Search Results (26)

Background: Esophagectomy remains a technically demanding oncologic procedure with substantial morbidity, despite ongoing advances in minimally invasive and robotic techniques. Limitations in intraoperative visualization and anatomical recognition contribute to complications such as nerve injury and bleeding. Artificial intelligence (AI)-based intraoperative video analysis has emerged as a potential adjunct to enhance surgical perception and safety, but its application in esophagectomy has not been comprehensively reviewed. Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Scopus, and Web of Science were searched without a lower date limit to identify eligible studies published up to January 2026, capturing early and contemporary applications of intraoperative AI in esophagectomy. Human studies involving any surgical approach were included. Data on the AI task, methodology, validation strategy, performance metrics, and reported clinical outcomes was extracted. Risk of bias was assessed using the ROBINS-I tool. Results: Six studies met the inclusion criteria, predominantly evaluating AI-driven analysis of intraoperative video during minimally invasive or robotic esophagectomy. Reported applications included real-time anatomical structure recognition, recurrent laryngeal nerve segmentation, detection of excessive nerve traction, instrument and event recognition, and surgical phase identification. Across studies, AI systems demonstrated performance comparable to expert surgeons for selected tasks and achieved real-time or near–real-time inference. One study reported earlier detection of excessive recurrent laryngeal nerve traction compared to conventional nerve integrity monitoring. However, most studies were retrospective, single-center, and feasibility-focused, with limited external validation and minimal assessment of patient-centered clinical outcomes. Conclusions: Artificial intelligence-based intraoperative analysis in esophagectomy is increasingly achievable and may enhance anatomical recognition, intraoperative risk detection, and procedural awareness. Nevertheless, current evidence remains preliminary, heterogeneous, and largely exploratory. Prospective, multicenter studies with standardized reporting and clinically meaningful outcome evaluation are required before routine implementation. Until such data is available, AI should be regarded as a complementary intraoperative tool rather than a standalone clinical decision-making system. Full article

The Himalayan metallogenic belt is a globally significant province for leucogranites and pegmatites. Recent exploration has yielded major breakthroughs in the exploration of pegmatite-type Li-Be-Nb-Ta rare-metal deposits within its eastern segment. Discoveries such as the Qiongjiagang and Lhozhag deposits underscore the region’s substantial mineralization potential. In contrast, the western Himalayan segment remains comparatively underexplored. This study presents the geology and geochronology of the newly identified Zhaguopu Li-Be-Nb-Ta deposit in the Gyirong area, providing critical new insights. The deposit is centered on the Gyirong granite dome, which features a core of tourmaline-bearing leucogranite surrounded by a peripheral zone of beryl-bearing pegmatites and vein- to lens-shaped spodumene pegmatites, all hosted within metamorphosed sandstone, slate, and marble. The largest individual spodumene pegmatite vein exceeds 400 m in length, with thicknesses ranging from 0.5 to 4 m and a cumulative thickness surpassing 50 m. Principal ore minerals include spodumene, beryl, and columbite-group minerals. U-Pb geochronology of zircon, monazite, and columbite-group minerals from the leucogranite and pegmatite units constrains the rare-metal mineralization to a tight interval of 25–23 Ma, contemporaneous with the Qiongjiagang and Lhozhag deposits. Whole-rock geochemical data define a coherent fractional crystallization sequence from tourmaline granite through beryl pegmatite to spodumene pegmatite, characterized by increasing SiO₂ and peraluminosity, and extreme depletion in Ba, Sr, Eu and Nb/Ta ratios. This geochemical trend underscores the critical role of extreme magmatic differentiation in rare-metal enrichment. Field relationships and these coeval ages strongly support a genetic model in which the mineralized pegmatites originated from the extreme fractional crystallization of a common, cogenetic magmatic suite. The timing of this mineralization event correlates precisely with the post-collisional extension of the Himalayan orogen and the activity of the Southern Tibet Detachment System. We conclude that the interplay between this large-scale tectonism and magmatic differentiation is the fundamental driver for rare-metal enrichment. The discovery of the Zhaguopu deposit highlights the significant and previously underestimated potential for major pegmatite-type rare-metal deposits in the western Himalayan belt. Full article

Conventional Security Operations Center (SOC) solutions struggle to process representative operational alert streams efficiently and adapt to evolving cyber threats, highlighting the need for automated, intelligent threat detection and prioritization. This study presents a custom AI-driven framework that leverages unsupervised learning techniques to support SOC analysts in cyber threat detection, anomaly identification, and alert prioritization. The framework applies several clustering methods: HDBSCAN, DBSCAN, KMeans, and Gaussian Mixture Models for alert segmentation, and integrates anomaly detection using LOF and Isolation Forest, complemented by semi-supervised detection via One-Class SVM. Using textual, categorical, and numerical features from Wazuh alerts across three datasets, the system performs clustering and anomaly detection in the original high-dimensional feature space, with UMAP applied solely for two-dimensional visualization. HDBSCAN consistently produced well-separated clusters with effective noise detection, while, Isolation Forest evaluated via 10-fold cross-validation exhibited stable anomaly flagging and clear score separation across both cyber alert event data and synthetic threat injection experiments. Furthermore, the framework formulates a composite priority ranking that integrates anomaly severity, cluster rarity, and SOC contextual weighting, yielding actionable alert rankings. An interactive, analyst-centric dashboard enables SOC teams to explore top alerts, clusters, associated MITRE techniques, priority rankings, and geolocation data, providing insights while preserving human oversight. Overall, the proposed system transforms complex alert streams into structured insights, enhancing SOC situational awareness, decision support, and operational efficiency. Full article

The hard bottom layer in paddy fields significantly impacts the driving stability, operational quality, and efficiency of agricultural machinery. Continuously improving the precision and efficiency of unmanned, precision operations for paddy field machinery is essential for realizing unmanned smart rice farms. Addressing the unclear influence patterns of hard bottom contours on typical scenarios of agricultural machinery motion and posture changes, this paper employs a rice transplanter chassis equipped with GNSS and AHRS. It proposes methods for acquiring motion state information and hard bottom contour data during agricultural operations, establishing motion state expression models for key points on the machinery antenna, bottom of the wheel, and rear axle center. A correlation analysis method between motion state and hard bottom contour parameters was established, revealing the influence mechanisms of typical hard bottom contours on machinery trajectory deviation, attitude response, and wheel trapping. Results indicate that hard bottom contour height and local roughness exert extremely significant effects on agricultural machinery heading deviation and lateral movement. Heading variation positively correlates with ridge height and negatively with wheel diameter. The constructed mathematical model for heading variation based on hard bottom contour height difference and wheel diameter achieves a coefficient of determination R² of 0.92. The roll attitude variation in agricultural machinery is primarily influenced by the terrain characteristics encountered by rear wheels. A theoretical model was developed for the offset displacement of the antenna position relative to the horizontal plane during roll motion. The accuracy of lateral deviation detection using the posture-corrected rear axle center and bottom of the wheel center improved by 40.7% and 39.0%, respectively, compared to direct measurement using the positioning antenna. During typical vehicle-trapping events, a segmented discrimination function for trapping states is developed when the terrain profile steeply declines within 5 s and roughness increases from 0.008 to 0.012. This method for analyzing how hard bottom terrain contours affect the position and attitude changes in agricultural machinery provides theoretical foundations and technical support for designing wheeled agricultural robots, path-tracking control for unmanned precision operations, and vehicle-trapping early warning systems. It holds significant importance for enhancing the intelligence and operational efficiency of paddy field machinery. Full article

Background: The asymmetric distribution of optical photons near the edges of Positron Emission Tomography (PET) sensor modules introduces errors in the coordinate reconstruction of scintillation events when center-of-gravity (CoG) algorithms are utilized. This issue, sometimes referred to as the “edge effect”, results in overlap of crystal pixel signatures in flood maps and potential image artifacts in reconstructed PET images. Methods: Partly segmented 5 mm thick borosilicate light guides with slits cut parallel to the edges are filled with barium sulfate to restrict the spread of optical photons near the edges of the light guide. Data acquisitions are performed using single PET sensor modules in coincidence, both with single and multiplexed channel readout. CoG and truncated center-of-gravity (TCoG) methods are used for coordinate reconstruction. Results: A 22 × 22 array of crystal signatures are distinguishable on crystal flood maps produced using sensor modules with solid light guides and 24 × 24 arrays can be identified when using a partly segmented light guide. The pixel resolution around the edges and corners of the flood map is further improved when TCoG is used for coordinate reconstruction. Summary: We show that the introduction of a partly segmented light guide greatly improves coordinate reconstruction accuracy at the edges of a sensor module. In addition, it is demonstrated that the partly segmented light guides can be used in parallel with other proposed methods designed to fix the “edge effect”, including TCoG, to further coordinate reconstruction improve accuracy and crystal flood map quality. Full article

Storm surges pose a significant threat to coastal regions worldwide, particularly as sea levels continue to rise due to climate change. This study aims to develop a storm surge height prediction model for the southeastern coast of Korea using a multiple linear regression (MLR) approach. Typhoon characteristics, including location and intensity derived from best-track data, were used as independent variables, while observed storm surge heights served as the dependent variable. The model’s predictive performance was assessed using the Root Mean Square Error (RMSE), Mean Absolute Error (MAE), Mean Squared Error (MSE) and the coefficient of determination (R²). To enhance model accuracy and interpretability, a threshold-based model configuration strategy was implemented by categorizing data according to (1) the distance between the typhoon center and the observation point, and (2) the magnitude of the observed storm surge height. The results indicate that restricting typhoon events to within 900–1000 km of the observation site and segmenting surge heights into low and high ranges significantly improves predictive skill, especially for extreme surge events. For example, at Masan station, the model achieved an R² of 0.82 for high storm surge height (>0.2 m), and Gwangyang station showed an R² of 0.57 at a 500 km distance threshold, demonstrating substantial skill in predicting extreme surges. However, limitations remain in capturing the variability of lower-magnitude surges, suggesting the need for future research incorporating nonlinear and ensemble methods. This study provides a foundation for improving coastal hazard prediction and contributes to the development of more effective early warning systems and risk management strategies. Full article

Under the context of global climate change, sea-level rise and frequent storm surge events pose significant challenges to coastal areas. Protecting coastlines from erosion, mitigating socio-economic losses, and maintaining ecosystem balance are critical for the sustainable development of coastal zones. The concept of “living shorelines” based on Nature-based Solutions (NbS) employs near-natural ecological restoration and protection measures. In low-energy coastal segments, natural materials are prioritized, while high-energy segments are supplemented with artificial structures. This approach not only enhances disaster resilience but also preserves coastal ecosystem stability and ecological functionality. This study constructs a coastal vitality evaluation system for Fujian Province, China, using the entropy weight method, integrating three dimensions: protective safety, ecological resilience, and economic vitality. Data from 2010 and 2020 were analyzed to assess the spatiotemporal evolution of coastal vitality. Results indicate that coastal vitality initially exhibited a spatial pattern of “low in the north, high in the center, and low in the south,” with vitality values ranging from 0.20 to 0.67 (higher values indicate stronger vitality). Over the past decade, ecological restoration projects have significantly improved coastal vitality, particularly in central and southern regions, where high-vitality segments increased markedly. Key factors influencing coastal vitality include water quality, cyclone intensity, biological shoreline length, and wetland area. NbS-aligned coastal management strategies and soft revetment practices have generated substantial ecological and economic benefits. To further enhance coastal vitality, region-specific approaches are recommended, emphasizing rational resource utilization, optimization of ecological and economic values, and the establishment of a sustainable evaluation framework. This study provides scientific insights for improving coastal protection capacity, ecological resilience, and economic potential. Full article

Background: Treating varicosities originating from a popliteal fossa perforating vein (PFPV) is challenging due to their proximity to nerves and complex morphology. Data on endovenous laser ablation (EVLA) for PFPV varicosis are limited. Methods: This retrospective, single-center study reviewed all primary varicose vein surgeries from May 2021 to December 2024. Only primary PFPV varicosis cases with CEAP stage C2s or higher were included. Patients with recurrent disease or primary truncal insufficiency due to reflux from the saphenopopliteal junction were excluded. EVLA was performed using 1470 nm radial laser catheters, targeting the reflux source and downstream varicose segments. Tumescent solution was applied to protect the surrounding structures. The primary outcome was early technical success via duplex ultrasound; the secondary outcome was the complication rate. Results: Of the 2375 limbs treated, 44 (1.9%) involved PFPV. The cohort included 16 men (36%) and 28 women (64%), with a mean age of 54. The median follow-up was 14 days. Technical success was achieved in 41 cases (93.2%). Foam sclerotherapy with polidocanol was performed in eight patients (18.2%), exclusively for superficial residual varicosities and never simultaneously with EVLA. Three treatment failures required re-operation, two of which were successfully re-treated. Minor postoperative complications occurred in two patients (4.5%). No nerve injuries or thrombotic events were observed. Conclusions: EVLA shows promising very early technical efficacy, with low morbidity, for treating PFPV varicosis. Based on our findings, prospective studies investigating the mid- and long-term outcomes of this technique are warranted to further validate its clinical utility. Full article

Background/Objectives: Available data suggest the diagnostic potential of testing microRNAs (miRs) in myocardial infarction, but their prognostic value remains unclear. To evaluate the prognostic value of circulating miRs (miR-1, miR-21, miR-133a, miR-208 and miR-499) for predicting major adverse cardiac events (MACEs), including death, non-fatal myocardial infarction (MI) or cardiovascular rehospitalization, in patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS). Methods: Our prospective, single-center, observational study included patients (pts) with NSTE-ACS admitted <24 h after symptoms onset and pts with confirmed stable coronary artery disease (SCAD) as controls. Relative expression of miRs was calculated, and subjects were categorized according to miRs expression on hospital admission into two groups (≤median and >median). Results: Overall, 103 NSTE-ACS (52 NSTEMI/51 UA) and 47 SCAD pts (median age 66 years, 67% male) were included. During the median 895 (581–1134) days of the follow-up, MACE occurred in 75 (50%) patients: 20 (13%) died, 28 (19%) presented with MI, and 65 (43%) were readmitted due to cardiovascular reasons. Incidence of MI, rehospitalization and MACE was significantly higher in pts with elevated (>median) miR-499 [MI: 34.3% vs. 7.3%; HR = 6.0 (2.8–12.7) for rehospitalization; 53.7% vs. 36.2%, HR = 2.3 (1.4–3.8) for MACE; 62.7% vs. 42%, HR = 2.4 (1.5–3.8)] for hospital readmission. In the Cox proportional hazards regression model, miR-499 expression above the median level [HR = 1.8 (1.1–3.1)], high-sensitivity cardiac troponin T [HR = 1.2 (1.02–1.5)], diabetes [HR = 1.7 (1.1–2.8)] and percutaneous intervention during hospital stay [HR = 2.1 (1.1–3.8)] were identified as independent predictors of MACE in long-term observation, even after adjustment for covariates. Conclusions: Elevated miR-499 level on hospital admission in NSTE-ACS is related to an increased rate of MACE in the 2.5-year follow-up. Full article

(1) Background: Heart rate variability (HRV) has been investigated in the context of ST-segment elevation myocardial infarction (STEMI). This study contributes to the field by assessing short-term HRV during primary percutaneous coronary intervention (PCI) using wearable technology, providing real-time insights into autonomic function. (2) Methods: This single-center, observational cohort study included 104 STEMI patients undergoing primary percutaneous coronary intervention (PCI). HRV parameters (including SDNN, RMSSD, pNN50, HF, SD1, and SD2/SD1 ratio) were measured using a wearable device (Empatica E4 wristband, CE certified). Measurements were taken throughout the entire duration of the primary PCI, as well as specifically during the initial 5 min and the final 5 min of the procedure. The association between HRV parameters and adverse outcomes, including in-hospital mortality and in-hospital major adverse cardiovascular events (MACE), were assessed. (3) Results: HRV parameters significantly decreased after myocardial revascularization, particularly SDNN, RMSSD, pNN50, HF, SD1, and SD2/SD1 ratio. Significant associations were found between reduced SD2/SD1 ratio, approximate entropy, and adverse outcomes, including increased in-hospital mortality and in-hospital MACE (respectively, p = 0.007, p = 0.017 and p = 0.006 and p = 0.005). The SD2/SD1 ratio was significantly lower in patients who died during the hospital stay (p = 0.008) compared to survivors. Approximate entropy was also significantly lower in deceased patients (p = 0.019). (4) Conclusions: Real-time HRV monitoring using wearable technology offers valuable data regarding dynamic physiological changes during primary PCI. Further studies are required to validate these preliminary results and to explore their potential implications for clinical practice. Full article

Background: Ehlers–Danlos syndrome (EDS), Marfan syndrome (MFS), and Loeys–Dietz syndrome (LDS) are connective tissue disorders frequently associated with vascular aneurysm formation, dissections, and subsequent major complications. Regular imaging surveillance is recommended for these conditions. However, no guidelines currently exist regarding imaging modality or surveillance intervals. Methods: This retrospective single-center observational study analyzed clinical and imaging data of patients attending an outpatient clinic for vascular connective tissue disorders between August 2008 and January 2024. Imaging (1424 data points in total) and clinical data were extracted from electronic health records. Analysis primarily included a comparison of vessel diameter progression across imaging modalities, with an additional review of the clinical history of vascular events. Results: In total, 19 patients with vascular connective tissue disorders (vCTDs) underwent consultations at our outpatient clinic. Nine (47.4%) patients experienced vascular events, while two (10.5%) passed away during the study period. Multimodal imaging surveillance revealed a tendency towards arterial diameter increase. Consistent ultrasound monitoring provided more reliable diameter progression data for the same arterial segment than a combination of imaging modalities. Temporal analysis indicated a tendency for the continuous growth of the abdominal aorta, the common and internal carotid artery, and the common femoral and popliteal artery. Conclusion: The study highlights the importance of standardized, modality-specific imaging protocols in monitoring patients with vCTDs. The variability in disease progression among these patients further complicates surveillance strategies, contemplating the need for individualized approaches. Further research and prospective multicenter studies are required to refine and improve monitoring protocols. Full article

Crater detection is useful for research into dating a planetary surface’s age and geological mapping. The high-resolution imaging camera (HiRIC) carried by the Tianwen-1 rover provides digital image model (DIM) datasets with a resolution of 0.7 m/pixel, which are suitable for detecting meter-scale craters. The existing deep-learning-based automatic crater detection algorithms require a large number of crater annotation datasets for training. However, there is currently a lack of datasets of optical images of small-sized craters. In this study, we propose a model based on the Segment Anything Model (SAM) to detect craters in Tianwen-1’s landing area and perform statistical analysis. The SAM network was used to obtain a segmentation mask of the craters from the DIM images. Then non-circular filtering was used to filter out irregular craters. Finally, deduplication and removal of false positives were performed to obtain accurate circular craters, and their center’s position and diameter were obtained through circular fitting analysis. We extracted 841,727 craters in total, with diameters ranging from 1.57 m to 7910.47 m. These data are useful for further Martian crater catalogs and crater datasets. Additionally, the crater size–frequency distribution (CSFD) was also analyzed, indicating that the surface ages of the Tianwen-1 landing area are ~3.25 billion years, with subsequent surface resurfacing events occurring ~1.67 billion years ago. Full article

On 6 February 2023, Türkiye experienced a pair of consecutive earthquakes with magnitudes of Mw 7.8 and 7.5, and accompanied by an intense aftershock sequence. These seismic events were particularly impactful on the segments of the East Anatolian Fault Zone (EAFZ), causing extensive damage to both human life and urban centers in Türkiye and Syria. This study explores the analysis of a dataset spanning almost one year following the Turkiye mainshocks, including 471 events with a magnitude of completeness (Mc) ≥ 4.4. We employed the maximum likelihood approach to estimate the b-value and Omori-Utsu parameters (K, c, and p-values). The estimated b-value is 1.21 ± 0.1, indicating that the mainshocks occurred in a region characterized by elevated stress levels, leading to a sequence of aftershocks of larger magnitudes due to notable irregularities in the rupture zone. The aftershock decay rate (p-value = 1.1 ± 0.04) indicates a rapid decrease in stress levels following the main shocks. However, the c-value of 0.204 ± 0.058 would indicate a relatively moderate or low initial productivity of aftershocks. Furthermore, the k-value of 76.75 ± 8.84 suggests that the decay of aftershock activity commenced within a range of approximately 68 to 86 days following the mainshocks. The fractal dimension (Dc) was assessed using the correlation integral method, yielding a value of 0.99 ± 0.03. This implies a tendency toward clustering in the aftershock seismicity and a linear configuration of the epicenters. The slip ratio during the aftershock activity was determined to be 0.75, signifying that 75% of the total slip occurred in the primary rupture, with the remaining fraction distributed among secondary faults. The methodologies and insights acquired in this research can be extended to assist in forecasting aftershock occurrences for future earthquakes, thus offering crucial data for future risk assessment. Full article

Background: Endovascular techniques have gained preference over peripheral arterial bypass surgery due to their minimally invasive nature; however, endovascular treatments often show limited efficacy in arterial segments with a high atherosclerotic load. The use of atherectomy devices enables the removal of calcified plaque material and may promote arterial wall remodeling. This study assessed the technical success, safety, and feasibility of the BYCROSS^® atherectomy device in femoropopliteal lesions. Methods: This single-center, retrospective cohort study analyzed elective patients undergoing BYCROSS^® atherectomy for chronic peripheral arterial disease from March 2022 to May 2023. Patient data, procedural details, and outcomes were retrospectively collected from electronic patient records. The primary performance endpoints of this study were technical success, complications, and patency rates. Primary safety endpoints included 30-day and short-term major adverse limb events (MALEs), major adverse cardiovascular events (MACEs), and mortality rate. Results: The study included 19 patients (median age, 71 years; 63% male) with Fontaine class IIb (26%), III (21%), or IV (53%). The BYCROSS^® atherectomy device was used to treat 22 limbs in the femoropopliteal tract, of which 11 lesions (50%) were occlusions and 11 were stenoses, with a median length of 24 cm (interquartile range: 17–38). Technical success was achieved in all cases: 4.5% required atherectomy only, 50% required additional balloon angioplasties, 41% required balloon angioplasties and stenting, and 4.5% required segments only stenting. Additional treatment of below-the-knee arteries was performed in 12 patients. Procedurally related complications (not limited to the use of the BYCROSS^® device) occurred in 23% of limbs, including distal embolization and laceration. At 30 days, mortality was 5%, the MACE rate was 11%, and the MALE rate was 0%. The observed mortality rate was not directly related to the procedure. Patency (<50% restenosis at duplex ultrasound) was 83% at 30 days. Conclusions: The use of the BYCROSS^® atherectomy device for the treatment of femoropopliteal lesions appears to be safe and feasible, with high technical success and low MALE and MACE rates in a challenging population with long-segment femoropopliteal lesions. Long-term follow-up in larger patient series is needed to confirm these findings and to determine the durability of this technique. Full article

Background: Minimally Invasive Staged Segmental Artery Coil Embolization (MIS²ACE) is a novel technique of spinal cord preconditioning used to reduce the risk of paraplegia in thoracoabdominal aortic aneurysm (TAAA) repair. In this study, we report our experience with MIS²ACE, including both degenerative and post-dissection TAAA, while we attempt to systematically summarize relevant data available in the literature. Design: single-center observational study with systematic review of the literature and meta-analysis. Methods: Initial retrospective analysis of 7 patients undergoing MIS²ACE over 12 sessions with a subsequent systematic review of the literature and meta-analysis of the available published data (PROSPERO protocol number: CRD42023477411). Baseline patient and aneurysm characteristics, along with procedural technique and outcomes, were analyzed. One-arm pooling of proportions was used to summarize available published data. Results: We treated seven patients (5 males, 71%) with a median age of 69 years (IQR 55,69). According to the Crawford classification, five patients (1%) had extent II TAAA, and two (29%) had extent III TAAA. Five patients (71%) had post-dissection -TAAA; four of them were after Stanford type A dissection, and one had a chronic type B dissection. Three patients (43%) had connective tissue disease. Of the seven patients, six (86%) underwent previous aortic surgery, while the median aneurysm diameter was 58 mm (IQR 55,58). MIS²ACE was successful in 11 sessions (92%). The median number of embolized arteries was 4 (IQR 1,4). There were no periprocedural complications in any embolization. The median embolization-operation time interval was 37.0 days (IQR 31,78). Two patients had open and five endovascular treatment. There were no events of spinal cord ischemia either after MIS²ACE or after the aortic repair. Out of the 432 initially retrieved articles, we included two studies in the meta-analysis, including patients with MIS²ACE for spinal cord preconditioning in addition to our cohort. The prevalence of pooled postoperative spinal cord ischemia among MIS²ACE patients is 1.9% (95% CI −0.028 to 0.066, p = 0.279; 3 studies; 81 patients, 127 coiling sessions). Conclusions: While the current published data is limited, our study further confirms that MIS²ACE is a technically feasible and safe option for spinal cord preconditioning. Full article