In the vast landscape of commercially available and newly emerging meshes for abdominal wall repair, surgeons must understand the biomechanical advantages of current synthetic and biologic mesh materials. A librarian conducted a literature search on PubMed, Web of Science, and CENTRAL, following PRISMA guidelines, to identify relevant articles published from January 2010 to January 2024. Two independent reviewers performed all screening steps. An exploratory quantitative synthesis was performed using generalized linear models with a Gamma distribution and log link. Our study identified 30 studies describing the physico-mechanical properties of 67 unique meshes. The majority of novel mesh materials were synthetic (85.07%, n = 57), compared to biologic (14.92%, n = 10). Pore sizes ranged from 0.10 mm² to 5.0 mm². They were subcategorized as small (0.01-0.28 mm2), medium (0.28-0.79 mm2), large (0.79-3.14 mm2), and very large (> 3.14 mm2), based on previous studies, which found these denominations to be more informative than the terms "microporous" and "macroporous." Suture retention strength, tensile strength, and burst strength were compared. Synthetic medium- to large-pore mesh performed sufficiently to withstand intra-abdominal pressures in terms of burst strength (>50 N/cm), tensile strength (>50 N/cm), and suture retention (>20 N) compared to small-pore synthetic mesh. Among biologic meshes, cross-linked biologic meshes demonstrated strong tensile and suture-retention strengths; however, data on other biomechanical properties were lacking. These results demonstrate the need to understand how the structural characteristics of each fully mesh design, such as fabrication technique and pore size, in conjunction with mechanical properties such as tensile strength, burst strength, and suture retention strength, influence clinical outcomes.
Surface modification techniques play a vital role in improving fogwater harvesting efficiency. In this study, stainless steel mesh was modified using pulsed laser ablation and subsequently functionalized with stearyl alcohol, an eco-friendly, low cost and fluorine-free hydrophobic agent. The fabricated surfaces were characterized by field emission scanning electron microscopy (FESEM), atomic force microscopy (AFM), energy dispersive X-ray spectroscopy (EDS), and elemental mapping to confirm their morphological and chemical features. The effects of laser patterning (0.5 and 1 cm line intervals), stearyl alcohol concentration, and immersion time were systematically investigated. Among all prepared samples, the chemically modified mesh with 0.5 cm laser patterning (m-L5) exhibited the highest performance, achieving a water harvesting rate (WHR) of 7.36 mg min-1 cm-2, which is ∼2.5 times higher than the pristine stainless-steel mesh. Furthermore, tilting angle experiments revealed that horizontal positioning (0°) provides superior efficiency compared to 45° and 90°. These results highlight the potential of sustainable surface engineering strategies for effective fog collection.
This video article demonstrates a novel single-port laparoscopic lateral suspension (LLS) technique for concurrently correcting anterior, middle, and posterior pelvic organ prolapse (POP). The method utilizes a tailored mesh with fixation to Denonvilliers fascia to enhance posterior support, addressing a key limitation of traditional LLS. Compared to transvaginal mesh, this approach aims to reduce complication rates while offering a shorter learning curve for surgeons proficient in laparoscopy. We present the case of a 72-year-old woman with stage IV POP who underwent the procedure, which involved precise dissection to key anatomical landmarks and the creation of a peritoneal tunnel for mesh suspension. The conclusion is that this technique achieves comprehensive multi-compartment reconstruction with enhanced posterior support and preserved vaginal integrity, presenting a viable alternative to existing surgical options.
There is a complex relationship between gastroesophageal reflux disease (GORD), hiatus hernia, obesity, and metabolic bariatric surgery. We report the outcomes of laparoscopic hiatus hernia repair (HHR) with BIO-A® mesh in the management of GORD post LSG in patients who developed a hiatus hernia with migration of the proximal gastric sleeve. A retrospective review of 50 patients who previously underwent LSG and revisional surgery (HHR, n = 25; RYGB, n = 25) between 2011 and 2022. The modified DeMeester scoring system was used to assess the severity of the patient's GORD symptoms pre-HHR/pre-RYGB and 6 months post-op. Twenty-five patients underwent HHR with BIO-A® mesh following a previous LSG. The severity of GORD six months post-HHR was significantly lower (0.96 ± 0.84 vs. 2.60 ± 0.50, p = < 0.0001). After HHR, 3/25 (12%) patients had ongoing GORD symptoms that were not medically controlled and underwent conversion to RYGB. In contrast, 25 patients underwent direct conversion to RYGB following a previous LSG. The severity of GORD at 6 months post-RYBG was significantly lower (0.40 ± 0.50 vs. 2.36 ± 0.64, p = < 0.0001). At six months, there was no significant difference in GORD symptoms when HHR was compared with RYGB (3.32 ± 1.6 vs. 3.76 ± 1.54, p = 0.4296). In appropriately selected patients, HHR with BIO-A® mesh appears safe and effective in managing persistent GORD following LSG, within the limits of this study. However further research is needed to explore its role and the long-term outcomes.
Early chest drain removal and discharge are standard in enhanced-recovery protocols after video-assisted thoracoscopic surgery (VATS) lobectomy, but rare wound complications may arise. We report a 71-year-old man who underwent uneventful 3-port right VATS lower lobectomy. The utility access incision measured approximately 3.5 cm, was protected with a SurgiSleeve® wound protector, and was closed in layers. No postoperative drain was placed through this site. The chest drain was removed on postoperative day 1 after absence of air leak and acceptable drainage output, and the patient was discharged on postoperative day 2. Two weeks later, serous pleural fluid leaked through the utility access wound. Conservative management with wound reinforcement, local compression, and empirical antibiotics failed. Re-exploration demonstrated clear pleural effusion without purulence, lung herniation, necrosis, or air leak. Selective reinforcement with polypropylene mesh anchored to the adjacent rib achieved wound stability, and the patient recovered without recurrence. Persistent pleural leakage through a VATS access wound is rare. In selected patients with persistent leakage after conservative management, and where infection has been reasonably excluded, mesh reinforcement may be considered as one feasible surgical option rather than a routine strategy.
Water-soluble polymers are widely used as model crowders, yet their effects on proteins are often interpreted using frameworks developed for rigid spherical depletants. Here we review polymer crowding from the perspective of scaling theory, emphasizing how polymer-specific length scales govern protein-polymer interactions across concentration regimes. In dilute solutions, depletion is set by the polymer radius of gyration and scales linearly with concentration. Above the overlap concentration, c∗, the relevant length becomes the correlation length, ξ(c), which defines the mesh size and controls both the magnitude and range of interactions. Protein association, folding, and intrinsically disordered protein structure follow distinct scaling regimes determined by the ratio of protein size to ξ. Deviations from classical predictions arise from polymer connectivity and soft protein-polymer interactions. The polymer-scaling perspective provides a unified framework linking polymer physics to protein thermodynamics in crowded environments.
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Contemporary abdominal wall reconstruction places a strong emphasis on optimizing extraperitoneal mesh placement. When the posterior layer is insufficient for closure, adjuncts such as hernia sac, omentum, or Vicryl mesh have been described. The outcomes of various posterior layer supplementation (PLS) materials, both autologous and non-autologous, have not been well examined. We aim to evaluate the outcomes of patients undergoing ventral hernia repair with extraperitoneal mesh placement who undergo PLS and compare how PLS materials impact these outcomes. All patients who underwent a retromuscular hernia (RM) repair with PLS between Jan 2021 and Jan 2025 at a single center were reviewed. Patient demographics, preoperative characteristics, intraoperative factors, and postoperative outcomes were evaluated. Descriptive statistics and comparative tests including Mann-Whitney U test, Student's t-test, and Fisher's exact test were utilized. Sixty-seven patients underwent RM repair with PLS. Supplement materials used included hernia sac, omentum, falciform ligament, prior mesh, new biologic, and biosynthetic coated mesh. Fifty-two percent (n = 35) of the repairs were retrorectus only and 48% (n = 32) were transversus abdominus releases. The average length of follow-up was 189 days with a recurrence rate of 3%. Sixty percent of PLS was performed with autologous material with 40% utilizing new biologic or biosynthetic coated meshes. SSI, SSO, and SSOPI were similar between the autologous and non-autologous supplementation groups (p = 1, p = 0.16, p = 0.29, respectively). There were more postoperative bowel obstructions in the non-autologous group (n = 4) as compared to the autologous group (n = 0) (p = 0.02). All the bowel obstructions were managed nonoperatively. Our findings suggest that outcomes are acceptable with minimal morbidity when comparing autologous tissue to biologic and biosynthetic coated mesh for PLS. The low recurrence rates observed, regardless of the material used, support the continued adoption of this approach. Proactive supplementation of the visceral sac may decrease need for lateral myofascial release.
The acquisition of the human pinna geometry requires elaborate equipment for accurate results. Even then, the results are often corrupted by measurement artifacts. We introduce Mesh2PPM, a framework facilitating the generation of a personalized and artifact-free pinna mesh. Mesh2PPM predicts the parameters of a parametric pinna model based on cubic Bézier curves (BezierPPM) from a pinna mesh via a vision transformer. We evaluated Mesh2PPM with multi-view renderings of synthetic pinna geometries, providing additional depth information, varying the grids of camera views, and jittering the camera views. While added depth information had no practically relevant effect, a grid with 3×3 camera views facilitated the lowest overall prediction errors and best counteracted the detrimental effects of jitter. For this grid, with and without jitter, the median Pompeiu-Hausdorff distances were 1.98 mm and 1.34 mm, respectively, and the root mean square distances were 0.92 mm and 0.52 mm. A refined analysis targeting the perceptually most important pinna regions for sound localization showed that multi-view information particularly improved the prediction of BezierPPM parameters describing the cavum-conchae region. The accuracy achieved indicates the suitability of Mesh2PPM to retrieve BezierPPM parameters from pinna meshes.
Accurate estimation of organ and effective doses in CT imaging is essential for risk assessment, protocol optimization, and personalized care in diagnostic radiology and nuclear medicine. We systematically benchmarked MIRDct, a freely available mesh phantom-based CT dose calculation software, against established reference software (National Cancer Institute Dosimetry System for Computed Tomography [NCICT] and VirtualDose [Virtual Phantoms]) by evaluating agreement between organ-absorbed doses and effective doses across representative scanners, phantoms, and protocols. Methods: Organ absorbed and effective doses were calculated for adult and pediatric phantoms for whole-body (WB) and regional (head, chest, abdomen-pelvis [AP]) CT examinations. MIRDct uses mesh-based International Commission on Radiologic Protection (ICRP) reference phantoms with anatomically realistic organ surfaces, whereas NCICT and VirtualDose use voxel-based ICRP 110 and hybrid Rensselaer Polytechnic Institute/University of Florida phantom models, respectively. For each software, volumetric CT dose index (CTDIvol) values were obtained from the software interface using matched acquisition parameters; in MIRDct, these values were derived from scanner console-reported outputs for the corresponding protocol settings. Organ absorbed doses, dose coefficients, and effective doses were computed across 44 matched scanner-phantom-protocol configurations. Inter-software differences were summarized using medians and interquartile ranges. For regional protocols, organ-absorbed doses were stratified by irradiation category (in-field, partial-in-field, out-of-field), to assess field-dependent variability. Results: CTDIvol​ values reported by the 3 software tools showed close agreement across matched protocol configurations, with median inter-software differences not exceeding 7%. For in-field organs, dose coefficients from NCICT and VirtualDose generally agreed with MIRDct values within ±25% across adult and pediatric head, chest, AP, and WB protocols, indicating good agreement in the primary beam region. Larger relative deviations occurred for partial-in-field and out-of-field organs, where doses were scatter-dominated; however, absolute organ doses were less than 2 mGy, limiting clinical relevance. Effective dose estimates showed similar concordance: differences were below 25% for all VirtualDose comparisons except head scans and for WB protocols, whereas adult chest and AP protocols differed by up to 40% relative to NCICT. These differences were associated with variations in phantom anatomy and fixed, pre-tabulated CTDIvol reference values in NCICT and VirtualDose, compared with protocol-specific, console-reported CTDIvol inputs in MIRDct. Conclusion: MIRDct provides organ- and effective-dose estimates that are broadly consistent with established CT dosimetry tools, with agreement typically within ±25% for in-field organs and within a few milligray for absolute doses across adult and pediatric protocols. The use of mesh-based ICRP reference phantoms with anatomically realistic organ surfaces, protocol-specific CTDIvol inputs from the scanner console, and uncertainty propagation supports its application as a research tool for CT dose benchmarking, protocol optimization, and quality assurance in diagnostic CT and nuclear medicine.
Robotic transabdominal retromuscular umbilical prosthetic repair (TARUP) is increasingly used for minimally invasive retromuscular ventral hernia repair, but data on implementation and learning curves in low-volume, non-tertiary community hospitals remain limited. We report early outcomes and operative efficiency during program initiation. Retrospective single-center cohort study in a non-specialist, non-tertiary community hospital. The first 50 consecutive robotic TARUP procedures (2022-2024) were screened; 43 patients were included after predefined exclusions. All hernias were primary midline ventral hernias (EHS width class W1). The primary outcome was operative time (skin-to-skin). Secondary outcomes included non-operative OR time, total OR time, mesh area, early postoperative pain (VAS at 2 h), length of stay (LOS), same-day discharge, and 30-day complications. Learning curves were assessed using chronological tertiles and CUSUM analysis. Retrospective single-center cohort study in a non-specialist, non-tertiary community hospital. The first 50 consecutive robotic TARUP procedures (2022-2024) were screened; 43 patients were included after predefined exclusions. All hernias were primary midline ventral hernias (EHS width class W1). The primary outcome was operative time (skin-to-skin). Secondary outcomes included non-operative OR time, total OR time, mesh area, early postoperative pain (VAS at 2 h), length of stay (LOS), same-day discharge, and 30-day complications (Clavien-Dindo). Learning curves were assessed using chronological tertiles and CUSUM analysis. In a low-volume, non-tertiary community hospital, robotic TARUP showed a clear learning curve with improved operative efficiency over chronological experience and declining minor complications, alongside favorable 30-day recovery outcomes in selected smaller, primary midline ventral hernias. Longer follow-up and broader hernia complexity are needed to assess durability and generalizability.
Abnormal talar biomechanics alter tibiotalar local mechanics and are implicated in several ankle-foot disorders. However, the relationship between graded talar external-rotation moments and local articular changes under controlled loading remains unclear. This study investigated the variation pattern and spatial migration of local mechanical responses on the distal tibial articular surface using a patient-specific three-dimensional finite element ankle model under closed-chain single-leg stance. CT data from the right ankle and foot were used to construct a three-dimensional finite element model including cortical bone, cancellous bone, articular cartilage, and major peri-ankle ligaments using Mimics, Geomagic, and SolidWorks. Mild plantarflexion was simulated by a 6° rotation about the line connecting the malleoli. Cartilage contact was defined as low-friction frictional contact, and ligaments were represented by equivalent spring elements. After mesh sensitivity analysis, a 2.0 mm mesh was selected. Fixed support was applied to the plantar surface of the calcaneus, and axial load was distributed between the tibia and fibula at a 5:1 ratio (500 N and 100 N). Graded talar external-rotation moments of 0-5.0 N·m were applied about the tibial long axis. Peak surface stress, peak contact pressure, and relative talar rotation were extracted. Peak surface stress first decreased and then increased, from 7.56 MPa at 0 N·m to 6.96 MPa at 2.2 N·m, before rising to 8.45 MPa at 5.0 N·m, indicating a relatively low-stress interval within 2.0-2.4 N·m. Peak contact pressure increased continuously from 2.55 MPa to 3.14 MPa, with a slower rise within 0-2.4 N·m and a more pronounced increase beyond 2.6 N·m. Relative talar rotation increased progressively from 0° to 1.61°. Both peak surface stress and peak contact pressure migrated overall from the anterolateral to the anteromedial tibial plafond. Under closed-chain single-leg stance loading, talar external rotation redistributes the local mechanical environment of the distal tibial articular surface. Peak surface stress shows a relatively low-stress interval, whereas peak contact pressure increases overall. These findings suggest that talar external rotation alters both local stress levels and the location of the primary tibiotalar contact zone, and should therefore be interpreted using multiple mechanical indicators.
Secondary anterior perineal hernia (SAPH) is an extremely rare clinical entity. Due to the fragility of the posterior anchoring tissues, mesh repair carries a risk of late complications, such as rectal injury. Herein, we report 2 cases of male SAPH successfully repaired using a pedicled gracilis muscle flap. Case 1: A man in his 70s developed a SAPH after undergoing a total cystectomy. Five years postoperatively, he presented with a bulging sensation in the perineal and scrotal regions, which caused significant discomfort, particularly when sitting. Physical examination revealed a protrusion extending from the base of the penis to the anus. Plain abdominal CT demonstrated herniation of the small intestine through a defect between the anus and the pubic bone, leading to a diagnosis of SAPH. The hernial sac was circumferentially dissected via a transperineal approach with the patient in the lithotomy position. A pedicled gracilis muscle flap was harvested from the left thigh, transposed through a subcutaneous tunnel, and packed into the hernial orifice. The flap was secured to the pubis, right ischium, and superficial transverse perineal muscle. No recurrence has been observed 3 months postoperatively. Case 2: A man in his 80s developed a hernia 1 year after a total cystectomy. Similar to Case 1, the hernia was repaired using a left gracilis muscle flap. No recurrence has been noted at the 15-month follow-up. Repair using a pedicled gracilis muscle flap is an effective procedure that avoids mesh-related complications.
Computational analysis of physiological and biomedical systems necessitate efficient geometry representations for high fidelity model predictions, including patient or device specificity. Particle-based Lagrangian computational approaches comprise a valuable approach to gain insights from quantitative velocity and pressure data from computational models. Examples include particle dynamics and transport in human vasculature for diseases such as stroke, thrombosis, and embolisms; and modern targeted drug delivery systems in the vascular network and respiratory airways. However, current particle simulation approaches can bear significant computational expense that scales with both number of particles and background fluid mesh resolution. A significant determinant of this computational expense is the contact resolution between particles and anatomically realistic vessel wall. Here, we develop an efficient particle dynamics model that leverages an implicit representation of real anatomical features using a signed distance field to efficiently resolve particle-wall contact. We outline the underlying algorithmic details, followed by a systematic illustration of performance and accuracy using simplified and analytically defined geometries and flow fields. Subsequently, we present a representative simulation of embolic particles along a human vascular segment where we compare our distance field-based approach against classical wall-contact checks based on assessing particle boundary intersection with triangulated surface mesh. Our approach transforms the underlying Lagrangian contact detection operation into an equivalent Eulerian operation, significantly speeding up bulk particle dynamics computations without significantly impacting accuracy or geometric fidelity.
Salvia hispanica L. (chia) seeds are recognized as a functional food rich in phenolic compounds, yet the mechanistic basis linking their chemical profile with antidiabetic activity remains insufficiently defined. To evaluate the antioxidant properties, α-glucosidase inhibition, antihyperglycemic and hypoglycemic responses of chia seed extracts of increasing polarity, and to characterize their major phenolics using UPLC-DAD-ESI-MS and molecular docking. n-hexane, dichloromethane, and methanolic extracts were assessed in normoglycemic Wistar rats using an oral sucrose tolerance test and an acute hypoglycemia model. In vitro inhibition of maltase, sucrase, and starch-degrading enzymes was quantified. Total phenolic content and antioxidant activity were determined by Folin-Ciocalteu, 2,2-diphenyl-1-picrylhydrazyl (DPPH), and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid (ABTS) assays. UPLC-DAD-ESI-MS tentatively identified phenolic constituents, and molecular docking was performed against α-glucosidase catalytic domains. The methanolic extract (MESh) exhibited the highest phenolic content and antioxidant activity, a phenolic profile dominated by rosmarinic acid, caffeic acid, and their hexosides, and the strongest antihyperglycemic effect, producing a glycemic curve comparable to acarbose. MESh moderately inhibited sucrase (61.5%), while the dichloromethane extracts moderately inhibited maltase (62.9%). Docking analyses revealed that rosmarinic acid and its hexoside displayed high binding affinities (-7.7 to - 8.1 kcal/mol) toward α-glucosidase targets, closely approaching those of acarbose (-7.9 to - 9.1 kcal/mol) and exceeding those of caffeic-acid derivatives, supporting their potential contribution to the in vitro and in vivo responses. Chia seed extracts exhibit complementary antidiabetic-related activities involving antioxidant effects, modulation of intestinal α-glucosidases, and attenuation of postprandial glycemic excursions. Rosmarinic-acid derivatives emerge as key contributors to these effects. These findings reinforce S. hispanica as a promising functional food for glycemic regulation.
Umbilical hernia is a frequently encountered surgical condition. Its optimal repair method remains debatable. This retrospective study presents a novel technique for umbilical hernia repair, the single-incision laparoscopic (SIL) preperitoneal repair, and compares it with the currently most widely adopted technique, intraperitoneal onlay mesh (IPOM). We reviewed cases of umbilical hernias (> 1 cm) treated with either SIL or IPOM at our center, detailing the SIL procedure and comparing demographics, complications, costs, and outcomes. In the study of 107 umbilical hernia patients, 61 underwent SIL repair and 46 underwent IPOM repair. Both groups had similar baseline characteristics. SIL had a shorter median operating time (57 vs. 64 min, p = 0.030) and a shorter postoperative stay (2 vs. 2.7 days, p = 0.019). SIL also had lower hospitalization costs (1709.7 ± 177.3 vs. (2545.4 ± 528.0 EUR, p < 0.001). No recurrences or mesh infections were observed during follow-up. Compared to the current laparoscopic IPOM plus standard, SIL preperitoneal repair demonstrates comparable safety and represents a feasible and reproducible minimally invasive alternative within the extraperitoneal spectrum. While this study observed shorter operative time and lower institutional costs, these findings should be interpreted with caution. No recurrences were observed during the short-term follow-up. This technique can be standardized, but further comparative studies are required to define its role relative to other established repairs.
The global burden of respiratory viral disease is shaped by two enduring threats: influenza, responsible for 290,000-650,000 annual deaths, and coronaviruses, exemplified by the catastrophic SARS-CoV-2 pandemic that caused over 7 million confirmed fatalities and profound socioeconomic disruption. Current strain-specific vaccines remain inherently reactive, incapable of anticipating antigenic drift, reassortment, or zoonotic emergence. A paradigm shift toward universal vaccines-designed to target evolutionarily conserved viral epitopes and confer durable, broad-spectrum protection across strains, subtypes, and viral genera-represents the most strategically consequential frontier in contemporary vaccinology and pandemic preparedness. This comparative narrative review provides an integrated synthesis of universal influenza vaccine (UIV) and pan-coronavirus vaccine (UCV) development, critically evaluating conserved immunological targets, advanced platform technologies, Phase I-III clinical pipeline status, and key translational barriers. By juxtaposing both developmental trajectories in a single analytical framework, we identify convergent scientific principles and divergent challenges to inform a unified pandemic preparedness strategy-an approach not previously addressed in the literature. A structured narrative review was conducted via systematic literature search of PubMed, EMBASE, and ClinicalTrials.gov covering 2015-June 2026, supplemented by hand-searching reference lists of landmark studies. MeSH and free-text terms encompassed universal influenza vaccines, pan-coronavirus vaccines, mRNA vaccine platforms, hemagglutinin stalk, neuraminidase, M2e, receptor-binding domain (RBD), fusion peptide, S2 subunit, and broadly neutralizing antibodies. Peer-reviewed original research articles, Phase I-III clinical trial reports, and authoritative reviews were included; non-English publications and preclinical-only studies lacking translational immunogenicity data were excluded. Conserved viral epitopes-principally the hemagglutinin (HA) stalk domain, neuraminidase (NA) ectodomain, and M2e protein for influenza, and the receptor-binding domain (RBD) Class 4 epitope, fusion peptide, and S2 subunit for coronaviruses-have been validated as targets for broadly neutralizing antibodies (bnAbs). Multiple advanced platforms, including lipid nanoparticle-encapsulated mRNA, adenoviral vectors, computationally designed self-assembling nanoparticles (Mosaic-8 RBD-I53-50, SpFN), and structure-guided protein antigens, are progressing through early-phase clinical trials with promising cross-reactive immunogenicity profiles. Comparative analysis reveals that UIV development benefits from well-characterised bnAb epitopes and established animal challenge models, while UCV development is accelerated by unprecedented mRNA manufacturing infrastructure and genomic surveillance networks built during the COVID-19 response. Shared translational obstacles include antigenic imprinting, the absence of validated correlates of protection for cross-strain immunity, and inequitable manufacturing scalability. Cross-strain protective vaccines against influenza and coronaviruses are scientifically achievable, supported by converging immunological principles and advancing clinical evidence across both fields. Accelerating translation to population-level protection requires coordinated investment in epitope-focused antigen engineering, correlate-of-protection validation, adaptive regulatory frameworks, and equitable global manufacturing capacity. Crucially, the scientific and policy lessons of COVID-19-both the remarkable speed enabled by prior platform investments and the inequities exposed in global vaccine distribution-must be integrated into universal respiratory virus vaccine programmes now, before the next pandemic forces another reactive response.
High-fidelity 3D reconstruction and precise phenotypic parameter extraction of banana plants are critical for crop growth monitoring and yield estimation in precision agriculture. However, traditional methods encounter significant bottlenecks: LiDAR systems are cost-prohibitive for widespread adoption, while traditional photogrammetry often fails to handle the complex canopy structures, severe occlusions, and weak texture features characteristic of banana leaves. To address these limitations, this article proposes a novel framework for 3D reconstruction and automatic phenotyping based on multi-view images captured by mobile phones. We introduce BN-NeRF, an enhanced Neural Radiance Field method built upon Instant-NGP. Specifically, we integrate three key technical improvements: (1) frame-level geometric calibration to correct camera pose drift caused by handheld motion; (2) sparse geometric anchoring to explicitly constrain depth and scale using sparse point clouds; and (3) thin-leaf prior regularization to suppress artifacts and improve the geometric accuracy of leaf surfaces. Building on this reconstruction, we establish a complete pipeline to recover explicit metric geometry from implicit radiance fields. By combining mesh topological analysis with geodesic algorithms, we achieve automated and precise extraction of key morphological parameters. Extensive experiments were conducted on a dataset of 90 banana plants in a real-world orchard. The results demonstrate that BN-NeRF achieves superior rendering quality (PSNR of 32.4 dB, SSIM of 0.951, and LPIPS of 0.152) while maintaining inference speeds comparable to Instant-NGP. Furthermore, the extracted phenotypic parameters showed strong agreement with manual ground truth across both leaf-level and structural traits. In addition to trait-specific regression performance, the evaluation also includes normalized completeness analysis, calibration-cube-based scale validation, and Bland-Altman agreement analysis, supporting the measurement reliability of BN-NeRF for field phenotyping. This study demonstrates that low-cost smartphone-based acquisition, combined with BN-NeRF, can support accurate field phenotyping of banana plants. In addition, an implemented mobile-cloud system was functionally validated through repeated end-to-end runs on an iPhone 13 client and a cloud workstation.
Aerosol therapy is an essential procedure in the treatment of acute and chronic respiratory diseases. Currently, there are no up-to-date guidelines from German-speaking countries on the selection and use of nebulizer systems in patients undergoing high-flow therapy via nasal cannula (HFT) and non-invasive ventilation (NIV). An interdisciplinary panel of experts consisting of pulmonologists and intensive care physicians developed practice-oriented recommendations for aerosol therapy under HFT and NIV. The evidence base was derived from a systematic search of the PubMed database of the US National Library of Medicine up to and including November 2025.Publications on clinical studies, reviews, guideline documents, and technical reports were included. The respective level of evidence of the information was evaluated. The recommendations were agreed upon in a multi-stage process. Aerosol administration under HFT and NIV with a vibrating mesh nebulizer (VMN) achieved better lung deposition compared to the use of a jet nebulizer (JN). A JN is suitable if VMNs are not available, if highly viscous drug solutions are to be nebulized, or if there are budgetary limitations. The choice and application of the nebulizer system should be patient-specific, consistent with the indication, taking into account technical, clinical, and economic requirements. Die Aerosoltherapie ist ein essenzielles Verfahren in der Behandlung akuter und chronischer Atemwegserkrankungen. Derzeit existiert keine aktuelle Leitlinie aus den deutschsprachigen Ländern zur Auswahl und Anwendung von Verneblersystemen bei Patienten unter High-Flow-Therapie via Nasenkanüle (HFT) und nichtinvasiver Beatmung (NIV).Ein interdisziplinäres Expertengremium aus Pneumologen und Intensivmedizinern entwickelte praxisorientierte Empfehlungen zur Aerosoltherapie unter HFT und NIV. Die Evidenzgrundlage bildete eine systematische Recherche in der Datenbank PubMed der US National Library of Medicine bis einschließlich November 2025.Einbezogen wurden Publikationen zu klinischen Studien, Übersichtsarbeiten, Leitliniendokumente und technische Berichte. Der jeweilige Evidenzgrad der Informationen wurde bewertet. Die Empfehlungen wurden in einem Mehrstufenverfahren konsentiert.Die Aerosolapplikation unter HFT und NIV mit einem Vibrating-Mesh-Vernebler (VMN) führt zu einer besseren Lungendeposition im Vergleich zur Verwendung eines Jet Nebulizers (JN). Ein JN ist geeignet, wenn VMN nicht verfügbar sind, hochvisköse Medikamentenlösungen vernebelt werden sollen oder wenn budgetäre Limitationen bestehen.Die Wahl und Anwendung des Verneblersystems sollte patientenindividuell, indikationsbezogen und unter Berücksichtigung technischer, klinischer und ökonomischer Rahmenbedingungen erfolgen.
Germline mutations in genes governing DNA repair, cell cycle regulation, and epigenetic modification are now recognized as common etiological factors for both cancer predisposition and reproductive dysfunction. This reveals a profound intersection between reproductive biology and oncogenesis. A systematic narrative review was conducted. The literature search spanned PubMed/MEDLINE, Scopus, and Web of Science using keywords and MeSH terms related to infertility phenotypes, cancer predisposition syndromes, and shared molecular mechanisms (e.g., DNA repair, epigenetics). The analysis identifies a core set of genes including BRCA1/2, TP53, ATM, and DNMT3A with pleiotropic roles. Mechanistically, defects in pathways like homologous recombination and mismatch repair disrupt meiotic fidelity, causing gametogenesis failure (e.g., BRCA2-mediated azoospermia), while fostering genomic instability that drives carcinogenesis. Clinically, distinct phenotypes emerge, such as BRCA1-associated premature ovarian insufficiency and TP53-related germ cell apoptosis. Mouse models validate these links, showing that homozygous loss often causes complete sterility. Translational strategies, including PGT-M for high-risk variants and microsurgical testicular sperm extraction (micro-TESE) with intracytoplasmic sperm injection (ICSI) for azoospermia, offer concrete methods for risk mitigation within integrated oncofertility programs. Infertility and cancer susceptibility are fundamentally linked through shared genetic vulnerabilities and molecular pathways. This necessitates a paradigm shift toward dual-risk management, involving universal genetic screening in idiopathic infertility, the development of polygenic risk models, and close multidisciplinary collaboration. While ethical challenges persist, these advances pave the way for personalized care that simultaneously addresses reproductive and oncologic health.