Heart failure is prevalent; however, there is no cost-effective screening option. Against formal echocardiography, we assessed the diagnostic performance of focused cardiac ultrasound (FoCUS), performed by novice users guided and interpreted by artificial intelligence (AI) for the assessment of left ventricular ejection fraction (LVEF). We prospectively enrolled 496 adults referred for diagnostic echocardiography. Novice operators (without clinical or imaging experience) underwent a 4-h imaging workshop, then performed FoCUS using a point-of-care device (Philips Lumify) utilizing real-time AI-image guidance (UltraSight). Images were assessed by AI-image interpretation software (Mayo Clinic), and two expert blinded echocardiologists. Median age was 67, 39% female, and body mass index range 17-56 kg/m2. Forty-one subjects (8.3%) exhibited moderate or greater LV dilatation and 28 (5.6%) had LVEF <40%. The median scan time was 4 min (IQR 3-5). Adequate views were achieved in 95.0% and 97.4% of subjects for AI interpretation and expert analysis, respectively. A two-step diagnostic screening process for low EF in which only abnormal AI reads or uninterpretable scans were reviewed by experts (15.1%) had a sensitivity 96.2%, specificity 95.4%, PPV 54.3%, and NPV 99.8%. A subsequent prospective validation study of 344 subjects demonstrated similar results (sensitivity 100%, specificity 99.4%). In this early feasibility investigation, AI-guidance technology embedded on a handheld device, enabled novice users without clinical or imaging experience to acquire sufficient quality images to accurately assess LVEF with minimal training. The technology evaluated in this study may hold promise for AI-guidance and interpretation to facilitate low-cost screening for cardiac dysfunction.
Maternal obesity affects approximately 16% of pregnancies worldwide and is a major concern for public health. This condition is associated with elevated risks of adverse outcomes, such as gestational diabetes, hypertensive disorders of pregnancy, and cardiovascular and metabolic disease (CVMD) during the life course. Our long-term experience with the (cost-)effective web-based Smarter Pregnancy coaching program is promising to mitigate these risks and improve lifestyle behaviours as well as maternal and neonatal health outcomes. Here our aim is to describe the rationale and study protocol for a randomised controlled trial (RCT) to investigate the clinical and cost-effectiveness, and implementation potential of Smarter Pregnancy Plus (SP+) from early pregnancy onwards in women with obesity. The HYGEIA study is designed as a multicentre, two-armed RCT. A total of 930 women with a body mass index ≥30 kg/m² and a singleton pregnancy of ≤14 weeks gestation will be recruited and randomised 1:1 to the intervention (n=465) and control group (n=465). The intervention group will receive six months of digital lifestyle coaching via the SP+ application, supported by at least one video consultation. SP+ is an extended, co-designed and tailored app version for pregnant women with obesity based on the validated SP program. It provides evidence-based coaching on nutrition, physical activity, mental health, folic acid and vitamin D supplement use, and smoking and alcohol cessation. The control group will receive usual care. Data will be collected through validated questionnaires, electronic medical records, financial records, and qualitative stakeholder sessions, guided by the Non adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS)-framework. The primary outcome is the incidence of maternal CVMD during pregnancy, assessed using a composite measure that includes gestational diabetes, hypertensive disorders of pregnancy, and worsening of pre-existing hypertension or diabetes. Secondary outcomes include changes in lifestyle behaviours, maternal and neonatal outcomes, quality of life, and cost-effectiveness. Tertiary outcomes involve patient satisfaction, provider feasibility and a roadmap for nationwide implementation. The HYGEIA study will provide evidence on the clinical impact, cost-effectiveness, and implementation potential of SP+ as a digital lifestyle intervention for pregnant women with obesity. If successful, SP+ could further enhance routine obstetric care and contribute to improving maternal and neonatal health while reducing healthcare costs. Dutch Trial Registration number NL-OMON57196 (URL: https://onderzoekmetmensen.nl/nl/node/57196/pdf ), date of registration 19-12-2024.
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）
The present exploratory study aimed at defining a concise, reproducible protocol for the use of low-cost image-based technologies for capturing udder-related biometric parameters in Mediterranean buffaloes. Results support the feasibility of smartphone-based solutions as reliable tools for field-scale morphological evaluation, providing a basis for future integration with animal health surveillance applications.
The European Commission's Digital Omnibus proposal aims to simplify the European Union's complex digital legislative framework, which includes the GDPR, Data Act, and AI Act. While streamlining regulatory compliance is an attractive objective for healthcare stakeholders, it must not compromise the foundational elements of patient rights, privacy, and data security. This policy-oriented perspective analyzes the proposed amendments and the subsequent European Data Protection Board (EDPB) and European Data Protection Supervisor (EDPS) Joint Opinion 2/2026. Through a thematic and doctrinal analysis of these regulatory documents, this article examines four critical areas impacting digital health: (1) definitions of personal and pseudonymised data; (2) data processing for scientific research and AI; (3) the balance between data subject rights and administrative burdens; and (4) emergency data access and ePrivacy. We argue that data security is a prerequisite for trustworthy digital health systems, and regulatory simplification must not inadvertently expand the attack surface for health data. We conclude that while the Digital Omnibus offers necessary relief from compliance fatigue, true digital health governance requires a 'security-by-design' roadmap. Policymakers must adopt targeted derogations for health data that facilitate EHDS cross-border interoperability and AI innovation, without dismantling the foundational pseudonymisation and transparency safeguards upon which patient trust relies.
Two decades of evidence have established flow diversion as an effective treatment for intracranial aneurysms. As the field enters its third decade, the central question is no longer whether it works, but how to deliver reliable arterial reconstruction consistently across anatomies, operators, and clinical settings. This editorial argues that flow diversion has reached biological maturity but not yet clinical maturity. Distal and small-vessel applications are now feasible with acceptable safety, shifting the priority from broader indications toward greater precision. Surface-modified devices and evidence-based antiplatelet strategies-exemplified by the randomized COATING trial-are reducing thrombogenicity and enabling simplified regimens, while standardized frameworks (such as the F2B2 classification) help distinguish benign braid adaptation from true device instability. Realizing the technology's potential will depend on three priorities: standardized imaging assessment, predictive patient selection, and validated biological endpoints, alongside reproducible deployment technique and attention to economic sustainability and global access. In our view, the next decade should deliver not simply more flow diversion, but better flow diversion-more predictable, more accessible, and more durable.
The growing antimicrobial resistance crisis has led to renewed interest in bacteriophage therapy, mostly for topical uses such as wound/burn care. However, the clinical application of topical phage therapy is delayed due to a major problem that dosing and delivery protocols lack standardization. By gathering scattered published studies on topical phage therapy, this review attempts to bridge the most important gap. We unpack the complicated interactions between phage titer (most of the time 107-109 PFU/mL), multiplicity of infection (MOI), and the stability of various formulations such as hydrogels, creams, and polymer-based sprays, which are some of the factors that determine the effectiveness of the treatment to the greatest extent. Our review extends to the bacterial load and biofilm maturity, whose raising is the main explanation of why mature biofilms need higher, repeated dosing or a combination of antibiotics and depolymerase-armed phages to be treated effectively. Additionally, we collect pharmacokinetic/pharmacodynamic (PK/PD) essentials from animal experiments and talk about the role of wound dressings in the controlled delivery of phages. The authors argue that topical phage therapy can be most effective only when it is a combined effort: accurate dose calculation, intelligent formulation design, and careful planning of the time for application. To get from the laboratory to the clinic, the field needs to urgently implement standardized PK/PD frameworks, stringent stability testing, and comprehensive clinical trials. This paper brings together these components to serve as a practical guide in the development of efficient, dependable, and easily translatable topical phage treatment regimens.
Machine-learning potentials (MLPs) promise near-first-principles fidelity at scales relevant to heterogeneous catalysis, yet the key determinant of their reliability remains the quality of the training data. A paramount challenge lies in constructing training sets that capture both the system-specific structural domains and the broader chemical variability arising from the complex, dynamic nature of heterogeneous catalytic systems. In this perspective, we argue that the key question is no longer simply how to generate more data, but how to generate the right data. We reinterpret the main strategies used to construct MLP training sets for heterogeneous catalysis through the lens of scope, relevance, and coverage. We then examine the challenges of data generation in catalytic systems and how they have shaped prevailing structure-based sampling practices, which encode system relevance and targeted coverage directly into the data set. We also discuss emerging interaction-based sampling strategies that aim to broaden local-interaction support beyond narrowly predefined systems. We conclude by consolidating a possible hybrid data generation workflow that combines the strengths of both approaches, thereby bringing MLPs closer to the simulation of complex heterogeneous catalytic systems.
暂无摘要（点击查看详情）
Nanosomes-lipid vesicles at the nanoscale-enable the encapsulation of both hydrophilic and lipophilic actives and are increasingly used as skin delivery systems in cosmetic products. Alongside nanoemulsions, polymer nanocapsules, and inorganic nanoparticles (e.g., TiO2, ZnO, Ag), they can enhance solubility, stability, residence time, and local bioavailability while enabling controlled release. This review summarizes nanocarrier structures, preparation concepts, and skin penetration pathways (transepidermal intercellular/transcellular and transappendageal), and discusses formulation factors that modulate delivery. We highlight applications in UV protection, anti-aging, and fragrance retention, focusing on lipid-based systems (liposomes/nanosomes, ethosomes, niosomes). Safety considerations are critically appraised with reference to EU and FDA frameworks, including physicochemical characterization, dermal penetration, irritation/sensitization, and genotoxicity testing. While most data indicate limited penetration through intact skin for particles ≥20 nm, enhanced uptake may occur under specific conditions (very small size, barrier impairment, mechanical stress), warranting careful risk assessment. We conclude with regulatory and sustainability perspectives and outline research priorities for long-term toxicology, in-use exposure, and standardization of methods.
This article proposes a novel integrative framework that unifies the clinical method and the scientific method as parallel processes of knowledge generation and decision-making, positioning point-of-care ultrasound (POCUS) and artificial intelligence (AI) as complementary extensions of the clinician's senses and reasoning that enhance diagnostic accuracy while preserving human judgment. The framework describes how experience and evidence interact through observation, hypothesis generation, testing, and revision, and illustrates how POCUS improves bedside diagnostic precision while AI supports data integration and interpretation. The central takeaway is that integrating AI and POCUS within the clinical-scientific method enables more structured interpretation of clinical data, reduces diagnostic uncertainty, and supports more timely and accurate decision-making while preserving clinician judgment as central.
暂无摘要（点击查看详情）
Over Earth's history, the Sun has continuously released coronal mass ejections of plasma that have flowed toward Earth, generating the need for reactive oxygen and nitrogen species (RONS) for plants. On the other hand, engineered plasma interacts with air, generating RONS. Thus, the natural process is simulated using engineered plasma (hereafter, plasma), which acts as an artificial Sun. Plasma agriculture offers a sustainable alternative by leveraging plasma-generated RONS to stimulate plant growth and generate nitrogen fertilizer through eco-friendly methods. The aim of this review is to provide a comprehensive evaluation of the use of plasma in agriculture to address global food insecurity, exacerbated by climate change and the environmental impacts of chemical-intensive farming. To tackle this issue, two methods are explored: plasma-assisted seed treatment and plasma-assisted nitrogen fixation in soil and water, referred to as plasma fertilizer. Plasma-assisted seed treatment is a pre-sowing technique designed to enhance crop yield and stress tolerance in a variety of important plant species. Conversely, plasma fertilizer serves as an environmentally friendly alternative to conventional fertilizers. This review focuses on identifying the scientific and translational priorities necessary to advance the field toward practical agricultural applications. This review is based on two interconnected concepts. The first is the biology of plasma-generated RONS, which serve as dose-dependent biochemical primers for seeds. At optimal concentrations, RONS initiate a series of responses in seeds, including modifications to the seed coat, increased activity of antioxidant enzymes, rebalancing of the phytohormones that control dormancy release, upregulation of germination-related gene expression, and epigenetic reprogramming. The second concept involves plasma-assisted C-N-H-O chemistry, in which plasma discharges convert atmospheric N2 into forms that are accessible to plants, thereby promoting overall growth. Together, these two concepts illustrate plasma agriculture's dual role in seed priming and sustainable fertilization.
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）