Search Results (192)

Malignant biliary obstruction is commonly treated with biliary stenting either endoscopically or percutaneously; however, tumor ingrowth might occlude the stent, often leading to recurrent jaundice and repeat interventions. Endobiliary microwave ablation (MWA) is an emerging adjunct intended to devitalize intraductal tumors and potentially prolong stent patency. This review assesses the state of the art of endobiliary ablation for malignant biliary obstruction, focusing on the technique and safety of percutaneous procedures, as well as patient outcomes. It also discusses the use of flexible endobiliary MWA for hilar cholangiocarcinoma. The review covers ablation methods such as radiofrequency and MWA, which can be performed endoscopically or percutaneously. Research indicates that endobiliary thermal ablation is technically feasible and can be safely combined with stenting. Some studies suggest it may prolong stent patency and decrease the necessity for repeat procedures compared with stenting alone. Percutaneous techniques may be particularly helpful in complex hilar cases, allowing accurate energy delivery, protection of secondary bile ducts, and tailored stent placement. New microwave systems can heat tissue more deeply and evenly than radiofrequency ablation, which may improve local tumor control. Endobiliary thermal ablation appears to be a useful supplement to stenting, especially for patients with unresectable hilar cholangiocarcinoma. Flexible percutaneous MWA probes could make this treatment more widely available. Still, more high-quality studies are needed to find optimal ablation settings, identify which patients benefit most, and compare this method with standard stenting. Full article

Purpose: Surgical resection has been the gold standard for colorectal liver metastases (CRLM) for decades. In recent years, thermal ablation has emerged as a first-line treatment option for small-size CRLM, while for intermediate-size lesions (3–5 cm), it is reserved for patients with unresectable disease. In this setting, thermal ablation has proven safe and effective, achieving durable local control (LC) in the majority of patients. This retrospective study compares oncological outcomes of thermal ablation versus surgical resection of intermediate-size (3–5 cm) CRLM. Material and methods: Patients treated with thermal ablation or surgical resection for intermediate-size CRLM between 2000 and 2025 were included. Baseline per-patient and per-procedure characteristics were compared across three groups: thermal ablation, surgical resection, and combined treatment. Per tumor characteristics were compared between thermal ablation and surgical resection. Primary outcomes included local tumor progression-free survival (LTPFS) and complication rates. Secondary outcomes were OS, distant progression-free survival (DPFS), LC, and length of hospital stay. Survival outcomes were analyzed using the Kaplan–Meier method; additionally, LTPFS was assessed using Cox proportional hazards regression models, with multivariable analyses performed to adjust for potential confounders. Results: A total of 320 patients with 448 metastases were included: 135 patients underwent thermal ablation, 156 underwent surgical resection, and 29 received combined treatment. LTPFS per tumor was significantly higher in the surgical resection group (HR 1.86, 95% CI 1.24–2.81, p = 0.0025), however, LC per tumor did not significantly differ amongst groups (HR 1.48, 95% CI 0.70–3.11, p = 0.307). Complication rates were significantly higher after resection (p < 0.001). OS and DPFS did not differ significantly between the three groups (p = 0.08 and p = 0.084). OS comparing only thermal ablation and resection was significantly lower in the thermal ablation group. Median hospital stay was 3, 5, and 7 days for the ablation, resection, and combined groups, respectively (p < 0.001). Conclusions: Thermal ablation offers a safe alternative to surgical resection for selected patients with intermediate-size (3–5 cm) CRLM, with higher treatment-site recurrence rates. With the option of repeat ablation, comparable local tumor control can be achieved. Improvements in local control with both modalities over time support the need for a prospective clinical trial. Full article

Urban water supply systems require considerable electrical energy inputs across all operational processes: raw water abstraction, treatment, transmission, and distribution. Consequently, water loss within these processes represents not merely a loss of water volume, but also additional energy consumption and an increase in carbon emissions, given that electricity generation relies predominantly on fossil fuels. This study applied two methodological approaches to analyze the role of water loss within the Water–Energy–Carbon (WEC) Nexus of the Metropolitan Waterworks Authority (MWA), Thailand, over the period 2017–2024. The first method utilized a detailed WEC linkage analysis to balance water inputs and outputs in each process to quantify specific losses: raw water, in-plant, transmission, and distribution losses. The second method applied the International Water Association’s Leakage Emissions Initiative framework, focusing specifically on potable real water loss in distribution process, which constituted the largest volume (64.85% of total losses) and embodied the highest specific energy consumption. Based on the first method, the average annual potable real water loss was 534.71 MCM/yr (23.58% of water supplied to distribution), corresponding to embedded energy and carbon emissions of 103.76 GWh/yr (24.89% of total energy consumption) and 49,562 tCO₂e/yr (24.89% of total carbon emission), respectively. Although the second method was considerably simplified, the estimated energy and carbon emission values were only slightly higher than those derived from the detailed method, demonstrating the second method’s effectiveness as a streamlined assessment tool. These findings underscored that water loss reduction initiatives are essential for minimizing energy consumption and carbon emissions, thereby supporting Thailand’s pathway toward Net Zero emissions by 2050. Full article

Background and Aim: Adjuvant therapy after curative intent treatment for hepatocellular carcinoma (HCC) is a significant unmet need. The IMbrave050 study demonstrated improved recurrence-free survival (RFS) in patients with high-risk HCC receiving adjuvant atezolizumab and bevacizumab post-curative treatment compared to active surveillance. However, the IMbrave050 cohort was predominantly Asian, largely underwent surgical resection, and had chronic liver disease (CLD) mainly due to hepatitis B features that differ markedly from the Australian setting, where microwave ablation (MWA) is more common and hepatitis B-related CLD is less prevalent. Given these differences, this study aimed to explore the performance of the IMbrave050 risk criteria in an Australian population of patients with early-stage HCC undergoing curative treatment to determine if the criteria identified patients with a high risk of recurrence who may benefit from adjuvant treatment. Method: We performed a retrospective 5-year study of 50 patients with early-stage HCC undergoing MWA with curative intent or liver resection. Patients were stratified into high- and low-risk groups using the IMbrave050 criteria. The primary outcomes were RFS and overall survival (OS) in the high- and low-risk cohorts. Results: For patients who underwent liver resection, the 1-year RFS was 77.8% and 100% in high- and low-risk patients respectively (p = NS). In those who underwent MWA, the 1-year RFS was 89.5% in the high-risk cohort and 73.3% in the low-risk cohort (p = NS). OS at 1-year was 100% in all cohorts (p = NS). Conclusions: In this Western cohort receiving predominantly ablation as curative therapy the current high-risk criteria do not reliably distinguish between those with increased risk of early recurrence and those without. Criteria defining high-risk may need to be refined to better identify patients who may benefit from adjuvant therapy in this setting. Full article

Background: Obsessive–compulsive disorder (OCD) is a heterogeneous psychiatric condition with substantial heritability. Early genetic studies were often underpowered and produced limited reproducibility, but recent large-scale genomic and multi-omic approaches are beginning to elucidate the genetic architecture of OCD. Objectives: This review aims to synthesise current evidence from recent genomic and epigenomic studies on OCD and their implications for molecular pathways of pathogenesis, including endophenotypes. Methods: We reviewed peer-reviewed literature and preprints published in recent years, focusing on multiple genetic approaches, including genome-wide association studies (GWAS), whole exome sequencing (WES), whole genome sequencing (WGS), and methylome-wide association studies (MWAS). We then integrated the results with endophenotypic evidence at the biochemical, physiological, structural, functional, and executive/cognitive levels. Results: Recent large-scale genomic studies provide strong evidence of a highly polygenic contribution from common variants, while rare coding and structural variants also contribute measurably, with enriched signals in pathways relevant to neurodevelopment and, in some cohorts, early-onset presentations. Epigenomic studies have moved from scattered findings to more replicable methylation patterns, including loci influenced by nearby genetic variation and indications of sex-dependent effects. Although convergence at the single-gene level remains limited, cross-study and cross-omics signals increasingly point to biological domains involving synaptic organisation and plasticity, neurological development and chromatin regulation, immune/stress pathways, and cellular homeostasis. Conclusions: The biology of OCD risk is best represented by an integrative model combining polygenic load, contributions from rare variants, and regulatory (epigenetic) mechanisms that influence intermediate phenotypes at the circuit and cognitive levels. The current findings are not yet clinically applicable for individual diagnosis; however, they may inform future multidisciplinary research frameworks and, in the longer term, contribute to the development of more personalised approaches in OCD. Full article

Poly(lactic acid) (PLA)-based nanocomposites containing a mixture of graphene nanoplatelets (GNP) and carbon nanotube (CNT) as hybrid fillers were prepared using a solution-assisted sonication process followed by melt processing. The effects of the filler dispersion on dielectric properties and microwave absorbing (MWA) performance were systematically investigated. Two ionic liquids (ILs), trihexyl-(tetra-decyl)phosphonium bis (trifluoromethanesulfonyl)imide (IL1) and 11-carboxyundecyl-triphenylphosphonium bromide (IL2), were employed as dispersing agents for the carbonaceous fillers. Incorporation of IL-treated fillers resulted in enhanced dielectric permittivity and improved MWA performance of the PLA composites. The MWA properties were evaluated in X- band and Ku-band. A minimum reflection loss (RL) of −34 dB and an effective absorption bandwidth (EAB) of 2.1 GHz were achieved for the composite containing GNP/CNT/IL2 (HB3) at a weight ratio of 2.5:0.5:0.5 wt% with one 3 mm thick layer. The superior performance of IL2 is attributed to π-π and π-cation interactions between its phenyl-containing cation and the carbonaceous fillers, as well as improved compatibility with the PLA matrix due to carboxyl groups. Additionally, three-layered composite structures, combining PLA/GNP as the outer layer with IL-assisted hybrid fillers in the core and PLA/CNT at the bottom layer, achieved an extended EAB of 4.5 GHz for GNP/HB2/CNT arrangement and 4.35 GHz for the GNP/HB3/CNT arrangement, driven by enhanced scattering and internal reflection of microwaves. These results demonstrate the potential of IL-assisted hybrid filler dispersion in PLA for developing biodegradable materials with multifunctional applications as charge storage capacitors and microwave absorbing materials for sustainable electronics. Full article

Minimally invasive ablative therapies have emerged as effective and safe alternate approach for the management of renal cell carcinoma (RCC), particularly in patients who are ineligible for surgery due to comorbidities or high operative risk. Techniques such as radiofrequency ablation (RFA), microwave ablation (MWA), cryoablation (CA), and high-intensity focused ultrasound (HIFU) offer kidney-sparing treatment with reduced morbidity. Current evidence suggests that for cT1a tumors (<4 cm), thermal ablation achieves technical success rates exceeding 95%, with local recurrence rates ranging from 1% to 9% and major complication rates generally below 5–7%. RFA is particularly suitable for small peripheral tumors, MWA enables rapid and deeper heating for larger or more vascular lesions, and CA provides precise control near critical structures. HIFU remains largely experimental with limited clinical applicability. Overall, these strategies demonstrate favorable oncological outcomes, emphasizing the importance of careful patient selection, multidisciplinary evaluation, and further studies to refine technique-specific indications and integration with systemic therapies. Full article

Potassium (K) is a vital macronutrient for plant growth and yield, yet most soil K occurs in insoluble mineral forms, limiting availability to crops. Reliance on chemical K fertilizers is unsustainable due to cost and environmental concerns. Microbial solubilization of mineral K, particularly by purple nonsulfur bacteria (PNSB), offers an eco-friendly alternative. This study focused on isolating mica-potassium-solubilizing purple nonsulfur bacteria (MK-PNSB) from in-dyke alluvial soil and assessing their effects on hybrid maize germination and seedling growth. Among the isolates, the results showed that strain M-Wa-19 released the highest amount of soluble K under microaerobic light conditions (27.4 mg∙L⁻¹). Under aerobic dark conditions, M-Wa-24 and M-Wa-26 released 20.1–21.0 mg∙L⁻¹ of soluble K. Strains M-Wa-21, M-Wa-25, and M-Sl-13 solubilized K in the range of 14.3–25.1 mg∙L⁻¹ and 12.9–24.4 mg∙L⁻¹ under both incubation conditions. The selected strains were identified by 16S rRNA as Rhodopseudomonas palustris strain M-Sl-13 (PX588604), Rhodoplanes pokkaliisoli strain M-Wa-19 (PX588605), Afifella marina strain M-Wa-21 (PX588606), Rhodocista pekingensis strain M-Wa-24 (PX588607), Rhodocista pekingensis strain M-Wa-25 (PX588608), and Rhodocista pekingensis strain M-Wa-26 (PX588609). None exhibited toxicity to maize seeds; instead, all enhanced seed vigor indices by up to 99.7% and improved plant height and root biomass by 19.0–26.2% and 14.4–22.9%, respectively, under static hydroponic conditions. At a 1:1000 (bacteria and distilled water) dilution rate, strains M-Wa-26, M-Wa-25, M-Sl-13, M-Wa-24, M-Wa-19, and M-Wa-21, along with the six-strain mixture, improved seed vigor index by 3.96–7.91%. These findings suggest that MK-PNSB, individually or in mixtures, hold promise as biofertilizer candidates for sustainable K management in crop production. Full article

Objectives: Primary objective was to report the feasibility, safety and efficacy of percutaneous ablation of hepatic malignant tumors that are undetectable or inconspicuous in non-enhanced computed tomography (CT) scans using an electromagnetic navigation system with a marker option. Secondary objectives included the evaluation of technical parameters including the accuracy of needle placement, the number of control CT acquisitions, and procedural duration. Methods: This prospective study (performed from 1 March 2022 until 30 November 2024) included all patients with hepatic tumors (not visible or poorly defined on non-enhanced CT) who underwent percutaneous microwave ablation (MWA). Technical efficacy was assessed with contrast-enhanced CT immediately post-ablation, and oncologic outcomes (overall and progression-free survival) were evaluated with MRI at 1, 3, and 6 months. Results: Fifteen patients (12 males, 3 females; mean age of 66 years) with 16 tumors (median diameter of 15 mm) were treated in 16 sessions. Tumor types included hepatocellular carcinoma (n = 7), colorectal metastasis (n = 4), ocular melanoma (n = 1), neuroendocrine tumor (n = 1), intrahepatic cholangiocarcinoma (n = 1), and breast cancer metastasis (n = 1). Median procedure time was 53 min, scans number was nine, needle length was 12 cm, and median deviation was 1 mm. No complications were reported. Primary efficacy rate was 94% (15/16), rising to a secondary (assisted) technique efficacy of 100% after re-ablation (one session). During median follow-up of 23 months, local tumor progression-free survival was 100%; distant progression-free survival was 80%, and two patients (13.3%) died, one being cancer-related. Conclusions: Electromagnetic navigation with a marker option enables safe, accurate, and effective MWA of inconspicuous hepatic tumors, achieving excellent local control with favorable oncologic outcomes. Full article

Background: Bronchoscopic thermal ablation has emerged as a minimally invasive therapeutic option for managing pulmonary nodules in patients unsuitable for surgery or radiotherapy. Robotic-assisted bronchoscopy (RAB) offers enhanced stability and precise navigation, potentially improving the safety and accuracy of bronchoscopic ablation. However, clinical data on RAB-guided microwave ablation (MWA) remains limited. Therefore, further evidence is needed to evaluate its feasibility, safety, and early therapeutic performance. Methods: We conducted a single-center retrospective feasibility study of shape-sensing RAB-guided MWA (ssRAB-MWA) for pulmonary nodules between October 2024 and September 2025. Eligible lesions (≤3.0 cm) included both primary lung cancers and metastatic nodules. All procedures were performed under general anesthesia using the ssRAB system integrated with cone-beam CT for intra-procedural confirmation. Technical success, safety outcomes, and short-term efficacy were assessed. Results: Nine patients (with 11 lesions: 3 primary, 8 metastatic) underwent ssRAB-MWA with 100% technical success. The median ablation time per nodule was 10 min (range, 1–26). One patient developed post-ablation pneumonia requiring hospitalization; no pneumothorax, major bleeding, or airway injury occurred. All lesions exhibited a transient increase in size immediately following MWA, followed by gradual reduction or stabilization over time. PET-CT evaluation demonstrated metabolic remission in primary lesions, with one patient achieving pathologic complete response after surgery. Conclusions: ssRAB-MWA appears to be a feasible and safe navigation-guided technique for small pulmonary lesions, offering encouraging early local control in both primary and metastatic lung cancers. This platform may expand the therapeutic spectrum of interventional pulmonology, bridging diagnosis and local therapy. Larger multicenter studies are warranted to validate long-term outcomes. Full article

This study investigated the relationship between maternal barium (Ba) exposure and the risk of miscarriage using metabolomics and machine learning. Analyses were performed on samples from 183 pregnant women from Nanjing: the concentration of Ba in whole blood was measured using inductively coupled plasma mass spectrometry (ICP-MS), and untargeted metabolomics was performed on decidual tissue using high-resolution accurate mass spectrometry (UHPLC-QExactive HF-X). A metabolome-wide association study (MWAS) and mediation interaction effect analysis (MITM) identified metabolites and pathways linked to Ba exposure and miscarriage risk. Among 523 detected metabolites, 19 metabolites and 5 pathways were significantly associated with both Ba exposure and miscarriage, particularly glycerophospholipid metabolism. The effect of Ba exposure on miscarriage risk was mediated by five metabolites, with cuminaldehyde showing the highest share of the total mediating effect (54.74%). These metabolites, including N-acetyl-L-methionine, 4-hydroxynonenal, DG(18:0/18:3(9Z,12Z,15Z)/0:0), 10-formyldihydrofolate, and eicosadienoic acid, were used as biomarkers in a predictive model. The XGBoost model achieved an optimal AUC of 0.90 (95%CI: 0.83–0.96). This study suggests that maternal Ba exposure increases miscarriage risk, potentially through disruptions in amino acid metabolism, oxidative stress, and lipid peroxidation, and highlights the potential of metabolite biomarkers for predicting adverse birth outcomes. Full article

Artificial intelligence (AI) is increasingly shaping interventional oncology, with growing interest in its application across thermal ablation modalities such as radiofrequency ablation (RFA), cryoablation, high-intensity focused ultrasound (HIFU), and microwave ablation (MWA). This review characterises the current landscape of AI-enhanced thermal ablation, with particular emphasis on emerging opportunities within MWA technologies. We examine how AI-driven methods—convolutional neural networks, radiomics, and reinforcement learning—are being applied to optimise patient selection, automate image segmentation, predict treatment response, and support real-time procedural guidance. Comparative insights are provided across ablation modalities to contextualise the unique challenges and opportunities presented by microwave systems. Emphasis is placed on integrating AI into clinical workflows, ensuring safety, improving consistency, and advancing personalised therapy. Tables summarising AI methods and applications, a conceptual workflow figure, and a research gap analysis for MWA are included to guide future work. While existing applications remain largely investigational, the convergence of AI with advanced imaging and energy delivery holds significant promise for precision oncology. We conclude with a roadmap for research and clinical translation, highlighting the need for prospective validation, regulatory clarity, and interdisciplinary collaboration to support the adoption of AI-enabled thermal ablation into routine practice. Full article

A radio source with a period of 75.88 s, suspected of being an ultra-long period pulsar, was discovered in 2020 with the MeerKAT radio telescope. Here, we report the detection of radio pulses from this object in multi-epoch ASKAP image data at frequencies between 744 MHz and 1800 MHz and a search for pulses made in Murchison Widefield Array data at 154 MHz. The ASKAP detections pre-date and extend other published observations and so support the belief the pulsar emission has been persistent. The non-detection of the pulsar in MWA data is consistent with a recent report that the spectrum turns over at low frequencies. An ASKAP image of the field centred at 943 MHz confirms the MeerKAT detection of diffuse emission surrounding the pulsar. Full article

Objectives: This single-center retrospective study evaluates the clinical efficacy and safety of percutaneous ablation using microwave ablation (MWA) and irreversible electroporation (IRE) in patients with breast cancer liver metastases (BCLM). Methods: Between August 2018 and December 2023, 32 patients underwent 40 image-guided ablations for 57 BCLM. Mean age was 61.3 years (range: 32–85), and mean tumor size was 2.9 cm (range: 0.9–7.0 cm). Fifty lesions were treated with MWA and seven with IRE. Clinical efficacy was assessed by m-RECIST response at first follow-up imaging (after ≥1 month) and by monitoring local tumor progression (LTP), local tumor progression-free survival (LTPFS), and overall survival (OS). Safety was evaluated by adverse events according to CTCAE. Kaplan–Meier statistics were used for LTPFS and OS. Results: Median follow-up was 32.4 months (95% CI 16.6–48.0). Complete response was observed in 34 tumors (59.6%), partial response in 14 (24.6%), and progressive disease in 9 (15.8%). LTP occurred in 37 tumors (64.9%), with a median time to progression of 11.1 months (95% CI 1.4–20.8). One- and two-year LTPFS rates were 43.6% and 34.1%. Sixteen patients died during follow-up, with median OS of 27.8 months (95% CI 19.0–36.6) and 1- and 2-year OS rates of 90.1% and 55.9%. No major complications occurred. Complications included eight Grade 1 and two Grade 2 complications. Conclusions: Percutaneous ablation demonstrates clinical efficacy and a favorable safety profile in selected BCLM patients, achieving OS comparable to the current literature. Further studies should clarify its additive role within multimodality treatment. Full article

Background/Objectives: Hepatocellular carcinoma (HCC) ranks as the third most prevalent cancer and is the second leading cause of cancer-related deaths globally. This study sought to evaluate microwave ablation (MWA), radiofrequency ablation (RFA), and percutaneous ethanol injection (PEI)—whether used separately or together (RFA+PEI, MWA+PEI)—for treating single HCC lesions ≤5 cm, focusing on outcomes, survival rates, complications, costs, and recurrence rates. Methods: This retrospective–prospective research study involved 250 patients with solitary HCC lesions measuring ≤5 cm, recruited from the National Liver Institute at Menoufia University. Patients were evenly divided into five groups, each containing (n = 50): RFA, MWA, PEI, combined RFA+PEI, and combined MWA+PEI. Indications and contraindications adhered to the Barcelona Clinic Liver Cancer (BCLC) guidelines. Results: Three patients were administered antiviral therapy 1–2 years after ablation. Average intervention costs were 17,340 ± 700, 31,200 ± 900, 1140 ± 300, 17,500 ± 0.0, and 33,800 ± 0.0 EGP for groups 1 through 5, respectively. Short-term advancement rates were 12%, 8%, 18%, 4%, and 2%. After 36 months, all patients survived six months after ablation. Average survival durations were 2.44 ± 1.17, 2.59 ± 1.02, 2.69 ± 0.99, 2.83 ± 1.06,and 2.91 ± 1.04 years, respectively. Complications were mainly minor (pain, nausea, and low-grade fever); one patient experienced an abscess and biloma post-MWA, one experienced minimal pleural effusion, and two combined-therapy cases had abdominal wall hematoma. Conclusions: RFA, MWA, and PEI—whether used individually or together—are successful treatment choices for early-stage HCC. The combination of MWA and PEI demonstrated the most favorable results, minimal recurrence rates, and the longest duration of progression-free survival. Full article