Search Results (1,624)

Background and Objectives: Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy. Ultrasonography is a widely used diagnostic method for CTS, and the median-to-ulnar nerve cross-sectional area ratio (MUR) is a well-known parameter. However, the ulnar nerve may be affected by various conditions of the median nerve; therefore, we considered finding further parameters. The aim of the study is to identify the correlation between the median nerve-to-ulnar artery cross-sectional area ratio (MUAR) and existing ultrasonographic parameters used as diagnostic indicators of CTS. Materials and Methods: Sixty-seven wrists from forty-two patients who were diagnosed with CTS by electrodiagnostic studies within 4 years before enrollment were retrospectively analyzed in this study. The median nerve cross-sectional area (CSA), ulnar nerve CSA, and ulnar artery CSA at full dilation were measured. In addition to well-defined CTS ultrasonographic parameters, the MUAR were calculated. All measurements were gathered at three levels. The reproducibility was evaluated through intraclass correlation coefficients (ICCs) and Bland–Altman plots. Results: The MUAR at the carpal tunnel inlet showed a strong positive correlation with the MUR at the same level (ρ = 0.738, p < 0.05) and the median nerve wrist forearm ratio (ρ = 0.541, p < 0.05). In addition, the MUAR at the carpal tunnel outlet presented a strong positive correlation with MUR at the carpal tunnel inlet (ρ = 0.528, p < 0.05). The MUAR at 12 cm proximal to the distal wrist crease showed a strong positive correlation with the MUR at the corresponding level (ρ = 0.613, p < 0.05). Intra-rater and inter-rater reliability showed a high degree of agreement (ICCs > 0.90). Conclusions: This study demonstrates correlations between known CTS parameters and MUAR and suggests the possibility of MUAR as a reliable CTS diagnostic tool. Further research is recommended to validate these findings. Full article

Background: The morphology of the acromion has long been implicated in shoulder pathology, particularly in relation to subacromial impingement and rotator cuff disease. More recently, interest has shifted toward the posterior acromion, with studies examining its potential role in posterior instability, eccentric glenohumeral osteoarthritis, and massive rotator cuff tears. Methods: A critical literature review of nine studies assessing sagittal acromial tilt, posterior coverage, and acromial height was conducted, emphasizing reproducibility and clinical significance across different shoulder disorders. Results: In posterior instability and eccentric osteoarthritis, the acromion is generally described as more horizontally oriented, less covering posteriorly, and positioned higher. Conversely, in massive cuff tears, it tends to appear more posteriorly covering without consistent change in tilt. Although these trends suggest a possible biomechanical role for the acromion, reported values vary widely between studies, and significant overlap exists between pathological and control groups. Such variability is compounded by differences in imaging modality, definitions of anatomical landmarks, and the frequent reduction of three-dimensional structures into two-dimensional projections. These methodological inconsistencies undermine reproducibility and limit the clinical applicability of posterior acromial parameters. Conclusions: Posterior acromial morphology appears to influence shoulder biomechanics, but existing measurements should be considered population-level markers rather than diagnostic thresholds. Future research should adopt standardized, three-dimensional, pathology-independent reference models anchored to stable scapular landmarks and validated across imaging modalities to improve reproducibility and clinical utility. Full article

Gallium oxide-based devices are critical in various applications, including industrial safety, the gas and petroleum sectors, and research environments. However, the deep etching process has not been thoroughly explored. Key parameters such as etching rate, selectivity, uniformity, isotropic/anisotropic behavior, and surface properties all influence the effectiveness of the etching process and its reproducibility. This research was motivated by the need for efficient fabrication processes, particularly in applications where sensors must operate in harsh environments, due to their instead of owning to low leakage current density of their power devices. In this study, we studied a deep etching technique for Ga₂O₃, focusing on the chemical stability of the two planes and identifying suitable protocols that could enhance etching depth via a dry-etching process. A deep ion-etching process for Ga₂O₃ was successfully developed, achieving deep etches of 6.97 µm in the Ga₂O₃. These advancements pave the way for high-aspect-ratio Ga₂O₃ nanostructures, offering new possibilities for robust nanosensors in harsh environments. Full article

Omsk hemorrhagic fever is an acute zoonotic disease caused by Omsk hemorrhagic fever virus, a member of the genus Flavivirus (family Flaviviridae), with a reported case-fatality rate of approximately 3%. Historically confined to southwestern Siberia, ecological changes raise concerns about possible spread to non-endemic regions. Although no Omsk hemorrhagic fever cases have been reported in the Republic of Korea, the risk of accidental importation highlights the importance of establishing a reliable diagnostic protocol. We established and validated an institutionally developed diagnostic protocol employing real-time reverse transcription polymerase chain reaction targeting the NS2A and C genes of Omsk hemorrhagic fever virus. Primers and probes were designed from all available genomes to ensure broad strain coverage. Human ribonuclease P was used as an internal control to verify nucleic acid extraction and amplification. Using synthetic deoxyribonucleic acid fragments and in vitro-transcribed ribonucleic acid, assay performance was optimized, and analytical sensitivity was determined using probit analysis. The limits of detection were 74.50 copies/µL (threshold cycle 32.99) for NS2A and 70.41 copies/µL (threshold cycle 35.38) for C. Specificity testing using representative flaviviruses (West Nile virus, Yellow fever virus, Zika virus, St. Louis encephalitis virus, and Tick-borne encephalitis virus) and an alphavirus (Venezuelan equine encephalitis virus) demonstrated no cross-reactivity. The assay demonstrated high sensitivity, specificity, and reproducibility, supporting its potential application in national and international Omsk hemorrhagic fever virus surveillance systems. Full article

Background: The rising prevalence of gastric, biliary, and pancreatic surgeries has led to an increasing population of patients with surgically altered anatomy (SAA). In this setting, conventional endoscopic retrograde cholangiopancreatography (ERCP) is often limited by anatomical barriers, resulting in high rates of technical failure and complications. While device-assisted enteroscopy (DAE) has expanded therapeutic possibilities, its efficacy remains modest in complex reconstructions. Methods: This review analyzed recent literature from PubMed, Embase, and Scopus up to April 2025, focusing on diagnostic and therapeutic roles of endoscopic ultrasound (EUS) in SAA. Particular attention was given to cases where standard endoscopic, percutaneous, or surgical techniques failed and to studies comparing EUS-guided approaches with alternative modalities. Results: EUS has transitioned from a primarily diagnostic modality to a versatile therapeutic platform in SAA. Techniques such as EUS-guided rendezvous, antegrade drainage, and hepaticogastrostomy have shown technical and clinical success rates exceeding 80–90%, often comparable or superior to interventional radiology, while reducing the need for external drains. Innovative procedures, including EUS-directed transgastric ERCP (EDGE) and EUS-directed enteroenteric bypass (EDEE), have transformed the management of Roux-en-Y gastric bypass and bilioenteric anastomoses, providing durable and reusable access for repeated interventions. Despite these advances, EUS-guided interventions remain technically demanding, requiring advanced endoscopic and radiologic skills, specialized devices, and are best performed in tertiary referral centers. Conclusions: EUS has redefined the treatment paradigm of biliopancreatic diseases in patients with SAA, increasingly emerging as the preferred minimally invasive approach when conventional techniques fail. Future developments will focus on dedicated devices, standardized guidelines, and structured training programs to optimize outcomes. Multidisciplinary collaboration and centralization in high-volume centers remain essential to ensure safety, efficacy, and reproducibility. Full article

Using big data for risk analysis of construction projects is a largely unexplored area. In this traditional industry, risk identification is often based either on so-called domain expert knowledge, in other words on experience, or on different statistical and quantitative analysis of individual past projects. The motivation of this research is based on the implemented and evaluated data-driven and AI-based DARIA approach to identify financial risks in the execution phase of transportation infrastructure construction projects that shows exceptional results at an early stage of the project execution phase and has already been deployed into enterprise-wide production within the STRABAG group. Due to DARIA’s productive use, concern and doubts about the trustworthiness of its ML algorithm are certainly possible, especially when DARIA identifies risky projects while all conventional metrics within the STRABAG controlling system do not identify any problems. “If AI systems do not prove to be worthy of trust, their widespread acceptance and adoption will be hindered, and the potentially vast societal and economic benefits will not be fully realized”. Thus, and based on the results of a user study during DARIA’s successful deployment into enterprise-wide production, this paper focuses on the identification of suitable indicators to measure the trustworthiness of the DARIA ML algorithm in the interaction between individuals and systems as well as on the modeling of the reproducibility of the internal state of DARIA’s ML model. Full article

Background: Biopsy remains the gold standard for characterizing breast cancer, but it is invasive, costly, and may not fully capture tumor heterogeneity. Advances in artificial intelligence (AI) now allow for the extraction of biological and clinical information from medical images, raising the possibility of using imaging as a non-invasive alternative. Methods: A semi-systematic review was conducted to identify AI-based approaches applied to mammography (MM) and breast tomosynthesis (BT) for tumor subtyping, staging, and prognosis. A PubMed search retrieved 1091 articles, of which 81 studies met inclusion criteria (63 MM, 18 BT). Studies were analyzed by clinical target, modality, AI pipeline, number of cases, dataset type, and performance metrics (AUC, accuracy, or C-index). Results: Most studies focused on tumor subtyping, particularly receptor status and molecular classification. Contrast-enhanced spectral mammography (CESM) was frequently used in radiomics pipelines, while end-to-end deep learning (DL) approaches were increasingly applied to MM. Deep models achieved strong performance for ER/PR and HER2 status prediction, especially in large datasets. Fewer studies addressed staging or prognosis, but promising results were obtained for axillary lymph node (ALN) metastasis and pathological complete response (pCR). Multimodal and longitudinal approaches—especially those combining MM or BT with MRI or ultrasound—show improved accuracy but remain rare. Public datasets were used in only a minority of studies, limiting reproducibility. Conclusions: AI models can predict key tumor characteristics directly from MM and BT, showing promise as non-invasive tools to complement or even replace biopsy. However, challenges remain in terms of generalizability, external validation, and clinical integration. Future work should prioritize standardized annotations, larger multicentric datasets, and integration of histological or transcriptomic validation to ensure robustness and real-world applicability. Full article

Background/Objectives: Endometrial carcinoma is an emerging challenge for public health systems globally, especially in countries with a high development index. Traditionally, histopathological staging and grading have been the main criteria informing treatment modalities. More recently, clinically actionable molecular targets have been developed, following observations from the TCGA project and the ProMisE cohort. Although promising, the cost of these methods is an obstacle for some countries that lack well developed theranostics infrastructure in their public systems. This study aimed to contextualize our center’s diagnostic experience from the perspective of histopathological diagnosis. Methods: This is a retrospective study that selected 109 cases of already diagnosed endometrial carcinoma from the interval of 2017–2023. We analyzed traditional parameters related to staging and grading, using the FIGO 2009 system as well as basic histological parameters (lymphovascular invasion, perineural invasion, necrosis). Excel and SPSS 26 were used for database management and correlations. Findings were contextualized using the more recent studies that reported on similar parameters. Results: Higher-grade tumors were associated with lymphovascular invasion (p = 0.04) and lymph node involvement (p = 0.0006), as well as deeper myoinvasion (p = 0.0018). Myoinvasion (p = 0.013) and lymphovascular invasion (p = 0.0001) were associated with advanced disease (FIGO III and IV). Our cohort showed a relative paucity (6.5%) of non-endometrioid endometrial carcinoma and presence of lymphovascular invasion (9.2%). Perineural invasion was found in 3 cases with extrauterine involvement. Conclusions: Histopathological diagnosis represents an integral component in informing clinical management for endometrial carcinoma and should serve as a means of triage for more expensive molecular techniques. It nevertheless presents reproducibility issues. Further efforts should focus on resolving such issues or possibly introducing less-researched parameters like perineural invasion. Full article

This paper presents the development and experimental verification of a second-order polynomial regression model for predicting the adhesion strength of coatings produced by electric arc metallization (EAM). The aim of the study is to optimize three key process parameters: current strength (I), carrier gas pressure (P) and nozzle-to-substrate distance (L) in order to maximize the adhesion strength of the coating to the substrate. Experimental data were obtained from the central composite plan within the response surface method (RSM) and processed using analysis of variance (ANOVA). A pronounced synergistic interaction between pressure and distance was found (P × L), whereas current strength had no statistically significant effect in the range investigated. Optimal parameters (I = 200 A, P = 6.5 bar, L = 190 mm) provided an adhesion strength of ~15.4 kN, which was within 8.5% of the model’s prediction, confirming its accuracy. The proposed two-stage approach—combining statistical modeling with experimental fine-tuning in the global extremum zone—made it possible to improve the accuracy of the forecast and link statistical dependencies with the physical and mechanical mechanisms of adhesion formation (kinetic energy of particles, residual thermoelastic stresses). This method provides engineering-based recommendations for industrial application of EAM, reduces the cost of parameter selection, and improves the reproducibility of coating properties. Full article

Analysis of the genetic diversity of natural populations of economically valuable plants is important for conservation and selection strategies. In this study, the genetic diversity of 11 natural populations of Hippophae rhamnoides L.—sea buckthorn from different regions of Kazakhstan—was studied using Inter-Primer Binding Site Polymorphism (iPBS) markers based on conserved sequences of tRNA primer-binding sites (PBSs) that initiate retrotransposon replication. Universal PBS primers yielded reproducible and informative amplicons, forming unique profiles for each sample. Analysis of molecular variance showed that 60% of the total genetic variation was due to intrapopulation differences and 40% was due to interpopulation differentiation. The highest genetic diversity was found in the Shetlasty and Tersayryk sea buckthorn populations, whereas the Karatal and Topkain populations were characterised by minimal values, although unique alleles were observed in the latter population, indicating possible adaptation to local environmental conditions or genetic isolation. Principal coordinate analysis, UPGMA clustering, and Bayesian structure analysis (K = 4) confirmed geographical structuring. This study provides insights into the genetic structure of sea buckthorn populations in Kazakhstan and demonstrates the effectiveness of iPBS markers for assessing intraspecific diversity. The obtained results provide a basis for the conversation of H. rhamnoides gene pool and underscore the need for both in situ conservation of genetically rich populations and ex situ protection of vulnerable groups. Full article

Background/Objectives: In this proof-of-concept study, the objective was to evaluate the phenotypic CarbaLux combination rapid test in terms of guiding the therapy of infections caused by multidrug-resistant Gram-negative bacteria with carbapenemase inhibitors and carbapenems, and to compare its results and practicability with standard diagnostic methods. Methods: In the classical CarbaLux test, a fluorescent carbapenem serves as a UV–visible diagnostic surrogate for clinically used carbapenem antibiotics. When exposed to extracted carbapenemases from bacterial colony growth on agar plates, fluorescence rapidly disappears, showing whether monotherapy with carbapenems is possible or must be rejected. It was expected that a specific inhibitor that protects imipenem or meropenem from enzymatic deactivation during antibacterial therapy would perform the same in vitro with fluorescent carbapenem and preserve its fluorescence. The new additional CarbaLux combination test is used if the classic test is positive for carbapenemases: a classic test tube pre-dosed with fluorescent carbapenem is spiked with cloxacillin; with recently launched carbapenemase inhibitors, e.g., avibactam, relebactam, zidebactam, nacubactam, or vaborbactam; or with picolinic acid. Fourteen Enterobacterales and six Acinetobacter baumannii isolates were analyzed. Results: At fixed concentrations, the new inhibitors protected fluorescent carbapenem from bacterial KPC-mediated inactivation and partially from AmpC beta-lactamase-mediated inactivation. In addition, avibactam also effectively inhibited OXA-48-like enzymes. Cloxacillin selectively inhibited AmpC beta-lactamases extracted from Enterobacter complex species. Non-therapeutic picolinic acid was specific for metallo-beta-lactamases and thus identified infections by pathogens that cannot be treated with carbapenems alone or in combination. Conclusions: Inhibitor/fluorescent carbapenem mixtures corresponding to therapeutic inhibitor/carbapenem combinations allow us to visualize the efficacy of carbapenemase inhibitors. The in vitro results are consistent with clinical experience regarding combination therapy. Enzymatic assays provide a rapid yes/no answer for carbapenem mono- or combination therapy and offer several advantages over current carbapenemase testing methods. In contrast to PCR and lateral flow tests, which only target a selection of carbapenemases, enzymatic assays work by employing a reproducible phenotypic mechanism. They are simpler, broader in scope, and more cost-effective; they can also detect antimicrobial heteroresistance or AmpC beta-lactamase hyperproduction, which is normally undetected when performing automated antibiotic susceptibility testing. The new tests are suitable for clinical diagnosis, public health purposes, and infection control. Full article

The transformation of energy systems towards low emission is one of the key assumptions of the climate and energy policy of the European Union and many countries around the world. These changes include not only the power and transport sectors but also the heating of residential buildings, which consume significant amounts of energy and emit large amounts of greenhouse gases. This article presents a detailed comparative analysis of the costs of heating using an air-to-water heat pump and a condensing gas boiler. The study concerned a retrofitted single-family building from the 1990s, located in southern Poland. The calculations were made taking into account daily meteorological data for two full heating seasons: 2022/2023 and 2023/2024. This approach made it possible to more precisely reproduce real operating conditions. The study was conducted for various configurations of the central heating system: surface and radiator. The following parameters were also taken into account: (1) variable heat pump parameters, such as supply temperature LWT and coefficient of performance COP; (2) current tariffs for electricity and natural gas; and (3) forecasted tariffs for electricity and natural gas in the conditions of market liberalization and phasing out of protective mechanisms. A comparison of the two heating seasons revealed lower costs with a heat pump. In some cases, the cost of heat generated by a gas boiler was over 100% higher than with a heat pump. This applies to both heating seasons. Under the current tariffs, the calculated gas cost for the first season was PLN 6856 (EUR 1605) (1 EUR = 4.27 PLN) compared to heat pump heating costs ranging from PLN 3191 to PLN 4576 (EUR 747 to 1072). For future gas and electricity tariffs, the costs were PLN 8227 (EUR 1926) for gas and PLN 3841 to PLN 5304 (EUR 899 to 1242) for a heat pump. Similarly, for the second heating season, these values were PLN 6055 (EUR 1418) for gas heating and PLN 2741–3917 (EUR 642–917) for a heat pump under the current tariffs, and PLN 7267 (EUR 1702) and PLN 3307–4540 (EUR 774–1064) under future tariffs. This means percentage savings of between approximately 33% and 55%, depending on the heating type and tariff. Therefore, the obtained results indicate the higher profitability of using an air heat pump compared to a gas boiler. This advantage was maintained in all the discussed scenarios, and its scale depended on the type of installation, supply temperature, and the selected electricity tariff. The highest economic profitability was noted for low-temperature systems. These results can provide a basis for making rational investment and design decisions in the context of the energy transformation of single-family housing. Full article

Background: This study compared the performance of a Head-mounted Virtual Reality Perimeter (HVRP) with the Humphrey Field Analyzer (HFA), the standard in automated perimetry. The HFA is the established standard for automated perimetry but is constrained by lengthy testing, bulky equipment, and limited patient comfort. Comparative data on newer head-mounted virtual reality perimeters are limited, leaving uncertainty about their clinical reliability and potential advantages. Aim: The aim was to evaluate parameters such as visual field outcomes, portability, patient comfort, eye tracking, and usability. Methods: Participants underwent testing with both devices, assessing metrics like mean deviation (MD), pattern standard deviation (PSD), and duration. Results: The HVRP demonstrated small but statistically significant differences in MD and PSD compared to the HFA, while maintaining a consistent trend across participants. MD values were slightly more negative for HFA than HVRP (average difference −0.60 dB, p = 0.0006), while pattern standard deviation was marginally higher with HFA (average difference 0.38 dB, p = 0.00018). Although statistically significant, these differences were small in magnitude and do not undermine the clinical utility or reproducibility of the device. Notably, HVRP showed markedly shorter testing times with HVRP (7.15 vs. 18.11 min, mean difference 10.96 min, p < 0.0001). Its lightweight, portable design allowed for bedside and home testing, enhancing accessibility for pediatric, geriatric, and mobility-impaired patients. Participants reported greater comfort due to the headset design, which eliminated the need for chin rests. The device also offers potential for AI integration and remote data analysis. Conclusions: The HVRP proved to be a reliable, user-friendly alternative to traditional perimetry. Its advantages in comfort, portability, and test efficiency support its use in both clinical settings and remote screening programs for visual field assessment. Its portability and user-friendly design support broader use in clinical practice and expand possibilities for bedside assessment, home monitoring, and remote screening, particularly in populations with limited access to conventional perimetry. Full article

Lattice structures produced by additive manufacturing are increasingly used in lightweight, load-bearing applications, yet their mechanical performance is strongly influenced by geometry, process parameters, and boundary conditions. This study investigates the compressive behavior of body-centered cubic (BCC) 316L stainless steel lattices fabricated by laser powder bed fusion (LPBF). Four relative densities (20%, 40%, 60%, and 80%) were achieved by varying the strut diameter, and specimens were built in both vertical and horizontal orientations. Quasi-static compression tests characterized the elastic modulus, yield strength, energy absorption, and mean force, while finite element simulations reproduced the deformation and hardening behavior. The experimental results showed a direct correlation between density and mechanical properties, with vertically built specimens performing slightly better due to reduced processing defects. Simulations quantified the effect of strut–joint rounding and the need for multi-cell configurations to closely match the experimental curves. Regardless of the boundary conditions, for a density of 20%, simulating a single cell underestimated stiffness because of unconstrained strut buckling. For higher densities and thicker struts, this sensitivity to boundary conditions strongly decreased, indicating the possibility of using a single cell for shorter simulations—a point rarely discussed in the literature. Both experiments and simulations confirmed Gibson–Ashby scaling for elastic modulus and yield strength, while the tangent modulus was highly sensitive to boundary conditions. The combined experimental and numerical results provide a framework for the reliable modeling and design of metallic lattices for energy absorption, biomedical, and lightweight structural applications. Full article

Outdoor ice rinks have long been a staple for inexpensive exercise and entertainment in cold environments. However, the possible deterioration of or impact on outdoor ice rinks from a changing climate is poorly understood due to no or little monitoring of data of such facilities. To investigate long-term changes in ice rinks over recent decades, an energy-balance-based ice rink model (with three versions considering precipitation and melt) was applied to a simulated ice rink for two representative area—Dorset of south-central Ontario and the Experimental Lakes Area (ELA) of northwestern Ontario, Canada. The model was calibrated and tested using four-year ice rink data (since limited data are available) and applied to a 40-year period starting in 1978 to reproduce the dates of rink-on and rink-off, rink duration in a season, and ice water equivalent under daily climate inputs, and to illustrate any changing trend in these variables, i.e., the ice rink responses to changed climate. Results showed no clear trend in any ice rink features over four decades, attributed to winter temperature that did not increase substantially (a weak driver), no change in events of rain-on-ice and snowfall-on-rink, and reduced wind speed (possibly slowing ice melting). This is the first trial of a physically based rink model to evaluate outdoor ice rinks. More in situ monitoring and in-depth modelling are necessary, and this model can help guide the monitoring. Full article