Search Results (529)

Lung cancer remains the leading cause of cancer-related mortality worldwide, largely due to late-stage diagnosis, biological heterogeneity, and persistent challenges in staging and treatment selection. This narrative review summarizes current and emerging applications of AI across lung cancer screening and early detection, imaging-based staging and prognostication, tissue and liquid biopsy-based tumor characterization, treatment planning, surgical and intraoperative guidance, and drug discovery. In imaging, deep learning models have demonstrated high performance in pulmonary nodule detection, risk stratification, and prediction of molecular alterations, while also showing promise in improving screening efficiency and reducing interpretive variability. In pathology and liquid biopsy domains, AI enables prediction of driver mutations, immunotherapy response, and survival outcomes directly from histopathology slides, circulating tumor DNA, and other blood-based biomarkers, facilitating minimally invasive precision oncology approaches. In treatment planning and delivery, AI systems are being developed to support clinical decision-making, surgical planning (through advanced image segmentation and delineation of operative anatomy), and intraoperative navigation through robotic and computer vision-enabled platforms. Despite these advances, significant barriers remain, including limited real-world validation, algorithmic biases, workflow integration issues, and unresolved ethical and legal concerns. Future progress will depend on the development of transparent, clinically validated, and generalizable AI systems that augment rather than replace the expertise of clinical providers and healthcare teams. Active engagement from pulmonologists, oncologists, radiologists, and thoracic surgeons will be essential in guiding safe implementation and ensuring that AI-driven innovations translate into meaningful improvements in patient outcomes. Full article

The corneal endothelium is essential for maintaining corneal transparency through active fluid transport and barrier function. Corneal cell loss from disease, ageing or surgical trauma underlies a significant proportion of corneal blindness worldwide, with Fuchs’ endothelial corneal dystrophy (FECD) and pseudophakic bullous keratopathy (PBK) representing the dominant clinical indications for corneal transplantation. While Descemet’s membrane endothelial keratoplasty (DMEK) has substantially improved surgical outcomes, the procedure remains constrained by global donor tissue shortage. Regenerative medicine offers a compelling alternative by exploiting the latent proliferative and reparative potential of corneal endothelial progenitor populations. This review synthesises current knowledge on the foundational biology of corneal endothelial progenitor populations and the optimisation of expansion platforms to emerging preclinical and clinical evidence for both cell-based and pharmacological regenerative strategies. We also consider the outstanding translational challenges of potency standardisation, GMP-compliant manufacturing and regulatory navigation, as well as the longer-term potential of biomaterial-cell platforms and personalised iPSC-based medicine. The cumulative evidence positions progenitor-based approaches as viable and increasingly well-characterised alternatives to conventional donor transplantation, although their routine clinical use awaits the optimisation of manufacturing and regulatory platforms. Full article

Background: Precise implant placement is crucial during inferior alveolar nerve (IAN) bypass in the posterior mandible where bone height above the IAN is limited. This in vitro study compared the accuracy of static computer-assisted implant surgery (sCAIS) and dynamic computer-assisted implant surgery (dCAIS) for implant placement during IAN bypass. Methods: Two cone-beam computed tomography (CBCT) mandibular models with deficient bone height (<7 mm) above the IAN canal, classified as clinical scenario I and clinical scenario II, were used as an in vitro setting. Thirty models per clinical scenario were prepared, after which 60 dental implants were placed in the edentulous area of tooth no. 47. Software-based analysis compared planned and actual implant placements by postoperative CBCT. The two models were compared for deviation in distance to the inferior alveolar nerve (DIAN), entry-3D deviation, entry-2D deviation, apex-3D deviation, apex-vertical deviation, and angular deviation by comparative statistical analysis. Results: Both sCAIS and dCAIS showed less deviation from planned implant position in both scenarios. No statistically significant differences were detected except for angular deviation (sCAIS: 1.73° vs. dCAIS: 1.19°, p = 0.004), including clinical scenario I (sCAIS: 1.65° vs. dCAIS: 1.19°, p = 0.033) and II (sCAIS: 1.98° vs. dCAIS: 1.2°, p = 0.033). Conclusions: Both approaches showed minor deviation in both IAN bypass models, while dCAIS showed better angular control, requiring future in vitro and in vivo research in complex clinical environments. Full article

The adoption of neoadjuvant immune checkpoint inhibitor (ICI)-based chemoimmunotherapy has fundamentally transformed the operative landscape of resectable non-small cell lung cancer (NSCLC). Surgeons are now routinely confronted with ICI-altered tissue planes characterized by hilar fibrosis, vascular friability, and disrupted lymph node architecture. Simultaneously, robotic-assisted thoracic surgery (RATS) has consolidated its position as the dominant minimally invasive platform for pulmonary resection, accounting for the majority of lobectomies and segmentectomies performed at high-volume centers in 2023. Whether RATS confers specific technical advantages in this increasingly complex operative context remains incompletely characterized. We conducted a structured narrative review of published evidence, synthesizing data from randomized controlled trials, prospective cohorts, national registry analyses, and emerging technology reports addressing RATS in the setting of neoadjuvant ICI-based therapy for NSCLC. A systematic literature search was conducted across PubMed and EMBASE using predefined search terms. Available evidence, though largely retrospective and limited by small sample sizes, consistently demonstrates that RATS after neoadjuvant chemoimmunotherapy is technically feasible and oncologically sound, with R0 resection achievable in virtually all cases. The enhanced three-dimensional visualization, tremor filtration, and instrument degrees of freedom afforded by robotic platforms appear particularly advantageous in the setting of dense hilar adhesions and fragile pulmonary vasculature. Lymph node yield, a recognized robotic advantage, is preserved or enhanced despite post-ICI fibrosis. Pooled conversion rates to thoracotomy, derived from post hoc surgical analyses of ICI trial populations rather than trials designed to measure conversion, are higher than for upfront resection; available retrospective single-center data, including one direct RATS-versus-VATS comparison, suggest lower conversion rates with RATS in experienced hands, though this conclusion requires prospective validation. Emerging platform integrations, including combined robotic bronchoscopy and thoracoscopic surgery, single-port systems, and artificial intelligence-assisted anatomical navigation, are poised to further extend the reach of minimally invasive surgery in this challenging clinical scenario. In experienced centers, RATS appears to offer a technically favorable minimally invasive platform for pulmonary resection after neoadjuvant ICI-based therapy, with potential advantages over VATS in managing immunotherapy-altered anatomy; however, this conclusion is derived from retrospective series and should be interpreted cautiously pending prospective comparative data. Prospective multicenter trials with standardized surgical endpoints are urgently needed. Full article

Background: Robotic-assisted bronchoscopy enables precise navigation to peripheral pulmonary lesions and expands minimally invasive diagnostic options in thoracic surgery. At our institution, the ION™ Endoluminal System (Intuitive Surgical, Sunnyvale, CA, USA) was introduced to improve diagnostic accuracy in challenging peripheral targets. It is widely recognized that a defined number of procedures is required to achieve procedural proficiency and optimal clinical outcomes when adopting a novel platform. Therefore, this retrospective single-center study aimed to evaluate the learning curve associated with the implementation of this technology in a thoracic surgery center. Methods: In this retrospective study, all consecutive patients who underwent robotic-assisted bronchoscopies performed using the ION™ Endoluminal System (Intuitive Surgical, Sunnyvale, CA, USA) for the diagnosis of peripheral pulmonary lesions between August 2024 and March 2026 were analyzed. A total of 128 lesions in 89 patients were initially identified. Cases involving marker placement without diagnostic biopsy, as well as procedures not performed by the primary operator, were excluded. After applying exclusion criteria, 109 procedures in 76 patients were included. The mean patient age was 65.4 ± 9.1 years, and 44 patients were female (57.9%). To assess the learning curve, procedures were chronologically divided into three groups: early (cases 1–36), intermediate (37–73), and late (74–109). Outcome measures included procedure time, number of biopsies per lesion, tumor size, and diagnostic yield. Group comparisons were performed using non-parametric and chi-square tests. Procedural learning was assessed by cumulative sum (CUSUM) analysis of procedure time. Results: The overall diagnostic yield was 85.3% (93/109). The diagnostic yield increased over time from 73.0% in the early phase to 83.3% in the intermediate phase and 94.6% in the late phase. The overall comparison was statistically insignificant (χ² p = 0.117); however, there was a significant linear trend across phases, indicating progressive improvement with exposure to the application of this technology. Procedure time decreased significantly from a median of 49.0 min in the early phase to 31.0 min in the intermediate phase and 30.0 min in the late phase (p < 0.001). At the same time, the number of biopsies per lesion increased significantly (p < 0.001). Tumor size did not differ significantly between groups (p = 0.170). Conclusions: Robotic-assisted bronchoscopy demonstrates a clear learning curve, characterized by increasing diagnostic yield and significantly reduced procedure time during the implementation phase. The technique can be effectively integrated into the thoracic surgical diagnostic workflow and represents a valuable addition to minimally invasive diagnostics for peripheral pulmonary lesions. Full article

Robotic assistance in minimally invasive surgery has significantly improved precision and dexterity; however, many supportive tasks, such as blood aspiration, still rely on manual operation. This work presents the design and implementation of a supervised autonomous robotic aspirator for detecting and removing bleeding in an in vitro experimental model. The proposed system integrates a perception module based on a convolutional neural network for real-time blood segmentation, a task planner for high-level action execution, and a control strategy based on artificial potential fields for autonomous navigation. Additionally, a mixed-reality human–robot interaction interface is incorporated to enable system supervision and seamless transition to teleoperation when required. The system was experimentally validated with a set of in vitro experiments under three representative bleeding scenarios, evaluating four suction strategies based on the computation method for the target selection. Results demonstrate high blood removal rates (above 80% in all cases) and high suction efficiency. The comparative analysis reveals that the performance of the suction strategies is scenario-dependent and highlights a trade-off between suction efficiency and removed area. These findings support the feasibility of autonomous robotic aspiration and provide insights into the design of adaptive strategies for surgical assistance, contributing toward increased task autonomy and reduced need for continuous manual suction control during minimally invasive procedures. Full article

Background/Objectives: Older adults with cancer in the postoperative environment face complex vulnerability, exacerbated by the frailty of ageing and the aggressiveness of surgical treatment. In this highly demanding context, nurses play a crucial role as patient advocates. However, there is a knowledge gap regarding how advocacy is perceived and experienced by the nurse-patient dyad. This qualitative study aims to explain the practice of advocacy by comparing the perspectives of nurses and patients in order to construct part of a substantive theory on the subject. Methods: The Grounded Theory methodological approach was adopted. The sample included 6 specialist nurses and 10 older cancer patients from the ICU. Data collection consisted of participant observation and semi-structured interviews with both groups of participants. The analysis followed the constant comparison method, using MAXQDA software (version 24.10.0; VERBI Software; Berlin, Germany), allowing for the systematic and comparative identification of codes and categories from the two data sources. Results: The core process, defined as The Advocacy-Adjustment Dyad, reveals how older adult cancer patients navigate critical care through a symbiotic interplay of coping and support. Patients autonomously deploy Internal Adjustment mechanisms namely, Shielding the Emotional Self, to mitigate disease stress. Concurrently, the nurse operationalizes the Dynamic Expert Nurse Advocacy Cycle through a Therapeutic Alliance that prioritizes the patient’s best interest, integrates the Family as an anchor, and ensures a meaningful understanding of information. This dyadic interaction transforms the ICU from a purely technological setting into a therapeutic space, ensuring the Preservation of Personhood and the safeguarding of the patient’s self-determination. Conclusions: This study is pioneering in integrating the patient’s voice into the construction of a theory on advocacy in critical care, demonstrating that its effectiveness is a process of mutual interaction and not merely a unilateral function of the nurse. The findings emphasise the need to actively include the patient’s perspective in training and policy, offering valuable implications for optimizing older adult-centered care. Full article

Objective: To describe the surgical technique and early clinical outcomes of prone-transpsoas single-position corpectomy (PTP-corpectomy) for the management of complex thoracolumbar spinal pathology. Background: PTP-corpectomy is an emerging technique for providing simultaneous lateral and posterior spinal access without patient repositioning. The previous literature describes the PTP approach for interbody fusions; however, evaluation of its use for corpectomy is limited. This case series reports our experience with the PTP-corpectomy procedure at our institution. Methods: We retrospectively reviewed seven patients who underwent PTP-corpectomy surgery for complex spinal pathologies, including severe kyphoscoliosis, traumatic burst fractures, and revision in 2022–2025. Collected variables included demographics, comorbidities, surgical history, perioperative details, radiographic imaging, and clinical outcomes. Results: All seven patients successfully underwent PTP-corpectomy. The average operative time was 460.6 ± 147.1 min, and the estimated blood loss (EBL) was 892.9 ± 898.3 mL. Average length of stay (LOS) postoperatively was 6.7 ± 3.0 days. One case required revision of a preexisting construct and complex wound closure with plastic surgery, which had significantly increased operative time and blood loss (767 min, 2700 mL). Excluding this complicated case, the average time was 409 ± 63.7 min, and EBL was 591.7 ± 454.3 mL. All seven patients maintained clinical stability postoperatively, demonstrating improvements in pain and functional status at latest follow-up. Follow-up time ranged from 41 to 375 days. Conclusions: Our experience adds to the limited body of evidence that the PTP approach is well suited for corpectomy procedures, and that it is feasible, safe, and effective at improving clinical outcomes for complex spinal pathologies. This series adds to the limited case volume describing this technique in the current literature. Future studies with larger patient populations are warranted to further validate these findings. Full article

Background: Fractures of the upper cervical spine are challenging to treat due to their proximity to critical neurovascular structures and the need for immediate, stable fixation. Open posterior fixation remains the standard but is associated with soft-tissue disruption and morbidity. Minimally invasive, navigation-assisted pedicle screw fixation represents a viable alternative for older populations, significantly reducing surgical morbidity and tissue trauma. The present study evaluates the accuracy, safety, and perioperative outcomes of minimally invasive navigated posterolateral C1–C2 fixation. Methods: We conducted a retrospective consecutive case review of 51 patients who underwent minimally invasive C1–C2 screw fixation between 2019 and 2024. All procedures were performed using intraoperative O-arm imaging and StealthStation S8 navigation. Screw placement accuracy was assessed using the Bredow modification of the Gertzbein–Robbins and Heary classifications. Perioperative data, including operative time, screw dimensions, radiation dose, complications, and hospital stay, were recorded. Results: Fifty-one patients were included in the study. A total of 212 screws were placed. According to Gertzbein–Robbins grading, 92.4% were Grade A, 6.6% were Grade B, and 1% were Grade C. According to Heary grading, 95% were Grade I and 5% were Grade III. No vertebral artery injuries, new neurological deficits, or intraoperative hardware failures occurred. The mean screw lengths were 33.2 mm (SD = 3.38 mm) (C1) and 32 mm (SD = 4.30 mm) (C2). The mean operative time was 128 min (SD = 52.95 min). The mean radiation dose was 629.16 mGy·cm² (SD = 372.2 mGy·cm²). One superficial wound infection occurred. The median postoperative NRS was 4 (IQR: 4–5). The mean hospital stay was 4.21 (SD = 3.77) days. Conclusions: Our findings demonstrate that the presented approach for C1–C2 fixation is a highly accurate and safe alternative to open posterior fixation for upper cervical fractures. Full article

Minimally invasive spine surgery (MISS) has progressively transformed the management of spinal disorders by reducing soft-tissue disruption, perioperative morbidity, and recovery time while maintaining clinical outcomes comparable to conventional open techniques. Beyond its technical evolution, MISS has increasingly assumed a central role in the treatment of bone-related spinal conditions, including vertebral fractures, degenerative instability, metastatic disease, and osteoporosis-associated pathology. This narrative review provides a comprehensive overview of the evolution of MISS with a specific focus on its interaction with vertebral bone biology, implant stability, and fusion processes. A structured literature search of the PubMed/MEDLINE database was conducted, including English-language studies published between 1980 and June 2025 addressing MISS techniques, enabling technologies, and bone-related clinical outcomes. Current evidence suggests that MISS may preserve paraspinal vascularization and soft tissue integrity, potentially supporting bone healing and fusion, although high-quality comparative data remain limited. The effectiveness of MISS in osteoporotic and metastatic vertebral disease is closely linked to bone quality, implant anchorage, and biomechanical considerations, particularly in the context of pedicle screw fixation and interbody support. Emerging technologies—including navigation, robotics, and artificial intelligence—may enhance accuracy in implant placement and reduce bone-related complications, but robust evidence of long-term benefit is still lacking. Despite its advantages, MISS presents important limitations, including a steep learning curve, increased costs, and uncertain superiority in terms of fusion rates and long-term biomechanical stability. Future research should prioritize high-quality comparative studies focusing on bone healing, implant integration, and patient-specific factors such as bone density. MISS should therefore be interpreted not only as a surgical paradigm shift but as an evolving strategy for optimizing outcomes in bone-related spinal disorders. Full article

Background: Achieving adequate oncological margins in tumors involving the thoracic costovertebral junction is technically challenging because of complex regional anatomy and the need to preserve neurological and biomechanical integrity. This case report describes a robot-assisted margin-extension strategy after incomplete resection of a thoracic costovertebral chondrosarcoma. Methods: A 31-year-old man with grade 1 chondrosarcoma of the left sixth rib underwent second-stage surgical radicalization after prior incomplete resection with positive medial margins. Following multidisciplinary discussion, a single-stage posterior procedure was performed, including robot-assisted T4–T8 stabilization with radiolucent CFR-PEEK instrumentation and robot-assisted sagittal vertebral osteotomy (“Postage-Stamp Osteotomy”) of T6 to achieve en bloc removal of the involved costovertebral segment. Results: The osteotomy was executed using a pedicle-referenced robotic trajectory workflow with sequential navigated drilling and controlled completion with a navigated osteotome. Total operative time was 379 min, with estimated blood loss of 800 mL. No major intraoperative neurovascular complications occurred. Histopathology confirmed negative margins. The patient was mobilized on postoperative day 1 and discharged on postoperative day 6 without new neurological deficits. Radiological follow-up at 3 months showed no recurrence, while clinical follow-up at 5 months demonstrated full return to baseline activities. Conclusions: This report describes a technically feasible robot-assisted margin-extension strategy in a highly selected thoracic spinal oncology scenario. Although long-term oncological conclusions cannot be drawn from a single case, tailored technology-enabled margin-oriented approaches may represent a case-specific option in carefully selected patients. Full article

Lymph node-to-vein anastomosis (LNVA) is an emerging physiologic treatment for fluid-predominant lymphedema that combines the efficacy of lymphatic bypass with reduced technical complexity. Despite its advantages, LNVA is limited by challenges in identifying suitable lymph nodes and recipient veins. This study evaluated whether three-dimensional stereolithography (SLA) could improve surgical planning, intraoperative navigation, and efficiency in robotic LNVA. A retrospective comparative study was conducted of 29 patients who underwent robotic inguinal LNVA between November 2024 and September 2025. Thirteen procedures were performed using standard robotic LNVA (control group), and sixteen were performed with the addition of SLA-assisted planning and navigation (study group). Patient-specific SLA models were created from contrast-enhanced CT data, segmented into lymph nodes, veins, arteries, and bony landmarks, and printed at 1:1 scale for incision planning and real-time intraoperative reference. Outcome measures included operative time, time to identification of target structures (TITS), surgeon-perceived operative difficulty (SPOD), and early patient-reported outcomes. Mean operative time was similar between groups (171 vs. 161 min), but TITS was significantly shorter with SLA (36 vs. 27 min; p = 0.021). Double LNVA was achieved in 69% of SLA cases compared with 8% of controls, without prolonging operative duration. SPOD was significantly lower in the SLA group (p < 0.001). All anastomoses were patent intraoperatively, and all patients reported symptom relief at one month. Model fabrication required approximately eight hours and averaged $270 per case. Stereolithography enhances robotic LNVA by providing a tangible three-dimensional roadmap that improves intraoperative orientation, reduces identification time, and enables multiple anastomoses without added operative burden. With modest cost and rapid production, SLA makes LNVA more precise, reproducible, and scalable—facilitating wider adoption and serving as a foundation for future outcome-based research. Full article

Thin-slice high-resolution computed tomography (CT) has improved the detection of small pulmonary nodules, increasing the demand for minimally invasive diagnostic and therapeutic resection. While lobectomy with lymph node dissection remains the standard surgical approach for many patients with resectable non-small cell lung cancer, accumulating evidence supports sublobar resection for selected small, peripheral, and ground-glass-dominant lesions when sufficient margins are achievable. In thoracoscopic and robotic surgery, localization of nodules ≤10 mm or lesions located >5 mm from the pleural surface can be challenging, and failure to identify the target may lead to conversion, larger resection than intended, or prolonged operative time. Several localization strategies have been developed, including CT-guided percutaneous wire/coil/dye marking, bronchoscopic dye mapping, and virtual-assisted lung mapping (VAL-MAP), robotic-assisted bronchoscopic dye or fiducial localization, radiofrequency identification microtag systems (Surgical Real-Time FInger Navigation and Detection) that provide real-time depth information, and single-stage intraoperative CT-guided marking and resection in hybrid operating rooms. This review synthesizes representative evidence and published outcome ranges, and compares workflows, marker-to-lesion precision metrics, complication profiles, operational burden, and cost structures. We emphasize the practical contrast between two-stage and single-stage workflows, the access-route differences between transthoracic and transbronchial techniques, and the need to report localization-to-incision “time at risk”. We also present an expert-consensus decision algorithm aimed at facilitating tailored selection of localization strategies for modern minimally invasive thoracic surgery. Full article

Background and Purpose: The integration of flow diverter (FD) treatment into hybrid operating rooms (HORs) raises concerns regarding radiation safety, especially when transitioning from biplane systems to single-plane configurations. In this study, we evaluated the impact of distinct procedural-imaging configurations on patient radiation exposure during FD treatment for unruptured cerebral aneurysms. Methods: We retrospectively reviewed 93 patients (HOR: 22; biplane neuroangiography suite [NIS]: 71) treated between 2020 and 2024. Key metrics included fluoroscopy time (FT) and dose area product (DAP), subdivided into 2D fluoroscopy and 3D rotational angiography (3D-RA). Linear regression was used to identify independent predictors of radiation dose. Results: While the HOR significantly reduced fluoroscopy time (19.3 vs. 26.1 min, p = 0.002), it was associated with a higher total DAP compared to the NIS (299.1 vs. 96.3 Gy·cm², p < 0.001). This increase was primarily driven by a substantially higher radiation dose delivered per 3D-RA acquisition in the HOR environment rather than an increased frequency of 3D imaging. Multivariate analysis confirmed that the surgical imaging configuration was the dominant factor influencing total radiation exposure rather than aneurysm complexity or patient characteristics. Conclusions: Hybrid ORs provide procedural efficiency but involve a significant risk of increased radiation dose due to the reliance on 3D imaging for single-plane navigation. These findings serve as preliminary institutional benchmark data, underscoring the need for adaptive radiation management and configuration-specific protocols to optimize patient safety across diverse surgical imaging suites. Full article

Background: Cardiovascular disease remains the leading global cause of morbidity and mortality. Mental health disorders are common comorbidities that significantly influence how patients access and navigate specialist care. Increasingly, mental illness is recognized not merely as a comorbidity but as a potential driver of inequities in cardiovascular care, affecting diagnosis, referral, procedural management, and long-term secondary prevention. These concerns are particularly relevant in cardiac surgery, where care pathways are complex and resource-intensive. Aims and Objectives: This narrative review examines recent evidence on inequalities in access to cardiac surgery and postoperative outcomes among patients with mental health disorders. Particular emphasis is placed on severe mental illness, mood disorders, anxiety-related conditions, and mixed psychiatric cohorts. Materials and Methods: A structured narrative review approach was employed. PubMed and ScienceDirect were systematically searched for peer-reviewed studies published between 2020 and 2025, including cohort studies, registry analyses, systematic reviews, and meta-analyses. The evidence was synthesized thematically, focusing on access to care, perioperative management, clinical outcomes, underlying mechanisms, ethical considerations, policy implications, and future research directions. Results: Evidence suggests that patients with mental health disorders are more likely to undergo cardiac surgery via emergency pathways, experience longer hospital stays, and have higher rates of readmission. Individuals with severe mental illness are less likely to receive invasive coronary procedures compared to the general population and exhibit higher short- and long-term mortality following acute coronary syndromes. Among psychiatric subgroups, psychosis-spectrum disorders appear to be associated with the greatest excess risk of morbidity, mortality, and adverse long-term surgical outcomes. Conclusions: Patients with mental health disorders face inequities across the entire surgical pathway, including preoperative, perioperative, and postoperative phases. Key contributing factors include stigma, diagnostic overshadowing, fragmented healthcare systems, socioeconomic disadvantage, and insufficiently developed models of integrated care. Addressing these disparities requires redesigned referral pathways, strengthened multidisciplinary collaboration (including cardiology, cardiac surgery, psychiatry, and primary care), and a shift toward interventional research aimed at reducing inequities rather than solely documenting them. Full article