Vitiligo is acommon chronic disease leading to pigment cell loss in the skin. Despite international consensus recommendations on diagnosis and treatment and the German AWMF S1-guideline published in April 2021, no data exist on the adherence to these recommendations among German dermatologists in private practice. The aim of this pilot project and feasibility study was to obtain preliminary insight into the medical care situation provided by German dermatology practices to people with vitiligo. In across-sectional observational study, we addressed 572dermatologists working in German private practices with aquestionnaire on attitude, utilized diagnostic procedures, and prescription of reimbursable therapies. The majority (53.7%) considered vitiligo acosmetic problem. Over half (51.1%) of the dermatologists did not use any of the diagnostic methods surveyed, and approximately aquarter (25.6%) did not use any of the therapies surveyed. Dermatologists who regard vitiligo as aserious disease use diagnostic procedures significantly more often and prescribe guideline-based therapies significantly more frequently than those who view vitiligo as acosmetic issue. Our cross-sectional observational and pilot study suggests adramatic undertreatment of patients with vitiligo in private practices in Germany. Larger and more detailed studies are needed to confirm our preliminary data. In addition, measures that improve guideline-compliant therapy are required.

IntroductionThe use of digital solutions including patient-reported outcomes is limited to follow-up of patients with established diagnoses but is rarely used as first step of the diagnostic process substituting a personal contact with a health professional. We report on the diagnostic validity and cost per patient implications based on a feasibility study of a new virtual diagnostic service (VDS) for common neurological sleep disorders that, as a first step, involves the collection and automated analysis of self-reported digital patient data.MethodsThe VDS was established at the Odense University Hospital, Denmark. Assessment of diagnostic validity of the underlying algorithm was conducted independently and blinded. Estimation of effects on cost per patient was based on administrative hospital cost data comparing similar periods before and after the introduction of VDS and estimates for travel and time consumption to assess the patients' economic benefits.ResultsA questionnaire-based algorithm was developed leveraging the diagnostic criteria of the American Academy of Sleep Medicine; comprehensibility was secured and improved by initial patient involvement. Parallel use of both the questionnaire and assessment by a senior sleep specialist of the first 20 patients revealed no discernible safety concerns and resulted in additional linguistic adaptions. The final questionnaire was completed by 123 of 157 patients (78.3%) identified as suitable for VDS. The questionnaire-based algorithm resulted in correct use of additional diagnostic procedures in 84 out of 95 patients with final diagnosis at data closure (88.4%, Cohen's kappa: 0.84). The algorithm proposed a specific diagnosis in 55 patients that was correct in 49.1% of cases (Cohen's kappa: 0.39). The economic analysis revealed a 46.7% reduction of the time from referral to diagnosis of the patient (226.5 days to 120.7 days). The average number of contacts with health professionals decreased from 2.15 to 1.26, the average direct costs per patients were reduced by 39.6% from 1811 Danish Kroner (DKK) to 1093 DKK. We estimated a 40.6% reduction of the total costs per patients from 3904 DKK to 2320 DKK including time consumption and travel costs.DiscussionThis first feasibility study indicates that use of digital diagnostic solutions as first step of the diagnostic process of neurological sleep disorders combined with an essentially complete virtual work flow has high accuracy and may be associated with reduced time for diagnostics and cost reductions for health providers and patients.

Robot-assisted, monoplane C-arm angiography systems designed for hybrid operating rooms represent an alternative approach to neuroendovascular procedures. Conversely, non-computer-assisted monoplane systems or conventional biplane systems in angiography suites are widely established. This study aims to evaluate the effectiveness, safety and efficiency of a robotic C-arm angiography system in performing neuroendovascular interventions, including cerebrovascular digital subtraction angiography (DSA), embolization of the middle meningeal artery (MMA) in subdural hematoma, and mechanical thrombectomy for vessel occlusion. All patients undergoing DSA, MMA embolization, or mechanical thrombectomy between July 2020 and December 2024 were retrospectively included. Procedures were performed using a monoplane robotic C-arm system (ARTIS pheno, Siemens Healthineers, Munich, Germany) in a hybrid operating room. Clinical data, procedural details, and imaging outcomes were analyzed. Radiation exposure was assessed by fluoroscopy time, air kerma, and dose-area product (DAP). A total of 49 procedures were analyzed, including 28 DSAs, 6 MMA embolizations, and 15 mechanical thrombectomies. DSA and MMA embolization (EMMA grade ≥2) achieved 100% procedural success, while mechanical thrombectomies achieved successful reperfusion (mTICI ≥2b) in 93.3% of cases. Median procedure durations were 34.0 (IQR 18.0-45.0) minutes for DSA, 70.0 (IQR 28.0-126.0) minutes for MMA embolization, and 84.0 (IQR 67.0-106.0) minutes for mechanical thrombectomy. Median fluoroscopy times were 5.2 (IQR 2.9-11.5) minutes (DSA), 21.3 (IQR 8.8-36.5) minutes (MMA embolization), and 21.2 (IQR 18.5-42.9) minutes (mechanical thrombectomy). Median DAPs were 7262.5 (IQR 3867.8-11570.8) µGy·m² (DSA), 16135.5 (IQR 8244.2-18216.2) µGy·m² (MMA embolization), and 9875.2 (IQR 6524.3-18455.5) µGy·m² (mechanical thrombectomy). Additional 3D-angiography or cone-beam CT (CBCT) was associated with higher radiation exposure. Basic neuroendovascular procedures can be safely and efficiently performed using a monoplane robotic C-arm in a hybrid operating room, achieving procedural success and radiation exposure levels comparable to conventional biplane systems.

This study assessed the feasibility of contrast-enhanced ultrasound (CEUS) for evaluating renal perfusion in horses and compared perfusion parameters between age groups. In a prospective study, eight healthy horses were divided into young (3-5 years, n=4) and old (16-17 years, n=4) groups. All animals underwent B-mode, Doppler ultrasonography, and CEUS of the right kidney after an intravenous bolus of SonoVue (0.02mL/kg). Qualitative analysis assessed contrast kinetics, whereas quantitative parameters (peak intensity, time to peak [TP], area under the curve, and wash-out time) were obtained from time-intensity curves in the renal cortex and medulla. The technique was safely performed in all horses, and the 0.02mL/kg dose proved optimal for achieving adequate renal enhancement and consistent quantitative measurements. Quantitative analysis revealed a significantly longer TP in the renal cortex of older horses compared to young ones (p=0.03), suggesting an age-related reduction in perfusion velocity. No other parameters showed significant differences. CEUS proved to be a feasible and safe method for assessing renal perfusion in horses. The prolonged cortical TP in older animals indicates that CEUS may be a sensitive tool for detecting early, subclinical perfusion changes associated with aging, warranting further investigation in horses with renal disease.

Silica-coated nanosized zero-valent iron/persulfate system for sequential reduction-oxidation remediation of subsurface contamination: A feasibility study.

Accurate assessment of upper limb motor function is critical for guiding effective rehabilitation strategies in stroke survivors. The Fugl-Meyer Assessment for Upper Extremity (FMA-UE) is a widely used clinical tool, yet it is time-consuming and subject to inter-patient variability. A low-cost, computer vision-based exergame was developed to provide a remote rehabilitation alternative that also enables motor assessment. This approach represents a promising alternative for scalable and objective assessment, but requires validation. This study aims to evaluate the feasibility and preliminary validity of a computer vision-based exergame system for assessing upper limb motor function in individual post-stroke. Specifically, it investigates correlations between kinematic features derived from gameplay and FMA-UE scores. It is expected that gameplay-derived metrics, such as range of motion, jitter index, and average hand angle, will show moderate to strong correlations with the FMA-UE, supporting the exergame's potential as a remote assessment tool. This is a cross-sectional feasibility and preliminary concurrent validity pilot study with 15-30 individuals with chronic stroke. Participants will perform a markerless camera-based exergame producing pseudo-3D hand coordinates using MediaPipe-based hand tracking. Kinematic features, including range of motion, average hand angle, and jitter index, will be extracted from gameplay. Each participant will also be evaluated using the FMA-UE by a certified therapist. Correlation and regression analyses will assess the relationship between exergame metrics and clinical scores. Usability will be assessed using the System Usability Scale (SUS). We expect moderate to strong correlations between selected gameplay metrics and FMA-UE scores, particularly for range of motion, average hand angle, total traveled distance, jitter index, and score. The system is also expected to demonstrate high usability, indicating its feasibility for broader use in rehabilitation settings. If validated, the proposed exergame may serve as an accessible and scalable digital tool to support future development of objective assessment tools in stroke rehabilitation, potentially reducing clinical workload and enabling remote evaluations. A future large-scale study will evaluate test-retest reliability, longitudinal responsiveness, and home-based implementation.

Modern robotic systems, particularly for microsurgical procedures, are offering increasingly new perspectives in the field of vascular surgery. A novel robot-assisted platform specially designed for microanastomoses is already used successfully in lymphatic vessel surgery and special flap plasty procedures. To expand these applications to the vascular field, this clinical feasibility study evaluated this system for creating arteriovenous fistulas in the upper extremity for dialysis. Following conventional vessel preparation, the anastomoses for the arteriovenous fistulas were performed using the microsurgical robotic platform. An experienced vascular surgeon performed the anastomoses (vein to artery, end-to-side) with continuous sutures. Once the anastomoses had been completed and blood flow was restored, they were tested for leaks. In all 3 patients, an arteriovenous fistula was successfully created using the microsurgical device. Preparing and positioning the robotic system was straightforward and uncomplicated. Anastomosis times varied between 28 and 36 minutes. In one case, a second stitch was required after blood flow was restored, which was also performed using the device. Follow-up ultrasound examinations revealed successful fistula reconstruction in all patients without any complications. The microsurgical robotic platform has been successfully used to create precise arteriovenous anastomoses for dialysis therapy. This robotic system may offer a variety of advantages, especially for small vessels, including improved tissue preservation, precision, and visualization. Further development of these technologies could lead to new applications, particularly in vascular medicine.

Interpretable and non-linear machine learning models for quantitative ICG perfusion assessment in colorectal cancer anastomosis: A feasibility study.

Electromagnetic Intraoperative Positioning System (IOPS) Is Safe and Effective as a 3D Imaging Adjunct in Endovascular Aortic Surgery-A Safety and Feasibility Study.

Mobility deficits are the most common form of disability in the United States and can significantly impair function and activities of daily living. Assistive devices have the potential to reduce physical limitations and support functional independence. This pilot study evaluated the Gigstride wearable device for its effects on pain reduction and gait-related outcomes. This prospective, single-arm feasibility study was conducted at a tertiary academic center and included adults ≥18 years with lower extremity deficits. The primary outcome was pain, measured by the Numeric Rating Scale (NRS) during level ambulation and stair climbing. Secondary outcomes included performance on the modified 10-meter walk test with return and the Timed Up and Go (TUG) test. Patient-reported experience and the practicality of implementing the device in a larger-scale study were also assessed. A total of forty-four patients were enrolled (mean age 66 years; 57% female). Gigstride use significantly reduced pain during level ambulation and stair climbing, with no significant changes in secondary outcomes. Median walking pain decreased by 1 NRS point (p = 0.00032), and stair-related pain decreased by 0.5 NRS points (p = 0.00025). Gigstride wearable device use appears feasible and may provide modest reductions in mobility-related pain. However, the limited magnitude of pain reduction and absence of functional improvement in this study highlights the need for larger, controlled studies. The www.ClinicalTrials.gov identifier is NCT06548087.

Diagnostic CT-guided online adaptive radiotherapy for locally advanced colon cancer: a prospective implementation and feasibility study.

Zirconium-89-based PSMA PET/CT with delayed imaging for early detection of biochemical recurrence in prostate cancer patients with PSA ≤ 0.2 ng/mL: A feasibility study.

Exploring three-dimensional reconstruction with Neural Radiance Field (NeRF) for coronary roadmap navigation and view-planning in X-ray coronary angiography: A feasibility study.

Obesity is an independent risk factor for various chronic diseases and malignancies. The incidence of thyroid cancer is significantly higher in obese populations. Current clinical practice often adopts staged treatment for obesity with thyroid cancer, which presents challenges including cancer management and prolonged recovery. The simultaneous implementation of bariatric surgery and radical thyroidectomy may represent a more efficient therapeutic strategy. This study evaluates the clinical value of this combined approach by comparing clinical data with standalone bariatric surgery, focusing on feasibility, safety, and comparative metabolic and weight loss efficacy. Patients who underwent laparoscopic bariatric surgery at our center from March 2015 to March 2023 were retrospectively collected. Using propensity score matching method, patients were stratified into two cohorts: the simultaneous group (SS group, n = 24) receiving combined bariatric surgery with radical thyroidectomy, and bariatric surgery group (BS group, n = 72). Surgical outcomes, complications, and 2-year follow-up data were compared. Preoperative characteristics were comparable (p > 0.05). The SS group had longer operative duration (median 242.50 vs. 104.50min, p < 0.05) and higher blood loss (35.00 vs. 25.00 mL, p < 0.05) than the BS group, with no significant difference in short-term complications (p > 0.05). At 2 years postoperatively, the SS group reported no hypocalcemia, hypothyroidism, or cancer recurrence. Both groups achieved significant, comparable reductions in weight, body mass index, and metabolic parameters postoperatively. For patients with obesity complicated by T1-T2N0M0 low-risk papillary thyroid carcinoma, this pilot study demonstrates that simultaneous bariatric surgery and radical thyroidectomy is safe and feasible, without an increased risk of complications. The efficacy of this combined approach in terms of weight loss and metabolic improvement is comparable to that of standalone bariatric surgery, highlighting its clinical application value in centers with relevant combined clinical experience.

Adolescence is when mental disorders such as psychosis frequently emerge, with long-term impacts on social functioning if left untreated. Early intervention, including cognitive behavioural therapy (CBT) and innovative approaches like virtual reality (VR)-assisted therapy, can help young people in their social recovery. During the development phase of REVIVE therapy, input was gathered through group consultations with 10 youth advisors aged 16-25 who had lived experience. Their insights informed the design of the virtual social environments. A feasibility and acceptability study was conducted with eight participants at clinical high risk (CHR) for psychosis. Participants received up to 10 VR-assisted CBT sessions focused on enhancing social recovery. Feasibility and acceptability were assessed through structured evaluations. Out of the 13 eligible service users with clinical high risk for psychosis (CHR) status, 10 expressed interest in enrolling in the REVIVE study, leading to eight participants being included. The recruitment conversion rate was 77%, while retention rates showed 38% for therapy and 63% for the study. Therapy completers achieved an average of 74% toward their personal social goal by the end of treatment. Participants reported overall positive experiences with the VR therapy and suggested improvements for program flexibility, personalisation, and content variety. While the REVIVE VR-CBT therapy is deemed moderately feasible and acceptable for young people with clinical high risk (CHR) status, significant barriers underscore existing challenges and the necessity for a personalised and supportive approach. The small sample size restricts the ability to generalise findings and precludes robust statistical analyses.

Application of the semi-analytical BIXS method to tritium analysis in titanium tritide: A feasibility and reconstruction accuracy study.

Nurse-coordinated, transitional care intervention for hospitalised older adults in a frailty registry: The TRANSFER-II feasibility and acceptability study.

Evaluating the feasibility of a remote sampling method for neurofilament light chain measurements in Multiple Sclerosis.

Structural health monitoring often involves temperature measurement. However, traditional sensors cannot measure subsurface temperature non-invasively, making them unsuitable for monitoring temperature-driven damage mechanisms such as high-cycle thermal fatigue. This limitation arises, in part, due to effective thermal low-pass filtering caused by material properties. A previous feasibility study demonstrated that subsurface temperature can be inferred non-invasively in mild steel subjected to uniform heating. This was achieved using the ultrasonic-based inverse thermal modelling (ITM) method, which assumes the temperature of a component can be described by a 1D system. This study investigated the behaviour of ITM under non-uniform heating applied to the 'inaccessible' surface of a stainless steel sample through experiments and simulations. The experimental results show that ITM over-predicts temperature by as much as 120% when the heated region is small compared with the 10mm ultrasonic beam size. In simulation, the overestimation was reduced as the size of the heating source increased, effectively making the temperature distribution more uniform across the volume through which the ultrasonic wave travels. Despite the overestimation under non-uniform heating, ITM overcomes the thermal low-pass filtering, allowing the detection of thermal transients compared with a thermocouple mounted on the 'accessible' surface of a component.

The evolvement of smart cementitious materials with self-monitoring features, evaluating and early warning the structural integrity of infrastructures at an early stage is of great importance both for the service and sustainability aspects. This feasibility study investigates two grades of commercially available continuous single carbon nanotube fiber (CNTF) filaments embedded in a sustainable geopolymer (GP) matrix to assess their potential as piezoresistive elements for mechanical deformation sensing via straightforward two-probe DC electrical resistance measurements. Prior their incorporation, the CNTF filaments were systematically characterized. Afterwards, smart composites were prepared by a simple casting method around the CNTF and the GP reaction was monitored. Thereby, a prominent change of the pure electronic electrical properties was identified upon ageing, exhibiting similar electrical resistance evolution profiles, capturing the transition from fresh mixture to a rigid matrix within 24 h. Subsequently, the integrated CNTFs were utilized as mechanical stress sensors during static and cyclic three-point-bending, as well as compression loading conditions, respectively. The obtained results demonstrate the ability to reliably detect applied mechanical loads through the electrical signal, expressed as the fractional change in electrical resistance (FCR) combined with efficient electrical current transmission independently of environmental influencing factors. Importantly, cyclic compression tests confirmed highly reversible and repeatable electrical responses achieving circa 10% FCR. The outcome indicates that such CNTF/GP multifunctional building materials are capable to be used as durable, built-in and real-time structural health monitoring (SHM) indicators to enable an autonomous maintenance of civil infrastructures. • Multifunctional building structures for sustainable construction • Self-sensing cementitious composites without dispersion issues by single CNTF filaments • Geopolymer-based piezoresistive sensors with pure DC electronic properties • Structural integrity monitoring upon bending and compression modes • Stable static and cyclic piezoresistive response