Biological micro-dissection has a wide range of applications in the field of molecular pathology. The current laser-assisted dissection technology is expensive, and laser radiation can lead to sample contamination. As an economical and pollution-free micro-dissection method, piezoelectric ultrasonic micro-dissection has a wide application prospect. However, the performance of the current piezoelectric ultrasonic micro-dissection technology is unsatisfactory. In this paper, a novel piezoelectric ultrasonic micro-dissection device based on a flexure mechanism is proposed in order to solve the problems of low dissecting precision and excessive wear of the dissecting needle caused by the harmful lateral vibration of the current piezoelectric ultrasonic micro-dissection device. By analyzing the flexibility of flexure hinge, the type of flexure beam and the optimal design parameters are determined. Through comparing the harmonic response simulation analysis of the micro-dissection device based on a flexure mechanism and the traditional micro-dissection device without the flexure mechanism, the newly designed micro-dissection device achieves the best vibration effect when the driving frequency is 28kHz, compared with the traditional micro-dissection device, the lateral vibration suppression effect is improved by 68%. Then, based on the 3D printing technology, a prototype of a novel micro-dissection device was produced, and its performance was tested. It was found that the flexure mechanism did indeed suppress the lateral vibration of the needle tip. Finally, the experiments of 5μm thick paraffin-embedded rat liver sections were carried out, and the effects of different dissecting parameters on the dissecting effect were analyzed, and the optimal dissecting parameters were obtained. By comparing the dissecting effects of the tissue sample and the wear condition of the needle tip between the novel micro-dissection device and the traditional micro-dissection device under their optimal dissecting parameters, it is proved that the suppression of harmful lateral vibration not only significantly improves the dissecting effect, but also improves the service life and durability of the dissecting needle, which is beneficial to reduce the equipment costs.

This paper proposes a novel biologically inspired design for an insect-scale flapping robot. The proposed scheme employs two motors to drive four wings, mimicking the flapping motion of nat-ural four-winged insects. The vehicle incorporates two pairs of flapping wings to generate lift force, with a transmission mechanism featuring flexure hinges instead of pivot joints, resulting in reduced weight and volume. The flexure hinges also exhibit nonlinear stiffness to facilitate smooth wing motion. The vehicle is designed to be symmetrical in structure, with the wings of each section generating greater lift through the clap-and-fling mechanism. The final product weighs 6.2g, pos-sesses a wingspan of 17cm, a one-sided flapping wing angle of 103 degrees, and generates lift that exceeds its weight, attesting to its successful design.

The flywheel is a widespread mechanical component used for the storage of kinetic energy and angular momentum. It typically consists of a cylindrical inertia rotating about its axis on rolling bearings, which involves undesired friction, lubrication, and wear. This paper presents an alternative mechanism that is functionally equivalent to a classical flywheel while relying exclusively on limited-stroke flexure-joints. This novel 1-degrees-of-freedom zero-stiffness mechanism has no wear and requires no lubrication: it is thus compatible with extreme environments, such as vacuum, cryogenics, or ionizing radiation. The mechanism is composed of two coupled pivoting rigid bodies whose individual angular momenta vary during motion but whose sum is constant at all times when the pivoting rate is constant. The quantitative comparison of the flexure-based flywheel to classical ones based on a hollow cylinder as inertia shows that the former stores typically 6 times less angular momentum and kinetic energy for the same mass while occupying typically 10 times more volume. The freedom of design of the shape of the rigid bodies offers the possibility of modifying the ratio of the kinetic energy stored versus angular momentum, which is not possible with classical flywheels. For example, a flexure-based flywheel with rigid pivoting bodies in the shape of thin discs stores 100 times more kinetic energy than a classical flywheel with the same angular momentum. A proof-of-concept prototype was successfully built and characterized in terms of reaction moment generation, which validates the presented analytical model.

A compact 2-DOF (two degrees of freedom) piezoelectric-driven platform for 3D cellular bio-assembly systems has been proposed based on “Z-shaped” flexure hinges. Multiple linear motions with high resolution both in x and y directions are achieved. The “Z-shaped” flexure hinges and the parallel-six-connecting-rods structure are utilized to obtain the lowest working stress while compared with other types of flexure hinges. In order to achieve the optimized structure, matrix-based compliance modeling (MCM) method and finite element method (FEM) are used to evaluate both the static and dynamic performances of the proposed 2-DOF piezoelectric-driven platform. Experimental results indicate that the maximum motion displacements for x stage and y stage are lx=17.65 μm and ly=15.45 μm, respectively. The step response time for x stage and y stage are tx=1.7 ms and ty =1.6 ms, respectively.

Adding steel fibers to concrete improves the capacity in tension-driven failure modes. An example is the shear capacity in steel fiber reinforced concrete (SFRC) beams with longitudinal reinforcement and without shear reinforcement. Since no mechanical models exist that can fully describe the behavior of SFRC beams without shear reinforcement failing in shear, a number of empirical equations have been suggested in the past. This paper compiles the existing empirical equations and code provisions for the prediction of the shear capacity of SFRC beams failing in shear as well as a database of 487 experiments reported in the literature. The experimental shear capacities from the database are then compared to the prediction equations. This comparison shows a large scatter on the ratio of experimental to predicted values. The practice of defining the tensile strength of SFRC based on different experiments internationally makes the comparison difficult. For design purposes, the code prediction methods based on the Eurocode shear expression provide reasonable results (with coefficients of variation on the ratio of tested to predicted results of 27% - 29%). None of the currently available methods properly describe the behavior of SFRC beams failing in shear. As such, this work shows the need for studies that address the different shear-carrying mechanisms in SFRC and its crack kinematics.

The practical necessity of strengthening of reinforced concrete structure elements requires a choice of a method which would provide cost-effectiveness, simplicity of construction and durability of the chosen solution. One of the ways is strengthening using the material belonging to the group of micro-reinforced concretes called ferrocement. The paper presents the comparative analysis of some of the results of RC beams exposed mainly to flexure, strengthened with ferrocement elements (strips) applied by gluing on the on the tensed side of RC beams. The results are obtained using the experimental, analytical and numerical research on the adequate models. Strengthening of the beams was performed in the form of four types of ferrocement strips (four different strip widths and four different numbers of wire mesh layers). The numerical non-linear analysis using finite elements method (FEM) was employed, with the introduction of the corresponding characteristics of constitutive material obtained by the experiments on the test specimens. The analytical researches were performed using known analytical calculation methods in order to formulate the model for the calculation of the ultimate and serviceability limit states of the strengthened cross-section. The results presented in the paper, through their comparative compatibility, confirmed the applicability of this strengthening method.

In this paper, a voice coil motor (VCM) actuated fast tool servo (FTS) system is developed for diamond turning. To guide motions of the VCM actuator, a crossed double parallelogram flexure mechanism is selected featuring totally symmetric structure with high lateral stiffness. To facilitate the determination of the multi-physical parameters, analytical models of both electromagnetic and mechanical systems are developed. The designed FTS with balanced stroke and natural frequency is then verified through the finite element analysis. Finally, the prototype of the VCM actuated FTS is fabricated and experimentally demonstrated to have a stroke of ±59.02 μm and a first natural frequency of 253 Hz. By constructing a closed-loop control using PID controller with the internal-model based resonant controller, the error for tracking a harmonic trajectory with ±10 μm amplitude and 120 Hz frequency is obtained to be ±0.2 μm, demonstrating the capability of the FTS for high accuracy trajectory tracking.

Guided image filter implicitly balances noise and details based on local variance, achieving noise suppression while preserving prominent edges. However, we have observed limitations in using variance to distinguish between noise and image details, resulting in the suppression of fine structures alongside noise. Furthermore, the goal of enhancing image details, which is crucial in image filtering, has not been adequately addressed in edge-preserving filter design. In this paper, we approach image filtering as a problem of spectral energy reconfiguration, where the gain of each spectral band is adaptively regulated to achieve simultaneous noise suppression and detail enhancement. Instead of relying on variance, we employ a linear noise estimator to obtain the Signal-to-Noise Ratio (SNR) measurement necessary for dynamic gain regulation. Similar to the guided image filter, we determine the filter coefficients by solving the closed-form solution of the optimizer. We demonstrate that the proposed extended guided filter effectively integrates information from multiple spectral bands locally, allowing for the joint enhancement of meaningful details while simultaneously smoothing noise.

Background - Mandibular flexion (MF) is a complex biomechanical phenomenon, which involves a deformation of the mandible, due mainly to the contraction of the masticatory muscles, and can have numerous clinical effects. The main aim of the current systematic review is to highlight the different factors that can increase MF, to help clinicians, identify patients to whom they should pay more attention. As a secondary outcome, we wanted to analyze the preventive measures and suitable techniques to be adopted to minimize the negative effects of this phenomenon on oral fixed rehabilitations. Methods - The review, which was carried out in accordance with the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) flowchart, was recorded in the “International Prospective Register of Systematic Reviews” (PROSPERO). As research questions, “Patient/Population, Intervention, Comparison and Outcomes” (PICO) questions were employed. Using the ROBINS-I technique, the risk of bias in non-randomized clinical studies was evaluated. Results - The initial electronic search identified over 1300 potential articles, of which 54 studies were included in this systematic review. Information regarding the relationship between MF and individual factors, mandibular movements, impression-taking and fixed rehabilitations were obtained. Conclusions – The studies included in this systematic review showed that MF is greater during protrusive movements, in the posterior areas of the lower jaw, and in patients with brachial facial type, greater jaw length, small gonial angle and less density, length and bone surface of the symphysis. The biomechanical effects of mandibular flexion on fixed restorations are debated. Prospective clinical and radiological observational studies should be conducted to evaluate the potential short-, medium- and long-term consequences of MF.

Ultrasonic based inspection of thin-walled structures often requires prior knowledge of their mechanical properties. Their accurate estimation could be achieved in a non-destructive manner employing, e.g., elastic guided waves. Such procedures require efficient approaches for experimental data extraction and processing, which is still a challenging task. An advanced automated technique for material properties identification of an elastic waveguide is proposed in this investigation. It relies on the information on dispersion characteristics of guided waves, which are extracted by applying the matrix pencil method to the measurements obtained via laser Doppler vibrometry. Two objective functions have been successfully tested, and the advantages of both approaches are discussed (accuracy vs computational costs). The numerical analysis employing the synthetic data generated via the mathematical model as well as experimental data shows that both approaches are stable and accurate. The influence of the presence of various modes in the extracted data is investigated. One can conclude that the influence of the corruptions related to the extraction of dispersion curves is not critical if the majority of guided waves propagating in the considered frequency range are presented. Possible extensions of the proposed technique for damaged and multi-layered structures are also discussed.

A concept of guided artillery rockets with reusable first stage otherwise called a rocket launcher aircraft (RLA) is presented. RLA raises the second stage rockets (SSR) to an altitude of up to 20 km. While RLA is moving at low supersonic speed, it releases one or more SSRs. RLA returns to the base within a few minutes of it’s launch. SSRs use slow burning motors to gain altitude and velocity. At the apogee of their flight SSRs release projectiles which fly to the target and strike it at high impact velocity. The projectiles reach a target at ranges of up to 374 km and impact velocity up to 1.35 km/s. We show that a rocket launched at high altitude and high initial velocity does not need expensive thermal protection to survive ascent. Delivery of munitions to target by the system described should be much less expensive than delivery by a conventional rocket. All parameters of RLA, SSR, and their trajectories are calculated based on theoretical (mechanical and thermo-dynamical) analysis and on several MatLab programs.

A galvalume corrugated sheet was utilized as formwork for a reinforced concrete beam in flexure. A numerical model was validated to the experimentally obtained data, and further adopted to simulate the behavior of this composite structure under elevated temperatures. The properties and constitutive stress-strain data of the basic materials were obtained from experiments, and superimposed into the finite element model. The study concluded that the load carrying capacity of the member decreased as a direct function on temperature increase, and the cracking moment was very sensitive to the temperature fluctuation. The elevated temperatures also altered the failure mode.

For shear-critical structural elements where the use of stirrups is not desirable, such as slabs or beams with reinforcement congestion, steel fibers can be used as shear reinforcement. The contribution of the steel fibers to the shear capacity lies in the action of the steel fibers bridging the shear crack, which increases the shear capacity and prevents a brittle failure mode. This study evaluates the effect of the amount of fibers in a concrete mix on the shear capacity of steel fiber reinforced concrete beams with mild steel tension reinforcement and without stirrups. For this purpose, twelve beams were tested. Five different fiber volume fractions were studied: 0.0%, 0.3%, 0.6%, 0.9%, and 1.2%. For each different steel fiber concrete mix, the concrete compressive strength was determined on cylinders and the tensile strength was determined in a flexural test on beam specimens. Additionally, the influence of fibers on the shear capacity is analyzed based on results reported in the literature, as well as based on the expressions derived for estimating the shear capacity of steel fiber reinforced concrete beams. The outcome of these experiments is that a fiber percentage of 1.2% or fiber factor of 0.96 can be used to replace minimum stirrups according to ACI 318-14 and a 0.6% fiber volume fraction or fiber factor of 0.48 to replace minimum stirrups according to Eurocode 2. A fiber percentage of 1.2% or fiber factor of 0.96 was observed to change the failure mode from shear failure to flexural failure. The results of this presented study support the inclusion of provisions for steel fiber reinforced concrete in building codes and provides recommendations for inclusion in ACI 318-14 and Eurocode 2, so that a wider adoption of steel fiber reinforced concrete can be achieved in the construction industry.

This work deals with the evaluation of adhesive single-lap joints using ultrasonic guided waves. An adhesive bonded lap joint can be modelled as a three-layer system made up of two adherents and an adhesive. The propagation of guided waves in the joint is developed from matrix formulations. The behavior of the different guided wave modes that propagate in the bonded region is characterized and it is found that their relative amplitudes can be estimated based on the properties of the incoming wave that propagates in the non-bonded region. It was verified that the excitation of these modes is ruled by the degree in which the shapes of both modes match each other. A 3D simulation of two aluminium bonded plates using 500 kHz ultrasonic transducers in a pitch and catch configuration was implemented using the Matlab k-Wave toolbox. Scattering effects due to some produced defects located in the bond line of the lap joints were simulated. Experimental setup with some artificial defects produced in the aluminum joints were used in order to compare with the simulated. Qualitative agreement was observed for the two approaches. The observed deviation can be due to the different characteristics of the experimental and simulated defects.

In this work the effect of recycled concrete aggregate modified with mineral admixtures and Nano-silica on the mechanical properties and performance of the concrete was investigated after curing in tap water for 28 and 90 days. The compressive, ƒc, indirect tensile, ƒt, and flexural, ƒb, strengths for cured concrete specimens were measured and concrete strength ratios were analyzed. The water and rapid chloride permeability were measured. SEM analysis of microstructure was, also, investigated. The coarse aggregates used were dolomite (control) and recycled concrete aggregate with the incorporation of different mineral admixtures including ground granulated blast slag and granite as well as Nano-silica. It was found that, the slump values of the dolomite concrete decreases compared with recycle aggregate concrete. The results indicate that, the concrete mix containing recycle aggregate have the highest compressive strength, tensile strength and flexural strength compered to concrete mix containing dolomite aggregate. As far as the compressive strength is concerned, the addition 1 % NS and 15 % of slag improved the physico-mechanical properties of the recycled aggregate concretes compared to the other mixes after curing in tap water.

Cervical cancer remains a major public health problem. Despite the screening programs, cervical cancer is the second most commonly diagnosed cancer. Most of the cases occur in less developed countries, and it is the third leading cause of cancer death among females. In 2000–2007, the five-year relative survival rate for European women diagnosed with cervical cancer was 62%.[1] Standard treatment for locally advanced cervical cancer reveals external beam radiotherapy (EBRT) with concurrent chemotherapy followed by image-guided adaptive brachytherapy (IGABT) boost [2, 3]. In the last years, the Gynaecological (GYN) working group composed of Group Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) has developed new recommendations for the treatment of cervical cancer based on IGABT. The treatment plan includes 3-dimensional (3D) imaging based on magnetic resonance imaging (MRI) or computed tomography (CT), adaptive to the target volume and organ at risk [4–6]. The brachytherapy insertion is made under anaesthesia. At the time of the application insertion, the ultrasound is used to guide the dilatation of the uterine canal and assess the depth of the uterine cavity. In this paper, we review the data available in international literature about the use of ultrasound (US) in brachytherapy treatment of cervical cancer.

Numerical methods, including machine learning methods, are now actively used in the applications related to guided wave propagation. The method proposed in this study for material properties characterization is based on the algorithm of the clustering of multivariate data series obtained as a result of the application of the matrix pencil method to the experimental data. In the proposed technique, multi-objective optimization is employed to improve the accuracy of particular parameter identification. At the first stage, the computationally efficient method based on the calculation of the Fourier transform of Green's matrix is employed iteratively and the obtained solution is used for the filter construction with decreasing bandwidth, which allows us to obtain nearly noise-free classified data (with mode separation). The filter provides data separation between all guided waves in a natural way, which is needed at the second stage, where the slower method based on the minimization of the slowness residuals is applied to the data. The method might be applied for material properties identification in plates with thin coatings/interlayers, multi-layered anisotropic laminates etc.

ABSTRACT Objectives: Typical Diagnostic Reference Levels (DRL) in terms of Computed Tomography Dose Index (CTDI) and patient dose in terms of Effective Dose (ED ) and Size Specific Dose Estimate (SSDE) were estimated in Computed Tomography (CT) guided biopsy procedures. Materials and Methods: A total of 226 CT biopsy procedures - Iliac bone, liver, lung, mediastinum and para-aortic tissue - were retrospectively analyzed and Typical DRL extracted based on ICRP 135 instructions. Results: For helical mode acquisitions, DRLs in terms of CTDIvol were 9.7 mGy for Iliac bone, 8.9 mGy for liver, 8.8 mGy for lung, 7.9 mGy for mediastinal mass and 9 mGy for para-aortic lymph nodes biopsy procedures. For biopsy acquisitions, DRL values were 7.3 mGy, 7.7 mGy, 5.6 mGy, 5.6 mGy and 7.4 mGy respectively. Also, SSDE median values ranged from 7.6 mGy to 10 mGy for biopsy acquisitions and 11,3 mGy to 12,6 mGy for helical acquisitions, as well as the median values for effective dose ranged from 1.6 mSv to 5,7 mSv for biopsy scans and 3.9 to 9.3 mSv for helical scans. Conclusions: The use of DLR as an optimization tool for CT-guided biopsy procedures revealed that helical scans across the entire anatomical region greatly affect radiation dose compared to biopsy acquisitions.

Insufficient oral ridge tissue presents a challenge in the treatment of dental implants. One method to enhance alveolar crest dimensions is guided bone regeneration (GBR); however, existing membranes have certain limitations. To address this issue, we aimed to compare the effectiveness of a resorbable bilayer membrane composed of poly(l-lactic acid) and poly(-caprolactone) （PLACL）with that of a collagen membrane（COL） in a rat GBR model. The rat calvaria was used as an experimental model by placing a plastic cylinder. Forty male Fisher rats underwent surgery, and micro-computed tomography and histomorphometric analyses were performed to assess bone regeneration. The results showed that bone regeneration was similar across all the groups. However, after 24 weeks, the PLACL membrane demonstrated significant resilience, occasional partial degradation, and intermittent air bubble formation. This extended preservation of the barrier effect has great potential to facilitate optimal bone regeneration. In conclusion, this study shows that the PLACL membrane is a promising alternative to GBR. By providing a durable barrier and supporting bone regeneration over an extended period, this resorbable bilayer membrane may address the limitations of the current membranes. Further studies and clinical trials are warranted to validate the efficacy and safety of this drug in humans.

Two types of trenches cross-section in conventional vertical and brand new reverse-V-shape have fabricated on SCD substrate by micro-jet water-assist laser, the epitaxial lateral overgrowth technique has applied by microwave plasma chemical vapor deposition system in forming multiple micrometer-size channels. Raman and SEM techniques have applied in analyze both types growth layer characterization. Optical microscope has used to test microchannels hollowness. As a result, with the brand new reverse-V-shape trench, epitaxial lateral overgrowth layer reaches higher SCD surface morphology and crystal quality.

We report on the isolation of the previously uncultured Neocallimastigomycota SK4 lineage by two independent research groups from a wild aoudad sheep rumen sample (Texas, USA) and an alpaca fecal sample (Baden-Württemberg, Germany). Isolates from both locations showed near identical morphological and microscopic features, forming medium-sized white filamentous colonies with a white center of sporangia on agar roll tubes and a heavy biofilm in liquid media. Microscopic analysis revealed monocentric thalli, and spherical polyflagellated zoospores with 7–20 flagella. Zoospore release occurred through an apical pore as well as by sporangial wall rupturing, a duality that is unique amongst described AGF strains. Isolates were capable of growing on a wide range of mono-, oligo-, and polysaccharides substrates. Phylogenetic assessment based on the D1-D2 large rRNA subunit (D1-D2 LSU) and internal transcribed spacer-1 (ITS-1) regions demonstrated high sequence identity (minimum identity of 99.07% and 96.96%, respectively) between all isolates; but low sequence identity (92.4% and 86.7%, respectively) to their closest cultured relatives. D1-D2 LSU phylogenetic trees grouped the isolates as a new monophyletic clade within the Orpinomyces-Neocallimastix-Pecoramyces-Feramyces-Ghazallamyces supragenus group. D1-D2 LSU and ITS-1 sequences from the obtained isolates were either identical, or displayed extremely high sequence similarity to sequences recovered from the same Aoudad sheep sample on which isolation was conducted, as well as several sequences recovered from domestic sheep and few other herbivores. Interestingly, members of the SK4 clade seem to be encountered in animals grazing on summer pasture. We hence propose accommodating these novel isolates in a new genus, Aestipascuomyces (derived from the Latin word for “summer pasture”), and a new species, A. dupliciliberatus. The type strain is Aestipascuomyces dupliciliberatus strain R4.

: Image guided superficial radiation therapy (IGSRT) combines superficial radiation therapy (SRT) with full dermal visualization (FDV) via high resolution dermal ultrasound (HRDUS) for the treatment of non-melanoma skin cancer (NMSC). The gold standard for IGSRT delivery includes a comprehensive cancer care model with support for the dermatologists by a multidisciplinary team. When delivered in this model, IGSRT can achieve cure rates of 99% for treatment of NMSC. This paper focuses on the benefits of IGSRT during therapy. Medical records from 7 dermatology clinics of 883 patients with 1,507 cases of NMSC treated with IGSRT be-tween 2017 and 2018 were retrospectively reviewed. 92% of the NMSC lesions showed daily depth fluctuations, 60.32% of lesions did not require changes during therapy, and nearly 40% of lesions required at least one compensatory change during therapy. 83% of NMSC lesions were labeled high-risk based on the 2024 NCCN guidelines. Increasing and decreasing tumor depth measurements during IGSRT inform dermatologists when adaptive changes in energy (kV), TDF and dose will result in more efficacy and less toxicity, respectively.

(1) Background: This retrospective study aimed to compare the efficacy and safety of one-stage computed tomography (OSCT)- to that of two-stage computed tomography (TSCT)-guided localization for the surgical removal of small lung nodules. (2) Methods: We collected data from patients with ipsilateral pulmonary nodules who underwent localization before surgical removal at Veteran General Hospital Kaohsiung between October 2017 and January 2022. The patients were divided into the OSCT and TSCT groups. (3) Results: We found that OSCT significantly reduced the localization time and risky time compared to TSCT, and the success rate of localization and incidence of pneumothorax were similar in both groups. However, the time spent under general anesthesia was longer in the OSCT group than in the TSCT group. (4) Conclusions: The OSCT-guided approach to localize pulmonary nodules in hybrid operation room is a safe and effective technique for the surgical removal of small lung nodules.

Objective: to evaluate the feasibility of the intra-operative application of a specimen PET/CT imager in a clinical setting. Materials and methods: this is a pilot analysis performed in three patients who received an intra-operative administration of 68Ga-PSMA-11 (n=2) and 68Ga-DOTA-TOC (n=1), respectively. Patients were administrated with PET radiopharmaceuticals to perform radio-guided surgery with a beta-probe detector during radical prostatectomy for prostate cancer (PCa) and salvage lymphadenectomy for recurrent neuroendocrine tumor (NET) of the ileum, respectively. All procedures have been performed within two ongoing clinical trials in our Institute (NCT05596851 and NCT05448157). Pathologic assessment with immunohistochemistry (PSMA-staining and SSA immunoreactivity) was considered as standard of truth. Specimen images were compared with baseline PET/CT images and histopathological analysis. Results: Patients received 1 MBq/Kg of 68Ga-PSMA-11 (PCa) or 1.2 MBq/Kg of 68Ga-DOTA-TOC (NET) prior to surgery. Specimens were collected, positioned in the dedicated specimen container, and scanned to obtain high resolution PET/CT images. In all cases a perfect match was observed between the findings detected by the specimen imager and histopathology. Overall, the PET spatial resolution was sensibly higher for the specimen images compared to the baseline whole-body PET/CT images. Furthermore, the use of the PET/CT specimen imager did not significantly interfere with any procedures, and the overall length of the surgery was not affected using the PET/CT specimen imager. Finally, the radiation exposure of the operating theater staff was lower than 40 µSv per procedure (range 26 – 40 Sv). Conclusion: the image acquisition of specimens obtained by patients who received intra-surgery injection of 68Ga-PSMA-11 and 68Ga-DOTA-TOC was feasible and reliable also in a live-experience session and has been easily adapted to surgery daily-practice. The high sensitivity, together with the evaluation of intra-lesion tumor heterogeneity, were the most relevant results since the data derived from specimen PET/CT imaging matched perfectly with the histopathological analysis.

Guided ultrasonic waves are suitable for use in the context of structural health monitoring of thin-walled, plate-like structures. Hence, observing the wave propagation in the plates can provide an indication of whether damage has occurred in the structure. In this work, the wave propagation in fiber metal laminate consisting of thin steel foils and layers of carbon fiber-reinforced polymer is studied, focusing on the main propagation characteristics like dispersion diagrams and displacement fields. For this purpose, the dispersion diagrams derived from the analytical framework and numerical simulations are first determined and compared to each other. Next, the displacement fields are computed using the global matrix method for two excitation frequencies. The results derived from the analytical framework is used to validate numerically determined displacement fields based on a 2D and a 3D modeling approach. For both investigations the results of the analytical treatment and the numerical simulation show good agreement. Furthermore, the displacement field reveals the typical and well-known characteristics of the propagation of guided waves in thin-walled structures. Since the use of full 3D models involves a very high computational cost, this work also successfully investigates the possibility for model order reduction to decrease the computational time and costs of the simulation without the loss of accuracy.

Hard tissue apposition along the root canal walls is a slow, normally occurring physiological aging process. In response to tooth wear, local deposition of hard tissue may also occur in the pulp at a slow pace. Sometimes, the rate of hard tissue deposition acceleration may seem to be uncontrolled after dental trauma, autotransplantation, and orthodontic therapy, leading to rapid partial or total obliteration of the root canal space. This situation is called calcific metamorphosis (CM) or pulp canal obliteration (PCO). Although the incidence of pulpal necrosis in these teeth is believed to be infrequent, conventional endodontic therapy in severely calcified canals poses extreme difficulties and a higher risk for procedural accidents. This article aims to review the available approaches for the predictable negotiation of calcified canals and to introduce the buckling resistance activation test (BRAT) technique.

This paper describes the design and implementation of an ultrasonic non-contact air-coupled technique (UNCACT) using antisymmetric Lamb waves (ALW) for NDT assessment in novel composite sandwich plates of the car body shell. This technique is complemented with a C-Scan image implementation using this kind of guided waves. The finite element method using Comsol 6.1 is developed for the interpretation of the several wave modes presented in the experiments, including the ALW mode. The phase velocity method (PVM) is applied for the verification of the ALW mode in the portion of the RF signal necessary in the C-Scan image.

Objective: Surgical eradication of malignant glioma cells is theoretically impossible. Therefore, reducing the number of remaining tumor cells around the brain-tumor interface (BTI) is crucial for achieving satisfactory clinical results. The usefulness of fluorescence-guided resection for the treatment of malignant glioma was recently reported, but the detection of infiltrating tumor cells in the BTI using a surgical microscope is not realistic. Therefore, we developed an intraoperative rapid fluorescence cytology system, and evaluated its clinical feasibility for the management of malignant glioma. Materials and methods: Twenty-five selected patients with malignant glioma (newly diagnosed: 17; recurrent: 8) underwent surgical resection under photodiagnosis using photosensitizer Talaporfin sodium and a semiconductor laser. Intraoperatively, a crush smear preparation was made from a tiny amount of tumor tissue, and the fluorescence emitted upon 620/660 nm excitation was evaluated rapidly using a compact fluorescence microscope in the operating theater. Results: Fluorescence intensities of tumor tissues measured using a surgical microscope correlated with the tumor cell densities of tissues evaluated by measuring the red fluorescence emitted from the cytoplasm of tumor cells using a fluorescence microscope. A “weak fluorescence” indicated a reduction in the tumor cell density, whereas “no fluorescence” did not indicate the complete eradication of the tumor cells, but indicated that few tumor cells were emitting fluorescence.Conclusion: The rapid intraoperative detection of fluorescence from glioma cells using a compact fluorescence microscope was a useful to evaluate the presence of tumor cells in the resection cavity walls, and provides surgical implications for the more complete resection of malignant gliomas.

Photogrammetry involves aerial photography of the earth’s surface and subsequently processing the images to provide a more accurate depiction of the area (Orthophotography). It’s used by the Spanish Instituto Geográfico Nacional to update road cartography but requires a significant amount of manual labor due to the need to perform visual inspection of all tiled images. Deep Learning techniques (artificial neural networks with more than one hidden layer) can perform road detection but it is still unclear how to find the optimal network architecture. Our system applies grammar guided genetic programming to the search of deep neural network architectures. In this kind of evolutive algorithm all the population individuals (here candidate network architectures) are constrained to rules specified by a grammar that defines valid and useful structural patterns to guide the search process. Grammar used includes well-known complex structures (e.g. Inception-like modules) combined with a custom designed mutation operator (dynamically links the mutation probability to structural diversity). Pilot results show that the system is able to design models for road detection that obtain test accuracies similar to that reached by state of the art models when evaluated over a dataset from the Spanish National Aerial Orthophotography Plan.

The objective of this case report is to introduce a customized CAD/CAM freeze-dried bone allograft (FDBA) block for its use in Guided Bone Regeneration (GBR) procedures for severely deficient maxillary bones. Additionally, a special newly developed remote incision technique is presented to avoid wound dehiscence. The results show an optimal integration behaviour of the FDBA block after six months and the formation of new vital bone. Thus, the results of the present case report confirm the use of the customized CAD/CAM bone block for augmentation of complex defects in the maxillary aesthetic zone as a successful treatment concept.

In "genome editing," a type of genetic engineering, DNA is added, taken away, or changed in an organism's genome. Biomedicine, biotechnology, and synthetic biology, just to name a few, have all gained a lot from how often this method is used. Before the editing process can start, a Double-Strand Breaks (DSB) must be made in the DNA at a specific gene. Researchers have made nucleases, which are sometimes called "molecular scissors," to fix this DSB. Transcription activator-like effector nucleases (TALENs), Zinc-finger nucleases (ZFNs), and homing endonucleases are all examples of protein targets that have been studied and changed. The last part gave an overview of these study projects and explained how to make Cas12a for specific uses. The applications of Cas12a have been extensively studied in recent years, but the protein still holds a lot of promise as a treatment and screening tool. In order to give a quick review of CRISPR-Cas12a and its uses, we will briefly talk about the structure and function of the different parts of the reaction pathway that lead up to the catalysis of the target DNA. Cas12a uses a multistep process to make sure that it is selecting the right DNA. This is a good trait for a device that changes the DNA because it makes it less likely that something bad will happen. Even though data shows that a new CRISPR RNAs (crRNA) molecule can stop Cas12a from randomly destroying ssDNA, it may still hurt the host cell while trying to change the genome. The action of Cas12a catalysis, which is a powerful tool for changing the genome, needs to be changed so that it can be more easily controlled and managed. Using what we know about how Cas12a works, we have made mutants that are less active on ssDNA and more active on dsDNA. So far, only Cas9 and Cas12a, which are both part of the CRISPR family, have been used to change the genome. Because of how similar and different these two endonucleases are, CRISPR can now be used for multiple scientific purposes. Cas12a is better than Cas9 because it makes double-strand breaks (DSBs) that favor Homology-Directed Repair (HDR) over Non-homologous end joining (NHEJ) and can change more than one copy of the genome at the same time. Both Cas9 and Cas12a are being changed to make them better at detecting Protospacer Adjacent Motif (PAM) than they are in their natural state. This will make it possible to start focusing on more genes.

In neonatal equines, pathologies involving umbilical structures are an important cause of morbidity, and surgical removal of urachal remnants is a common procedure in clinical practice. Surgery involving the ventral abdominal wall can cause substantial pain, leading to complications and prolonged recovery. The objectives of this study were to describe a two-point bilateral ultrasound-guided rectus sheath block at the level of the umbilicus and to evaluate the extent of dye distribution in foal cadavers. Ten foal cadavers were included in the study, in which a bilateral two-point ultrasound-guided rectus sheath block was performed—one injection cranially and a second one caudally to the umbilicus. The injectate consisted of a mixture of iodinated contrast medium and blue dye at a volume of 0.25 mL kg-1 per injection point (total 1 mL kg-1). After the injection, computer tomography and subsequent dissection of the ventral abdominal wall were performed. The extension of the contrast medium, the number of stained nerves, and contamination of the abdominal cavity were evaluated. The cranio-caudal extension of the contrast ranged from 0.8 to 1.4 centimeters per milliliter of injectate. The most commonly stained ventral branches of spinal nerves were thoracic (Th) nerves 16, 17, and 18 (95%, 85%, and 80% of the nerves, respectively). Abdominal contamination was found in 4 animals. The results suggest that the block could provide periumbilical analgesia. Further studies with different volumes of injectate and living animals are warranted.

Statistical based reconstruction methods and signal processing tooling techniques are implemented and used to detect delaminations or debondings within composite items. From literature it appears that, although a single procedure for the estimation of the structural health is a fast solution, a multiple analysis based on different reconstruction methods or different damage parameters could provide more detailed information about the location and the severity of possible failures. This work discusses the advantage of using cross-correlation analysis in a data-driven approach based on ultrasonic guided waves (GW) tomographic technique and piezoelectrics (PWAS) in pitch-catch configuration. In this sense, this work evidences an improvement in damage detection when the cross-correlation is included as part of the GW-based system for damage assessment approach. The specimens used as test structures to demonstrate the validity of the methodology derive from an aircraft wing test article where damages are specified as skin delamination produced by low energy impact.

Laminate structures composed of stiff plates and thin soft interlayers are widely used in aerospace, automotive and civil engineering encouraging the development of reliable non-destructive strategies for their condition assessment. In the paper, elastodynamic behaviour of such laminate structures is investigated with emphasis on its application in ultrasonic based NDT and SHM for the identification of interlayer mechanical and interfacial contact properties. A particular attention is given to the practically important frequency range, in which the wavelength considerably exceeds the thickness of the film. Three layer model with spring-type boundary conditions employed for imperfect contact simulation is used for numerical investigation. Novel effective boundary conditions are derived via asymptotic expansion technique and used for analysis of the peculiar properties of elastic guided waves in considered laminates. It is revealed that the thin and soft film influences the behaviour of the laminate mainly via the effective stiffnesses being a combination of the elastic moduli of the film, its thickness and interface stiffnesses. To evaluate each of these parameters separately (or to figure out that the available experimental data are insufficient), a step-wise procedure employing the effective boundary conditions is proposed and tested versus the laser Doppler vibrometry data for Lamb waves in Aluminium/Polymer film/Alumunium structure. The possibility of using film-related thickness resonance frequencies to estimate the film properties and contact quality is also demonstrated. Additionally, the rich family of edge waves is also investigated, and the splitting of fundamental edge waves into pairs is revealed.

An improved anti-noise morphology vision navigation algorithm is proposed for intelligent tractor tillage in a complex agricultural field environment. At first the two key steps, Guided Filtering and improved anti-noise morphology navigation line extraction were addressed in detail. Then the experiments were carried out in order to verify the effectiveness and advancement of the presented algorithm. Finally, the optimal template and it’s application condition were studied for improving the image processing speed. The comparison experiment results show that the YCbCr color space has minimum time consumption of 0.094 s in comparison with HSV, HIS and 2R-G-B color spaces. The Guided Filtering method can effectively distinguish the boundary between the new and old soil than other competing vanilla methods such as Tarel, Multi-scale Retinex, Wavelet-based Retinex and Homomorphic Filtering inspite of having the fastest processing speed of 0.113 s. The extracted soil boundary line of the improved anti-noise morphology algorithm has best precision and speed compared with other operators such as Sobel, Roberts, Prewitt and Log. After comparing different size of image template, the optimal template with the size of 140×260 pixels can meet high precision vision navigation while the course deviation angle is not more than 7.5°. The maximum tractor speed of the optimal template and global template are 51.41 km/h and 27.47 km/h respectively which can meet real-time vision navigation requirement of the smart tractor tillage operation in the field. The experimental vision navigation results demonstrated the feasibility of the autonomous vision navigation for tractor tillage operation in the field using the new and old soil boundary line extracted by the proposed improved anti-noise morphology algorithm which has broad application prospect.

An improved anti-noise morphology vision navigation algorithm is proposed for intelligent tractor tillage in a complex agricultural field environment. Firstly, the two key steps, Guided Filtering and improved anti-noise morphology navigation line extraction, were addressed in detail. Then the experiments were carried out in order to verify the effectiveness and advancement of the presented algorithm. Finally, the optimal template and its application condition were studied for improving the image processing speed. The comparison experiment results show that the YCbCr color space has minimum time consumption, 0.094 s, compared with HSV, HIS and 2R-G-B color spaces. The Guided Filtering method can enhance the new & old soil boundary effectively than any other methods such as Tarel, Multi-scale Retinex, Wavelet-based Retinex and Homomorphic Filtering, meanwhile, has the fastest processing speed of 0.113 s. The extracted soil boundary line of the improved anti-noise morphology algorithm has best precision and speed compared with other operators such as Sobel, Roberts, Prewitt and Log. After comparing different size of image template, the optimal template with the size of 140×260 pixels can meet high precision vision navigation while the course deviation angle is not more than 7.5°. The maximum tractor speed of the optimal template and global template are 51.41 km/h and 27.47 km/h respectively which can meet real-time vision navigation requirement of the smart tractor tillage operation in the field. The experimental vision navigation results demonstrated the feasibility of the autonomous vision navigation for tractor tillage operation in the field using the new & old soil boundary line extracted by the proposed improved anti-noise morphology algorithm which has broad application prospect.

Hypotrochoidal profile contours have been produced in industrial applications in recent years using twin-spindle processes, and they are considered effective high-quality solutions for positive shaft–hub connections. This study mainly concerns analytical approaches to determine the bending stresses in hypotrochoidal profile shafts. The formulation was developed according to bending principles using the mathematical theory of elasticity and conformal mappings. The loading was further used to investigate the rotating bending behaviour. The stress factors for the classical calculation of maximum bending stresses were also determined for all those profiles presented and compiled in the German standard DIN3689-1 for practical applications. The results were also compared with the corresponding numerical and experimental results, and very good agreement was observed. Additionally, based on previous work, the stress factor was determined for the case of torsional loading to calculate the maximum torsional stresses in the standardised profiles, and the results are listed in a table. This study contributes to the further refinement of the current DIN3689 standard.

Bioprospecting native Australian plants offers potential discovery of latent and novel bioactive compounds. Promising cytotoxic and antibacterial activity of methanolic extracts of Pittosporum angustifolium and Terminalia ferdinandiana led to further fractionation and isolation using our laboratory’s bioassay guided fractionation protocol. Hence, the aim of this study was to further evaluate the bioactivity of the fractions and subfractions and characterize bioactive compounds using liquid chromatography mass spectroscopy (LC-MS/MS) and gas chromatography MS (GC-MS). Compounds tentatively identified in P. angustifolium Fraction 1 using LC-ESI-QTOF-MS/MS were chlorogenic acid and/or neochlorogenic acid, bergapten, berberine, 8’-epitanegool and rosmarinic acid. GC-MS analysis data showed the presence of around 100 compounds, mainly comprising of carboxylic acids, sugars, sugar alcohols, amino acids, and monoalkylglycerols. Furthermore, the fractions obtained from T. ferdinandiana flesh extracts showed no cytotoxicity, except against HT29 cell lines, and only Fraction 2 exhibited some antibacterial activity. The reduced bioactivity observed in the T. ferdinandiana fractions could be attributed to the potential loss of synergy as compounds become separated within the fractions. As a result, further fractionation, and separation of compounds in these samples were not pursued. However, additional dose-dependent studies are warranted to validate the bioactivity of T. ferdinandiana flesh fractions, particularly since this is an understudied species. Moreover, LC-MS/GC-MS studies confirm the presence of bioactive compounds in P. angustifolium Fraction 1/subfractions which helps to explain the significant acute anti-cancer activity of this plant. The screening process designed in this study has the potential to pave the way for developing scientifically validated phytochemical/bioactivity information on ethnomedicinal plants, thereby facilitating further bioprospecting efforts, and supporting the discovery of novel drugs in modern medicine.

Structural health monitoring (SHM) has become paramount for developing cheaper and more reliable maintenance policies. The advantages coming from adopting such process have turned out to be particularly evident when dealing with plated structures. In this context, state-of-the-art methods are based on exciting and acquiring ultrasonic guided waves through a permanently installed sensor network. A baseline is registered when the structure is healthy, and newly acquired signals are compared to it to detect, localize and quantify damage. To this purpose, the performance of traditional methods based on tomographic algorithms has been overcome by machine learning approaches, which allow processing a larger amount of data without losing diagnostic information. However, to date, no diagnostic method can deal with varying environmental and operational conditions. This works aims to develop a framework for mitigating the impact of temperature variations on ultrasonic guided wave-based SHM through generative artificial intelligence. A variational autoencoder and singular value decomposition were combined to learn the influence of temperature on guided waves. After training, the generative part of the algorithm was used to reconstruct signals at new unseen temperatures. Moreover, a refined version of the algorithm called forced variational autoencoder was introduced to further improve the reconstruction capabilities. The accuracy of the proposed framework was demonstrated against real measurements on a composite plate.

Gastric outlet obstruction (GOO) poses a common and challenging clinical scenario, characterized by mechanical blockage in the pylorus, distal stomach, or duodenum, resulting in symptoms such as nausea, vomiting, abdominal pain, and early satiety. Its diverse etiology encompasses both benign and malignant disorders. The spectrum of current treatment modalities extends from conservative approaches to more invasive interventions, incorporating procedures like surgical gastroenterostomy (SGE), self-expandable metallic stents (SEMS) placement, and the advanced technique of endoscopic ultrasound-guided gastroenterostomy (EUS-GE). While surgery is favored for longer life expectancy, stents are preferred in malignant gastric outlet stenosis. The novel EUS-GE technique, employing a lumen-apposing self-expandable metal stent (LAMS), combines the immediate efficacy of stents with the enduring benefits of gastroenterostomy. Despite its promising outcomes, EUS-GE is a technically demanding procedure requiring specialized expertise and facilities.

This paper presents the design and experimental results of a long cavity length Nd: YAG laser with large stable zone for water jet guided laser (WJGL) applications. The design is based on the light transmission matrix and resonator stability conditions, aiming to achieve a large stable zone and a short cut-off thermal focal length (CTFL). A folded concave resonator is researched to enhance the cavity length, and the influence of the tun-able cavity arm length on the oscillating beam in the resonator and in the YAG crystal is theoretically studied. Moreover, the effects of the output mirror curvature and the cavity arm length on the range of the stable area and the cut-off thermal focal length are also investigated. Experimental results show that a stable green laser output is obtained after second harmonic generation (SHG), with a pulse width ranging from 43ns to 143ns within the laser operating frequency range of 5-20kHz. At an operation frequency of 10kHz, the output power is 21.33W, and the instability of the output power within 400 minutes is 0.88%. The laser source achieves a maximum power of 25.7W at 20kHz, and the maximum single pulse energy reaches 2.7mJ at 6kHz. Finally, this is used as the laser source to couple with a water jet with a diameter of 100 microns, achieving a lossless water conductivity transmission over 60mm length with a peak power density of 0.742GW/cm2. These results demonstrate the suitability of the designed laser source for WJGL technology research.

Optical switching is an essential part of photonic integrated circuits and the focus of research at the moment. In this research, an optical switch design working on the phenomenon of the guided-mode resonances in 3D photonic crystals-based structure is reported. The optical-switching mechanism is studied in a dielectric slab-waveguide-based structure operating in the near-infrared range in a telecom window of 1.55 µm. The mechanism is investigated by interference of two signals, i.e., the data signal and the control signal. The data signal is coupled into the optical structure and filtered utilizing guided-mode resonance, whereas, the control signal is index guided in the optical structure. The amplification or de-amplification of the data signal is controlled by tuning the spectral properties of the optical sources and structural parameters of the device. The parameters are optimized first using a single-cell model with periodic boundary conditions and later in a finite 3D-FDTD model of the device. The numerical design is computed in an open-source Finite Difference Time Domain simulation platform. Optical amplification in the range of 13.75 % is achieved in the data signal with a decrease in the linewidth up to 0.0079 µm and a quality factor of 114.58. The proposed device presents great potential in the field of photonic integrated circuits, biomedical technology, and programmable photonics.

Resveratrol is a well-known natural polyphenol with a plethora of pharmacological activities. As a potent antioxidant, resveratrol is highly oxidizable, and readily reacts with reactive oxygen species (ROS). Such a reaction not only leads to a decrease in ROS levels in a biological environ-ment but may also generate a wide range of metabolites with altered bioactivities. Inspired by this notion, in the current study, our aim was to take a diversity-oriented chemical approach to study the chemical space of oxidized resveratrol metabolites. Chemical oxidation of resveratrol and a bioactivity-guided isolation strategy using xanthine oxidase (XO) and radical scavenging activities led to the isolation of a diverse group of compounds, including a chlorine-substituted compound (2), two iodine-substituted compounds (3 and 4), two viniferins (5 and 6), an eth-oxy-substituted compound (7) two ethoxy-substituted dimers (8 and 9). Compounds 4, 7, 8 and 9 are reported here for the first time. All compounds without ethoxy-substitution exerted stronger XO inhibition than their parent compound, resveratrol. By enzyme kinetic and in silico docking studies compounds 2, 3 and 4 were identified as potent competitive inhibitors of the enzyme while the viniferins acted as mixed-type inhibitors. Further, compounds 2 and 9 had better DPPH scavenging activity and oxygen radical absorbing capacity than resveratrol. Our results suggest that the antioxidant activity of resveratrol is modulated by the effect of a cascade of chemically stable oxidized metabolites, several of which have significantly altered target specificity as compared to their parent compound.

Leaf crude extract (aqueous) of Oroxylum indicum (L.) Kurz induces genomic DNA fragmentation, comet formation, and inhibition of cell proliferation in prostate cancer cell line, PC3 as assessed by agarose gel electrophoresis, comet assay, and MTT assay respectively. The bioactive compound was purified through bioassay-guided fractionation using preparative HPLC and MTT as-say. The brown and water-soluble compound was characterized using 1H and 13C nuclear magnetic resonance (NMR), fourier transform infrared (FT-IR) and electrospray ionization (ESI) mass spectrometry, and the compound was iden-tified as a glycosylated hydroquinone derivative, 2-[p-(2-Carboxyhydrazino)phenoxy]-6-(hydroxymethyl) tetrahy-dro-2H-pyran-3,4,5-triol (molecular formula, C13H18N2O8; molecular mass = 330). The identified phytocompound has not been reported earlier elsewhere. Therefore, the common name of the novel anticancer phytocompound isolated from oroxylum indicum in this current study is named as oroxyquinone. The half-maximal inhibitory concentration (IC50) of oroxyquinone on PC3 cells was 19.44 µg/ml (95% CI = 17.97 to 21.04). Oroxyquinone induced cell cycle arrest at S phases and inhibition of cell migration on PC3 as assessed by flow cytome-try and wound healing assay respectively. On investigating the molecular mechanism of inducing apoptosis, the results indicated that the oroxyquinone induced apoptosis through the p38 pathway and cell cycle arrest, however, not through caspase-3 and PARP pathways. The present study identifies a novel an-ticancer molecule and provides scientific evidence supporting the therapeutic potency of OI for ethnomedicinal uses.

Tropical forests constitute prolific sanctuary of unique floral diversity and potential medicinal sources, however, many of them remains unexplored. Herein, seven Mascarene endemic plants leaves were extracted and evaluated for their in vitro antioxidant properties and antiproliferative effects on a panel of cancer cell lines using MTT and clonogenic cell survival assay. Flow cytometry and comet assay were used to investigate the cell cycle and DNA damaging effects, respectively. Bioassay guided-fractionation coupled with LC-Mass spectrometry (MS), gas chromatography-MS, and nuclear magnetic resonance spectroscopy analysis were used to identify the bioactive compounds. Among the seven plants tested, Terminalia bentzoë was comparatively the most potent antioxidant extract with significantly (p < 0.05) higher cytotoxic activities. T. bentzoë extract further selectively suppressed the growth of human hepatocellular carcinoma cells and significantly halted the cell cycle progression in G0/G1 phase, decreased the cells replicative potential and induced significant DNA damage. Ten phenolic compounds including punicalagin and ellagic acid were identified and likely contributed to the extract potent antioxidant and cytotoxic activities. These results established a promising basis for further in-depth investigations on the potential use of T. bentzoë as supportive therapy in cancer management.

Background: Fine-needle aspiration cytology (FNAC) is widely used to diagnose and monitor thyroid nodules. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is the standard for interpreting FNAC specimens. The risk of malignancy in Bethesda III nodules also known as Atypia of Undetermined Significance (AUS) varies significantly throughout several studies published worldwide. This retrospective study examines the risk of cancer in thyroid FNAC categorized as Bethesda III, as identified in the final histopathology of thyroidectomy specimens at a single endocrine surgery center. Methods: This retrospective cohort analysis included 1038 consecutive patients who underwent elective thyroid surgery with complete follow up data between January 2020 and March 2024. Preoperative data on clinical and pathological characteristics have been collected. The final histopathology report from the thyroidectomy specimen was compared to the results of the preoperative FNAC on nodules that were judged to be Bethesda category III. Statistical methods were performed using SPSS version 29. Results: A total of 670 ultrasound-guided FNACs (64.5%) performed during the study period were included in the final analysis. The study population was predominantly female, represented by 79.6% of patients with a mean age of 42.5 (SD 12.1), while 20.4% were male and significantly older with mean age 45.13 years (p = 0.02). The FNAC inadequacy rate was 5.1%, which was associated with a high risk of malignancy (6 out of 34, 17.6%). Out of the total sample size of 170 patients classified as group III, 57 were found to have malignancies in final surgical histopathology, representing 33.5% of the cases within this category. The secondary gender-related outcome analysis showed that female patients classified under the Bethesda II category had a significantly higher risk of malignancy, with a rate of 21.2%, compared to males who had a malignancy rate of 3.4% in the same Bethesda category (p = 0.001, chi square test). However, female had more better prognostic non-invasive tumors than male (p = 0.02, chi square test). Conclusion: The study's results indicate that Bethesda categories II and III are associated with a higher risk of malignancy in comparison to the reports of the first and third editions of the TBSRTC, particularly for female patients classified under category II.

A maxillary totally edentulism was rehabilitated with one-piece implants starting from pre-existing totally removable denture. A 3D digital scan of the removable denture and upper and lower arches was performed. On this basis, a prototype with optimal esthetic and functional outcomes was re-alized and turned into a custom-made radiological stent with markers. The superimposition of STL and DICOM files allowed the virtual planning of one-piece implants ideal position. The stackable templates composed of a fixed component, namely base template, and removable components, were realized. The fixed component, once secured with anchor pins to the bone, was no longer removed. The removable components, screwed to the fixed component, were used to perform the implant surgery and the immediate prosthetic loading. A base template allowed for maintaining a fixed reference during the entire workflow, improving the transition between the digital project, the surgical procedure, and the prosthetic rehabilitation.

Large volume bone defect regeneration is complex and demands time to complete. Several regeneration phases with unique characteristics including immune responses follow, overlap, and interdepend on each other and, if successful, lead to the regeneration of the organ bone's form and function. However, during traumatic, infectious, or neoplastic clinical cases, the intrinsic bone regeneration capacity may exceed, and surgical intervention is indicated. Scaffold-guided bone regeneration (SGBR) has recently shown efficacy in preclinical and clinical studies. To investigate different SGBR strategies over periods of up to 3 years we have established a well characterized large segmental tibial bone defect ovine model, for which we have developed and optimized immunohistochemistry (IHC) protocols. We present an overview of the immunohistochemical characterization of different experimental groups in which all ovine segmental defects were treated with a bone grafting technique combined with a three-dimensionally printed medical-grade polycaprolactone-tricalcium phosphate (mPCL-TCP) scaffold. The qualitative data set is based on osteoimmunological findings gained from IHC analyses of over &gt;350 sheep surgeries over the past two decades. Our systematic and standardized IHC protocols enabled us to gain further insight into the complex and long-drawn-out bone regeneration processes, which ultimately proved to be a critical element for successful translational research.

Light Detection and Ranging (LiDAR) technology, a cutting-edge advancement in mobile applications, presents a myriad of compelling use cases, including enhancing low-light photography, capturing and sharing 3D images of fascinating objects, and elevating the overall augmented reality (AR) experience. However, its widespread adoption has been hindered by the prohibitive costs and substantial power consumption associated with its implementation. To surmount these obstacles, this paper proposes a low-power, low-cost, SPAD-based system-on-chip (SoC) which packages the microlens arrays (MLA) and incorporates with a light-weight RGB-guided sparse depth imaging completion neural network for 3D LiDAR imaging. The proposed SoC integrates an 8x8 Single-Photon Avalanche Detectors (SPADs) macro pixel array with time-to-digital converters (TDC) and charge pump, fabricated using a 180nm bipolar-CMOS-DMOS (BCD) process. A random MLA-based homogenizing diffuser efficiently transforms Gaussian beams into flat-topped beams with a 45° field of view (FOV), enabling flash projection at the transmitter. To further enhance resolution and broaden application possibilities, a lightweight neural network employing RGB-guided sparse depth complementation is proposed, enabling a substantial expansion of image resolution from 8x8 to quarter video graphics array level (QVGA; 256x256). Experimental results demonstrate the effectiveness and stability of the hardware encompassing the SoC and optical system, as well as the lightweight features and accuracy of the algorithmic neural network. This integrated state-of-the-art hardware-software solution offers a promising and inspiring foundation for developing consumer-level 3D imaging applications.

Vertical and horizontal bone augmentation is one of the most challenging techniques in bone engineering. The use of barrier membranes and scaffolds in guided bone regeneration (GBR) procedures is a common approach for the treatment of lost bone around teeth and dental implants. The aim of this study was to estimate the barrier effects of a synthetic poly (lactic acid/caprolactone) [P(PA/CL)] bilayer membrane for GBR, compared to a porcine collagen bilayer membrane, in the vertical augmentation model on 10–12-months old rat skull without periosteum. The HAp block (diameter: 4 mm, height: 3 mm, porosity:75%, average pore size:150 μm) was placed on the rat skull without a periosteum. The P(LA/CL) membrane (solid layer: 25 μm, porous layer: 175 μm) or the collagen membrane (solid layer, porous layer) was applied onto the HAp block. At 3, 6, and 12 weeks after the surgery, the incised tissues were fixed, decalcified, and stained with hematoxylin and eosin for histological evaluation. The P(LA/CL) membrane remained until 12 weeks and could achieve barrier effects to inhibit cellular invasion from the repositioned soft tissues. Local bone formation occurred in the interconnected pores of HAp at 6 weeks. On the other hand, the collagen membrane did not inhibit cellular invasion for its expansion until 3 weeks, and was absorbed until 6 weeks. The results indicated that the P(LA/CL) membrane might be effective in GBR as occlusive absorbable membrane.

Data-driven models (DDMs) are extensively used in environmental modeling but face challenges due to limited training data and potential results not adhering to physical laws. To address this challenge, this study developed a process-guided deep learning (PGDL) model, integrating a long short-term memory (LSTM) neural network and a process-based model (PBM), CE-QUAL-W2 (W2), to predict water temperature in a stratified reservoir. The PGDL included an energy constraint term from W2's thermal energy equilibrium into the cost function of the LSTM, besides the mean square error term. In PGDL, parameters were optimized by penalizing deviations from the energy law, ensuring adherence to physical constraints. Compared to LSTM, PGDL demonstrated enhanced satisfaction with the energy balance and superior performance in water temperature prediction. Even with less field data for training, PGDL outperformed both LSTM and calibrated W2 after pre-training with data generated using the uncalibrated W2. Therefore, integration of DDM with a PBM ensured physical consistency in water temperature prediction for complex stratified reservoirs with limited data. Moreover, pre-training the PGDL with PBM proved highly effective in mitigating bias and variance due to insufficient field measurement data.

The work presents a Structural Health Monitoring (SHM) electronic system with real-time ac-quisition and processing for the determination of impact location in laminates. The novelty of this work is the quantitative evaluation of impact location errors using the Lamb wave guided mode S0, captured and processed in real-time by up to eight piezoelectric sensors. The differential time of arrival is used to minimize an error function for the position estimation. The impact energy is correlated to the amplitudes of the antisymmetric (A0 ) mode and the electronic design is de-scribed to avoid saturation for signal acquisition. The same electronic is designed to acquire symmetric (S0 ) low level signals by adequate gain, bandwidth and signal to noise ration. Such signals propagate into a 1.4mm thick aluminum laminate at the group velocity of 5150m/s with frequency frequency components above 270kHz and can be discriminated from the A0 mode to calculate accurately the differential arrival time. The results show that the error is not improved better than S0 wavelength in impact localization by using six out of eight sensors connected to the electronic system.

The smart management of water resources is an increasingly important topic in today's society. In this context, the paradigm of Smart Water Grids (SWGs) aims at a constant monitoring through a network of smart nodes deployed over the water distribution infrastructure. In such a way, a continuous assessment of water quality and state of health of the pipeline infrastructure can be achieved, allowing an early detection of leaks and water contamination. Acoustic wave-based technology has arisen as a viable communication technique among the nodes of the network. Such technology can be suitable to replace traditional wireless networks in SWGs, as the acoustic channel is intrinsically embedded in the water supply network. However, the fluid-filled pipe is one of the most challenging media to be employed for data communication. This paper aims at reviewing those works dealing with acoustic-based communication networks in real large-scale urban water supply networks. An overview on the characteristics, trends and design challenges of existing works is provided as a guideline for future research.

The discovered light modulation capabilities of diatom silicious valves make them an excellent toolkit for photonic devices and applications. In this work, a reproducible surface-enhanced Raman-scattering (SERS) enhancement was achieved with hybrid substrates employing diatom silica valves coated with an ultrathin uniform gold film. Three structurally different hybrid substrates, based on the valves of three dissimilar diatom species, have been compared to elucidate the structural contribution to SERS enhancement. The comparative analysis of obtained results showed that substrates containing cylindrical Aulacoseira sp. valves achieved the highest enhancement up to 14-fold. Numerical analysis based on the frequency domain finite element method was carried out to supplement the experimental results. Our results demonstrate that diatom valves of different shapes can enhance the SERS signal, offering a toolbox for SERS-based sensors, where the magnitude of the enhancement depends on valve geometry and ultrastructure.

Lamb waves occur in thin-walled structures in two wave modes, the symmetric and antisymmetric mode. Their oscillation on the structures‘ surfaces is either in phase (symmetric) or shifted by a phase angle of π (antisymmetric). In this work, a method is developed to compare the surfaces‘ oscillation phase relation. It is based on the evaluation of time signals regarding the instantaneous phase angle using the continuous wavelet transformation and as a comparative method the short-time Fourier transformation. For this purpose, numerical simulations utilizing the finite element method provide time signals from the top and bottom surface of different thin-walled structures. They differ with respect to their material settings and laminate configurations. The numerically obtained time signals are evaluated by the developed methods. The occurring oscillation phase differences on the top and bottom surface are studied and both methods are compared. Subsequently, the oscillation phase is evaluated experimentally for the wave propagation in a fiber metal laminate. It is shown that the method based on the continuous wavelet transformation is suitable for the evaluation of oscillation phase relations in time signals. Additionally, it is proven that fiber metal laminates show only two phase relations which indicates the occurrence of Lamb waves.

This work investigates how integrated polyimide inlays with applied sensor bodies influence the guided ultrasonic wave propagation in narrow glass fiber-reinforced polymer specimens. Preliminary numerical simulations indicate that in a damping-free specimen, the inlays show reflections for the S0-mode propagation. Hence, an air-coupled ultrasonic technique and a 3D laser Doppler vibrometer measurement are used to measure different parts of the propagating waves’ displacement field after burst excitation at different frequencies. No significant reflections on the inlay can be seen in the experiments. However, it is shown that the reflections from the strip specimen’s narrow width cause periodical reflections that superimpose with the excited wave fronts. A continuous wavelet transformation in the time-frequency domain filters discontinuities from the measurement signal and is used for reconstruction of the time signals. The reconstructed signals are used in a spatial continuous wavelet transformation to identify the occurring wavelengths and hence to prove the assumption of reflections from the narrow edges. Since the amplitude of the reflections identified in the numerical data at the polyimide inlays are an order of magnitude smaller than the excited wave packages, it is concluded that material damping of the epoxy resin matrix extincts possible reflections from the inlays.

Structural health monitoring of lightweight constructions made of composite materials can be performed using guided ultrasonic waves. If modern fiber metal laminates are used, this requires integrated sensors that can record the inner displacement oscillations caused by the propagating guided ultrasonic waves. Therefore, we have developed a robust MEMS vibrometer that can be integrated with structural and functional compliance. This vibrometer is directly sensitive to the high-frequency displacements from structure-borne ultrasound when excited between its first and second natural frequency. The vibrometer is mostly realized by processes earlier developed for a pressure sensor but with additional femtosecond laser ablation and wafer bonding. The piezoresistive transducer made from silicon is encapsulated between top and bottom glass lids. The natural frequencies are experimentally determined using an optical micro vibrometer setup. The vibrometer functionality and usability for structural health monitoring are demonstrated on a customized test rig by recording application-relevant guided ultrasonic wave packages with a central frequency of 100 kHz at a distance of 200 mm from the exciting ultrasound transducer.

The aim of this article is to evaluate and compare, retrospectively, the efficacy of two regenerative periodontal procedures in patients suffering from aggressive periodontitis (AgP). Twenty-eight patients were diagnosed with AgP, suffering from multiple intra-bony defects (IBD); that were treated by one of two regenerative modalities of periodontal therapy randomly assigned to each patient: a. guided tissue regeneration (GTR) or b. an application of enamel matrix derivatives (EMD) combined with DBX. The monitoring of the treated sites included recordings of probing depth (PD), clinical attachment level (CAL), and gingival recession. Pre-treatment and follow-up (up to 10 years from the surgery) recordings were analyzed statistically within and between groups. A significant reduction was shown at time on PD and CAL values, however, not between subject groups. CAL values decreased in all sites. At EMD group (44 sites) CAL gain was 1.92 mm (±1.68) from pre-treatment to follow-up (p<0.001) and at the GTR group (12 sites) CAL gain of 2.27 (±1.82) mm. In conclusion, 1-10 years observations have shown that surgical treatment of AgP patients by either GTR or by application of EMD/DBX results in similar successful clinical results.

During last decades multiple therapeutic approaches have been explored for improved management of peritoneally disseminated malignancies – a grim condition known as peritoneal carcinomatosis (PC). Intraperitoneal administration can be used to achieve elevated local concentration and extended half-life of the drugs in the peritoneal cavity to improve their anticancer efficacy. However, IP-administered chemotherapeutics have a short residence time in the IP space, and are not tumor selective. An increasing body of work suggests that functionalization of drugs and nanoparticles with targeting peptides increases their peritoneal retention and provides a robust and specific tumor binding and penetration that translates into improved therapeutic response. Here we review a progress in affinity targeting of intraperitoneal anticancer compounds, imaging agents and nanoparticles with tumor homing peptides. We review classes of tumor homing peptides relevant for PC targeting, payloads for peptide-guided precision delivery, applications for targeted compounds and the effects of nanoformulation of drugs and imaging agents on affinity-based tumor delivery.

Background: The purpose of this study was to compare the immediate and long-term complications that are associated with the utilized techniques for the insertion of indwelling central venous catheters, that is the open surgical technique, the ultrasound-guided technique and the transcutaneous technique based on external anatomical landmarks in the right internal jugular vein, to a pediatric population. Methods: This was a prospective randomized trial based on a pediatric patient population, under 16 years of age, of a tertiary pediatric-oncological hospital. Procedure was performed by a medical team with varying experience regarding the percutaneous and open insertion methods. We studied the outcome of our procedure, based on the immediate and delayed complication rate, as well as the needed time in order to complete the procedure and mean duration of line use. Results: The patients that were inserted in our protocol were divided into three subgroups, based on the selected technique for the insertion of the central venous catheter. A total number of 88 insertions (25.4%) (out of 346) were based on the technique that was using external anatomical landmarks, 121 insertions were based on the ultrasound-guided transcutaneous technique (34,9%), whereas in 137 cases (39.5%) the open surgical technique was preferred. All cases that were related to catheter re-insertion were excluded from our study. We performed a statistical analysis regarding the catheter dwell time between the three subgroups of patients and no significant difference was recorded. Moreover, the development of thrombosis was investigated, and we mentioned that the higher percentage of this complication was related with the transcutaneous external landmark and open surgical technique. Also, the incidence of infection was taken into consideration, which manifested an increased incidence when the transcutaneous technique based on external landmarks was used. Conclusions: Ultrasound guided percutaneous insertion was considered to be a safe and effective technique for the insertion of central venous catheters. Our study also demonstrated a decrease in operating times, when performed by operators with increasing expertise, increased preservation of the diameter of the venous lumen, and no increase in complication rates when the ultrasound-guided technique was selected.

This paper focuses on parametric model order reduction (PMOR) of guided ultrasonic wave propagation and its interaction with damage in a fiber metal laminate (FML). Structural health monitoring in FML seeks to detect, localize and characterize the damage with high accuracy and minimal use of sensors. This can be achieved by the inverse problem analysis approach which employs the signal measurement data recorded by the embedded sensors in the structure. The inverse analysis requires to solve the forward simulation of the underlying system several thousand times. These simulations are often exorbitantly expensive and triggered the need for improving their computational efficiency. A PMOR approach hinged on the proper orthogonal decomposition method is presented in this paper. An adaptive parameter sampling technique is established with the aid of a surrogate model to efficiently update the reduced-order basis in a greedy fashion. A numerical experiment is conducted to illustrate the parametric training of the reduced-order model. The results show that the reduced-order solution based on the PMOR approach is accurately complying with that of the high fidelity solution.

Background Robotic-assisted thoracic surgery (RATS) has become the standard procedure for treating lung malignancy, offering numerous advantages over traditional methods. However, the minimally invasive nature of RATS presents unique challenges, notably a limited field of view and reduced tactile feedback for the surgeon. These limitations can significantly impact the surgeon's ability to navigate complex anatomical structures during surgery. To address these challenges, we recognized the need for enhanced preoperative familiarization with each patient’s specific anatomy. In response, we developed an innovative virtual reality (VR) surgical navigation system, utilizing head-mounted displays (HMDs), designed to provide surgeons with a more comprehensive and interactive understanding of the patient's anatomy before the actual surgery. This VR system aims to extend the surgeon's capabilities in both preoperative sumilation and intraoperative navigation, potentially mitigating the inherent limitations of RATS. Methods Three-dimensional (3D) volumized data, meticulously extracted from preoperative computed tomography (CT) scans, were seamlessly integrated into the Perspectus VR Education software. These data were then displayed on an HMD, facilitating an interactive 3D reconstruction of pulmonary structures. This reconstruction allowed for each structure to be visualized individually, enabling detailed preoperative resection simulations tailored to each patient's unique anatomy. During RATS, these specific 3D reconstructed images were made accessible within the surgeon's console through the TilePro™ multi-display input, providing real-time, intraoperative guidance. Results During the preoperative simulations, the 3D anatomic structure of the pulmonary vessels, as well as the spatial relationship between the lesion and adjacent tissues, were successfully visualized. This enhanced visualization enabled surgeons to thoroughly evaluate a patient's anatomy, significantly improving the safety and accuracy of the subsequent procedure. The integration of VR software with the HMD provided surgeons with a true 3D interaction with real patient data. This setup not only offered a unique perspective through the surgical console but also allowed for easy manipulation of the data on a mobile laptop, thereby enhancing the overall surgical planning process. Conclusions VR simulation using HMDs offers a viewing experience akin to that of a robotic 3D viewer, potentially providing an innovative avenue for surgeons to develop specific robotic surgical skills without the need for practicing on live patients. This technology, when integrated with routine imaging modalities, can significantly enhance preoperative planning. Such integration not only contributes to the safety but also improves the accuracy of anatomical resections. Our findings suggest that VR simulation with HMDs is particularly effective in assisting surgeons to accurately identify lesion locations in RATS, thereby optimizing surgical outcomes.

Background: Glioblastoma remains a challenging brain tumor to treat due to its infiltrative nature. Accurately identifying tumor boundaries during surgery is crucial for successful tumor resection. This study introduces an innovative intraoperative visualization method utilizing a surgical fluorescence microscope to precisely locate tumor cells. The focus of the study is on IR-Glint, a novel preparation comprising Cy7.5-labeled aptamers Gli-233nt and Gli-55_3L specific to human glioblastoma. Methods: The aptamers were modified using molecular modeling and quantum chemical techniques. The effectiveness of the preparation was assessed using flow cytometry and microscopy on primary cultures of human glioblastoma. In vivo studies were conducted on mouse and rabbit models, employing orthotopic xenotransplantation of human brain glioblastoma with various imaging techniques, including PET/CT, in vivo fluorescence visualization, confocal laser scanning, and surgical microscopy. Results: The experiments validated the potential of IR-Glint for intraoperative visualization of glioblastoma using infrared imaging. Surface application of the aptamer-based formulation on the brain allowed clear visualization of the tumor, aiding surgeons in tumor resection. This approach also reduces the dosage required and mitigates potential toxic effects on the patient. Conclusions: This study demonstrates the promising potential of using in-frared dye-labeled aptamers for intraoperative visualization of glioblastoma. By improving surgical treatment outcomes in neurosurgery, this novel approach may pave the way for future advancements in the field.

This article aims to assess, discuss and analyze the disturbances caused by electromagnetic field (EMF) noise of medical devices used nearby living tissues, as well as the corresponding functional control via the electromagnetic compatibility (EMC) of these devices. These are minimally invasive and non-ionizing devices allowing various healthcare actions involving monitoring, assistance, diagnosis and image-guided medical interventions. Following to an introduction of the main items of the paper, the different imaging methodologies are conferred, accounting for their nature, functioning, employment condition and patient comfort and safety. Then the magnetic resonance imaging (MRI) components and their fields, the consequential MRI-compatibility concept and possible image artifacts are detailed and analyzed. Next, the MRI-assisted robotic treatments, the possible robotic external matter introductions in the imager, the features of MRI-compatible materials and the conformity control of MRI-compatibility, are analyzed and conferred. Afterward, the embedded, wearable and detachable medical devices, their EMF perturbation control and their necessary shielding protection technologies are presented and analyzed. Then, the EMC control procedure, the EMF governing equations, the body numerical virtual models, are conferred and reviewed. A qualitative methodology, case study, simple example illustrating the mentioned methodology is presented. The last Section of the paper discussed potential details and expansions of the different notions conferred in the paper, in the perspective of monitoring the disturbances due to EMF noise of medical devices working near living tissues.

Spinal metastatic tumors are common and often cause debilitating symptoms. Image-guided percutaneous thermal ablation (IPTA) has gained significant recognition in managing spinal column tumors due to its exceptional precision and effectiveness. Conventional guidance modalities, including computed tomography, fluoroscopy, and ultrasound, have been important in targeting spinal column tumors while minimizing harm to adjacent critical structures. This study presents a novel approach utilizing a fusion of Cone Beam Computed Tomography with Magnetic Resonance Imaging to guide percutaneous thermal ablation for four patients with secondary spinal column tumors. The visual analog scale (VAS) evaluated procedure effectiveness during an 18-month follow-up. Percutaneous vertebroplasty was performed in two cases, and a thermostat was used during all procedures. Imaging was performed using the Stealth Station navigation system Spine 8 (SSS8) and a 1.5T MRI machine. The fusion of CBCT with MRI allowed precise tumor localization and guidance for thermal ablation. Initial results indicate successful tumor ablation and symptom reduction, emphasizing the potential of CBCT-MRI fusion in spinal column tumor management. This innovative approach is promising in optimizing therapy for secondary spinal column tumors. Further studies are necessary to validate its efficacy and applicability.

Classifying spinal tumors can be challenging due to nonspecific clinical and radiological qualities, and a precise biopsy is crucial for an accurate diagnosis and treatment planning. This study aimed to enhance the accuracy and efficiency of spinal biopsies integrating Cone Beam Computed Tomography (CBCT) and magnetic resonance imaging (MRI) modalities using an O-arm CT navigation system. Eighteen patients with diverse spinal lesions underwent 18 biopsies following the Stealth Station navigation system Spine 8 protocol. Preoperative MRI scans were merged with intraoperative CT navigation systems for continuous monitoring during the biopsy process. The combined imaging technique accurately identified the diseased lesion type in all biopsies, demonstrating 100% sensitivity and specificity. In conclusion, combining MRI and CT imaging modalities significantly improved spinal biopsy accuracy and efficiency, differentiating between pathological entities. However, large-scale studies are desired to validate these findings and investigate potential benefits in different clinical scenarios. Although this method requires general anesthesia, its potential profits in avoiding misdiagnosed lesions and decreasing the need for further invasive procedures make it a promising approach for improving spinal biopsy accuracy and efficiency.

The shortage of physicians in rural communities contributes to increased mortality rates among Medicare beneficiaries. This increase in mortality risk is commonly due to diseases such as heart disease and cancer, including melanoma and non-melanoma skin cancer (NMSC). Mohs micrographic surgery (MMS) is considered the gold-standard treatment for NMSC tumors, however, due to a shortage of dermatologists and Mohs surgeons in rural areas, access to MMS is limited. In these areas, image guided superficial radiation therapy (IGSRT) serves as a viable option for the treatment of NMSC lesions, with fewer recurrences and 99% cure rates, which are comparable to MMS cure rates. IGSRT is performed in dermatology clinics with support from a multidisciplinary team, including radiation therapists, medical physicists, radiation oncologists, and dermatologists. As IGSRT is able to be performed by general dermatologists, Medicare beneficiaries in rural communities will have an increase in access to treatment options and a decrease in delayed skin cancer treatment.

Introduction – Molecular tests can contribute to improve the preoperative diagnosis of thyroid nodules. Tests available are expensive and not adapted to different population. Aim – This study aimed to compare the cyto-histological genetic profile, and to evaluate the reliability of molecular tests on Ultrasound-guided Fine Needle Aspiration Cytology (US-FNAC) in accurately diagnosing differentiated thyroid carcinomas (DTCs) and predicting biologic behavior of papillary thyroid carcinomas (PTCs). Material and methods – The series included 259 patients with paired cyto-histological samples totalizing 518 samples. The genetic alterations were analyzed by PCR/Sanger sequencing. The association with clinicopathologic features was evaluated in PTCs. Results/Discussion – From the 259 patients included, histologies were 50 (19.3%) benign controls and 209 (80.7%) DTCs cases, from which 182 were PTCs; cytologies were 5.8% non-diagnostic, 18.2% benign, 39% indeterminate and 37.1% malignant. In histology, indeterminate nodules (n=101) were 22.8% benign and 77.2% malignant. Mutation frequencies in cytology and histology specimens were, respectively, TERTp: 3.7% vs. 7.9%; BRAF: 19.5% vs. 25.1%; RAS: 11% vs. 17.5%. The overall cyto-histological agreement of the genetic mutations was 94.9%, Cohen’s k=0.67, and in indeterminate nodules 95.7%, k=0.64. The identified mutations exhibited a discriminative ability in diagnosing DTC with a specificity of 100% for TERTp and BRAF, and of 94% for RAS, albeit with low sensitivity. TERTp and BRAF mutations were associated with aggressive clinicopathological features and tumor progression in PTCs (p<0.001). The obtained good cyto-histological agreement suggests that molecular analysis in US-FNAC may anticipate the genetic profile and the behavior of thyroid tumors, confirming malignancy and contributing to refer patients towards surgery.

This paper describes a proposed fractional filter-based multi-scale underwater and hazy image enhancement algorithm. The proposed system combines a modified global contrast operator with fractional order-based multi-scale filters used to generate several images, which are fused based on entropy and standard deviation. The multi-scale-global enhancement technique enables fully adaptive and controlled colour correction and contrast enhancement without over exposure of highlights when processing hazy and underwater images. This in addition to illumination/reflectance estimation coupled with global and local contrast enhancement. The proposed algorithm is also compared with the most recent available state-of-the-art multi-scale fusion de-hazing algorithm. Experimental comparisons indicate that the proposed approach yields better edge and contrast enhancement results without halo effect, colour degradation and is faster and more adaptive than all other algorithms from the literature.

Surgical navigation has evolved as a vital tool in maxillofacial surgery, offering precise and patient-specific data. This study explores the clinical applications and accuracy of intraoperative tool tracking in maxillofacial surgery. The research includes 37 patients with various pathologies who underwent surgery assisted by a surgical navigation system using tracked instruments. The study showcases two representative cases: one involving coronoid hyperplasia with mouth opening deficit and another addressing nose-orbital-ethmoidal-frontal ossifying fibroma resection. The results indicate that surgical navigation with tracked instruments provides high precision (<1.5 mm error), reduced surgical time, and less invasive approaches. The study highlights the potential for reproducible outcomes and increased safety, especially in complex cases. Despite some limitations, the synergy between surgical navigation and tracked instruments offers a promising approach in maxillofacial surgery, expanding its applications beyond current practices.

Abstract: A recent approach to radiotherapy for prostate cancer is the administration of high doses of radiation to the prostate while minimizing the risk of side effects. Thus, image-guided radiotherapy utilizes advanced imaging techniques and is a feasible strategy for increasing the radiation dose. New radioactive particles are another approach to achieving high doses and safe procedures. Prostate brachytherapy is currently considered as a combination therapy. Spacers are useful to protect adjacent organs, specifically the rectum, from excessive radiation exposure.

A method for generating fluoroscopic (time-varying) volumetric images using patient-specific motion models derived from 4-dimensional cone-beam CT (4D-CBCT) images is developed. 4D-CBCT images acquired immediately prior to treatment have the potential to accurately represent patient anatomy and respiration during treatment. Fluoroscopic 3D image estimation is done in two steps: 1) deriving motion models and 2) optimization. To derive motion models, every phase in a 4D-CBCT set is registered to a reference phase chosen from the same set using deformable image registration (DIR). Principal components analysis (PCA) is used to reduce the dimensionality of the displacement vector fields (DVFs) resulting from DIR into a few vectors representing organ motion found in the DVFs. The PCA motion models are optimized iteratively by comparing a cone-beam CT (CBCT) projection to a simulated projection computed from both the motion model and a reference 4D-CBCT phase, resulting in a sequence of fluoroscopic 3D images. Patient datasets were used to evaluate the method by estimating the tumor location in the generated images compared to manually defined ground truth positions. Experimental results showed that the average tumor mean absolute error (MAE) along the superior-inferior (SI) direction and the 95th percentile in two patient datasets were (2.29 mm and 5.79 mm) for patient 1 and (1.89 mm and 4.82 mm) for patient 2. This study has demonstrated the feasibility of deriving 4D-CBCT-based PCA motion models that have the potential to account for the 3D non-rigid patient motion and localize tumors and other patient anatomical structures on the day of treatment.

This review article is focused on the analysis of the state of the art of sensors for guided 9 ultrasonic waves for the detection and localization of impacts, therefore of interest for the structural 10 health monitoring (SHM). The recent developments in sensor technologies are then reported and 11 discussed through the many references in recent scientific literature. The physical phenomena re-12 lated to impact event and the main physical quantities are then introduced to discuss their im-13 portance in the development of the hardware and software components for SHM systems. An im-14 portant aspect of the article is the description of the different ultrasonic sensor technologies cur-15 rently present in the literature and what advantages and disadvantages they could bring, in relation 16 to the various phenomena investigated. In this context, the analysis of the front-end electronics is 17 deepened, the type of data transmission both in terms of wired and wireless technology and in terms 18 of online and offline signal processing. The integration aspects of sensors for the creation of net-19 works with autonomous nodes with the possibility of powering through energy harvesting devices 20 and the embedded processing capacity is also studied. Finally, the emerging sector of processing 21 techniques using deep learning and artificial intelligence concludes the review by indicating the 22 potential for the detection and autonomous characterization of the impacts.