Search Results (4,132)

Neuromuscular hip dysplasia (NHD) is a common deformity in children with cerebral palsy (CP). Although some predictive factors of NHD are known, the prediction of NHD is in its infancy. We present a Clinical Decision Support System (CDSS) designed to calculate the probability of developing NHD in children with CP. The system utilizes an ensemble of three machine learning (ML) algorithms: Neural Network (NN), Support Vector Machine (SVM), and Logistic Regression (LR). The development and evaluation of the CDSS followed the DECIDE-AI guidelines for AI-driven clinical decision support tools. The ensemble was trained on a data series from 182 subjects. Inclusion criteria were age between 12 and 18 years and diagnosis of CP from two specialized units. Clinical and functional data were collected prospectively between 2005 and 2023, and then analyzed in a cross-sectional study. Accuracy and area under the receiver operating characteristic (AUROC) were calculated for each method. Best logistic regression scores highlighted history of previous orthopedic surgery (p = 0.001), poor motor function (p = 0.004), truncal tone disorder (p = 0.008), scoliosis (p = 0.031), number of affected limbs (p = 0.05), and epilepsy (p = 0.05) as predictors of NHD. Both accuracy and AUROC were highest for NN, 83.7% and 0.92, respectively. The novelty of this study lies in the development of an efficient Clinical Decision Support System (CDSS) prototype, specifically designed to predict future outcomes of neuromuscular hip dysplasia (NHD) in patients with cerebral palsy (CP) using clinical data. The proposed system, PredictMed-CDSS, demonstrated strong predictive performance for estimating the probability of NHD development in children with CP, with the highest accuracy achieved using neural networks (NN). PredictMed-CDSS has the potential to assist clinicians in anticipating the need for early interventions and preventive strategies in the management of NHD among CP patients. Full article

Thyroid cancer is the most common endocrine malignancy, and preoperative distinction between benign and malignant nodules remains challenging, especially in cytologically indeterminate cases. Circulating microRNAs (miRNAs) have gained interest as non-invasive biomarkers due to their stability and involvement in tumorigenesis. This study aimed to assess the preoperative diagnostic value of circulating miR-146a and miR-221 in patients undergoing thyroidectomy. A total of 56 patients were included, of whom 24 had malignant and 32 had benign thyroid lesions confirmed by histopathology. Preoperative plasma levels of miR-146a and miR-221 were quantified using qRT-PCR, and relative expression was calculated with the 2^−ΔΔCt method. miR-221 expression was significantly higher in malignant cases, with an area under the ROC curve of 1.00, achieving 100% sensitivity and specificity at the optimal threshold. miR-146a showed no significant discriminatory ability. Weak correlations were observed between miRNA expression and clinical parameters such as age, TIRADS score, or thyroid volume. Logistic regression including miR-221 led to perfect separation, indicating strong predictive capacity but precluding multivariate modeling. These findings suggest that circulating miR-221 may serve as a highly accurate biomarker for thyroid malignancy and warrant further validation in larger, prospective cohorts. Full article

Terahertz (THz) has attracted substantial attention owing to its unique advantages in high-speed communications. However, conventional THz waveguide systems are inherently constrained by high transmission losses, stringent fabrication precision requirements, and extreme sensitivity to structural defects. Topological edge states with topological protection have driven significant advancements in THz wave manipulation. Nevertheless, the width of the topological waveguide based on edge states remains restricted. In this work, we put forward a type of spin photonic crystal with three-layer heterostructures, where large-area topological waveguide states are demonstrated. The results show that these topological waveguide states are localized within the region of Dirac photonic crystals. They also display spin-momentum-locking characteristics and maintain strong robustness against defects and sharp bends. Furthermore, a THz beam splitter and a topological beam modulator are implemented. The designed heterostructures expand the applications of multi-functional topological devices and provide a prospective pathway for overcoming the waveguide bottleneck in THz applications. Full article

With the rapid increase in global lithium demand, the exploration of newly discovered lithium in the bauxite of the Wenshan area in southeastern Yunnan has become increasingly important. However, the current research on clay-type lithium in the Wenshan area has primarily focused on local exploration, and large-scale predictive metallogenic studies remain limited. To address this, this study utilized multi-source remote sensing data from ZY1-02D and ASTER, combined with ALOS 12.5 m DEM and Sentinel-2 imagery, to carry out remote sensing mineral identification, structural interpretation, and prospectivity mapping for clay-type lithium in the Wenshan area. This study indicates that clay-type lithium in the Wenshan area is controlled by NW, EW, and NE linear structures and are mainly distributed in the region from north of the Wenshan–Malipo fault to south of the Guangnan–Funing fault. High-value areas of iron-rich silicates and iron–magnesium minerals revealed by ASTER data indicate lithium enrichment, while montmorillonite and cookeite identification by ZY1-02D have strong indicative significance for lithium. Field verification samples show the highest Li₂O content reaching 11,150 μg/g, with six samples meeting the comprehensive utilization criteria for lithium in bauxite (Li₂O ≥ 500 μg/g) and also showing an enrichment of rare earth elements (REEs) and gallium (Ga). By integrating stratigraphic, structural, mineral identification, geochemical characteristics, and field verification data, ten mineral exploration target areas were delineated. This study validates the effectiveness of remote sensing technology in the exploration of clay-type lithium and provides an applicable workflow for similar environments worldwide. Full article

Background: Pancreatic cystic lesions (PCLs), including intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs), pose a diagnostic challenge due to their variable malignant potential. Current guidelines, such as Fukuoka and American Gastroenterological Association (AGA), have moderate predictive accuracy and may lead to overtreatment or missed malignancies. Artificial intelligence (AI), incorporating machine learning (ML) and deep learning (DL), offers the potential to improve risk stratification, diagnosis, and management of PCLs by integrating clinical, radiological, and molecular data. This is the first systematic review to evaluate the application, performance, and clinical utility of AI models in the diagnosis, classification, prognosis, and management of pancreatic cysts. Methods: A systematic review was conducted in accordance with PRISMA guidelines and registered on PROSPERO (CRD420251008593). Databases searched included PubMed, EMBASE, Scopus, and Cochrane Library up to March 2025. The inclusion criteria encompassed original studies employing AI, ML, or DL in human subjects with pancreatic cysts, evaluating diagnostic, classification, or prognostic outcomes. Data were extracted on the study design, imaging modality, model type, sample size, performance metrics (accuracy, sensitivity, specificity, and area under the curve (AUC)), and validation methods. Study quality and bias were assessed using the PROBAST and adherence to TRIPOD reporting guidelines. Results: From 847 records, 31 studies met the inclusion criteria. Most were retrospective observational (n = 27, 87%) and focused on preoperative diagnostic applications (n = 30, 97%), with only one addressing prognosis. Imaging modalities included Computed Tomography (CT) (48%), endoscopic ultrasound (EUS) (26%), and Magnetic Resonance Imaging (MRI) (9.7%). Neural networks, particularly convolutional neural networks (CNNs), were the most common AI models (n = 16), followed by logistic regression (n = 4) and support vector machines (n = 3). The median reported AUC across studies was 0.912, with 55% of models achieving AUC ≥ 0.80. The models outperformed clinicians or existing guidelines in 11 studies. IPMN stratification and subtype classification were common focuses, with CNN-based EUS models achieving accuracies of up to 99.6%. Only 10 studies (32%) performed external validation. The risk of bias was high in 93.5% of studies, and TRIPOD adherence averaged 48%. Conclusions: AI demonstrates strong potential in improving the diagnosis and risk stratification of pancreatic cysts, with several models outperforming current clinical guidelines and human readers. However, widespread clinical adoption is hindered by high risk of bias, lack of external validation, and limited interpretability of complex models. Future work should prioritise multicentre prospective studies, standardised model reporting, and development of interpretable, externally validated tools to support clinical integration. Full article

Background and Objectives: There is a global rise of public interest in integrative medicine. The principles of integrative medicine combining conventional medicine with evidence-based complementary therapies have been implemented in many medical areas, including plastic surgery, to improve patient’s outcome. The aim of the present study was to systematically analyze the application and use of additional non-pharmacological interventions (NPIs) of patients of a German department of plastic surgery. Materials and Methods: The present real-world data study utilized data from the Network Oncology registry between 2016 and 2021. Patients included in this study were at the age of 18 or above, stayed at the department of plastic surgery and received at least one plastic surgical procedure. Adjusted multivariable logistic regression analyses were performed to detect associations between the acceptance of NPIs and predicting factors such as age, gender, year of admission, or length of hospital stay. Results: In total, 265 patients were enrolled in the study between January 2016 and December 2021 with a median age of 65 years (IQR: 52–80) and a male/female ratio of 0.77. Most of the patients received reconstructive surgery (90.19%), followed by hand surgery (5.68%) and aesthetic surgery (2.64%). In total, 42.5% of the enrolled patients accepted and applied NPIs. Physiotherapy, rhythmical embrocations, and compresses were the most often administered NPIs. Conclusions: This exploratory analysis provides a descriptive overview of the application and acceptance of NPIs in plastic surgery patients within a German integrative care setting. While NPIs appear to be well accepted by a subset of patients, further prospective studies are needed to evaluate their impact on clinical outcomes such as postoperative recovery, pain management, patient-reported quality of life, and overall satisfaction with care. Full article

Background/Objectives. This manuscript presents an overview of advances in oncological radiotherapy as an effective treatment method for cancerous tumors, focusing on mechanisms of action within metabolite–antimetabolite systems. The urgency of this topic is underscored by the fact that cancer remains one of the leading causes of death worldwide: as of 2022, approximately 20 million new cases were diagnosed globally, accounting for about 0.25% of the total population. Given prognostic models predicting a steady increase in cancer incidence to 35 million cases by 2050, there is an urgent need for the latest developments in physics, chemistry, molecular biology, pharmacy, and strict adherence to oncological vigilance. The purpose of this work is to demonstrate the relationship between the nature and mechanisms of past diagnostic and therapeutic oncology approaches, their current improvements, and future prospects. Particular emphasis is placed on isotope technologies in the production of therapeutic nuclides, focusing on the mechanisms of formation of simple and complex theranostic compounds and their classification according to target specificity. Methods. The methodology involved searching, selecting, and analyzing information from PubMed, Scopus, and Web of Science databases, as well as from available official online sources over the past 20 years. The search was structured around the structure–mechanism–effect relationship of active pharmaceutical ingredients (APIs). The manuscript, including graphic materials, was prepared using a narrative synthesis method. Results. The results present a sequential analysis of materials related to isotope technology, particularly nucleus stability and instability. An explanation of theranostic principles enabled a detailed description of the action mechanisms of radiopharmaceuticals on various receptors within the metabolite–antimetabolite system using specific drug models. Attention is also given to radioactive nanotheranostics, exemplified by the mechanisms of action of radioactive nanoparticles such as Tc-99m, AuNPs, wwAgNPs, FeNPs, and others. Conclusions. Radiotheranostics, which combines the diagnostic properties of unstable nuclei with therapeutic effects, serves as an effective adjunctive and/or independent method for treating cancer patients. Despite the emergence of resistance to both chemotherapy and radiotherapy, existing nuclide resources provide protection against subsequent tumor metastasis. However, given the unfavorable cancer incidence prognosis over the next 25 years, the development of “preventive” drugs is recommended. Progress in this area will be facilitated by modern medical knowledge and a deeper understanding of ligand–receptor interactions to trigger apoptosis in rapidly proliferating cells. Full article

Background/Objective: Accurately identifying women at high risk for preterm birth among those with threatened preterm labor (PTL) is crucial for effective interventions or tocolytic management to reduce preterm birth and its complications. This study aimed to determine the predictive value of cervical elastography for preterm delivery before 37 weeks of gestation in patients with threatened PTL and a cervical length greater than 15 mm. Methods: This prospective cohort study included pregnant women presenting with threatened PTL at between 24 and 34 weeks gestation. All participants underwent cervical elastography at diagnosis. We compared cervical elastography parameters between women who delivered spontaneously preterm (<37 weeks) and those who delivered at full term and assessed the ability of these parameters to predict spontaneous preterm delivery. Results: Among the 107 enrolled individuals with threatened PTL and a cervical length of ≥15 mm, 55 (42%) experienced preterm birth (<37 weeks). Internal os stiffness (IOS), internal-to-external os stiffness ratio (IOS/EOS ratio), and elasticity contrast index (ECI) were significantly associated with a risk of preterm birth compared to full-term birth. The IOS/EOS ratio was associated with 10-fold higher odds of preterm birth at <37 weeks (95% confidence interval [CI], 1.82–59.98), and ECI was associated with 1.5-fold higher odds (95% CI, 1.01–2.37). The IOS/EOS ratio demonstrated good predictive value (area under the curve (AUC) = 0.678) and the combination of CL ≤ 25 mm and the IOS/EOS ratio had good diagnostic performance for predicting preterm birth (AUC = 0.708). Conclusions: Cervical elastography using the E-Cervix™ system appears to improve the ability to predict preterm birth in pregnant women with threatened PTL and a cervical length greater than 15 mm. Full article

Acid mine drainage (AMD) remains a critical environmental challenge in South Africa due to its severe impact on water quality, ecosystems and public health. Numerous studies on AMD management, treatment and resource recovery have been conducted over the past 20 years. This study presents a comprehensive review of research activities on AMD in South Africa from 1998 to 2025, highlighting key trends, emerging challenges and future directions. The study reveals a significant focus on passive and active treatment methods, environmental remediation and the recovery of valuable resources, such as iron, rare earth elements (REEs) and gypsum. A bibliometric analysis was conducted to identify the most influential studies and thematic research areas over the years. Bibliometric tools (Biblioshiny and VOSviewer) were used to analyse the data that was extracted from the PubMed database. The findings indicate that research production has increased significantly over time, with substantial contributions from top academics and institutions. Advanced treatment technologies, the use of artificial intelligence and circular economy strategies for resource recovery are among the new research prospects identified in this study. Despite substantial progress, persistent challenges, such as scalability, economic viability and policy implementation, remain. Furthermore, few technologies have moved beyond pilot-scale implementation, underscoring the need for greater investment in field-scale research and technology transfer. This study recommends stronger industry–academic collaboration, the development of standardised treatment protocols and enhanced government policy support to facilitate sustainable AMD management. The study emphasises the necessity of data-driven approaches, sustainable technology and interdisciplinary cooperation to address AMD’s socioeconomic and environmental effects in the ensuing decades. Full article

Background: The relationship between spleen and bone marrow stiffness, and other features of abnormal myeloproliferation has long been described. However, the scientific knowledge in this area remains very superficial. This review evaluated the diagnostic effectiveness of various ultrasound (US) methods in the assessment of neoplastic myeloproliferation using spleen stiffness measurement (SSM). Aim: To explore the diagnostic accuracy of US techniques in assessing spleen stiffness, determining which of them may be suitable for the diagnosis of myeloproliferative diseases in adults. Methods: The review included original retrospective or prospective studies published in the last five years (2019–2024) in peer-reviewed medical journals that reported receiver operating characteristics (ROCs) for SSM and the articles concerning the relation between SSM values and neoplastic myeloproliferation. The studies were identified through PubMed searches on 1 July and 1 December 2024. Quality was assessed using the QUADAS-2 tool. Results were tabulated according to the diagnostic method separately for myeloproliferative neoplasms (MNs) and for other clinical findings. Results: The review included 52 studies providing ROCs for SSM or compatibility between operators, and five studies covering the relation between SSM values and MNs. Conclusions: Acoustic radiation force impulse (ARFI), two-dimensional shear wave elastography (2D-SWE), transient elastography (TE), and point shear wave elastography (p-SWE) are promising methods for measuring SSM that can be incorporated into the diagnosis, screening, and monitoring system in MNs. Full article

Background: Artificial intelligence (AI) and machine learning (ML) have been reshaping maternal, fetal, neonatal, and reproductive healthcare by enhancing risk prediction, diagnostic accuracy, and operational efficiency across the perinatal continuum. However, no comprehensive synthesis has yet been published. Objective: To conduct a scoping review of reviews of AI/ML applications spanning reproductive, prenatal, postpartum, neonatal, and early child-development care. Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, and Scopus through April 2025. Two reviewers independently screened records, extracted data, and assessed methodological quality using AMSTAR 2 for systematic reviews, ROBIS for bias assessment, SANRA for narrative reviews, and JBI guidance for scoping reviews. Results: Thirty-nine reviews met our inclusion criteria. In preconception and fertility treatment, convolutional neural network-based platforms can identify viable embryos and key sperm parameters with over 90 percent accuracy, and machine-learning models can personalize follicle-stimulating hormone regimens to boost mature oocyte yield while reducing overall medication use. Digital sexual-health chatbots have enhanced patient education, pre-exposure prophylaxis adherence, and safer sexual behaviors, although data-privacy safeguards and bias mitigation remain priorities. During pregnancy, advanced deep-learning models can segment fetal anatomy on ultrasound images with more than 90 percent overlap compared to expert annotations and can detect anomalies with sensitivity exceeding 93 percent. Predictive biometric tools can estimate gestational age within one week with accuracy and fetal weight within approximately 190 g. In the postpartum period, AI-driven decision-support systems and conversational agents can facilitate early screening for depression and can guide follow-up care. Wearable sensors enable remote monitoring of maternal blood pressure and heart rate to support timely clinical intervention. Within neonatal care, the Heart Rate Observation (HeRO) system has reduced mortality among very low-birth-weight infants by roughly 20 percent, and additional AI models can predict neonatal sepsis, retinopathy of prematurity, and necrotizing enterocolitis with area-under-the-curve values above 0.80. From an operational standpoint, automated ultrasound workflows deliver biometric measurements at about 14 milliseconds per frame, and dynamic scheduling in IVF laboratories lowers staff workload and per-cycle costs. Home-monitoring platforms for pregnant women are associated with 7–11 percent reductions in maternal mortality and preeclampsia incidence. Despite these advances, most evidence derives from retrospective, single-center studies with limited external validation. Low-resource settings, especially in Sub-Saharan Africa, remain under-represented, and few AI solutions are fully embedded in electronic health records. Conclusions: AI holds transformative promise for perinatal care but will require prospective multicenter validation, equity-centered design, robust governance, transparent fairness audits, and seamless electronic health record integration to translate these innovations into routine practice and improve maternal and neonatal outcomes. Full article

The Barcelona Metropolitan Area (AMB) has implemented various policies to reduce car use and promote more sustainable mobility. Initiatives such as superblocks, Low Emission Zones (LEZs), and the Bicivia network aim to transform the urban model in response to environmental and congestion challenges. However, the high reliance on private vehicles for intermunicipal travel, uneven infrastructure, and social resistance to certain changes remain significant issues. This study examines the evolution of mobility patterns and assesses the effectiveness of the above policies in fostering real and sustainable change. A mixed-methods approach was adopted, which combined an exploratory factor analysis (EFA) of 2011–2024 data, trend linear regression, and a comparative international analysis. The EFA identified four key structural dimensions: traditional transport infrastructure, active mobility and bus lines, public bicycles and mixed use, and transport efficiency and punctuality. The findings reveal a clear reduction in private car use and an increase in sustainable modes of transport. This indicates that there are prospects for future transformation. Nonetheless, challenges persist in intermunicipal mobility and the public acceptance of the measures. This study provides empirical and comparative evidence and emphasizes the need for integrated metropolitan governance to achieve a resilient and sustainable urban model. Full article

As a pivotal clean energy source with considerable reserves, geothermal water plays an indispensable role in diminishing reliance on fossil fuels and accomplishing carbon neutrality. This study employed conventional electrical prospecting and radon gas surveys in the Lantian area of Ningdu, aimed at curtailing geothermal development costs by precise targeting of resource locations. The investigations successfully delineated fracture structures within the Lantian region. Distinct anomalies were identified in the electrical profiling along Survey Lines 1, 2, and 4, with the most pronounced features observed on Line 4. Accordingly, characteristic peak anomalies were exhibited by the radon gas measurement profiles S1, S2, and S4 corresponding to Lines 1, 2, and 4, respectively. The synergistic interpretation of resistivity and radon survey data recognized two primary fracture zones: the NE-trending zone F1 and the NEE-trending zone F2. This integrated approach not only ascertained the efficacy of the radon gas measurement, but also lays a robust basis for future geothermal water exploration targeting. Full article

Information and communication technologies (ICTs) are becoming increasingly important for sustainable rural development through the smart village concept. This study aims to model ICT’s potential for public services management in European rural areas. It identifies ICT applications across rural service domains, analyzes how these technologies address specific rural challenges, and evaluates their benefits, implementation barriers, and future prospects for sustainable rural development. A qualitative content analysis method was applied using purposive sampling to analyze 79 peer-reviewed articles from EBSCO and Elsevier databases (2000–2024). A deductive approach employed predefined categories to systematically classify ICT applications across rural public service domains, with data coded according to technology scope, problems addressed, and implementation challenges. The analysis identified 15 ICT application domains (agriculture, healthcare, education, governance, energy, transport, etc.) and 42 key technology categories (Internet of Things, artificial intelligence, blockchain, cloud computing, digital platforms, mobile applications, etc.). These technologies address four fundamental rural challenges: limited service accessibility, inefficient resource management, demographic pressures, and social exclusion. This study provides the first comprehensive systematic categorization of ICT applications in smart villages, establishing a theoretical framework connecting technology deployment with sustainable development dimensions. Findings demonstrate that successful ICT implementation requires integrated urban–rural cooperation, community-centered approaches, and balanced attention to economic, social, and environmental sustainability. The research identifies persistent challenges, including inadequate infrastructure, limited digital competencies, and high implementation costs, providing actionable insights for policymakers and practitioners developing ICT-enabled rural development strategies. Full article

This study developed a copper mineral prospectivity map for the Koldar massif, Kazakhstan, using an integrated approach combining geophysical and satellite methods. A strong spatialgenetic link was identified between faults and hydrothermal mineralization, with faults acting as key conduits for ore-bearing fluids. Lineament analysis and density mapping confirmed the high permeability of the Koldar massif, indicating its structural prospectivity. Hyperspectral and multispectral data (ASTER, PRISMA, WorldView-3) were applied for detailed mapping of hydrothermal alteration (phyllic, propylitic, argillic zones), which are critical for discovering porphyry copper deposits. In particular, WorldView-3 imagery facilitated the identification of new prospective zones. The transformation of magnetic and gravity data successfully delineated geological features and structural boundaries, confirming the fractured nature of the massif, a key structural factor for mineralization. The resulting map of prospective zones, created by normalizing and integrating four evidential layers (lineament density, PRISMA-derived hydrothermal alteration, magnetic, and gravity anomalies), is thoroughly validated, successfully outlining the known Aktogay, Aidarly, and Kyzylkiya deposits. Furthermore, new, previously underestimated prospective areas were identified. This work fills a significant knowledge gap concerning the Koldar massif, which had not been extensively studied using satellite methods previously. The key advantage of this research lies in its comprehensive approach and the successful application of high-quality hyperspectral imagery for mapping new prospective zones, offering a cost-effective and efficient alternative to traditional ground-based investigations. Full article