Search Results (6,504)

This study presents a low-cost edge-IoT-based structural health monitoring (SHM) architecture for crack monitoring in operational underground tunnels. The system integrates crack-displacement sensing, temperature measurement, ESP32-based edge processing, LoRa/MQTT communication, AES/ECDSA-based data protection, and cloud-based data management. The architecture was validated through a 30-day field campaign at two representative cracks in the Hai Van Tunnel, with measurements acquired at 60 s sampling intervals. The results show that edge-based wavelet–Kalman processing improved measurement stability and reduced high-frequency noise, while the implemented security mechanism introduced only minor latency relative to the monitoring cycle. The two monitored cracks exhibited small micrometer-scale fluctuations associated with temperature variation and showed no cumulative widening trend during the observation period. This study demonstrates the feasibility of campaign-based tunnel crack monitoring using a trustworthy edge-sensing architecture, while longer deployments with more sensing nodes are needed to fully evaluate scalability and operational durability. Full article

Background/Objectives: Advanced implant anchorage techniques are increasingly used to manage severe maxillary bone deficiency and to avoid extensive bone augmentation procedures. This case series report aimed to describe the canine bypass anchorage technique and to evaluate the short- to medium-term clinical outcomes and survival of implants placed using this approach. Materials and Methods: Thirteen patients presenting with missing maxillary premolars or posterior segments and insufficient alveolar bone height for conventional axial implant placement were treated using the canine bypass technique. A total of 19 long one-piece implants were inserted palatally to the canine root, engaging distant cortical bone of the nasal cavity and/or palatal alveolar process. Pre- and postoperative cone-beam computed tomography (CBCT) examinations were performed to assess implant positioning and anchorage. Patients were followed up to 3.5 years. Results: The mean follow-up period was 26.1 ± 10.8 months. Nasal cortical anchorage was achieved in 84.2% of implants, and palatal cortical anchorage in 73.7%; both anchorage types were obtained simultaneously in 57.9% of cases. The mean distance between the implant and canine root was 1.27 ± 1.4 mm (range: −1.0 to 4.5 mm), including cases of direct implant–tooth contact and periodontal ligament space transgression. All implants remained functional throughout the observation period, yielding a cumulative survival rate of 100%. Canine pulp vitality was preserved in all non-endodontically treated teeth. Conclusions: Within the limitations of this case series report, the canine bypass anchorage technique appears to be a feasible and minimally invasive treatment option for maxillary rehabilitation with implant-supported restoration in selected patients with severe bone deficiency, potentially allowing avoidance of sinus augmentation procedures. Further prospective studies with larger patient cohorts and longer follow-up periods are required to confirm the long-term safety, predictability, and clinical applicability of this approach. Full article

Educational information systems have evolved into highly interconnected digital landscapes that support learning management platforms, student information systems, institutional repositories, and online assessment environments. As these systems increasingly operate across cloud infrastructures and mobile devices, ensuring the confidentiality, integrity, and availability (CIA Triad) of educational data is critical for safeguarding institutional operations and maintaining trust in digital education services. This paper investigates how next-generation security protocols, such as adaptive multi-factor authentication and advanced access control and data protection mechanisms, can reinforce ISO/IEC 27001:2022 requirements within contemporary educational information systems. The analysis maps emerging protocol capabilities to relevant new ISO/IEC 27001:2022 control domains, illustrating how they mitigate threats associated with unauthorized access, data manipulation, and service disruption. The proposed framework is further supported by an implementation-oriented mapping and an illustrative operational architecture that demonstrates the feasibility of translating prioritized security determinants into practical mechanisms. The FAHP analysis identifies access control mechanisms, backup and recovery, and data validation as the three highest-weighted determinants, with aggregate weights of 0.061, 0.059, and 0.057, respectively. These determinants are translated into a determinant-driven Security Operationalization Matrix that connects ISO/IEC 27001:2022 control domains, CIA dimensions, and technology recommendations, and is complemented by implementation feasibility considerations tailored to the budgetary, infrastructural, and resource constraints characteristic of educational institutions. Based on the prioritization results and conceptual operationalization, the proposed integrative approach provides a structured and progressively adoptable foundation for CIA-oriented security governance in digital educational environments. Full article

Smart labels are emerging as a key enabling technology for product traceability, environmental monitoring, and user interaction within Internet of Things (IoT) ecosystems. This work presents the design and experimental validation of a low-power smart label platform integrating Bluetooth Low Energy (BLE) communication, temperature sensing, and dynamic e-paper visualization based on the HY0020 System-on-Chip (SoC). This platform was implemented on a custom Printed Circuit Board (PCB) designed around a 1.02-inch monochrome e-paper display and incorporates a TXS0108E interface to support reliable display communication. The developed prototype enables wireless user interaction, dynamic QR code rendering, and ambient temperature monitoring while maintaining low average power consumption. Experimental evaluation included BLE communication testing, display operation validation, temperature monitoring assessment using the integrated HY0020 sensor, and energy consumption characterization. Experimental results confirmed reliable BLE connectivity, stable temperature monitoring performance under normal environmental conditions, and an estimated battery lifetime of approximately 54 days under the evaluated operating profile. The presented platform demonstrates the feasibility of integrating sensing, wireless communication, and electrophoretic display technology within a compact battery-powered smart label device. The proposed architecture provides a practical proof-of-concept foundation for future applications involving product traceability, digital information management, and Digital Product Passport (DPP)-oriented services. Full article

This study examines the association between corporate governance and financial performance and investigates whether real earnings management (REM) mediates this relationship in an emerging-market context. Using a balanced panel of 434 nonfinancial listed firms in Vietnam from 2020 to 2024, yielding 2170 firm-year observations, the study employs feasible generalized least squares (FGLS) after diagnostic tests indicate heteroskedasticity and autocorrelation. The Durbin–Wu–Hausman test does not indicate significant endogeneity in the current model specification. REM is measured using the Roychowdhury-based approach, and mediation effects are examined through sequential regressions. Tobin’s Q is used for robustness testing, and a two-step System GMM is used as an additional robustness test. The results show that board size, institutional ownership, and state ownership are positively associated with financial performance, while board independence is negatively associated with performance. Board financial expertise has no significant direct relationship with performance. REM is negatively associated with financial performance and serves as a mediating channel in the governance–performance relationship. The study contributes to the corporate governance literature by showing that REM can transmit governance effects to firm performance in an emerging market characterized by evolving enforcement, state ownership, and potential gaps between formal and substantive governance mechanisms. Full article

Data centers have become essential infrastructure for digital services, while their rapidly growing electricity demand makes coordinated workload and power management an important optimization problem. This paper studies the multi-data-center operation problem under time-of-use electricity pricing and formulates it as a multi-data-center mixed-integer nonlinear programming model (MDC-MINLP). The model jointly represents binary task scheduling decisions, including temporal workload shifting and spatial task migration, and continuous power-side variables, including device-level utilization, IT and auxiliary power consumption, energy storage dynamics, grid power procurement, and quality-of-service constraints. The objective is to minimize the total operating cost by integrating electricity purchasing cost, IT operation loss, storage degradation cost, and migration cost. To solve the resulting large-scale discrete–continuous coupled problem, an Adaptive Large Neighborhood Search algorithm with Hierarchical Collaboration (HC-ALNS) is proposed. HC-ALNS reconstructs feasible task action sets, employs a surrogate objective for fast candidate screening, performs accurate power-layer evaluation for selected solutions, and adaptively adjusts search intensity according to convergence behavior. Numerical results show that HC-ALNS reduces the total operating cost by 3.67% and achieves better convergence and solution quality than NSGA-II and PSO. These findings demonstrate that the proposed MDC-MINLP and HC-ALNS provide an effective mathematical optimization framework for coordinated computation–power scheduling. Full article

Cardiovascular disease remains the leading cause of mortality in kidney transplant recipients (KTRs). Arterial hypertension is present in a vast majority of patients after kidney transplantation, constituting the most prevalent cardiovascular comorbidity, and is a significant modifiable risk factor for other cardiovascular complications and graft loss. The 2024 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines do not address blood pressure control strategies in KTRs, and the prior 2021 KDIGO recommendations targeting values below 130/80 mmHg rely primarily on data extrapolated from non-KTR populations. This represents an existing evidence gap in the management of post-transplant hypertension. Dihydropyridine calcium channel blockers and angiotensin receptor blockers remain first-line antihypertensive medications, although most studies assessing their effectiveness in KTRs date back more than 15 years. The current treatment guidelines are based largely on limited and outdated data. Optimal selection and individualization of immunosuppressive therapy and—when feasible—its modification in some KTRs may be important in improving blood pressure control. This includes, for example, a reduction in the calcineurin inhibitor or steroid dose, as well as the use of mTOR inhibitors or belatacept. The lack of large, up-to-date randomized trials in the KTR population underscores the pressing need for further extensive research focused on this patient group. Full article

The growing number of breast cancer survivors is expected to increase the absolute number of locoregional recurrences requiring management, necessitating improvements in treating recurrences or tumours that occur within the initial radiation field (IFR). However, there are no guidelines on reirradiation (RT2) for breast cancer IFRs. We aimed to investigate locoregional practice patterns and outcomes. We retrospectively identified patients who received adjuvant RT1 for resected breast cancer and subsequently received curative-intent RT2 for IFRs at two large tertiary centres. A chart review obtained treatment, patient, and tumour characteristics. Descriptive statistics were calculated to characterize practice patterns, toxicity, and survival outcomes. Thirty-five patients met inclusion criteria across 18 years, with mean follow-up time of 43 months. Median time from RT1 to progression was 70.1 months. Most IFRs were in the breast or chest wall alone (48.6%). Regional nodal irradiation (RNI) was given in 23% of RT1 and 48.6% of RT2. Complete field overlap occurred in 60% of patients. Ten patients (28.6%) had a second recurrence (i.e., after RT2). Five-year OS was 65.4%, the median OS was not reached, and the mean OS was 73.7 months (95% CI 59.8–87.7 months). Freedom from recurrence (after RT2) was 71%. Shorter time to initial recurrence was associated with second recurrence (p = 0.018), and second recurrence was found to be predictive of death (p < 0.001). Four (11.4%) patients developed fibrosis, 75% of which developed after RT1. Eight (22.9%) patients developed lymphedema, 75% of which developed after RT1, all of which were documented as stable after RT2. Managing breast cancer IFRs with RT2 appears to be a feasible approach with reasonably consistent practice patterns in appropriately selected patients. Toxicity appears to be driven by the initial treatment course, and survival outcomes are acceptable. Full article

Background: Treatment-resistant obsessive–compulsive disorder (TR-OCD) remains a major therapeutic challenge. Although current guidelines recommend optimized serotonin reuptake inhibitor (SRI) therapy, clomipramine switching, exposure and response prevention, and antipsychotic augmentation, a substantial proportion of patients continue to experience severe and disabling symptoms. In such cases, clinicians may consider pharmacological intensification strategies beyond guideline-endorsed algorithms. Methods: This study combines a structured narrative synthesis of pharmacological strategies for TR-OCD with a retrospective observational case series from a tertiary OCD referral clinic. Treatment resistance was defined as failure to achieve at least a 35% reduction in Yale–Brown Obsessive Compulsive Scale (Y-BOCS) score after at least two adequate SRI trials, including clomipramine, and optimized exposure and response prevention when available. Five patients treated with pharmacological intensification strategies were included. The primary outcome was percentage change in Y-BOCS score at 12 weeks. Results: The case series illustrates five strategies used in highly refractory OCD: supratherapeutic SSRI dosing, SSRI plus mirtazapine augmentation, dual SSRI therapy, serotonergic intensification in a clozapine-treated patient, and glutamatergic/GABAergic augmentation with topiramate. Baseline Y-BOCS scores ranged from 28 to 32. At 12 weeks, symptom reduction ranged from 23% to 36%. One patient met criteria for response, three showed near-response, and one demonstrated partial improvement. No cases of serotonin toxicity or clinically significant cardiac complications occurred. Conclusions: These cases suggest that carefully monitored pharmacological intensification may be feasible in selected specialist settings, but efficacy and safety require confirmation in prospective controlled studies. Recommendations: Pharmacological intensification should be reserved for highly refractory patients managed in specialist services, implemented with gradual titration, structured serotonin toxicity and electrocardiographic monitoring, and explicit individualized risk–benefit discussion; dual SSRI therapy should be regarded as the most experimental and highest-risk serotonergic option; and prospective controlled studies incorporating standardized functional outcomes are needed to refine patient-selection criteria and clarify which patients may benefit. Full article

Despite the large amount of successful existing methods and frameworks for planning sets of multiple unmanned aerial systems (UASs), there is still a lack of coordination frameworks that are capable of coping with real-world operational conditions. This paper presents U-Plan, an integrated management framework for the coordination of multi-UAS missions. U-Plan is designed to plan, schedule, monitor, and replan a heterogeneous set of UASs to complete point of interest (PoI) visiting missions while ensuring that all the generated trajectories are safe, feasible, and compliant with the required PoIs’ arrival times, UAS kinematics and energy constraints, and the existing 3D no-fly zones (NFZs). U-Plan is designed as a practical tool for strongly dynamic missions and is built upon three core components: (1) an NFZ-aware route computation method that explicitly accounts for NFZs prior to vehicle routing problem (VRP) optimization, resulting in shorter NFZ-safe routes; (2) a trajectory smoothing module that ensures the generation of kinematically feasible trajectories for fixed-wing UASs; and (3) a mission supervision module for real-time monitoring and replanning in case of changes in the UAS, mission, wind speed, or airspace restrictions. To validate the proposed architecture, we conducted rigorous experiments utilizing the VECTOR-SIL autopilot and Visionair Ground Control Station to realistically replicate the behavior of certified fixed-wing autopilots under various weather conditions using the exact same hardware and flight control software that runs onboard the physical drones. The validation shows U-Plan’s capacity to efficiently satisfy complex mission requirements with strong scalability. Due to its high computational efficiency, U-Plan enables online mission replanning, allowing UAS fleets to seamlessly adapt to changes that are typical of real-world operational scenarios. Full article

Objectives: We aimed to descriptively evaluate the feasibility and clinical utility of TowardPi BO (4K ultra-HD microscope integrated with a 400 kHz swept-source intraoperative optical coherence tomography (SS-iOCT) system) in managing various ophthalmic surgical conditions in a real-world setting. Methods: We analyzed surgical videos and data from 123 consecutive cases that underwent elective surgery with the assistance of this SS-iOCT system at Beijing Tongren Hospital between 2 September 2025 and 10 February 2026. Cases were included when the iOCT provided critical, real-time information that directly influenced surgical decision-making or technique modification. Cases were excluded if iOCT served only routine confirmatory or educational purposes without altering the surgical plan. Results: A total of 72 surgical cases were included, comprising 7 intraocular lens implantations with ciliary sulcus fixation, 19 macular holes, 3 cases of macular hole retinal detachment (MHRD), 4 cases of macular schisis with or without foveal detachment (MSRD), 12 cases of submacular hemorrhage, 20 cases of rhegmatogenous retinal detachment (RRD), and 7 intraocular mass lesions. The 400 kHz SS-iOCT significantly aided in surgical visualization, guided real-time decision-making, and prompted modifications in surgical techniques. Conclusions: To our knowledge, this is the first real-world study to evaluate the application of a 400 kHz SS-iOCT system across a wide spectrum of ophthalmic conditions, including its novel use in intraocular tumors. From routine to complex surgical cases, SS-iOCT enhances surgical precision and facilitates real-time decision-making, ultimately contributing to improved surgical outcomes. Full article

Background/Objectives: Adult patients supported with extracorporeal membrane oxygenation (ECMO) frequently require invasive diagnostic, therapeutic, surgical, or bedside procedures during ongoing extracorporeal support. These procedures are clinically challenging because ECMO-related anticoagulation, platelet dysfunction, acquired coagulopathy, and circuit-related coagulation activation may increase both bleeding and thrombotic risks. This systematic review evaluated the safety of invasive procedures performed during adult ECMO support, excluding tracheostomy/tracheotomy because this procedure has recently been addressed in a dedicated systematic review. Methods: A systematic search of PubMed/MEDLINE and Scopus was performed. The final bibliographic data collection was completed in April 2026. Studies were eligible if they included adult ECMO or extracorporeal life support patients undergoing invasive procedures during ongoing ECMO support, or with ECMO used as procedural support, and reported at least one procedure-specific safety outcome. Primary outcomes were procedure-related complications, bleeding, major bleeding, and transfusion requirements. Secondary outcomes included thrombotic and circuit-related complications, oxygenator exchange, reintervention, reoperation, procedural failure, ECMO duration, intensive care unit and hospital length of stay, and mortality. Results: The final qualitative synthesis included 46 studies, comprising 26 studies from PubMed/MEDLINE and 20 additional unique studies from Scopus. Included procedures were grouped into six domains: airway, bronchoscopic, and tracheobronchial procedures; thoracic surgery and lung resections; abdominal surgery, gastrointestinal endoscopy, and decompressive laparotomy; lung transplantation and perioperative extracorporeal life support; cardiovascular, vascular, pulmonary embolism-related, and mechanical circulatory support-related procedures; and mixed non-cardiac surgery. Airway and bronchoscopic procedures generally showed high procedural success in selected cohorts, although registry-level tracheal procedure data reported hemorrhagic complications in 26.0% and surgical-site bleeding in 13.0%. Emergency thoracic and abdominal procedures carried the highest bleeding, transfusion, reintervention, and mortality burden. Lung transplantation studies showed that ECMO can be integrated into perioperative pathways, but hemothorax, transfusion, thromboembolism, and anticoagulation strategy remained central safety issues. Conclusions: Invasive procedures during adult ECMO are feasible in selected patients and experienced centers, but procedural safety varies markedly by procedure type, urgency, baseline disease severity, and anticoagulation strategy. A procedure-centered, multidisciplinary approach with individualized anticoagulation management and careful planning is essential. Full article

Heart rate variability (HRV) is an established biomarker of autonomic nervous system activity, yet its profile in miniature cattle remains poorly understood despite their growing importance in sustainable farming. This study compared HRV parameters between miniature and Holstein cows and assessed the influence of age on these profiles. Eighty clinically healthy female cattle (40 miniature, 40 Holstein), aged 2 to 8 years, were evaluated under field conditions using a Polar H10 heart rate monitor. RR intervals were analyzed using Kubios HRV software to obtain time- and frequency-domain indices. Miniature cows exhibited significantly lower heart rates and higher time-domain measures (RMSSD and SDNN) compared to Holsteins, while frequency-domain analysis revealed significant differences in LF, HF, and LF/HF ratio, suggesting group-associated differences in proportional autonomic balance. Age-stratified analysis revealed that these physiological distinctions were more pronounced in older cows (6–8 years). However, given the observational cross-sectional design of this study, confounding factors—specifically the different farm environments, management systems, and the active lactation status of the Holstein group—preclude attributing these differences solely to breed or body size. Therefore, these results suggest an associative physiological pattern rather than a definitive autonomic adaptation. Despite these limitations, portable HRV monitoring proved feasible under farm conditions, providing valuable preliminary baseline data that can inform future controlled studies on bovine cardiovascular welfare. Full article

The growing demand for sustainable energy carriers has intensified interest in hydrogen production from renewable resources and waste-derived substrates. In this context, microbial electrolysis cells (MECs) have emerged as a promising technology for the simultaneous treatment of organic waste and biohydrogen generation. This review provides an overview of recent advances in MEC systems, focusing on reactor configurations, performance indicators such as hydrogen production rate, coulombic efficiency, and chemical oxygen demand removal. Attention is given to the valorization of real waste streams, including municipal and agro-industrial effluents, highlighting the differences between laboratory- and pilot-scale applications. While numerous studies have demonstrated the technical feasibility of MECs, several bottlenecks still limit their large-scale implementation, including challenges associated with the use of complex substrates. In particular, untreated wastewater often leads to reduced process efficiency due to its variable composition and the occurrence of competing microbial pathways. To overcome these limitations, integrated approaches are also discussed, with emphasis on the coupling of dark fermentation, capable of enhancing substrate biodegradability through the production of volatile fatty acids, with MEC systems. Overall, MEC technology represents a promising pathway for sustainable hydrogen production within circular waste management frameworks, although further advancements are required to enable its practical application. Full article

Air Traffic Control Officers (ATCOs) are responsible for controlling air traffic and ensuring the safety of the aircraft. Capacity, understood as the maximum number of aircraft that can be safely managed for one hour, is calculated based on the workload of ATCOs. This calculation normally is based on a manual and tedious data collection process that demands a high consumption of human resources. To improve and relieve human re-sources, automation tools that automatically generate a preliminary annotation of Air Traffic Control (ATC) activity have been developed. This paper focuses on the feasibility of employing data-driven approaches using neural networks to classify ATC events, as well as if it is possible to improve the performance of these ATC-activity tools. Particularly, this approach seeks to infer ATC intent for separation actions, which are the most critical in terms of ATC workload. A modular methodology has been developed to include information from different sources: flight plans, radar trajectories, trajectory prediction, conflict detection and rule-based knowledge. Different experiments are evaluated based on the different input’s combination, as well as three neural networks (Multilayer Perceptron, Convolutional Neural Network and TabNet). Results show that TabNet is the best neural network option, reaching a similar performance in task classification than current ATC tools and improving classification metrics around 4% by employing the outputs of ATC tool metrics as inputs. Full article