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17 pages, 281 KB  
Article
Prognostic Factors for Adverse Outcomes in Odontogenic Infections Requiring Hospitalization: A Single-Center Retrospective Study in Kraków, Poland
by Michał Gontarz, Agata Wieczorkiewicz, Andrei Hramyka, Jakub Bargiel, Krzysztof Gąsiorowski, Paweł Szczurowski, Kamil Nelke, Barbara Czopik, Ömer Uranbey, Katarzyna Rusek and Grażyna Wyszyńska-Pawelec
J. Clin. Med. 2026, 15(13), 5120; https://doi.org/10.3390/jcm15135120 - 1 Jul 2026
Abstract
Background/Objectives: Odontogenic infections range from localized abscesses to life-threatening deep neck infections and are a frequent cause of emergency admission. We aimed to identify prognostic factors for postoperative complications after their surgical treatment. Methods: We retrospectively analyzed 194 adults (59.3% male) [...] Read more.
Background/Objectives: Odontogenic infections range from localized abscesses to life-threatening deep neck infections and are a frequent cause of emergency admission. We aimed to identify prognostic factors for postoperative complications after their surgical treatment. Methods: We retrospectively analyzed 194 adults (59.3% male) treated at the Department of Cranio-Maxillofacial Surgery in Cracow between 2020 and 2025. The primary outcome was any postoperative complication, graded by the Clavien–Dindo classification and dichotomized into minor (grade I–II) and major (grade ≥ III). Prolonged hospitalization and prolonged irrigation (>7 days) were secondary outcomes. Pre-specified main factors (advanced age, diffuse phlegmonous spread, diabetes mellitus) and covariates (sex, maxillary location, systemic disease) were tested by uni- and multivariable logistic regression. Results: Comorbidities were present in 69.1%. Complications occurred in 49 patients (25.3%): 19 (9.8%) minor and 30 (15.5%) major, including 12 grade IV intensive-care events and two deaths (grade V). In multivariable analysis, diffuse phlegmonous spread independently predicted any complication (adjusted OR 11.7), major complication (OR 23.4), prolonged hospitalization (OR 5.02) and prolonged irrigation (OR 4.39; all p ≤ 0.004). Advancing age independently predicted major complications (OR 1.03 per year, p = 0.037). Both fatal cases shared phlegmon, maxillary location and diabetes. Conclusions: Diffuse phlegmonous spread was the principal prognostic factor across all adverse outcomes, with advancing age additionally predicting major complications. Because intensive-care admission occurred almost exclusively in phlegmon patients, this association is partly definitional. Early identification of diffuse spread and advanced age may support effective triage. Full article
13 pages, 284 KB  
Review
IBS-Related Faecal Incontinence: A Focused Narrative Review of Mechanisms, Evidence, and Conservative Care Considerations
by Yohei Okawa
Gastrointest. Disord. 2026, 8(3), 33; https://doi.org/10.3390/gidisord8030033 - 29 Jun 2026
Viewed by 160
Abstract
Background: Faecal incontinence (FI) may occur in patients with irritable bowel syndrome (IBS), particularly when loose stool, urgency, reduced warning time, fluctuating bowel habits, or constipation with retention interferes with timely defaecation. However, IBS-related FI should be distinguished from FI caused primarily by [...] Read more.
Background: Faecal incontinence (FI) may occur in patients with irritable bowel syndrome (IBS), particularly when loose stool, urgency, reduced warning time, fluctuating bowel habits, or constipation with retention interferes with timely defaecation. However, IBS-related FI should be distinguished from FI caused primarily by structural sphincter injury, neurological disease, advanced frailty, or other organic gastrointestinal disorders. This focused narrative review examines IBS-specific mechanisms and conservative care considerations relevant to FI risk. Methods: This article is a focused narrative review rather than a systematic review, scoping review, clinical guideline, or formal GRADE assessment. PubMed and the Ichushi-Web/Japanese Medical Abstracts Society were searched for studies published from January 2000 to June 2026. Search terms were combined and included irritable bowel syndrome with faecal/fecal incontinence, urgency, diarrhoea/diarrhea, constipation, stool form, bowel diaries, diet, FODMAP, fibre/fiber, pelvic floor rehabilitation, biofeedback, skin care, absorbent products, ultrasound, and conservative management. Studies directly addressing IBS mechanisms or symptom management, FI assessment or conservative FI care, or implementation issues relevant to IBS-related FI were deemed eligible. Results: Direct studies of FI prevention in IBS patients are scarce. The most defensible IBS-specific targets are loose stool, urgency, reduced warning time, alternating bowel habits, constipation with retention or incomplete evacuation, diet- or medication-related triggers, stress-related exacerbation, and toilet access. Broader FI evidence supports supportive measures such as skin protection, absorbent products, pelvic floor rehabilitation, biofeedback, transanal irrigation, and referral, but these measures are not IBS-specific unless they are connected to IBS-related symptom pathways. Synthesis: Evidence was organized into three categories: direct IBS evidence, general FI evidence, and indirect implementation evidence from continence-care settings. No formal certainty ratings or recommendation strengths were assigned; statements are therefore framed as clinical considerations and areas for future study rather than guideline-level recommendations. Conclusions: IBS-related FI should be discussed as a symptom-risk pathway within IBS rather than as FI in general. Available evidence suggests the value of assessing IBS subtype, stool form, urgency, triggers, warning time, and toileting circumstances before applying general FI support. Because direct preventive trials are limited, conclusions should be interpreted as practice-informing clinical considerations rather than firm recommendations. Full article
13 pages, 1499 KB  
Article
A New Ultrasound Method to Study the Relations Between Ileocecal Valve Incontinence and Inflammation in Metabolic Associated Steatotic Liver Disease
by Antonio Salvati, Lorenzo Bertellotti, Francesco Faita, Daniela Campani, Giovanni Petralli, Simone Cappelli, Ferruccio Bonino and Maurizia Rossana Brunetto
Livers 2026, 6(3), 54; https://doi.org/10.3390/livers6030054 - 18 Jun 2026
Viewed by 266
Abstract
Background: Small intestine bacterial overgrowth (SIBO) is associated with steatohepatitis (SH) in subjects with metabolic-associated steatotic liver disease (MASLD). The impact of ileocecal valve (ICV) incontinence, a major cause of SIBO in patients with MASLD, remains unknown because of the unmet need for [...] Read more.
Background: Small intestine bacterial overgrowth (SIBO) is associated with steatohepatitis (SH) in subjects with metabolic-associated steatotic liver disease (MASLD). The impact of ileocecal valve (ICV) incontinence, a major cause of SIBO in patients with MASLD, remains unknown because of the unmet need for a non-X-ray-dependent diagnosis. Methods: Exploiting water as contrast medium and colonic irrigation via a hydro-colon machine (Clean Colon Srl, Monza, Italy), we developed a new abdominal ultrasound (US) procedure for diagnosing and grading ICV incontinence. In a pilot, observational, feasibility and safety study, we correlated a new ICV incontinence parameter with irritable bowel syndrome (IBS, ROMA IV criteria), serum transaminases (AST, ALT), platelet counts, FIB-4, US liver steatosis and stiffness (LS, measured by Shear Wave and Transient Elastography, SWE and TE). Results: We prospectively studied 32 consecutive subjects with IBS who underwent a pre-colonoscopy colon cleansing after informed consent: 19 males (59%), body mass index (BMI) 26.6 ± 2.6 kg/m2, age 57 ± 19 years, 16 (50%) with US liver steatosis. The half-hour (27 min, range 20–35 min) procedure was safe and well tolerated except in two males with prostate hypertrophy. ICV incontinence was graded (after 2500–3000 mL irrigation) according to cecum/right-colon distention with/without (immediate or delayed) reflux into terminal ileum (TI): 0 = cecum distension without TI reflux; 1 = cecum distension with TI reflux; 2 = absence of cecum distension with TI reflux. Cecum/right-colon distention (grade 0 or 1) was perceived by the patients whereas the right colon irrigation with complete ICV incontinence (grade 2) was symptomless. ICV continence associated with LS (p ≤ 0.0001). A histologic diagnosis of non-alcoholic steatohepatitis was confirmed in a 35-year-old obese male with SIBO and LS > 8 kPa (8.7/8.5 kPa by SWE/TE):steatosis (grade S3) with hepatocyte ballooning, lobular inflammation (grade 6/8) without fibrosis (stage 0/4, F0). Conclusions: The new US-based approach provides a feasible, easy-to-perform, mini-invasive tool for the diagnosis and grading of ICV incontinence. Preliminary results prompt prospective studies investigating the impact of ICV incontinence as a possible co-factor of steatohepatitis in patients with MASLD. Full article
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24 pages, 5490 KB  
Article
A Phased and Graded Drought Limited Water Level Strategy for Mitigating Flood Drought Abrupt Alternation Events: A Case Study of the Three Gorges Reservoir
by Zhiling Zhou, Lei Liu, Shuai Liu and Shu Chen
Water 2026, 18(11), 1333; https://doi.org/10.3390/w18111333 - 31 May 2026
Viewed by 389
Abstract
In recent decades, flood drought abrupt alternation (FDAA) events have intensified markedly in the middle and lower reaches of the Yangtze River Basin (MLYRB), exposing limitations of the conventional single flood-limited water level (FLWL) operation of the Three Gorges Reservoir. To better address [...] Read more.
In recent decades, flood drought abrupt alternation (FDAA) events have intensified markedly in the middle and lower reaches of the Yangtze River Basin (MLYRB), exposing limitations of the conventional single flood-limited water level (FLWL) operation of the Three Gorges Reservoir. To better address drought risk during the flood season, this study develops a phased and graded drought-limited water level (DLWL) operation framework. FDAA events were identified using a hybrid method combining the Short-term Flood-Drought Abrupt Alternation Index and the Standardized Runoff Index. A multi-objective optimization model solved by NSGA-III was employed to determine staged DLWLs across five operational periods with tiered thresholds prioritizing urban, ecological, and irrigation water demands. Results show that FDAA events are mainly concentrated in June–October and have intensified significantly since 2010. Compared with conventional operation, the optimized DLWL framework substantially improves irrigation water supply reliability and reservoir fullness, while maintaining urban and ecological water supply security. Validation during typical wet years indicates that the proposed strategy introduces no evident reduction in flood control safety. Full article
(This article belongs to the Special Issue Optimization of Reservoir Operations)
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30 pages, 15261 KB  
Article
Influence on the Deficit of Terrestrial Water Storage in China from the Perspective of Natural Regionalization
by Wen Liu, Xinwen Xu, Yi He, Lanting Gong and Bo Liu
Land 2026, 15(5), 807; https://doi.org/10.3390/land15050807 - 9 May 2026
Viewed by 259
Abstract
Under the background of global change, the threshold for the propagation of meteorological drought to hydrological drought is crucial for drought early warning and water resource management. However, traditional threshold studies often adopt subjective and fixed conditional probabilities and lack the revelation of [...] Read more.
Under the background of global change, the threshold for the propagation of meteorological drought to hydrological drought is crucial for drought early warning and water resource management. However, traditional threshold studies often adopt subjective and fixed conditional probabilities and lack the revelation of the driving mechanisms under macroscopic natural geographical differentiation. This study integrates terrestrial water storage anomaly (TWSA) data derived from the Gravity Recovery and Climate Experiment (GRACE) and its Follow-On (GRACE-FO) mission, the standardized precipitation evapotranspiration index (SPEI), and multi-source environmental data to construct an objective threshold identification method based on Copula joint distribution and “system resilience loss”, and combines explainable machine learning to systematically explore the critical threshold for meteorological drought, triggering a TWSA deficit and its driving mechanisms from the perspectives of three major natural regions, the Eastern Monsoon Region (EMR), the Northwestern Arid Region (NAR), and the Tibetan Plateau Region (TPR). The results show that: (1) from 2005 to 2024, the TWSA significantly decreased in nearly half of China’s regions, with significant regional differentiation; (2) the response of the TWSA to meteorological drought has a significant lag (an average of 9–12 months), and shows a spatial pattern of slower in the east and faster in the northwest; (3) the probability of a TWSA deficit and the triggering threshold both have obvious grade dependence and spatial heterogeneity, with the lowest threshold in the northwest arid region, which is the most sensitive; (4) the threshold is driven by the synergy of multiple factors, with “water dominance and energy modulation”, and the dominant factors show regional differentiation; and (5) irrigation agriculture significantly reduces the drought triggering threshold and exacerbates system vulnerability. This study provides a scientific basis for understanding the geographical differentiation laws of drought propagation and regional early warning management. Full article
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10 pages, 3914 KB  
Case Report
Regeneration Versus Granulation Tissue Healing in a Hopeless Mature Mandibular Molar Post-Endodontic Management: A 40-Month Follow-Up Case Report
by Elhassan Hassanein, Petra Gierthmuehlen, Almaha S. Algazlan, Dalia Kaisarly and Moataz Elgezawi
Dent. J. 2026, 14(4), 243; https://doi.org/10.3390/dj14040243 - 20 Apr 2026
Viewed by 783
Abstract
Objective: To report a rare case of pulp space tissue growth in a mature mandibular molar with severe endo-periodontal involvement after conservative endodontic treatment and to discuss the possible biological explanations, including regeneration and granulation tissue healing. Severe endo-periodontal lesions are challenging, particularly [...] Read more.
Objective: To report a rare case of pulp space tissue growth in a mature mandibular molar with severe endo-periodontal involvement after conservative endodontic treatment and to discuss the possible biological explanations, including regeneration and granulation tissue healing. Severe endo-periodontal lesions are challenging, particularly as endodontic regeneration is usually observed in immature teeth, while revascularization in mature teeth, especially in cases of advanced periodontal disease, is rare, as demonstrated in this case. Methods: This study reports a rare case of tissue regeneration versus granulation tissue healing in the pulp space, occurring alongside periodontal healing, in a mature mandibular molar with necrotic pulp and severe periodontal involvement. A 52-year-old patient presented with a mature mandibular molar (tooth #19) exhibiting necrotic pulp with severe endo-periodontal involvement, including grade-3 mobility, tenderness to percussion, a 12 mm probing depth, and extensive periradicular radiolucency. The tooth was diagnosed with necrotic pulp and symptomatic apical periodontitis and was deemed hopeless, with extraction planned. Results: Following patient refusal, endodontic treatment was initiated, including cleaning, shaping, and placement of the intracanal medicament, Ledermix. The patient canceled the extraction due to symptom resolution and disappeared for 12 months. On return, the patient presented with spontaneous pain exacerbated by thermal stimuli, consistent with symptoms of irreversible pulpitis. Clinical examination revealed significant clinical and radiographic improvements, including reduced probing depth (3 mm), no mobility, resolution of apical translucency, radiographic findings suggestive of canal narrowing, and a positive pulp sensibility response. Re-entry elicited profuse bleeding with newly formed vital tissue beneath the medicament. Sodium hypochlorite irrigation failed to achieve hemostasis; inflamed tissue was removed; root canals were cleaned, shaped and obturated; and treatment was completed with placement of a permanent coronal resin composite restoration. A forty-month follow-up showed an asymptomatic tooth with clinical and radiographic healing. Conclusions: This case demonstrates that conservative endodontic management may result in favorable clinical and radiographic outcomes in mature teeth with severe endo-peroidontal involvement, influencing extraction decisions. It provides clinical evidence suggestive of tissue regeneration and periodontal healing in a mature tooth with necrotic pulp and severe periodontal compromise, challenging conventional prognosis. The observed pulp space tissue growth may be suggestive of regeneration; however, alternative explanations, including granulation tissue healing or repair processes, cannot be excluded. Healing by granulation tissue in the pulp space remains possible. Root canal treatment in advanced endo-perio lesions can yield favorable outcomes and may influence extraction decisions. Further clinical and histological studies are needed to clarify underlying mechanisms and optimize treatment strategies. Full article
(This article belongs to the Special Issue Advances in Regenerative Endodontics)
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24 pages, 50518 KB  
Article
Cotton Growth Stage Identification Integrating Unmanned Aerial System Images and Artificial Intelligence Algorithm
by Esirige, Hui Peng, Haibin Gu, Yueyang Zhou, Ruhan Gao, Rui Chen and Xinna Men
Drones 2026, 10(3), 207; https://doi.org/10.3390/drones10030207 - 15 Mar 2026
Viewed by 651
Abstract
Unmanned aerial systems (UASs) and artificial intelligence (AI) allow for the effective monitoring of the plants, but it is difficult to determine the stages of cotton development in the process of irrigation gradients. In this paper, UAS images were combined with deep learning [...] Read more.
Unmanned aerial systems (UASs) and artificial intelligence (AI) allow for the effective monitoring of the plants, but it is difficult to determine the stages of cotton development in the process of irrigation gradients. In this paper, UAS images were combined with deep learning to conduct field-scale cotton phenology classification in graded drought situations. SegNet, U-Net, and DeepLabv3+ were trained on various sample sizes and tested on global accuracy (GA), mean intersection-over-union (mIoU), and mean boundary F-score (mBF). It was found that DeepLabv3+ outperformed all other methods and yielded the most uniform delineation of crop row spacing, canopy edges, and boll opening boundaries throughout the entire growing season. Under single-stage training, performance became stable at training sample sizes ≥ 960 for the seedling and squaring stages, whereas the boll and boll-opening stages required ≥ 1280; for full-season training, performance became stable when the sample size reached 4480 (GA = 0.98, mIoU = 0.95, mBF = 0.81). Cross-treatment evaluation indicated that errors were mainly concentrated between adjacent stages, with higher confusion under the 0% irrigation treatment and more stable identification results under the 90% irrigation treatment. A DAP 138 field survey (36 points) confirmed an irrigation-gradient phenological shift from boll-opening dominance at 0% irrigation to universal boll at 90% irrigation, consistent with spatial phenology maps. Overall, the proposed framework provides a cost-effective, field-scale solution to support precision irrigation management in arid cotton-growing regions. Full article
(This article belongs to the Special Issue Drones and AI for Crop Information Sensing and Decision-Making Models)
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14 pages, 469 KB  
Review
Prevention and Treatment of Surgical Site Infections in Orthopaedic Surgery: An Italian Delphi Consensus on Risk Stratification and Wound Irrigation Strategies
by Pier Francesco Indelli, Massimiliano De Paolis, Arcangelo Russo, Massimo Fantoni, Augusto Palermo, Giovanni Pomponio, Alessandro Scalise, Domenico Tigani, Bruno Violante, Steven L. Percival, Biagio Zampogna and Pierluigi Viale
J. Clin. Med. 2026, 15(5), 1718; https://doi.org/10.3390/jcm15051718 - 24 Feb 2026
Viewed by 1864
Abstract
Introduction: Surgical site infections (SSIs) and prosthetic joint infections remain among the most serious complications in orthopedic surgery, and chemical debridement is recommended for all septic revisions. The combination of polyhexanide (PHMB) and poloxamer (PLX), with in vitro antimicrobial and antibiofilm activity, [...] Read more.
Introduction: Surgical site infections (SSIs) and prosthetic joint infections remain among the most serious complications in orthopedic surgery, and chemical debridement is recommended for all septic revisions. The combination of polyhexanide (PHMB) and poloxamer (PLX), with in vitro antimicrobial and antibiofilm activity, represents a promising antiseptic solution. An Italian Delphi consensus was conducted to define the indications and clinical applications of PHMB/PLX as an antiseptic solution. Materials and Methods: A steering committee convened a panel of orthopedic surgeons, infectious disease specialists, and wound care specialists with expertise in musculoskeletal infections. A modified three-phase Delphi process was conducted. Twelve clinical questions and four outcome measures were developed through literature review and iterative discussion. Two Delphi rounds were conducted using a 9-point Likert scale, and statements were rated according to the GRADE method. Results: Twelve statements were developed, and all achieved strong consensus after two Delphi rounds. The panel identified key patient-related risk factors (smoking, diabetes, obesity, immunosuppression) and procedure-related risks (open fractures, primary/revision arthroplasty, prolonged operative time). Antiseptic irrigation was considered superior to saline, and PHMB-PLX was considered potentially useful based on expert opinion as an addition to mechanical debridement given its antibiofilm activity and good cytocompatibility. Low-pressure irrigation and short exposure times are the preferred application methods, while avoiding use on cartilage or neural tissues. Conclusions: The Delphi panel reached strong consensus supporting the intraoperative use of PHMB-PLX due to its potential as an antiseptic adjunct, supported by expert consensus and translational evidence for preventing and treating SSIs in orthopedic surgery. The panel recommended conducting high-quality clinical research to verify these findings and improve standardized irrigation protocols. Full article
(This article belongs to the Special Issue Clinical Advances in Trauma and Orthopaedic Surgery)
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15 pages, 280 KB  
Article
Postoperative Flare and Corneal Endothelial Cell Loss After Eight-Chop Technique Phacoemulsification: A Prospective Observational Study
by Tsuyoshi Sato
J. Clin. Med. 2026, 15(2), 557; https://doi.org/10.3390/jcm15020557 - 9 Jan 2026
Cited by 1 | Viewed by 618
Abstract
Objectives: The Eight-chop technique is a mechanically based nuclear segmentation method designed to improve surgical efficiency and reduce intraocular tissue stress during phacoemulsification. Early postoperative aqueous flare serves as an objective indicator of surgical invasiveness, whereas corneal endothelial cell density (CECD) loss [...] Read more.
Objectives: The Eight-chop technique is a mechanically based nuclear segmentation method designed to improve surgical efficiency and reduce intraocular tissue stress during phacoemulsification. Early postoperative aqueous flare serves as an objective indicator of surgical invasiveness, whereas corneal endothelial cell density (CECD) loss represents a structural measure of endothelial injury. Although both parameters are clinically important, their relationship has not been systematically investigated in the context of this newer mechanical fragmentation approach. Methods: This prospective observational study included 118 eyes from 70 non-diabetic patients undergoing uncomplicated Eight-chop phacoemulsification. Aqueous flare was measured preoperatively and at postoperative Day 1, Day 7, Week 7, and Week 19 using laser flare photometry. CECD was evaluated preoperatively and at Weeks 7 and 19. Changes over time were analyzed using paired t-tests. Linear mixed-effects models (random intercept = patient ID) were constructed to assess predictors of CECD loss and postoperative intraocular pressure (IOP) reduction. Explanatory variables included Day 1 flare, age, preoperative CECD, nucleus hardness (Emery-Little grade), cumulative dissipated energy (CDE), and irrigation fluid volume. Results: Postoperative flare increased significantly at all time points (all p < 0.001), peaking on Day 7 (16.7 ± 9.21 photon counts/ms). CECD loss was extremely small, averaging 1.38% at Week 7 and 1.46% at Week 19. In mixed-effects models, Day 1 flare was not associated with CECD loss at Week 7 (p = 0.35) or Week 19 (p = 0.85). Significant predictors of CECD loss included Emery-Little grade (p = 0.004 at Week 7; p = 0.025 at Week 19), with borderline contributions from CDE and irrigation volume. IOP decreased significantly at Weeks 7 and 19; however, Day 1 flare did not predict IOP reduction. Conclusions: Eight-chop phacoemulsification produced uniformly low postoperative inflammation and exceptionally small corneal endothelial cell loss. Early postoperative flare did not predict CECD loss, suggesting that the Eight-chop technique provides a highly standardized, low-invasiveness surgical environment. These findings suggest that the Eight-chop technique lowers ultrasound energy requirements and may help reduce corneal endothelial stress relative to standard phacoemulsification. Full article
(This article belongs to the Section Ophthalmology)
10 pages, 353 KB  
Article
Intraoperative Neurophysiological Monitoring in Full-Endoscopic Cervical Endoscopic ULBD
by Miles Hudson, Sarah Esposito, Mark M. Zaki, Simon M. Glynn, Osama N. Kashlan, John Ogunlade, Chandan Krishna, Joshua Bakhsheshian and Christoph P. Hofstetter
J. Clin. Med. 2026, 15(1), 327; https://doi.org/10.3390/jcm15010327 - 1 Jan 2026
Cited by 1 | Viewed by 1192
Abstract
Background/Objectives: To evaluate risk factors for postoperative neurological deficits following cervical endoscopic unilateral laminotomy for bilateral decompression (CE-ULBD) and to determine whether intraoperative neurophysiological monitoring (IONM) can predict neurological compromise. Methods: A multicenter retrospective review was performed on 42 CE-ULBD procedures conducted between [...] Read more.
Background/Objectives: To evaluate risk factors for postoperative neurological deficits following cervical endoscopic unilateral laminotomy for bilateral decompression (CE-ULBD) and to determine whether intraoperative neurophysiological monitoring (IONM) can predict neurological compromise. Methods: A multicenter retrospective review was performed on 42 CE-ULBD procedures conducted between 2016 and 2024; 33 cases met the inclusion criteria with available imaging and electromyography data. Demographic, operative, and neurophysiological variables were analyzed. Preoperative stenosis severity was graded using the Kang MRI system. Intraoperative IONM data, including electromyography firing and motor evoked potential (MEP) changes, were correlated with new postoperative weakness. Results: The cohort (69.1% male, mean age 70.2 ± 1.7 years, mean BMI 29.6 ± 1.1) included 56 decompressed levels. The most common operative levels were C3-4 (37%) and C4-5 (24%). Postoperative weakness occurred in four patients (12.1%), all of whom had severe (Grade 3) preoperative stenosis. Among these, 50% exhibited preoperative weakness. Neuromonitoring changes correlated significantly with postoperative weakness (Fisher’s Exact, p < 0.001); 100% of patients with new post-operative weakness had sustained MEP decrease at the time of closure. Conclusions: Patients with severe cervical stenosis and preoperative weakness are at heightened risk of postoperative neurological deficits following CE-ULBD. Elevated epidural pressure from continuous irrigation in a constricted canal may exacerbate cord compression, particularly in those with preexisting myelopathy. IONM changes strongly correlate with new deficits and may exacerbate cord compression, particularly in those with preexisting myelopathy, and may serve as an early warning system for impending neurological injury. Surgeons should exercise caution and maintain low irrigation pressures in patients with severe stenosis undergoing endoscopic cervical decompression. Full article
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27 pages, 27558 KB  
Article
A Versatile and Low-Cost IoT Solution for Bioclimatic Monitoring in Precision Viticulture
by António Vieira, Nuno Silva, David Pascoal and Raul Morais
Future Internet 2026, 18(1), 16; https://doi.org/10.3390/fi18010016 - 27 Dec 2025
Viewed by 1216
Abstract
Bioclimatic monitoring at vineyard scale is essential for irrigation management and disease-risk assessment, yet many systems rely on expensive commercial stations or generic IoT nodes with limited validation and little focus on small and medium-sized winegrowers. This application-driven engineering work investigates whether decision-support-grade [...] Read more.
Bioclimatic monitoring at vineyard scale is essential for irrigation management and disease-risk assessment, yet many systems rely on expensive commercial stations or generic IoT nodes with limited validation and little focus on small and medium-sized winegrowers. This application-driven engineering work investigates whether decision-support-grade bioclimatic data for precision viticulture can be obtained from a low-cost station, by proposing a solar-powered proximal node that integrates soil, plant, and atmospheric sensors on a dedicated PCB that communicates via LoRaWAN. The node operates in a 15-min cycle, with sensing parameters selected to provide the minimum information required for key Precision Viticulture applications. It was deployed in a commercial vineyard side by side with a commercial station, quantifying sensor agreement, communication reliability, and energy consumption. The results show low error rates and consistent agronomic interpretation of environmental conditions, disease risk, precipitation events, and soil and water dynamics. The LoRaWAN link reached a 97% packet-delivery ratio with an average consumption of about 2.5 Wh per day. Material cost is approximately 260 €, one order of magnitude lower than a comparable station. These results indicate that, under real vineyard conditions and compared with a commercial reference, the proposed low-cost system provides agronomically useful, reliable bioclimatic monitoring. Full article
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17 pages, 2256 KB  
Article
Determination of UAV Flight Altitude and Time for Optimizing Variable-Rate Nitrogen Prescription Maps for Winter Wheat in the North China Plain
by Minne Zhang, Weixia Zhao and Jiusheng Li
Agronomy 2025, 15(11), 2627; https://doi.org/10.3390/agronomy15112627 - 16 Nov 2025
Cited by 1 | Viewed by 927
Abstract
An unmanned aerial vehicle (UAV) multi-spectral system provides a monitoring platform to rapidly obtain crop spectral information that can reflect crop nitrogen status for the generation of dynamic variable-rate nitrogen (VRN). To improve the accuracy of VRN prescription maps, a method of generating [...] Read more.
An unmanned aerial vehicle (UAV) multi-spectral system provides a monitoring platform to rapidly obtain crop spectral information that can reflect crop nitrogen status for the generation of dynamic variable-rate nitrogen (VRN). To improve the accuracy of VRN prescription maps, a method of generating VRN prescription maps on the basis of the vegetation index was proposed, and the effects of UAV flight time and altitude on VRN prescription maps were analyzed. The experimental site was located in Dacaozhuang, Hebei Province, China, and the experimental crop was winter wheat (Lunxuan 145). The flight altitudes of the UAV system were set to 50, 70 and 90 m. The flight times were set to 8:00 a.m., 11:00 a.m., 2:00 p.m. and 5:00 p.m. local time. The flight area was 1.18 ha with a 60° rotation angle under a three-span center pivot irrigation system with an overhang. UAV flight missions were executed during the jointing, heading, and grain filling phases of winter wheat. There were 90 management zones with pie shapes in total, which were composed of a 10° angle in the rotation direction and 4 sprinklers along the lateral direction. The vegetation indices (VIs) which are closely related to crop nutrient status were selected and used to generate distribution maps, which were superimposed with the management zones to generate VRN prescription maps. The results demonstrated that the red-edge soil adjusted vegetation index (RESAVI) was relatively more sensitive to the nitrogen status of winter wheat than the other VIs were. The RESAVI distributions were stable during periods with a solar elevation angle greater than 50° (11:00 a.m.–2:00 p.m. local time), and the VRN prescription maps were similar, with the overlap percentage of the same fertilization grade being greater than 80% and the relative error of the fertilization amount being less than 5%. Compared with that at 2:00 p.m., the overlap percentage of the same fertilization grade was 56.6% in both seasons at 8:00 a.m., whereas flights at 5:00 p.m. exhibited overlaps of 70.9% and 44.6% in the 2023 and 2024 seasons, respectively. Conversely, the flight altitude had little influence on the fertilizer amount and VRN prescription maps. The difference in the amount of fertilizer used was less than 3% at different flight altitudes. The required time is half of that for a 50 m flight when the flight altitude is 70 m and one third of that when the flight altitude is 90 m. Our study recommended operating the UAV multi-spectral system at solar elevation angles greater than 50° when generating VRN prescription maps of winter wheat, and the flight height can be adjusted according to the field area and the endurance time of the UAV. Full article
(This article belongs to the Section Precision and Digital Agriculture)
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17 pages, 651 KB  
Article
The Effect of Piezoelectric (Piezo) Versus Classic Lateral Osteotomy on the Lacrimal Drainage System (LDS): A Retrospective, Single-Center, Controlled Study
by Serkan Dedeoğlu, Günay Kozan, Muhammed Ayral and Betül Dertsiz Kozan
Medicina 2025, 61(11), 1979; https://doi.org/10.3390/medicina61111979 - 5 Nov 2025
Cited by 1 | Viewed by 727
Abstract
Background and Objectives: Lateral osteotomies in rhinoplasty run adjacent to the lacrimal drainage system (LDS), risking postoperative tearing. Piezoelectric (piezo) devices enable precise bone cuts that may reduce LDS trauma. We compared the 1-month incidence of objective lacrimal dysfunction after piezo versus classic [...] Read more.
Background and Objectives: Lateral osteotomies in rhinoplasty run adjacent to the lacrimal drainage system (LDS), risking postoperative tearing. Piezoelectric (piezo) devices enable precise bone cuts that may reduce LDS trauma. We compared the 1-month incidence of objective lacrimal dysfunction after piezo versus classic osteotomy. Materials and Methods: Retrospective, single-center controlled cohort (1 January 2024–1 January 2025) at a tertiary ENT clinic. Consecutive patients aged 19–45 with pre-operative paranasal sinus CT and no prior lacrimal disorder were grouped by osteotomy technique (piezo vs. classic; n = 65 per arm). Assessments were performed at postoperative day 7–10 and at 1, 3, and 6–12 months. The primary endpoint was 1-month objective lacrimal dysfunction, defined as fluorescein dye disappearance test (FDDT) grade ≥1 or reflux/resistance on irrigation plus symptoms (Munk ≥2). Pre-specified statistical tests were used. Results: Early tearing favored piezo. At week 1, epiphora occurred in 32.3% with piezo versus 46.1% with classic (p = 0.041); by month 6, rates were 4.6% versus 15.1% (p = 0.031). Differences at months 1 and 3 also favored piezo but were not statistically significant (p = 0.062 and p = 0.088). FDDT positivity was lower with piezo at week 1 (23.0% vs. 38.4%, p = 0.045) and month 6 (3.0% vs. 10.7%, p = 0.048). Irrigation obstruction was less frequent with piezo at week 1 (7.6% vs. 21.5%, p = 0.026), but groups converged by months 1 (15.4% vs. 12.3%, p = 0.80) and 3 (6.2% vs. 4.6%, p > 0.99). Punctum stenosis/occlusion remained uncommon in both groups without significant differences. Conclusions: Piezo-assisted lateral osteotomy is associated with less early lacrimal dysfunction and lower 6-month epiphora compared with the classic technique. Convergence of irrigation findings by 1–3 months suggests postoperative edema as the dominant transient mechanism. Given the retrospective, single-center design and low event rates, multicenter prospective studies powered for early LDS outcomes are warranted. Full article
(This article belongs to the Section Surgery)
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24 pages, 5528 KB  
Article
Accurate Identification of High-Potential Reserved Cultivated Land Resources: A Convolutional Neural Network-Based Intelligent Selection Framework Verified in Qinghai Province on the Qinghai–Tibet Plateau, China
by Bohao Miao, Yan Zhou and Jianghong Zhu
Land 2025, 14(10), 1931; https://doi.org/10.3390/land14101931 - 23 Sep 2025
Viewed by 884
Abstract
The sustainable use of farmland depends on the precise identification of promising reserved cultivated land resources, particularly in regions with fragmented spatial patterns and complex environmental conditions. Traditional evaluation methods often rely on limited indicators and neglect patch morphology, leading to restricted accuracy [...] Read more.
The sustainable use of farmland depends on the precise identification of promising reserved cultivated land resources, particularly in regions with fragmented spatial patterns and complex environmental conditions. Traditional evaluation methods often rely on limited indicators and neglect patch morphology, leading to restricted accuracy and applicability. To address this issue, an innovative intelligent-selection framework is proposed that integrates multi-source data evaluation with patch-morphology verification and employs convolutional neural networks (CNNs), applied in Qinghai Province, China. The framework combines one-dimensional and two-dimensional CNN models, incorporating 11 key indicators—including slope, irrigation conditions, and contiguity—together with patch morphology to predict development priority. Results show that the two models achieve predictive accuracies of 98.48% and 91.95%, respectively, outperforming the traditional Analytic Hierarchy Process (AHP) and effectively filtering out irregular patches unsuitable for cultivation. Further SHAP analysis and ablation experiments reveal the contributions of individual indicators, with slope identified as the dominant factor in prioritization. Overall, the study demonstrates that integrating multi-source data evaluation with patch-morphology verification within a machine-learning framework significantly enhances prioritization accuracy. The proposed framework provides a transferable, evidence-based pathway for the graded utilization of reserved cultivated land resources and the reinforcement of farmland security strategies. Full article
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17 pages, 3745 KB  
Article
Photogrammetric and LiDAR Scanning with iPhone 13 Pro: Accuracy, Precision and Field Application on Hazelnut Trees
by Elèna Grobler and Giuseppe Celano
Sensors 2025, 25(18), 5629; https://doi.org/10.3390/s25185629 - 9 Sep 2025
Cited by 3 | Viewed by 3259
Abstract
Accurate estimation of tree structural and morphological parameters is essential in precision fruit farming, supporting optimised irrigation management, biomass estimation and carbon stock assessment. While traditional field-based measurements remain widely used, they are often time-consuming and subject to operator-induced errors. In recent years, [...] Read more.
Accurate estimation of tree structural and morphological parameters is essential in precision fruit farming, supporting optimised irrigation management, biomass estimation and carbon stock assessment. While traditional field-based measurements remain widely used, they are often time-consuming and subject to operator-induced errors. In recent years, Terrestrial Laser Scanning (TLS) and UAV-based photogrammetry have been successfully employed to generate high-resolution 3D reconstructions of plants; however, their cost and operational constraints limit their scalability in routine field applications. This study investigates the performances of a low-cost, consumer-grade device—the iPhone 13 Pro equipped with an integrated LiDAR sensor and RGB camera—for 3D scanning of fruit tree structures. Cylindrical targets with known geometric dimensions were scanned using both the LiDAR and photogrammetric (Photo) modes of the Polycam© application, with accuracy and precision assessed by comparing extracted measurements to reference values. Field applicability was also tested on hazelnut trees, assessing height, stem diameter and leaf area: the Photo mode delivered the highest accuracy (systematic error of 0.007 m and R2 = 0.99) and strong agreement with manual leaf measurements (R2 = 0.93). These results demonstrate that smartphone-based 3D scanning can provide a practical, low-cost approach for structural characterisation in fruit orchards, supporting more efficient crop monitoring. Full article
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