Search Results (785)

Hemorrhagic shock remains a leading cause of preventable death in trauma, yet traditional vital signs may fail to reflect early blood loss before physiological compensatory mechanisms are no longer able to maintain hemodynamic stability. The Compensatory Reserve Measurement (CRM) algorithm offers early detection capability using physiological waveforms but requires testing with emerging wearable sensor technologies for operational deployment. This study tested the Epicore Epidermal Patch for Imperceptible Care (EPIC) wearable healthcare device (WHD) for CRM-based hemodynamic monitoring during progressive central hypovolemia induced by lower-body negative pressure (LBNP) to simulate hemorrhage. Twenty participants underwent progressive LBNP while photoplethysmography (PPG) signals were recorded from EPIC sensors placed at the clavicle and triceps alongside a clinical-grade finger pulse oximeter for reference. Signal quality, heart-rate accuracy, and CRM predictions were evaluated across multiple filtering approaches. The triceps placement achieved signal quality comparable to the pulse oximeter reference when Chebyshev Type II filtering was applied, as well as high heart-rate accuracy. CRM derived from the EPIC sensor placed at the triceps tracked compensatory trends during progressive hypovolemia, but prediction magnitudes were inaccurate compared to calculated CRM values. In contrast, the clavicle placement consistently performed poorly across all measurements, regardless of the signal-processing approach. These findings support the feasibility of soft, flexible wearable sensors for continuous hemorrhage monitoring at the triceps location in operational environments where traditional finger-based pulse oximetry is impractical. Full article

Background: Robot-assisted surgery has become increasingly used across multiple specialties; however, its integration into aesthetic plastic surgery remains limited. Individualized patient requirements, such as concealed scar placement, superficial soft tissue dissection, and patient-specific docking angles, are major challenges to its adoption, unlike in other specialties. This review aimed to evaluate the current use of robotic systems in plastic surgery, with a particular focus on aesthetic procedures, operative outcomes, and existing technological limitations. Methods: Multiple databases, including PubMed, Scopus, and Google Scholar, were extensively searched to identify studies published between 2011 and 2026. Data on robotic platforms, operative duration, rehabilitation outcomes, and aesthetic indications were extracted and analyzed. Robotic systems such as da Vinci, Symani, MUSA, and ARTAS demonstrated feasibility across reconstructive subspecialties. However, their clinical application remains limited, as purely aesthetic procedures are rare, highlighting a significant lack of standardized docking methods and dedicated instruments. Results: The data show that robotic platforms offer great advantages, such as precision and minimally invasive access; however, their high costs, bulky instrumentation, and limited docking methods represent barriers to their adoption in aesthetic surgery. Conclusions: Robot-assisted aesthetic plastic surgery remains in the early stage of development. Further research is required to establish reproducible docking standards and expand its clinical indications. Advancements in single-port systems, artificial intelligence integration, and surgeon training will facilitate broader clinical implementation. Full article

The evolution toward sixth-generation (6G) networks envisions humans as active nodes within a fully interconnected digital ecosystem, supported by data collected from in-body and on-body sensors. Since many of these devices are not equipped to connect directly to 6G networks, Wireless Body Area Networks (WBANs) serve as an essential intermediate layer. However, conventional radio-frequency technologies face limitations in terms of energy efficiency, security, and data integrity, motivating the adoption of lightweight security mechanisms. Physical Layer Security (PLS), and in particular Physical Key Extraction (PKE), offers a promising solution by enabling legitimate devices to derive shared cryptographic keys from the reciprocal properties of the communication channel. Galvanic coupling (GC) communication has recently emerged as an on-body transmission technology alternative to radio-frequency (RF), which exploits low-power electrical signals propagating through biological tissue. Building on prior feasibility studies, this work proposes a PKE framework tailored to GC channels, integrating a lightweight key reconciliation method, based on Hamming (7,4) error-correction codes, and evaluating system performance through dedicated reliability and security Key Performance Indicators (KPIs). Results reveal a trade-off shaped by electrode placement and channel quantization parameters. Among the ones tested, the optimal configuration is achieved with a 3 cm transverse inter-electrode spacing at both transmitter and receiver, and a 3 cm longitudinal separation between transmitter and receiver, by quantizing the channel impulse response with two quantization bits. While this work focuses on validating the method in controlled conditions in order to establish a reliable study framework, future developments will focus on enhanced reconciliation, privacy amplification, and analysis of the GC channel considering physiological and environmental variations. Full article

Background and Objectives: Severe alveolar atrophy may pose significant challenges for dental rehabilitation. Recent advances in digital planning and CAD/CAM technology have renewed the interest in patient-specific subperiosteal implants as a treatment option for anatomically challenging cases. This cohort study evaluated changes in oral health-related quality of life and patient satisfaction following rehabilitation with customized subperiosteal implants in severe alveolar atrophy. Materials and Methods: This cohort study included all consecutive adult patients with severe alveolar atrophy who underwent reconstruction with patient-specific subperiosteal implants at the Department of Oral and Maxillofacial Surgery of “Evangelismos” General Hospital, Athens, Greece, in 2025. Oral health-related quality of life was assessed using the validated OHIP-14 questionnaire preoperatively and 12 months postoperatively. Patient satisfaction was evaluated using a numerical rating scale (NRS). Secondary outcomes included postoperative complications, implant exposure, implant stability, and need for reoperation. Comparisons between baseline and 12-month scores were performed using the Wilcoxon signed-rank test. Results: Nine patients who had completed 12-month follow-up were included. Five were male, and all implants were placed in the maxilla. Significant improvement was observed in oral health-related quality of life, with the median OHIP-14 total score decreasing from 41 preoperatively to 1 at the 12-month follow-up. Patient satisfaction also improved significantly, with the median NRS total score increasing from 17 to 58. Improvements were consistent across all OHIP-14 domains and all NRS items. No major complications were recorded. One patient developed early wound dehiscence, and one patient presented with implant exposure at the anterior palate. At the final follow-up twelve months postoperatively, all implants remained clinically and radiographically stable. Conclusions: These preliminary short-term findings suggest that customized subperiosteal implants may be a promising option for selected patients with severe alveolar atrophy in whom placement of conventional endosseous implants is not feasible; however, the results should be interpreted cautiously given the very small sample size and observational design. Full article

Water invasion has become a critical challenge during the late-stage development of gas reservoirs, particularly under harsh conditions characterized by high temperature, high salinity, and strong reservoir heterogeneity. Chemical water shutoff technologies have thus gained increasing attention as effective solutions for selectively restricting water production while preserving gas deliverability. This review systematically summarizes recent advances in chemical water shutoff for gas reservoirs, focusing on polymer gels, nanocomposite materials, relative permeability modification agents, and emerging functional fluids. The reviewed materials are analyzed in terms of dominant sealing mechanisms, gas–water selectivity, reservoir adaptability, and performance under extreme formation conditions. By critically comparing their advantages, limitations, and field applicability, key challenges related to deep placement, selective sealing, long-term stability, and engineering controllability are identified. To address these limitations, emerging concepts such as zonal synergistic water control and bioinspired gas–water barriers are discussed, integrating wettability regulation, multiscale sealing, and adaptive material responses. These strategies provide a conceptual framework and research direction for the design of next-generation, efficient, and sustainable chemical water shutoff systems in complex gas reservoirs. Full article

Background/Objectives: Adult spinal deformity (ASD) correction is a complex surgery to restore spinal alignment and relieve patients’ symptoms. Modern techniques and technologies allow for aggressive surgical correction in tissue-friendly ways that preserve anatomy and may enable faster recovery. Robotic-assisted posterior spinal stabilization may be used as an adjunct to complex ASD reconstruction to facilitate a minimally invasive approach, reduce perioperative morbidity and physiological insult, and allow for the performance of procedures traditionally reserved for large academic centers to be effectively performed by qualified surgeons in optimized patients at smaller hospitals with fewer resources. The objective of this study is to assess realignment, perioperative complications, and patient-reported outcomes of complex, minimally invasive, robotic-assisted adult spinal deformity correction in a surgical specialty hospital. Methods: Demographic, surgical, and perioperative data were collected from the medical record. The Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) for pain scores were collected preoperatively and at regular post-op visits. X-rays were captured preoperatively before hospital discharge and at follow-up visits. Results: Fifty consecutive deformity patients were corrected with a two-stage approach (anterior column reconstruction followed by posterior stabilization with robotic-assisted screw placement on the next day) at a 48-bed (eight operating rooms), surgeon-owned, subspecialty hospital. The average patient age was 70 years, and 64% were female. The average estimated blood loss (EBL) values for the first and second stages were 62 mL and 205 mL, respectively. The average operative time was 172 min during the first stage and 210 min for the second stage. Three interbody spacers (first stage) and 16 screws (second stage) were inserted on average in each procedure. The average length of stay (LOS) in the hospital was 5 days, and the average follow-up period was 10.6 months. No patients required a transfer to another facility with intensive care unit (ICU) capabilities, and none required a revision of hardware placement. There was an average reduction in the lumbar coronal scoliotic curve of 14.5° and an increase in lumbar lordosis of 14.8° at the latest follow-up (p < 0.01). The average mismatch between pelvic incidence and lumbar lordosis (PI-LL) preoperatively was 17.6°, which was reduced to 9.6° at the latest postoperative follow-up (p < 0.01). Mean ODI (%) and NRS scores were significantly improved by 33.8% (46.7 ± 13.3 to 30.9 ± 19.8; p < 0.01) and 55% (6.0 ± 2.2 to 2.7 ± 2.6; p < 0.01), respectively, at last follow-up. Conclusions: This study demonstrates the feasibility of performing complex, robotic-assisted ASD corrective surgery in a surgical specialty hospital, achieving significant correction of sagittal and coronal deformities, relieving patients’ symptoms, and offering efficiency and consistency to pedicle screw placement. This study demonstrates that a minimally invasive approach to complex deformity reconstruction reduces perioperative morbidity with decreased operative times, EBL, and LOS when compared to historic controls. This approach allows for the democratization of deformity care in that procedures typically reserved for large academic centers can be successfully accomplished at smaller institutions in optimized patients by qualified surgeons with appropriate perioperative support staff. Full article

Background/Objectives: Portable and wearable ECG technologies are increasingly used in adult cardiac monitoring. However, evidence supporting their feasibility and diagnostic performance in pediatric populations remains limited. This systematic review evaluates the diagnostic accuracy, usability, artifact susceptibility, and user acceptance of mobile ECG technologies in pediatric cardiology. Methods: A systematic literature search was performed in the Embase, PubMed, Scopus, and Web of Science databases. The review was conducted in accordance with the PRISMA 2020 guidelines and was registered in the PROSPERO database. Results: A total of 30 publications were included in the final analysis. Portable ECG devices demonstrated good feasibility diagnostic utility in children. Handheld systems provided high-quality tracings with strong agreement with standard 12-lead ECGs and higher adherence, as well as user satisfaction compared with conventional event recorders. However, automated rhythm classification frequently misidentified pediatric arrhythmias. Smartwatch-based ECG recordings showed high diagnostic accuracy when manually interpreted, but automated algorithms were unreliable, particularly for tachyarrhythmias and conduction abnormalities. Alternative electrode placement strategies improved smartwatch performance, and patient acceptance was consistently high. ECG patch monitoring, particularly with extended-wear devices, achieved the highest diagnostic yield, detecting arrhythmias often missed by short-duration Holter monitoring while maintaining comparable signal quality. Conclusions: Mobile ECG technologies represent a promising adjunct for pediatric rhythm surveillance, offering diagnostic performance comparable to standard modalities when interpreted by clinicians and improved usability and patient acceptance. Persistent limitations include the poor reliability of adult-oriented automated algorithms and the underrepresentation of younger children and the predominantly off-label use of these devices in pediatric populations, underscoring the need for pediatric-specific algorithm development and age-adapted device design. Full article

In the new industrial revolution 5.0 era, manufacturing facilities with manual assembly have higher expectations, higher mass customization, and more human involvement, as well as including new digital technologies in smart workstations. Given these expectations, the cognitive load of manual assembly workers is increasing. Cognitive assessment systems are being added to manufacturing facilities to work in parallel with physical and sensory assistance systems to establish better work conditions for workers and better overall system performance. This paper presents an exploratory study using eye-tracking as an assessment system to identify potential locations of increased cognitive workload and errors to better understand where and how to employ assistance for workers to improve the manual assembly and inspection process. The results of this study indicate that the highest workload occurs with measuring and inspection tasks, and most errors occur during the assembly of parts, where their geometry impacts placement. It also demonstrates the feasibility of eye-tracking as a low-cost, integral part of the human–computer system in the assembly environment. Full article

Background/Objectives: Totally endoscopic mitral valve repair reduces surgical trauma and accelerates recovery but can be technically challenging, particularly for precise annuloplasty suturing. The VirtuoSEW^® (LSI Solutions, Victor, NY 14564m, USA) automated annular suturing system was developed to standardize and simplify suture placement. This study was an early evaluation of this technology’s safety, efficacy, and feasibility in totally endoscopic microInvasive mitral valve repair (µMVr). Methods: We conducted a retrospective observational study of 20 patients with severe mitral valve disease of various etiologies. All patients underwent mitral valve repair using the VirtuoSEW^® system for automated placement of annuloplasty sutures, combined with leaflet resection or chordal management as appropriate. Postoperative outcomes were assessed at one month using echocardiography and clinical evaluation. Perioperative and postoperative complications and early mortality were systematically recorded. Results: VirtuoSEW^®-assisted mitral valve repair was safe and effective, achieving complete elimination of severe mitral regurgitation in all patients (N = 20, 100%). Annuloplasty rings included Physio-ring (N = 12, 60%), Memo 3D (N = 4, 20%), and Memo 4D (N = 4, 20%), combined with leaflet repair techniques: leaflet plication (N = 5, 25%), neochordae implantation (N = 7, 35%), sliding plasty (N = 2, 10%), commissural repair (N = 1, 5%), and hemibutterfly repair (N = 1, 5%). Concomitant procedures included: tricuspid valve repair (N = 1, 5%) and atrial septal defect closure (N = 1, 5%). Mitral annulus diameter decreased from 42.0 ± 5.3 mm to 34.2 ± 2.2 mm (p = 0.001). Mean total surgery, cardiopulmonary bypass, and aortic cross-clamp times were 170.3 ± 21.3, 143.4 ± 21.5, and 80.4 ± 7.9 min, respectively. ICU stay was 1.0 ± 0.2 days, with a hospital stay of 8.0 ± 1.9 days. No perioperative complications—including bleeding (N = 0, 0%), stroke (N = 0, 0%), infections (N = 0, 0%), or 30-day mortality (N = 0, 0%)—occurred. Conclusions: µMVR invasive mitral valve repair using the VirtuoSEW^® system is safe, effective, and reproducible, as well as compatible with almost all repair techniques, providing complete restoration of valve competence with no early device-related complications. To our knowledge, this is the first clinical study reporting outcomes with this device, supporting its potential to streamline mitral repair and improve procedural efficiency. Full article

Sustainable ridge-based peanut production following winter wheat requires soil preparation technologies capable of simultaneously ensuring precise ridge formation, reduced energy consumption and efficient in situ utilisation of crop residues. This study aimed to develop and experimentally validate a combined soil preparation technology integrating shallow tillage, deep loosening and ridge formation within a single field pass, and to quantify its technological and biological performance. Field experiments were conducted using a prototype combined machine with analytically justified geometric parameters of the working tools, followed by multifactor optimisation and statistical modelling. Technological performance was assessed by soil fragmentation degree and draft resistance, while biological effects were evaluated using residue incorporation (Pz), biodegradation coefficient after 60 days (k₆₀) and dehydrogenase activity after 30 days (DHA₃₀). The results showed statistically significant nonlinear relationships between tool parameters and technological responses, with coefficients of determination exceeding 0.94 for soil fragmentation and 0.97 for draft resistance. The proposed technology increased residue incorporation efficiency by 15–20%, enhanced biodegradation intensity (k₆₀) by up to 18%, and reduced energy consumption due to single-pass operation compared with conventional multi-pass systems. A strong relationship between Pz and biological indicators confirmed the key role of residue placement in controlling microbial processes. These findings demonstrate that integrated control of soil processing and residue placement enables energy-efficient single-pass technologies for ridge-based peanut production systems. Full article

The delivery of energy and water meter data, management and control information on separate networks is expensive and defeats the gains of the Advanced Metering Infrastructure (AMI) Smart Grid (SG). In most cases, energy, gas and water services are offered by the same organizational entity, hence the use of different infrastructure for data, service delivery, control and management is expensive and highly illogical. There is a need for a combined energy and water infrastructure to reap the benefits of the AMI SG. Furthermore, combined metering will result in accurate billing, potential cost savings, and improved resource management. This work therefore develops and investigates a combined energy and water AMI smart metering framework. This is possible through a thorough understanding of the AMI technological standards. The implementation of such a system is not trivial, as it depends on many factors: environmental, geographical, technological, economical, regulatory and the existing legacy infrastructure. Optimal technological implementation choices are developed towards an integrated AMI infrastructure. An experimental test bed is developed for delivering energy and water metering data to the utility. The optimal placement results favor the system of separating energy and water actuators at the home area network of the SG while using an integrated communication system. Such a system is feasible, given the different evolution of electricity and water meters and their placement at the home area network, and enables water metering to benefit from the more advanced electrical metering infrastructure. Full article

Background: Hyaluronic acid (HA) hydrogels are the most widely used injectable fillers for facial rejuvenation. A new generation of HA fillers crosslinked with poly(ethylene glycol) diglycidyl ether (PEGDE) has been developed to enhance cohesiveness, tissue integration, stability, and longevity while minimizing swelling and immunogenicity. Owing to their distinct viscoelastic properties, PEGDE-crosslinked HA fillers may require product-specific selection and adapted injection techniques. Objective: The objective of this study is to provide practical, expert-based recommendations for the safe and effective use of PEGDE-crosslinked HA hydrogels in facial aesthetic treatments. Methods: A multidisciplinary panel of nine Italian experts in aesthetic medicine, each with more than 15 years of experience using HA fillers, developed consensus recommendations based on clinical practice and available evidence. A pre-meeting questionnaire informed structured discussions during a face-to-face meeting held in Paris in January 2024. The nominal group technique was applied, with consensus defined as agreement by at least 80% of panel members. Results: Consensus was reached on product selection, injection planes, delivery devices, techniques, and typical treatment volumes for PEGDE-HA hydrogels across multiple facial regions, including the forehead, temples, midface, nasolabial folds, chin, jawline, and lips. Recommended injection techniques included microbolus, macrobolus, and retrograde linear threading, with placement ranging from superficial subcutaneous to supraperiosteal planes depending on the anatomical area and clinical indication. Typical injection volumes generally ranged from 0.1 to 0.5 mL per side. Optional ultrasound mapping was considered beneficial in selected high-risk or superficial procedures to improve anatomical safety. Conclusions: These expert consensus recommendations provide practical guidance for clinicians using PEGDE-crosslinked HA hydrogels in facial rejuvenation. Tailoring product characteristics to injection depth, technique, and regional anatomy may help optimize clinical outcomes and procedural safety. Future research priorities include prospective comparative studies with other crosslinking technologies, standardized reporting of adverse events, long-term outcome registries, and further evaluation of ultrasound-guided injection strategies. Full article

Plant layout significantly influences manufacturing performance by optimizing the placement of machines and resources to enhance output and minimize operational costs. We redesigned the layout for the steaming line of a food manufacturing facility to improve line efficiency and labor productivity without compromising product quality. We used the define-measure-analyze-design-verify six sigma methodology to identify problems and develop solutions. Layout modifications were validated using ProModel 2016. Results demonstrated reduced process bottlenecks and improved workflow. The results offered actionable insights into food manufacturing and similar industries, promoting the adoption of data-driven, technology-enabled approaches to enhance operational efficiency and productivity. Full article

In this study, we comparatively assessed short-read (Illumina), long-read (Oxford Nanopore Technologies, ONT), and hybrid (Illumina + ONT) sequencing strategies for bacterial genome analysis using the aquaculture-derived isolate 160P. Genomic DNA was extracted and sequenced on Illumina paired-end and ONT long-read platforms, and de novo assemblies were generated using SPAdes, Canu, Flye, and Unicycler under short-read-only, long-read-only, and hybrid workflows, followed by evaluation with QUAST assembly metrics. Among the tested approaches, the hybrid Unicycler assembly provided the highest contiguity, yielding seven contigs and a dominant 4.55 Mb contig consistent with near-complete chromosomal representation. Downstream analyses included functional genome annotation and in silico screening of antimicrobial resistance determinants (CARD), virulence-associated genes (VFDB), and secondary metabolite biosynthetic gene clusters (antiSMASH). Comparative genomic relatedness based on Average Nucleotide Identity (ANI) and digital DNA–DNA Hybridization (dDDH) indicated that 160P is most closely related to Aeromonas sobria CECT 4245^T yet falls below commonly applied species-level thresholds, supporting its placement as a genomically distinct lineage warranting further taxonomic investigation. Collectively, these findings underscore the value of hybrid sequencing for improving assembly continuity, enhancing annotation completeness, and strengthening taxonomic resolution in bacterial pathogen genomics. Full article

Background/Objectives: Among vat polymerization technologies, liquid-crystal display (LCD) 3D printing has gained popularity in dentistry because of its affordability and acceptable resolution. However, the factors influencing the dimensional accuracy of LCD-printed surgical splints, particularly build platform position, remain insufficiently investigated. This study aimed to evaluate the influence of build platform position on the trueness and precision of orthognathic surgical splints fabricated using LCD 3D printing technology. Methods: Thirty-six surgical splints were printed from a master digital file using an LCD 3D printer. All surgical splints were printed with a 90-degree layer orientation to the building platform. The layer thickness was set at 100 μm. The surgical splints were divided into three groups according to their printing position on the building platform: middle (M), left (Lt), and right (Rt). Each 3D-printed surgical splint was sprayed with an opaque scanning spray and then rescanned to create digital files for testing. A surface-based superimposition and deviation analysis was performed using specialized 3D software to evaluate accuracy of surgical splints. Root mean square error (RMSE) values were statistically analyzed. Results: There were no statistically significant differences in trueness among the middle, left, and right printing positions on the build platform (p > 0.05). In contrast, printing position significantly affected precision, with surgical splints printed at the center of the build platform demonstrating significantly lower RMSE values compared with those printed at the left and right positions (p < 0.001). In addition, no significant difference in precision was detected between the left and right positions. Conclusions: The printing position on the build platform significantly influences the precision of orthognathic surgical splints fabricated using LCD 3D printing technology. Splints printed at the central region of the build platform exhibited the highest precision, whereas trueness was not significantly affected by printing position. These findings suggest that preferential placement of surgical splints at the center of the build platform may improve fabrication consistency and predictability in digital orthognathic surgery workflows. Full article