Search Results (279)

In modern intelligent food processing, the unpredictable variability in pomelo orientation on high-speed conveyors poses a significant challenge to automated grading and precision peeling operations. To address this, a deep learning-based method is proposed for the real-time detection of pomelo posture. Firstly, a pomelo posture dataset was constructed to support model training and validation. Secondly, to balance the extraction of posture features from uniform fruits with the low-power constraints of edge deployment, a domain-specific architectural optimization is presented. Building on the YOLOv8n framework, the proposed model synergistically integrates specialized modules. A lightweight GhostHGNetV2 foundation is utilized to significantly reduce computational redundancy while maintaining the resolution required to detect key anatomical landmarks. To overcome spatial confusion and capture multi-scale global appearance information, a multi-path coordinate attention (MPCA) module is introduced. Furthermore, the SlimNeck architecture and VoVGSCSP module streamline multi-scale feature fusion via one-time aggregation, effectively preventing computational bottlenecks. This design optimizes the computational efficiency of the model while maintaining detection accuracy. Experimental results demonstrate that compared with the baseline YOLOv8n model, the proposed method increased the mAP50 accuracy by 3.67% while reducing parameter count and computational load by 17.5% and 23.3%, respectively. Additionally, it achieved a processing speed of 19.3 FPS on the Jetson Orin Nano 6G edge platform. This research provides a critical technical foundation for the recognition of pomelo posture, enabling subsequent orientation rectification and fostering the development of streamlined, automated pomelo processing lines. Full article

Landmark epidemiological studies and clinical trials, such as the Seven Countries Study, the Lyon Diet Heart Study, the PREDIMED Study and the CORDIOPREV Study, have shown significant reductions in cardiovascular events in those following the Mediterranean diet (MD). The aim of the present work is to summarize the most robust available evidence and the major biological pathways underlying the protective effects of the MD, with particular emphasis on the role of PAF inhibitors. Mechanistically, MD functions through a complex synergy of antioxidant, anti-inflammatory, and antithrombotic effects that collectively improve lipid profiles, enhance endothelial function, optimize postprandial metabolism and cell membrane signaling, making it a functional model for human longevity. The PAF-Implicated Atherosclerosis Theory has emerged as a key unifying framework, proposing that Platelet-Activating Factor (PAF)—a highly potent lipid inflammatory mediator—plays a central role in the initiation and progression of atherosclerosis. Oxidized LDL promotes the production of PAF and PAF-like lipids, leading to endothelial dysfunction, vascular inflammation, and atherosclerotic plaque formation. Traditional Mediterranean foods are rich in natural PAF inhibitors, particularly the polar lipid fractions of extra virgin olive oil, as well as wine, fish, vegetables, onions, and garlic. Animal studies demonstrate that these compounds can reduce or even regress atherosclerotic lesions, independently of serum cholesterol levels. Human dietary interventions have further shown that MD-based meals and functional foods enriched with PAF inhibitors reduce PAF activity and improve thrombosis-related biomarkers. This mechanistic framework helps explain phenomena such as the “French Paradox” and the cardio-protective effects associated with fish consumption. Moreover, the extraction of PAF inhibitors from Mediterranean food by-products, such as olive pomace, offers promising ecological and economic advantages. Collectively, targeting PAF and increasing dietary intake of PAF inhibitors represent promising strategies for the prevention and management of atherosclerosis and other inflammatory diseases, supporting the view that PAF may function as a major, modifiable risk factor in these conditions. Full article

Background/Objectives: Superior cluneal nerve entrapment syndrome (SCNES) is an underrecognized cause of chronic low back pain, particularly in adolescents where published experience is limited. This article describes a reproducible open surgical technique for superior cluneal nerve (SCN) decompression. Methods: We outline indications and relative contraindications, required instrumentation, key surface landmarks, and a stepwise operative approach. The nerve is identified where SCN branches traverse the thoracolumbar fascia and fibro-osseous tunnel near the posterior iliac crest. Decompression is performed via limited fasciotomy and release of surrounding soft tissues, with attention given to identifying additional branches requiring release. Results: The technique provides consistent exposure and decompression of the SCN branches using an approximately 5 cm oblique incision centered over the expected crossing point (about 7 cm lateral to the midline and roughly 4 cm lateral to the PSIS). Pearls and pitfalls are provided to reduce peri-incisional numbness and avoid thermal injury to the nerve. Conclusions: Open SCN decompression is a focused procedure that can be considered after confirmation of SCNES by clinical criteria and response to diagnostic block. Standardizing technique and postoperative care may facilitate broader adoption and future outcome studies in pediatric populations. Full article

The management of urothelial carcinoma (UC) is undergoing a paradigm shift from static anatomical staging to molecularly guided dynamic approaches that integrate time as a critical therapeutic variable. This evolution is driven by liquid biopsies, particularly circulating tumor DNA, which allow real-time tumor interrogation. We conducted this expert review to synthesize landmark evidence, enabling technologies, and implementation challenges in dynamic precision oncology for UC. In this non-systematic narrative review, we searched PubMed/MEDLINE, Embase, Web of Science, and the Cochrane Library for articles published between January 2015 and February 2026. Studies were selected based on their relevance to dynamic precision oncology, clinical actionability, and translational implementation, prioritizing landmark randomized controlled trials providing level 1–2 evidence, large prospective cohorts, and key translational studies. Enfortumab vedotin plus pembrolizumab established the new first-line standard for metastatic UC, achieving a median overall survival of 33.8 months versus 15.9 months (hazard ratio [HR] 0.51, 95% confidence interval 0.43–0.61). Circulating tumor DNA demonstrates robust prognostic value for molecular residual disease (MRD) detection (Level 2a evidence), stratifying recurrence risk with hazard ratios of approximately 4.5. Critically, the IMvigor011 trial has now provided Level 1b evidence that ctDNA-guided adjuvant atezolizumab improves both disease-free survival (DFS) (HR 0.64, p = 0.0047) and OS (HR 0.59, p = 0.0131) in ctDNA(+) patients, while validating treatment de-escalation in ctDNA(−) patients (1-year DFS 95%). Erdafitinib in patients harboring FGFR2/3 alterations (HR 0.64) confirms the value of genomic profiling. Major limitations include the inherent selection bias of this non-systematic approach, substantial platform heterogeneity, and lack of standardization. In conclusion, dynamic precision oncology has transformed UC management, with the IMvigor011 trial establishing ctDNA-guided MRD status as the first phase 3-validated predictive biomarker framework for adjuvant therapy selection in a solid tumor. Implementation requires adherence to established standardization frameworks, cross-platform and cross-agent validations, and tiered implementation strategies to ensure equitable access across diverse resource settings. Full article

As deepfakes become increasingly realistic, there is a growing need for robust and highly accurate facial forgery detection algorithms. Existing studies show that global feature modeling approaches (Transformer, VMamba) are effective in capturing long-range dependencies, yet they often lack sufficient sensitivity to localized facial tampering artifacts. Meanwhile, traditional convolutional methods excel at extracting local image features but struggle to incorporate prior knowledge about facial anatomy, resulting in limited representational capability. To address these limitations, this paper proposes LGMamba, a novel detection framework that integrates facial guidance focusing on key facial components and fine-grained detail regions commonly manipulated in deepfakes with global modeling. First, we introduce an innovative Landmark-Guided Convolution (LGConv), which adaptively adjusts convolutional sampling positions using facial landmark information. This allows the model to attend to forgery-prone facial regions, such as the eyes and mouth. Second, we design a parallel Facial Structure Awareness Block (FSAB) to operate alongside the VMamba-based visual State-Space Model. Equipped with a multi-stage residual design and a CBAM attention mechanism, FSAB enhances the model’s sensitivity to subtle facial artifacts, enabling joint exploitation of global semantic consistency and fine-grained forgery cues within a unified architecture. The proposed LGMamba achieves superior performance compared to existing mainstream approaches. In cross-dataset evaluations, it attains AUC scores of 92.34% on CD1 and 96.01% on CD2, outperforming all compared methods. Full article

Cholangiocarcinoma (CCA) is a highly lethal, heterogeneous malignancy arising from the biliary tract. Although the prevalence of CCA is relatively low, its incidence has increased in the last few decades, and the overall prognosis is poor. Surgical resection remains the most efficacious treatment modality for CCA. However, due to its aggressive nature and often asymptomatic presentation, most patients are first diagnosed with advanced disease, precluding them from curative intervention. Moreover, due to its heterogeneity at the molecular, genomic, and epigenetic levels, drug treatment of CCA remains challenging. In this review, we discuss the current standard drug treatment approaches, recent breakthroughs, and promising new therapeutics for CCA. We summarize key clinical data for the standard first-line chemotherapy regimen and its efficacy and resistance mechanisms, along with more recent studies supporting or proposing second-line treatments. We highlight landmark clinical trials, including ABC-02, which established gemcitabine-cisplatin (GC) as the first-line regimen against biliary cancers. Additionally, we discuss recent findings on the susceptibility of CCA against targeted therapies and other immunologic molecules, including results from the KEYNOTE-966 and TOPAZ-1 clinical trials. Finally, we critically analyze new therapeutics in the preclinical and clinical space, such as CAR-T cells and oncolytic viruses that may be effective against CCA. Full article

Objectives: This study aims to define the surgical anatomy, technical feasibility, advantages, and limitations of the TPPA through detailed cadaveric dissection and a representative clinical case, evaluating its potential as a safe and effective alternative to traditional approaches to the mesiotemporal lobe. Methods: A cadaveric dissection was performed on one adult head injected with colored latex, using standard microsurgical instruments and high-definition video documentation. Each procedural step was recorded and illustrated with cadaveric photographs. Additionally, a clinical case of mesiotemporal cavernous hemangioma resected via TPPA is presented, including an operative video. Results: The dissection demonstrated a direct and safe trajectory to the amygdala and hippocampal head, with clear identification of key vascular and white matter landmarks. In the clinical case, the lesion was completely resected with no postoperative neurological deficits. Conclusions: The TPPA represents a novel microsurgical corridor to the mesiotemporal region, minimizing cortical disruption, Sylvian fissure dissection, and manipulation of middle cerebral artery branches. Although its exposure is limited posteriorly, the TPPA could offer an optimal balance between functional preservation and surgical accessibility, constituting a valuable addition to the modern microsurgical armamentarium. Full article

Subway public spaces have been identified as a vital medium for showcasing urban culture. The design quality of these spaces has been shown to have a profound influence on passengers’ spatial perception and cultural experience. However, amid rapid urbanization, subway stations commonly face issues such as homogeneous spatial interfaces and unclear cultural themes, resulting in diminished station identifiability. This study integrates post-use evaluation with Importance–Performance Analysis (IPA) to establish an assessment and optimization pathway aimed at systematically identifying and prioritizing key design elements for enhancing cultural identifiability. Taking Tianjin Gulou Station as a case study, user feedback collected through questionnaires identified 12 indicators influencing identifiability satisfaction. The reliability and validity of the questionnaire were confirmed through validity analysis and paired-sample t-tests, while IPA was employed to clarify improvement priorities. The results indicate that the overall perceived importance of cultural identifiability at Gulou Station significantly exceeds satisfaction levels. Landmark installations, art walls, and vertical transportation fall within the “high importance-low satisfaction” quadrant, which is identified as a primary area of focus for enhancement. Basic interface elements such as flooring and ceilings require enhancement, while transfer entrances and station name walls constitute advantageous designs warranting preservation. Based on the findings of the present study, three targeted design strategies are proposed: enhancing spatial perception, constructing cultural continuity, and integrating multidimensional experiences. These approaches seek to address the “spatial-cultural” perception gap, providing actionable pathways for the distinctive renewal of subway spaces. Full article

Objectives: This study aimed to analyze the three-dimensional displacement of maxillary first molars using a finite element model with two headgear configurations, namely cervical and horizontal pull headgears, as well as pendulum, infrazygomatic miniscrews, Bollard miniplates, Advanced Molar Distalization Appliance (AMDA), and Beneslider. The goal was to clarify how variations in anchorage design and force direction influence molar movement across the sagittal, vertical, and transverse planes. Methods: A three-dimensional finite element model of the maxillary dentition and supporting structures was constructed using reference anatomical data and standardized material properties. Each appliance was virtually simulated under its clinically recommended force magnitude and direction to ensure realistic biomechanical conditions. The orientation of each force vector relative to the molar’s center of resistance (CR) was analyzed, and resulting tooth displacements were quantified along the sagittal (Z), vertical (Y), and transverse (X) axes using 49-node reference paths connecting key anatomical landmarks. Results: Appliances applying forces through or above the molar CR, such as the AMDA, infrazygomatic miniscrews, and Bollard miniplates, produced nearly bodily distalization with minimal tipping (<0.6° (range 0.3–0.6°)) and slight intrusion (−0.12 to −0.18 mm). Conversely, systems delivering forces below the CR, such as the cervical headgear and pendulum, resulted in greater crown tipping and extrusion. The Beneslider exhibited an intermediate displacement pattern with moderate vertical control. Conclusions: Force vector height and direction relative to the molar CR critically determine 3D displacement behavior. Skeletal anchorage and adjustable systems, particularly the AMDA, demonstrated the most controlled distalization pattern with minimal tipping, whereas conventional tooth-borne designs induced more tipping and extrusion. Full article

To advance research in multi-agent reinforcement learning (MARL) for pursuit–evasion scenarios, this paper introduces a novel algorithm called Expert Knowledge and Opponent Modeling Multi-UAV Deep Deterministic Policy Gradient (EO-MADDPG). EO-MADDPG consists of two key components: the integration of expert knowledge and real-time sampled data and the prediction of evader UAV actions. The expert knowledge includes a multi-UAV formation control algorithm and an encirclement strategy, which incorporates consensus algorithms and Apollonius circle guidance. Additionally, the network-training framework is optimized by integrating information about opponent actions under a fixed policy for improved prediction accuracy. The experiments focus on three vs. one and three vs. two scenarios, where pursuer UAVs utilize EO-MADDPG and evader UAVs follow fixed policies with Gaussian perturbations. Experimental results show that EO-MADDPG achieves success rates of 99.9 ± 0.3% and 97.5 ± 1.4% (mean ± std over five seeds) in three vs. one and three vs. two pursuit–evasion simulations, respectively, outperforming the baseline MADDPG (72.7 ± 6.0% and 64.4 ± 34.4%). Ablation studies and cooperative landmark tasks further demonstrate improved training stability and interpretability. Full article

Background: Liquid biopsy using circulating tumor DNA (ctDNA) is rapidly reshaping gastrointestinal (GI) oncology. The highest-impact applications are molecular residual disease (mRD) detection after curative-intent therapy and early recognition of progression or resistance during systemic treatment. Methods: We performed a structured, clinically oriented narrative synthesis by using explicit search, eligibility, evidence prioritization, and clinical interpretation rules, integrating landmark prospective cohorts, randomized ctDNA-guided strategy trials where available, meta-analyses, key methodological research (e.g., pre-analytics, assay design, and clonal hematopoiesis (CH)/clonal hematopoiesis of indeterminate potential (CHIP)), and selected trial registries. Results: In resected colorectal cancer (CRC), postoperative ctDNA positivity is among the strongest known biomarkers of recurrence risk; large prospective studies demonstrate clear separation of disease-free survival (DFS)/overall survival (OS) between mRD+ and mRD− patients. In stage II colon cancer, randomized data (DYNAMIC) show that a ctDNA-guided strategy reduces adjuvant chemotherapy exposure without compromising long-term outcomes. In metastatic CRC, ctDNA supports early response monitoring and resistance tracking; ctDNA-selected anti-EGFR rechallenge provides a model of biomarker-driven actionability (CHRONOS). In gastroesophageal cancers, longitudinal ctDNA dynamics correlate with relapse risk and treatment efficacy, and in esophageal squamous cell carcinoma, ctDNA after neoadjuvant chemoradiotherapy informs residual disease risk and adjuvant stratification. In pancreatic ductal adenocarcinoma and hepatobiliary malignancies, sensitivity is constrained by low shedding and background cell-free DNA (cfDNA), yet ctDNA positivity remains clinically meaningful, and emerging data in resected extrahepatic cholangiocarcinoma (STAMP-linked analyses) show that ctDNA dynamics during adjuvant therapy predict recurrence. Conclusions: ctDNA is a clinically validated biomarker for mRD in CRC, whereas in other GI cancers, it remains a promising but methodologically heterogeneous tool whose clinical utility is tumor- and context-dependent. The next phase requires interventional trials demonstrating outcome improvement, harmonized sampling and reporting standards, and rigorous control of confounders (notably CH/CHIP). Full article

With the rapid advancement of autonomous driving technology and the commercialization of Human–Machine Interface (HMI) services, camera-based systems for external environment perception are being extensively deployed. While comprehensive camera systems enhance safety and convenience, they simultaneously raise serious privacy concerns by collecting facial and biometric information of Vulnerable Road Users (VRUs) and passengers. Although facial anonymization technology has emerged as a key solution, the field currently faces a fundamental challenge: the absence of unified performance evaluation criteria. Existing studies employ disparate evaluation metrics, making objective inter-model comparison and performance verification difficult. This study proposes quantitative evaluation metrics and corresponding evaluation criteria that enable systematic and objective assessment of facial anonymization model performance. Through large-scale experiments, we developed quantitative evaluation metrics encompassing facial landmark variations, visual similarity, and re-identification prevention capability, and derived specific threshold values based on statistical methodologies. Furthermore, to validate the proposed evaluation criteria, we conducted systematic empirical assessments using models that adopt different technical approaches. The validation experiments showed that the evaluation criteria proposed in this study can be applied across models with distinct technical characteristics. This research is expected to contribute to resolving the heterogeneous evaluation criteria issues in existing studies by providing unified evaluation criteria. It may also support the development of privacy protection technologies in autonomous driving environments. Full article

Objective: This study aimed to determine the relationship between sigmoid sinus dehiscence (SSD), sigmoid sinus topography, mastoid pneumatization, and adjacent temporal bone structures in patients with pulsatile tinnitus (PT). Methods: A retrospective analysis was performed on 344 temporal bone cone-beam computed tomography (CBCT) scans (172 PT patients and 172 age- and sex-matched controls). The degree of mastoid pneumatization, presence and size of SSD, sinus topography, and distances between the sigmoid sinus and key landmarks—the lateral semicircular canal (LSCC), jugular bulb (HJB), and external auditory canal (EAC)—were measured. Quantitative and qualitative characteristics were compared between groups, and independent predictors of PT were identified using multivariate logistic regression. Results: Compared to controls, SSD was substantially more common in the PT group (115/172 vs. 44/172, p < 0.001). Patients with PT had significantly larger anteroposterior and vertical sigmoid sinus dehiscence diameters (4.61 ± 0.99 mm vs. 3.87 ± 0.25 mm and 3.37 ± 0.47 mm vs. 2.92 ± 0.14 mm, respectively; both p < 0.01). Additionally, in the PT group, the sigmoid sinus was situated closer to the lateral semicircular canal, jugular bulb (JB), and external auditory canal (all p < 0.01). Conclusions: Venous pulsatile tinnitus was substantially correlated with sigmoid sinus dehiscence, sinus topography, and decreased sinus–EAC distance. Quantitative CBCT evaluation of these anatomical relationships could help with surgical planning and enhance diagnostic evaluation. Full article

Background/Objectives: Accurate implant positioning in total knee arthroplasty (TKA) depends on reliable intraoperative landmark registration. In imageless TKA, registration errors can alter cutting-plane orientation and compromise alignment. This study quantitatively evaluated how anatomical landmark registration errors affect cutting-plane orientation in imageless TKA. Methods: A CAD-based simulation with controlled experimental validation using 3D-printed bone models was performed to reproduce the imageless TKA workflow. Controlled errors were introduced into key femoral and tibial landmarks, and the resulting deviations were quantified. The primary evaluation metrics were angular deviations in varus/valgus, flexion/extension, and internal/external rotation. Results: Coronal and rotational alignment showed the greatest sensitivity to registration error. In the femur, anteroposterior epicondylar displacement had the strongest rotational influence, with sensitivity reaching about 0.5°/mm, whereas mediolateral displacement of the tibial anteroposterior landmarks showed the highest sensitivity at about 1.4°/mm. Similar trends were observed in both simulation and experimental validation cases. Conclusions: The findings indicate that small registration errors can produce clinically significant cutting-plane deviations in imageless TKA, particularly at the femoral transepicondylar and tibial anteroposterior landmarks, and may approach commonly accepted alignment thresholds. Full article

Background: The mental foramen is a key anatomical structure of the mandible through which the mental nerve and accompanying vessels emerge. Accurate knowledge of its location and morphology is essential for safe dental and surgical procedures in the anterior mandible. Objective: This study was conducted as a systematic review to summarize current evidence on the morphology, localization, and anatomical variants of the mental foramen and their clinical relevance. Methods: The PubMed and Google Scholar databases were searched for studies published between 2015 and 2025 in accordance with current systematic review guidelines. Cone-beam computed tomography (CBCT) studies and anthropological investigations assessing the position, dimensions, and anatomical variants of the mental foramen were included. Results: Thirty-five studies (30 CBCT-based and 5 anthropological) comprising a total of 6240 mandibles or patients were analyzed qualitatively. Considerable variability was observed in the horizontal and vertical position of the mental foramen in relation to mandibular borders and dental landmarks. Anatomical variations included differences in size and shape, the presence of unilateral or bilateral accessory mental foramina, and rare cases of unilateral or bilateral absence of the foramen. Conclusions: The synthesis of recent CBCT and anthropological data across diverse populations highlights clinically relevant patterns of variability. This study identifies key positional patterns and variants of the mental foramen, which can inform clinical planning and help reduce the risk of mental nerve injury. Full article