Search Results (6,110)

Background: Silicone chin implants have been widely used is plastic and esthetic surgery of the face being considered as safe and efficient way for chin augmentation. However, complications such as bone resorption, displacement or ectopic bone formation may occur. Methods: The objective of this study was to evaluate complications associated with silicone chin implants and revision surgery protocols. Results: Among 98 patients who received silicone chin implants, 24 (11 males, 13 females) exhibited complications. The most commonly diagnosed issues were displacement (n = 3), bone resorption (n = 9), both conditions (n = 3), and patient dissatisfaction (n = 7). All patients were qualified for revision surgery, which included silicone implant removal followed by sliding genioplasty (n = 7), orthognathic surgery (n = 4), custom-made chin implant placement (n = 7), and repositioning and fixation (n = 1). After revision surgery, no complications occurred. Conclusions: Observations from this revision cohort suggest that careful patient selection and consideration of orthognathic or customized implant-based approaches may reduce the risk of dissatisfaction and revision surgery in patients with dentofacial deformities, or those seeking gender confirmation surgeries, compared to stock silicone implants. Full article

Background/Objectives: Safe placement of sacral vertebra 1 (S1) screws is essential in lumbosacral instrumentation and iliosacral fixation. Existing anatomical safe zones are largely based on averaged geometry and do not provide quantitative probability estimates for permissible deviations from an ideal entry point. This study aims to develop a probabilistic, computed tomography–based (CT-based) safe zone model for S1 screw placement. Methods: This retrospective imaging-based anatomical modeling study will analyze 1000 anonymized lumbosacral CT scans. A reproducible reference entry point will be defined on the lateral S1 projection, and bilateral offset-based virtual screw trajectories will be evaluated. Two independent raters will classify each trajectory as intraosseous or extraosseous. Probabilistic safety maps will be generated by aggregating binary classifications across offsets and directions. Interobserver reliability will be assessed using Cohen’s kappa, and anatomical influences will be analyzed using multivariable regression models. Results: The study is expected to generate continuous probabilistic safety maps illustrating the likelihood of intraosseous S1 screw placement across predefined offset distances and directions from the reference entry point. These maps are anticipated to demonstrate a gradual transition from high to low safety probabilities rather than a binary safe–unsafe boundary, and to identify anatomical factors influencing screw containment. Conclusions: This protocol describes a CT-based probabilistic modeling approach to S1 screw placement that aims to provide a more nuanced and quantitative definition of anatomical safe zones. If successful, the proposed method may improve preoperative planning and intraoperative decision-making by moving beyond averaged geometric constraints toward probability-informed screw placement. Full article

Background: Full field electroretinography (ERG) is an essential tool for assessing retinal function and diagnosing retinal diseases. In recent years, mydriasis-free handheld ERG devices have emerged as portable, non-invasive alternatives to traditional ERG systems. Their main application has been in the screening and monitoring of diabetic retinopathy (DR), particularly in settings with limited access to standard ERG equipment and in pediatric populations where conventional testing may be difficult to perform. This review aims to evaluate the current evidence on handheld ERG devices in ocular diseases, with a focus on their reliability, diagnostic accuracy, and inherent limitations. Methods: A review was conducted to identify studies evaluating handheld ERG devices in diverse clinical settings, including retinal diseases, DR, pediatric populations, and conditions such as glaucoma. A comprehensive search of the Pubmed and Embase databases was performed for studies published up to December 2024. Search terms included “mydriasis free ERG”, “handheld ERG”, “portable ERG”, “RETeval”, “healthy subjects”, “retinal diseases”, “diabetic retinopathy”, “glaucoma”, and “pediatric diseases”, as well as relevant MeSH terms and synonyms. Case reports, conference abstracts, non-human studies, and letters were excluded. After screening titles and abstracts, additional studies not meeting the inclusion criteria were excluded. Of 279 records that were initially identified, 55 met the eligibility criteria and were included in the final review. Results were synthesized narratively due to heterogeneity in the study design, populations, and outcomes. Findings were organized thematically according to clinical context. Results: A total of 57 studies were included in the review: 19 conducted in healthy subjects, 13 in diabetic retinopathy, eight in selected retinopathies, eight in glaucoma, and 14 in pediatric cohorts. Five studies overlapped between groups due to shared populations or study designs. No meta-analysis was performed due to heterogeneity in study design and outcome measures; therefore, findings were summarized narratively across disease categories. Handheld ERG devices have been evaluated in healthy subjects, patients with DR, other retinal pathologies, glaucoma and pediatric cohorts. Evidence indicates that these devices provide a rapid, non-invasive assessment of retinal function and are particularly valuable where conventional ERG is difficult to implement and potentially well-suited for screening purposes. They show good sensitivity and reasonable specificity for detecting functional changes, making them suitable for screening purposes. However, limitations exist: reduced performance in detecting early-stage disease and cone dysfunction, risk of false positives, and variability in waveform morphology and amplitude compared with traditional ERG systems. Reproducibility challenges are noted among pediatric patients and individuals with poor fixation or unstable eye movements. These discrepancies highlight the need for establishing robust normative datasets for both healthy subjects and specific disease states. Conclusions: Handheld ERG devices provide a rapid, accessible and user-friendly option for retinal assessment. While not a replacement for conventional ERG, they serve as complementary tools, particularly in early disease and in contexts where standard testing is less feasible. Further research is required to refine testing protocols, improve diagnostic accuracy, and validate their application across a broader spectrum of ocular diseases. Full article

Background: Infections in hand surgery represent a clinically relevant complication, particularly in trauma-related procedures and in the presence of internal fixation devices. Data specifically addressing microbiological profiles and antimicrobial resistance patterns in hand surgery remain limited. Methods: A monocentric retrospective observational study was conducted, including 72 patients treated for hand surgery infections between January 2024 and June 2025. Microbiological isolates and antimicrobial susceptibility profiles were analyzed and stratified according to the clinical scenario, including trauma-related infections and infections associated with internal fixation devices. Monomicrobial and polymicrobial infections were evaluated separately. Results: Trauma-related infections accounted for 77.8% of cases, of which 64.3% were monomicrobial and 35.7% polymicrobial. Monomicrobial trauma-related infections were predominantly caused by Staphylococcus aureus, with methicillin resistance detected in 25.0% of cases. Polymicrobial trauma-related infections showed greater microbiological complexity but limited antimicrobial resistance. Infections associated with internal fixation devices represented 22.2% of cases and demonstrated a higher proportion of polymicrobial infections. Across all subgroups, no extended-spectrum beta-lactamase–producing Enterobacterales or carbapenem-resistant organisms were identified. Conclusions: This study fills an important evidence gap by characterizing pathogens and antimicrobial resistance in a dedicated hand surgery cohort, an area where published microbiological data remain limited compared with other orthopedic subspecialties. Hand surgery infections exhibit distinct microbiological and resistance profiles depending on the clinical scenario and microbial complexity. Despite frequent polymicrobial involvement, high-level antimicrobial resistance remains uncommon, supporting the value of local microbiological surveillance to guide empirical therapy. Full article

Shiqian Taicha (Camellia sinensis) is a local tea cultivar originating from Shiqian County and Guizhou (China) that is suitable for both green and black tea. The year-on-year manufacturing conditions, which affect chemical quality, were elucidated through the analysis of 78 green tea and 38 black tea commercial batches manufactured in 2021–2023. The batches were manufactured by the same process, but these naturally varied in raw-leaf status and factory parameters. The moisture content, water-soluble extract, free amino acids, tea polyphenols, caffeine, gallic acid, total ash, total catechins and individual catechins were predicted using a calibrated near-infrared (NIR) spectroscopy model and membership function evaluation, which integrated multiple indices to produce an overall quality score for each year and tea type. The amino acids of green tea peaked in the year 2022, (with 4.55%) whereas the polyphenols (which refers to carbon-based molecules) was in the year 2021, (with 24.22%), and the total catechins was in the year 2021, (with 16.71%); due to these observations, the ratio of phenol-to-amino was high in the year 2021, with (10.09); while the year 2022 had a lower ratio with (3.41). Although there were fewer differences from region to region with black tea, 2022 was better in terms of moisture control, amino acids retention and composite score with a value of 0.585. The assessment of the membership function indicated that 2022 was the most ideal tea production year for green tea (0.506) as well as black tea (0.477), with 2021 tea (0.486) and 2023 tea (0.488) following next based on type. The data presents quantitatively stable fixation and moisture/fermentation management targets to improve Shiqian Taicha value and consistency. Full article

Phosphorus is a fundamental macronutrient, yet its low bioavailability in most soils makes phosphorus deficiency one of the most persistent constraints limiting global crop productivity. Although mineral fertilisation has long been the primary strategy for maintaining adequate P supply, inefficient fertiliser use and strong soil phosphorus fixation result in substantial losses. As a result, current research is shifting toward integrated phosphorus management approaches that combine optimised fertilisation techniques, unconventional phosphorus sources, and biological tools that mobilise soil-bound phosphorus. At the same time, silicon has emerged as a promising modulator of plant stress resilience, which can also influence phosphorus homeostasis. Silicon enhances plant physiological robustness by strengthening tissues, improving photosynthetic performance, and activating antioxidant pathways. Silicon may also modify phosphorus mobility in soils, promoting more efficient uptake and utilisation in plant tissues. This review synthesises current knowledge on physiological and molecular plant responses to phosphorus deficiency. It compares modern fertilisation strategies, ranging from precision fertilisation to unconventional phosphorus fertilisers. Particular attention is devoted to the emerging role of silicon in improving phosphorus availability and in enhancing crop plant phosphorus-use efficiency. The review concludes with future research directions that may help integrate silicon-based interventions into sustainable nutrient-management systems. Full article

Standard materials for middle clavicle implants are limited to Titanium and Stainless Steel; their high Young’s Modulus promotes stress shielding, which causes complications such as malunion or implant failure. This study investigates alternative materials, Cobalt Chromium, Polyether ether ketone (PEEK), Magnesium, and Polylactic Acid (PLA), along with the standard materials, to understand their stress distributions, assess the likelihood of stress shielding, and evaluate their viability through the use of ANSYS 2025 R1 Finite Element Analysis (FEA). The materials are tested with four plate variations: Superior Plate, Anteroinferior Plate, Thin Dual Plate, and Thick Dual Plate, subjected to a simultaneous load of 100 N compressive, 100 N bending, and 1 Nm torsional, and were compared according to their maximum von Mises Stresses in plate, bone, and fracture line. High Young’s Modulus materials (Titanium, Stainless Steel, and Cobalt Chromium) had maximum von Mises plate stresses ranging from 200 to 265 MPa. In contrast, lower Young’s Modulus materials (Magnesium, PEEK, and PLA) showed maximum von Mises stresses of only around 115 to 170 MPa. PLA showed insufficient material strength, with bone stresses being around 30 MPa greater than plate stresses. PEEK showed viability but failed in material strength for the superior plate variation, as its maximum von Mises Stress of 168.13 MPa exceeded the yield strength of 125 MPa. Magnesium showed the best results, with bone and plate stresses near each other, and passed all viability criteria, demonstrating good material strength and a low risk of stress shielding. The results reinforce the use of Titanium and Stainless Steel as standards, show the viability of Cobalt Chromium for patients needing increased stability but with risks of stress shielding, demonstrate Magnesium for bioabsorbability and low stress shielding risk, suggest PEEK for low load applications, and reveal that PLA has insufficient strength. The study provides a comprehensive comparison of different materials with various variations, which provides a foundation for future studies to analyze material behavior. Full article

The global carbon cycle has become increasingly unbalanced over the past century as anthropogenic fluxes into the atmosphere far exceed the sequestration capacity of land and ocean systems. Data from 2025 show estimated annual anthropogenic emissions of ≈11.2 gigatonnes of carbon (GtC), while only ≈5.6 GtC are sequestered by land and ocean sinks mainly provided by photosynthetic CO₂ fixation. The resulting surplus of carbon emissions has led to a doubling of atmospheric CO₂ concentrations above pre-industrial values to ≈430 ppm, which is a major driver of increasingly erratic climatic phenomena. Recent data indicate that fossil fuel use will continue rising up to and beyond 2050, largely negating the drive to cut CO₂ emissions as recommended by the IPCC and other reputable transnational bodies. Hence, there is an urgent need to reduce atmospheric CO₂ levels via carbon sequestration. This review focuses on the proven capacity of biological mechanisms to sequester CO₂ at a global scale with an annual capacity in the range of gigatonnes of carbon. New measures such as re- and a-forestation, plus improved and more sustainable management of tropical tree crops, can further increase the carbon sequestration potential of these plants. By implementing these and other nature-based solutions, the highly productive tropical vegetation belt could contribute an additional 1–2 Gt of carbon sequestration via natural forests and perennial tree crops. In order to expedite this process, we examine the use of new modalities of transparent carbon trading systems that include selected tropical crops. As highlighted at COP30 in Brazil and elsewhere, this would enable tropical countries to derive benefit for costs incurred in land management changes such as reforestation, regenerative farming, and intercropping to benefit smallholders and other rural communities. In particular, carbon finance is emerging as a critical driver, with appropriately regulated and transparent carbon credit schemes offering fungible monetary compensation for climate-positive land management. Full article

Despite the increasing adoption of desktop virtual reality (VR) in higher education, the specific instructional efficacy of 3D interactive prompts remains inadequately understood. This study examines how such prompts—specifically dynamic spatial annotations and 3D animated demonstrations—influence learning outcomes within a desktop virtual learning environment (DVLE). Employing a quasi-experimental design integrated with eye-tracking and multimodal learning analytics, university students were assigned to either an experimental group (DVLE with 3D prompts) or a control group (basic DVLE) while completing physics tasks. Data collection encompassed eye-tracking metrics (fixation heatmaps, pupil diameter and dwell time), post-test performance (assessing knowledge comprehension and spatial problem-solving), and cognitive load ratings. Results indicated that the experimental group achieved significantly superior learning outcomes, particularly in spatial understanding and dynamic reasoning, alongside optimized visual attention patterns—characterized by shorter initial fixation latency and prolonged fixation on key 3D elements—and reduced cognitive load. Eye-tracking metrics were positively correlated with post-test scores, confirming that 3D prompts enhance learning by improving spatial attention guidance. These findings demonstrate that embedding 3D interactive prompts in DVLEs effectively directs visual attention, alleviates cognitive burden, and improves learning efficiency, offering valuable implications for the design of immersive educational settings. Full article

Background: The implantable miniature telescope is used to provide functional vision for patients with advanced AMD. However, despite the considerable cost of the device, there are strict criteria to be met for this procedure, since the patients require challenging neuroadaptation afterward, which sometimes fails and leads to the necessity of device explantation. Visual outcomes also depend on the stability of the microtelescope; tilts cause unwanted optical aberrations and can lead to device luxation, with sight-threatening complications. Case report: This case presents a novel technique for fixing the ophthalmic telescope device SING-IMT™. A 76-year-old female with pre-operative visual acuity of 15 letters on the ETDRS scale underwent surgery on her left eye. The superior haptic was fixed at the 12 o’clock position with a Prolene 5-0 suture, achieving good postoperative stability. The implant was stable throughout the entire observation period. Conclusions: Implant stability is crucial for maximizing visual potential in patients with advanced AMD selected for the procedure, since visual acuity in the peripheral retina, where the perceived image eventually lands, is much lower than the macula. Therefore, there is a need to standardize surgical approaches and use objective follow-up measures to assess long-term patient satisfaction. Full article

Background and Objectives: Vaginal vault prolapse is a known complication following anterior pelvic exenteration in women undergoing radical cystectomy. The aim of this study is to evaluate the feasibility, safety, and early outcomes of a novel anatomical approach for preventing vaginal vault prolapse after radical cystectomy. This study introduces a standardized laparoscopic technique that utilizes round ligament preservation and fixation to provide anatomical support to the vaginal apex. Materials and Methods: This study is a retrospective analysis of prospectively collected data from a single center, including thirteen female patients with uterus and adnexa in situ who underwent laparoscopic radical cystectomy with bilateral round ligament fixation to the vaginal cuff. The round ligaments were mobilized and sutured without tension. Vaginal closure was performed with barbed sutures. Results: No intraoperative complications occurred. At a median follow-up of 18.2 months, no cases of vaginal vault prolapse or dehiscence were observed. One patient experienced transient pelvic discomfort. Conclusions: This is the first report of a standardized mesh-free approach for vaginal apex support during laparoscopic anterior exenteration. The technique is feasible, safe, and may reduce postoperative prolapse risk. Full article

White noise has been proposed to enhance cognitive performance in children with ADHD, but findings are inconsistent, and benefits vary across tasks and individuals. Such variability suggests that diagnostic comparisons may overlook meaningful developmental differences. This exploratory study examined whether developmental characteristics and subjective evaluations of auditory and visual white noise predicted performance changes in two eye-movement tasks: Prolonged Fixation (PF) and Memory-Guided Saccades (MGS). Children with varying degrees of ADHD symptoms completed both tasks under noise and no-noise conditions, and noise benefit scores were calculated as the performance difference between conditions. Overall, white-noise effects were small and dependent on noise modality and task. In the PF task, large parent-rated perceptual difficulties and high visual noise discomfort were associated with improved performance under noise. In the MGS task, poor motor skills predicted visual noise benefit, whereas large visual noise discomfort predicted reduced noise benefit. These findings suggest that beneficial effects of white noise are influenced by developmental characteristics and subjective perception in task-dependent ways. The results highlight the need for individualized, transdiagnostic approaches in future noise research and challenge the notion of white noise as categorically beneficial for ADHD. Full article

Eye movement classification, particularly the identification of fixations and saccades, plays a vital role in advancing our understanding of neurological functions and cognitive processing. Conventional modalities of data, such as RGB webcams, often face limitations such as motion blur, latency and susceptibility to noise. Neuromorphic Vision Sensors, also known as event cameras (ECs), capture pixel-level changes asynchronously and at a high temporal resolution, making them well suited for detecting the swift transitions inherent to eye movements. However, the resulting data are sparse, which makes them less well suited for use with conventional algorithms. Spiking Neural Networks (SNNs) are gaining attention due to their discrete spatio-temporal spike mechanism ideally suited for sparse data. These networks offer a biologically inspired computational paradigm capable of modeling the temporal dynamics captured by event cameras. This study validates the use of Spiking Neural Networks (SNNs) with event cameras for efficient eye movement classification. We manually annotated the EV-Eye dataset, the largest publicly available event-based eye-tracking benchmark, into sequences of saccades and fixations, and we propose a convolutional SNN architecture operating directly on spike streams. Our model achieves an accuracy of 94% and a precision of 0.92 across annotated data from 10 users. As the first work to apply SNNs to eye movement classification using event data, we benchmark our approach against spiking baselines such as SpikingVGG and SpikingDenseNet, and additionally provide a detailed computational complexity comparison between SNN and ANN counterparts. Our results highlight the efficiency and robustness of SNNs for event-based vision tasks, with over one order of magnitude improvement in computational efficiency, with implications for fast and low-power neurocognitive diagnostic systems. Full article

Background and Objectives: This biomechanical study aimed to compare the fixation stability of proximal fragments and assess the mechanical properties in models of unstable basicervical intertrochanteric fractures. Materials and Methods: Thirty-six synthetic femur models were utilized. After cephalomedullary nail insertion, unstable basicervical intertrochanteric fractures were created using an engraving machine. Specimens were divided into three groups based on the femoral head fixation method: Group 1 (n = 12, single 100 mm lag screw); Group 2 (n = 12, lag screw + 75 mm anti-rotation screw); and Group 3 (n = 12, lag screw + 95 mm anti-rotation screw). The anti-rotation screws were full-threaded locking screws positioned just below the lag screw. After applying 10,000 vertical cyclic loads, stereophotogrammetry was used to evaluate the proximal fragment rotation in three planes (coronal, sagittal, and axial), and screw-tip displacement was measured radiographically. Vertical load was then applied at a 10 mm/min rate until structural failure. Results: Rotational change in the sagittal plane was least in Group 3 (Group 1 = 1.7 ± 1.3°, Group 2 = 1.0 ± 0.8°, Group 3 = 0.6 ± 0.6°, p = 0.038). Varus (coronal plane) and retroversion (axial plane) collapse did not differ significantly among the three groups. While cranial migration showed no difference, axial migration was the significantly lowest in Group 3 (Group 1 = 1.07 ± 0.62 mm, Group 2 = 0.60 ± 0.57 mm, Group 3 = 0.50 ± 0.43 mm, p = 0.040). Failure load was slightly higher in Groups 2 and 3 than in Group 1, but without statistical significance. No significant differences were observed between Group 2 and Group 3 in any biomechanical outcomes. Conclusions: The novel cephalomedullary nail with a long inferior anti-rotation screw significantly reduced rotational instability and axial migration compared to a single-lag screw. There was no significant difference in the rotational stability between the 75 mm and 95 mm anti-rotation screw groups. This novel nail demonstrates superior biomechanical properties in this experimental model and warrants clinical evaluation for treating unstable basicervical intertrochanteric fractures. Full article

Disentangling the impacts of ecological restoration from climate change is an ongoing challenge in remote sensing since the traditional correlative approaches often cannot elucidate causal mechanisms. To overcome this, we introduce a Causal Remote Sensing Framework that uses multi-source satellite data (2000–2020), machine learning (XGBoost, SHAP) and causal inference (T-Learner) to build pixel-level counterfactuals. Using this framework, we assessed the Return Grazing to Grassland Program (RGGP) on the Qinghai–Tibet Plateau. Our results demonstrate that a warming and wetting climate improved Water yield (WY) while at the same time decreasing sand fixation (SF) in 83.6% of the region. Notably, the restoration project became the main factor that slowed this decline. After controlling for observational selection bias, the program had a net positive effect of (+6.02 t hm⁻²), reducing degradation in 64.6% of treated areas. This framework provides a practical way for the remote sensing community to go beyond change monitoring to allow the diagnosis of the causal mechanisms in complex human-environment systems. Full article