Search Results (5,997)

Background and Objectives: Hysterectomy is a common non-obstetric procedure. Minimally invasive techniques, such as laparoscopy and robot-assisted surgery, have replaced open surgery for benign gynecologic conditions. Robotic surgery offers reduced blood loss and shorter hospital stays but is limited by high costs. Articulating laparoscopic instruments aim to replicate robotic dexterity cost-effectively. However, comparative data on these two approaches in hysterectomy are limited. Materials and Methods: This multicenter study analyzed the outcomes of hysterectomies for benign gynecological diseases using articulating laparoscopic instruments (prospectively recruited) and robot-assisted surgery (retrospectively reviewed). The surgeries were performed by minimally invasive gynecological surgeons in South Korea, Japan, and Taiwan. The baseline characteristics, operative details, and outcomes, including operative time, blood loss, complications, and hospital stay, were compared. Statistical significance was set at p < 0.05. Results: A total of 151 patients were analyzed, including 67 in the articulating laparoscopy group and 84 in the robot-assisted group. The operating times were comparable (114.9 vs. 119.9 min, p = 0.22). The articulating group primarily underwent dual-port surgery (79.1%), whereas the robot-assisted group required four or more ports in 71.4% of the cases (p < 0.001). Postoperative complications occurred in both groups, without a significant difference (9.0% vs. 3.6%, p = 0.17). No severe complications or significant differences in the 30-day readmission rates were observed. Conclusions: Articulating laparoscopic instruments provide outcomes comparable to robot-assisted surgery in hysterectomy while reducing the number of ports required. Further studies are needed to explore the learning curve and long-term impact on surgical outcomes. Full article

Helminth parasites of wild animals represent a major threat to the health of these animals, leading to significant losses in performance, health, and zoonotic implications. In some zoos, anthelmintics have traditionally been used to control these parasites, many of which are also zoonotic. Other actions, such as the removal of organic waste, have also been adopted. Few or no control measures are applied to free-ranging wild animals. Helminthophagous fungi are a promising biological alternative. When animals ingest fungal spores, they are excreted in their feces, where they trap and destroy helminth larvae and eggs, preventing and reducing the parasite load in the environment. Another alternative is to administer fungi by spraying them directly into the environment. This review aims to examine the use of helminthophagous fungi in the control of helminthiases in wild animals, highlighting their potential to minimize dependence on chemical treatments and promote sustainable animal breeding and production. There are many challenges to making this viable, such as environmental variability, stability of formulations, and acceptance of this new technology. These fungi have been shown to reduce parasite burdens in wild animals by up to 75% and can be administered through the animals’ feeding troughs. To date, evidence shows that helminthophagous fungi can reliably curb environmental parasite loads for extended periods, offering a sustainable alternative to repeated anthelmintic dosing. Their use has been linked to tangible gains in body condition, weight, and overall welfare in various captive and free-ranging wildlife species. Full article

Introduction: Ocular complications associated with dental procedures are diverse but have been primarily reported through case reports and series, with no comprehensive reviews to date. The underlying mechanisms of these complications are often poorly understood by medical professionals, partly due to limited interdisciplinary education. This review aims to bridge this gap by summarizing the relevant anatomical connections between the oral and ocular regions, exploring the mechanisms through which dental procedures may lead to ophthalmic complications, and detailing their clinical presentations, progression, and potential management and preventive strategies. Methods: Published case reports and case series from 1950 to October 2024 that described ophthalmic complications in human patients following dental procedures were included in this scoping review. Results: Dental procedures can give rise to a variety of ophthalmological complications, whether neuro–ophthalmic (e.g., diplopia, ptosis, or vision loss), vascular (e.g., retrobulbar hemorrhage or cervical artery dissection), infectious (e.g., orbital cellulitis or abscess), mechanical (e.g., orbital trauma or fractures), or air-related (e.g., orbital and subcutaneous emphysema). Conclusions: Most of the ophthalmological complications following dental procedures are often reversible, but some can be vision-threatening or lead to permanent sequelae if not promptly recognized and managed. Prevention through precise technique and anatomical awareness, early identification of symptoms, and timely multidisciplinary collaboration are crucial to minimizing risks and ensuring better patient outcomes. Full article

Maintaining well integrity is essential in the oil and gas industry to prevent environmental hazards, operational risks, and economic losses. Cement bond log (CBL) tools are essential in evaluating cement bonding and ensuring wellbore stability. This study presents a patent landscape review of CBL technologies, based on 3473 patent documents from the Lens.org database. After eliminating duplicates and irrelevant entries, 167 granted patents were selected for in-depth analysis. These were categorized by technology type (wave, electrical, radiation, neutron, and other tools) and by material focus (formation, casing, cement, and borehole fluid). The findings reveal a dominant focus on formation evaluation (59.9%) and a growing reliance on wave-based (22.2%) and other advanced tools (25.1%), indicating a shift toward high-precision diagnostics. Geographically, 75% of granted patents were filed through the U.S. Patent and Trademark Office, and 97.6% were held by companies, underscoring the dominance of corporate innovation and the minimal presence of academia and individuals. The review also identifies notable patents that reflect significant technical innovations and discusses their role in advancing diagnostic capabilities. These insights emphasize the need for broader collaboration and targeted research to advance well integrity technologies in line with industry goals for operational performance and safety. Full article

Highly integrable silicon carbide (SiC) has emerged as a promising platform for photonic integrated circuits (PICs), offering a comprehensive set of material and optical properties that are ideal for the integration of nonlinear devices and solid-state quantum defects. However, despite significant progress in nanofabrication technology, the development of SiC on an insulator (SiCOI)-based photonics faces challenges due to fabrication-induced material optical losses and complex processing steps. An alternative approach to mitigate these fabrication challenges is the direct deposition of amorphous SiC on an insulator (a-SiCOI). However, there is a lack of systematic studies aimed at producing high optical quality a-SiC thin films, and correspondingly, on evaluating and determining their optical properties in the telecom range. To this end, we have studied a single-source precursor, 1,3,5-trisilacyclohexane (TSCH, C₃H₁₂Si₃), and chemical vapor deposition (CVD) processes for the deposition of SiC thin films in a low-temperature range (650–800 °C) on a multitude of different substrates. We have successfully demonstrated the fabrication of smooth, uniform, and stoichiometric a-SiCOI thin films of 20 nm to 600 nm with a highly controlled growth rate of ~0.5 Å/s and minimal surface roughness of ~5 Å. Spectroscopic ellipsometry and resonant micro-photoluminescence excitation spectroscopy and mapping reveal a high index of refraction (~2.7) and a minimal absorption coefficient (<200 cm⁻¹) in the telecom C-band, demonstrating the high optical quality of the films. These findings establish a strong foundation for scalable production of high-quality a-SiCOI thin films, enabling their application in advanced chip-scale telecom PIC technologies. Full article

Background/Objectives: This study aimed to investigate the optimal sound presentation level for sound localization testing to assess the effect of hearing interventions in individuals with unilateral conductive hearing loss (UCHL). Methods: Nine participants with normal hearing were tested, and simulated two-stage UCHL was created using earmuffs and earplugs. We created two types of masking conditions: (1) only an earplug inserted, and (2) an earplug inserted with an earmuff worn. A sound localization test was performed for each condition. The sound presentation levels were 40, 45, 50, 55, 60, 65, and 70 dB SPL, and the results were evaluated using root mean square and d-values. Results: Both values showed little difference in masking Condition 2, regardless of the sound presentation level, whereas in masking Condition 1, the values were at their minimum at 55 dB SPL. In addition, comparing the differences between masking Conditions 1 and 2 for each sound presentation level, the greatest difference was observed at 55 dB SPL for both values. Conclusions: The optimal sound presentation level for sound localization testing to assess hearing intervention effects in UCHL was 55 dB. This result may be attributed to the effect of input from the non-masked ear, accounting for interaural attenuation; the effect was considered minimal at 55 dB SPL. Full article

In this study, we aimed to address the lack of systematic research on key collision dynamics parameters (elastic restitution coefficient) in the full mechanization of rapeseed operations, which hinders the development of precision agriculture. In this present work, the restitution coefficient of rapeseed was systematically investigated, and a predictive model (R² = 0.959) was also established by using Box–Behnken design response surface methodology (BBD-RSM). The results show that the collision restitution coefficient varies in the range of 0.539–0.649, with the key influencing factors ranked as follows: moisture content (M_c) > material layer thickness (L) > drop height (H). The EDEM simulation methodology was adopted to validate the experimental results, and the results show that there is a minimal relative error (−1% < δ < 1%) between the measured and simulated rebound heights, indicating that the established model shows a reliable prediction performance. Moreover, by comprehensively analyzing stress, strain, and energy during the collision process between rapeseed and Q235 steel, it can be concluded that the process can be divided into five stages—free fall, collision compression, collision recovery, rebound oscillation, and rebound stabilization. The maximum stress (1.19 × 10⁻² MPa) and strain (6.43 × 10⁻⁶ mm) were observed at the beginning of the collision recovery stage, which can provide some theoretical and practical basis for optimizing and designing rapeseed machines, thus achieving the goals of precise control, harvest loss reduction, and increased yields. Full article

Modular multilevel converters (MMCs) are widely used in power-conversion applications, including distributed energy storage integration, because of their scalability, high efficiency, and reduced harmonic distortion. Integrating battery storage systems into MMC submodules using dual active bridge (DAB) converters provides electrical isolation and reduces voltage stress, harmonics, and common-mode issues. However, voltage fluctuations due to the battery state of charge can compromise the zero-voltage switching (ZVS) operation of a DAB and increase the reactive power circulation, leading to higher losses and reduced system performance. To address these challenges, this study investigated an active control strategy for submodule voltage regulation in an MMC with DAB-based battery integration. Assuming single-phase-shift modulation, two control strategies were evaluated. The first strategy regulated the DAB voltage on one side to match the battery voltage on the other, scaled by the high-frequency transformer turns ratio, which facilitated the ZVS operation and reduced the reactive power. The second strategy optimized this voltage to minimize the total power-conversion losses. The proposed control strategies improved the efficiency, particularly at low power levels, achieving several percentage points of improvement compared to maintaining a constant voltage. Full article

Biofilms are structured microbial communities that pose significant challenges to food safety and quality within the food-processing industry. Their formation on equipment and surfaces enables persistent contamination, microbial resistance, and recurring outbreaks of foodborne illness. This review provides a comprehensive synthesis of current knowledge on biofilm formation mechanisms, genetic regulation, and the unique behavior of multi-species biofilms. The review evaluates modern detection and monitoring technologies, including PCR, biosensors, and advanced microscopy, and compares their effectiveness in industrial contexts. Real-world outbreak data and a global economic impact analysis underscore the urgency for more effective regulatory frameworks and sanitation innovations. The findings highlight the critical need for integrated, proactive biofilm management approaches to safeguard food safety, reduce public health risks, and minimize economic losses across global food sectors. Full article

This study investigates the mechanical, morphological, and wear properties of SiO₂-filled tri-axial warp-knitted (TWK) glass fiber-reinforced vinyl ester matrix composites, with a focus on void fraction, tensile, flexural, hardness, and wear behavior. Adding SiO₂ fillers reduced void fractions, enhancing composite strength, with values ranging from 1.63% to 5.31%. Tensile tests revealed that composites with 5 wt% SiO₂ (GV1) exhibited superior tensile strength, Young’s modulus, and elongation due to enhanced fiber–matrix interaction. Conversely, composites with 10 wt% SiO₂ (GV2) showed decreased tensile performance, indicating increased brittleness. Flexural tests demonstrated that GV1 outperformed GV2, showcasing higher flexural strength, elastic modulus, and deflection, reflecting improved load-bearing capacity at optimal filler content. Shore D hardness tests confirmed that GV1 had the highest hardness among the specimens. SEM analysis revealed wear behavior under various loads and sliding distances. GV1 exhibited minimal wear loss at lower loads and distances, while higher loads caused significant matrix detachment and fiber damage. These findings highlight the importance of optimizing SiO₂ filler content to enhance epoxy composites’ mechanical and tribological performance. Full article

Digital image quality is crucial for reliable analysis in applications such as medical imaging, satellite remote sensing, and video surveillance. However, traditional denoising methods struggle to balance noise removal with detail preservation and lack adaptability to various types of noise. We propose a novel three-module architecture for image denoising, comprising a generator, a dual-path-UNet-based denoiser, and a discriminator. The generator creates synthetic noise patterns to augment training data, while the dual-path-UNet denoiser uses multiple receptive field modules to preserve fine details and dense feature fusion to maintain global structural integrity. The discriminator provides adversarial feedback to enhance denoising performance. This dual-path adversarial training mechanism addresses the limitations of traditional methods by simultaneously capturing both local details and global structures. Experiments on the SIDD, DND, and PolyU datasets demonstrate superior performance. We compare our architecture with the latest state-of-the-art GAN variants through comprehensive qualitative and quantitative evaluations. These results confirm the effectiveness of noise removal with minimal loss of critical image details. The proposed architecture enhances image denoising capabilities in complex noise scenarios, providing a robust solution for applications that require high image fidelity. By enhancing adaptability to various types of noise while maintaining structural integrity, this method provides a versatile tool for image processing tasks that require preserving detail. Full article

Background/Objectives: Anterior dental trauma in adolescents presents complex restorative challenges due to ongoing craniofacial development and high aesthetic expectations. This study evaluated the long-term clinical performance of feldspathic ceramic veneers and lithium disilicate crowns used in the anterior region following dental trauma in adolescents. Methods: A total of 209 restorations were placed in 85 adolescents (50 females, 35 males), aged 11.1–17.9 years (mean age: 15.1 years). Of these, 144 were lithium disilicate crowns, and 65 were feldspathic ceramic veneers. All restorations were fabricated using minimally invasive protocols and followed up for periods ranging from 3 to 60 months. Outcomes were assessed based on standardized clinical criteria for success and failure. Results: Lithium disilicate crowns exhibited superior long-term performance, with the majority of failures occurring in feldspathic veneers (p < 0.001), primarily due to chipping or structural fracture. Age and gender had no statistically significant influence on failure rates. Conclusions: Both feldspathic and lithium disilicate ceramic restorations represent viable treatment options for anterior dental trauma in adolescents. However, lithium disilicate demonstrates greater mechanical reliability, particularly in teeth with significant hard tissue loss. These results support the use of durable ceramic materials in adolescent restorative protocols involving dental trauma. Full article

Background and Objectives: The management of type 2 diabetes (T2D) extends beyond glycemic control, requiring a more global strategy that includes optimization of body composition, even more so in the context of sarcopenia and visceral adiposity, as they contribute to poor outcomes. Past reviews have typically been focused on weight reduction or glycemic effectiveness, with limited inclusion of new therapies’ effects on muscle and fat distribution. In addition, the emergence of incretin-based therapies and dual agonists such as tirzepatide requires an updated synthesis of their impacts on body composition. This review attempts to bridge the gap by taking a systematic approach to how current blood-glucose lowering therapies affect lean body mass, fat mass, and the risk of sarcopenia in T2D patients. Materials and Methods: Between January 2015 and March 2025, we conducted a narrative review by searching the PubMed, Scopus, and Web of Science databases for English-language articles. The keywords were combinations of the following: “type 2 diabetes,” “lean body mass,” “fat mass,” “body composition,” “sarcopenia,” “GLP-1 receptor agonists,” “SGLT2 inhibitors,” “tirzepatide,” and “antidiabetic pharmacotherapy.” Reference lists were searched manually as well. The highest precedence was assigned to studies that aimed at adult type 2 diabetic subjects and reported body composition results. Inclusion criteria for studies were: (1) type 2 diabetic mellitus adult patients and (2) reporting measures of body composition (e.g., lean body mass, fat mass, or muscle function). We prioritized randomized controlled trials and large observational studies and excluded mixed diabetic populations, non-pharmacological interventions only, and poor reporting of body composition. Results: Metformin was widely found to be weight-neutral with minimal effects on muscle mass. Insulin therapy, being an anabolic hormone, often leads to fat mass accumulation and increases the risk of sarcopenic obesity. Incretin-based therapies induced substantial weight loss, mostly from fat mass. Notable results were observed in studies with tirzepatide, demonstrating superior reduction not only in fat mass, but also in visceral fat. Sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors) promote fat loss but are associated with a small yet significant decrease in lean muscle mass. Conclusions: Blood-glucose lowering therapies demonstrated clinically relevant effects on body composition. Treatment should be personalized, balancing glycemic control, cardiovascular, and renal benefits, together with optimal impact on muscle mass along with glycemic, cardiovascular, and renal benefits. Full article

Chromosomal microarray analysis (CMA) was performed for 40 patients with B-ALL undergoing treatment according to the ALL-2016 protocol to investigate the copy number alterations (CNAs) and copy neutral loss of heterozygosity (cnLOH) associated with minimal residual disease (MRD)-positive remission. Aberrations involving over 20,000 genes were identified, and a random forest approach was applied to isolate a subset of genes whose CNAs and cnLOH are significantly associated with poor therapeutic response. We have assembled the triple matched healthy population data and used that data as a reference, but not as a matched control. We identified a recurrent cluster of cnLOH in the 19q13.2–19q13.31 region, significantly enriched in MRD-positive patients (70% vs. 47% in the reference group vs. 16% in MRD-negative patients). This region includes the pregnancy-specific glycoprotein (PSG) gene family and the oncogene ERF, suggesting a potential role in leukemic persistence and treatment resistance. Additionally, we observed significant deletions involving 7p22.3 and 16q13, often as part of large-scale losses affecting almost the entire chromosomes 7 and 16, indicative of global chromosomal instability. These findings highlight specific genomic regions potentially involved in therapy resistance and may contribute to improved risk stratification in B-ALL. Our findings emphasize the value of high-resolution CMA in diagnostics and risk stratification and suggest that PSG genes and other candidate genes could serve as biomarkers for predicting treatment outcomes. Full article

Purpose: To present the findings of our preliminary experience using daily image-guided radiotherapy (IGRT) supported by implanted fiducial markers (FMs) in the radiotherapy of the vaginal cuff, in a cohort of post-surgery endometrial cancer patients. Methods: Patients with vaginal cuff cancer requiring adjuvant radiation with external beams were enrolled. Five patients underwent radiation therapy targeting the pelvic disease and positive lymph nodes, with doses of 50.4 Gy in twenty-eight fractions and a subsequent stereotactic boost on the vaginal vault at a dose of 5 Gy in a single fraction. One patient was administered 30 Gy in five fractions to the vaginal vault. These patients underwent external beam RT following the implantation of three 0.40 × 10 mm gold fiducial markers (FMs). Our IGRT strategy involved real-time 2D kV image-based monitoring of the fiducial markers during the treatment delivery as a surrogate of the vaginal cuff. To explore the potential role of FMs throughout the treatment process, we analyzed cine movies of the 2D kV-triggered images during delivery, as well as the image registration between pre- and post-treatment CBCT scans and the planning CT (pCT). Each CBCT used to trigger fraction delivery was segmented to define the rectum, bladder, and vaginal cuff. We calculated a standard metric to assess the similarity among the images (Dice index). Results: All the patients completed radiotherapy and experienced good tolerance without any reported acute or long-term toxicity. We did not observe any loss of FMs during or before treatment. A total of twenty CBCTs were analyzed across ten fractions. The observed trend showed a relatively emptier bladder compared to the simulation phase, with the bladder filling during the delivery. This resulted in a final median Dice similarity coefficient (DSC) of 0.90, indicating strong performance. The rectum reproducibility revealed greater variability, negatively affecting the quality of the delivery. Only in two patients, FMs showed intrafractional shift > 5 mm, probably associated with considerable rectal volume changes. Target coverage was preserved due to a safe CTV-to-PTV margin (10 mm). Conclusions: In our preliminary study, CBCT in combination with the use of fiducial markers to guide the delivery proved to be a feasible method for IGRT both before and during the treatment of post-operative gynecological cancer. In particular, this approach seems to be promising in selected patients to facilitate the use of SBRT instead of BRT (brachytherapy), thanks to margin reduction and adaptive strategies to optimize dose delivery while minimizing toxicity. A larger sample of patients is needed to confirm our results. Full article