Search Results (5,340)

This study presents a methodology to automatically assess visibility distance on secondary roads using mobile LiDAR systems. The method evaluates both braking and overtaking visibility distances based on the 3D geometry of the road, applying a dynamic analysis through a series of parametrised quadrangular pyramids that simulate the driver’s field of view. Road segments are classified into three risk levels, low, medium, and high, according to the feasibility of stopping or overtaking safely. The methodology was validated on three secondary roads in Spain, achieving an average accuracy of 92.7% when compared to existing road signage. These results demonstrate the method’s potential to improve road safety through continuous, data-driven visibility monitoring. Its application supports advanced driver assistance systems and offers road authorities a reliable tool for proactive risk assessment and road infrastructure planning. Full article

Background: Autoimmune cholestatic liver diseases (AICLDs), including primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), are characterized by progressive biliary injury and cholestasis, leading to an impaired quantity/quality of life. Pruritus affects 20–70% of patients and is often refractory to current treatments. Ileal bile acid transporter (IBAT) inhibitors reduce bile acid reabsorption and may alleviate cholestatic pruritus. This systematic review and meta-analysis evaluates their efficacy and safety in adults with AICLD. Methods: Following PRISMA guidelines, we systematically searched PubMed, Embase, and Cochrane-CENTRAL for studies assessing IBAT inhibitors in adult AICLD patients with pruritus for ≥12 weeks. The primary outcome was the change in the 5-D Pruritus Scale. Secondary outcomes included sleep quality, serum bile acids, liver biochemistry, and safety. Heterogeneity was assessed using Cochrane Q and I² statistics. Results: Three studies (n = 180) met inclusion criteria, including two RCTs and one single-arm study. Patients (78% female; 85% PBC; 77% linerixibat) showed a significant pruritus reduction (MD = −4.93, 95%CI [−6.26, −3.59], p < 0.0001), accompanied by improved sleep quality (MD = −8.12, 95%CI [−13.54, −2.70], p = 0.0033). Serum bile acids, FGF19, and autotaxin decreased significantly, with increased C4 levels. AST and GGT declined, while ALP, ALT, and bilirubin remained stable. Adverse events occurred in 89.7%, mainly diarrhea (22.7%), nausea (12.2%), and abdominal pain (18.2%); serious events were rare (2.2%). Conclusions: IBAT inhibitors significantly reduce pruritus and improve sleep in AICLD, with a favorable safety profile. These findings support their potential as a novel therapeutic option for cholestatic pruritus in adults with AICLD. Full article

Autonomous public transport (APT) is revolutionizing urban mobility by integrating advanced technologies, including electric autonomous buses and shared autonomous vehicles (SAVs). This paper examines the historical evolution of APT, from early automation efforts in the 1920s to the deployment of autonomous shuttles in contemporary cities. It highlights technological milestones, legislative developments, and shifts in public perception that have influenced the adoption of APT. The research identifies key benefits of APT, including enhanced road safety, reduced greenhouse gas emissions, and improved cost-efficiency in public transport operations. Additionally, the environmental potential of SAVs to reduce traffic congestion and emissions is explored, particularly when integrated with renewable energy sources and sustainable urban planning. However, the study also addresses significant challenges, such as handling emergencies without human intervention, rising cybersecurity threats, and employment displacement in the transportation sector. Social equity concerns are also discussed, especially regarding access and the risk of increasing urban inequality. This paper contributes to the broader discourse on sustainable mobility, transportation innovation, and the future of smart cities by providing a comprehensive analysis of both opportunities and obstacles. Effective policy frameworks and inclusive planning are essential for the successful implementation of APT systems worldwide. Full article

Background: Gut microbiota dysregulation is increasingly recognized as a key contributor to the progression of liver cirrhosis and its complications, particularly hepatic encephalopathy. Fecal microbiota transplantation (FMT) has emerged as a novel therapeutic strategy aimed at restoring intestinal microbial homeostasis and modulating systemic inflammation. Methods: This prospective, single-center clinical trial evaluated the short-term safety and efficacy of FMT in patients with alcohol-related liver cirrhosis. Clinical assessment, liver stiffness (via elastography), steatosis (controlled attenuation parameter), inflammatory biomarkers, and extended biochemical panels were analyzed at baseline, one week and one month post-FMT. A control group receiving standard medical therapy was used for comparison. Results: FMT was associated with a significant reduction in hepatic encephalopathy severity (p = 0.014), sustained improvements in liver stiffness (p = 0.027) and decreased steatosis (p = 0.025). At one month, C-reactive protein and neutrophil-to-lymphocyte ratio both declined significantly (p = 0.043), indicating a measurable anti-inflammatory effect. No serious adverse events were recorded. In comparison with controls, FMT recipients showed lower systemic inflammation and improved neuropsychiatric status. Conclusions: FMT demonstrated a favorable safety profile and yielded early clinical and biochemical benefits in patients with cirrhosis. These preliminary findings support the potential utility of microbiota-based interventions in chronic liver disease and warrant validation in larger, multicenter trials. Full article

Machine vision technologies play a critical role in the advancement of modern human-centric manufacturing systems. This study investigates their practical applications in improving both safety and productivity within industrial environments. Particular attention is given to areas such as quality assurance, worker protection, and process optimization, illustrating how intelligent visual inspection systems and real-time data analysis contribute to increased operational efficiency and higher safety standards. The research methodology combines an in-depth analysis of industrial case studies, including one from the frozen dough industry, with a systematic review of the current literature on machine vision technologies in manufacturing. The findings highlight the potential of such systems to reduce human error, maintain consistent product quality, minimize material waste, and promote safer and more adaptable work environments. This study offers valuable insights into the integration of advanced visual technologies within human-centered production environments, while also addressing key challenges and future opportunities for innovation and technological evolution. Full article

Introduction: The radiofrequency catheter ablation (RFCA) of ventricular arrhythmias (VAs) originating from the right ventricular outflow tract (RVOT) is a well-established therapy. Traditionally, RFCA is guided using electroanatomical 3D mapping systems involving manual catheter navigation within cardiac chambers. While effective, this approach may be time-consuming, and it carries a potential risk of cardiac wall perforation. Although the risk is low, it cannot be underestimated. Therefore, alternative mapping methods are sought to reduce procedural times and improve the overall efficiency of RVOT-VAs ablation. Aim: To evaluate the safety, feasibility, and efficacy of a universal RVOT 3D model implementation for the ablation of idiopathic RVOT-VAs. Methods: Consecutive patients undergoing VA ablation supported with a universal RVOT 3D model (3D-MODEL group) were included in the study. The RVOT universal model in this group was created by processing DICOM images for the improved segmentation of anatomical structures, followed by production using 3D printing technology. Patients who underwent classic endocardial electroanatomical mapping served as controls (EAM group). Results: A total of 228 patients were included in the study (143 women, age 50 ± 17 years): 149 in the 3D-MODEL group and 79 in the EAM group. The acute complete elimination of clinical VAs was achieved for 133 (89%) of patients in the 3D-MODEL group vs. 65 (82%) in the EAM group (p = 0.14). The procedural time was significantly shorter in the 3D-MODEL group compared to the EAM group (38 ± 14 min vs. 80 ± 39 min, p < 0.001). A significant difference was also observed in the radiofrequency time between the 3D-MODEL and EAM groups (251 ± 176 s vs. 503 ± 425 s, p < 0.001). No significant difference in fluoroscopy time was found between the groups (284 ± 167 s vs. 260 ± 327 s, p = 0.49). Two cases of cardiac tamponade occurred, both in patients from the EAM group. During follow-up, lasting 14 ± 10 months, 87% of patients in the 3D-MODEL group and 75% in the EAM group remained arrhythmia-free (p = 0.45). Conclusions: The use of universal RVOT 3D modeling is a feasible, safe, and effective alternative to classic electroanatomical mapping in the ablation of idiopathic RVOT-VAs. Full article

Background: The optimal surgical approach for malignant pleural mesothelioma (PM) remains a topic of debate. While extrapleural pneumonectomy (EPP) offers radical resection, it is associated with significant morbidity. Pleurectomy/decortication (P/D) is less extensive but may offer comparable oncologic outcomes with reduced perioperative risk. This study aimed to conduct a comprehensive systematic review and meta-analysis to systematically evaluate and quantitatively compare survival outcomes, 30-day postoperative mortality, and baseline characteristics between patients undergoing P/D and EPP for PM. Methods: A systematic review was conducted in accordance with the PRISMA guidelines. MEDLINE, Embase, and Scopus were searched up to May 2025. Studies comparing EPP and P/D in PM that reported on survival, mortality, or baseline demographics were included. Data from 24 retrospective studies were extracted. Pooled estimates were calculated using random-effects models. Meta-regression and subgroup analyses were performed by geographic region and publication year. Results: P/D was associated with a significantly improved overall survival compared to EPP in the primary analysis (mean difference = 7.01 months; 95% CI: 1.15–12.86; p = 0.018), with substantial heterogeneity (I² = 98.5%). In a sensitivity analysis excluding one statistical outlier, the survival benefit remained significant (mean difference = 4.31 months; 95% CI: 1.69–6.93), and heterogeneity was markedly reduced. The 30-day mortality rate was also significantly lower for P/D (odds ratio = 0.34; 95% CI: 0.13–0.88; p = 0.027). Patients undergoing P/D were, on average, 3.78 years older than those undergoing EPP (p < 0.001), whereas no significant difference was observed in the sex distribution between groups. Subgroup analyses by region and publication year confirmed the robustness of the findings. Meta-regression did not reveal substantial modifiers of survival. Conclusions: P/D demonstrates superior overall survival and reduced perioperative mortality compared to EPP, without evidence of baseline demographic confounding. These findings, derived from retrospective comparative studies, support the preferential use of P/D in eligible patients, particularly in high-volume centers, given its favorable safety profile and superior median survival. However, the absence of randomized trials directly comparing P/D and EPP and the potential influence of patient selection warrant cautious interpretation, and surgical decisions should be tailored to individual patient factors within a multidisciplinary setting. Full article

Accurate wave forecasting under typhoon conditions is essential for coastal safety in the Pearl River Estuary. This study explores the use of Random Forest (RF) and Long Short-Term Memory (LSTM) models to predict significant wave heights, using SWAN-simulated data from 87 historical typhoon events. Ten representative typhoons were reserved for independent testing. Results show that the LSTM model outperforms RF in 3 h forecasts, achieving a lower mean RMSE and higher R², particularly in capturing wave peaks under highly dynamic conditions. For 6 h forecasts, both models exhibit decreased accuracy, with RF performing slightly better in stable scenarios, while LSTM remains more responsive in complex wave evolution. Generalization tests at three nearby stations demonstrate that both models, especially LSTM, retain strong predictive skill beyond the training location. These findings highlight the potential of combining numerical wave models with machine learning for short-term, data-driven wave forecasting in typhoon-prone and observation-sparse regions. The study also points to future improvements through integration of wind field predictors, model updating strategies, and ensemble meteorological data. Full article

Immune checkpoint inhibitors (ICIs) have emerged as first-line therapy for advanced-stage HCC with modest response rates (<33%). Combination treatments offer the potential to improve response rates while improving outcomes. This study evaluates the safety and outcomes of first-line Yttrium-90 plus ICI (⁹⁰Y-ICI). A retrospective, multi-center study was conducted in HCC patients receiving first-line ⁹⁰Y-ICI with atezolizumab plus bevacizumab (Atezo/Bev) or tremelimumab plus durvalumab (Treme/Durva). Treatment response was evaluated at follow-up for planned ⁹⁰Y treatment cycle. Time-to-event measures of time to progression (TTP), progression-free survival (PFS), and overall survival (OS) served as primary endpoints, with first cycle response rates and AEs as secondary outcomes. This study included 37 patients receiving ⁹⁰Y-ICI from 2021 to 2024 (16-month median follow-up). The cohort was predominantly Child-Pugh A (92%) with HCV-related cirrhosis (67%), advanced stage (54%), and a median index HCC size of 8.0 cm (IQR: 6—12 cm). Grade 3–4 AEs occurred in six patients (16%). The target objective response (OR) rate was 83%, with a 50% target complete response (CR) rate. Overall OR was 61% with an overall CR of 39%. Median PFS was 11 months with 1-year rates of 50%. Patients with a target CR had improved TTP (p = 0.004), PFS (p = 0.003), and OS (p = 0.003). The cohort’s 2-year OS was 41% with a median OS of 19 months (CI: 12–37 months). First-line ⁹⁰Y-ICI therapy in HCC is safe and effective, with no deviation in anticipated results. Patients achieving target CR showed significantly improved TTP, PFS, and OS, supporting target CR as an optimal treatment target. Full article

Spinal cord injury (SCI) profoundly affects motor–sensory functions, reducing mobility and quality of life. Robotic exoskeletons offer a promising solution to support gait training, improve mobility, and prevent secondary complications. Existing research predominantly focuses on complete SCI, with limited exploration of long-term effects and tailored training for incomplete SCI. This study investigates device-based outcomes of personalized exoskeleton gait training in 33 individuals with incomplete SCI, with different lesion levels: cervical, thoracic, and lumbar. Participants underwent up to 39 sessions of gait training with a commercially available lower limb exoskeleton. Session parameters, including duration, intensity, and modality, were tailored to each individual’s clinical needs as determined by a medical team. Analysis focused on endurance, performance on the device, and patient-reported outcomes related to walking fluidity, safety, and satisfaction. Results showed overall improvement in endurance and performance, with the most significant gains observed in participants with thoracic-level injuries. All participants reported increased perceived safety, walking fluidity, and high satisfaction with the training. These findings support the potential of personalized exoskeleton training to enhance outcomes and experiences for individuals with incomplete SCI. The difference in improvement between lesion levels highlights the need for customized approaches to address the diverse clinical conditions within this population. Full article

Low back pain (LBP) remains one of the most prevalent and disabling musculoskeletal conditions globally, with profound social, economic, and healthcare implications. The rising incidence and chronic nature of LBP highlight the need for more objective, personalized, and effective approaches to assessment and rehabilitation. In this context, bioengineering has emerged as a transformative field, offering novel tools and methodologies that enhance the understanding and management of LBP. This narrative review examines current bioengineering applications in both diagnostic and therapeutic domains. For assessment, technologies such as wearable inertial sensors, three-dimensional motion capture systems, surface electromyography, and biomechanical modeling provide real-time, quantitative insights into posture, movement patterns, and muscle activity. On the therapeutic front, innovations including robotic exoskeletons, neuromuscular electrical stimulation, virtual reality-based rehabilitation, and tele-rehabilitation platforms are increasingly being integrated into multimodal treatment protocols. These technologies support precision medicine by tailoring interventions to each patient’s biomechanical and functional profile. Furthermore, the incorporation of artificial intelligence into clinical workflows enables automated data analysis, predictive modeling, and decision support systems, while future directions such as digital twin technology hold promise for personalized simulation and outcome forecasting. While these advancements are promising, further validation in large-scale, real-world settings is required to ensure safety, efficacy, and equitable accessibility. Ultimately, bioengineering provides a multidimensional, data-driven framework that has the potential to significantly improve the assessment, rehabilitation, and overall management of LBP. Full article

Medium and variable vessel vasculitides are a heterogeneous group of rare, immune-mediated vascular disorders that are associated with significant morbidity and mortality. The standard treatment approach involves glucocorticoids and immunosuppressive agents. However, many patients exhibit poor tolerance or respond inadequately to these medications. Recent advances in biologic therapies and Janus Kinase inhibitors (JAKis) offer promising alternatives. This review consolidates current knowledge on the pathogenesis, immunology, and therapeutic efficacy of biologics and JAKis in the management of medium and variable vessel vasculitis. While further research is needed to establish long-term safety and optimize treatment protocols, biologics and JAKis represent emerging therapeutic strategies with the potential to improve outcomes. Full article

Fermentation, a traditional method for enhancing nutritional value and functionality, has significant potential for improving the quality, safety and acceptability of farmed insect products. In this study, yellow mealworm, house cricket and migratory locust were fermented using Lactobacillus plantarum and a commercial starter culture for 48 h. Samples were analyzed for proximate composition, amino and fatty acid profiles, elemental composition and oxidation stability. Fermentation reduced total dietary fiber in yellow mealworm (33%) and house cricket (12%), and increased non-protein nitrogen (38% and 16%), while total and protein nitrogen remained unaffected. Fatty acid profiles also remained unchanged, whereas the amino acid composition varied depending on the species and fermentation culture. Essential mineral concentrations varied depending on species and fermentation culture Fe (19–23%), K (25%), Mg (12–23%), Mn (36–378%), Na (20–49%) and P (22%) increased, levels of Se (15%), and Cu (16%) decreased, while Zn levels showed inconsistent trends among treatments. Oxidation stability of yellow mealworm (41–42%) and migratory locust (21–29%) decreased, but improved for house cricket (153–167%). Overall, fermentation enhanced the nutritional value of edible insects, although the extent of improvement varied by species and fermentation culture. Full article

Efficient human detection in video streams is essential for various IoT applications, including surveillance, smart cities, intelligent transportation systems (ITSs), and industrial automation. However, resource-constrained IoT devices often face limitations in handling deep learning-based object detection. This study proposes a collaborative edge computing framework utilizing multiple Raspberry Pi-based IoT devices to improve YOLOv11-based human detection performance. By distributing video frames across multiple edge devices, the proposed system effectively balances the computational load, resulting in an increase in the FPS (Frames Per Second) for processed video outputs. The experimental results confirm that as more edge devices collaborate, overall video processing efficiency improves, demonstrating the feasibility of distributed object detection for scalable and cost-effective IoT-based video analytics. In particular, the proposed approach holds significant potential for ITS applications such as pedestrian monitoring at intersections, real-time incident detection, and enhancing traffic safety by enabling responsive and decentralized analysis at the edge. Full article

Musculoskeletal disorders (MSDs) remain a critical occupational health issue for nursing personnel worldwide, resulting from physically demanding tasks such as patient handling and prolonged working hours. These injuries not only compromise nursing staff’s health but also impair their performance, productivity, and overall well-being. This review analyzes the current state of assistive technologies aimed at preventing MSDs in nursing staff, highlighting their effectiveness, implementation challenges, and potential benefits. A systematic selection of the scientific literature from major databases including Web of Science, Scopus, ScienceDirect, PubMed, Taylor & Francis, and ProQuest was conducted, complemented by open-access patent records. The screening process, involving two independent reviewers, achieved moderate agreement (Cohen’s Kappa = 0.418). The findings reveal that the most affected anatomical areas include the back, shoulders, and knees. Technological interventions are classified into three main categories: physical assistance devices, digital monitoring tools, and training programs. These integrated approaches offer promising avenues to enhance occupational safety, reduce injury rates, and improve nurses’ quality of life and professional performance. Full article