Search Results (65,823)

This paper outlines the process of developing a low-cost system for home appliance control via real-time hand gesture classification using Computer Vision and a custom lightweight machine learning model. This system strives to enable those with speech or hearing disabilities to interface with smart home devices in real time using hand gestures, such as is possible with voice-activated ‘smart assistants’ currently available. The system runs on a Raspberry Pi 5 to enable future IoT integration and reduce costs. The system also uses the official camera module v2 and 7-inch touchscreen. Frame preprocessing uses MediaPipe to assign hand coordinates, and NumPy tools to normalise them. A machine learning model then predicts the gesture. The model, a feed-forward network consisting of five fully connected layers, was built using Keras 3 and compiled with TensorFlow Lite. Training data utilised the HaGRIDv2 dataset, modified to consist of 15 one-handed gestures from its original of 23 one- and two-handed gestures. When used to train the model, validation metrics of 0.90 accuracy and 0.31 loss were returned. The system can control both analogue and digital hardware via GPIO pins and, when recognising a gesture, averages 20.4 frames per second with no observable delay. Full article

Background and Objectives: This study aimed to investigate the effect of intraoperative hyaluronic acid (HA) application on short-term functional outcomes after open surgical repair of Achilles tendon rupture. Materials and Methods: This retrospective cohort study included 102 patients screened at three tertiary centers (January 2023–October 2024). After applying the exclusion criteria, 64 patients were analyzed (32 HA, 32 control), with group allocation based on the intraoperative use of HA. The primary outcomes were the American Orthopaedic Foot and Ankle Society (AOFAS) Score and the Achilles Tendon Total Rupture Score (ATRS), evaluated at 3, 6, and 12 months; the Short Form 36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, assessed at 6 and 12 months; and physical-performance tests (heel-rise endurance, single-leg hop distance, and calf muscle strength), performed at 6 and 12 months. Complications, including re-rupture, wound infection, and delayed wound healing, were also recorded. Results: At 6 months, the HA group had higher AOFAS scores (mean difference: 9.0, 95% CI: 6.3–11.7, p = 0.008) and ATRSs (mean difference: 7.0, 95% CI: 3.8–10.2, p = 0.008) than the controls. The differences were smaller but remained significant at 12 months (AOFAS mean difference: 5.0, 95% CI: 2.5–7.5, p = 0.034; ATRS mean difference: 4.0, 95% CI: 1.1–6.9, p = 0.034). The SF-36 PCS and MCS scores were also superior in the HA group at 6 and 12 months (all p < 0.05). The physical-performance tests (heel-rise endurance, single-leg hop, calf strength) showed significant mean differences, with the HA group scoring higher at both timepoints (all p < 0.05). Complication rates were low and not significantly different between groups (all p > 0.05). Conclusions: Intraoperative HA application during open Achilles tendon repair was associated with improvements in short-term functional recovery, general health status, and physical performance without increasing complication rates. These findings support the use of HA as a safe adjunct to optimize tendon gliding; however, prospective randomized controlled trials are needed to confirm these results. Full article

Three species of land crab occur in The Bahamas; these are an important source of protein and income for Bahamian islanders. The crab harvesters represent an important and largely untapped knowledge source. We conducted surveys on the Bahamian islands of Andros, New Providence, and Eleuthera to document crabbing practices and catalogue this local ecological knowledge (LEK) of land crabs. The survey primarily employed close-ended questions targeting land crab harvesters; we also recorded general feedback from open-ended questions. Crab collection was primarily for self-consumption. Catch rates varied among islands, and were the highest on Andros. There was a preference for white land crabs (Cardisoma guanhumi) on Andros, whereas on Eleuthera and New Providence, there was no preference for either white or black crabs (Gecarcinus ruricola). The majority of respondents reported a decline in white and black crab numbers, with land development and overharvesting being consistently cited factors. On Andros, forest fires were also reported to account for the loss of crab habitat, whereas on Eleuthera, invasive raccoons were blamed for the population decline. Respondents identified broadleaf forests as critical refuges and food sources for black crabs. Birds were the major predator, confirming findings for other land crab species. Land crabs were not merely a food resource but represented a complex nexus of ecological knowledge, economic systems, cultural traditions, and community practices within Bahamian society. We demonstrated a substantial overlap between traditional and scientific knowledge systems, providing valuable insights into land crab behaviour, habitat use, and ecology that complements formal scientific research. Full article

Background: Postoperative atrial fibrillation (POAF) is the most frequent arrhythmic complication following cardiac surgery, affecting nearly 20–30% of patients. While conventional risk factors such as age, hypertension, and atrial enlargement are well known, emerging evidence suggests that cancer itself constitutes a significant, yet underrecognized, contributor to POAF risk. Objective: This review aims to systematically examine the association of cancer with POAF, explore underlying pathophysiological mechanisms, and discuss clinical implications for risk stratification and management in cardiac surgical patients with concurrent or historical malignancies. Methods: A comprehensive review of recent literature was conducted using PubMed and Scopus databases. Studies focusing on the epidemiology, mechanisms, and clinical management of POAF in patients with cancer were evaluated. AI-assisted tools (OpenAI’s ChatGPT) were used for formatting the graphical abstract. Results: Lung, breast, gastrointestinal, hematologic, and prostate cancers demonstrate the strongest association with POAF. The arrhythmogenic mechanisms include systemic inflammation, hypercoagulability, direct cardiotoxicity from cancer therapies, autonomic dysregulation, and paraneoplastic syndromes. Integration of oncologic variables into perioperative cardiovascular care is essential for precision risk assessment and outcome optimization. In a recent prospective cardiac surgery cohort, active or historical cancer independently conferred ~4-fold higher odds of POAF (adjusted OR: 3.85, 95% CI: 1.54–9.66), with cancer present in 15% of POAF cases versus 4% of non-POAF patients. Conclusions: Cancer represents a pivotal and multifactorial risk factor for POAF after cardiac surgery. Recognizing its role calls for a multidisciplinary approach that aligns oncologic and cardiovascular care to mitigate arrhythmic risk and improve surgical outcomes. Full article

Background/Objectives:Hydrogels are highly hydrated, biocompatible polymer networks increasingly investigated as drug-delivery systems (DDS) for analgesics. Their ability to modulate local release, prolong drug residence time, and reduce systemic toxicity positions them as promising platforms in perioperative, chronic, and localized pain settings. This scoping review aimed to systematically map clinical applications, efficacy, and safety of hydrogel-based DDS for analgesics, while also documenting non-DDS uses where the matrix itself contributes to pain modulation through physical mechanisms. Methods: Following PRISMA-ScR guidance, PubMed, Embase, and Cochrane databases were searched without publication date restrictions. Only peer-reviewed clinical studies were included; preclinical studies and non-journal literature were excluded. Screening and selection were performed in duplicate. Data extracted included drug class, hydrogel technology, clinical setting, outcomes, and safety. Protocol was registered with Open Science Framework. Results: A total of 26 clinical studies evaluating hydrogel formulations as DDS for analgesics were included. Most were randomized controlled trials, spanning 1996–2024. Local anesthetics were the most frequent drug class, followed by opioids, corticosteroids, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), and neuromodulators. Application sites were predominantly topical/transdermal and perioperative/incisional. Across the DDS cohort, most of the studies reported improved analgesic outcomes, including reduced pain scores and lower rescue medication use; neutral or unclear results were rare. Safety reporting was limited, but tolerability was generally favorable. Additionally, 38 non-DDS studies demonstrated pain reduction through hydrogel-mediated cooling, lubrication, or barrier effects, particularly in burns, ocular surface disorders, and discogenic pain. Conclusions: Hydrogel-based DDS for analgesics show consistent clinical signals of benefit across diverse contexts, aligning with their mechanistic rationale. While current evidence supports their role as effective, well-tolerated platforms, translational gaps remain, particularly for hybrid nanotechnology systems and standardized safety reporting. Non-DDS applications confirm the intrinsic analgesic potential of hydrogel matrices, underscoring their relevance in multimodal pain management strategies. Full article

Autism Spectrum Disorder (ASD) is a complex and multifactorial neurodevelopmental condition whose pathogenesis remains only partially elucidated. Earlier accounts of oxidative stress in ASD often relied on the reductive paradigm of an imbalance between oxidants and antioxidants. In contrast, this narrative review, based on a systematic examination of 1102 publications indexed in scientific databases from 2002 to July 2025, reframes the discussion in terms of redox system dysfunction, a broader and more integrative construct. Here, reactive oxidant species, molecular targets, and reducing/antioxidant counterparts are considered elements of a dynamic circuitry whose maladaptation progressively undermines homeostasis. The sequence of events unfolds in three stages. The first is primary redox dysfunction, manifesting as alterations in metabolic, signaling, and defense pathways. From this disturbance, a second stage arises, marked by functional derailment of cellular compartments—from membranes and cytosol to organelles and nuclei—including mitochondrial and peroxisomal deficits. Ultimately, a third stage emerges, defined by neurodevelopmental alterations such as impaired neurotransmission, synaptic dysfunction, abnormal plasticity, morphogenetic defects, neuroinflammation, and gut–brain–microbiota disarrangements. This progression situates the redox system as a central hub at the interface between human cells and the microbiota, resonating with the ecological and evolutionary principles of the holobiont and the One Health framework. By weaving dispersed evidence into a coherent perspective, this review advances beyond previous analyses, offering a unifying paradigm that connects biochemical dysfunction to clinical heterogeneity in ASD and opens new directions for interdisciplinary research. Full article

This paper presents a high-sensitivity multi-point seawater temperature detection system based on the virtual Vernier effect, achieved through multiplexed Fabry–Perot (FP) cavities combined with optical frequency-modulated continuous wave (FMCW) interferometry. To address the nonlinear frequency scanning issue inherent in FMCW systems, this paper implemented a software compensation method. This approach enables accurate positioning of multiple FP sub-sensors and effective demodulation of the sensing interference spectrum (SIS) for each FP interferometer (FPI). Through digital signal processing (DSP) algorithms and spectral demodulation, each sub-FP sensor generates an artificial reference spectrum (ARS). The virtual Vernier effect is then achieved by means of a computational process that combines the SIS intensity with the corresponding ARS intensity. This eliminates the need for physical reference arrays with carefully detuned spatial frequencies, as is required in traditional Vernier effect implementations. The sensitivity amplification can be dynamically adjusted with the modulation function parameters. Experimental results demonstrate that an optical fiber link of 82.3 m was achieved with a high spatial resolution of 23.9 $\mathsf{\mu }\mathrm{m}$. Within the temperature range of ${30 }^{\circ }\mathrm{C}$ to ${70 }^{\circ }\mathrm{C}$, the temperature sensitivities of the three enhanced EIS reached −275.56 $\mathrm{pm}{/}^{\circ }\mathrm{C}$, −269.78 $\mathrm{pm}{/}^{\circ }\mathrm{C}$, and −280.67 $\mathrm{pm}{/}^{\circ }\mathrm{C}$, respectively, representing amplification factors of 3.32, 4.93, and 6.13 compared to a single SIS. The presented approach not only enables effective multiplexing and spatial localization of multiple fiber sensors but also successfully amplifies weak signal detection. This breakthrough provides crucial technical support for implementing quasi-distributed optical sensitization sensing in marine environments, opening new possibilities for high-precision oceanographic monitoring. Full article

Background/Objectives: Adults with type 1 diabetes (T1D) experience disproportionately high rates of depression, anxiety, and psychological distress, yet integration of behavioral health into diabetes care remains limited. The objective of this study was to identify barriers and facilitators to mental health treatment among adults with T1D, using the Behavior Change Wheel as a framework to inform future integrated care strategies. Methods: We conducted five online focus groups with 21 adults with T1D. Discussions were guided by a semi-structured guide, with questions on lived experience, accessibility of mental health treatment, and integrated service delivery informed by the COM-B model domains. Transcripts were analyzed using qualitative content analysis, whereby meaning units were open-coded and then deductively categorized into COM-B constructs of capability, opportunity, and motivation. Results: Participants described limited psychological capability to address mental health due to the heavy self-management burden of T1D, lack of knowledge about navigating care, and uncertainty about treatment interactions. Physical opportunities were constrained by fragmented systems, high costs, and competing responsibilities. However, co-located services and telehealth were viewed as facilitators. Social opportunity was shaped by stigma, isolation, and feeling burdensome, with peer communities providing critical support. Motivation was undermined by past traumatic encounters with psychiatric care and the burden of educating providers about diabetes, contributing to mistrust and avoidance of treatment. Conclusions: Findings highlight how capability, opportunity, and motivation interact to influence engagement with mental health care among adults with T1D. Addressing these barriers through tailored, integrated models of care may strengthen access, trust, and long-term treatment engagement. Full article

In open-network environments of smart buildings and urban infrastructure, abnormal traffic from security and energy monitoring systems is critical for operational safety and decision reliability. We can develop malware that exploits building automation protocols to simulate attacks involving the falsification or modification of chiller controller commands, thereby endangering the entire network infrastructure. Intrusion detection systems rely on abundant labeled abnormal traffic data to detect attack patterns, improving network system reliability. However, transmitting such data faces two major challenges: single-feature representations fail to capture comprehensive traffic features, limiting the information representation for artificial intelligence (AI)-based detection models, and unconcealed abnormal traffic is easily intercepted by firewalls or intrusion detection systems, hindering cross-departmental sharing. Existing methods struggle to balance feature integrity and transmission stealth, often sacrificing one for the other or relying on easily detectable spatial-domain steganography. To address these gaps, we propose a multi-channel imaging hiding method that reconstructs abnormal traffic into multi-channel images by combining three mappings to generate grayscale images that depict traffic state transitions, dynamic trends, and internal similarity, respectively. These images are combined to enhance feature representation and embedded into frequency-domain adversarial examples, enabling evasion of security devices while preserving traffic integrity. Experimental results demonstrate that our method captures richer information than single-representation approaches, achieving a PSNR of 44.5 dB (a 6.0 dB improvement over existing methods) and an SSIM of 0.97. The high-fidelity reconstructions enabled by these gains facilitate the secure and efficient sharing of abnormal traffic data, thereby enhancing AI-driven security in smart buildings. Full article

Background: Pelvic injuries of the sacroiliac joint are unstable and require surgical intervention following high-energy trauma. In this study, we aimed to present the long-term clinical outcomes of patients with sacroiliac joint separation and sacroiliac fracture dislocation (crescent) injury. We compared the surgical interventions performed on the sacroiliac joint based on patient clinical data. Methods: By reviewing the records of 850 pelvic fractures treated in our clinic between 2000 and 2020, we identified 110 patients with sacroiliac joint injuries who were included in the study. The fractures were classified based on patient files and radiographs. The patients were categorized according to the surgical interventions performed on the sacroiliac joint into two groups: closed reduction with percutaneous iliosacral screws and open reduction with plates and screws. We further divided the patients who underwent open reduction and plate–screw fixation into anterior and posterior surgical approaches. Clinical outcomes were obtained by evaluating patients using a subjective pelvic scoring system. Additionally, complications observed after surgeries were investigated. Results: A total of 121 fractures from 110 patients were included in the study. Eleven of the patients had bilateral sacroiliac joint injuries, for which bilateral surgery was performed. The mean age of the patients at the time of injury was 35.15 years (range from 6 to 80 years). The mean follow-up period was 103.45 months (range from 16 to 253 months). According to the scoring system, the highest success rate was observed in plate–screw operations performed through the anterior approach to the sacroiliac joint, with excellent to good results in approximately 92% of patients. Both open reduction and internal fixation through the posterior approach and closed reduction and percutaneous iliosacral screw surgery yielded successful functional results, with no statistically significant difference between the methods (p = 0.880). Regarding complications, the most important problems were infections associated with plate–screw procedures using the posterior approach and neurologic injuries resulting from closed reduction screw surgery. Conclusions: Effective management of sacroiliac joint injuries requires surgical expertise and individualized treatment strategies. With appropriate technique and fixation, both open and closed surgical methods can achieve satisfactory anatomical reduction and functional outcomes. Although standardized treatment protocols may be developed, tailoring the approach to each patient is more important for optimal clinical success. Full article

Carbon nanotubes (CNTs) have opened new routes in the field of chemical sensing due to their unparalleled electrical conductivity, high surface area, and versatile functionalization capabilities. This review systematically examined the latest advancements in CNT-based chemical sensors, with a focus on their sensing mechanism, functionalization strategies, and applications. A spotlight was cast on the wide-ranging applications of CNT-based chemical sensors, spanning environmental analysis, drug detection, healthcare, food quality control, gases detection, strain sensing, etc. Finally, through a comprehensive SWOT analysis, the strengths, weaknesses, opportunities, and existing threats, along with emerging trends of CNTs in the sensing field, were elucidated. This review systematically summarized the applications of CNTs across six major fields, highlighting more than 60 CNT-based sensing materials. We aim to provide a forward-looking perspective on how CNTs will continue to shape the future of chemical sensing. Full article

Background: There is no consensus on the “best” sequencing for open reduction and internal fixation (ORIF) in multiple mandibular fractures involving the condyle. Objective: The objective of this study is to compare the outcomes between a “top-to-bottom” and a “bottom-to-top” ORIF sequence for multifocal mandibular fractures at the author’s institution. Patients and Methods: A retrospective cohort study of adult dentate patients with multifocal mandibular fractures treated with ORIF. Inclusion criteria were the presence of at least one condylar neck or basis fracture and one “non-condylar” mandibular fracture. The authors evaluated the reduction quality using radiological and clinical parameters, including the ramus/condylar neck angle, the presence of a gap at the lingual aspect in the dentate area, dental occlusion, the need for a redo operation, and the need for postoperative occlusal fine-tuning. Results: A total of 31 patients had a bottom-to-top sequence, 4 patients had a substandard outcome, 4 had an acceptable outcome, and 23 achieved an ideal outcome. Ten patients underwent a top-to-bottom sequence; one patient had an acceptable outcome, and nine patients achieved ideal outcomes. There was no significant difference between sequencing and outcome. (p = 0.231). However, the odds ratio for a suboptimal outcome regarding the bottom-to-top surgery as opposed to the top-to-bottom surgery was 4.80 (CI: 0.53–236.07). In other words, the odds of having a suboptimal outcome and a bottom-to-top sequence were 4.80 times higher than having a suboptimal outcome and a top-to-bottom sequence. Conclusions: Based on our results, the top-to-bottom ORIF sequence appeared to be a favorable factor. Full article

Background: Pregnancy is a time when women are uniquely engaged with the healthcare system and are often motivated to participate in activities directed toward improvement of their own health and ensuring the health of their unborn child, which also provides an opportunity for healthcare interventions such as treatment for hepatitis C virus (HCV) infection. Methods: This was a multi-site, prospective, open-label, pharmacokinetic (PK) study conducted at two large maternity hospitals in Melbourne, Australia, to evaluate the safety and pharmacokinetics of antenatal sofosbuvir (SOF) and velpatasvir (VEL) treatment administered for 12 weeks during the second and third trimester. Five women were recruited and underwent detailed PK assessments across three visits. Results: Compared to historical data in non-pregnant women, SOF area under the concentration curve (AUC) and maximum concentrations (Cmax) were 60% and 49% higher in pregnancy, respectively. In contrast, exposure to the inactive metabolite of SOF, GS-331007, was 43% lower in pregnancy. Both Cmax and AUC for VEL in pregnancy were similar to values reported in historic non-pregnant women (~21% lower in pregnant women). SOF/VEL was safe and well tolerated. Conclusions: These results add to the limited published experience prescribing antivirals in pregnancy and provide further support for a larger ongoing prospective study and other efforts to support HCV treatment in pregnancy. Full article

The work is focused on the study of the influence of different types of inorganic fillers, in combination with modifiers, on the rheological, thermal, and mechanical properties of a biodegradable mixture based on PLA/PHB. Ten types of inorganic fillers based on talc, magnesium hydroxide, aluminum hydroxide, calcium carbonate, and silicon dioxide were used in the study, along with three types of modifiers. It was concluded that fillers containing reactive OH groups on their surface act as strong pro-degradants in PLA/PHB blends, and their degrading effect can be suppressed by the addition of reactive modifiers. Each modifier acts specifically with different types of fillers. Therefore, it is necessary to select a suitable filler/modifier combination not only for fillers with different chemical compositions but also for fillers with different morphologies within the same chemical type. Moreover, the preparation of PLA/PHB/magnesium hydroxide blends with suitable processing and application properties opens the possibility of developing environmentally friendly polymeric materials with a reduced flammability. The addition of talc, which has a platelet structure, can increase the barrier properties of the mixture. Full article

With the rapid development of artificial intelligence and machine learning technologies, automatic speech recognition (ASR) and text-to-speech (TTS) have become key components of the digital transformation of society. The Kazakh language, as a representative of the Turkic language family, remains a low-resource language with limited audio corpora, language models, and high-quality speech synthesis systems. This study provides a comprehensive analysis of existing speech recognition and synthesis models, emphasizing their applicability and adaptation to the Kazakh language. Special attention is given to linguistic and technical barriers, including the agglutinative structure, rich vowel system, and phonemic variability. Both open-source and commercial solutions were evaluated, including Whisper, GPT-4 Transcribe, ElevenLabs, OpenAI TTS, Voiser, KazakhTTS2, and TurkicTTS. Speech recognition systems were assessed using BLEU, WER, TER, chrF, and COMET, while speech synthesis was evaluated with MCD, PESQ, STOI, and DNSMOS, thus covering both lexical–semantic and acoustic–perceptual characteristics. The results demonstrate that, for speech-to-text (STT), the strongest performance was achieved by Soyle on domain-specific data (BLEU 74.93, WER 18.61), while Voiser showed balanced accuracy (WER 40.65–37.11, chrF 80.88–84.51) and GPT-4 Transcribe achieved robust semantic preservation (COMET up to 1.02). In contrast, Whisper performed weakest (WER 77.10, BLEU 13.22), requiring further adaptation for Kazakh. For text-to-speech (TTS), KazakhTTS2 delivered the most natural perceptual quality (DNSMOS 8.79–8.96), while OpenAI TTS achieved the best spectral accuracy (MCD 123.44–117.11, PESQ 1.14). TurkicTTS offered reliable intelligibility (STOI 0.15, PESQ 1.16), and ElevenLabs produced natural but less spectrally accurate speech. Full article