Search Results (1,632)

Background: The Fontan procedure is a palliative surgery for patients with single-ventricle congenital heart disease (CHD), but it is associated with postoperative and long-term mortality and morbidity. Accurate, individualized risk stratification remains a challenge with traditional models. This study aimed to develop and validate a deep learning (DL) model to predict postoperative mortality after the Fontan procedure and to identify key predictive factors. Methods: We retrospectively analysed data from 230 patients who underwent the Fontan procedure between 2010 and 2024. A Deep Neural Network (DNN) model was developed using comprehensive preoperative, intraoperative, and postoperative clinical, biochemical, and hemodynamic variables. The dataset was split using five-fold cross-validation, with 80% for training and 20% for testing in each fold. The Synthetic Minority Over-sampling Technique (SMOTE) was used to fix class imbalance. Model performance was evaluated using five-fold stratified cross-validation. We assessed accuracy, precision, recall, F1-score, and Area Under the Receiver Operating Characteristic Curve (AUC-ROC). SHapley Additive exPlanations (SHAP) analysis was employed to enhance model interpretability and identify the importance of features. A user-friendly clinical application interface was developed using Streamlit. This study was reported in accordance with the TRIPOD + AI reporting guidelines. Results: The DNN model demonstrated superior performance in predicting postoperative mortality, achieving an overall accuracy of 91.5% (95% CI: 87.2–94.8%), precision of 83.3% (95% CI: 76.5–89.1%), recall (sensitivity) of 90.9% (95% CI: 85.2–95.1%), specificity of 92.5% (95% CI: 88.3–95.7%), F1-score of 87.0% (95% CI: 82.1–91.3%), and an AUC-ROC of 0.94 (95% CI: 0.88–0.99). SHAP analysis identified key predictors of mortality, such as pulmonary artery pressure, ventricular end-diastolic pressure, preoperative BNP levels, and severity of AV valve regurgitation. The Streamlit application offered a user-friendly interface for personalized risk evaluation. Conclusions: A deep learning model that incorporates detailed clinical data can precisely forecast postoperative mortality in patients undergoing Fontan surgeries. This AI-based method, combined with interpretability techniques, provides a valuable tool for personalized risk assessment. It has the potential to improve preoperative counseling, optimize perioperative care, and enhance patient outcomes. However, additional external validation is needed to verify its broader applicability and clinical usefulness. Full article

Industrial processes governed by food safety regulations, such as high-temperature short-time (HTST) pasteurization, rely on continuous sensor monitoring to ensure compliance with standards like Hazard Analysis and Critical Control Points (HACCP). However, extracting actionable process insights from raw sensor data remains a non-trivial task, largely due to the continuous, multivariate, and often high-frequency characteristics of the signals, which can obscure clear activity boundaries and introduce significant variability in temporal patterns. This paper proposes a process mining framework to extract activity-based representations from multivariate sensor data in a pasteurization scenario. By modelling temperature, pH, conductivity, viscosity, turbidity, flow, and pressure signals, the approach segments continuous data into discrete operational phases and generates event logs aligned with domain semantics. Unsupervised learning techniques, including Hidden Markov Models (HMMs), are used to infer latent process stages, while domain knowledge guides their interpretation in accordance with critical control points (CCPs). The extracted models support conformance checking against HACCP-based procedures and enable predictive process-monitoring tasks such as next-activity prediction and remaining time estimation. Experimental results on synthetic (literature-grounded data) demonstrated the method’s ability to enhance safety, compliance, and operational efficiency. This study illustrates how integrating process mining with regulatory principles can bridge the gap between continuous sensor streams and structured process analysis in food manufacturing. Full article

Fuchs endothelial corneal dystrophy (FECD) is the leading cause of endothelial failure requiring keratoplasty in industrialised nations. Descemet membrane endothelial keratoplasty (DMEK) has become the gold-standard surgical therapy, yet it is constrained by limited donor tissue and a steep learning curve. This narrative review summarises current and emerging therapeutic strategies for FECD. We describe conventional endothelial keratoplasty and its outcomes, tissue-sparing procedures such as descemetorhexis without endothelial keratoplasty (DWEK) and quarter-DMEK, regenerative approaches including cultured endothelial cell injection and synthetic corneal substitutes, and adjunctive innovations ranging from Rho-associated kinase inhibitors to artificial intelligence-assisted diagnostics. Challenges surrounding donor shortages, variable clinical outcomes, regulatory hurdles and cost are critically appraised. We conclude by outlining future directions that are likely to combine advanced surgical techniques with cell-based and biomaterial solutions to deliver accessible, long-term restoration of vision for patients with FECD. Full article

Background: Bone defects resulting from trauma, infection, or benign tumors pose major challenges in orthopedic surgery. Traditional approaches, such as autologous bone grafting, are limited by donor site morbidity and graft availability. CERAMENT™, a synthetic bone substitute composed of calcium sulfate and hydroxyapatite, offers an alternative with osteoconductive properties, controlled resorption, and injectability. Methods: A scoping review was conducted in accordance with PRISMA-ScR guidelines. Literature searches were performed in PubMed, Embase, and Scopus through 3 July 2025, using the terms “CERAMENT™” and “Orthopedics.” Studies were selected based on the PICO framework, focusing on clinical applications of CERAMENT™ in human orthopedic procedures. Results: Out of 480 initial records, 22 studies met the inclusion criteria. CERAMENT™ demonstrated favorable outcomes in a range of orthopedic settings. In the CERTiFy trial, it was non-inferior to autologous grafting in tibial plateau fractures. CERAMENT™ achieved full wound healing and bone remodeling in chronic osteomyelitis. Additional studies reported positive outcomes in tumor-related defect reconstruction, spinal augmentation, and foot and ankle surgery, highlighting reduced surgical morbidity and faster recovery. Conclusions: CERAMENT™ offers a versatile, effective solution for bone reconstruction across multiple orthopedic domains. Its clinical performance, ease of use, and antimicrobial capabilities support its integration into routine orthopedic practice. Further research may refine its indications and long-term benefits. Full article

When carbon quantum dots (CDs) are used to enhance photosynthesis, they inevitably enter the plant. However, the dose-dependent effects of CDs on plant growth are poorly understood. In this study, we investigated the dose-dependent effects of CDs on soybean growth. CDs were synthesized from citric acid and urea via a hydrothermal procedure. The analysis of the structure, chemical composition, and optical properties revealed that synthetic CDs have a sphere-like shape with rich hydrophilic groups on their surface. CDs exhibited superior upconverted photoluminescence properties and emitted strong fluorescence (exciting wavelength of 220 nm; emitting wavelength of 438 nm). Various concentrations of synthetic CDs (0–1000 mg L⁻¹), as a photosynthesis enhancer, were applied to soybean plants under hydroculture for 1–10 days. CDs positively affected soybean growth at concentrations less than 200 mg L⁻¹. However, at higher concentrations (500 or 1000 mg L⁻¹), they exhibited significant toxicity to plant growth, which was evidenced by the mass accumulation of CDs in damaged leaves. Metabolomic and transcriptomic analyses indicated that CDs at a low concentration (100 mg L⁻¹) could increase antioxidant and biomass accumulation in soybeans to promote plant growth. This study provided valuable insights into the impacts of CDs on plants in sustainable agricultural practices involving the use of nanomaterials. Full article

Tungsten is a series of metals considered strategic by the European Union, so there is great interest in its recovery from both raw materials and secondary products. Within these raw materials, there are cassiterite deposits containing tungsten. It is from one of these deposits (located in the northwest of Spain) that after electrostatic separation, a scheelite concentrate (4.8% tungsten) has been obtained. This concentrate has been processed through two hydrometallurgical procedures. In one case, alkaline leaching in sodium carbonate medium is used to obtain sodium tungstate solutions, which in turn allows synthetic scheelite (calcium tungstate) or tungstic acid to be obtained. The second procedure, which uses acidic leaching (hydrochloric acid medium), yields tungstic acid as the final product. In all of the above cases, the experimental conditions to yield the best tungsten recovery rates are defined. The different products (sodium tungstate solutions and tungstic acid) afforded were used as precursors to yield synthetic scheelite and nanotungsten compounds as amorphous meta- and paratungstate salts and non-stoichiometric tungsten blue oxides. Full article

This article proposes a novel application of the Bayesian variable selection framework for driver telematics data. Unlike the traditional LASSO, the Bayesian variable selection framework allows us to incorporate the importance of certain features in advance in the variable selection procedure so that the traditional features more likely remain in the ratemaking models. The applicability of the proposed framework in the ratemaking practices is also validated via synthetic telematics data. Full article

6-Nitrodopamine is an endogenous catecholamine responsible for numerous biological activities. Here, an improved method for the synthesis of both 6-nitrohomovanillic acid (6-NHVA) and its regioisomer 5-nitrohomovanillic acid (5-NHVA) is reported. The developed one-step synthetic procedures ensured the efficient preparation of the target compounds in good yields. Comprehensive structural characterization was achieved through one- and two-dimensional NMR studies and by high-resolution mass spectrometry (HR-MS/MS). The presence of both substances was identified in human amniotic fluid by LC-MS/MS. Full article

Cardiovascular diseases (CVDs) are increasingly being defined not only in terms of metabolic or purely vascular disorders, but also as complex immunometabolic disorders. One of the most groundbreaking discoveries in recent years is the role of neutrophil extracellular networks (NETs/NENs) as a key link between chronic vascular wall inflammation and thrombotic processes. In this article, we present a synthetic overview of the latest data on the biology of NETs/NENs and their impact on the development of atherosclerosis, endothelial dysfunction, and the mechanisms of immunothrombosis. We highlight how these structures contribute to the weakening of atherosclerotic plaque stability, impaired endothelial barrier integrity, platelet activation, and the initiation of the coagulation cascade. We also discuss the modulating role of classic risk factors such as hypertension, dyslipidemia, and exposure to tobacco smoke, which may increase the formation or hinder the elimination of NETs/NENs. We also focus on the practical application of this knowledge: we present biomarkers associated with the presence of NETs/NENs (cfDNA, MPO–DNA complexes, CitH3, NE), which may be useful in diagnostics and risk stratification, and we discuss innovative therapeutic strategies. In addition to classic methods for indirectly inhibiting NET/NEN formation (antiplatelet, anti-inflammatory, and immunometabolic agents), we present experimental approaches aimed at their neutralization and removal (e.g., DNase I, elastase, and myeloperoxidase inhibitors). We pay particular attention to the context of cardiac and cardiac surgical procedures (Percutaneous Coronary Intervention-PCI, coronary artery bypass grafting-CABG), where rapid NET/NEN bursts can increase the risk of acute thrombotic complications. The overall evidence indicates that NETs/NENs represent an innovative and promising research and therapeutic target, allowing us to view cardiovascular diseases in a new light—as a dynamic interaction of inflammatory, atherosclerotic, and thrombotic processes. This opens up new possibilities in diagnostics, combination treatment and personalisation of therapy, although further research and standardization of detection methods remain necessary. Full article

The use of machine learning methods for the development of robust and flexible visual inspection systems has shown promising results. However, their performance is highly dependent on the large amount and diversity of training data, which is difficult to obtain in practice. Recent developments in synthetic dataset generation have seen increasing success in overcoming these problems. However, the prevailing work revolves around the usage of generative models, which suffer from data shortages, hallucinations, and provide limited support for unobserved edge-cases. In this work, we present the first synthetic data generation pipeline that is capable of generating large datasets of physically realistic textures exhibiting sophisticated structured patterns. Our framework is based on procedural texture modelling with interpretable parameters, uniquely allowing us to guarantee precise control over the texture parameters as we generate a high variety of observed and unobserved texture instances. We publish the dual dataset used in this paper, presenting models of sandblasting, parallel, and spiral milling textures, which are commonly present on manufactured metal products. To evaluate the dataset quality, we go beyond final model performance comparison by measuring different image similarities between the real and synthetic domains. This uncovered a trend, indicating these metrics could be used to predict downstream detection performance, which can strongly impact future developments of synthetic data. Full article

Background: Corneal endothelial dysfunction continues to be a primary indication for corneal transplantation globally. Due to ongoing constraints in donor tissue availability and graft durability, artificial graft technologies are increasingly recognized as viable alternatives, particularly for eyes unsuitable for conventional allogeneic transplantation. Aim: This article examines the contemporary state of artificial corneal endothelial grafts, emphasizing technological advancements, incorporation into surgical procedures, and their developing function in meeting the unfulfilled requirements of endothelial keratoplasty. Methods: A comprehensive synthesis of recent preclinical and clinical literature was performed, concentrating on scaffold-based constructs, cell-seeded and acellular methodologies, biomaterial characteristics, and innovative surgical delivery techniques. The review highlights translational pathways and contrasts the initial outcomes of artificial and donor-derived endothelial grafts. Results: Advancements in regenerative biomaterials and cell culture systems have resulted in the development of functional endothelial substitutes. Engineered grafts, comprising decellularized stromal carriers, synthetic polymer matrices, and human cell-laden constructs, have demonstrated promising biocompatibility and functional results in preliminary trials. The integration of these constructs into methods akin to Descemet membrane endothelial keratoplasty (DMEK) has improved clinical viability, diminished immunologic risk, and shown potential for visual recovery. Conclusions: Artificial endothelial grafts signify a revolutionary advancement in corneal surgery, addressing donor shortages and expanding the applications of endothelial keratoplasty. Although additional clinical validation and regulatory processes are required, existing evidence indicates that these technologies may soon transform treatment protocols for corneal endothelial disease. Full article

A major challenge for robots that provide physical assistance is adapting to the needs of different people. To overcome this, personalised assistive models can be created by observing the demonstrations of help provided by an assistant, a setting known as Learning Assistance by Demonstration (LAD). In this work, the case of robotic wheelchairs and drivers with hand control disabilities, which make navigation more challenging, was considered. To better understand LAD and its features, a simulator capable of generating repeatable examples of the triadic interactions between drivers, robots, and assistants was developed. The software is designed to be modular and parametrisable, enabling customisation and experimentation with various synthetic disabilities and scenarios. This approach was employed to design more effective data collection procedures and to enhance learning models. With these, it is shown that, at least in simulation, LAD can be used as follows: for different disabilities; to help consistently; to generalise to physically different environments; and to create customised assistive policies. In summary, the results provide further evidence that LAD is a viable approach for efficiently creating personalised assistive solutions for robotic wheelchairs. Full article

Background/Objectives: Covalent conjugation of an antibiotic vancomycin (VCM) moiety and a photosensitizing mesochlorin (mChl_Pd) unit into one molecular entity may present the potential to produce the combinatorial effect of both antibacterial photodynamic therapeutic (aPDT) and antibiotic activities. Our recent study indicated that a short linkage of <4 (C−C/or C−N) bond distances between these two moieties resulted in significant steric hindrance due to the bulky VCM, which greatly reduces the accessibility of the agent to the cell surface of methicillin-resistant Staphylococcus aureus (MRSA). The observed aPDT efficacy was found to be minimal. Here, we report that the revision of this linkage, via an EG₁₀ unit using identical synthetic procedures, was able to resolve the issue. Methods: Accordingly, the corresponding combinatorial aPDT−antibiotic compound, consisting of two covalently bonded quaternary ammonium pentacationic arms on the mesochlorin chromophore core, designated as VCMe-mChl_Pd-N₁₀⁺ (LC40e⁺), was prepared for applications in antibacterial photodynamic inactivation (aPDI) activity. It was selected to investigate its enhanced binding and targeting ability to the surface of Gram-positive MRSA cells. Subsequent antibacterial photodynamic therapeutic (aPDT) activity to inactivate MRSA was investigated to substantiate the corresponding cell-surface binding effect on the efficacy of aPDT. Results: We found that the covalent combination of 10 positive charges and an MRSA-targeting vancomycin (VCM) moiety in a conjugated structure, functioning as an antibiotic–decacationic photosensitizing agent (Abx-dcPS), was capable of largely improving the MRSA cell-targeting efficiency. Importantly, variation in the chain length of the oligo(ethylene glycol) linker of VCMe-mChl_Pd-N₁₀⁺, which was sufficiently long enough to properly separate the photoactive mesochlorin ring moiety from the VCM moiety within the molecular structure, resulted in significantly enhanced aPDT activity. The new conjugate provided nearly complete eradication (>6.5-log₁₀ colony-forming units (CFU) reduction) of MRSA cells in vitro. The aPDT efficacy followed the order Abx-dcPS (combinatorial decacationic) > dcPS (decacationic) >> nPS (nonionic). This order was also verified by the relative physical binding trend of these PSs using either nPS-, dcPS-, or Abx-dcPS-pretreated and pre-fixed MRSA cells in investigations of fluorescent confocal microscopy, UV–vis fluorescence spectroscopy, and transmission electron microscopy (TEM). Conclusions: Furthermore, the molecular conjugate of Abx-dcPS may provide covalent co-delivery of two drug components concurrently, which might also serve as an effective antibiotic agent after aPDT and potentially prevent the reoccurrence of MRSA-induced infection. Full article

The area encompassing the Campi Flegrei and Vesuvio volcanoes, situated approximately 25 km apart and bisected by the city of Naples, Italy, is recognised as one of the most hazardous regions globally. In recent decades, the Campi Flegrei caldera has undergone significant changes in its monitored geophysical, geochemical and geodetical signals. The most recent, ongoing unrest began in 2005, resulting in an uplift of over 150 centimetres in the area of maximum uplift. Previous analyses of deformation data from ERS/ENVISAT (available up to 2010) and Sentinel-1 (available since 2015) Synthetic Aperture Radar (SAR) imagery, as well as global navigation satellite system data, have suggested that the shape of the deformation field at Campi Flegrei has remained constant and that the area around Vesuvio experienced a slight subsidence in the early 2000s, concurrently with a change in the sign of the ground deformation (from subsidence to uplift) at Campi Flegrei. This study presents and provides the ground displacement time series obtained from RADARSAT-2 images of the entire volcanic area from 2010 to 2015, thus filling the temporal gap between the ERS/ENVISAT and Sentinel-1 missions. The time series were generated using a bespoke procedure, based on the Sentinel Application Platform and the GMTSAR software. The validity of the displacement time series has been confirmed through comparison with continuous Global Positioning System data from the Neapolitan Volcanoes Continuous GPS network. Analysis of RADARSAT-2 ground displacements indicates that velocities in the vicinity of Vesuvio were no greater than a few millimetres per year, and no discernible deformation pattern is evident. Consequently, given the uncertainty in Differential Interferometry Synthetic Aperture Radar (DInSAR) measurements, there is no evidence to suggest deformation activity close to Vesuvio between 2010 and 2015. In contrast to Vesuvio, significant deformation is evident in the Campi Flegrei area. The shape of the ground displacement field remained constant between 2010 and 2015, within the uncertainty of DInSAR measurements. The mean upward velocity reaches a maximum of approximately 5 cm y⁻¹, while the mean eastward velocity reaches 2.4 cm y⁻¹. Full article

The Signal Amplification By Reversible Exchange (SABRE) technique provides enhancement of Nuclear Magnetic Resonance (NMR) signals up to several orders of magnitude using chemical exchange of a substrate and parahydrogen on an iridium complex. Therefore, the availability of such a catalytic complex to a broader community is an absolutely vital step for dissemination of the groundbreaking SABRE methodology. The most common SABRE catalyst, which is activated in situ, is based on Ir-IMes system (IMes = 1,3-Bis(2,4,6-trimethylphenyl)imidazol-2-ylidene). Earlier approaches for the synthesis of this catalyst often relied on specialized equipment and were limited to a comparatively small scale. This, in turn, increased the barrier of entry for new scientists to the area of SABRE hyperpolarization. Here, we present a robust, inexpensive, and easy to reproduce synthetic procedure for the preparation of this SABRE catalyst, which does not require specialized inert atmosphere equipment like a glove box or Schlenk line. The synthesis was validated on the scale of several grams vs. tens of milligrams scale in the reported approaches. The resulting SABRE catalyst, [Ir(IMes)(COD)Cl], was activated in situ and further evaluated in hyperpolarization experiments resulting in signal enhancements comparable to (or higher than) those for the catalyst prepared using Schlenk line equipment. Full article