Search Results (10,171)

Background: The prognostic significance of histological transformation (HT) in treatment-naive diffuse large B-cell lymphoma (DLBCL) remains controversial. This study aimed to evaluate the clinical outcomes and failure patterns of treatment-naive transformed DLBCL (trDLBCL) compared with de novo DLBCL using a large-scale cohort. Methods: We retrospectively analyzed 1735 consecutively enrolled treatment-naive DLBCL patients (118 trDLBCL and 1617 de novo). Propensity score matching (PSM) was performed to balance baseline characteristics. Survival outcomes were assessed using Kaplan–Meier and Cox proportional hazards models. Subgroups were defined by pathology (t-FL vs. t-MZL) and pattern: concurrent (synchronous indolent lymphoma and DLBCL components at diagnosis)vs. pure transformation (DLBCL occurring as the sole histology in patients with a prior history of untreated indolent lymphoma). Results: In the overall cohort, trDLBCL was associated with significantly inferior progression-free survival (PFS) compared with de novo disease and remained an independent adverse prognostic factor in multivariable analysis (HR 1.754, p < 0.001). These findings were confirmed in a 1:1 propensity score-matched cohort (108 pairs), where trDLBCL continued to show worse PFS (p < 0.01), while overall survival (OS) was comparable (p = 0.99). Within trDLBCL patients, the underlying indolent subtype (t-FL vs. t-MZL) did not significantly affect survival (PFS p = 0.17, OS p = 0.35), whereas “pure transformation” was associated with markedly inferior PFS (p = 0.005) and OS (HR 2.56, p = 0.02) compared with concurrent transformation. Failure pattern analysis revealed a higher risk of early progression in trDLBCL (POD24: 30.56% vs. 18.52%; OR 1.94, 95% CI: 1.05–3.56), whereas central nervous system (CNS) involvement was low and comparable between groups (2.78% vs. 0.93%, p = 0.62). Conclusions: Treatment-naive trDLBCL is associated with inferior PFS driven by early progression, whereas OS is comparable due to effective salvage therapies. Pure transformation appeared to define a higher-risk subgroup with inferior disease control, supporting the need for future prospective studies to evaluate risk-adapted frontline, consolidation, or maintenance strategies. Full article

The reliability of engineering structures is essential to ensure safety, durability, and sustainability. In reinforced concrete (RC), shear resistance is one of the most uncertain design aspects due to the natural variability of material properties and construction quality. Conventional design methods defined by Eurocode rely on characteristic values and partial safety factors that may not reflect the actual performance of in situ concrete. This study proposes a probabilistic framework for shear assessment that integrates material variability derived from conformity testing. Statistical parameters, including mean value and coefficients of variation (COV) of compressive strength, are incorporated into comparative reliability analysis using the First-Order Reliability Method (FORM) and Latin Hypercube Sampling (LHS). Parametric analyses are performed to quantify the influence of material variability on the reliability index β and failure probability P_f. The effect of varying the coefficient of variation (CoV) of the concrete compressive strength is investigated in the range from 0.01 to 0.2, both under the assumption of statistical independence and with consideration of correlation between selected variables. The sensitivity analysis is carried out to provide clear insight into the influence of uncertainty in the input parameters on the reliability of the considered limit state. The proposed framework provides a more realistic representation of structural safety and supports data-driven, performance-based management of concrete infrastructures. Full article

Excitotoxicity is one of the factors that participates in neurodegeneration, impairing neuronal and glial cells’ function, and leading to the development of chronic neurodegenerative diseases. The main mechanism of action lies in the overstimulation of excitatory receptors, especially the NMDA (N-methyl-D-aspartic acid) receptor, by glutamate, which promotes a massive influx of Ca²⁺ that is not sufficiently buffered by the intracellular machinery, or not released by mechanisms such as Ca²⁺ ATPase and plasma membrane Ca²⁺/Na⁺ exchanger promoting, among other toxic effects, mitochondrial damage and an increase in reactive oxygen species (ROS). Notably, many cases reported of long COVID-19 describe significant brain alterations and neuropsychiatric disorders, including delirium, depression, etc., and patients required increased use of antidepressant or anxiolytic drugs, for example. In addition, emerging evidence links neurodegeneration as a potential long-term sequelae associated with an increased number of patients with cognitive disorders. This review analyzes data from the literature regarding brain alterations associated with post-COVID-19 syndrome and explores a potential link to the excitotoxicity pathways, due to its participation in neurodegeneration by homeostatic failure, and it is clearly present in various brain conditions, such as Alzheimer’s and Parkinson’s diseases. Full article

The reliability assessment of power supply systems is complicated by the branched network topology, redundancy, switching operations, post-failure restoration, operating constraints, and uneven equipment degradation. Additional difficulties arise because calculations based on averaged normative parameters often fail to reflect the actual condition of specific components. This review critically compares reliability assessment methods for power supply systems, with particular attention to the technical condition of electrical equipment. Fault tree analysis and the logic–probabilistic method are discussed as structural approaches. Markov models are examined as tools for describing transitions between equipment states. Monte Carlo-based simulation is considered for calculating adequacy deficits and the operational consequences of supply interruptions. Reliability parameterization based on health indices, correction factors, and consumed life is also analyzed. The analysis indicates that no single methodology is equally effective at all problem levels. The main contribution is to separate technical condition parameterization, structural operability modeling, and adequacy assessment into interacting layers. This structure links condition indicators, such as health indices or consumed life, with system-level reliability and deficit indices through element-state probabilities. The review therefore supports a multi-level framework in which technical condition is considered at the element level, structural reliability is evaluated by the logic–probabilistic method, and failure consequences are assessed by simulation. Full article

Glass fiber/epoxy (GF/EP) composites are widely used in high-voltage electrical equipment due to their excellent specific strength, durability and dielectric properties. However, long-term exposure to hygrothermal environments will lead to performance degradation of the material, which seriously threatens its service reliability. To solve this problem, accelerated aging tests were systematically carried out in this study by immersing GF/EP specimens in deionized water at room temperature and 80 °C. The performance evolution laws and failure mechanisms of the material were investigated through moisture absorption kinetic analysis, tensile property testing, scanning electron microscope (SEM) fracture observation and breakdown voltage testing. The results show that the initial moisture absorption behavior of the material follows the Fickian diffusion mechanism, and the water diffusion rate at 80 °C is 31.8 times that at room temperature. After 35 days of aging, the retention rate of the maximum tensile force is 86.6% for the room temperature group, while it decreases to 38.2% for the 80 °C group. SEM observations show that the failure mode of the material changes from ductile fracture to brittle fracture after aging at 80 °C, accompanied by serious interfacial debonding. Temperature is the dominant factor for insulation performance degradation: the breakdown voltage retention rate is above 91% at room temperature, while it decreases to about 37% at 80 °C, and the influence of 60% maximum tensile force ($F_{\mathrm{m}\mathrm{a}\mathrm{x}}$) preloading is relatively small. This study provides experimental data and theoretical support for the performance evaluation and life prediction of GF/EP composites in harsh hygrothermal service environments of high-voltage electrical equipment. Full article

Operational shutdowns following hazardous liquid pipeline incidents are critical but poorly understood events that impact the U.S. energy supply. Although prior research has investigated the causes and outcomes of pipeline failures, limited work has explained what drives both the likelihood of a shutdown and the duration once it begins. The goal of this study is to address this gap by developing a hurdle regression model to examine the two-stage shutdown mechanism in pipeline incidents, using the Pipeline and Hazardous Materials Safety Administration (PHMSA) incident dataset from 2010 to 2025. The hurdle model consists of a logistic regression restricted to pre-decision predictors to model the probability of shutdown, and a lognormal regression to model the duration of those leading to shutdown. The results revealed that distinct factors are associated with each outcome. Shutdown probability is associated with pre-decision operational and contextual indicators, including operating pressure at the time of incident, accident type, location, monitoring presence, and response delay. In contrast, shutdown duration is associated with logistical complexity and post-incident severity, including incidents at pipeline crossings, pressures exceeding 110% of the maximum operating pressure, and reported property damage. These findings, while exploratory in nature given the use of public incident data, offer practical reference points for operators and regulators who aim to shorten recovery time and strengthen the resilience of energy infrastructure. Full article

Background and Objectives: There is limited evidence supporting the incorporation of dietary patterns into heart failure (HF) management. The Dietary Approaches to Stop Hypertension (DASH) diet is linked to cardiovascular disease prevention, but evidence correlating DASH adherence to HF risk is sparse. This study is the first prospective investigation into the relationship between the DASH diet, incident HF and its associated risk factors—hypertension and diabetes mellitus (DM)—in Australian women. Materials and Methods: Survey data (2001–2022) from the Australian Longitudinal Study on Women’s Health (ALSWH) was analysed, where DASH diet scores were calculated from food frequency questionnaire (FFQ) responses and categorised into quintiles. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between DASH adherence and incident HF. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% CIs for secondary endpoints, hypertension and DM, and dietary exposure was modelled as a time-varying covariate. Results: 10 594 women (mean age 52.5 ± 1.45 years) participated and, at 21-year follow-up, there were 136 (1.3%) cases of HF, 2182 (20.6%) and 994 (5.7%) cases of hypertension and DM, respectively. After adjustment for covariates (including age and socioeconomic factors), no association was found between the highest DASH quintile and incident HF [OR 0.73, 95% CI: 0.37–1.43; p = 0.20]. However, adjusted HRs for hypertension and DM—0.73 (95% CI: 0.63–0.84; p < 0.001) and 0.65 (95% CI: 0.53–0.81; p < 0.001), respectively—indicated significant associations. Conclusions: In Australian women, DASH diet adherence was associated with a significantly lower risk of hypertension and DM, both of which are HF risk factors. The finding of no direct statistically significant association between the DASH diet and incident HF might reflect the small incidence of HF in our cohort. Full article

Background: Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening soft tissue infection characterized by fascial necrosis, with mortality rates of 20–30%. Despite its rarity, NF is increasingly encountered due to the rising prevalence of predisposing factors. Data from Southern European tertiary centers remain scarce. Methods: We retrospectively reviewed all patients ≥18 years with radiological and/or surgical diagnosis of NF managed at IRCCS Policlinico San Matteo, Pavia, Italy, between November 2018 and August 2023. Clinical, microbiological, and treatment data were extracted from electronic medical records. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was calculated retrospectively. The Charlson Comorbidity Index was computed for each patient. Given the small sample size, we adopted a purely descriptive analytical approach without inferential testing. Results: Thirteen patients met inclusion criteria (median age 58 years, IQR 44.5–79.5; 69.2% male). The most common comorbidities were diabetes mellitus (6/13, 46.2%), renal failure (4/13, 30.8%), and chronic liver disease (4/13, 30.8%). The age-adjusted Charlson Index ranged from 0 to 11 (median 4). Lower limbs were the most frequently affected anatomic site (5/13, 38.5%), followed by the perineal/genital region (Fournier gangrene, 4/13, 30.8%). Type II (monomicrobial) NF predominated (9/13, 69.2%). Microbiological cultures were positive in 8/13 patients (61.5%): Gram-positive cocci were isolated in 5/8 (62.5%) and mixed aerobic/anaerobic flora in 3/8 (37.5%). Empirical antibiotic regimens included a piperacillin–tazobactam backbone in 6/12 (50.0%) patients and a meropenem-based combination in 5/12 (41.7%); 6/12 patients underwent targeted de-escalation after culture results. Two patients (15.4%) died in hospital, both with Fournier gangrene and Type I infection (mortality 2/4, 50.0% in Type I vs. 0/9 in Type II). The median length of stay was 26 days (IQR 17–28.5). All patients had LRINEC ≥6 at admission, with 9/13 (69.2%) classified as high risk (≥8). Conclusions: In this small retrospective Italian cohort, NF was most frequently associated with diabetes and high comorbidity burden. Type I (polymicrobial) infections, predominantly involving the perineal region, showed worse outcomes than Type II infections. The clinical experience accumulated during this study period subsequently informed the development of an institutional empirical antimicrobial protocol for skin and soft tissue infections at our hospital. Full article

Anastomotic leakage (AL) is a significant complication associated with elevated morbidity and mortality rates following colorectal surgery. This complication primarily arises due to impaired wound healing. Anastomotic and intestinal wound healing is generally divided into three phases: inflammation, proliferation, and remodeling. The physiological transition between these phases is primarily orchestrated by macrophages, which are key regulators of inflammation and tissue repair. They undergo sequential phenotypic changes from pro-inflammatory to anti-inflammatory states and are involved in the phagocytosis of bacteria or debris, but also attract fibroblasts for collagen production and deposition. Importantly, they can promote local perfusion by secreting pro-angiogenic and growth factors. Failure of this transition from pro- to anti-inflammatory properties is associated with AL, scarring, and fibrosis. Intestinal macrophages represent the largest pool of resident myeloid cells and are promising cellular targets for therapeutic interventions. In this narrative review, we focus on intestinal and anastomotic wound healing, highlight the dichotomous role of macrophages, and discuss potential therapeutic strategies. A detailed understanding of macrophage polarization, recruitment, and targeted modulation may enhance wound healing and prevent complications such as AL. Full article

Compression testing of high-performance carbon fiber composites remains challenging due to premature failure modes in unidirectional laminates, which can underestimate true material strength. This study investigates the compressive behavior of T800-grade carbon fiber-reinforced polymer (CFRP) cross-ply ([90/0]_2s) and unidirectional ([0]₈) laminates using finite element simulation and experimental testing following the SACMA SRM-1R-94 standard, combined with macroscopic and microscopic failure analysis. The results show that cross-ply laminates consistently exhibit valid mid-gauge failure with lower data dispersion (coefficient of variation: 3.44%), whereas unidirectional laminates are prone to invalid root failures (crushing or shear). The compressive strength derived from cross-ply laminates using the back-out factor (2040 MPa) is 13% higher than that from direct unidirectional testing (1802 MPa), attributed to the in situ effect where adjacent 90-degree plies suppress fiber microbuckling. The cross-ply approach provides a more reliable and practical method for characterizing the true in situ compressive strength of high-performance CFRP composites. Full article

This study investigated the degradation behavior of a polyurethane acrylate coating/Q345B steel system under the coastal atmospheric conditions of Wenchang, Hainan, and evaluated the correlation between indoor accelerated tests and outdoor exposure. Outdoor exposure tests, single-factor accelerated tests (UV irradiation and neutral salt spray), and a multi-factor cyclic accelerated test combining UV, salt spray, humidity, and thermal cycling were conducted. Coating degradation was characterized by morphological observation, gloss measurement, adhesion testing, and electrochemical impedance spectroscopy. The results showed that after 8 months of outdoor exposure, localized rust spots, blistering, and under-film corrosion appeared on the coating surface. The gloss loss rate reached 15.72% after 3 months, while adhesion decreased from 5.83 MPa to 2.39 MPa during prolonged exposure. UV irradiation mainly affected gloss degradation, whereas corrosive media penetration played a dominant role in adhesion loss and electrochemical deterioration. Compared with single-factor tests, the multi-factor cyclic accelerated test exhibited the highest correlation with outdoor exposure. The corresponding correlation coefficients for gloss loss, adhesion, and low-frequency impedance modulus were 0.9764, 0.9988, and 0.9929, respectively, while the gray relational coefficients reached 0.8334, 0.8467, and 0.7977. These results demonstrate that the multi-factor cyclic accelerated test more accurately reproduces the degradation behavior and failure characteristics observed in the coastal atmosphere of Hainan. The proposed method provides a practical approach for indoor–outdoor correlation analysis and durability evaluation of protective coatings in marine atmospheric environments. Full article

Containerized mobile power supplies (CMPS), a critical energy replenishment carrier for all-electric ships, have caused severe economic losses via frequent fire and explosion accidents during temporary port storage in recent years. Existing literature focuses on battery thermal runaway under laboratory conditions and maritime transport risk analysis, but its conclusions are not directly applicable to port temporary storage. Port storage, featuring full-charge quiescent placement and high turnover, differs significantly from maritime transport, while its high-temperature and humid environment is distinct from laboratory settings. Furthermore, no system safety-based risk assessment framework exists, failing to deliver targeted mitigation strategies for practical operations. To address these issues, fault tree analysis (FTA), Bayesian network (BN), and attack–defense game theory were combined to build a systematic safety risk assessment framework. FTA clarified the hazard factors’ correlation mechanism; based on FTA, BN conducted a quantitative evaluation. Extended from BN results, attack–defense game theory identified key risk evolution paths and formulated targeted prevention and control measures. The main conclusions are as follows: Combined with similar accident features and port storage scenario attributes, internal correlations between hazard-inducing factors were clarified via FTA. Based on expert evaluations and BN calculation, the target port’s fire accident occurrence probability was determined as 2.41%, with two core root nodes identified via sensitivity analysis. Two critical risk evolution paths corresponding to IE1 (thermal runaway initiation) and IE2 (failure of protection and emergency response systems) were identified via game theory and traversal method, with occurrence probabilities of 1.50% and 1.77%, respectively. Targeted prevention and control measures adapted to the port storage scenario were proposed based on path triggering mechanisms. These findings provide theoretical support for port enterprises to improve CMPS fire prevention and emergency response capabilities, elevate port safety management levels, and promote the safe development of the all-electric vessel shipping industry. Full article

Road-railway combined steel truss bridges are increasingly adopted in urban infrastructure due to their structural efficiency and versatility. This study proposes a three-level multi-scale finite element framework to investigate the safety reserve and progressive failure mechanism of a four-span (80 + 120 + 120 + 80 m) continuous steel truss bridge carrying both highway and railway traffic. At the macro level, a beam element model was established in Midas/Civil to determine the most unfavorable loading configurations, yielding a minimum buckling load factor of 31.0 under dead load and a maximum vertical displacement of 175 mm at mid-span under combined traffic loading. At the meso level, a mixed beam–shell element model incorporating geometric and material nonlinearities was developed in ABAQUS, revealing an ultimate load factor of 6.61 with distinct progressive failure characteristics: initial yielding occurs near the intermediate pier supports, where deformation is constrained, while final instability develops at Joint A17 due to its lower relative stiffness. At the micro level, a refined solid-shell submodel of the critical joint, driven by displacement boundary conditions extracted from the global model, was constructed to capture the local failure mechanism. The results demonstrate that the governing failure mode is shear buckling of the gusset plate, induced by a vertical displacement differential of approximately 30 mm between the web members on opposite sides of the joint arising from differential stiffness. The stress analysis further reveals pronounced stress concentrations in the splice plates adjacent to the more flexible web member, confirming the asymmetric load distribution mechanism. Based on these findings, strengthening measures including increased gusset plate thickness at pier-top joints, optimized chord sections, and the use of higher-strength steel in critical regions are recommended. Full article

Pavement repair has become an increasingly time-critical operation as traffic volumes grow and lane-closure windows shrink. This has driven demand for materials that gain full structural strength quickly, reopen to traffic within hours, and hold up longer than conventional patches. This study evaluates polymer concrete (PC), a thermosetting resin-bound aggregate system, through combined laboratory characterization and three-dimensional finite element analysis. Compressive strength, splitting tensile strength, unit weight, and apparent porosity were measured at 1, 3, 7, and 28 days of curing. PC reached 85.97 MPa in compression and 7.63 MPa in tension by day three, with near-zero porosity (0.15%) maintained throughout. These three-day values were used directly as material inputs in the three-dimensional finite element analysis (FEA), reflecting the early traffic reopening scenario that defines rapid repair practice. Structural performance was assessed through 36 static analyses in ANSYS 2024 R2, covering flexible (Hot Mix Asphalt, HMA) and rigid (Jointed Plain Concrete Pavement, JPCP) pavement types, three patch sizes (250 × 250 mm, 500 × 500 mm, and 1000 × 1000 mm), and nine load scenarios per configuration. Safety factors (SF) against internal cracking, interfacial debonding, and compressive failure were computed for both PC and traditional patches. PC consistently outperformed HMA and Portland cement concrete patches across all metrics. On rigid pavements, interfacial safety factors exceeded 22.0, confirming that standard surface preparation is sufficient. On flexible pavements, adopting 0.78 MPa as a conservative lower-bound estimate of PC-HMA interfacial bond strength, five scenarios exhibit debonding risk (250-C, 500-C, 500-D, 1000-C, and 1000-D; SF = 0.47–0.99), while the remaining four show high interfacial risk (SF = 1.11–1.30); primer application and mechanical scarification are required for all PC repairs on flexible pavements regardless of patch geometry. Taken together, the experimental and numerical evidence positions PC as a credible, high-performance option for highway repair. Full article

In shale gas extraction, solid particles such as fracturing proppants cause erosion in production and transmission pipelines. Cyclone desanders are widely used for gas–solid separation, but high-velocity sand-laden fluids frequently induce equipment failure, leakage and safety risks. Therefore, research on erosion and protective measures is essential. This study focuses on the desander at the M shale gas wellhead, where wall thickness was measured at three monitoring points to determine erosion rates. A CFD-based numerical erosion model for the cyclone desander was developed using ANSYS Fluent within the ANSYS Workbench 19.2 environment (ANSYS, Inc., Canonsburg, PA, USA). The model was validated by comparing simulation results with field data, revealing the distribution patterns of the velocity field, pressure field, and erosion rate. The study analyzed the impact of nine factors on desander erosion: inlet aspect ratio, cylinder radius, cone length, dust discharge port diameter, exhaust port diameter, particle size, particle concentration, inlet velocity, and operating pressure, clarifying the erosion variation patterns for each factor. SPSSAU V25.0 (Beijing Qingsi Technology Co., Ltd., Beijing, China) was employed to analyze the significance of these nine factors, identifying six significant influencing factors: inlet aspect ratio, cylinder diameter, dust discharge port diameter, particle size, particle concentration, and inlet velocity. Subsequently, response surface analysis was performed using Design-Expert 13 (Stat-Ease, Inc., Minneapolis, MN, USA) to obtain the relationship between the factors and their impact on maximum erosion, leading to the establishment of a predictive model for the maximum erosion rate. In addition, geometry optimization, local wall thickening, coating protection, material selection, and bionic rib structures were discussed as erosion-mitigation strategies. The optimized geometry reduced the erosion rate at the inlet and dust discharge outlet by 20.4% and 21.8%, respectively, while the bionic rib structure reduced the maximum erosion rate by 58%. Full article