Search Results (5,014)

Background: Patients with ankylotic spines suffering from vertebral column fractures are frequently operated on to maintain spinal stability and prevent secondary displacement and nerve damage. The aim of this study was to identify a subset of patients that may be treated non-operatively, thus avoiding operative complications in this group of patients. Methods: Extension-type injuries in patients with DISH (diffuse idiopathic skeletal hyperostosis) not involving the posterior elements of the spine comprised the study group. Results: Twenty two extension fractures occurred in 21 patients with DISH in SZMC (Shaare Zedek Medical Cente) between 2014–2025. All patients were treated non-operatively. Patients were allowed free mobilization, and no orthosis was used. The only limitation was keeping the bed inclined to 20–30 degrees to prevent extension at the fracture site. All fractures healed uneventfully, and no patient required late surgical intervention, and no neurological complications were noted. Conclusions: Patients with DISH who sustain extension-type injuries of the thoracolumbar spine, with no involvement of the posterior elements, may be treated non-operatively, with good results. Full article

Background and Objective: Adverse pathology to high-risk prostate cancer (PCa) after radical prostatectomy (upgrading) poses a threat to risk stratification and treatment planning. The impact on sexual function, urinary continence, and health-related quality of life (HRQOL) remains unclear. Methods: From 2004 to 2024, 4189 patients with preop low-/intermediate-risk PCa (Gleason score 6 or 7a, PSA ≤ 20 ng/mL) underwent radical prostatectomy at our department and were analyzed. Primary endpoint was HRQOL, erectile function, and urinary continence. Secondary endpoint was rate of salvage therapies and biochemical-free survival. Propensity score matching was performed using “operative time”, “robot-assisted surgery”, “blood loss”, “nerve-sparing surgery”, “age”, and “BMI” to represent comparable surgical approach. Median follow-up was 39 months (Interquartile-range (IQR) 15–60). Key Findings and Limitations: Patients who were upgraded to high-risk PCa showed a higher rate of postoperative radiotherapy and androgen-deprivation therapy compared to patients who were not upgraded (21% vs. 7%, p < 0.001; 9% vs. 3%, p = 0.002). Five-year biochemical recurrence-free survival was 68% in the upgrading group vs. 84% in the no-upgrading group (p < 0.001). We saw no difference in patient-reported HRQOL, urinary continence, or erectile function. Multivariable analysis showed that postoperative upgrading was a significant risk for not achieving good overall HRQOL (OR: 0.77, 95% CI: 0.61–0.97, p = 0.028) during the follow-up. Conclusions and Clinical Implications: Although postoperative upgrading to high-risk PCa leads to worse oncologic outcomes and higher salvage therapy rates, this study indicates that its impact on health-related quality of life is minimal and should not deter a cautious approach to radical prostatectomy. Full article

Fissure swarms and dike swarms in Iceland constitute the main parts of volcanic systems that are 40–150 km long, 5–20 km wide, extend to depths of 10–20 km, and contain 2 × 10¹⁴ outcrop-scale (≥0.1 m) and 10^22–23 down to grain-scale (≥1 mm) fractures, suggesting that statistical physics is an appropriate method of analysis. Length-size distributions of 565 outcrop-scale Holocene fissures (tension fractures and normal faults) and 1041 Neogene dikes show good to excellent fits with negative power laws and exponential laws. Here, the Helmholtz free energy is used to represent the energy supplied to the swarms and to derive the Gibbs–Shannon entropy formula. The calculated entropies of 12 sets and subsets of fissures and 3 sets and subsets of dikes all show strong positive correlations with sets/subsets length ranges and scaling exponents. Statistical physics considerations suggest that, at a given time, the probability of the overall state of stress in a crustal segment being heterogeneous is much greater than the state of stress being homogeneous and favourable to the propagation of a fissure or a dike. In a heterogeneous stress field, most fissures/dikes become arrested after a short propagation—which is a formal explanation of the observed statistical size-length distributions. As the size of the stress-homogenised rock volume increases larger fissures/dikes can form, increasing the length range of the distribution (and its entropy) which may, potentially, transform from an exponential distribution into a power-law distribution. Full article

The usage of fossil fuels has resulted in increasingly severe environmental problems, such as climate change, air pollution, water pollution, etc. Hydrogen energy is considered one of the most promising clean energies to replace fossil fuels due to its pollution-free and high-heat properties. However, the oxygen evolution reaction (OER) remains a critical challenge due to its high overpotential and slow kinetics during water electrolysis for hydrogen production. Electrocatalysts play an important role in lowering the overpotential of OER and promoting the kinetics. Co₃O₄-based electrocatalysts have emerged as promising candidates for the oxygen evolution reaction (OER) due to their favorable catalytic activity and good compatibility compared with precious metal-based electrocatalysts. This review presents a summary of the recent developments in the synthesis strategies and mechanisms of Co₃O₄-based electrocatalysts for the OER. Various synthesis strategies have been explored to control the size, morphology, and composition of Co₃O₄ nanoparticles. These strategies enable the fabrication of well-defined nanostructures with enhanced catalytic performance. Additionally, the mechanisms of OER catalysis on Co₃O₄-based electrocatalysts have been elucidated. Coordinatively unsaturated sites, synergistic effects with other elements, surface restructuring, and pH dependency have been identified as crucial factors influencing the catalytic activity. The understanding of these mechanisms provides insights into the design and optimization of Co₃O₄-based electrocatalysts for efficient OER applications. The recent advancements discussed in this review offer valuable perspectives for researchers working on the development of electrocatalysts for the OER, with the goal of achieving sustainable and efficient energy conversion and storage systems. Full article

Introduction: Biodegradable Temporizing Matrix (BTM) is a new synthetic dermal substitute suitable for wound closure and tissue regeneration. The data in paediatric population remain limited. The study purpose is to review the indications for BTM application in paediatric patients, evaluate the short-term and long-term results, including complications and functional outcomes, as well as to share some unique observations regarding the use of BTM in paediatric population. Patients and Methods: Patients undergoing reconstructive surgery and BTM application during the last three years were included. Data collected included patient demographics, primary diagnosis, previous surgical management, post-operative complications and final outcomes. BTM was used in 32 patients. The indications varied including epidermolysis bullosa (n = 6), burns (n = 4), trauma (n = 7), infection (n = 4), ischemia or necrosis (n = 11). Results: The results were satisfying with acceptable aesthetic and functional outcomes. Complications included haematoma underneath the BTM leading to BTM removal and re-application (n = 1), BTM infection (n = 1) and split-thickness skin graft failure on top of BTM requiring re-grafting (n = 2). Conclusions: BTM can be a good alternative to large skin grafts, locoregional flaps or even free flaps. The big advantages over other dermal substitutes or skin grafts are that BTM is less prone to infection and offers excellent scarring by preserving the normal skin architecture. Specifically in children, BTM might not require grafting, resulting in spontaneous healing with good scarring. In critically ill patients, BTM reduces the operation time and there is no donor site morbidity. BTM should be considered in the reconstructive ladder when discussing defect coverage options in children and young people. Full article

Introduction: Living with coeliac disease (CD) requires lifelong adherence to a strict gluten-free diet (GFD). This study assessed GFD adherence, symptom burden, autoimmune comorbidities, and dietetic support among Hellenic CD patients. Methods: A cross-sectional survey was completed by 272 adults with CD. Adherence was measured using the Hellenic version of the Celiac Dietary Adherence Test (H-CDAT). Results: The mean H-CDAT score was 13.5 ± 3.5. Good adherence was observed in 44.9% of participants, while 14.3% showed poor adherence. Symptom burden was high: 39.3% reported partial symptom resolution and 3.7% had ongoing symptoms. Among patients, 25.0% had multiple autoimmune conditions, ranging from two to four. Dietetic support was limited: 61.5% were not referred to a dietitian at diagnosis, and 75.4% had no regular follow-up. Higher H-CDAT scores, indicating poorer adherence, were significantly associated with younger age (p = 0.014), earlier diagnosis (p = 0.01), and ongoing symptoms (p < 0.01). Age at diagnosis was also positively associated with autoimmune comorbidity count. Conclusions: These findings highlight the need for earlier diagnosis, improved access to structured dietetic support, and individualized care to optimize GFD adherence and improve outcomes in patients with CD. Full article

The XPO1 (exportin 1) gene encodes exportin 1 protein responsible for transporting proteins and RNA from the nucleus to the cytoplasm. It has been used as a biomarker for lymphoma detection. XPO1^E571K mutation has been frequently observed and identified as a good prognostic indicator for lymphoma patients. The detection of a target molecule released by lymphoma cells into blood circulation (cell-free circulating tumor DNA, cfDNA) is a better method than tissue biopsy. However, cfDNA concentration in blood circulation is very low in cancer patients. Therefore, a precise and sensitive method is needed. In this study, cfDNA was extracted, and then the XPO1 gene was detected and amplified using conventional PCR. Sanger sequencing was employed to verify the DNA sequences. FAST-COLD-PCR was developed to detect XPO1^E571K gene mutation using a CFX96 Touch Real-Time PCR System. The optimal critical temperature (Tc) was 73.3 °C, allowing selective amplification of XPO1^E571K mutant DNA while wild-type XPO1 could not be amplified. XPO1^E571K gene mutation can be detected by this method with high specificity and sensitivity in lymphoma patients. This approach facilitates rapid and straightforward detection in a timely manner after the diagnosis. Accordingly, the optimized FAST-COLD-PCR conditions can be used as a prototype for XPO1^E571K mutant detection in lymphoma patients. Full article

In this article, an efficient and straightforward protocol for the construction of complex dispirocyclic skeletons via regioselective intramolecular Michael addition is presented. Diverse dispirocyclic compounds were synthesized under mild and transition-metal-free conditions with good to excellent yields. Most stereoisomers were conveniently separated by column chromatography, and their relative configurations were identified by single-crystal X-Ray diffraction of representative compounds. A scale-up experiment validated the practicality of this method. In an in vitro assay, some dispirocyclic compounds exhibited potent cytotoxicity with an IC₅₀ value of 10⁻⁶ mol/L. Full article

Background: Consolidation therapy with durvalumab after definitive chemoradiotherapy (CRT) has become the standard care for patients with stage III non-small-cell lung cancer (NSCLC) following the PACIFIC trial. However, real-world data evaluating outcomes under routine clinical conditions remain limited, particularly in European cohorts. Methods: In this retrospective single-center study, we analyzed clinical data from 72 patients with stage III NSCLC treated with definitive CRT between 2017 and 2022. The patients were stratified by receipt of durvalumab consolidation. Univariable and multivariable Cox regression models were used to assess overall survival (OS) and progression-free survival (PFS). Stepwise variable selection based on the Akaike Information Criterion (AIC) was used to construct an optimized multivariable model. A sensitivity analysis with adjustment for treatment period (2017–2018 vs. 2019–2022) was conducted to account for the introduction of durvalumab into routine clinical practice. Results: Among 72 patients, 35 received durvalumab and 37 did not. The median OS was 2.08 years; the 3- and 5-year OS rates were 38.6% and 30.3%, respectively. Multivariable regression revealed significantly improved OS associated with Karnofsky performance status (KPS) > 80% (HR 0.29, p = 0.003), Charlson Comorbidity Index (CCI) ≤ 2 (HR 0.39, p = 0.009), and durvalumab treatment (HR 3.99, p = 0.008). PD-L1 expression ≥ 1% showed a trend toward improved OS (HR 3.72, p = 0.063). The median progression-free survival (PFS) for the total cohort was 1.17 years. The estimated 3- and 5-year PFS rates were 31.1% and 26.3%, respectively. Patients treated with durvalumab had a longer median PFS (20.5 months) compared to those without durvalumab (12.0 months). In the multivariable analysis, KPS > 80% (HR 0.29, p < 0.001), CCI ≤ 2 (HR 0.53, p = 0.048), and durvalumab treatment (HR 2.81, p = 0.023) were significantly associated with improved PFS. A sensitivity analysis adjusting for treatment period—reflecting the introduction of durvalumab into routine clinical practice from 2019—confirmed the robustness of these findings. Conclusions: Our findings support the clinical benefit of durvalumab consolidation following CRT in a real-world population, especially in patients with good performance status and low comorbidity burden. These results confirm and extend the PACIFIC trial findings into routine clinical practice, highlighting the prognostic value of functional status and comorbidity alongside PD-L1 expression. Full article

Objective: To compare the effect of different bone augmentation procedures, namely, autogenous bone blocks (ABBs) versus guided bone regeneration (GBR), on patient-reported outcomes (PROMs). Methods: This systematic review was conducted according to the PRISMA guidelines. A MEDLINE, Embase, and Web of Science search was conducted by two independent reviewers in combination with a free-hand search in relevant journals until June 2025. Outcomes were PROMs to enhance our understanding of the evolution of these procedures. Results: The electronic search yielded 6291 articles. After title screening, 67 articles were further analyzed for abstract review, which resulted in 14 articles eligible for full-text reading. Six articles were finally included based on the exclusion and inclusion criteria with a total of 295 patients. The overall study quality was low, since only two RCTs could be included. One study demonstrated a high risk of bias. Different PROMs were examined and compared such as pain, edema, neurosensory disturbance, Patient-Reported Predominant Symptom, OHIP-14, postoperative analgesic usage, willingness to repeat, and likelihood to recommend. Meta-analysis was not achievable due to a lack of direct comparisons and heterogeneity in terms of PROMs. Evaluation points varied between pretreatment and up to nearly 10-years of follow-up. Conclusions: Despite significant heterogeneity and reporting, this systematic review concluded that ABB and GBR are well-tolerated procedures. Trends such as transient postoperative pain and swelling with a minor occurring of neurosensory disturbances were reported in a few studies. Overall, a good perception of postoperative recovery was reported for both treatment modalities. Good quality of life was noted related to GBR procedures. Patient-reported outcomes were only analyzed for patients who completed the entire follow-up period. This may introduce bias, as patients who dropped out and were more likely to experience complications were not represented, potentially resulting in a more favorable portrayal of the outcomes. Further well-conducted prospective studies with a long follow-up are needed for an evidence-based evaluation and comparison of PROMs for these procedures. Full article

In this study, the design and synthesis of a novel series of cinnamic acid and 1,2,4-triazole hybrids were reported, aiming to enhance antioxidant and lipoxygenase inhibitory activities through pharmacophore combination. Cinnamic acid derivatives and 1,2,4-triazoles exhibit a broad spectrum of biological activities; therefore, by synthesizing hybrid molecules, we would like to exploit the beneficial characteristics of each scaffold. The general synthetic procedure comprises three synthetic steps, starting from the reaction of appropriate substituted cinnamic acid with hydrazine monohydrate in acetonitrile with cyclohexane and resulting in the formation of hydrazides. Consequently, the hydrazides reacted with phenylisothiocyanate under microwave irradiation conditions. Then, cyclization proceeded to the 1,2,4-triazole after the addition of NaOH solution and microwave irradiation. All the synthesized derivatives have been studied for their ability (a) to interact with the free radical DPPH, (b) inhibit lipid peroxidation induced by AAPH, and (c) inhibit soybean lipoxygenase. The synthesized derivatives have shown significant antioxidant activity and have been proved to be very good lipoxygenase inhibitors. Compounds 4b and 4g (IC₅₀ = 4.5 μM) are the most potent within the series followed by compound 6a (IC₅₀ = 5.0 μM). All the synthesized derivatives have been subjected to docking studies related to soybean lipoxygenase. Compound 4g exhibited a docking score of −9.2 kcal/mol and formed hydrophobic interactions with Val126, Tyr525, Lys526, Arg533, and Trp772, as well as a π−cation interaction with Lys526. Full article

Due to diverse lighting conditions and photo environments, shadows are almost ubiquitous in images, especially document images captured with mobile devices. Shadows not only seriously affect the visual quality and readability of a document but also significantly hinder image processing. Although shadow removal research has achieved good results in natural scenes, specific studies on document images are lacking. To effectively remove shadows in document images, the dark illumination correction network is proposed, which mainly consists of two modules: shadow detection and illumination correction. First, a simplified shadow-corrected attention block is designed to combine spatial and channel attention, which is used to extract the features, detect the shadow mask, and correct the illumination. Then, the shadow detection block detects shadow intensity and outputs a soft shadow mask to determine the probability of each pixel belonging to shadow. Lastly, the illumination correction block corrects dark illumination with a soft shadow mask and outputs a shadow-free document image. Our experiments on five datasets show that the proposed method achieved state-of-the-art results, proving the effectiveness of illumination correction. Full article

In comparison to shallow coal seams, deep coal seams exhibit characteristics of high temperature, pressure, and in-situ stress, leading to significant differences in reservoir properties that constrain the effective development of deep coalbed methane (CBM). This study takes the Carboniferous deep 8# coal seam in the Yulin area of Ordos basin as the research subject. Based on the test results from core drilling wells, a comprehensive analysis of the characteristics and variation patterns of coal reservoir properties and a comparative analysis of the exploration and development potential of deep CBM are conducted, aiming to provide guidance for the development of deep CBM in the Ordos basin. The research results indicate that the coal seams are primarily composed of primary structure coal, with semi-bright to bright being the dominant macroscopic coal types. The maximum vitrinite reflectance (R_o,max) ranges between 1.99% and 2.24%, the organic is type III, and the high Vitrinite content provides a substantial material basis for the generation of CBM. Longitudinally, influenced by sedimentary environment and plant types, the lower part of the coal seam exhibits higher Vitrinite content and fixed carbon (FC_ad). The pore morphology is mainly characterized by wedge-shaped/parallel plate-shaped pores and open ventilation pores, with good connectivity, which is favorable for the storage and output of CBM. Micropores (<2 nm) have the highest volume proportion, showing an increasing trend with burial depth, and due to interlayer sliding and capillary condensation, the pore size (<2 nm) distribution follows an N shape. The full-scale pore heterogeneity (fractal dimension) gradually increases with increasing buried depth. Macroscopic fractures are mostly found in bright coal bands, while microscopic fractures are more developed in Vitrinite, showing a positive correlation between fracture density and Vitrinite content. The porosity and permeability conditions of reservoirs are comparable to the Daning–Jixian block, mostly constituting oversaturated gas reservoirs with a critical depth of 2400–2600 m and a high proportion of free gas, exhibiting promising development prospects, and the middle and upper coal seams are favorable intervals. In terms of resource conditions, preservation conditions, and reservoir alterability, the development potential of CBM from the Carboniferous deep 8# coal seam is comparable to the Linxing block but inferior to the Daning–Jixian block and Baijiahai uplift. Full article

In order to explore the essence of the anticoccidiosis of anticoccidial drugs under bioelectric currents, the intermolecular double-proton transfer and conformational transformation of 4-pyridone-3-carboxylic acid were investigated by quantum chemistry calculations (at the M06-2X/6-311++G**, M06-2X/aug-cc-pVTZ and CCSD(T)/aug-cc-pVTZ levels) and finite temperature string (FTS) under external electric fields. The solvent effect of H₂O on the double-proton transfer was evaluated by the integral equation formalism polarized continuum model. The results indicate that the influences of the external electric fields along the direction of the dipole moment on double-proton transfer are significant. The corresponding products are controlled by the direction of the external electric field. Due to the first-order Stark effect, some good linear relationships form between the changes of the structures, atoms in molecules (AIMs) results, surface electrostatic potentials, barriers of the transition state, and the external electric field strengths. From the gas to solvent phase, the barrier heights increased. The spatial order parameters (ϕ, ψ) of the conformational transformation could be quickly converged through the umbrella sampling and parameter averaging, and thus the free-energy landscape for the conformational transformation was obtained. Under the external electric field, there is competition between the double-proton transfer and conformational transformation. The external electric field greatly affects the cooperativity transfer, while it has little effect on the conformational transformation. This study is helpful in the selection and updating of anticoccidial drugs. Full article

As a promising n-type semiconductor thermoelectric material, ZnO has great potential in the high-temperature working temperature range due to its advantages of abundant sources, low cost, high thermal stability, and good chemical stability, as well as being pollution-free. Sr-doped ZnO-based thermoelectric materials were prepared using the methods of room-temperature powder synthesis and high-temperature block synthesis. The phase composition, crystal structure, and thermoelectric performances of ZnO samples with different Sr doping levels were analyzed using XRD, material simulation software and thermoelectric testing devices, and the optimal doping concentrations were obtained. The results show that Sr doping could cause the Zn-O bond to become shorter; in addition, the hybridization between Zn and O atoms would become stronger, and the Sr atom would modify the density of states near the Fermi level, which could significantly increase the carrier concentration, electrical conductivity, and corresponding power factor. Sr doping could cause lattice distortion, enhance the phonon scattering effect, and decrease the lattice thermal conductivity and thermal conductivity. Sr doping can achieve the effect of improving electrical transport performance and decreasing thermal transport performance. The ZT value increased to ~0.418 at 873 K, which is ~4.2 times the highest ZT of the undoped ZnO sample. The Vickers hardness was increased to ~351.1 HV, which is 45% higher than the pristine ZnO. Full article