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Feasibility of Image-guided Navigation with Electromagnetic Tracking During Robot-assisted Sentinel Node Biopsy:A Prospective Study
Get PDFBackground and objective: Image-guided surgical navigation (IGSN) can enhance surgical precision and safety. The expansion of minimally invasive surgery has increased the demand for integration of these navigation systems into robot-assisted surgery. Our objective was to evaluate the integration of electromagnetic tracking with IGSN in robot-assisted sentinel lymph node biopsy (SLNB).Methods: We conducted a prospective feasibility study to test the use of IGSN in SLNB. In total, 25 patients scheduled for SLNB at The Netherlands Cancer Institute were included (March 2022 to March 2023). SLNB using IGSN was performed using a standardised technique with a da Vinci robot (Intuitive Surgical, Sunnyvale, CA, USA) in four-arm configuration. Feasibility was determined as the percentage of sentinel nodes (SNs) successfully identified via IGSN. Successful SN resection was defined as SNs correctly localised via navigation and validated ex vivo with a gamma probe. Surgeon feedback on the robot-assisted IGSN workflow was evaluated using the System Usability Scale (SUS).Key findings and limitations: In accordance with the protocol, the first five patients were used for workflow optimisation, and the subsequent 20 patients were included in the analysis. IGSN led to successful identification of 91% (50/55) of the SNs. There were no complications associated with navigation. The surgeon feedback (SUS) was 60.9, with lowest scores reported for the user interface and workflow integration.Conclusions: IGSN during robot-assisted surgery was feasible and safe. The technique allowed identification and removal of predefined small pelvic lymph nodes.Patient summary: We carried out a study on the feasibility of imaging-guided navigation in robot-assisted prostate surgery. Our results show that this technique is feasible, safe, and effective.</p
Synergies of Deep and Classical Exploratory Landscape Features for Automated Algorithm Selection
No full textPer-instance automated algorithm selection (AAS) aims at leveraging the complementarity of optimization algorithms with respect to different problem types. State-of-the-art AAS methods for numerical black-box optimization rely on supervised learning techniques that are supported by exploratory landscape analysis (ELA) feature sets. Recent works question the generalization ability of popular AAS approaches, which motivated the design of alternative feature sets. In this work, we take a closer look at the recently proposed set of Deep ELA features and investigate the ways in which Deep ELA complements the classical ELA feature sets. To this end, we first study the correlation between the two feature collections, both through pairwise classification and through regression models. The complementarity observed in these analyses is confirmed by an AAS study, where models combining deep and classical features outperform those that are restricted to selecting from only of the two collections.</p
The Historical Development of Ethics of Emerging Technologies
Get PDFThis article traces the historical development of the ethics of emerging technologies. It argues that during the late 2000s and 2010s, the field of ethics of technology transformed from a fragmented, reactive, and methodologically underdeveloped discipline focused on mature technologies and lacking policy orientation into a more cohesive, proactive, methodologically sophisticated, and policy-focused field with a strong emphasis on emerging technologies. An agenda for this transition was set in Jim Moor’s seminal publication “Why We Need Better Ethics for Emerging Technologies”.</p
Advanced analytics to improve energy efficiency of steel industry - A systematic review on ladle logistics
Get PDFThe steel industry, a significant contributor to global energy consumption and CO2 emissions, must adopt innovative approaches to improve efficiency and sustainability. This systematic literature review focused on identifying advanced analytical methods that have the capability of enabling informed decision-making in optimising steel ladle logistics—a key process within steel-making that influences energy use and emissions. The scientific landscape has State-of-the-Art optimiser algorithms built using mathematical models to generate ladle logistics schedules. The evaluation of such decision support systems is generally carried out using various techniques. This review uniquely highlights how discrete event simulation (DES) can be integrated with optimization models for robust validation of scheduling decisions. This paper explores validation techniques incorporating historical operational data and simulation modelling to ensure that theoretical optimization translates to practical, real-world applications. Key sustainability indicators, such as CO2 emission intensity and energy consumption per tonne of steel, are identified and assessed for their role in aligning steel production with environmental goals such that they can be adapted to validate the levels reported by the optimization model against the simulation model. The findings reveal that integrating DES alongside the optimization model enhances the feasibility and robustness of scheduling models. This approach supports the industry's shift towards sustainable practices by providing decision-makers with reliable tools for optimising logistics, reducing energy consumption, and minimizing emissions.</p
Knowing your weaknesses is your greatest strength: Mapping CVE to CWE by leveraging CWE Hierarchy and LLMs
No full textEffective defense against threat actors requires that security professionals accurately identify the underlying weaknesses associated with common vulnerabilities and exposures (CVEs). This understanding is crucial for deploying appropriate defensive mechanisms and prioritizing remediation efforts. However, manually mapping CVEs to common weakness enumerations (CWEs) has become increasingly impractical due to the rapid increase of new CVEs and the extensive, complex CWE taxonomy. In 2025, the number of CVEs that are waiting for analysis exceeded 24,000.To automate the mapping between CVEs and CWEs, we propose to leverage two insights. To harness the power of large language models, we first fine-tune different language models to perform this mapping based on the vulnerability-to-weakness relation. Second, we propose a supervised framework leveraging the hierarchical structure of CWEs, where we first categorize vulnerabilities into broad CWE classes (e.g., Injection, Buffer Overflow), which helps capture high-level patterns, and then utilizes specialized subnetworks to distinguish fine-grained differences within each class. Evaluated on a benchmark that covers 95% of all CVEs associated with a CWE, our approach improves F1‑score by more than 6.2% over the best prior supervised method, demonstrating the value of combining model fine‑tuning with hierarchy‑aware classification
Multi-actor Policy Dynamics in Research Evaluation:Experts, Databases, and Academics
Get PDFThis mixed-methods study examines the complex interplay of actors and factors shaping research assessment policies in Lithuania in the years 1996–2008, a period of transition towards Western practices. Analysing policy documents, bibliometric data, interviews, and grey literature, we focus on the interactions among policymakers, international experts, providers of publication data, and researchers. Our findings reveal the significant influence of international networks on Lithuanian policymakers, leading to the adoption of quantitative assessment and reliance on Web of Science data. However, this narrow focus, coupled with existing power dynamics and top-down decision-making, led to gamesmanship in publishing practices and conflicts among disciplines, culminating in a Constitutional Court challenge. This research also highlights the substantial role of journal publishers and data providers in influencing policy shifts. We underscore the need for international organisations to adopt open data sources that encompass a wider array of scholarly outputs. Additionally, national policymakers must consider disciplinary differences and research capacity when designing assessment policies. The Lithuanian experience serves as a cautionary tale, emphasising the importance of context-specific, inclusive, and flexible research assessment systems, particularly in light of ongoing reforms such as the Coalition for Advancing Research Assessment (CoARA).</p
Heart rhythm management optimisation of pacemaker recipients using remote monitoring:the HERO registry
Get PDFIntroduction: Current expert consensus recommends remote monitoring (RM) for cardiac implantable electronic devices (CIEDs). As this recommendation is primarily based on studies involving implantable cardioverter defibrillators (ICDs), the HERO (HEart Rhythm management Optimisation of pacemaker recipients using remote monitoring) study aimed to reinforce this recommendation for pacemaker recipients. Methods: The exploratory, retrospective, single-centre HERO study included 203 patients with an increased stroke risk (CHA2DS2-VASc score ≥ 2) but without a history of atrial fibrillation or flutter, who received a pacemaker between January 2016 and April 2018. Occurrence and detection time of atrial and ventricular arrhythmias were analysed in patients with RM (RM+; n = 60) and those without RM (RM−; n = 143), together with CIED adverse events, cardiology visits and anticoagulation adjustments. Results: The median age of the patients was 80 (73–85) years, with 55.2% being men. During a median follow-up of 5.0 years, 53.7% were diagnosed with at least one arrhythmic event (RM+ 60.0% vs RM− 51.0%, p = 0.28). The median time from pacemaker implantation to detection of first arrhythmic event was 2.5 (0.5–8.2) years in the RM+ group versus 2.8 (1.2–8.0) years in the RM− group (hazard ratio 0.89; 95% confidence interval 0.59–1.35; p = 0.58). There were no differences in the number of adverse events or anticoagulation adjustments during follow-up. More CIED telephone consultations were conducted in the RM+ group. Conclusion: A substantial proportion of pacemaker patients experienced one or more arrhythmic events during follow-up. The HERO study did not demonstrate a difference in time to detection of the first event when using remote monitoring.</p
The adoption and diffusion of the International Patient Summary
Get PDFThe International Patient Summary (IPS) provides a standardized set of essential clinical data, designed to ensure safe and effective healthcare delivery during unscheduled or emergency medical situations. Despite its potential benefits, the practical value and opportunities for improvement remain underexplored. This study evaluates the clinical relevance of the IPS and its capacity to enhance healthcare outcomes through a literature review, combined with interviews with healthcare professionals. The results demonstrate significant advantages, such as better care quality, improved data accessibility, and enhanced patient safety. However, challenges including data security concerns, technical limitations, and high implementation costs hinder widespread adoption. To fully leverage the IPS's potential, strategies must focus on strengthening data privacy, promoting interoperability across electronic health records, and actively engaging healthcare professionals in the implementation process. Overall, this study underscores the importance of leveraging the value and addressing these barriers to continue the global standardization and success of the IPS.</p
On the Use of CVRP to Diagnose Faulty Elements in Antenna Arrays
No full textThis paper investigates the application of Constrained-View Radiated Power (CVRP) for diagnosing phased array element failures, specifically focusing on on-off element failure. CVRP, similar to Partial Radiated Power (PRP), considers a specific Field-of-View (FoV) but normalizes it by the FoV area. The study explores CVRP's effectiveness in detecting failures in a 2x8 cosine element array under beam-steering conditions, accounting for random and depointing errors, angular resolution, and pattern rotation. Results indicate that CVRP can detect on-off failures based on angular resolution and error severity, under the assumption of reduced Total Radiated Power (TRP) with element failures. Additionally, CVRP is effective with partial far-field patterns, making it suitable for near-field, indirect far-field, and far-field measurement systems without requiring phase acquisition in the latter two.</p
Dirac structure for linear dynamical systems on Sobolev spaces
No full textThe port-Hamiltonian structure of linear dynamical systems is defined by a Dirac structure. In this paper we prove existence and well-posedness of a Dirac structure for linear dynamical systems on Sobolev spaces of differential forms on a bounded, connected and oriented manifold with Lipschitz continuous boundary. This result extends the proof of a Dirac structure for linear dynamical systems originally defined on smooth differential forms to a much larger class of function spaces, which is of theoretical importance and provides a solid basis for the numerical discretization of many linear port-Hamiltonian dynamical systems.</p