Search Results (185)

Objectives: The increasing incidence of unruptured intracranial aneurysms (UIAs) has led to significant demands on neurovascular boards. Large language models (LLMs), such as ChatGPT-4, ChatGPT-3.5, Claude, and Atlas GPT, have emerged as tools to support clinical decision-making. This study compares treatment recommendations from these AI models with those of an interdisciplinary neurovascular board to evaluate their accuracy and alignment. Methods: We retrospectively included all 57 patients with UIAs discussed by the neurovascular board in 2023. The board’s consensus decision served as the reference standard. Key clinical and radiographic data, including PHASES, ELAPSS, and UIATS scores, were provided to the AI models. Each model was tasked with recommending either conservative or operative management and specifying the treatment modality (clipping, coiling, flow diverter, or WEB device/flow diverter) where appropriate. AI model recommendations were compared with the board’s decisions for management and the specific treatment modality of the UIA. Results: ChatGPT-4 achieved the highest accuracy in correctly predicting conservative or operative management (89%) and specific treatment types (73%), followed by Atlas GPT (74% accuracy in conservative/operative decisions and 55% accuracy in specific treatment types), Claude (70% accuracy in conservative/operative decisions and 50% accuracy in specific treatment types), and ChatGPT-3.5 (82% accuracy in conservative/operative decisions and 27% accuracy in specific treatment types). ChatGPT-3.5 displayed a strong preference for clipping (94.3%). ELAPSS scores significantly influenced AI recommendations and decision-making, particularly for ChatGPT-4 and ChatGPT-3.5. Follow-up recommendations for conservative management were shorter among AI models, with Claude suggesting the shortest interval (7.72 months) compared to the neurovascular board’s 13.36 months. Conclusions: AI models, particularly ChatGPT-4, align closely with expert neurovascular board decisions and offer promising support for initial clinical decision-making, particularly in resource-limited settings. However, interdisciplinary neurovascular boards remain unreplaceable for UIA management, and AI should be viewed as a complementary tool. The observed improvement from ChatGPT-3.5 to ChatGPT-4 underscores the rapid evolution of AI technology, and further advancements are expected to enhance both performance and accuracy in the future. Full article

The fashion industry faces a critical sustainability crisis, contributing up to 10% of global carbon emissions and generating 92 million tons of textile waste annually. The study highlights the complex interplay of material flows, business models, power structures, and cultural mindsets, presenting a multi-scaled framework for advancing cleaner production and circularity in one of the world’s most resource-intensive sectors. This study proposes a transformative model for circular bioeconomy in fashion, integrating systems-change theory, degrowth economics, and emotional durability. Through case studies, including Patagonia, Eileen Fisher, and EU policy frameworks, the paper demonstrates how circular strategies can reduce waste, extend product lifecycles, and promote ethical labor practices. Notably, brands implementing take-back programs and recycled materials have diverted over 1.5 million garments from landfills and achieved up to 70% recycled content. The study critically addresses challenges such as technological solutionism, systemic greenwashing, and waste colonialism, concluding that incremental changes are insufficient. A paradigm shift in business models, consumer culture, and policy is essential for a regenerative and just fashion future. Full article

Flow-diverting stents (FDS) are sophisticated endovascular devices that aim to modulate blood flow and promote aneurysm thrombosis while maintaining branch vessel patency. Initially designed and developed for the treatment of intracranial aneurysms, these devices have since been applied to the peripheral circulation. However, they are still used sporadically, largely due to a lack of the scientific evidence supporting its use in visceral aneurysms. This review article aims to provide an overview of the current data on the clinical outcomes from the use of FDS in the treatment of complex visceral and renal aneurysms or pseudoaneurysms and to assess the added value of these devices. Full article

Chinese coalbed methane (CBM) reservoirs exhibit characteristically low recovery rates due to adsorbed gas dominance and “three-low” properties (low permeability, low pressure, and low saturation). CO₂ thermal drive (CTD) technology addresses this challenge by leveraging dual mechanisms—thermal desorption and displacement to enhance production; however, its effectiveness necessitates uniform fracture networks for temperature field homogeneity—a requirement unmet by conventional long-fracture fracturing. To bridge this gap, a coupled seepage–heat–stress–fracture model was developed, and the temperature field evolution during CTD in coal under non-uniform fracture networks was determined. Integrating multi-cluster fracture propagation with stress barrier and intra-stage stress differential characteristics, a stress-barrier-responsive diverting fracturing technology meeting CTD requirements was established. Results demonstrate that high in situ stress and significant stress differentials induce asymmetric fracture propagation, generating detrimental CO₂ channeling pathways and localized temperature cold islands that drastically reduce CTD efficiency. Further examination of multi-cluster fracture dynamics identifies stress shadow effects and intra-stage stress differentials as primary controlling factors. To overcome these constraints, an innovative fracture network uniformity control technique is proposed, leveraging synergistic interactions between diverting parameters and stress barriers through precise particle size gradation (16–18 mm targeting toe obstruction versus 19–21 mm sealing heel), optimized pumping displacements modulation (6 m³/min enhancing heel efficiency contrasted with 10 m³/min improving toe coverage), and calibrated diverting concentrations (34.6–46.2% ensuring uniform cluster intake). This methodology incorporates dynamic intra-stage adjustments where large-particle/low-rate combinations suppress toe flow in heel-dominant high-stress zones, small-particle/high-rate approaches control heel migration in toe-dominant high-stress zones, and elevated concentrations (57.7–69.2%) activate mid-cluster fractures in central high-stress zones—collectively establishing a tailored framework that facilitates precise flow regulation, enhances thermal conformance, and achieves dual thermal conduction and adsorption displacement objectives for CTD applications. Full article

Intracranial aneurysms are a serious cerebrovascular condition with a risk of subarachnoid hemorrhage due to rupture, leading to high mortality and morbidity. Flow Diverter Stents (FDSs) have become an important endovascular treatment option for unruptured large or wide-neck aneurysms. Hemodynamic factors significantly influence treatment outcomes in aneurysms treated with FDSs, and Computational Fluid Dynamics (CFD) has been widely used to evaluate post-deployment flow characteristics. However, conventional wire-resolved CFD methods require extremely fine meshes to reconstruct individual FDS wires, resulting in prohibitively high computational costs. This severely limits their feasibility for use in clinical treatment planning, where fast and robust simulations are essential. To address this limitation, we developed a computationally efficient CFD method that incorporates a porous media model accounting for local variations in wire density after FDS deployment. Based on Virtual Stent Simulation, the FDS region was defined as a hollow cylindrical domain with spatially varying resistance derived from cell-specific wire density. We validated the proposed method using 15 clinical cases, demonstrating close agreement with conventional wire-resolved CFD results. Relative errors in key hemodynamic parameters, including velocity, shear rate, inflow rate, and turnover time, were within 5%, with correlation coefficients exceeding 0.98. The number of grid elements, the data size, and total analysis time were reduced by over 90%. The method also allowed comparison between Total-Filling (OKM Grade A) and Occlusion (Grade D) cases, and evaluation of different FDS sizing, positioning, and coil-assisted strategies. The proposed method enables practical and efficient CFD analysis following FDS treatment and supports hemodynamics-based treatment planning of aneurysms. Full article

The gas reservoir of the Sinian Dengying Formation (Member 4) in Sichuan Basin exhibits extensive development of inter-clast dissolution pores and vugs within its carbonate reservoirs, characterized by low porosity (average 3.21%) and low permeability (average 2.19 mD). With the progressive development of the Moxi (MX)structure, the existing stimulation techniques require further optimization based on the specific geological characteristics of these reservoirs. Through large-scale true tri-axial physical simulation experiments, this study systematically evaluated the performance of three principal acid systems in reservoir stimulation: (1) Self-generating acid systems, which enhance etching through the thermal decomposition of ester precursors to provide sustained reactive capabilities. (2) Gelled acid systems, characterized by high viscosity and effectiveness in reducing breakdown pressure (18~35% lower than conventional systems), are ideal for generating complex fracture networks. (3) Diverting acid systems, designed to improve fracture branching density by managing fluid flow heterogeneity. This study emphasizes hybrid acid combinations, particularly self-generating acid prepad coupled with gelled acid systems, to leverage their synergistic advantages. Field trials implementing these optimized systems revealed that conventional guar-based fracturing fluids demonstrated 40% higher breakdown pressures compared to acid systems, rendering hydraulic fracturing unsuitable for MX reservoirs. Comparative analysis confirmed gelled acid’s superiority over diverting acid in tensile strength reduction and fracture network complexity. Field implementations using reservoir-quality-adaptive strategies—gelled acid fracturing for main reservoir sections and integrated self-generating acid prepad + gelled acid systems for marginal zones—demonstrated the technical superiority of the hybrid system under MX reservoir conditions. This optimized protocol enhanced fracture length by 28% and stimulated reservoir volume by 36%, achieving a 36% single-well production increase. The technical framework provides an engineered solution for productivity enhancement in deep carbonate gas reservoirs within the G-M structural domain, with particular efficacy for reservoirs featuring dual low-porosity and low-permeability characteristics. Full article

Lightning strikes pose a significant risk during outdoor activities. The connection between conventionally used rescue blankets in alpine emergencies and the risk of lightning injury is unclear. This experimental study investigated whether rescue blankets made of aluminum-coated polyethylene terephthalate increase the likelihood of lightning injuries. High-voltage experiments of up to 2.5 MV were conducted in a controlled laboratory setting, exposing manikins to realistic lightning discharges. In a balanced test environment, two conventionally used brands were investigated. Upward leaders frequently formed on the edges along the fold lines of the foils and were significantly longer in crumpled rescue blankets (p = 0.004). When a lightning strike occurred, the thin metallic layer evaporated at the contact point without igniting the blanket or damaging the underlying plastic film. The blankets diverted surface currents and prevented current flow to the manikins, indicating potentially protective effects. The findings of this experimental study suggest that upward leaders rise from the edge areas of rescue blankets, although there is no increased risk for a direct strike. Rescue blankets may even provide partial protection against exposure to electrical charges. Full article

Introduction: Primary extracranial vertebral artery aneurysms are sporadic in the general population. They are uncommon in individuals with neurofibromatosis type 1. During pregnancy or in the puerperium, the risk of aneurysm rupture in individuals with neurofibromatosis type 1 and extracranial aneurysms is elevated. Rupture of a vertebral artery aneurysm is an emergency condition and can be fatal. Case presentation: We present the case of a 33-year-old woman in the puerperium with neurofibromatosis type 1 who had a vertebral symptomatic artery aneurysm. During a previous hospitalization, two months before the treatment of the vertebral aneurysm, a same-sided aneurysm of the thyrocervical trunk was successfully treated with endovascular coiling because of aneurysm rupture. In this case report, the vertebral artery aneurysm was successfully managed using a flow diverter stent graft. Conclusions: This is the first reported case of a successfully treated symptomatic vertebral artery aneurysm with a flow diverter stent graft in a patient with neurofibromatosis type 1 during the early puerperium. Endovascular treatment with a stent graft is a minimally invasive, safe, and effective treatment for patients with vertebral artery aneurysms. Early diagnosis of non-ruptured vertebral artery aneurysms is a crucial as well as appropriate treatment, which should be undertaken in a timely manner to prevent serious complications or a fatal outcome. Full article

This study addresses the unclear mechanisms by which preferential flow channels (PFCs), formed during long-term waterflooding, affect nano-gel microsphere (NGM) flooding efficiency, utilizing CMG reservoir numerical simulation software. A dynamic evolution model of PFCs was established by coupling CROCKTAB (stress–porosity hysteresis) and CROCKTABW (water saturation-driven permeability evolution), and the deep flooding mechanism of NGMs (based on their gel properties such as swelling, elastic deformation, and adsorption, and characterized by a “plugging-migration-replugging” process) was integrated. The results demonstrate that neglecting PFCs overestimates recovery by 8.7%, while NGMs reduce permeability by 33% (from 12 to 8 mD) in high-conductivity zones via “bridge-plug-filter cake” structures, diverting flow to low-permeability layers (+33% permeability, from 4.5 to 6 mD). Field application in a Chang 6 tight reservoir (permeability variation coefficient 0.82) confirms a >10-year effective period with 0.84% incremental recovery (from 7.31% to 8.15%) and favorable economics (ROI ≈ 10:1), providing a theoretical and engineering framework for gel-based conformance control in analogous reservoirs. Full article

Spirodela polyrhiza is a suitable model organism for investigating plant developmental influences due to its intracolonial variations in response to various environmental fluctuations, like nutrient deficiency. In this study, transmission electron microscopy was used to examine age-dependent variation in chloroplast ultrastructure, while pigment levels (chlorophyll and anthocyanins), starch accumulation, and metabolic activity (photosynthetic and respiratory rates) were measured to determine metabolic responses to sulfur deficiency. For a comprehensive insight into electron transport efficiency and the redox states of the photosynthetic apparatus, rapid light curves, chlorophyll fluorescence (JIP test parameters), and modulated reflection at 820 nm were analyzed. Under S deficit, mother fronds relied on stored reserves to maintain functional PSII but accumulated reduced PQ pools, slowing electron flow beyond PSII. The first-generation daughter fronds, despite having higher baseline photosynthetic capacity, exhibited the largest decline in photosynthetic indicators (e.g., rETR fell about 50%), limitations in the water-splitting complex, and reduced PSI end-acceptor capacity that resulted in donor- and acceptor-side bottlenecks of electron transport. The youngest granddaughter fronds avoided these bottlenecks by absorbing less light per PSII, channeling electrons through the alternative pathway to balance PQ pools and redox-stable PSI while diverting more carbon into starch and anthocyanin production up to 5-fold for both. These coordinated and age-specific adjustments that provide response flexibility may help maintain photosynthetic function of the colony and facilitate rapid recovery when sulfur becomes available again. Full article

Against the backdrop of China’s “public-to-railway” freight policy that has led to railway yard congestion and imbalanced modal capacity utilization, this study develops a Dual-Channel Cargo-Transportation Service (DCTS) system model using queuing theory to optimize freight flow allocation and pricing strategies. Integrating the behavioral decisions of governments, carriers, and cargo owners, the research employs M/M/1 queuing models and the Logit choice framework to analyze the dynamic equilibrium between goods waiting times and carrier profits, exploring objectives of minimizing system-average waiting time and maximizing carrier profits. Key findings show that regulating highway pricing can effectively divert freight flows to reduce railway congestion and improve system efficiency, with optimal pricing intervals for highways identified based on service capacity to balance congestion relief and profitability. The model quantifies the trade-off between transportation costs and waiting times to guide cargo owners’ mode choices, and numerical simulations validate that strategic highway price adjustments alleviate bottlenecks and enhance modal synergy. This paper provides a theoretical basis for the government to formulate freight-transportation policies and optimize freight flow allocation. At the same time, it also provides a practical, theoretical basis and methodological reference for carrier pricing decisions, as well as for solving the problem of freight flow congestion and optimizing the pricing of transportation services. Full article

Background: Steal syndrome in the setting of microvascular reconstruction refers to a phenomenon whereby blood flow is diverted from the native tissue to the free flap, leading to ischemia and potential limb loss. In the present study, we aim to comprehensively evaluate the occurrence and management of steal syndrome in free flap reconstruction of the lower extremities. Methods: A thorough literature search was conducted across the MEDLINE, Embase, Cochrane Library, and Scopus databases up to 29 January 2025. Studies were selected based on predefined inclusion criteria focusing on free flap microvascular reconstruction in the lower extremities with a focus on steal syndrome. Two independent reviewers assessed and extracted data. Results: Three studies were included, involving seven patients, with a mean age of 65.66 ± 5.89 years, who developed steal syndrome following free flap microvascular reconstruction. The most common revision involved below-the-knee amputation (BKA) due to ischemic complications. Comorbidities such as peripheral vascular disease (PVD), diabetes, and hypertension were present in all cases. The majority of anastomoses (85.7%) were end-to-side (ETS), with only one case utilizing a flow-through configuration. The majority of cases (n = 5, 71.4%) were reconstructed using latissimus dorsi (LD) flaps, with the remaining two cases using rectus abdominis (n = 1) and gracilis (n = 1) flaps. The recipient vessel was the anterior tibial artery in two patients (28.6%), the dorsalis pedis artery in two patients (28.6%), and the popliteal artery in three patients (42.9%). The most common salvage procedure was below-the-knee amputation (BKA), performed in four patients (57.1%). One patient required revision of the venous anastomosis and flap debridement, followed by a Chopart amputation (n = 1, 14.3%). Conclusions: The occurrence of steal syndrome in free flap microvascular reconstruction of the lower extremities is rare but can lead to significant complications, including amputation. The findings indicate that steal syndrome is more likely in patients with pre-existing vascular conditions such as PVD and diabetes. While surgical technique and flap type may influence its development, further studies are needed to identify specific anatomical and clinical predictors. The absence of a unified treatment guideline underscores the need for further investigation into effective management strategies to prevent amputation and optimize patient outcomes. Full article

Background and Purpose: Mechanical thrombectomy in the context of internal carotid artery dissection (ICA-D) lesions is an undesirable procedure that may necessitate carotid stenting. Flow-diverting stents (FDSs) are promising devices with numerous advantages, particularly in cases involving tortuous anatomy. Here, we investigate the use of FDSs in the acute management of carotid dissection during mechanical thrombectomy procedures in patients with dissection-related strokes. Materials and Methods: This was a multicentric retrospective observational study of consecutive patients admitted for mechanical thrombectomy due to acute ischaemic stroke with ICA-D and treated with an FDS in the acute setting between July 2018 and February 2023. Patient records, procedural details, and post-procedural outcomes, including follow-up data, were reviewed. Results: A total of 11 patients (10 patients with unilateral ICA-D and one patient with bilateral ICA-D) were included, 10 of whom were male, with a median age of 54 years (range: 35–85 years) and NIHSS scores at admission ranging from 3 to 32 (median 13). Eight cases (73%) involved intracranial occlusion (tandem stroke), with the intracranial occlusion managed first each time. An FDS was selected when the dissection was long and/or the ICA was tortuous, and successful deployment was achieved in all patients with a favourable angiographic outcome (TICI 2B-3). A favourable outcome (modified Rankin scale 0–2 at 90 days) was observed in five patients (45%), with four patients (36%) experiencing symptomatic ICH and three patients having stent occlusion out of the 12 treated ICA-D cases. Conclusions: The use of FDSs for acute stenting in ICA-D-related stroke can be performed efficiently, resulting in excellent angiographic outcomes and an acceptable rate of favourable outcomes specific to the pathology. Larger prospective studies are still needed to confirm the potential benefits of FDSs in acute situations. Full article

Dust accumulation on Photovoltaic (PV) panels represents a major challenge for the operation of panels. There are several passive dust mitigation techniques, such as using a dust shield whose performance has been enhanced by integrating it with an air nozzle. The air exiting the nozzle acts as an air barrier that obstructs the approach of dust particles to the panel’s surface. The objective of this study is to minimize dust accumulation over PV panels by adding slits within the dust shield. The function of the slit is to induce air drafts that can sweep dust away from the surface of the PV panel. Numerical simulations are performed to determine the influence of the slit size and position on dust mitigation. It has been found that there is a critical slit size, such that the deposition of particles for slits of sizes smaller or larger than that size decreases. Increasing the slit size increases dust deposition until a certain limit, i.e., the critical size, and that is due to the Coanda effect that keeps the flow intact with the shield until it reaches the panels’ surface, which increases the dust accumulation rate. On the other hand, increasing the slit size above the critical size decreases the dust deposition due to the change from a non-inertial flow to an inertial flow, which diverts the incoming particles from reaching the panels’ surface. Also, it has been found that keeping the slit location away from the panel’s surface decreases the accumulation of dust over the panels’ surface. Therefore, based on the performed simulations, the slit size should always be either greater or smaller than the critical size and as far as possible from the panel’s surface to minimize dust accumulation over PV panels. Full article

With the increasing global population and migration toward coastal regions, and the rising demand for coastal urbanization, including the development of living spaces, ports, and tourism infrastructure, the need for coastal defense structures (CDSs) is also increasing. Traditional CDSs, such as breakwaters, typically composed of hard units designed to block and divert wave and current energy, often fail to support diverse and abundant marine communities because of their impact on current and sediment transport, the introduction of invasive species, and the loss of natural habitats. Marine ecoengineering aims at increasing CDS ecological services and the development of marine organisms on them. In this study, carried out in a coral reef environment, we examined the relationship between coral colony protection levels and three factors related to their development, namely, coral fragment survival rate, larval settlement, and water motion (flow rate), across three distinct niches: Exposed, Semi-sheltered, and Sheltered. Coral survivability was assessed through fragment planting, while recruitment was monitored using ceramic settlement tiles. Water motion was measured in all defined niches using plaster of Paris Clod-Cards. Additionally, concrete barrier structures were placed in Exposed niches to test whether artificially added protective elements could enhance coral fragment survival. No differences were found in coral settlement between the niches. Flow rate patterns remained similar in Exposed and Sheltered niches due to vortex formation in the Sheltered zones. Survival analysis revealed variability between niches, with the addition of artificial shelter barriers leading to the highest coral fragment survival on the breakwater. This study contributes to the development of ways to enhance coral development with the goal of transforming artificial barriers into functional artificial reefs. Full article