Search Results (276)

Cell-based therapeutics are redefining interventions for vision loss by enabling tissue replacement, regeneration, and neuroprotection. This review surveys contemporary cellular strategies in ophthalmology through the lenses of therapeutic effectiveness, translational readiness, and governance. We profile principal sources—embryonic and induced pluripotent stem cells, mesenchymal stromal cells, retinal pigment epithelium, retinal progenitor and limbal stem cells—and enabling platforms including extracellular vesicles, encapsulated cell technology and biomaterial scaffolds. We synthesize clinical evidence across age-related macular degeneration, inherited retinal dystrophies, and corneal injury/limbal stem-cell deficiency, and highlight emerging applications for glaucoma and diabetic retinopathy. Delivery routes (subretinal, intravitreal, anterior segment) and graft formats (single cells, sheets/patches, organoids) are compared using standardized structural and functional endpoints. Persistent barriers include GMP-compliant derivation and release testing; differentiation fidelity, maturation, and potency; genomic stability and tumorigenicity risk; graft survival, synaptic integration, and immune rejection despite ocular immune privilege; the scarcity of validated biomarkers and harmonized outcome measures and ethical, regulatory, and health-economic constraints. Promising trajectories span off-the-shelf allogeneic products, patient-specific iPSC-derived grafts, organoid and 3D-bioprinted tissues, gene-plus-cell combinations, and cell-free extracellular-vesicle therapeutics. Overall, cell-based therapies remain investigational. With adequately powered trials, methodological harmonization, long-term surveillance, scalable xeno-free manufacturing, and equitable access frameworks, they may eventually become standards of care; at present, approvals are limited to specific products/indications and regions, and no cell therapy is the standard of care for retinal disease. Full article

Background and Objectives: Ultra-hypofractionated radiotherapy (uhRT) is increasingly used for low- and intermediate-risk localized prostate cancer, necessitating exceptional precision compared to conventional fractionation. CBCT-based online-adaptive uhRT may help mitigate pelvic organ motion but has not yet been established in clinical routine. We report initial clinical experiences focusing on the feasibility and technical aspects of treatment delivery. Materials and Methods: Seven patients (35 fractions) with low- or intermediate-risk prostate cancer were treated with online-adaptive uhRT on the Varian Ethos^® system within routine clinical care. The target included the prostate and proximal seminal vesicles (CTV1, 5 × 7.25 Gy), with an integrated boost to the prostate (CTV2, 5 × 8.00 Gy). For each fraction, dose–volume histogram (DVH) parameters for targets and organs at risk (OARs) were recorded retrospectively for both scheduled and adaptive plans, along with the plan selection decision. Plan quality was evaluated per clinical DVH constraints and target coverage. The treatment time was recorded. Results: Online-adaptive uhRT was successfully delivered every day in 5 patients and on alternate days in 2 patients. Mean treatment time was 30:17 (±05:49 SD) minutes per fraction. The median recorded change in target and OAR volumes was <10%. Adaptive plans resulted in a statistically significantly improved target coverage for CTV1 (V100%, p = 0.01), PTV1 (D98%, p < 0.001), PTV2 boost (D98%, p < 0.001) in Wilcoxon signed-rank tests. OAR dose reduction was limited, with a small improvement in bladder V40Gy (p = 0.02). Adaptive plans were applied in 32/35 fractions (91.4%). To encompass intra-fractional motion in 95% of fractions, positional adjustments up to 0.77 cm (longitudinal), 0.37 cm (lateral), and 0.59 cm (sagittal) were required. Conclusions: Online-adaptive uhRT appears feasible, leading to optimized target volume coverage. Considerable treatment times must be taken into account. A second CBCT is recommended to compensate for intra-fractional motion. Further research regarding patient-related endpoints and cost-effectiveness is highly needed. Full article

Urban Air Mobility (UAM) has the potential to revolutionize urban transportation, largely with the deployment of Unmanned Aerial Vehicles (UAVs), commonly known as drones. After an initial stage focused on technology requirements, research is now shifting toward investigating operational requirements, which are unavoidably affected by urban characteristics. This study aims to explore the implementation of UAM services within urban environments by mapping the current scientific landscape from a city-focused perspective. Following a systematic search procedure, a bibliometric analysis was conducted on studies published between 2010 and 2024, examining over 350 articles that address UAM and urban-related topics. Trends in publication volume and scientific impact were analysed, along with influential manuscripts, collaborations, and leading countries in the field. Through a keyword co-occurrence analysis, five main research themes were identified: air traffic management, risk assessment, environmental factors (wind and noise), and vertiport location. These themes were further explored through a scoping review to assess current research and emerging directions. The findings highlight that urban characteristics are not just operational constraints but also fundamental elements that shape UAM strategies, influencing UAV path planning, safety, environmental constraints, and infrastructure design. Future research directions include the development of urban digital twins, comprehensive urban spatial databases, and multi-objective optimization frameworks to support the effective implementation of UAM into cities. Full article

Prior research has proposed a basic configuration for a deep-sea mining system integrating slurry transport and wastewater discharge, and examined the operational characteristics of water-driven diaphragm pumps. Against the backdrop of commercial deep-sea polymetallic nodule exploitation, this study focuses on the technical design of seabed diaphragm pump groups and hydraulic parameter matching for a coupled slurry transport-wastewater discharge system. The solid–liquid two-phase output characteristics of the water-driven diaphragm pump were analyzed, leading to the proposal of a four-pump staggered configuration to ensure continuous particulate discharge throughout the full operating cycle. To meet commercial mining capacity requirements, the system consists of two sets (each with four pumps) operating with a phase offset to reduce fluctuations in slurry output concentration. A centralized output device was developed for the pump group, and a centralized mixing tank was designed based on analyses of outlet pipe length and positional effects. CFD-DEM simulations show that the combined effects of phased pump operation and centralized mixing tank mixing result in the slurry concentration delivered to the riser pipeline staying within ±1% of the mean for up to 57.8% of the system’s operational time. Considering the characteristics of both diaphragm and centrifugal pumps, the system is designed to output high-concentration slurry from the seabed diaphragm pumps, driven solely by wastewater, while centrifugal pumps provide lower-concentration transport by adding supplementary water from a buffer—thus reducing the risk of clogging. Under the constraints of centrifugal pump capacity, the system’s hydraulic parameters were optimized to maximize overall slurry transport efficiency while minimizing the energy consumption from wastewater discharge. The resulting configuration defines the flow rate and slurry concentration of the diaphragm pump group. Compared with conventional centrifugal pump-based transport schemes, the proposed system increases the slurry pipeline efficiency from 53.14% to 55.43% and reduces wastewater discharge-related pipeline resistance losses from 475.9 mH₂O to 361.7 mH₂O. Full article

Background/Objectives: Complex endovascular solutions have expanded treatment options for complex abdominal aortic aneurysms (cAAA), particularly in elderly high-risk patients. However, these techniques are limited by anatomical constraints and costs, while the superiority over open repair (OSR) remains debatable. This study aimed to compare short- and mid-term outcomes of OSR for cAAA in patients aged ≥80 versus <80 years. Methods: Retrospective analysis was performed for patients who underwent OSR for cAAA between 2017 and 2022 at two tertiary vascular centers. A total of 226 patients (median age 71 years [IQR 66–80]; 89% male) were included, of whom 74 were aged ≥80 years. Primary endpoints were 30-day mortality, major adverse cardiovascular events (MACE), and early reintervention. Secondary endpoints included length of stay (LOS), acute kidney injury, new renal dysfunction, mid-term survival (≤5 years), and procedure-related reintervention. Propensity score matching (PSM) was performed to adjust for baseline differences. Results: Out of 1087 screened patients, 226 met the inclusion criteria: 74 octogenarians and 152 younger patients. Thirty-day mortality was significantly higher in octogenarians (9.5% vs. 0.7%; p < 0.001), as was the incidence of MACE (8.2% vs. 1.9%; p = 0.026). Rates of kidney impairment LOS and other major complications were comparable. During a median follow-up of 42.7 months, mid-term survival and freedom from reintervention did not differ significantly between groups. PSM analysis confirmed higher early mortality and cardiovascular events in octogenarians but similar mid-term outcomes. Conclusions: Although octogenarians undergoing OSR for cAAA face increased early mortality and cardiovascular complications, their mid-term survival and freedom from reintervention are comparable to younger patients. These results suggest that age alone should not represent a contraindication to open repair in appropriately selected individuals. Full article

Cyberattacks on pipeline operational technology systems pose growing risks to energy infrastructure. This study develops a physics-informed simulation and optimization framework for analyzing cyber–physical threats in petroleum pipeline networks. The model integrates networked hydraulic dynamics, SCADA-based state estimation, model predictive control (MPC), and a bilevel formulation for stealthy false-data injection (FDI) attacks. Pipeline flow and pressure dynamics are modeled on a directed graph using nodal pressure evolution and edge-based Weymouth-type relations, including control-aware equipment such as valves and compressors. An extended Kalman filter estimates the full network state from partial SCADA telemetry. The controller computes pressure-safe control inputs via MPC under actuator constraints and forecasted demands. Adversarial manipulation is formalized as a bilevel optimization problem where an attacker perturbs sensor data to degrade throughput while remaining undetected by bad-data detectors. This attack–control interaction is solved via Karush–Kuhn–Tucker (KKT) reformulation, which results in a tractable mixed-integer quadratic program. Test gas pipeline case studies demonstrate the covert reduction in service delivery under attack. Results show that undetectable attacks can cause sustained throughput loss with minimal instantaneous deviation. This reveals the need for integrated detection and control strategies in cyber–physical infrastructure. Full article

This paper presents a power-centric systems-engineering approach for PlanarSats and for atto-, and femto-class spacecraft where surface-limited power dominates design. We review agency practices (The National Aeronautics and Space Administration (NASA), European Space Agency (ESA), Japan Aerospace Exploration Agency (JAXA)) and the American Institute of Aeronautics and Astronautics (AIAA) framework, then extend them with refined low-power subcategories and a log-linear method for selecting phase- and class-appropriate power contingencies. The method is applied to historical and conceptual PlanarSats to show how contingencies translate into required array area, allowable incidence angles, and duty cycle, linking power sizing to geometry and operations. We define the operational power envelope as the range of satellite orientations and conditions under which generated power meets or exceeds mission requirements. Consistent with agency guidance, sizing is performed to the maximum expected value (MEV) (CBE plus contingency); when bounding or stress analyses are needed, we report the maximum possible value (MPV) (Maximum Possible Value) by applying justified system-level margins to the MEV. Results indicate that disciplined, phase-aware contingency selection materially reduces power-related risk and supports reliable, scalable PlanarSat missions under severe physical constraints. Full article

Climate change and environmental degradation pose significant challenges to public health globally, intensifying the frequency and severity of related health incidents. Field epidemiology, traditionally focused on infectious disease outbreaks, is now increasingly recognised as vital in addressing environmental and climate-related health threats. This study explores how organisations like Public Health Wales (PHW) can develop field epidemiology services responsive to these emerging challenges. Semi-structured interviews were conducted with 18 global and national experts in field epidemiology, environmental health, and related disciplines. An inductive content analysis approach was used to identify themes relating to best practices, challenges, competencies, and future directions in environmental field epidemiology. Key findings emphasise the necessity for integrated, multi-sectoral collaboration, capacity building in One Health competencies, and innovative surveillance systems that incorporate environmental and climate data and exposure measures. Participants highlighted barriers such as fragmented governance, data quality issues, and resource constraints. The evolving role of field epidemiology includes applications of environmental and climate-related health phenomena to encompass prevention, preparedness, and recovery phases, supported by technological advancements and holistic health security frameworks. To effectively address environmental and climate-related health incidents, field epidemiology services must evolve towards integrated, multidisciplinary, and adaptive frameworks. Organisations like PHW may consider strengthening international collaboration, investing in workforce development, and implementing integrated surveillance systems that incorporate environmental drivers of health. These strategic priorities align with global public health functions and support resilient health systems capable of mitigating climate-related health risks. Full article

With amateur and professional musicians facing high risks to mental and physical health, it is important to reflect on the nature of instrumental music education and to design novel educational approaches that take the development of well-being into account. In this article, I plead for a “caring” stance towards instrumental music education, conceiving the development of well-being as an integral element of the development of musicianship. First, I define such a caring stance, conceiving of musical development and the development of well-being as the two chains of the DNA of music education, with the PERMA building blocks of well-being as the bases of the ladder that connects the two chains. Next, I discuss how a synergy between the development of musicianship and well-being can be achieved by a constraints-led approach to integrating these building blocks of well-being into the dynamics of a music lesson. Then, I present a novel approach to instrumental music education that seeks to achieve the synergy between developing well-being and musicianship by educating the performing body beyond a mere instrumentalist approach to the body and musical instruments through the incorporation of movement-based learning activities. After elaborating on the guiding principles of this “kinemusical” approach, I exemplify the presented framework by discussing two learning activities in relation to the constraints-led integration of the PERMA building blocks of well-being. This exploratory work is presented as an initial step in a broader research agenda. It invites critical engagement and dialog to refine and advance the proposed kinemusical approach, with implications for both formal music education and the wider field of music research. Full article

Background: Mental health is increasingly recognized as an integral component of occupational health and safety, particularly in high-risk industries such as construction. However, in Saudi Arabia, limited attention has been given to understanding mental health knowledge, beliefs, and workplace support mechanisms, especially among a diverse workforce that includes both migrant and national employees. Methods: This qualitative study employed semi-structured interviews with 30 construction sector participants occupying a range of professional roles. Thematic analysis was conducted using NVivo 15 software, guided by the COM-B model and Health Belief Model, to explore perceptions related to mental health, safety practices, and organizational interventions. Results: The findings highlight significant disparities between migrant and national workers. Migrant workers reported greater challenges related to language barriers, cultural stigma, and a lack of access to culturally appropriate mental health support. National workers described slightly better access to safety and health initiatives but still reported inadequate mental health training. Key barriers across the workforce included limited leadership engagement, stigma, resource constraints, and insufficient organizational training. Existing health and safety programmes were largely focused on physical safety, with minimal incorporation of mental health concerns. Conclusions: The study reveals a pressing need to integrate mental health into occupational safety frameworks in the Saudi construction sector. Culturally sensitive, leadership-supported mental health initiatives are essential to addressing disparities and promoting holistic workers’ well-being across both migrant and national populations. Full article

This qualitative study investigates how local project managers interpret the concept of participation when implementing participatory processes under the Emilia-Romagna (Italy) regional framework. Drawing on 41 in-depth interviews with project managers and key personnel from participatory initiatives funded between 2020 and 2024, the research examines how these actors interpret the concept of participation and how their views align with regional objectives. Thematic analysis reveals that participation is widely viewed as a process of shared responsibility, co-decision, empowerment, and active citizenship. Participants described participation as both a political and relational act, involving co-responsibility, information exchange, and commitment to the common good. While many embraced a transformative vision of participation, others highlighted institutional constraints and the risk of participation being reduced to rhetoric. Additionally, gendered differences emerged in the way participants framed participation, with women emphasizing relational and care-based dimensions, and men focusing more on agency and power. The findings suggest that participation, when meaningfully enacted, is seen as a driver of democratic engagement and institutional trust, but it requires a sustained effort to go beyond procedures and enable genuine collaboration between institutions and citizens. Full article

Objective: The COVID-19 pandemic disrupted the seasonal pattern of RSV infections, increasing cases outside the typical epidemic season. This study aimed to assess the pandemic’s impact on the clinical characteristics of RSV infections in children hospitalized at the Polish Mother’s Memorial Health Institute in Łódź, based on a 9-year observation period from 2016 to 2024. Methods: A retrospective analysis was conducted on 330 children hospitalized for RSV between 2016 and 2024. Patients were divided into pre-COVID-19 (2016–2020, n = 160) and post-COVID-19 (2021–2024, n = 170) groups. The hospitalization course, the treatment duration, the use of oxygen, antibiotics, systemic steroids, the patient age structure, and risk factors were compared. Results: Following the pandemic, the age profile of hospitalized RSV patients shifted, with more children over 12 months (27% post-COVID-19 vs. 18% pre-COVID-19). RSV hospitalizations increased as COVID-19 cases declined (correlation coefficient: −1.0; p < 0.001). The average hospitalization duration decreased by 1.8 days (p = 0.002). Oxygen therapy was used more frequently post-pandemic (p < 0.001), while antibiotic use decreased (51.75% vs. 81.25%; p < 0.001). No significant difference was observed in ICU transfer rates. Premature infants and children with congenital defects experienced longer hospitalizations, with a stronger correlation noted post-COVID-19 (0.38; p < 0.001). Conclusions: The COVID-19 pandemic changed the profile of children hospitalized with RSV, increasing the proportion of older patients. Despite shorter hospital stays, prematurity and congenital anomalies remained key risk factors for severe disease. Study limitations include its retrospective design, selection bias, and limited socio-demographic and clinical data due to pandemic-related constraints. Full article

This study aimed to identify and analyse the main difficulties faced by family farmers in producing and supplying vegetables through short food supply chains. Semi-structured interviews were conducted with seven family farmers in a large city in southern Brazil. We sought to include at least one farmer supplying each of the main identified outlets: schools, restaurants, supermarkets, street markets, and consumer groups. Contacts were obtained through rural producer organisations. Data were recorded, transcribed, and analysed using thematic analysis. Three groups of difficulties emerged: (i) production—including seasonality, pest, and disease management, climate-related losses, and limited technical support; (ii) sales—such as price competition, logistical challenges, and inconsistent demand; and (iii) consumption—particularly low consumer habits regarding vegetable purchase and preparation, and preference for non-seasonal products. The study concludes that the main challenges to strengthening short food supply chains are the limited engagement of young people in farming, lack of specialised technical assistance, climate-related risks, bureaucratic barriers, and the high costs of organic certification. Farmers also reported logistic difficulties and constraints in supplying restaurants due to demand for a narrow range of products disregarding seasonality. At the consumer level, habits shaped by conventional food systems emerged as obstacles. Strategies such as alternative markets, farmer organisations, supportive public policies, and initiatives to promote cooking skills and consumer awareness are key to enhancing resilience and expanding the supply of healthy foods. Full article

Ergonomic risk assessment is crucial for preventing work-related musculoskeletal disorders (WMSDs), which often arise from repetitive tasks, prolonged sitting, and load handling, leading to absenteeism and increased healthcare costs. Biomechanical risk assessment, such as RULA/REBA, is increasingly being enhanced by camera-based motion capture systems, either marker-based (MBSs) or markerless systems (MCBSs). This systematic review compared MBSs and MCBSs regarding accuracy, validity, and reliability for industrial ergonomic risk analysis. A comprehensive search of PubMed, WoS, ScienceDirect, IEEE Xplore, and PEDro (31 May 2025) identified 898 records; after screening with PICO-based eligibility criteria, 20 quantitative studies were included. Methodological quality was assessed with the COSMIN Risk of Bias tool, synthesized using PRISMA 2020, and graded with EBRO criteria. MBSs showed the highest precision (0.5–1.5 mm error) and reliability (ICC > 0.90) but were limited by cost and laboratory constraints. MCBSs demonstrated moderate-to-high accuracy (5–20 mm error; mean joint-angle error: 2.31° ± 4.00°) and good reliability (ICC > 0.80), with greater practicality in field settings. Several studies reported strong validity for RULA/REBA prediction (accuracy up to 89%, κ = 0.71). In conclusion, MCBSs provide a feasible, scalable alternative to traditional ergonomic assessment, combining reliability with usability and supporting integration into occupational risk prevention. Full article

Truck drivers play a pivotal role in global freight transport systems, yet their occupational and behavioral risk exposures make them a priority population in road safety research. This systematic review examines the factors influencing risky driving behaviors among truck drivers and their impacts on road safety outcomes. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, the review aimed to identify hazardous driving behaviors, the internal and external factors contributing to these behaviors, and their consequences for traffic safety. Inclusion criteria targeted original research published in English between 2009 and 2024 specifically focused on truck driver behavior and road safety outcomes. Systematic searches across PubMed, Scopus, Web of Science, and IEEE Xplore yielded 104 studies meeting these criteria. The synthesis revealed prevalent risky behaviors—such as speeding, fatigue-related impairments, distracted driving, and substance use—driven by internal factors (e.g., health conditions, psychological stress) and external pressures (e.g., occupational demands, regulatory constraints). These behaviors were consistently associated with increased crash risk. Nonetheless, limitations including the exclusion of non-English studies, reliance on self-reported data, and lack of standardized metrics constrained cross-study comparability and generalizability. Effective interventions identified include fatigue management programs, driver monitoring technologies, and positive safety climates. Findings underscore the urgent need for evidence-based, multifaceted strategies to enhance truck driver safety and inform policy, industry practices, and future research. Full article