Search Results (1,014)

AUVs offer the potential for in situ MP detection at constant, pre-set depths in marine environments. By carrying onboard MP detectors, AUVs can serve as alternatives to traditional methods of sample collection, processing, and analysis, while also addressing the inefficiencies and complexities associated with conventional detection procedures. This study conducts a comprehensive review of existing and potential MP detection methods that can be integrated with AUVs for in situ detection. In particular, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, this review analyzes selected studies on MP detection using AUVs. It finds that real-time, in situ MP detection via AUVs or multi-AUV systems remains underdeveloped. Key challenges include deep-sea communication, sensor integration, and underwater durability. The review highlights the current advances, research gaps, and future directions for AUV-based MP detection technologies. Full article

This review synthesizes research on smart insole prototypes and their designs, focusing on those incorporating artificial intelligence (AI) and a wireless communication/transmission system. The main objective of this work is to summarize existing studies, identify key trends, evaluate the performance of these innovative biomechanical tools, and recognize the factors that could lead to optimization. This comprehensive analysis includes studies from PubMed, Scopus, and Web of Science databases and other investigations on the critical themes to consider. It follows strict inclusion and exclusion criteria, ensuring the quality and accuracy of the overview. The findings emphasize significant progress in smart insoles, particularly in AI-enhanced prototypes, while addressing existing challenges and problems. This review helps guide potential future research and define practical application directions. The growing importance of biomechanics, especially on smart insoles, underscores the considerable potential of these innovations to monitor and improve human movement in both clinical and non-clinical settings, promising a future of more effective and personalized health and performance interventions. This protocol was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on 6 February 2025 and was last updated on 6 February 2025. Full article

The integration of artificial intelligence (AI) in medical imaging has revolutionized diagnostic capabilities, yet the black-box nature of deep learning models poses significant challenges for clinical adoption. Current explainable AI (XAI) approaches, including SHAP, LIME, and Grad-CAM, predominantly focus on post hoc explanations that may inadvertently undermine clinical decision-making by providing misleading confidence in AI outputs. This paper presents a systematic review and meta-analysis of 67 studies (covering 23 radiology, 19 pathology, and 25 ophthalmology applications) evaluating XAI fidelity, stability, and performance trade-offs across medical imaging modalities. Our meta-analysis of 847 initially identified studies reveals that LIME achieves superior fidelity (0.81, 95% CI: 0.78–0.84) compared to SHAP (0.38, 95% CI: 0.35–0.41) and Grad-CAM (0.54, 95% CI: 0.51–0.57) across all modalities. Post hoc explanations demonstrated poor stability under noise perturbation, with SHAP showing 53% degradation in ophthalmology applications (ρ = 0.42 at 10% noise) compared to 11% in radiology (ρ = 0.89). We demonstrate a consistent 5–7% AUC performance penalty for interpretable models but identify modality-specific stability patterns suggesting that tailored XAI approaches are necessary. Based on these empirical findings, we propose a comprehensive three-pillar accountability framework that prioritizes transparency in model development, interpretability in architecture design, and a cautious deployment of post hoc explanations with explicit uncertainty quantification. This approach offers a pathway toward genuinely accountable AI systems that enhance rather than compromise clinical decision-making quality and patient safety. Full article

The World Health Organization (WHO) declared snakebite envenoming (SBE) as a neglected tropical disease in 2017. Antivenom is the gold standard of treatment, but many healthcare barriers exist, and hence, affected populations are often unable to access it. The challenge is further perpetuated by the lack of attention from national health authorities, poor regulatory systems and policies, and mismanagement of antivenom. This study aims to map the evidence regarding snake antivenom regulations globally and identify gaps in the literature to inform future research and policy. This review was conducted using the original Arksey and O’Malley framework by three independent reviewers, and the results were reported using the Preferred Reporting Items for Systematic reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). A search strategy was developed with assistance from a librarian, and six databases were searched: PubMed, SCOPUS, ProQuest Central, Africa Wide Web, Academic Search Output, and Web of Science. Screening was conducted independently by the reviewers, using Rayyan, and conflicts were resolved with discussions. A total of 84 articles were included for data extraction. The major themes that emerged from the included studies were regarding antivenom availability, accessibility, manufacturing, and regulations. The study revealed massive gaps in terms of policies governing antivenom management, especially in Asia and Africa. The literature does not offer sufficient evidence on management guidelines for antivenom in the endemic regions, despite identifying the challenges in supply. However, significant information from Latin America revealed self-sufficient production, involvement of national health bodies in establishing efficient regulations, effective distribution nationally and regionally, and technology sharing to reduce SBE-related mortality. Full article

With the accelerated commercialization of autonomous vehicles, new accident types and complex risk factors have emerged beyond the scope of existing traffic safety management systems. This study aims to contribute to sustainable safety by establishing a quantitative basis for early recognition and response to high-risk situations in urban traffic environments where autonomous and conventional vehicles coexist. To this end, high-risk factors were identified through a combination of literature meta-analysis, accident history and image analysis, autonomous driving video review, and expert seminars. For analytical structuring, the six-layer scenario framework from the PEGASUS project was redefined. Using the analytic hierarchy process (AHP), 28 high-risk factors were identified. A risk prediction model framework was then developed, incorporating observational indicators derived from expert rankings. These indicators were structured as input variables for both road segments and autonomous vehicles, enabling spatial risk assessment through agent-based strategies. This space–object integration-based prediction model supports the early detection of high-risk situations, the designation of high-enforcement zones, and the development of preventive safety systems, infrastructure improvements, and policy measures. Ultimately, the findings offer a pathway toward achieving sustainable safety in mixed traffic environments during the initial deployment phase of autonomous vehicles. Full article

Background: Dehydration is a prevalent and potentially serious condition, particularly affecting vulnerable populations such as children and older adults. Prompt recognition and intervention are critical for preventing associated complications. Methods: A systematic review and meta-analysis were conducted, registered in PROSPERO (CRD42024594780), to identify key clinical and demographic risk factors associated with dehydration. A comprehensive search of PubMed, Scopus, and the Cochrane Library was performed for studies published between 2000 and 2024. The risk of bias in included studies was assessed using the Newcastle–Ottawa Scale and the Cochrane Risk-of-Bias (RoB) tool. Ten studies met the inclusion criteria for quantitative synthesis. Based on pooled diagnostic metrics, a preliminary scoring tool was developed for dehydration risk stratification. Results: The pooled sensitivity and specificity of common clinical signs, such as thirst, dry mouth, and dark urine, were 85% (95% CI: 80–90%) and 70% (95% CI: 65–75%), respectively. The positive predictive value (PPV) was 75%, and the negative predictive value (NPV) was 80%. Pediatric subgroup analysis yielded the most robust data, while data for adult and elderly populations were limited. A conceptual risk scoring system was proposed based on relative diagnostic utility, though it has not yet been externally validated. Conclusions: Simple clinical signs demonstrate reasonable diagnostic accuracy for identifying individuals at risk of dehydration. The proposed scoring system offers a promising, evidence-informed framework for early risk assessment but requires further validation in prospective studies before integration into clinical practice. Full article

This article systematically reviews biopolymer phase change materials (PCMs) for TES applications. The review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using databases from Scopus, Web of Science, and Google Scholar. The biopolymer PCMs are categorized as natural, synthetic, and hybrid (a combination of natural and synthetic). A total of 82 articles were included in the analysis. Several thermal properties, mechanical properties, advancements, and challenges are discussed. This article aims to review biopolymer PCMs and identify research gaps for future development. Natural biopolymer PCMs include lipid, lignin, polysaccharides, proteins, etc. Synthetic biopolymer PCMs include supramolecular, polyethylene glycol, polyurethane, polyrotaxane, polylactic acid, etc. Hybrid biopolymer PCMs combine natural and synthetic polymers with conductive fillers, balancing high latent heat with improved thermal stability and durability, although issues, like leakage and low conductivity, persist. It is found that biopolymers can be used as the core and supporting matrix of PCMs. Several cases and configurations of core, supporting matrix, and fillers in the development of PCM from biopolymers are discussed. This article also demonstrates that several natural, synthetic, and hybrid biopolymer PCMs hold promise for demanding TES applications due to their tunable properties and reliability. Biopolymer PCMs offer a sustainable alternative to petroleum-derived substances by minimizing environmental harm, cutting carbon emissions, and promoting a circular economy. This review also highlights several challenges, such as feedstock selection, purification and encapsulation, system compatibility, and standardization, that future research might address to enable scalable, safe, and cost-effective biopolymer PCM solutions. Full article

Background: Patients with end-stage renal disease (ESRD) are at elevated risk for device-related complications following pacemaker implantation. Leadless pacemakers (LPMs) offer theoretical advantages over transvenous pacemakers (TVPs), but their safety and efficacy in this high-risk population remain unclear. Our aim was to compare clinical outcomes and complication profiles between leadless and transvenous pacemakers in patients with ESRD. Methods: We conducted a systematic review and meta-analysis according to PRISMA guidelines, including three retrospective studies comparing LPMs and TVPs in ESRD patients. The primary endpoint was overall complications post-implantation. Secondary outcomes included early mortality (within 30 days), access site complications, device-related events, thrombotic events, and respiratory complications. A random-effects model was used to pool odds ratios (ORs) and 95% confidence intervals (CIs). Results: Three studies comprising 10.075 ESRD patients were included. No significant difference was found in overall complications (OR 1.35, 95% CI 0.78–2.33, p = 0.14) or early mortality (OR 1.01, 95% CI 0.42–2.43, p = 0.97) between LPM and TVP groups. However, LPMs were associated with increased access site complications (OR 2.51, 95% CI 1.06–5.90, p = 0.04), thrombotic events (OR 1.42, 95% CI 1.14–1.78, p = 0.03), and respiratory complications (OR 1.43, 95% CI 1.01–2.03, p = 0.05). Device-related complication rates were similar (OR, 1.09; 95% CI, 0.63–1.88; p = 0.30). Heterogeneity was low across most outcomes. Conclusions: Among patients with ESRD, leadless pacemakers did not reduce overall complications or short-term mortality compared to transvenous systems and were associated with increased risk of certain procedural complications. These findings could support a personalized approach to device selection in ESRD and highlight the need for further prospective studies to guide clinical decision-making in this population. Full article

The treatment of shoulder dysplasia resulting from brachial plexus birth injury (BPBI) remains a matter of debate within pediatric orthopedic and neurosurgical communities. Various approaches have been proposed to address the muscular imbalance and joint incongruity that develop in affected children, with special attention paid to the roles of humeral head reduction and tendon transfers. Background/Objectives: These procedures aim to correct the disproportionate strength between internal and external rotators of the shoulder. However, the specific contribution of skeletal procedures such as glenoid osteotomy to restoring shoulder mechanics remains controversial. Glenoid osteotomy, a technique that involves surgically reorienting the glenoid cavity, is hypothesized to promote better containment of the humeral head and allow more physiological joint development. On one hand, altering the glenoid axis could enhance joint congruency and facilitate remodeling during growth. On the other hand, there is limited evidence supporting its efficacy and safety. Methods: This review aims to assess the available literature to determine whether glenoid osteotomy represents a safe and effective procedure for patients with BPBI-associated shoulder dysplasia. A comprehensive literature search yielded 1380 titles. After excluding studies focused on adults and those failing to meet inclusion criteria, only three studies were selected for final analysis. Due to the limited data and variability in study design, no statistical meta-analysis could be performed. Results: Findings suggest that glenoid osteotomy, particularly when combined with tendon transfers, may lead to improvements in shoulder abduction and external rotation. However, outcomes are often difficult to interpret in isolation, and the specific benefits attributable to the osteotomy remain unclear. The lack of standardized imaging, follow-up, and scoring systems limits the strength of current conclusions. Conclusions: Further multicenter, prospective studies are needed to evaluate the long-term efficacy of glenoid osteotomy, its role in skeletal remodeling, and its contribution to overall shoulder stability and function. Such studies would help clarify the true potential of this surgical technique in the broader context of BPBI treatment. Full article

Background: The renin–angiotensin system (RAS) is pivotal in regulating cardiovascular function, while cardio-genomics offers insights into genetic factors influencing cardiovascular disease (CVD) susceptibility. Aim: This study investigates the relationship between the angiotensin-converting enzyme insertion/deletion variant (ACE I/D) and the angiotensinogen gene M235T variant (AGT M235T) in Mediterranean, North African, and Middle Eastern populations. Methods: A systematic review and meta-analysis, encompassing studies until December 2023, were conducted utilizing the PubMed and Scopus databases. The study followed the PICO checklist to enroll in the review process. The meta-analysis results were obtained using CMA software V2. Results: An analysis of 12 studies (2984 participants) for ACE I/D and 7 studies (2275 participants) for AGT M235T revealed significant associations between these gene variants and increased CVD risk in Mediterranean and North African populations. Conclusions: These findings underscore the utility of cardio-genomics in delineating CVD susceptibility among these groups, emphasizing targeted interventions and personalized treatment strategies Full article

This study examines the diversity of terminologies associated with assistive technology (AT), a crucial field that promotes autonomy and inclusion for people with disabilities. Although the wide use of assistive technology is observed in the literature, a variety of terms are often used interchangeably, which hinders research, technological development, and the formulation of public policies. In this sense, this systematic review aimed to identify, categorise, and analyse the diversity of terms used to describe AT in the scientific literature, contributing to greater conceptual clarity and supporting structured and interdisciplinary development in the field. A comprehensive search was conducted in July 2024 across the Scopus, Web of Science, and PubMed databases, covering publications from 1989 to 2024. Eligible studies were peer-reviewed journal articles in English that conceptually defined at least one AT-related term. The selection process followed the PRISMA 2020 guidelines and included studies from Q1 and Q2 journals to ensure academic rigour. A total of 117 studies were included out of 11,941 initial records. Sixteen distinct terms were identified and grouped into five clusters based on semantic and functional similarities: Cluster 1—Technologies for assistance and inclusion. Cluster 2—Functional assistive devices. Cluster 3—Assistive interaction interfaces. Cluster 4—Assistive environmental technologies. Cluster 5—Assistive systems. A complementary meta-analysis revealed geographic and temporal trends, indicating that terms such as “assistive technology” and “assistive device” are globally dominant. In contrast, others, like “enabling technology,” are more context-specific and emerging. The findings contribute theoretically by providing a structured framework for understanding AT terminology and practically by supporting the design of public policy and interdisciplinary communication. Full article

The regulation of calcium (Ca²⁺) homeostasis is a critical process in both plant and animal systems, involving complex interplay between various organelles and a diverse network of channels, pumps, and transporters. This review provides a concise overview of inter-organellar Ca²⁺ homeostasis, highlighting key regulators and mechanisms in plant and animal cells. We discuss the roles of key Ca²⁺ channels and transporters, including IP₃Rs, RyRs, TPCs, MCUs, TRPMLs, and P2XRs in animals, as well as their plant counterparts. Here, we explore recent innovations in structural biology and advanced microscopic techniques that have enhanced our understanding of these proteins’ structure, functions, and regulations. We examine the importance of membrane contact sites in facilitating Ca²⁺ transfer between organelles and the specific expression patterns of Ca²⁺ channels and transporters. Furthermore, we address the physiological implications of inter-organellar Ca²⁺ homeostasis and its relevance in various pathological conditions. For extended comparability, a brief excursus into bacterial intracellular Ca²⁺ homeostasis is also made. This meta-analysis aims to bridge the gap between plant and animal Ca²⁺ signaling research, identifying common themes and unique adaptations in these diverse biological systems. Full article

Acromegaly is caused by an excessive secretion of growth hormone and the secondary elevation of IGF-1 levels, leading to progressive changes in multiple body systems, including the craniofacial region and oral cavity. Dental manifestations such as mandibular overgrowth, macroglossia, malocclusion, periodontal disease, and prosthetic difficulties represent not only a clinical component of the disease but also a significant therapeutic and diagnostic challenge. The aim of this review is to present the current state of knowledge on the relationship between acromegaly and oral health and to analyze the role of interdisciplinary collaboration between endocrinologists and dentists in patient care. For this narrative review, a literature search was conducted in the PubMed, Scopus, and Web of Science databases covering the period from 2000 to 2025. Sixty-two peer-reviewed publications meeting the methodological and thematic criteria were included in the analysis, including original studies, meta-analyses, systematic reviews, and case reports. The results indicate significant correlations between disease activity and the severity of periodontal and microbiological changes, while effective endocrine treatment only results in the partial regression of morphological changes. Particular attention was given to the role of the dentist in recognizing the early symptoms of the disease, planning prosthetic and surgical treatment, and monitoring therapy-related complications. Interdisciplinary collaboration models, including integrated clinics and co-managed care, were also described as optimal systemic solutions for improving treatment quality. The conclusion drawn from the analysis are as follows: there is a need for the permanent integration of dentistry into the standard of interdisciplinary care for patients with acromegaly, in both diagnostic and therapeutic dimensions. Increasing awareness among dentists and developing integrated collaboration models may reduce the time to diagnosis, improve patients’ quality of life, and enable the more effective management of craniofacial complications in the course of this rare disease. Full article

As the generation of Municipal Solid Waste (MSW) has exponentially increased, this poses a challenge for waste managers, such as municipalities, to effectively control waste streams. If waste streams are not managed correctly, they negatively contribute to climate change, marine plastic pollution and human health effects. Therefore, waste streams need to be identified, categorised and valorised to ensure that the most effective waste management strategy is employed. Research suggests that a more efficient process of identifying and categorising waste at the source can achieve this. Therefore, the aim of the paper is to identify the state of research of AI-powered drones in identifying and categorising waste. This paper will conduct a systematic review and meta-analysis on the application of drone technology integrated with image sensing technology and deep learning methods for waste management. Different systems are explored, and a quantitative meta-analysis of their performance metrics (such as the F1 score) is conducted to determine the best integration of technology. Therefore, the research proposes designing and developing a hybrid deep learning model with integrated architecture (YOLO-Transformer model) that can capture Multispectral imagery data from drones for waste stream identification, categorisation and potential valorisation for waste managers in small-scale environments. Full article

Urban population growth is intensifying pressure on mobility systems, with road transportation contributing to environmental and sustainability challenges. Policymakers must navigate complex uncertainties in addressing rising mobility demand while pursuing sustainability goals. Advanced technologies offer promise, but their real-world effectiveness in urban contexts remains underexplored. This meta-review comprised three complementary studies: a broad analysis of sustainable mobility with Norwegian case studies, and systematic literature reviews on digital twins and Big Data/AI applications in urban mobility, covering the period of 2019–2024. Using structured criteria, we synthesised findings from 72 relevant articles to identify major trends, limitations, and opportunities. The findings show that mobility policies often prioritise technocentric solutions that unintentionally hinder sustainability goals. Digital twins show potential for traffic simulation, urban planning, and public engagement, while machine learning techniques support traffic forecasting and multimodal integration. However, persistent challenges include data interoperability, model validation, and insufficient stakeholder engagement. We identify a hierarchy of mobility modes where public transit and active mobility outperform private vehicles in sustainability and user satisfaction. Integrating electrification and automation and sharing models with data-informed governance can enhance urban liveability. We propose actionable pathways leveraging Big Data and AI, outlining the roles of various stakeholders in advancing sustainable urban mobility futures. Full article