Search Results (3,618)

Background:Scutellaria baicalensis (Scu) extract has been traditionally used in the treatment of stroke-related syndromes, yet its underlying molecular mechanisms, particularly those involving ferroptosis, remain to be fully elucidated. Purpose: This study aims to validate the hypothesis that Scu extract improves cerebral ischemia-reperfusion injury (CIRI) by inhibiting ferroptosis through the PI3K/AKT signaling pathway. Methods: This study employed middle cerebral artery occlusion (MCAO) in male Sprague-Dawley (SD) rats and oxygen–glucose deprivation/reoxygenation (OGD/R) models to evaluate the protective effects of Scu extract against CIRI. Multiple approaches were integrated to elucidate the underlying mechanisms. Furthermore, a range of experimental techniques, including neurological function assessment, TTC staining, histopathological analysis, biochemical assays, qPCR, transmission electron microscopy (TEM), reactive oxygen species (ROS) detection, Western blotting, and immunofluorescence, were used to comprehensively validate its neuroprotective effects. Results: Scu extract significantly improved neurological outcomes and attenuated brain injury in MCAO rats. Proteomic analysis revealed significant enrichment of ferroptosis-related pathways, which was supported by reduced mitochondrial damage, decreased iron accumulation, and restoration of the SLC7A11/GPX4 axis. Subsequently, UPLC/Q-TOF-MS analysis revealed that four major bioactive components were absorbed in MCAO rats. KEGG pathway analysis based on network pharmacology further indicated that the PI3K/AKT signaling pathway is a key regulatory target. Notably, pharmacological inhibition of PI3K with LY294002 markedly abolished the anti-ferroptotic effects of Scu extract, which was further confirmed in vitro. Conclusions: This study demonstrates that Scu extract confers neuroprotection against CIRI in MCAO rats potentially through inhibiting ferroptosis via activation of the PI3K/AKT pathway. Full article

Background/Objectives: Exposure to particulate matter (PM) containing bacterial endotoxins triggers inflammation and oxidative stress in the respiratory epithelium. In this study, we investigated chitosan nanoparticle-loaded Cordyceps militaris grown on germinated Rhynchosia nulubilis (GCN) as a potential functional food-derived ingredient against PM- and lipopolysaccharide (LPS)-induced cellular damage in human lung epithelial cells. Methods: This study employed an integrative approach combining GCN analysis with bioinformatics methods using a PM- and LPS-induced pulmonary cellular inflammation model. Gene Expression Omnibus (GEO) transcriptomic datasets and Cytoscape-based network analysis were utilized to identify key hub genes and signaling pathways associated with PM- and LPS-induced pulmonary inflammation, which were subsequently validated by RT-PCR and Western blotting. Results: Nano-encapsulation significantly improved the antioxidant capacity and storage stability of the extract compared with non-encapsulated Cordyceps militaris grown on germinated Rhynchosia nulubilis (GRC). GCN markedly attenuated PM- and LPS-induced cytotoxicity and intracellular reactive oxygen species (ROS) production in a dose-dependent manner, resulting in a therapeutic index approximately 4.5-fold higher than that of GRC under PM and LPS co-exposure. Bioinformatics analysis identified inflammation-related genes and pathways associated with PM- and LPS-induced pulmonary responses, primarily enriched in tumor necrosis factor (TNF)-related inflammatory pathways, Toll-like receptor signaling, and cytokine signaling. Consistent with these findings, GCN suppressed the expression of C-X-C motif chemokine ligand 2 (CXCL-2) and tumor necrosis factor-alpha (TNF-α) mRNA and inhibited mitogen-activated protein kinase (MAPK)-mediated activator protein-1 (AP-1) and nuclear factor-kappa B (NF-κB) signaling pathways in human type II alveolar epithelial cells (A549). Conclusions: Collectively, nano-encapsulation enhanced the stability and bioactivity of Cordyceps militaris-based extracts, suggesting that GCN may have potential as a functional food-derived candidate ingredient to protect airway epithelial cells against inflammation and oxidative stress induced by PM and LPS. As this study was conducted using an in vitro A549 epithelial cell model, further validation in physiologically relevant systems is needed to confirm its translational applicability. Full article

The aqueous seed extract of Ammodaucus leucotrichus Cosson & Durieu (AL-AE), a Saharan annual herb of the family Apiaceae, was evaluated for the first time as a green corrosion inhibitor for mild steel in 1.0 M hydrochloric acid. GC-MS analysis after acetylation derivatization identified ten constituents representing 99.22% of the total detected area, with 17-pentatriacontene (47.69%), 2,4-di-tert-butylphenol (13.24%), and myo-inositol (8.62%) as the dominant species. Inhibition performance was assessed by electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization (PDP) over 25–100 ppm at 298–328 K. At 100 ppm and 298 K, AL-AE achieved 96.17% by EIS and 97.10% by PDP. Adsorption obeyed the Langmuir model with a standard free energy of adsorption of −38.2 kJ mol⁻¹, consistent with a mixed physisorption–chemisorption mechanism. SEM/EDS confirmed protective film formation, with surface oxygen dropping from 34.9 to 4.1 wt%. Density functional theory (DFT) calculations at the B97-3c/CPCM (water) level in ORCA 6.1 identified 2,4-di-tert-butylphenol as the most reactive constituent, while Fukui index analysis based on Mulliken population analysis located the preferential adsorption sites on each molecule. Full article

A biogenic ZnO/Ag photoelectrode treated with atmospheric-pressure plasma was evaluated as an anode in a photo-assisted electroflotation system for the transformation of chromophoric pollutants in real industrial wastewater. ZnO was synthesized from Azadirachta indica leaf extract and plasma-treated for 10 min (M2) and 15 min (M3), with an untreated reference (M1). XRD, SEM-EDS, Raman, FTIR, EPR, and XPS analyses showed that the plasma preserved the wurtzite structure, relaxed the bulk, and modified the surface by removing residues, deoxygenating it, and activating oxygen vacancies (V_O). Although M3 reached the highest deoxygenation, M2 showed the most favorable response; thus, the performance did not depend only on the total amount of V_O. Under dark conditions, M2 showed a 14.86 percent decrease in COD compared to the control in a single batch and had the most negative ORP value. However, only ORP came close to statistical significance after multiplicity correction, with p_adj = 0.055. Under illumination, it showed the strongest photoinduced changes in conductivity and total suspended solids. The light–dark differences (ΔL−O) showed sign reversals in COD, conductivity, and pH, which identified three functional regimes and indicated that the electronic coupling of the surface V_O, rather than its amount, controlled the performance. ΔL−O was proposed as an operational test to distinguish these regimes, with the plasma exposure time as a key control variable. Because the effluent responses were single determinations, they are considered exploratory; the mechanism is primarily based on structural and spectroscopic characterization and supported by photoelectrochemical tests. Full article

Background: To investigate the protective effects of Phellodendron amurense Rupr. polysaccharides (PAP), alkaloids, and flavonoids in alleviating diabetic kidney disease (DKD) and to elucidate the role of the PI3K/AKT/GSK-3β/Nrf2 signaling pathway. Methods: Active components were extracted and quantified. In vitro, high-glucose (HG)-induced human kidney-2 (HK-2) cells were used to screen the optimal fraction via CCK-8, reactive oxygen species (ROS), TdT-mediated dUTP Nick-End Labeling (TUNEL), and Western Blot (WB) assays. In vivo, a DKD rat model was established using 2% Streptozotocin (STZ) and a high-fat with high-sugar diet. Rats were treated with PAP and LY294002. Renal damage and signaling pathway proteins were evaluated using histological staining and WB. Results: Among the tested components, PAP conferred the most pronounced cytoprotection against HG-induced injury in HK-2 cells. PAP significantly reduced glomerular damage, collagen deposition, and glycogen accumulation in the kidneys of DKD rats. Mechanistically, PAP activated the PI3K/AKT/GSK-3β/Nrf2 pathway, upregulating HO-1 and NQO1, while inhibiting the TGF-β1/Smad2 pathway and Bcl-2/Bax-mediated apoptosis. These protective effects were significantly attenuated by LY294002. Conclusions: Among the tested fractions under the present experimental conditions, PAP exhibited the most pronounced protective activity. These protective effects were partially mediated through the PI3K/AKT/GSK-3β/Nrf2 pathway, which enhanced antioxidant capacity while reducing fibrosis and apoptosis. Full article

Ascophyllum nodosum extracts (ANE) are widely used biostimulants associated with improvements in plant growth, productivity, nutrient acquisition, and abiotic stress tolerance. However, the molecular mechanisms linking extract composition to plant signaling and physiological responses remain incompletely resolved. ANE contains a complex mixture of bioactive constituents, including polysaccharides, osmolytes, phenolic compounds, and phytohormone-like molecules. Their composition varies according to biomass source, environmental conditions, and extraction methodology, contributing to variability in biological activity. Current evidence suggests that ANE functions mainly as a signaling modulator rather than a direct nutrient source. ANE treatment has been associated with early cellular responses, including cytosolic Ca²⁺ influx, reactive oxygen species (ROS) generation, and mitogen-activated protein kinase (MAPK)-associated signaling events. However, many proposed mechanisms remain unresolved, and a considerable proportion of the available mechanistic evidence originates from studies using purified ANE-derived polysaccharides or related elicitor systems. ANE-associated responses include modulation of nutrient transport, primary metabolism, hormonal regulation, transcriptional reprogramming, and stress-responsive pathways, contributing to improved root development, nutrient acquisition, and defense-related responses. Nevertheless, limited knowledge of receptor-mediated perception mechanisms, signaling hierarchies, and extract-dependent variability continues to constrain mechanistic understanding and reproducibility. Future research should prioritize receptor identification, bioassay-guided fractionation, integrated multi-omics approaches, and improved standardization of extraction and formulation procedures. These advances will be essential for establishing robust mechanistic models and supporting the development of evidence-based ANE biostimulants for sustainable crop production. Full article

Spatially explicit water-quality information is critical for precision management in pond aquaculture but point sampling alone cannot capture pond-to-pond heterogeneity in multi-unit farms. This single-date, single-farm study re-evaluated the potential of UAV hyperspectral imagery for water-quality screening in inland aquaculture ponds in Shanghai, China, using site-matched extraction from a 138-band orthomosaic (450–998 nm, Cubert S185) acquired during a single UAV survey on 24 August 2023 and matched with 23 GPS-registered sampling sites. Eight water-quality parameters were analyzed: chemical oxygen demand (COD), total phosphorus (TP), total nitrogen (TN), ammonium (${\mathrm{NH}}_4^{+}$ ), nitrite (${\mathrm{NO}}_2^{-}$), nephelometric turbidity unit (NTU), chlorophyll-a (Chla), and total suspended solids (TSS). Raw single-band correlations were modest ($\left|\mathrm{r}\right|$= 0.236–0.417), but two-band difference spectral indices (DSI), normalized spectral indices (NSI), and ratio spectral indices (RSI) substantially improved sensitivity, with $\left|\mathrm{r}\right|$ reaching 0.558–0.928. Quadratic inversion models were calibrated on the full dataset and assessed using three validation layers: two-fold cross-validation, nested leave-one-pond-out (LOPO) validation with within-fold predictor reselection, and extraction-window sensitivity tests. Bootstrap 95% confidence intervals for calibration (Cal) R² characterize small-sample uncertainty (n = 23). Three parameters satisfied all three defensibility criteria (Cal R² > 0.5, CV R² > 0.2, and LOPO R² > 0.2): ${\mathrm{NH}}_4^{+}$ (Cal R² = 0.836 [0.61, 0.94]; LOPO R² = 0.420), COD (0.607 [0.34, 0.82]; 0.328), and NTU (0.862 [0.77, 0.96]; 0.204). TP, TN, ${\mathrm{NO}}_2^{-}$, TSS, and Chla showed overfit behavior under nested holdout and were demoted to exploratory products. A TreeSHAP analysis confirmed that band-to-band contrast carried more explanatory power than raw reflectance magnitude. Extraction-sensitivity tests further demonstrated that positional uncertainty (±2-pixel offset: ΔCV $R^2$= 0.23–0.41) exceeded averaging-window sensitivity (3 × 3→10 × 10: ΔCV $R^2$ ≤ 0.11), identifying geolocation control as the dominant robustness constraint. This single-date, single-farm reanalysis suggests that UAV hyperspectral imagery may support exploratory pond-scale screening of ${\mathrm{NH}}_4^{+}$, COD, and NTU. However, robust quantitative inversion and broader transferability remain unverified and will require denser sampling, improved geolocation control, pond-edge masking, multi-site observations, and multi-temporal calibration. Full article

Cobalt occupies an irreplaceable strategic position in renewable energy and high-end advanced industries. As high-grade mineral resources gradually deplete, associated sulfide minerals have attracted increasing attention as alternative sources of cobalt. This study investigated a selective extraction of cobalt from low-grade cobalt-bearing pyrite using oxygen-pressure acid leaching. The Gibbs free energy (ΔG) of key chemical reactions in the leaching system was calculated to verify the thermodynamic feasibility of the process. The effects of critical parameters, including oxygen pressure, initial acidity, stirring speed, leaching time, and temperature, on cobalt leaching efficiency and phase transformation characteristics were systematically investigated. Under optimal conditions of oxygen pressure 1.5 MPa, H₂SO₄ initial acidity 7.36 g·L⁻¹ (0.82 mol/L), stirring speed 300 rpm, leaching duration 120 min, and temperature 230 °C, the cobalt leaching rate reached 98.2%, whereas the leaching rates of iron and aluminum were only 19.79% and 28.11%, respectively. Combined with SEM-EDS, XRD, and XPS characterization results, oxygen pressure acid leaching effectively destroyed the lattice structure of cobalt-bearing pyrite and liberates lattice-hosted cobalt, thereby facilitating efficient cobalt leaching. At high-temperature and oxygen pressure conditions, Fe³⁺ underwent hydrolysis and precipitated as hematite (Fe₂O₃) or hydronium jarosite (H₃O)Fe₃(SO₄)₂(OH)₆, enabling the selective extraction of cobalt. Aluminum in cobalt-bearing pyrite primarily occurred as the stable boehmite (AlOOH) phase, exhibiting excellent acid resistance and low dissolution during leaching. This study broadens the utilization pathway of low-grade cobalt resources and provides valuable insights and a scientific theoretical basis for the efficient treatment of cobalt-containing sulfide concentrates and tailings. Full article

Cigarette smoke is a major inducer of oxidative stress, promoting reactive oxygen species (ROS) accumulation and contributing to the pathogenesis of chronic obstructive pulmonary disease (COPD) and lung cancer. Heated tobacco products (HTP) and e-cigarettes are promoted as reduced-risk alternatives; however, their impact on cellular redox regulation remains unclear. Here, we investigated the effects of conventional cigarette smoke extract (CSE), HTP, and e-cigarette extracts on hydrogen peroxide (H₂O₂) permeability mediated by aquaporins (peroxiporins) and on the activity of key antioxidant enzymes (catalase, superoxide dismutase, and glutathione peroxidase) in ATII-like cells. Eight aquaporins were detected at the mRNA level, and seven were confirmed at the protein level. CSE markedly inhibited H₂O₂ permeability across plasma, mitochondrial, and nuclear membranes. HTP extract impaired H₂O₂ transport across the plasma membrane and nuclear envelope, while mitochondrial permeability was preserved. Both CSE and HTP extract reduced superoxide dismutase and glutathione peroxidase activities. In contrast, e-cigarette extract exerted minimal effects on membrane H₂O₂ permeability and selectively decreased superoxide dismutase activity. Overall, our findings identify a graded pattern of oxidative toxicity (CSE > HTP > e-cigarette) and highlight peroxiporins as critical regulators of intracellular redox homeostasis. Although less harmful than cigarettes, alternative nicotine delivery systems are not biologically inert. Full article

Propolis is a natural resinous product with a broad spectrum of biological activities, including immunomodulatory and anti-inflammatory effects. Increasing evidence suggests that propolis may influence pathways involved in tissue remodeling and fibrosis; however, comparative studies evaluating different propolis types in endothelial models remain limited. Brain microvascular endothelial cells, as a key component of the blood–brain barrier, constitute a relevant in vitro model for studying anti-inflammatory and neurovascular responses under both physiological and pathological conditions. The aim of this study was to compare the effects of Brazilian green propolis (EEP-BRA) and Polish brown propolis extracts (EEP-PL) on the immunological and fibrotic responses of brain microvascular endothelial cells. Human brain microvascular endothelial cells (hCMEC/D3-BBB) were exposed to propolis extracts (EEP-BRA and EEP-PL) under normoxic and hypoxic conditions to reflect diverse microenvironmental states. The analysis focused on the modulation of release of selected cytokines, including IL-10, IL-4, IL-6, IFN-γ, GM-CSF, TNF-α, IL-2, IL-8, and TGF-β, with particular emphasis on TGF-β as a key regulator of fibrosis. Results: Both propolis extracts significantly modulated cytokine production, although their effects differed depending on the origin of the propolis and oxygen conditions. Under the hypoxia condition followed by IFN-α stimulation, EEP-PL-50 was associated with reduced TNF-α (0.54 vs. 3.61 pg/mL; Hedges g = −6.78; large effect size, p > 0.05) and decreased TGF-β1, IL-8 and TGF-β2/β3. EEP-BRA-50 elicited a distinct profile characterized by increased IL-6 (171.58 vs. 27.63 pg/mL; p < 0.001; g = +6.15) and GM-CSF, while reducing TGF-β1. Both extracts preserved viability > 70% (ISO 10993-5). In conclusion, the results demonstrate that EEP-BRA and EEP-PL exert distinct immunomodulatory effects on brain endothelial cells. These findings highlight the importance of propolis origin in determining its biological activity and support its potential application in modulating inflammation and neurovascular responses. Full article

An undescribed seco-kaurane diterpenoid, benincaside A (BA), was isolated from the seeds of Benincasa hispida. The seeds of B. hispida have been traditionally used in folk medicine and previous studies have reported anti-tumor potential in B. hispida seed extracts. Accordingly, we investigated the cytotoxicity and underlying mechanisms of BA in colorectal cancer cells. BA inhibited growth in HT29, Colo205, HCT116, and CT26 colorectal cancer cells, as determined by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, while showing no toxicity toward normal human umbilical vein endothelial cells (HUVEC) and human fibroblast WS-1 cells. In HCT116 cells, BA-induced deoxyribonucleic acid (DNA) damage and apoptosis, as evidenced by morphological changes, 4,6-diamidino-2-phenylindole dihydrochloride (DAPI) staining, and assays of caspase-8 and caspase-3 activities. BA triggered apoptotic cell death via the extrinsic pathway, as indicated by elevated caspase-8 and caspase-3 activities. Intracellular reactive oxygen species (ROS) generation was observed in BA-treated HCT116 cells. The growth-inhibitory effects were significantly attenuated by pretreatment with N-acetylcysteine (NAC, an antioxidant), caffeine (an ATM kinase inhibitor), z-VAD-fmk (pan-caspase inhibitor), or z-IETD-fmk (caspase-8-specific inhibitor). Colorimetric assays confirmed increased caspase-8 and caspase-3 activities in BA-treated cells. This study is the first to report ROS-dependent signaling as a key mechanism underlying BA-induced cell death in HCT116 human colorectal cancer cells. Full article

Cisplatin is a widely used platinum-based chemotherapeutic agent that often causes irreversible hair cell loss, leading to hearing impairment. To date, effective strategies for preventing cisplatin-induced ototoxicity remain limited. Corchorus olitorius L. (COL) is rich in bioactive phytochemicals with antioxidant and anti-inflammatory properties; however, the protective role of COL stem against cisplatin-induced hearing loss has not been explored. This study aimed to determine whether COL stem extract treatment could mitigate cisplatin-induced hair cell damage in the lateral line system of zebrafish. Herein, we use 7-day post-fertilization (dpf) transgenic zebrafish larvae as a high-throughput screening platform to assessed COL stem extract against cisplatin-induced hair cell injury. Endpoints included mechanotransduction (MET) function, reactive oxygen species (ROS) production, apoptotic and inflammatory responses, and locomotor behavior. Antioxidant capacity and acute toxicity were also evaluated. Pretreatment with COL stem extract preserved hair cell viability, restored MET function, reduced ROS accumulation, upregulated Nrf-2-dependent cytoprotective genes, suppressed apoptosis, and attenuated macrophage infiltration. The recovery of swimming behavior correlated with hair cell protection, confirming the phenotypic relevance. This study demonstrates, for the first time, that COL stem exerts potent otoprotective effects through antioxidative, anti-apoptotic, and anti-inflammatory mechanisms, contributes to maintain mechanosensory function and swimming behavior. The findings support COL stem as a promising candidate for otoprotection and validate zebrafish-based high-throughput screening for novel therapeutic discovery. Full article

Vitex madiensis Oliv. (Lamiaceae) is a species growing in tropical and subtropical regions throughout the world. In several African countries, the different organs of this plant, leaves, fruits, stem bark and roots are used in folk medicine for the treatment of headaches, toothaches, aches and pains. In this study, we investigated the phytochemical profile of Vitex madiensis leaf extracts using LC-MS. The antioxidant and anti-inflammatory potential of crude extracts, fractions, and pure molecules was evaluated using reactive oxygen species (ROSs) production assays and cyclooxygenase-2 inhibition assays. A bio-guided fractionation was carried out to identify the most active fractions and resulted in the isolation of four phytoecdysteroids from the n-butanol fraction: 20-hydroxyecdysone, ajugasterone C, vitexirone, and pterosterone. 20-hydroxyecdysone showed very good anti-inflammatory properties with a significant reduction of more than 70% of COX-2 expression in induced LPS-stimulated human blood leukocytes compared to the control. This study confirmed the therapeutic potential of phytoecdysteroids. Full article

This study assessed the potential of Oleaster leaves as a valuable cosmetic ingredient by comparing aqueous and hydroalcoholic ultrasound-assisted extracts of Oleaster leaves to those of the Olive tree. The hydroalcoholic Oleaster leaf extract showed a higher content in phenolic and flavonoid compounds, with an oleuropein and verbascoside content of 58 mg/g of dry leaves and 3.2 mg/g of dry leaves, respectively. To refine the comparison of their molecular composition, the extracts were analyzed using UHPLC-HRMS/MS. About twenty compounds, including secoiridoids, flavonoids and triterpenic acid derivatives, were annotated in both extracts, demonstrating their similarity. DPPH, CUPRAC and enzymatic SOD assays showed a good antioxidant activity with high inhibition (60–90%) for both Oleaster and Olive tree leaf extracts. The hydroalcoholic extracts at 62.5 µg/mL also exhibited 60–80% of protection against reactive oxygen species (ROS) in H₂O₂-stressed HaCaT cells, confirming this antioxidant capacity without demonstrating a severe cytotoxicity, which remained below 40%. The anti-inflammatory potential of the extracts was also demonstrated using COX-2 inhibition, which was around 70%, and by measuring the concentration of IL-8 in HaCaT cells under pro-inflammatory conditions, which decreased in the presence of extracts at a concentration of 50 pg/mL, similar to that observed for the positive control. Thus, the hydroalcoholic ultrasound extract of Oleaster leaves demonstrated its high potential to develop sustainable and active cosmetic ingredients. Full article

Objective: The objectives of this study were to characterise induction-phase regional cerebral oxygen saturation (rSO₂)–mean arterial pressure (MAP) dynamics during near-infrared spectroscopy (NIRS)-guided selective carotid endarterectomy (CEA) and to examine whether the Awake→Intubated pressure–oxygenation pattern may represent an early adjunctive physiological signal of subsequent cross-clamp-related ipsilateral cerebral desaturation. Methods: In this retrospective observational cohort study, 322 consecutive elective CEAs managed with an NIRS-guided selective shunting protocol between October 2019 and February 2025 were analysed, after excluding patients considered for routine pre-emptive shunting because of contralateral internal carotid artery occlusion or ≥70% stenosis. Standardised MAP and bilateral rSO₂ values were extracted at the Awake, Intubated, and Clamp stages, defined as 3 min after carotid cross-clamping. Awake→Intubated ipsilateral ΔrSO₂/ΔMAP was evaluated as a continuous, exploratory pressure–oxygenation index, with MAP–rSO₂ directional change classified as concordant or discordant. Clamp-related desaturation was defined as a ≥20% ipsilateral rSO₂ decrease from Awake to Clamp. Discrimination and adjusted associations were evaluated using receiver operating characteristic analysis and multivariable logistic regression, respectively. Results: Clamp-related ≥20% ipsilateral rSO₂ desaturation occurred in 43 patients (13.4%). The Awake→Intubated ipsilateral ΔrSO₂/ΔMAP ratio differed significantly between patients with and without ≥20% desaturation and showed significant discrimination on receiver operating characteristic analysis, with an area under the curve (AUC) of 0.799 (95% confidence interval [CI] 0.723–0.876; p < 0.001). Concordant pressure–oxygenation change was more frequent among patients with ≥20% desaturation (31/43, 72.1%), whereas discordant change predominated among those without desaturation (228/279, 81.7%; p < 0.001). In multivariable analysis, Awake→Intubated ipsilateral ΔrSO₂/ΔMAP remained associated with clamp-related ≥20% desaturation after adjustment (adjusted odds ratio [OR] 1.63, 95% CI 1.15–2.33; p = 0.006), along with symptomatic presentation and 50–69% contralateral stenosis. Postoperative stroke occurred in 4/322 patients (1.2%), and no 30-day mortality occurred. Conclusions: During NIRS-guided selective CEA, induction-phase rSO₂–MAP dynamics were associated with subsequent cross-clamp-related ipsilateral cerebral desaturation. As the outcome was a NIRS-defined desaturation rather than an independent clinical, neurological, or imaging endpoint, these findings indicate association with a surrogate marker rather than prediction of clinically relevant cerebral ischaemia. The Awake→Intubated ΔrSO₂/ΔMAP ratio and directional pressure–oxygenation pattern may represent early adjunctive physiological signals associated with clamp-related desaturation. These findings are hypothesis-generating and require prospective validation with systematic multimodal monitoring. Full article