Feasibility, safety and effectiveness of robot-assisted radical prostatectomy with a new robotic surgical system: a prospective, controlled, randomized clinical trial.

BACKGROUND: Robot-assisted radical prostatectomy (RARP) gains increasing popularity in the surgical management of prostate cancer (PCa) but is challenged by its prohibitive expense. A domestic robotic system has been developed to address this issue, but data comparing the self-developed robot with the widely used robot is lacking. We performed a randomized clinical trial to compare KD-SR-01® and DaVinci® robots in terms of perioperative, short-term oncological and functional outcomes in RARP. MATERIALS AND METHODS: We prospectively enrolled patients with clinically localized PCa. Patients were randomized to undergo either KD-SR-01®-RARP (K-RARP) or DaVinci®-RARP (D-RARP) by the same surgical team. The baseline, perioperative, short-term oncologic and urinary functional data were collected and compared. RESULTS: We enrolled 39 patients, including 20 patients undergoing K-RARP and 19 undergoing D-RARP. Demographic and tumor characteristics were comparable between groups. All surgeries were performed successfully with no conversion to open. The operative time was similar (P = 0.095) and K-RARP offered less volume of intraoperative bleeding (P < 0.001). Four patients in the K-RARP group and three in the D-RARP group developed postoperative complications (P = 0.732). Patients undergoing K-RARP had less volume of drainage (P = 0.022). Positive surgical margins were observed in three patients undergoing K-RARP and five undergoing D-RARP (P = 0.451). During the follow up, one patient receiving K-RARP group and two receiving D-RARP group had measurable prostate specific antigen (P = 0.605). Urine leakage, urinary control and pad usage were comparable between groups at six weeks post-surgery. CONCLUSIONS: The two surgical robots yielded similar results in feasibility, safety and short-term oncologic and functional efficacy for RARP. TRIAL REGISTRATION: The trial has been registered at www.chictr.org.cn with a registration number of ChiCTR2200057000 on 25th February 2022.

Development Trends and Prospects of Technology-Based Solutions for Health Challenges in Aging Over the Past 25 Years: Bibliometric Analysis.

BACKGROUND: As the global population ages, we witness a broad scientific and technological revolution tailored to meet the health challenges of older adults. Over the past 25 years, technological innovations, ranging from advanced medical devices to user-friendly mobile apps, are transforming the way we address these challenges, offering new avenues to enhance the quality of life and well-being of the aging demographic. OBJECTIVE: This study aimed to systematically review the development trends in technology for managing and caring for the health of older adults over the past 25 years and to project future development prospects. METHODS: We conducted a comprehensive bibliometric analysis of literatures related to technology-based solutions for health challenges in aging, published up to March 18, 2024. The search was performed using the Web of Science Core Collection, covering a span from 1999 to 2024. Our search strategy was designed to capture a broad spectrum of terms associated with aging, health challenges specific to older adults, and technological interventions. RESULTS: A total of 1133 publications were found in the Web of Science Core Collection. The publication trend over these 25 years showed a gradual but fluctuating increase. The United States was the most productive country and participated in international collaboration most frequently. The predominant keywords identified through this analysis included "dementia," "telemedicine," "older-adults," "telehealth," and "care." The keywords with citation bursts included "telemedicine" and "digital health." CONCLUSIONS: The scientific and technological revolution has significantly improved older adult health management, particularly in chronic disease monitoring, mobility, and social connectivity. The momentum for innovation continues to build, with future research likely to focus on predictive analytics and personalized health care solutions, further enhancing older adults' independence and quality of life.

Breathing in danger: Understanding the multifaceted impact of air pollution on health impacts.

Air pollution, a pervasive environmental threat that spans urban and rural landscapes alike, poses significant risks to human health, exacerbating respiratory conditions, triggering cardiovascular problems, and contributing to a myriad of other health complications across diverse populations worldwide. This article delves into the multifarious impacts of air pollution, utilizing cutting-edge research methodologies and big data analytics to offer a comprehensive overview. It highlights the emergence of new pollutants, their sources, and characteristics, thereby broadening our understanding of contemporary air quality challenges. The detrimental health effects of air pollution are examined thoroughly, emphasizing both short-term and long-term impacts. Particularly vulnerable populations are identified, underscoring the need for targeted health risk assessments and interventions. The article presents an in-depth analysis of the global disease burden attributable to air pollution, offering a comparative perspective that illuminates the varying impacts across different regions. Furthermore, it addresses the economic ramifications of air pollution, quantifying health and economic losses, and discusses the implications for public policy and health care systems. Innovative air pollution intervention measures are explored, including case studies demonstrating their effectiveness. The paper also brings to light recent discoveries and insights in the field, setting the stage for future research directions. It calls for international cooperation in tackling air pollution and underscores the crucial role of public awareness and education in mitigating its impacts. This comprehensive exploration serves not only as a scientific discourse but also as a clarion call for action against the invisible but insidious threat of air pollution, making it a vital read for researchers, policymakers, and the general public.

Impact of public-private partnerships investment and FDI on CO2 emissions: A study of six global investment countries.

This study investigates the impact of public-private partnerships investment in energy and FDI on environmental quality in global investment countries during 1995-2018. Economic growth, technological innovations and consumption of clean energy are also considered as additional determinants of environmental quality. The study applied advanced panel econometric models. Our empirical results affirm the evidence of a long-run association between environmental quality and its determinants. Specifically, economic growth as well as clean energy use improves quality of environment by lowering carbon emissions. Public-private partnerships investment in energy, FDI and technological innovations decrease carbon emissions. Energy consumption (generated from fossil fuel) increases carbon emissions. Heterogeneous causality evidence indicates the presence of a unidirectional causality relation from carbon emissions to public-private partnerships investment in energy and a feedback causality occurs between consumption of clean energy and CO2 emissions. This empirical evidence provides new insights for both policymakers and governments to support public-private partnership investments in energy for the improvement of quality of environment in global investment countries.

Advancing noise management in aviation: Strategic approaches for preventing noise-induced hearing loss.

As urbanization and population growth escalate, the challenge of noise pollution intensifies, particularly within the aviation industry. This review examines current insights into noise-induced hearing loss (NIHL) in aviation, highlighting the risks to pilots, cabin crew, aircraft maintenance engineers, and ground staff from continuous exposure to high-level noise. It evaluates existing noise management and hearing conservation strategies, identifying key obstacles and exploring new technological solutions. While progress in developing protective devices and noise control technologies is evident, gaps in their widespread implementation persist. The study underscores the need for an integrated strategy combining regulatory compliance, technological advances, and targeted educational efforts. It advocates for global collaboration and policy development to safeguard the auditory health of aviation workers and proposes a strategic framework to enhance hearing conservation practices within the unique challenges of the aviation sector.

Achieving zero emission targets: The influence of green bonds on clean energy investment and environmental quality.

The effectiveness of green finance in driving clean energy and environmental sustainability in the current era is receiving attention. Therefore, this study proposes an empirical framework highlighting the effects of green bonds (GB) on clean energy investment (CEI), clean energy investment efficiency (CEE) and environmental sustainability of 29 green bond issuing countries between 2014 and 2022. Using system and difference GMM approaches, this study finds that (i) green bond issuance drives clean energy investment. (ii) Green bonds sufficiently enhance the selected countries' environmental quality. These results supplement the promotion of green bonds in increasing the transfer of funds towards renewable energy projects by reducing reliance on fossil fuels. (iii) Using Driscoll & Kraay, Fully Modified-OLS, and changing the dependent variable, this study further supported the idea that green bonds effectively promote the CEE and environmental sustainability of the chosen countries. (iv) Similarly, this study conducted income heterogeneity, showing that green bonds improve high- and middle-income countries' CEI and environmental quality. (v) Finally, the results indicate that resource consumption escalates CO2 emissions by declining the CEI. Technological innovations increase CEI, whereas they do not mitigate CO2 emissions directly, hinting at the requirement for a comprehensive approach. Therefore, inclusive policies on green bond frameworks, robust incentives, and rigorous environmental criteria should be implemented to attract investment in clean energy development and ensure the environmental sustainability of the selected countries.

The Evolution of Single-Cell RNA Sequencing Technology and Application: Progress and Perspectives.

As an emerging sequencing technology, single-cell RNA sequencing (scRNA-Seq) has become a powerful tool for describing cell subpopulation classification and cell heterogeneity by achieving high-throughput and multidimensional analysis of individual cells and circumventing the shortcomings of traditional sequencing for detecting the average transcript level of cell populations. It has been applied to life science and medicine research fields such as tracking dynamic cell differentiation, revealing sensitive effector cells, and key molecular events of diseases. This review focuses on the recent technological innovations in scRNA-Seq, highlighting the latest research results with scRNA-Seq as the core technology in frontier research areas such as embryology, histology, oncology, and immunology. In addition, this review outlines the prospects for its innovative application in traditional Chinese medicine (TCM) research and discusses the key issues currently being addressed by scRNA-Seq and its great potential for exploring disease diagnostic targets and uncovering drug therapeutic targets in combination with multiomics technologies.

[Funding programs in the research field old age and technology : Discourse analysis of calls for proposals]. / Förderprogramme im Forschungsfeld Alter und Technik : Diskursanalyse von Ausschreibungen.

BACKGROUND: A research funding field has been established throughout Europe for the development and use of (digital) technologies for older people to strengthen their autonomy and participation. In the research practice, however, it is hypothesized that there are problems that partly result from the funding programs. OBJECTIVE: The analysis of calls for proposals from a critical gerontological perspective should reveal possible causes. In doing so, the implicit ideas of age, technologies and their interrelationships of the calls for proposals are reconstructed. MATERIAL AND METHODS: The sample consisted of calls for proposals of the Federal Ministry of Education and Research (2006-2021), which were examined by a discourse analysis. In addition, the identified discourse is interpreted in the sense of Foucault as a powerful discourse that influences the research field. RESULTS: Old age is considered to be deficient and older people as being incompetent with respect to technology. Technologies are seen as having great potential for solving the problems associated with old age on individual, institutional and societal levels. The fact that the discourse unfolds its effect in research practice is clarified through its contextualisation. DISCUSSION: The strong focus on technologies means that problems of older people that cannot be solved with technologies are neglected. This leads to power inequalities in projects as well as to the fact that the development process is guided less by needs than by innovations. The construction of age as deficient also flows into research practice and determines the product design. CONCLUSION: With this critical cultural gerontological view of research funding, implicit problems that need to be addressed can be made visible.

Methods for Human-Centered eHealth Development: Narrative Scoping Review.

BACKGROUND: Thorough holistic development of eHealth can contribute to a good fit among the technology, its users, and the context. However, despite the availability of frameworks, not much is known about specific research activities for different aims, phases, and settings. This results in researchers having to reinvent the wheel. Consequently, there is a need to synthesize existing knowledge on research activities for participatory eHealth development processes. OBJECTIVE: The 3 main goals of this review are to create an overview of the development strategies used in studies based on the CeHRes (Center for eHealth Research) Roadmap, create an overview of the goals for which these methods can be used, and provide insight into the lessons learned about these methods. METHODS: We included eHealth development studies that were based on the phases and/or principles of the CeHRes Roadmap. This framework was selected because of its focus on participatory, iterative eHealth design in context and to limit the scope of this review. Data were extracted about the type of strategy used, rationale for using the strategy, research questions, and reported information on lessons learned. The most frequently mentioned lessons learned were summarized using a narrative, inductive approach. RESULTS: In the included 160 papers, a distinction was made between overarching development methods (n=10) and products (n=7). Methods are used to gather new data, whereas products can be used to synthesize previously collected data and support the collection of new data. The identified methods were focus groups, interviews, questionnaires, usability tests, literature studies, desk research, log data analyses, card sorting, Delphi studies, and experience sampling. The identified products were prototypes, requirements, stakeholder maps, values, behavior change strategies, personas, and business models. Examples of how these methods and products were applied in the development process and information about lessons learned were provided. CONCLUSIONS: This study shows that there is a plethora of methods and products that can be used at different points in the development process and in different settings. To do justice to the complexity of eHealth development, it seems that multiple strategies should be combined. In addition, we found no evidence for an optimal single step-by-step approach to develop eHealth. Rather, researchers need to select the most suitable research methods for their research objectives, the context in which data are collected, and the characteristics of the participants. This study serves as a first step toward creating a toolkit to support researchers in applying the CeHRes Roadmap to practice. In this way, they can shape the most suitable and efficient eHealth development process.

[Is a tele-emergency physician system a sensible addition in rural German regions?-An analysis from a medical and economic perspective]. / Ist das Telenotarzt-System eine sinnvolle Ergänzung im ländlichen Raum? ­ Eine Analyse aus medizinischer und ökonomischer Perspektive.

BACKGROUND AND OBJECTIVES: In 2017, a tele-emergency-physician system was implemented in the county of Vorpommern-Greifswald (Germany) to optimise the prehospital emergency medical service and to counteract current challenges. It was evaluated from a medical and economic perspective whether a tele-emergency physician system is a useful addition to the existing prehospital emergency system, especially in rural regions. MATERIALS AND METHODS: Approximately 250,000 emergency medical service data from the years 2015 to 2020 (before and after the implementation of the telemedical system) were analysed in a pre-post comparison. A total of 3611 tele-emergency physician cases were analysed regarding medical indication and time-related factors. Additionally, total costs of the tele-emergency physician system as well as a cost analysis regarding prehospital and hospital medical costs of selected diseases were performed. RESULTS: The tele-emergency physician treated patients of all age groups with a wide spectrum of diseases. Of the cases, 48.2% were moderate to severe but not life-threatening disorders. Patients as well as emergency medical service personnel embraced the new system. According to the data, ambulances that were equipped with the telemedical system had the number of missions requiring an emergency physician on scene reduced significantly by 20%. The yearly costs of this telemedical system amount to €1.7 million. CONCLUSIONS: The tele-emergency physician system proved to be a telemedical innovation that is medically advisable, functional and cost-efficient. Therefore, the tele-emergency physician system continued to operate after the end of the research project and is ready to be implemented across Germany.

A Middle Pleistocene abrading tool from Tabun Cave, Israel: A search for the roots of abrading technology in human evolution.

During the reanalysis of the finds from Jelinek's and Ronen's excavations at Tabun Cave, Israel, we encountered a cobble bearing traces of mechanical alterations similar to those recorded on grinding tools. However, the artifact derives from the early layers of the Acheulo-Yabrudian complex of the late Lower Paleolithic (ca. 350 ka), a time with no evidence for grinding or abrasion. Accordingly, we sought to determine whether the traces on the artifact can be attributed to purposeful human action. We conducted a detailed use-wear analysis of the cobble and implemented an experimental program, gaining positive results for the hypothesis of purposeful human practice. We argue that the significance and novelty of early abrading technology is that it marks a new mode of raw material manipulation-one that is categorically different from other modes of tool use observed among earlier hominins or other primates and animals. Throughout the Early Pleistocene, use of stone tools was associated with vertical motions (battering, pounding, striking) or with the application of a thin or narrow working edge, leveled at cutting or scraping. Conversely, abrading consists in applying a wide working surface in a continuous sequence of horizontal motions, geared to modify or reduce the surfaces of a targeted material. The emergence of this technology joins additional behavioral changes recently identified and attributed to the Middle Pleistocene, illustrating the growing and diversifying capabilities of early hominins to harness technology to shape their environment.

Examining the temporal impact of stock market development on carbon intensity: Evidence from South Asian countries.

The growing size of stock market in the South Asian countries might have contributed to raising the level of industrial production and energy consumption. This upturned energy usage might have widened the scope for carbon emissions because these nations heavily rely on fossil fuels. In this milieu, therefore, in the present study, we assessed the impacts of stock market development, per capita income, trade expansion, renewable energy solutions, and technological innovations on carbon intensity in the four South Asia countries from 1990 to 2016. The empirical results based on the CS-ARDL approach revealed that stock market development, per capita income, and trade expansion invigorated carbon intensity in the South Asian countries. On the contrary, the increased usage of renewable energy solutions and technological advancement helped in reducing the energy-led carbon intensity. Further, the interaction of stock market with renewable energy, and subsequently with technological advancement delivered insignificant coefficients, which indicates the inefficacy of renewable energy and technological advancement in regulating stock market-led carbon intensity during the study period. Therefore, by considering the need for complementarity between economic growth and environmental targets, we proposed a multipronged policy framework, which may help the selected countries to attain the Sustainable Development Goals, with a special focus on SDG 7, 8, 9, and 13.

[Strategic flight planning or why the Bavarian Mountain Rescue Service relies on drones]. / Strategische Flugplanung oder warum die Bergwacht Bayern auf Drohnen setzt.

The Bavarian Mountain Rescue Service has always shown a great interest in innovations, chances and possibilities. Against this background, in 2012 the construction of a new structure was initiated, the localization, communication and situation report team (LKLD: Lokalisation, Kommunikation und Lagedarstellung), which uses modern techniques, such as the GPS, mobile internet, thermal imaging, residual light amplification and drones. The use of unmanned aircraft systems (UAS) has already been proven to be very helpful and facilitative in the search for missing persons. Using UAS the LKLD teams could also successfully master unusual missions, e.g. for the inspection of damaged structures in the bridge construction after the tragic collapse of the bridge in Werneck or in connection with monitoring of dangerous alpine conditions. Motivated by these successes and by the political appreciation of their voluntary work, dedicated work is being carried out on further innovations. Under consideration are automated flights far beyond the range of visibility, transport of materials and drones which can carry passengers.

Medical drones: Disruptive technology makes the future happen.

Trauma surgery has always been driven forward by innovative technological advancements. The recent appearance of "advanced air mobility" (AAM) represents one of the next steps in these technological developments. These innovative flying systems have major implications for all of the various healthcare stages in trauma surgery: Unmanned aircraft systems, or drones, can deliver critical supplies on demand, just in time, without physical contact, within the "last mile delivery" concept, such as AEDs, critical medication, blood for transfusion etc. Electric vertical take-off and landing (eVTOL) devices add new horizons for healthcare thanks to the smallest take-off and landing areas. These eVTOLs are not only new aircraft but, thanks to the autonomous flying options, they are flying computers with novel technological opportunities on board. With these new, flying operation systems, the whole rescue chain will be completely revolutionized by much faster response intervals, patient transportation times, telemedical applications, optimized emergency medical services, laboratory transportation etc. Hence, this article aims to provide a tentative overview of these new exciting technological developments in the field of trauma surgery for the benefit of our patients.

New Sensor and Wearable Technologies to Aid in the Diagnosis and Treatment Monitoring of Parkinson's Disease.

Parkinson's disease (PD) is a degenerative disorder of the brain characterized by the impairment of the nigrostriatal system. This impairment leads to specific motor manifestations (i.e., bradykinesia, tremor, and rigidity) that are assessed through clinical examination, scales, and patient-reported outcomes. New sensor-based and wearable technologies are progressively revolutionizing PD care by objectively measuring these manifestations and improving PD diagnosis and treatment monitoring. However, their use is still limited in clinical practice, perhaps because of the absence of external validation and standards for their continuous use at home. In the near future, these systems will progressively complement traditional tools and revolutionize the way we diagnose and monitor patients with PD.

Rapid phenotyping towards personalized malaria medicine.

Malaria is major public health concerns which continues to claim the lives of more than 435,000 people each year. The challenges with anti-malarial drug resistance and detection of low parasitaemia forms an immediate barrier to achieve the fast-approaching United Nations Sustainable Development Goals of ending malaria epidemics by 2030. In this Opinion article, focusing on the recent published technologies, in particularly the nuclear magnetic resonance (NMR)-based diagnostic technologies, the authors offer their perspectives and highlight ways to bring these point-of-care technologies towards personalized medicine. To this end, they advocate an open sourcing initiative to rapidly close the gap between technological innovations and field implementation.

Food identification by barcode scanning in the Netherlands: a quality assessment of labelled food product databases underlying popular nutrition applications.

OBJECTIVE: The quality of labelled food product databases underlying popular diet applications (apps) with barcode scanners was investigated. DESIGN: Product identification rates for the scanned products and the availability and accuracy of nutrient values were calculated. SETTING: One hundred food products were selected from the two largest supermarket chains in the Netherlands. Using the barcode scanners of the selected apps, the products were scanned and the results recorded as food diary entries. The collected data were exported. SUBJECTS: Seven diet apps with barcode scanner and food recording feature were selected from the Google Play and Apple app stores. RESULTS: Energy values were available for 99 % of the scanned products, of which on average 79 % deviated not more than 5 % from the true value. MyFitnessPal provided values for sixteen nutrients, while Virtuagym Food and Yazio provided values for only four nutrients. MyFitnessPal also showed the largest percentage of correctly identified products (i.e. 96 %) and SparkPeople the smallest (i.e. 5 %). The accuracy of the provided nutrient values varied greatly between apps and nutrients. CONCLUSIONS: While energy was the most consistently and accurately reported value, the availability and accuracy of other values varied greatly between apps. Whereas popular diet apps with barcode scanners might be valuable tools for dietary assessments on the product and energy level, they appear less suitable for assessments on the nutrient level. The presence of user-generated database entries implies that the availability of food products might vary depending on the size and diversity of an app's user base.

User-documented food consumption data from publicly available apps: an analysis of opportunities and challenges for nutrition research.

BACKGROUND: The need for a better understanding of food consumption behaviour within its behavioural context has sparked the interest of nutrition researchers for user-documented food consumption data collected outside the research context using publicly available nutrition apps. The study aims to characterize the scientific, technical, legal and ethical features of this data in order to identify the opportunities and challenges associated with using this data for nutrition research. METHOD: A search for apps collecting food consumption data was conducted in October 2016 against UK Google Play and iTunes storefronts. 176 apps were selected based on user ratings and English language support. Publicly available information from the app stores and app-related websites was investigated and relevant data extracted and summarized. Our focus was on characteristics related to scientific relevance, data management and legal and ethical governance of user-documented food consumption data. RESULTS: Food diaries are the most common form of data collection, allowing for multiple inputs including generic food items, packaged products, or images. Standards and procedures for compiling food databases used for estimating energy and nutrient intakes remain largely undisclosed. Food consumption data is interlinked with various types of contextual data related to behavioural motivation, physical activity, health, and fitness. While exchange of data between apps is common practise, the majority of apps lack technical documentation regarding data export. There is a similar lack of documentation regarding the implemented terms of use and privacy policies. While users are usually the owners of their data, vendors are granted irrevocable and royalty free licenses to commercially exploit the data. CONCLUSION: Due to its magnitude, diversity, and interconnectedness, user-documented food consumption data offers promising opportunities for a better understanding of habitual food consumption behaviour and its determinants. Non-standardized or non-documented food data compilation procedures, data exchange protocols and formats, terms of use and privacy statements, however, limit possibilities to integrate, process and share user-documented food consumption data. An ongoing research effort is required, to keep pace with the technical advancements of food consumption apps, their evolving data networks and the legal and ethical regulations related to protecting app users and their personal data.

Studying Scale-Up and Spread as Social Practice: Theoretical Introduction and Empirical Case Study.

BACKGROUND: Health and care technologies often succeed on a small scale but fail to achieve widespread use (scale-up) or become routine practice in other settings (spread). One reason for this is under-theorization of the process of scale-up and spread, for which a potentially fruitful theoretical approach is to consider the adoption and use of technologies as social practices. OBJECTIVE: This study aimed to use an in-depth case study of assisted living to explore the feasibility and usefulness of a social practice approach to explaining the scale-up of an assisted-living technology across a local system of health and social care. METHODS: This was an individual case study of the implementation of a Global Positioning System (GPS) "geo-fence" for a person living with dementia, nested in a much wider program of ethnographic research and organizational case study of technology implementation across health and social care (Studies in Co-creating Assisted Living Solutions [SCALS] in the United Kingdom). A layered sociological analysis included micro-level data on the index case, meso-level data on the organization, and macro-level data on the wider social, technological, economic, and political context. Data (interviews, ethnographic notes, and documents) were analyzed and synthesized using structuration theory. RESULTS: A social practice lens enabled the uptake of the GPS technology to be studied in the context of what human actors found salient, meaningful, ethical, legal, materially possible, and professionally or culturally appropriate in particular social situations. Data extracts were used to illustrate three exemplar findings. First, professional practice is (and probably always will be) oriented not to "implementing technologies" but to providing excellent, ethical care to sick and vulnerable individuals. Second, in order to "work," health and care technologies rely heavily on human relationships and situated knowledge. Third, such technologies do not just need to be adopted by individuals; they need to be incorporated into personal habits and collaborative routines (both lay and professional). CONCLUSIONS: Health and care technologies need to be embedded within sociotechnical networks and made to work through situated knowledge, personal habits, and collaborative routines. A technology that "works" for one individual in a particular set of circumstances is unlikely to work in the same way for another in a different set of circumstances. We recommend the further study of social practices and the application of co-design principles. However, our findings suggest that even if this occurs, the scale-up and spread of many health and care technologies will be neither rapid nor smooth.