Search Results (8,124)

Objectives: This scoping review synthesized the available evidence on bedside ultrasonography used to confirm short-term nasogastric tube (NGT) placement in adults. Methods: The review followed JBI Collaboration methodology. Searches were conducted in CINAHL, Embase, LILACS, PubMed, and Scopus, as well as in gray literature sources (Google Scholar and ProQuest Dissertation & Thesis Global). Primary studies and clinical guidelines addressing bedside ultrasonography for short-term NGT placement in adults (≥18 years) were eligible, with no limits on language or publication year. Data were extracted and narratively summarized with the I-AIM framework (Indication, Acquisition, Interpretation, and Decision-Making). Results: Twenty-nine studies met the inclusion criteria. Most were single-center observational studies performed in intensive care units or emergency departments. Ultrasound was primarily used for confirmation prior to enteral nutrition initiation, while gastric decompression was less frequently reported. Acquisition protocols varied, although supine positioning, convex abdominal probes, and linear cervical probes were most commonly described. The gastric antrum and esophagus were the principal anatomical landmarks, with interpretation based on direct tube visualization and dynamic fogging; color Doppler was occasionally used. Radiography remained the reference standard in most studies, and only a minority initiated feeding based solely on ultrasound findings. Reported facilitators included bedside feasibility, absence of radiation exposure, and timeliness. Barriers included operator dependency, limited visualization in patients with obesity or gas interposition, protocol heterogeneity, and the limited methodological robustness of available studies. Conclusions: Current evidence suggests that ultrasonography may represent a feasible, radiation-free bedside approach for confirmation of NGT placement. Evidence from selected studies suggests that, with structured training, healthcare professionals may achieve diagnostic accuracy in specific clinical settings, although further robust multicenter investigations are needed to confirm these findings. Full article

Authentic, situated learning experiences which mirror the collaborative nature of healthcare practice are essential in preparing students for their future professions. Feedback literacy may be thought of as the understanding, capacity, and disposition needed to make sense of information and use it to enhance work or learning strategies. This study explored how feedback literacy can be developed through situated, interprofessional peer-to-peer feedback within a community-based paediatric health screening programme. Using an exploratory Action Research qualitative design, the planning activities stage explored current practice, gathering student insights via interviews, reflections, and a workshop to co-design an Interprofessional Feedback Conversation Guide (IPFCG). The IPFCG was piloted, integrating structured feedback tools and protected time for peer exchange, within the community screening activity. Feedback regarding use of the IPFCG contributed to the gathering data stage, which was followed by the evaluation and reflection stage. Evaluation revealed four key themes: value, engagement, optimising relationships, and structuring conversations. Students valued receiving feedback from peers outside their discipline, actively engaged with the process, emphasised the importance of building rapport, and utilised structured dialogue. These findings highlight how authentic, field-based learning can foster feedback literacy, enhancing the development of professional identity. The interprofessional nature of the program reflects the complexity of modern healthcare and demonstrates how curriculum-integrated models of authentic learning can enhance student engagement and workplace readiness. This study contributes to the evolving conversation about embedding authenticity in higher education and offers a practical model for building collaborative communication within situated learning experiences at scale. Full article

The integration of human judgment into artificial intelligence (AI) systems has emerged as a key research direction, particularly for high-stakes applications where full automation remains insufficient. Human-in-the-Loop (HITL) AI represents a field that combines machine learning capabilities with human oversight, feedback, and decision-making at various stages of the AI pipeline. This survey provides a systematic review of HITL approaches, covering theoretical foundations, technical methods, ethical considerations, and domain-specific applications. We propose a unified taxonomy that categorizes HITL systems based on loop placement, interaction granularity, and temporal characteristics. This review synthesizes findings from healthcare, autonomous systems, cybersecurity, and other high-risk domains where human oversight is essential. We also examine the challenges of scalability, cognitive load, and trust calibration that affect the practical deployment of HITL systems. The final section outlines open research directions and introduces a framework for designing effective human–AI collaborative systems. Full article

Active vibration control is crucial for mitigating harmful resonant vibrations in structures subjected to harmonic loads. While antiresonant (zero-placement) methods are effective for this purpose, existing state-feedback solutions require full state measurement, and output-feedback approaches often prioritize resonance assignment over direct harmonic cancellation. This work bridges this gap by proposing a novel systematic design for a proportional–derivative (PD) output-feedback controller to achieve antiresonance for second-order linear systems with a time delay in the actuators. The method first computes a homogeneous gain solution. It then leverages the parametrization of all antiresonant solutions as a constraint within a genetic algorithm optimization. The algorithm optimizes both the stability margin, characterized by an $M_s$-disk criterion, and the number of encirclements of the critical point $(-1,0)$ in the complex plane, as assessed by the Generalized Nyquist Stability Criterion. The proposed approach provides a practical, optimized output-feedback strategy for precise rejection of harmonic disturbances, as demonstrated through a collection of numerical examples from real-world applications. The results confirm the method’s effectiveness in synthesizing stabilizing controllers that enforce antiresonance while ensuring robust stability margins. Full article

Urban flood peak mitigation by green infrastructure (GI) is fundamentally a timing problem. Because GI storage is finite, interception occurs only within a brief active window; whether it reduces the outlet peak depends on GI placement in the network, routing lags, and rainfall timing. Here, we develop a timescale-based framework that links outlet peak reduction to the alignment among within-storm temporal structure, network response, and GI filling dynamics, providing a compact way to interpret when different network positions become most effective under a fixed GI design. Starting from a general convolution representation of runoff generation, interception, and routing, we show that peak reduction efficiency and location ranking can be organized by two nondimensional ratios—comparing storm duration and network response time to a characteristic GI filling time—plus simple descriptors of within-storm temporal structure. Under uniform rainfall, these ratios yield an interpretable regime diagram with analytical transition curves between downstream-, mid-network-, and upstream-optimal placement for a generic dispersive routing representation. Relaxing the uniform-rainfall assumption shows that within-storm variability can substantially reorganize these regimes because storm timing controls both how long GI storage remains available before it fills and which routed contributions overlap to form the outlet peak. Highly concentrated storms and storms with early internal peaks are especially likely to reorder the ranking of candidate locations relative to the uniform-rainfall baseline. Using 2351 observed hourly storm events evaluated across virtual catchments spanning fast to slow network responses, we quantify how often realistic event structure alters the optimal location and the regret associated with adopting a uniform design storm. The results motivate robustness-oriented placement strategies based on ensembles of plausible storm temporal structures, organized within the proposed timescale diagram rather than reliance on a single design hyetograph. Full article

Background: Solid waste collection is a relevant issue for municipalities and can be improved by installing volumetric sensors inside dumpsters. Sensors generate a maintenance cost but provide additional information to decide which dumpsters to empty in a given day when visiting all of them is expensive. Moreover, dumpsters close to each other are expected to follow similar filling trends, as they serve the same catchment area; hence, equipping them all with sensors may be inconvenient. This leads to the problem of finding sensor locations that minimize routing, waste overflow, and sensor maintenance costs. Methods: We tackle the problem using a heuristic based on adaptive large neighborhood search and a one-step look-ahead policy, performed through a rolling horizon method to approximate the multi-stage stochastic programming problem, in order to compute the number and locations of sensors to be installed, minimizing the total cost. Results: We apply the proposed approach to a realistic setting with 50 dumpsters in Torino. The results show that placing sensors in 21 dumpsters at optimized locations allowed saving about 17,000 € per year and reduced vehicle emissions by 15.5%. Conclusions: The proposed approach enables more cost-effective and sustainable waste collection operations. Full article

The design and manufacturing of carbon-fiber-reinforced polymer (CFRP) structures in aerospace require balancing high structural performance with cost-efficient, reproducible production. Conventional design and planning methods are often fragmented across disciplines, causing data discontinuities and limited traceability. This paper introduces a graph-based design language (GBDL) information architecture that integrates CFRP design and manufacturing within a unified, model-based framework. The approach formalizes engineering knowledge through process ontologies and graph-based data models linking geometry, material, tooling, and process parameters in a consistent, machine-interpretable form. Each step, from geometry derivation and structural design to prepreg hand lay-up and automated fiber placement, is represented within a shared design graph to ensure data consistency, transparency, and automated assessment of lead time, labor, cost, waste, and energy consumption. Although current implementations address selected use cases with partially automated interfaces, the architecture establishes a scalable foundation for full interoperability. A helicopter-frame case study demonstrates the applicability and adaptability of the method. Full article

This paper presents a hybrid 1D–3D computational framework for the dynamic analysis of lattice metamaterials for impact protection. Periodic and stochastic lattices are generated automatically; slender members are modeled with beams, and selected regions are locally enriched with 3D solids, with an interface strategy ensuring kinematic compatibility. A PA12 octagonal lattice (30 × 30 × 25 mm) is compressed in Abaqus/Explicit at a high strain rate. Two hybrid configurations, differing by the placement of a 3D unit cell, are compared to a beam-only reference. Global responses (modulus, densification strain, absorbed energy) are consistent across models, while the hybrid scheme recovers local stress concentrations and failure. Full article

Background/Objectives: Atraumatic electrode array insertion should be targeted in cochlear implantation. Robotic insertion is used in many centers worldwide. Our objective was to evaluate manual electrode placement and robot-assisted placement using RobOtol^® on human temporal bones (TBs), in terms of endocochlear trauma and completion of insertion. Methods: Sixteen TBs originating from eight bodies were implanted with Medel-FLEX24 electrodes through the round window. The right TB was implanted manually, while the left TB of the same body was implanted using RobOtol^® for electrode insertion. Results were analyzed through micro-computed tomography imaging. No statistical analysis was used, given the small sample size; a descriptive interpretation of micro-CT scans was rather preferred. Results: In the “manual group”, there were two cases (25%) of insertion trauma: elevation of basilar membrane at basal turn (Eshraghi-stage-1). In the “robotic group”, there were two cases (25%) of insertion trauma: one case of elevation of basilar membrane at the middle turn (Eshraghi-stage-1) and one case of dislocation of all electrodes in scala vestibuli (Eshraghi-stage-3). There were six cases (75%) of incomplete insertion in the “manual group” and four cases (50%) of incomplete insertion in the “robotic group”. Conclusions: Both techniques of electrode placement yielded fairly similar results, in terms of endocochlear trauma and completion of insertion. New larger-scale cadaveric and clinical studies are needed to determine the possible benefit of robot-assisted electrode insertion in cochlear implantation. Full article

Background/Objectives: This study aimed to characterize eyelid speculum-induced intraocular pressure (IOP) elevation during cataract surgery and identify ocular biometric factors that stratify susceptibility to this pressure response. This study was conducted at Zengyo Suzuki Eye Clinic, Kanagawa, Japan. Methods: In this retrospective observational study, we analyzed 100 eyes that underwent routine cataract surgery. IOP was measured immediately before and within 10 s of speculum opening in the seated position using a rebound tonometer. The eyelid speculum was opened to a maximal opening position, and the opening width was recorded. Biometric parameters included axial length (AL), central corneal thickness, white-to-white distance, anterior chamber depth, and temporal angle-opening distance. Associations between IOP elevation and biometric factors were analyzed. IOP elevation rate was quantified as the percentage increase from baseline. The discriminatory performance of axial length was evaluated using receiver operating characteristic (ROC) analysis. Results: Overall, 100 patients (100 eyes) were included in the analysis. Mean IOP increased significantly from 15.75 ± 2.77 mmHg before speculum placement to 21.42 ± 5.54 mmHg after placement. The mean IOP elevation rate was 36.0 ± 27.4%. Shorter AL was consistently associated with a greater proportional IOP elevation. ROC analysis demonstrated consistent stratification of IOP elevation susceptibility by AL (area under the curve [AUC] = 0.645), with eyes shorter than 23.84 mm showing greater pressure elevation (sensitivity, 73.1%; specificity, 56.0%). Eyes in the upper quartile of the IOP elevation rate exhibited relatively greater pressure elevation. Conclusions: Eyelid speculum placement imposes a clinically meaningful IOP load during cataract surgery, with shorter ALs making eyes more biomechanically susceptible to IOP elevation. Full article

A methodology was developed to evaluate the behavior of reinforced concrete slabs used in temporary traffic bridge systems installed over uncured cement concrete pavement sections using highly scaled-down experimental reinforced concrete slabs. A full-scale reinforced concrete slab was first designed and its behavior, such as strain and deflection, was numerically analyzed. A small-scale reinforced concrete slab was then designed considering a dimensional reduction ratio of 1/6. When using this reduction ratio, there is no actual reduced size steel bar, so the smallest size steel bar available must be used for placement. Therefore, numerical analyses were performed to design the steel bar arrangement of the small-scale slab so that the same behavior as that of the full-scale slab occurred. To conduct experiments, small-scale experimental slabs were fabricated according to the design. Since the size of coarse aggregates must be reduced in concrete used for small-scale slabs, specimens using the concrete mix design for full-scale slabs were also produced and the compressive strengths were compared to confirm that the strengths were the same. Next, a study was conducted on the selection of strain gauges that can be used in small-scale slab experiments, and a method for installing displacement gauges to accurately measure slab deflection was also designed. Based on this series of basic studies, load tests were performed to measure the strains and deflections of small-scale slabs. Comparing the measured behavior of the small-scale slab with the numerical analysis results, it was confirmed that the same behavior was observed. Therefore, the experimental results and numerical analysis results of the small-scale slab were consistent, and the numerical analysis results of the small-scale slab and the full-scale slab were identical, proving that the experimental results of the full-scale slab can be inferred through experiments using the small-scale slab. This study confirmed that if small-scale slabs are designed and manufactured to appropriately reflect the characteristics of full-scale slabs, even though the process is challenging, the behavior of full-scale slabs can be approximately determined through experiments using small-scale slabs. Full article

Pinching-antenna systems (PASSs) offer a low-complexity and reconfigurable solution for near-field downlink communications by deploying multiple radiating elements along a single waveguide. Existing studies mainly assume simplified propagation conditions or focus on spectral efficiency, while the impact of environment-dependent interference patterns arising from user-specific blockage conditions on energy-efficient design remains unclear. An energy-efficient downlink design for single-waveguide PASS based on environment-division multiple access (EDMA) is investigated. Under a given propagation environment, EDMA exploits user-dependent blockage and visibility differences through proper pinching-antenna placement, thereby inducing different multi-user interference patterns without increasing radio-frequency hardware complexity. We examine how such blockage-dependent interference influences the relationship between spectral efficiency and energy efficiency, and develop an energy-aware EDMA framework that jointly considers pinching-antenna locations and transmit power allocation under quality-of-service constraints. The resulting coupled design problem is solved through an alternating optimization procedure. EDMA is compared with conventional time-division multiple access (TDMA) using a unified hardware and power-consumption model. Numerical results reveal clear energy-efficiency threshold behaviors with respect to blockage intensity, user population, and service requirements. The results further show that EDMA can significantly outperform TDMA in specific operating regimes. Full article

Background: Velvet worms (Onychophora) occupy a pivotal phylogenetic position for deciphering the evolution of Panarthropoda, yet their exact placement within this clade remains debated. Furthermore, early studies in some onychophoran species revealed extensive gene rearrangements and the truncation or even loss of canonical transfer RNAs (tRNAs), features uncommon in other panarthropods. However, due to sparse representation, the pervasiveness and evolutionary significance of these genomic peculiarities across the phylum remain poorly understood. Methods: We sequenced and assembled three novel mitogenomes representing both extant onychophoran families (Epiperipatus barbadensis [Peripatidae]; Euperipatoides rowelli and Phallocephale tallagandensis [Peripatopsidae]) and conducted comparative analyses with five published species. Results: Onychophoran mitogenomes displayed high A+T content (mean 77.32%) but revealed a family-level divergence in GC skew. All genomes contained the standard 13 protein-coding genes (PCGs) and two ribosomal RNAs, yet tRNA counts varied significantly (ranging from 13 to 22), reflecting lineage-specific tRNA loss. Ancestral state reconstruction uncovered deep architectural divergence: Peripatopsidae retains the ancestral onychophoran gene arrangement, whereas Peripatidae exhibits a stable but derived gene order. Despite this architectural plasticity, synonymous codon usage patterns remained strictly conserved across the phylum, with all but one PCG evolving under strong purifying selection. Maximum likelihood phylogenetic reconstruction based on PCGs strongly supported Onychophora as the sister group to Arthropoda within Panarthropoda. Conclusions: Our findings provide robust molecular evidence supporting the Antennopoda hypothesis over the Tactopoda hypothesis for Panarthropoda phylogeny. Furthermore, we demonstrate extensive mitogenomic remodeling between the two extant onychophoran families, including divergent GC-skew patterns, tRNA contents, and gene arrangements. Full article

Urban air pollution is increasingly recognised as a determinant of mental wellbeing, yet most existing studies rely on static exposure estimates and lack spatial granularity. This limits understanding of how pollutant-specific patterns influence psychological states in real-world settings. To address this gap, we integrate real-time environmental and physiological data from 40 participants using the DigitalExposome dataset, applying multivariate and spatial analysis techniques. Our findings confirm that Particulate Matter (PM_2.5) exerts the strongest negative association with mental wellbeing while extending prior work by establishing a preliminary ranking of other pollutants Particulate Matter (PM₁₀), Particulate Matter (PM₁), Carbon Monoxide (CO), Nitrogen Dioxide (NO₂), Ammonia (NH₃). We applied statistical and spatial analysis methods, including heatmaps and Voronoi diagrams, to explore links between pollutants and wellbeing and compare the relative influence of air pollution and noise. This enabled identification of pollutant-specific hotspots and multi-level wellbeing patterns across individual, accumulated, and collective scales. These results demonstrate the value of spatial analysis for environmental health research and support targeted urban interventions, such as green space placement and traffic re-routing, to mitigate mental wellbeing risks. Full article

One of the most critical aspects of design for an analyst or designer is understanding the service loads that a system or component will experience. In a standard finite element (FE) analysis, the service load history is applied to the FE model to generate the corresponding history of stresses and strains, which are necessary for further evaluations. However, for components operating in complex environments, accurately measuring or predicting the service load history can be particularly challenging. Instrumenting a prototype with load transducers is often an expensive and time-consuming process and, most importantly, may physically alter the component, changing its mass, stiffness, and load path, causing discrepancies between the measured and actual loads. In this context, this paper presents a load identification method, enhancing the methodology behind the load identification theory and reducing the uncertainties inherent in the standard approach, primarily due to the placement, number, and orientation of strain gauges. Full article