associated macrophages leads to different activation outputs, they can both induce gelatinases through NF-κB, MAPK, and Akt pathways. Evidence from clinical tumour tissues, co-culture models, in vivo and in vitro studies supports the crucial interplay between TLR4 signalling and gelatinases production in tumour growth and metastasis. An in-depth understanding of this crosstalk may reveal new therapeutic opportunities in targeted strategies. Full article

Background/Objectives: Circumscribed oval, hypoechoic masses are common on screening breast ultrasound (US), and the vast majority are benign. Triple-receptor negative invasive breast cancer (TNBC) can appear similar, resulting in both human and artificial intelligence (AI) interpretive errors. Purpose: We sought to improve AI performance in distinguishing common benign masses from TNBC through a retrospective model refinement and validation study. Materials and Methods: In an Institutional Review Board-approved HIPAA-compliant protocol, from five academic medical centers, orthogonal ultrasound images of 1771 breast masses 2 cm or smaller were acquired, consisting of cysts, complicated cysts, other benign, and malignancies. Cases were randomized, controlling for lesion class, site, and patient age, with 1446 (including 402, 27.8%, malignancies) used for training and 325 (including 95, 29.2% malignancies) for validation using Koios DS^® (decision support, KDS) software version 2.0. A breast imaging radiologist from each center reviewed images and recorded BI-RADS features and assessment. Demographics, symptoms, and pathology or at least one-year follow-up was recorded. The KDS score was evaluated standalone and in combination with BI-RADS using logistic regression and ROC analysis with focus on specificity at sensitivity of 98%. Results: In training, KDS standalone performed comparably to BI-RADS, and significantly improved BI-RADS malignancy risk prediction (p < 0.001). The 98%–sensitivity threshold for combined KDS + BI-RADS was estimated and kept fixed during validation. In validation, KDS standalone performed similar to BI-RADS with AUC = 0.97 (CI: 0.95–0.98) versus 0.95 (p = 0.22), with sensitivity of 98% (93/95, CI: 95–100%) for both and specificity of 70.9% (163/230, CI: 65.0–76.7%) for KDS versus 63.9% for BI-RADS (147/230, p = 0.10). Combining KDS + BIRADS significantly improved overall performance (AUC 0.98, p < 0.001) and specificity (74.4%, 171/230, p < 0.001) while maintaining sensitivity at 98% (93/95). Conclusions: While KDS alone should not replace BI-RADS, when used in combination with BI-RADS, it can significantly improve specificity for highly accurate (98% sensitivity) triaging management of masses representative of those seen on screening US. Full article

Alveolar–pleural or broncho-pleural fistulas, leading to persistent air leaks (PALs), are associated with prolonged hospitalization and substantial morbidity. While guidelines advocate surgical repair as the primary treatment, its efficacy is limited. For patients recently subjected to thoracic surgery or those for whom surgery is contraindicated due to severe illness, viable treatment alternatives have been lacking. This article reviews the newer and less invasive treatment options for PALs. Further research is crucial, including randomized controlled trials comparing these options, and long-term monitoring of intervention outcomes is warranted. Full article

The C-terminal binding protein 1 (CTBP1) is a transcriptional corepressor with a major role in nervous system growth and development. There are only 20 published cases with CTBP1 mutations, displaying a phenotype of Hypotonia, Ataxia, Developmental Delay and Tooth enamel defect Syndrome (HADDTS). Histochemical evidence of decreased mitochondrial respiratory chain activity has been previously reported, but comprehensive data on the metabolic phenotype assessed by various cellular respiration parameters are still missing. We present a 10-year-old female with typical HADDTS features, harboring the most reported de novo heterozygous CTBP1 mutation c.991C>T. To elucidate her metabolic phenotype, we quantified mitochondrial respiration in peripheral blood mononuclear cells (PBMCs) utilizing an analyzer for assessing mitochondrial function (Seahorse XFp). Real-time metabolic assays revealed profound mitochondrial dysfunction with significantly attenuated maximal respiration and spare respiratory capacity compared to neurotypical controls. Following mitochondria-targeted nutritional support for one-year measurable bioenergetic improvements and reduced number of respiratory infections were registered. However, neurological recovery and new skill acquisition were not observed. We present a novel case of CTBP1-related neurodevelopmental disorder and demonstrate, for the first time, the application of non-invasive, real-time mitochondrial functional assessment in this setting, providing additional evidence for mitochondrial dysfunction in HADDTS. Full article

Noninvasive blood glucose monitoring is crucial for detecting early dysglycemia, yet continuous glucose monitors remain invasive and costly. Electrocardiogram (ECG) and its derived heart rate variability (HRV) measure may offer a noninvasive indicator of autonomic and cardiac responses associated with acute changes in glucose. In this study, 30 adults underwent a 75 g oral glucose tolerance test with concurrent ECG Holter and interstitial glucose monitoring. From these recordings, HRV and ECG features were extracted. A deep learning classifier with HRV and ECG was then trained to detect hyperglycemia (glucose ≥ 180 mg/dL). Cross-correlation analysis confirmed a significant association between HRV and glucose (Pearson r ~0.65, p < 0.05) when aligning each participant’s data according to individual response delays. The model achieved high classification performance under rigorous temporal validation (accuracy ~89%, area under the receiver operating characteristic curve ~0.89). Saliency analyses revealed that the classifier’s decisions focus on distinct ECG waveform transitions and key HRV features linked to glucose-induced autonomic changes. Overall, acute hyperglycemia elicited discernible changes in HRV and cardiac conduction, supporting the feasibility of this physiologically grounded approach for detecting the acute hyperglycemic phase under controlled conditions. This method holds promise for real-time implementation in wearable devices, enabling early diabetes risk screening. Full article

Objectives: CD93, an angiogenesis-related transmembrane glycoprotein, is transcriptomically downregulated in uterine corpus endometrial carcinoma, yet circulating protein levels have not been clinically evaluated. This study aimed to evaluate serum CD93 as a diagnostic biomarker for EC and to examine its association with clinicopathological parameters. Methods: In this single-center case–control study, serum CD93 concentrations were measured by enzyme-linked immunosorbent assay in 46 patients with histologically confirmed primary EC and 35 controls with histologically verified benign gynecological pathology. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed. Results: Serum CD93 was significantly lower in EC patients than controls (median 4.55 [IQR 3.51–6.97] vs. 10.24 [7.18–12.14] ng/mL; p < 0.001). In multivariable analysis adjusted for age and body mass index, lower CD93 remained independently associated with EC (OR = 0.521; 95% CI 0.061–0.720; p < 0.001). ROC analysis yielded an area under the curve of 0.845 (95% CI 0.759–0.921), with 82.6% sensitivity and 74.3% specificity at a cut-off of 7.338 ng/mL. CD93 levels showed no significant association with histological subtype, grade, lymphovascular space invasion, nodal metastasis, or recurrence. Conclusions: Serum CD93 is significantly reduced in EC and demonstrates independent diagnostic performance, supporting its prospective validation as a non-invasive biomarker in larger multicenter cohorts. Full article

Peripheral artery disease (PAD) involves atherosclerotic obstruction of the leg arteries and impairs function and structure of lower-limb tissues. Although traditionally regarded as a large-artery (macrovascular) disorder, PAD includes significant microvascular disease in the affected musculature, together leading to impaired leg perfusion. Monitoring muscle oxygenation during exercise provides an indirect index of limb perfusion and exercise capacity, and tracking its kinetics with near-infrared spectroscopy (NIRS; a portable, non-invasive technique measuring real-time tissue oxygen saturation) helps elucidate mechanisms underlying walking limitations in PAD. We systematically searched PubMed, Web of Science, and the Cochrane Library (1985–2025) for studies employing NIRS to monitor muscle oxygenation in PAD patients before, during, and after exercise. Of 628 articles screened, 11 met the inclusion criteria. NIRS demonstrated reliability and validity for monitoring muscle oxygenation in PAD. During walking, PAD patients showed a much steeper decline in muscle oxygenation and delayed recovery to baseline. Resting muscle oxygenation did not differ between patients with PAD and controls. These dynamics reveal the pathophysiological interplay in which proximal/macrovascular and distal/microvascular disease limit oxygen delivery and utilization in skeletal muscle. Accordingly, NIRS offers a sensitive, non-invasive tool to evaluate macro- and microvascular disease burden and monitor therapeutic response in PAD. Full article