Search Results (1,980)

Background: Despite advances in coronary artery disease (CAD) treatment, challenges persist, particularly in complex lesions. While percutaneous coronary intervention (PCI) is widely used, its outcomes can be affected by complications like restenosis. Optical coherence tomography (OCT), offering higher-resolution imaging than angiography, shows promise in guiding PCI. However, meta-analytical comparisons between OCT-guided and angiography-guided PCI remain limited. Methods: Databases, including PubMed, Scopus, Cochrane Library, and ClinicalTrials.gov, were queried through May 2025 to identify randomized controlled trials (RCTs) comparing OCT-guided PCI with angiography-guided PCI. Data were pooled using risk ratios (RRs) and mean difference (MD) with 95% confidence intervals (CIs) in a random-effects model. Results: Five RCTs involving 5737 patients (OCT: 2738 and angiography: 2999) were included. On pooled analysis, OCT-guided PCI was associated with a notable reduction in major adverse cardiovascular event (MACE) (RR: 0.71, p = 0.0001), cardiac mortality (RR: 0.43, p = 0.003), target lesion revascularization (TLR) (RR: 0.53, p = 0.007), and stroke (RR: 0.17, p = 0.02), compared to angiography-guided PCI. No significant differences were noted for all-cause mortality and myocardial infarction. Conclusions: In patients with complex coronary lesions, OCT-guided PCI reduces the risk of MACE, cardiac mortality, TLR, and stroke, compared to angiography-guided PCI only. This study supports incorporating advanced imaging techniques like OCT to improve clinical outcomes, especially in complex PCIs. Full article

Background/Objectives: This case study presents the first documented use of a low-cost, simulated, patient-specific three-dimensional (3D) printed model to support presurgical planning for an infant with Apert syndrome in a resource-limited setting. The primary objectives are to (1) demonstrate the value of 3D printing as a simulation tool for preoperative planning in low-resource environments and (2) identify opportunities for future AI-enhanced simulation models in craniofacial surgical planning. Methods: High-resolution CT data were segmented using InVesalius 3, with mesh refinement performed in ANSYS SpaceClaim (version 2021). The cranial model was fabricated using fused deposition modeling (FDM) on a Creality Ender-3 printer with Acrylonitrile Butadiene Styrene (ABS) filament. Results: The resulting 3D-printed simulated model enabled the surgical team to assess cranial anatomy, simulate incision placement, and rehearse osteotomies. These steps contributed to a reduction in operative time and fewer complications during surgery. Conclusions: This case demonstrates the value of accessible 3D printing as a simulation tool in surgical planning within low-resource settings. Building on this success, the study highlights potential points for AI integration, such as automated image segmentation and model reconstruction, to increase efficiency and scalability in future 3D-printed simulation models. Full article

Large-scale events, such as festivals and public gatherings, pose serious problems in terms of traffic congestion, slow transaction processing, and security risks to transportation planning. This study proposes a blockchain-based solution for enhancing the efficiency and security of intelligent transport systems (ITS) by utilizing state channels and rollups. Throughput is optimized, enabling transaction speeds of 800 to 3500 transactions per second (TPS) and delays of 5 to 1.5 s. Prevent data tampering, strengthen security, and enhance data integrity from 89% to 99.999%, as well as encryption efficacy from 90% to 98%. Furthermore, our system reduces congestion, optimizes vehicle movement, and shares real-time, secure data with stakeholders. Practical applications include fast and safe road toll payments, faster public transit ticketing, improved emergency response coordination, and enhanced urban mobility. The decentralized blockchain helps maintain trust among users, transportation authorities, and event organizers. Our approach extends beyond large-scale events and proposes a path toward ubiquitous, Artificial Intelligence (AI)-driven decision-making in a broader urban transit network, informing future operations in dynamic traffic optimization. This study demonstrates the potential of blockchain to create more intelligent, more secure, and scalable transportation systems, which will help reduce urban mobility inefficiencies and contribute to the development of resilient smart cities. Full article

The growing demand for low-emission maritime transport and efficient onboard energy management has intensified research into advanced control strategies for hybrid shipboard microgrids. These systems integrate both AC and DC power domains, incorporating renewable energy sources and battery storage to enhance fuel efficiency, reduce greenhouse gas emissions, and support operational flexibility. However, integrating renewable energy into shipboard microgrids introduces challenges, such as power fluctuations, varying line impedances, and disturbances caused by AC/DC load transitions, harmonics, and mismatches in demand and supply. These issues impact system stability and the seamless coordination of multiple distributed generators. To address these challenges, we proposed a hierarchical control strategy that supports sustainable operation by improving the voltage and frequency regulation under dynamic conditions, as demonstrated through both MATLAB/Simulink simulations and real-time hardware validation. Simulation results show that the proposed controller reduces the frequency deviation by up to 25.5% and power variation improved by 20.1% compared with conventional PI-based secondary control during load transition scenarios. Hardware implementation on the NVIDIA Jetson Nano confirms real-time feasibility, maintaining power and frequency tracking errors below 5% under dynamic loading. A comparative analysis of the classical PI and sliding mode control-based designs is conducted under various grid conditions, such as cold ironing mode of the shipboard microgrid, and load variations, considering both the AC and DC loads. The system stability and control law formulation are verified through simulations in MATLAB/SIMULINK and practical implementation. The experimental results demonstrate that the proposed secondary control architecture enhances the system robustness and ensures sustainable operation, making it a viable solution for modern shipboard microgrids transitioning towards green energy. Full article

Background and Objectives: Neonatal respiratory distress syndrome (NRDS), resulting from a deficiency of pulmonary surfactant (PS), can cause alveoli to collapse. Glucocorticoids reduce inflammation and are effective in reducing pulmonary swelling. This study aims to assess the effectiveness of the combination of PS and budesonide in the management of NRDS. Materials and Methods: Publications between 21 May and 24 November were screened through PubMed, Cochrane and Embase. Data analysis was performed on RevMan 5.3 software. Subgroup analysis was performed to evaluate the routes of administrations. Results: The use of budesonide along with pulmonary surfactant for treating NRDS revealed the following results: (1) a reduced duration of invasive mechanical ventilation (standardized mean difference (SMD) = −1.06, 95% confidence interval (CI) = −1.55 to −0.56, p < 0.0001); (2) reduced rate of bronchopulmonary dysplasia (BPD) occurrence (relative risk (RR) = 0.72, 95% CI = 0.60 to 0.86, p = 0.0003); (3) reduced duration for hospital admittance (SMD = −0.38, 95% CI = −0.64 to −0.11, p = 0.005). The occurrence of complications, i.e., sepsis, pneumothorax, retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), rate of mortality, hyperglycemia and intraventricular hemorrhage (IVH), was not significantly different among the intervention and comparison group except for patent ductus arteriosus (PDA) and pulmonary hemorrhage, with their incidence being higher in the control group (p = 0.002 and p = 0.05, respectively). Conclusions: The combination of pulmonary surfactant and budesonide decreases the occurrence of BPD, duration of mechanical ventilation, length of hospital stay and risk of pulmonary hemorrhage and PDA. It does not increase the risk of complications and death and is clinically safe. Full article

Enterprise architecture (EA) provides a strategic foundation for aligning business processes, IT infrastructure, and organizational strategy, enabling firms to navigate uncertainty and complexity. In developing economies, small and medium-sized enterprises (SMEs) face significant challenges in maintaining financial resilience and sustainable growth amidst frequent disruptions. This study investigates how EA-driven change events affect SME financial performance by activating three key adaptive mechanisms: improvisational capability, flexible IT systems, and organizational culture. A novel classification of EA change triggers is proposed to guide adaptive responses. Using survey data from 291 Pakistani SMEs collected during the COVID-19 crisis, the study employs structural equation modeling (SEM) to validate the conceptual model. The results indicate that improvisational capability and flexible IT systems significantly enhance financial performance, while the mediating role of organizational culture is statistically insignificant. This study contributes to EA and sustainability literature by integrating a typology of EA triggers with adaptive capabilities theory and testing their effects in a real-world crisis context. Full article

Neurodegenerative diseases (NDs) pose a major challenge to global healthcare systems owing to their devastating effects and limited treatment options. These disorders are characterized by progressive loss of neuronal structure and function, resulting in cognitive and motor impairments. Current therapies primarily focus on symptom management rather than on targeting the underlying causes. However, clustered regularly interspaced short palindromic repeat (CRISPR) technology offers a promising alternative by enabling precise genetic modifications that could halt or even reverse ND progression. CRISPR-Cas9, the most widely used CRISPR system, acts as a molecular scissor targeting specific DNA sequences for editing. By designing guide RNAs (gRNAs) to match sequences in genes associated with NDs, researchers can leverage CRISPR to knockout harmful genes, correct mutations, or insert protective genes. This review explores the potential of CRISPR-based therapies in comparison with traditional treatments for NDs. As research advances, CRISPR has the potential to revolutionize ND treatment by addressing its genetic underpinnings. Ongoing clinical trials and preclinical studies continue to expand our understanding and application of this powerful tool to fight debilitating conditions. Full article

This paper presents optimization of peak temperatures achieved during friction stir welding (FSW) of Al-6061-T6 alloys. This research work employed a novel approach by investigating the effect of FSW welding process parameters on peak temperatures through the implementation of finite element analysis (FEA), the Taguchi method, analysis of variance (ANOVA), and machine learning (ML) algorithms. COMSOL 6.0 Multiphysics was used to perform FEA to predict peak temperatures, incorporating seven distinctive welding parameters: tool material, pin diameter, shoulder diameter, tool rotational speed, welding speed, axial force, and coefficient of friction. The influence of these parameters was investigated using an L32 Taguchi array and analysis of variance (ANOVA), revealing that axial force and tool rotational speed were the most significant parameters affecting peak temperatures. Some simulations showed temperatures exceeding the material’s melting point, indicating the need for improved thermal control. This was achieved by using three machine learning (ML) algorithms, i.e., Logistic Regression, k-Nearest Neighbors (k-NN), and Naive Bayes. A dataset of 324 data points was prepared using a factorial design to implement these algorithms. These algorithms predicted the welding conditions where the temperature exceeded the melting temperature of Al-6061-T6. It was found that the Logistic Regression classifier demonstrated the highest performance, achieving an accuracy of 98.14% as compared to Naive Bayes and k-NN classifiers. These findings contribute to sustainable welding practices by minimizing excessive heat generation, preserving material properties, and enhancing weld quality. Full article

The indications for immune checkpoint inhibitor (ICI) use in cancer treatment continue to expand. This is attributable to their proven anticancer activity in addition to their tolerability and favorable toxicity profile as compared to conventional chemotherapeutic agents. ICIs work by blocking the inhibitory signals between tumor cells and T-cells, thereby enhancing the T-cell cytotoxic activity to inhibit tumor growth. Because of their immune-stimulating effect, ICIs are linked to adverse renal outcomes in both native and transplanted kidneys. The risk of kidney allograft rejection in the setting of ICI use has been reported to be around 40%, leading to an increased risk of graft loss. In this report, we review the literature examining outcomes in kidney transplant recipients receiving ICIs for various oncologic indications. Full article

Calcium channel blockers (CCBs), originally developed for cardiovascular indications, have gained attention for their therapeutic potential in neuropsychiatric, endocrine, and pain-related disorders. In neuropsychiatry, nimodipine and isradipine, both L-type CCBs, show mood-stabilizing and neuroprotective effects, with possible benefits in depression, bipolar disorder, and schizophrenia. In endocrinology, verapamil, a non-dihydropyridine L-type blocker, has been associated with the preservation of pancreatic β-cell function and reduced insulin dependence in diabetes. CCBs may also aid in managing primary aldosteronism and pheochromocytoma, particularly in patients with calcium signaling mutations. In pain medicine, α2δ ligands and selective blockers of N-type and T-type channels demonstrate efficacy in neuropathic and inflammatory pain. However, their broader use is limited by challenges in central nervous system (CNS) penetration, off-target effects, and heterogeneous trial outcomes. Future research should focus on pharmacogenetic stratification, novel delivery platforms, and combination strategies to optimize repurposing of CCBs across disciplines. Full article

This study evaluated the effect of biochars on growth performance, nutrient digestibility, carcass yield, bone mineralization, litter quality and footpad lesions in broilers. Eight hundred day-old chicks were randomly divided into four treatments, 10 replicates per treatment (20 birds/replicate) for 35 days. Treatments were basal diet (control), a control diet with corncob (CC) biochar (1%), a control diet with wheat straw (WS) biochar (1%) and a control diet with sugarcane bagasse (SCB) biochar (1%). Body weight gain (BWG), feed intake (FI) and feed conversion ratio (FCR) were recorded weekly. Nutrient digestibility, bone mineralization and carcass parameters were determined on the 21st and 35th days, while footpad lesions and litter quality were also assessed. The results revealed significant improvement (p < 0.05) in FI, BWG and FCR with supplementation. Nutrient digestibility was higher (p < 0.05) in the SCB biochar group. Tibia calcium and phosphorus levels were enhanced (p < 0.05) in the WS and SCB biochar groups, respectively. Footpad lesions were significantly lower (p < 0.05) in the CC biochar group, while litter quality was improved (p < 0.05) in the WS biochar group. Lymphoid organ relative weight results revealed that spleen weight was not affected by biochar supplementation in diet (p > 0.05), while dietary supplementation of CS and WS biochar in the diet resulted in the highest relative weights of thymus and bursa (p < 0.05). However, dietary supplementation of WS, SC and SCB biochar supplementation had affected positively the log value of the ND virus and IBV titers in birds. Overall, dietary supplementation of 1% biochars enhances growth performance, bone mineralization, footpad health immunity and litter quality in broilers. Full article

Background: Myocarditis is associated with increased mortality due to complications such as cardiogenic shock and arrhythmia. Trends of myocarditis-related mortality in the United States, along with demographic and regional disparities and changes during the COVID-19 pandemic, are unknown. Methods: We used the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database to extract data for myocarditis deaths from 1999 to 2023. The Joinpoint Regression Program was used to analyze long-term trends in mortality, and R Studio (version 4.4.1) was used to calculate expected and excess mortality for 2020 to 2023. Results: There were 33,016 myocarditis-related deaths from 1999 to 2023. The age-adjusted mortality rate (AAMR) of myocarditis deaths decreased by 46.08% from 7.40 (95% CI: 7.04–7.76) in 1999 to 3.99 (95% CI: 3.74–4.23) in 2019, with an APC of −2.59 (95% CI: −2.97 to −2.24). From 2019 to 2021, the AAMR increased by 46.62% to 5.85 (95% CI: 5.56–6.14) by 2021 (2019–2021 APC 22.3%*), reversing the gains of the previous two decades. By 2023, the AAMR recovered to 4.33 (95% CI: 4.09 to 4.58), though mortality was still higher than expected from pre-pandemic trends. From 2020 to 2023, there were 40.12% more deaths than expected, with 54.94% higher mortality in 2021. Briefly, 70.33% of excess myocarditis-related deaths also had COVID-19, with a peak of 76.15% of excess myocarditis deaths in 2021 being reported as involving COVID-19 infection. Significant disparities in mortality trends persisted, with males, NH Black or African Americans, and the elderly having higher mortality rates. Conclusions: Myocarditis mortality decreased in the United States from 1999 to 2019 but significantly increased during the COVID-19 pandemic years 2020 and 2021. At the height of the pandemic, COVID-19 infection contributed to almost three-quarters of excess myocarditis mortality. Significant disparities in myocarditis mortality persisted from 1999 to 2023. Full article

Background: Intravenous thrombolysis (IVT) is the standard treatment for ischemic stroke within 4.5 h of symptom onset. However, a significant proportion of patients present beyond this window. This study aims to evaluate the efficacy and safety of IVT beyond the 4.5 h window in selected patients. Methods: A systematic literature search was conducted across PubMed, Cochrane Library, and Google Scholar from inception to April 2025. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Results: A total of 12 RCTs were included, with 3236 patients. Compared to controls, IVT significantly improved excellent functional outcomes [OR: 1.40; 95% CI: 1.21–1.62] and good functional outcomes [OR: 1.26; 95% CI: 1.06–1.50] at 90 days. IVT also improved recanalization [OR: 2.47; 95% CI: 1.96–3.12], reperfusion [OR: 2.20; 95% CI: 1.26–3.84], and early neurological improvement [OR: 1.91; 95% CI: 1.12–3.26]. However, it was associated with a significantly higher risk of symptomatic intracranial hemorrhage (sICH) [OR: 2.17; 95% CI: 1.25–3.79], any ICH [OR: 1.49; 95% CI: 1.09–2.04], and type-II parenchymal hemorrhage (PH) [OR: 2.14; 95% CI: 1.19–3.83]. No significant difference was observed in systemic hemorrhage, 90-day all-cause mortality, 7-day mortality, or 90-day intervention-related mortality (p > 0.05). Conclusions: IVT beyond 4.5 h improves neurological outcomes in patients with ischemic stroke without increasing overall mortality or systemic bleeding, though it raises the risk of sICH, any ICH, and type-II PH. Further large RCTs are needed to confirm these findings and guide clinical practice. Full article

Smart cities use advanced infrastructure and technology to improve the quality of life for their citizens. Collaborative services in smart cities are making the smart city ecosystem more reliable. These services are required to enhance the operation of interoperable systems, such as smart transportation services that share their data with smart safety services to execute emergency response, surveillance, and criminal prevention measures. However, an important issue in this ecosystem is data security, which involves the protection of sensitive data exchange during the interoperability of heterogeneous smart services. Researchers have addressed these issues through blockchain integration and the implementation of smart contracts, where collaborative applications can enhance both the efficiency and security of the smart city ecosystem. Despite these facts, complexity is an issue in smart contracts since complex coding associated with their deployment might influence the performance and scalability of collaborative applications in interconnected systems. These challenges underscore the need to optimize smart contract code to ensure efficient and scalable solutions in the smart city ecosystem. In this article, we propose a new framework that integrates generative AI with blockchain in order to eliminate the limitations of smart contracts. We make use of models such as GPT-2, GPT-3, and GPT4, which natively can write and optimize code in an efficient manner and support multiple programming languages, including Python 3.12.x and Solidity. To validate our proposed framework, we integrate these models with already existing frameworks for collaborative smart services to optimize smart contract code, reducing resource-intensive processes while maintaining security and efficiency. Our findings demonstrate that GPT-4-based optimized smart contracts outperform other optimized and non-optimized approaches. This integration reduces smart contract execution overhead, enhances security, and improves scalability, paving the way for a more robust and efficient smart contract ecosystem in smart city applications. Full article