Search Results (750)

The accuracy of microseismic moment tensor inversion critically depends on the spatial configuration of surface sensor arrays, quantified by the condition number 𝜅(𝑮) of the dynamic response matrix. Existing optimization methods suffer from slow convergence and unreliability due to the fundamental lack of gradient information. In this specific context, the analytical gradient of 𝜅(𝑮) with respect to sensor positions via singular value perturbation theory and the chain rule of direction cosines are derived for the first time in this paper. Based on the analytical gradient, three optimization strategies are established: a BFGS quasi-Newton method with quadratic penalty (BP) for smoothly constrained regions; a sequential quadratic programming method (FMC/SQP) achieving the lowest condition numbers across all shapes with approximately 5000 evaluations; and a center-boundary parameterization method (CB) that exploits the structural regularity of optimal configurations to reduce variables from 2𝑁 to 𝑁 − 1, requiring only approximately 300 evaluations (1/16 of FMC). Systematic experiments on five region shapes and two complex constraint scenarios demonstrate that gradient methods achieve a 15–30% reduction in  across 4 of 5 shapes and a 5–31-fold improvement in robustness, with FMC reducing the average condition number by 25% at 15.4-fold better robustness than the baseline. Synthetic inversion experiments confirm that reducing  from approximately 1.5 × 104 to approximately 50 reduces moment tensor inversion error by approximately 50-fold. The analytical gradient framework is transferable to sensor placement problems across multiple disciplines, and the three-method toolchain offers a graduated accuracy–efficiency trade-off for practical deployment optimization. Full article

Chimeric antigen receptor (CAR) T-cell therapy has transformed the treatment of haematological malignancies, but conventional viral transduction results in semi-random genomic integration, contributing to heterogeneous CAR expression and potential insertional effects. Site-specific genome engineering offers an alternative by directing CAR insertion to defined genomic loci, allowing greater control over transgene expression and cellular function. This narrative review evaluates advances in site-specific CAR T-cell engineering, focusing on integration mechanisms, donor platforms, genomic loci, safety, and translational readiness. Homology-directed repair (HDR) and homology-independent targeted integration (HITI) are critically compared alongside viral and non-viral donor systems. Candidate loci are evaluated according to their functional consequences and level of evidence, with TRAC representing the most extensively characterised target, while PDCD1, CD7, CD247, and other loci offer distinct functional opportunities but remain supported by varying levels of preclinical and translational evidence. The review also examines genomic risks associated with targeted editing, including structural rearrangements and chromosome-scale abnormalities, and considers emerging applications in allogeneic, solid-tumour, and in vivo CAR T-cell engineering. Overall, site-specific integration provides a framework for linking CAR placement to therapeutic function, but no single locus or integration strategy is universally optimal. Clinical evidence remains limited relative to the expanding preclinical landscape, and genomic safety, scalable manufacturing, and clinical validation remain major priorities for translation. Full article

Automated three-dimensional (3D) mapping with a survey-grade terrestrial laser scanner (TLS) is the canonical instance of robotic stop-and-scan light detection and ranging (LiDAR) mapping: the mobile platform must remain stationary for minutes per scan, so the environment must be covered with as few scans as possible. Where to stop hinges on a coverage model predicting what a scan pose will observe. The conventional isotropic-disk model counts every free cell within sensing range as covered—including cells behind walls—and, therefore, skips scans that genuine observation requires. We replace the disk with a ray-cast visibility region computed on the robot’s live two-dimensional (2D) occupancy map, admitting only cells in direct line of sight; define a line-of-sight (LOS) coverage metric over mapped free space and drive a marginal-gain scan/skip rule embedded in frontier exploration. The planner thus performs 2D scan-station placement for subsequent 3D mapping. In a controlled paired ablation in simulation, the visibility rule raises LOS coverage from about 77% to 84–85% for one to two additional scans, and it also outperforms a disk baseline governed by the identical marginal-gain rule, isolating the coverage model itself as the decisive factor. In a fully autonomous on-hardware comparison in an industrial test room, with each rule driving a mobile platform carrying a Leica BLK360 G1, the visibility rule raised LOS coverage from 77.6% to 92.1%; every visibility run’s scans registered offline at survey grade (4–5 mm bundle error, 84–88% overlap), whereas disk runs yielded at best a single-link network and once a single unregistrable scan. The results indicate that, for the room-scale indoor environments studied, occlusion-aware visibility is a sounder basis than Euclidean proximity for stop-and-scan placement. Full article

Background: Continuous epidural analgesia is widely used for postoperative pain management in small infants. Epidural catheters may be inserted via a caudal-threaded approach or by direct lumbar/thoracic placement; however, comparative data on placement success, clinical use, postoperative analgesic outcomes, and complications remain limited. This study compared these two epidural techniques in small-weight infants undergoing surgery. Methods: This retrospective observational cohort study included all infants admitted to the Neonatal Intensive Care Unit at UPMC Children’s Hospital of Pittsburgh with documented epidural catheter placement in the chart between January 2018 and December 2024. Demographic and perioperative data were extracted from the electronic medical record. Outcomes included technical success of catheter placement; patient, surgical, and epidural characteristics; epidural medications; postoperative pain and sedation scores; opioid consumption; and epidural catheter complications. Results: A total of 104 patients had documentation of 105 epidural catheter placements in the chart; five procedures were unsuccessful in four patients, resulting in 100 successful epidural catheter placements (70 caudal-threaded and 30 direct lumbar/thoracic). Patient and surgical characteristics, postoperative pain and sedation scores, and opioid consumption did not differ significantly between groups. Direct lumbar/thoracic epidural catheter placement required longer procedure times. Patients in the direct lumbar/thoracic epidural group were more likely than those in the caudal-threaded group to receive a ropivacaine/clonidine infusion (47% vs. 4%; p < 0.001) and a programmed intermittent bolus of epidural infusion (60% vs. 3%; p < 0.001). The direct lumbar/thoracic group experienced more postoperative catheter-related complications than the caudal-threaded group (20% vs. 4%; p = 0.02), primarily catheter leakage requiring premature catheter removal. Conclusions: Epidural catheter placement was successful in 96.2% of patients. No statistically significant between-group differences were detected in postoperative pain scores, sedation scores, or opioid consumption between caudal-threaded and direct lumbar/thoracic epidural catheters in small-weight infants (median 3 kg) when placed by a Pediatric Acute Pain Service. Direct lumbar/thoracic epidural catheters were associated with a higher incidence of postoperative catheter leakage and premature catheter removal; however, these complications cannot be attributed solely to the location of epidural catheter insertion. These findings may help clinicians select the most appropriate epidural technique for postoperative pain management in this population. Full article

Background: Medication non-adherence is a major driver of poor therapeutic outcomes, and computer vision methods that observe facial movements offer a non-contact route to verifying oral medication intake. Objective: To map and synthesize the existing literature on computer vision techniques applicable to the monitoring of medication intake, focusing on face tracking methods, oral movement detection and deglutition recognition, and to assess their potential in supporting automatic medication adherence verification systems. Eligibility criteria: Peer-reviewed articles, conference papers, patents, theses and preprints published from 2016 onward, written in English or Portuguese, applying facial landmark tracking or face analysis to ingestion-related movements (mouth opening, hand-to-mouth motion, pill placement, mastication or deglutition); studies confined to object/pill detection without facial analysis, or to general food intake without transferability to medication, were excluded. Sources of evidence: A systematic screening of 362 initial records was conducted across six main electronic databases and repositories: Google Scholar, PubMed, ScienceDirect, arXiv, IEEE Xplore, and Espacenet. Charting methods: Data were charted with a standardized, pilot-tested extraction form capturing bibliographic attributes, dataset type, experimental environment, face tracking approach, tools/models, and target movements; extraction was performed by a single reviewer. Following the screening process, a final selection of 34 relevant studies was included for detailed analysis and mapping. Results: Among the 34 included studies, 14 employ facial landmarks, 11 utilize temporal deep learning models, 6 apply facial action models and 3 rely on hybrid multimodal approaches that combine video analysis, object detection and temporal modeling. Tasks such as detecting mouth opening or tracking pill-to-mouth movement show promising results, while accurately detecting deglutition remains a technical challenge due to high sensitivity and individual variability. Limitations: The majority of the literature relies on private or institutional datasets (31 studies) and operates in controlled laboratory environments (22 studies); only 2 studies evaluated their methods via independent external datasets, which limits the generalization of current solutions to real-world telemonitoring scenarios. Conclusions: The literature indicates the existence of solid technical foundations for developing automated medication intake verification systems. To advance the field toward practical deployment, future research must address the need for more diverse datasets, real-world validation and more robust, adaptable modeling frameworks. Full article

Coronary artery bypass grafting via median sternotomy carries considerable morbidity, and minimally invasive robotic approaches have been increasingly performed for surgical revascularization of coronary arteries. We report our institutional experience in robotic-assisted minimally invasive coronary revascularization in a broad patient population with complex multivessel disease. We retrospectively reviewed robotic-assisted minimally invasive direct coronary artery bypass (RA-MIDCAB) procedures performed at our center between January 2022 and June 2026. Patient demographics, additional procedures and in-hospital outcomes were recorded. A total of 242 patients were included (mean age 63.4 ± 9.7 years; 31 (12.8%) female). Single-vessel bypass was performed in 25 (10.3%) patients; 212 (87.6%) patients underwent an operation on the arrested heart (mean cross-clamp time 66.9 ± 21.7 min) and 15 (6.2%) received an off-pump operation (mean CPB time in on-pump patients 155.7 ± 46.0 min). Full arterial revascularization was achieved in 42 (17.4%) patients; a bilateral internal mammary artery configuration was used in 9 (3.7%) patients. Coronary endarterectomy was performed in 16 (6.6%) patients and concomitant left atrial appendage (LAA) occlusion was performed in three (1.2%) patients. Epiaortic ultrasonography-guided clamp placement was performed in 27 (11.2%) patients with ascending-aortic plaque. In-hospital mortality occurred in two (0.8%) patients; no patient sustained a major neurological deficit, and the transfusion rate was 9.9%. Mean ventilation time was 4.0 (3.0–6.0) hours and mean intensive care unit stay was 22.6 ± 11.2 h. With careful planning and accumulated experience, the indications for robotic-assisted minimally invasive revascularization can be extended to include patients who require full-arterial revascularization, have ascending aortic plaques, complex coronary disease requiring endarterectomy, or atrial fibrillation where concomitant left atrial appendage occlusion is indicated. Full article

This paper proposes and analyzes a symmetry-based shared-pool architecture for service continuity in UAV-assisted wireless sensor networks with aerial base station placement. Unlike the conventional dedicated architecture, in which individual sensor clusters are structurally associated with specific serving UAVs and replacement units provide cluster-centered redundancy, the proposed architecture treats all available UAVs as a common pool of functionally interchangeable service units that can be dynamically assigned to active clusters. The novelty of the approach lies in formalizing this functional interchangeability as permutation symmetry of the underlying stochastic model. Under homogeneous UAV reliability parameters and homogeneous cluster-demand characteristics, relabeling UAVs or non-tagged clusters does not change the system dynamics. This invariance permits the identity-dependent microscopic state space to be reduced to occupation-number macrostates defined by the number of unavailable UAVs and simultaneously active service demands, while symmetric access in overloaded states determines the tagged-cluster service probability. On this basis, an analytical availability model is developed that combines UAV failure–recovery dynamics, limited recovery capacity, stochastic cluster activity, and demand-driven allocation from a shared aerial resource. The proposed architecture is compared with a dedicated-service baseline under both equal-fleet and target-availability criteria. The results show that shared pooling can convert permutation-based functional symmetry into a practical fleet-efficiency gain: under low or moderate demand overlap and adequate recovery capacity, the same service-continuity target can be achieved with fewer UAVs than in the dedicated architecture, whereas the advantage decreases under strong demand overlap or severe pool depletion. The study therefore establishes a direct link between permutation symmetry, stochastic state-space reduction, shared redundancy, and UAV fleet efficiency in service-oriented aerial sensor networks. Full article

Primary implant stability arises from mechanical engagement at placement, and insertion torque is not a direct measure of osseointegration. This retrospective single-centre study included 101 MultiNeO titanium implant placements in 55 adults treated between April 2023 and January 2026. Four experienced operators placed implants subcrestally using a W&H Implantmed SI-1023, a bone-resistance-adapted drilling protocol, and a programmed target of 35 N·cm. Associations with recorded torque were assessed using a patient-clustered Gaussian generalized estimating equation adjusted for sex, age, anatomical sector, implant length and diameter, hard-tissue augmentation, and placement timing. The mean torque was 31.63 ± 5.57 N·cm; the median was 35 N·cm (Q1–Q3, 30–35). Recorded torque was 3.25 N·cm higher for implants placed in women than for those placed in men (95% CI 1.20–5.31; p = 0.002). Relative to maxillary anterior/premolar sites, mandibular molar sites showed higher torque (β = 4.02; p = 0.001), whereas mandibular anterior/premolar sites showed lower torque (β = −5.41; p = 0.013). Implant length had a modest adjusted association (β = 0.93 N·cm/mm; p = 0.022); age, diameter, augmentation, and placement timing did not. The concentration of recorded values at 35 N·cm reflects a clinical target rather than the device limit. These exploratory associations do not establish an intrinsic sex effect or predict osseointegration, and residual confounding due to unmeasured bone characteristics remains possible. Full article

This paper deals with enhanced control of blasting via processing of vibration signals. In the blasting process, a mixture of abrasive and air under pressure is fed to the workpiece. However, the pressure set by the operator in the compressor is not always the same as the pressure in the end nozzle; it can decrease due to the passage of the mixture through a longer supply hose. Our research was focused on classifying vibration signals measured in the outlet nozzle according to the mixture pressure. The developed algorithm is based on a smooth spectrum of vibrations obtained by the linear prediction method. To achieve optimal results, vibration signals from several sensing options were measured and compared in tests involving three types of accelerometers and three different positions of accelerometer placement on the nozzle, with regard to vibrations in the axial and radial directions. The best classification accuracy of 90.8% was achieved for a pressure resolution of 2 bars when measuring axial vibrations on the nozzle holder. Monitoring the outlet pressure of the mixture can improve existing blasting systems by improving the ability to automatically maintain optimal operating pressure during blasting. Full article

Wireless sensing networks increasingly extend into obstacle-prone deployments, where physical blockage degrades reliability and open propagation exposes transmission activity. Intelligent reflecting surfaces (IRSs) establish programmable paths around obstacles while passive elements remain constrained by severe cascaded attenuation. To address the tradeoff between reliability and covertness, we propose an unmanned aerial vehicle (UAV) -assisted active-IRS architecture under probabilistic line-of-sight and non-line-of-sight propagation conditions that accounts for direct leakage from the transmitter to the warden together with residual jammer cancellation and always-on IRS circuit noise under a finite output power budget. Furthermore, bidirectional Kullback–Leibler analysis identifies the reverse divergence as the tighter restriction and converts the covertness requirement into conservative gain bounds under warden location uncertainty and relative phase uncertainty conditions between the direct and aggregate reflected fields. Subsequently, closed-form phase control for calibrated equal-gain elements and gain monotonicity reduce the joint design to an exhaustive search over the prescribed placement grid. The numerical results demonstrate a SINR advantage over passive reflection and single-element relaying across the evaluated settings. The finite-array and hardware analyses show that gain back-off enforces a prescribed covert-outage limit while direct leakage and residual self-interference remain explicitly controlled. Overall, the framework provides a transparent basis for reliable covert sensing through UAV-assisted active reflection. Full article

Background/Objectives: The aim of this study was to evaluate the effect of intraoperative gaseous ozone applied to the implant osteotomy immediately before implant placement on early implant stability using a split-mouth design and resonance frequency analysis (RFA). Methods: This prospective, randomized controlled split-mouth study included 40 patients receiving 106 implants in bilaterally symmetrical edentulous sites. Patients and outcome assessors were blinded. In the ozone group, ozone gas was applied to the implant site for 60 s immediately before implant placement; the control group underwent the same surgical protocol without ozone application. The primary outcome was the change in implant stability quotient from baseline to three months (ΔISQ). Secondary outcomes included baseline and three-month ISQ values, insertion torque, and postoperative pain assessed using a visual analog scale. Results: All 106 implants were analyzed. No significant between-group differences were observed in baseline ISQ (β = −0.49; 95% CI: −2.73 to 1.75; p = 0.668) or insertion torque (β = −0.62 Ncm; 95% CI: −1.96 to 0.72; p = 0.362). At three months, ISQ was higher in the ozone group (β = 1.91; 95% CI: 0.75 to 3.06; p = 0.001). ΔISQ was also significantly greater in the ozone group (β = 2.40; 95% CI: 0.34 to 4.45; p = 0.022; Cohen’s d = 0.42). Implant stability increased significantly in both groups (both p < 0.001). Postoperative pain did not differ between groups (β = −0.23; 95% CI: −0.83 to 0.36; p = 0.446). Although the effect direction was consistent across sensitivity analyses, ΔISQ was not statistically significant in the patient-level paired analysis (p = 0.089). No adverse events were reported. Conclusions: Intraoperative ozone application was associated with a modest increase in early implant stability without a significant difference in postoperative pain. However, given the small effect size and sensitivity of the findings to the analytical method, further large-scale, multicenter randomized controlled trials are required. Clinically, intraoperative ozone may be considered a potential adjunct to standard implant placement protocols, but the current evidence is insufficient to support its routine use. Full article

As survival for cancer patients improves, the incidence of brain metastases has risen. This is likely due to improved systemic disease control, increased diligence in surveillance imaging in high-risk pathologies, improved neuro-imaging techniques and increased systemic screening for clinical trial enrollment. While there are well-established treatments for brain metastases, many patients will experience recurrence after definitive treatment. The management of these recurrent lesions is not well established and often varies on a per-patient basis, owing to the clinical complexity and variety of these patients. Patients with recurrent brain metastases have surgical procedural options to achieve local tumor control, including laser interstitial thermal therapy (LITT) repeat open surgical resection with or without placement of intracavity brachytherapy. Repeat resection can offer rapid improvement in neurological symptoms, performance status, and potentially survival. LITT is less invasive than a standard craniotomy but offers a chance at directed local treatment while still obtaining tissue for diagnostic purposes and achieving acceptable survival outcomes. Further study is needed to determine the role of LITT for recurrent brain metastases, but it is a useful tool, particularly for patients with deep-seated lesions who may not tolerate a large surgery. Intracavitary brachytherapy allows for the immediate delivery of highly conformal radiation to the surgical bed with excellent local control and low rates of radiation necrosis, even in previously irradiated patients. The decision regarding which of the above to employ for recurrent brain metastases will vary on a case-by-case basis, and further studies are needed to standardize their use for this growing problem. Full article

Industry 5.0 reframes industrial transformation as a human-centric, sustainable and resilient socio-technical transition. Yet comparable country-level evidence on the capabilities that enable this transition remains limited, particularly for late-digitalizing economies. This study benchmarks Türkiye against the 27 European Union member states using a systems-informed multi-criteria decision-making framework. Seven indicators represent three complementary capability domains: enterprise digitalization (artificial intelligence, cloud computing, data analytics and enterprise resource planning), human capability (basic or above-basic digital skills) and innovation capacity (R&D expenditure and high-technology exports). CRITIC–MARCOS is used as the primary model, while the full 2 × 2 combination of CRITIC and Entropy weighting with MARCOS and TOPSIS ranking, equal-domain weighting and indicator-exclusion tests assess sensitivity. Türkiye ranks 28th under CRITIC–MARCOS and remains between 26th and 28th across the principal specifications. Pairwise rank correlations range from 0.932 to 0.981, supporting the stability of Türkiye’s placement in the lower-readiness group despite variation in its exact rank across methods. Türkiye is below the unweighted EU-27 country mean for all indicators, with its largest relative shortfall in high-technology exports. The findings diagnose a structural gap in the digital, human-capability and innovation enablers of Industry 5.0; they do not measure the complete Industry 5.0 construct, particularly its direct human-centric, sustainability and resilience outcomes. Full article

Background: Transcranial direct current stimulation (tDCS) produces heterogeneous outcomes across cognitive, behavioural, and clinical studies. Sex-related differences may contribute to this variability. Objective: This narrative review examined whether and how sex moderates tDCS outcomes across behavioural, physiological, clinical, and modelling studies and considered potential underlying mechanisms. Materials and Methods: A structured literature search identified studies examining sex, or variables reported by the original authors as gender but operationalised through female–male group comparisons, as moderators of tDCS outcomes. After screening, 41 studies met the inclusion criteria, and 6 additional studies were identified through citation searching, yielding 47 studies. Because of substantial heterogeneity in populations, protocols, and outcomes, findings were synthesised narratively. Results: Sex-related effects were common but highly context-dependent, varying by montage, cortical target, stimulation intensity, reference placement, and outcome domain. They often emerged as interaction effects rather than main effects and were most apparent during demanding tasks, later learning phases, or delayed after-effects. Computational models indicated that identical stimulation settings may produce different intracranial electric fields in women and men because of anatomical differences. Hormonal and endocrine states, particularly in females, may further modify or amplify these effects. Sensation, tolerability, and blinding may also contribute under higher-intensity protocols but do not fully explain sex-contingent outcomes. Conclusions: Sex influences tDCS outcomes through interacting anatomical, hormonal, and task-related mechanisms rather than in a uniform manner. Future studies should treat sex as a mechanistically relevant moderator, incorporate dose- and hormone-aware designs, and use adequately powered analyses to improve reproducibility and support individualised neuromodulation. Full article

This work presents a numerical investigation of a direct oil cooling system for Axial Flux Permanent Magnet (AFPM) machines. Building upon the authors’ previous study, which established the fundamental fluid dynamic mechanisms governing oil jet impingement on curved coil surfaces, the present research extends the analysis by performing a systematic parametric optimization of nozzle diameter and axial position. A validated CFD model, benchmarked against experimental data from the literature, is employed to quantify the influence of jet momentum, stagnation pressure, and flow attachment on the resulting thermal performance. Nine configurations are simulated at constant coolant mass flow rate, revealing that the nozzle diameter is the dominant parameter: smaller diameters generate higher jet velocities, stronger stagnation regions, and larger jet-induced forces, leading to significantly enhanced heat transfer coefficients and Nusselt numbers. Nozzle height plays a secondary yet relevant role, as higher positions promote a more coherent jet core and improve impingement quality. Among the nine simulated cases, the configuration with D = 3 mm and L = 14 mm achieves the lowest hotspot temperature and the most efficient energetic behavior within the simulated set, with only a modest increase in pumping power. The results confirm that direct oil impingement is highly sensitive to jet momentum and angle of attack and demonstrate that optimized nozzle design can substantially improve the thermal management of high power density AFPM machines. This extended analysis provides quantitative references for nozzle sizing and placement within the simulated operating conditions with enhanced cooling efficiency. Full article