Search Results (8,240)

Background: New therapies like intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) for acute ischemic stroke (AIS) can significantly impact outcomes and complication rates. This study examines the nationwide impact of MT implementation on decompressive hemicraniectomy (DH) in Germany, accounting for the effects of the COVID-19 pandemic. Methods: Annual treatment numbers (2015 to 2023) for IVT, MT, DH, cranioplasty (CP), and Computer-Aided Design CP (CAD CP) were extracted using the Operation and Procedure Codes (OPS). Age and sex distributions were analysed in four age groups (0–39, 40–59, 60–79, ≥80 years). Hospitalizations for AIS, subarachnoid haemorrhage (SAH), and intracranial haemorrhage (ICH) were included. Annual treatment rates were calculated. Results: In 2015 250,802 patients with ACI, 11,082 patients with SAH and 47,336 patients with ICH were documented. Overall, AIS hospitalizations declined slightly by 1.1%, whereas SAH and ICH decreased more markedly by 15.6% and 14.3%, respectively, with the most pronounced reductions observed during the COVID-19 pandemic. Among AIS patients, intravenous thrombolysis increased from 16% to 20%, while mechanical thrombectomy rates increased from 3% to 9%. Both reperfusion therapies showed increasing use particularly among patients aged ≥80 years (IVT: +35%; MT: +42%). DH remained overall stable (+2.82%), with a predominance in men (60%). In contrast, CP procedures declined by 25.3%, whereas CAD CP increased by 35% during the observation period. Conclusions: Long-term increasing trends in reperfusion therapies, especially mechanical thrombectomy, were largely unaffected by the COVID-19 pandemic and—contrary to expectation—obviously had no influence on the emergence of decompressive hemicraniectomy in our descriptive analysis. Full article

Positive mental health (PMH) has recently become a key topic in biomedical research. Previous studies have explored the correlation between biological and psychological measures, but only a few have focused on the relationship between PMH and aging. This study aimed: (i) to explore the association between PMH and biological aging; (ii) to determine if and to what extent the observed association could be explained by shared genetic and environmental effects. A total of 401 twins (age 19–81 years, 32% male) from the Italian Twin Registry were recruited, and the twin study design was applied. A self-report psychological test battery was used to evaluate several PMH components. Blood samples were collected from participants to determine telomere length (TL) and mitochondrial DNA copy number (mtDNAcn). TL was negatively associated with attachment anxiety (r = −0.11, p = 0.037). A bivariate twin model provided heritability estimates of 0.14 (95% CI 0.001–0.43) for TL and 0.32 (0.16–0.45) for attachment anxiety, and a substantial negative genetic correlation [r_g = −0.55 (−1.00–0.00)] between them. Under the limitations of a cross-sectional study with a self-report wellbeing assessment, these results suggest that anxiety in a relationship with a partner may contribute to accelerated TL shortening, and shared genetic factors may underlie this link. Full article

Background/Objectives: Acute carotid tandem lesions (TLs), defined by concurrent cervical internal carotid artery (ICA) stenosis or occlusion and intracranial large vessel occlusion, occur in 10–20% of patients undergoing mechanical thrombectomy (MT) for acute ischemic stroke (AIS). Optimal periprocedural antiplatelet management during emergent carotid artery stenting (eCAS) remains uncertain, particularly regarding the balance between preventing stent thrombosis and avoiding hemorrhagic complications. Methods: A narrative review was conducted using PubMed and Scopus (until 6 March 2026) to identify English-language studies evaluating antiplatelet therapies during eCAS for TLs. We included seven real-world studies and registry analyses. Data on study design, patient characteristics, procedural strategies, angiographic results, functional outcomes, and safety metrics were extracted. Results: No randomized controlled trials (RCTs) were identified. The available evidence is derived exclusively from observational studies. Across these cohorts, glycoprotein IIb/IIIa inhibitors (GPIs), particularly tirofiban, were generally associated with lower rates of in-stent thrombosis and higher reperfusion success, with symptomatic intracranial hemorrhage (sICH) rates that appeared comparable to or lower than those reported with acetylsalicylic acid (ASA). Cangrelor, an intravenous (IV) P2Y₁₂ inhibitor, was associated with improved stent patency and increased likelihood of complete reperfusion, although reported effects on clinical outcomes were inconsistent when compared with GPIs or ASA. Aside from abciximab, potent IV antiplatelet agents did not consistently show an increased sICH signal. Oral dual antiplatelet therapy was also associated with improved technical outcomes without a clear excess in bleeding complications. Conclusions: Current real-world observational data suggest that rapid-acting IV antiplatelet agents—particularly GPIs and, increasingly, cangrelor—may represent feasible periprocedural options during eCAS for TLs, with potential benefits for technical success and no consistent evidence of increased hemorrhagic risk. However, interpretation is limited by study heterogeneity and non-randomized designs. The absence of RCTs highlights the need for prospective comparative studies and standardized periprocedural antiplatelet protocols. Full article

The delineation of the Area of Review (AoR) is a fundamental requirement for Class VI carbon storage permits in the United States. The regulatory definition of the pressure front relies on the potential for injected fluids or formation brine to migrate into an Underground Source of Drinking Water (USDW). However, in deep sedimentary basins such as the Texas Gulf Coast and offshore regions, targeted saline formations often lack overlying USDWs. In these scenarios, traditional methods for calculating the critical pressure threshold become mathematically undefined or yield infinite AoR boundaries. This paper proposes a practical, geomechanics-based methodology for defining the pressure front in the absence of a USDW, framed as an alternative site-specific approach under the authority of the UIC Program Director (40 CFR 146.84). By leveraging existing regulatory limits on injection pressure, the proposed framework establishes a threshold based on the minimum horizontal stress, caprock fracture pressure, and fault reactivation limits via Mohr–Coulomb failure analysis. The framework further incorporates capillary breakthrough pressure as a third containment threshold, ensuring that the most restrictive condition governs the AoR boundary. A synthetic case study of a deep Gulf Coast saline formation demonstrates that this approach produces a finite, physically meaningful AoR that scales appropriately with injection operations (evaluated at 1.0 and 2.0 Mt/yr) and captures post-injection pressure evolution during the Post-Injection Site Care (PISC) period. Sensitivity analyses on permeability and fracture gradients confirm the robustness of the method. The study also examines model limitations, injection feasibility boundaries, and extensions toward a probabilistic framework. This framework provides operators and regulators with a defensible, regulatory-consistent pathway for advancing carbon storage projects in deep sedimentary basins, complete with a standardized reviewer checklist and an example AoR delineation report template. Full article

Acute mountain sickness (AMS) arises from hypobaric hypoxia at high altitude and still lacks effective pharmacological treatments. Although hypoxic preconditioning via gradual ascent prevents AMS, the underlying molecular adaptations have not yielded therapeutics. Here, inspired by metabolic reprogramming during stepwise altitude adaptation, we screened for anti-hypoxia compounds and identified H0802 (N-(pyridin-2-yl) pyridine-2-carbothioamide) as the most promising candidate. H0802 markedly enhances hypoxic tolerance in mice, prolongs survival under acute hypoxia, improves survival during simulated high-altitude exposure, and attenuates hypoxia-induced lung injury, accompanied by combined anti-inflammatory and antioxidant effects. Transcriptomic profiling shows that H0802 elicits a gene expression signature resembling hypoxia, including key hypoxia-related genes (Edn1, Angptl4, Mt1, Gdf15, Slc7a5, and Hif-3α) involved in glucose and oxygen metabolism. Mechanistically, H0802 stabilizes endogenous hypoxia-inducible factor (HIF) proteins under normoxia by preventing ubiquitin-dependent degradation, thereby activating hypoxia-responsive genes. In vivo, H0802 pretreatment lowers circulating glucose and hepatic glycogen while increasing brain glucose uptake, suggesting a metabolic shift that preserves cerebral energy during acute hypoxic stress; it also modulates whole-body oxygen consumption. H0802 represents a candidate for anti-AMS therapy, and phenotypic optimization of H0802 provides a potential route for drug discovery. Full article

Background: Prostate cancer (PCa) imposes a substantial global health burden, with robot-assisted radical prostatectomy (RARP) established as the gold standard for localized disease. While da Vinci^® Xi maintains market dominance, Toumai^® MT-1000 offers a potentially cost-competitive alternative lacking prospective validation. Objective: To evaluate perioperative safety, oncologic quality (primary endpoint: positive surgical margins), early functional recovery (continence), and surgeon learning curve between Toumai^® MT-1000 (T-RARP) and da Vinci^® Xi RARP (DV-RARP) performed in high-volume European practice. Materials and Methods: This is a prospective single-center comparative study carried out at Policlinico Gemelli, Rome (May–November 2025), enrolling 80 patients with localized or locally advanced PCa, elected for radical prostatectomy and casually allocated to receive surgery with Toumai or the da Vinci robotic platform. The primary endpoint was the comparison of positive surgical margin (PSM) rates. Secondary endpoints included the comparison of operative time (skin-to-skin), estimated blood loss, length of hospital stay, 45-day postop outcomes, specifically Clavien–Dindo complications, urinary continence recovery (0–1 pad/day), and IIEF-5 scores. Learning curve was evaluated through the cumulative summation (CUSUM) analysis of operative times and linear regression of operative times (n = 80 cases). The analyses used STATA 19 with two-sided tests at p < 0.05 significance. Results: Baseline characteristics showed balance between cohorts (p > 0.05 for most covariates). Perioperative outcomes proved equivalent: median operative time (OT) was 192.5 min (IQR 165–230) for Toumai^® versus 183.5 min (IQR 147–225) for da Vinci^® Xi (p = 0.38); estimated blood loss (EBL) was 150 mL in both groups (p = 0.87); length of hospital stay (LOS) was 2 days in both groups (p = 0.92). PSM rates were identical at 17.5% (p = 0.79). Continence recovery reached 72.5% versus 80% (p = 0.43). Complications (Clavien–Dindo ≥ II) occurred in 7.5% versus 12.5% of cases (p = 0.45). The CUSUM analysis demonstrated operative time proficiency after only four procedures; operative time regression showed no significant trend (p = 0.38). Conclusions: Toumai^® MT-1000 demonstrates similar performance to da Vinci^® Xi across different RARP quality metrics, with no detectable learning curve for surgeons previously experienced with da Vinci. These findings support a safe integration of cost-effective platforms into clinical practice, pending multicenter randomized confirmation. Full article

Populations of several billfish species are declining due to overfishing and bycatch, and fundamental aspects of their biology and population dynamics remain poorly understood. We provide the first assessment of the population genetic structure of longbill spearfish (Tetrapturus pfluegeri) in the western Atlantic Ocean. We screened variation at 12 nuclear microsatellite loci (n = 144) and mitochondrial DNA control region sequences (mtCR, n = 177). Both marker types revealed three genetically differentiated clusters, with mean values for microsatellites showing differentiation of F_ST = 0.136 and D_EST = 0.201, and for mtCR F_ST = 0.645. Microsatellite markers demonstrated moderate-to-high genetic diversity, with a mean allelic richness of 6.73 alleles per locus, moderate heterozygosities (Ho = 0.446, He = 0.604), and a positive inbreeding coefficient (F_IS = 0.22) across the three sample collection sites. The overall estimated effective population size was 789.2 (95% CI: 246.7–∞). The mtCR exhibited 96 haplotypes, with high haplotype (0.989 ± 0.003) and nucleotide (0.025 ± 1.3%) diversities. We found higher mean relatedness within clusters than among them, supporting the interpretation of population subdivision and the Wahlund effect. Tajima’s D and Fu’s Fs were negative across all localities, with significant values observed along the Brazilian coast but not in the Caribbean Sea. These neutrality test results, together with low Harpending’s raggedness indices from DNA sequence mismatch distributions, are consistent with historical demographic expansion. Our findings establish a genetic baseline for fishery monitoring and management, contributing to the conservation of T. pfluegeri populations in the western Atlantic Ocean. Full article

Background/Objectives: Genetic identification of human skeletal remains plays a pivotal role in forensic investigations when other traditional or primary methods are not appropriate. Decomposition, storage and environmental conditions often leave the skeletal structure as the only basis for identification. This review synthesizes current methodologies and technological advances in damaged DNA extraction and analysis, emphasizing the forensic relevance of skeletal remains for genetic identification. Methods: A comprehensive literature analysis highlights the basis of genetic identification; sampling that considers intrinsic and extrinsic factors influencing the DNA yield and its quality; pre-treatment methods; extraction protocols that are suitable for its sensitivity; genetic marker panels that allow for human identification; and statistical evaluation and analysis of the results. The last chapter demonstrates the real-world impact of genetic identification on historical cases, underscoring its broader significance in legal, humanitarian, and socio-historical contexts, supporting a critical evaluation of best practices, methodological robustness, and ethical considerations within the field. Results: Teeth, femur and the petrous portion of temporal bone are the main samples used for genetic analysis. STR profiling and mitochondrial DNA are the gold standard markers for skeletal human identification. Minimally destructive protocols that enhance a high DNA yield are chosen, with silica-based methods being highlighted in the extraction protocols. Next-Generation Sequencing techniques have also improved analytical outcomes, by enabling high-throughput data generation, increased coverage depth, nucleotide-level sequence data, and high-level multiplexing of genetic targets. Conclusions: This review provides a comprehensive framework for researchers and practitioners seeking to optimize genetic identification workflows in forensic sciences and bioarcheology. These methodological advances have significantly increased identification success rates, especially in cases involving degraded or limited skeletal remains. Reviews such as this one help us to identify methodological gaps, ethical concerns, and future research directions, thereby establishing best practices when working with highly degraded skeletal material, supporting more reliable, standardized, and legally defensible applications of genetic identification in forensic, archeological, and humanitarian contexts. Full article

A hybridization assay based on the microfluidic biochip was developed to identify the origin of the Atlantic salmon species. Among the 215 single nucleotide polymorphic (SNP) sites found in the mtDNA of Salmo salar, we located five sites in devising our assay method. We found two sites that worked, while the others generated either insufficient signals or specificity. We have successfully identified the North American origin of the three samples, as confirmed by Sanger sequencing. Full article

This study estimates China’s methane (CH₄) emissions from 43 specific emission sources in 2020 and projects future trends through 2050 under two scenarios: Current Legislation (CLE) and Maximum Technically Feasible Reduction (MFR). The analysis utilises the Greenhouse gas and Air pollution Interactions and Synergies (GAINS) model methane framework, incorporating updated province-level activity data to capture the pronounced regional heterogeneity inherent in emission profiles and mitigation capacities. The results reveal a national CH₄ budget of 1114 MtCO₂e in 2020, with the energy sector (59%) and agriculture (28%) emerging as the primary contributors. A substantial technical mitigation potential is identified; by 2050, emissions could be curtailed by up to 48% relative to the CLE scenario, representing a 46% reduction from 2020 levels. The energy and waste sectors emerge as the primary contributors to this potential. Specifically, coal mining CH₄ abatement constitutes 58% of the energy sector’s total reduction potential, while enhanced solid waste management accounts for 97% of the mitigation within the waste sector. Key measures include ventilation air methane (VAM) oxidation and pre-mining degasification, as well as anaerobic digestion and recovery and utilization for energy use. Owing to regional disparities in hydrothermal conditions (representing the combined influence of temperature and moisture), demographic status, economic development, the most effective mitigation strategies vary across provinces. For example, pre-mining degasification and VAM oxidation are most impactful in major coal-producing regions such as Shanxi, Inner Mongolia, and Shaanxi. In contrast, anaerobic digestion, recovery and utilization, and waste incineration play a dominant role in more economically developed and densely populated provinces such as Jiangsu, Shandong and Zhejiang. By delineating region-specific technological priorities, this study quantifies the maximum technical mitigation potential for China and offers guidance for other nations facing similar mitigation challenges. Full article

Maritime Domain Awareness (MDA) relies heavily on data acquired from high-resolution optical spaceborne sensors; however, processing this massive quantity of sensor data via traditional supervised deep learning is severely bottlenecked by its dependency on exhaustively annotated datasets. Under extreme data scarcity, conventional architectures suffer severe performance degradation, rendering them impractical for time-critical, zero-day deployments. To overcome this barrier, we propose a training-free inference paradigm that leverages the extensive pre-trained knowledge of Large Vision-Language Models (VLMs). Specifically, we introduce a Domain Knowledge-Enhanced In-Context Learning (DK-ICL) framework coupled with a Macro-Topological Chain-of-Thought (MT-CoT) strategy. This approach bridges the perspective gap between natural images and top–down optical sensor imagery by translating expert remote sensing heuristics into a strict, step-by-step reasoning pipeline. Extensive evaluations demonstrate the substantial efficacy of this framework. Armed with merely 4 visual exemplars per category as in-context triggers, our MT-CoT augmented VLMs outperform traditional models trained under identical scarcity by over 38% in F1-score. Crucially, real-world case studies confirm that this zero-gradient approach maintains robust generalization on unannotated, out-of-distribution coastal clutters, achieving performance parity with data-heavy networks trained on 50 times the data volume. By substituting massive human annotation and GPU optimization with scalable logical deduction, this paradigm establishes a resource-efficient foundation for next-generation intelligent maritime sensing networks. Full article

Mitochondria are essential organelles that perform irreplaceable functions in neurons. The degeneration of neurons in Alzheimer’s disease (AD) is associated with mitochondrial damage, and Tau pathology represents a significant pathogenic factor in AD. However, the relationship between Tau and mitochondrial dysfunction during neuronal degeneration remains unclear. In this study, we investigated the effects and mechanisms by which extracellular Tau aggregates induce neuronal mitochondrial damage and dysfunction. The results showed that extracellular Tau aggregates lead to structural damage of mitochondria in SH-SY5Y cells and disrupt mitochondrial homeostasis. Extracellular Tau aggregates can also cause mitochondrial oxidative stress and inhibit oxidative phosphorylation in SH-SY5Y cells. Concurrently, extracellular Tau aggregates promote neuronal death through an increase in cytochrome C, mtDNA leakage and activation of the cGAS/STING pathway. We also explored the effects of a single-chain variable fragment antibody (scFv T1) and found that scFv T1 alleviated mitochondrial damage and dysfunction by inhibiting the formation of Tau aggregates. These findings suggest that targeting Tau pathology may be crucial to address neuronal mitochondrial impairment and that reduction of the toxicity associated with extracellular Tau aggregates could help slow Tau pathology progression. Full article

Soil nutrient loss and infertility in rocky desertification areas severely constrain ecological restoration. Exploring the impacts of external field remediation technologies on soil quality in these regions may offer novel strategies for soil enhancement and ecosystem recovery. This study conducted a three-month experiment to investigate the impact of continuous electric (ET, 20 V) and magnetic (MT, 200 mT) field treatments on soil nutrients, enzyme activities, and bacterial communities in simulated moderate and severe rocky desertification soils. Results showed that although an overall declining trends in total contents of key soil nutrients (Total nitrogen, total phosphorus, and total potassium), both electric and magnetic field treatments effectively mitigated the decreases of total nitrogen and potassium content (with the exception of total phosphorus) in rocky desertification soils, while improving their available contents compared to the control (CK). Electric field application significantly reduced the pH of moderate and severe rocky desertification soils through electrolysis, shifting the soil from alkaline (pH 7.69 and 7.73, respectively) to slightly acidic (pH 6.71 and 6.37, respectively); Both electric and magnetic field treatments enhanced urease and sucrase activities in moderately and severely rocky desertified soils. Compared to the CK, the increases were 21.92%, 4.46%, 5.70%, and 66.43% in moderately rocky desertified soil, and 10.06%, 42.15%, 20.66%, and 0.93% in severely rocky desertified soil, respectively. Their effects on phosphatase and catalase activities varied with the degree of rocky desertification. However, in severely rocky desertified soil, both treatments significantly increased phosphatase and catalase activities by 19.55%, 24.63%, 61.07%, and 38.05% compared to the CK, respectively. Furthermore, both electric and magnetic treatments significantly reduced bacterial α-diversity (chao1, ACE, Shannon, Simpson, and Pielou J indices) but optimized community structure by enriching dominant phyla with specific ecological functions, such as Pseudomonadota (7.63–41.10%), Bacteroidota (13.52–69.29%), and Verrucomicrobiota (38.26–104.81%). Functional prediction revealed that the abundances of dominant pathways (such as chemoheterotrophy, aerobic chemoheterotrophy, and nitrogen fixation) was enhanced following both treatments. Mantel analysis further indicated strengthened correlations among soil nutrients, enzyme activities, and bacterial communities, particularly under magnetic field treatment. These findings demonstrate that electric and magnetic field applications effectively facilitate nutrient cycling, stimulate enzyme activities, and optimize microbial community structure, thereby improving soil ecological functions and overall quality in rocky desertification regions, highlighting their potential for ecological restoration in karst areas. Full article

Objectives: Flat feet is a very common deformity in children. Often, radiologic evaluation for children with flat feet is made. Although the measurement reliability of some angles in flat feet has been evaluated in the literature, none of them have been performed in the age range of 3-7 years, when the deformity is most common. Our aim is to evaluate the interobserver and intraobserver reliability of the 7 angles that are used for assessing flat feet. Methods: Radiologic angles were measured by four independent observers (two specialists and two residents) in two separate sessions on the foot radiographs of 50 children aged 3-7 years with clinically diagnosed flat feet in the appropriate position and intra-class correlation coefficient was evaluated. Thus, interobserver and intraobserver reliability was measured. Results: High reliability values were found in the AP talus - 1st metatarsal (APT1MT) angle and calcaneus inclination (Cl) angle, while the reliability was moderate in the other angles. Intraobserver reliability values tended to be higher than interobserver values, which is consistent with other studies. Conclusions: It is useful to keep in mind that the measurement reliability is moderate except for APT1MT and CI when angles are measured in this specific age group. No positive effect of experience on measurement reliability was found in our study. Full article

The development of a green hydrogen industry is a strategic priority for Russia’s energy transition, yet the dynamics of scaling up this nascent sector remain poorly understood. This study uses agent-based modeling (ABM) to simulate the co-evolution of Russia’s electricity, hydrogen, and electrolyzer sectors over 2024–2050. The model incorporates three types of heterogeneous agents (power producers, hydrogen producers, and electrolyzer manufacturers) operating under bounded rationality. Four scenarios are examined across 50 Monte Carlo runs each, varying the electrolyzer learning rate (10–25%), willingness to pay for green hydrogen (2–6 $/kg), and government support intensity. The results reveal an endogenous three-phase development pattern: Phase I (2024–2028) dominated by renewable capacity build-up reaching ~30 GW; Phase II (2029–2040) characterized by rapid electrolyzer deployment scaling to 14.5 GW; and Phase III (2041–2050) marked by stabilization at approximately 30 GW producing 1.12 Mt/year at 3.1 $/kg. Two critical thresholds are identified: renewable capacity exceeding 30–38 GW and low-cost electricity above 4–7 TWh/year. The electrolyzer learning rate emerges as the most influential parameter, while the pessimistic scenario confirms market failure without a green premium (WTP < 2 $/kg). Strategic investment losses of 2–6 billion USD are necessary catalysts for industry emergence. Russia’s 2030 production target (0.55 Mt) is found structurally infeasible under all scenarios. Full article