Search Results (276)

Background: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is linked to metabolic syndrome, obesity, and type 2 diabetes. Omega-3 fatty acids, especially EPA and DHA from fish, may protect against hepatic steatosis. Methods: From 2015 to 2018, all participants were invited to the first follow-up, where 1426 (62% response rate) responded and underwent the same standardized protocol as at baseline. For this analysis, the study is a cross-sectional investigation focusing solely on follow-up data, which included 1297 adults. MASLD was diagnosed via standardized ultrasound, and dietary intake was assessed using the validated EPIC Food Frequency Questionnaire. Associations between total EPA and DHA intake and MASLD were examined using logistic regression models adjusted for age, sex, marital status, occupation, income, Mediterranean diet adherence, liver enzymes, and C-reactive protein. Results: Overall, 48.5% of participants had MASLD. Higher total EPA and DHA intake was associated with lower odds of MASLD (EPA highest vs. lowest quartile: OR = 0.572, 95% CI 0.400–0.818; DHA highest vs. lowest quartile: OR = 0.516, 95% CI 0.361–0.739). Intake of fatty fish contributed most strongly to this protective effect (EPA highest vs. lowest quartile: OR = 0.556, 95% CI 0.390–0.794; DHA highest vs. lowest quartile: OR = 0.575, 95% CI 0.403–0.820), whereas mollusks, crustaceans, and some processed/frozen fish showed weaker or no associations. A statistically significant trend of decreasing MASLD risk was observed across increasing quartiles of both EPA and DHA intake. Conclusions: Higher intake of EPA and DHA, especially from fatty fish, is linked to lower MASLD risk in this Mediterranean population, supporting recommendations for regular fish consumption to protect liver health. Full article

To address the frost heave damage issue of the trapezoidal lined canals in seasonally frozen regions and further ensure the stable operation of canals while reducing operation and maintenance costs, this study conducted a gradient sand-gravel cushion replacement experiment on the main canal of the Jingdian Irrigation District, China. For the experiment, east–west and north–south-oriented canal sections were selected, with frost heave meters and soil temperature-humidity meters installed. Dynamic changes in canal ground temperature, moisture content, and frost heave were monitored over two full freeze–thaw cycles. The results indicate the following: (1) The variation of ground temperature lags behind air temperature by 2–3 days; the ground temperature change on the canal slope is more pronounced than that at the canal bottom; and for the east–west-oriented canal, the ground temperature on the sunny slope is higher than that on the shady slope, while the ground temperatures on the two slopes of the north–south-oriented canal are similar. (2) The moisture content of the east–west-oriented canal changes drastically during the freezing period, showing a decreasing trend in the early freezing stage and a significant increasing trend in the thawing stage, whereas the moisture content of the north–south-oriented canal fluctuates slightly. (3) Canals with different orientations exhibit spatial differences in frost heave due to variations in solar radiation distribution. (4) The frost heave is negatively correlated with ground temperature, and its variation lags behind ground temperature by 1–2 days. (5) Increasing the replacement thickness of sand-gravel can significantly reduce the frost heave, with a reduction rate exceeding 50%. Under the action of freeze–thaw cycles, canals with gradient sand-gravel exhibit remarkable anti-frost effects. Thus, for trapezoidal lined canals in seasonally frozen regions, a gradient replacement scheme is recommended: For east–west canals, the replacement thickness is 40–100 cm for shady slopes and 30–70 cm for sunny slopes; for north–south canals, the replacement thickness is 30–70 cm for both slopes. In conclusion, gradient sand-gravel replacement is an effective anti-frost heave measure, providing a theoretical basis for the design of sand-gravel replacement for lined canals in seasonally frozen regions. Full article

Background: Serous papillary adenofibroma cyst (SPAC) of the ovary is a rare benign epithelial tumor that can mimic borderline or malignant ovarian neoplasms. Reports in young women are particularly scarce. Purpose: The aim of this study is to present a rare clinical case of ovarian SPAC in a young woman and to review the existing literature, highlighting diagnostic challenges and implications for fertility-preserving management. Methods: We present a clinical case of ovarian SPAC in a 41-year-old woman and conducted a narrative literature review. The search was performed in PubMed, Scopus, and Web of Science to identify reports published between 2000 and 2025. Additional relevant articles were also identified through manual screening of reference lists from selected papers. Results: MRI revealed a well-encapsulated septated cystic lesion with solid nodular components and post-contrast enhancement. Tumor markers, including CA 19-9, were elevated. Laparoscopic surgery with intraoperative frozen section confirmed the diagnosis of SPAC, allowing fertility-preserving management. Histopathology established the final diagnosis. Conclusions: This case emphasizes the importance of considering SPAC in the differential diagnosis of complex adnexal masses. Early recognition and intraoperative frozen section can guide conservative surgical strategies, avoiding overtreatment and preserving reproductive potential in young patients. Full article

As an effective engineering countermeasure against frost heave damage in seasonally frozen regions, thermal insulation boards (TIBs) were employed in embankments. This study established a test section featuring a thermal insulation–waterproof geotextile embankment in Dingxi, Gansu Province. Temperature and water content at various positions and depths within both the thermal insulation embankment (TIE) and an ordinary embankment (OE) were monitored and compared to analyze the effectiveness of the TIB. Following the installation of the insulation layer, the temperature distribution within the embankment became more uniform. The TIB effectively impeded downward heat transfer (cold energy influx) during the winter and upward heat transfer (heat energy flux) during the warm season. However, the water content within the TIE was observed to be higher than that in the OE, with water accumulation notably occurring at the embankment toe. While the TIB successfully mitigated slope damage and superficial soil frost heave, the waterproof geotextile concurrently induced moisture accumulation at the embankment toe. Consequently, implementing complementary drainage measures is essential. In seasonally frozen areas characterized by dry weather and relatively high winter temperatures, the potential damage caused by concentrated rainfall events to embankments requires particular attention. Full article

Endometrial hyperplasia, presenting without atypia (EH) or as atypical hyperplasia (AH), is considered a precursor of endometrial cancer and affects women of reproductive or perimenopausal age, posing a major public health concern. The aim of this study was to review and compare the most recently published influential guidelines providing recommendations on the management of endometrial hyperplasia. Thus, a comparative review of guidelines from the Royal College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynecologists of Canada, and the American College of Obstetricians and Gynecologists was conducted. There is a consensus regarding the optimal management strategies for EH, with observation and medical treatment being the first-line options and surgical treatment with total hysterectomy offering a second line in specific cases. Moreover, there is agreement regarding patients with AH, with surgical treatment being the recommended approach, while medical therapy is preferred for women who seek fertility preservation. Notably, close surveillance with endometrial biopsies every 3 or 6 months is suggested unanimously, as well as long-term follow-up in high-risk patients. Controversy exists regarding the initial diagnostic approach, with RCOG and SOGC suggesting outpatient endometrial biopsy, while ACOG recommends diagnostic hysteroscopy, as well as the therapeutic regimens for the oral treatment of EH. Surgical techniques such as endometrial ablation, intraoperative frozen section analysis, intraoperative visual inspection of the uterus, and morcellation constitute areas of controversy among the reviewed guidelines, and the surveillance protocols for women with EH are addressed differently between RCOG and SOGC. Notably, RCOG is the only medical society offering recommendations regarding women under HRT and those on therapy for breast cancer. The development of consistent international practice protocols for timely management strategies and surveillance protocols is of paramount importance to safely guide clinical practice and subsequently improve women’s health. Full article

Introduction: Non-surgical biopsy is recommended for diagnosing solid pulmonary nodules measuring >8 mm when the probability of malignancy is low to moderate. However, currently available biopsy methods do not have a sufficient diagnostic yield for nodule size <20 mm. Previous work has shown that one-lung flooding (OLF) enables complete lung sonography and good demarcation of lung nodules. Therefore, here, we report the first experiences with ultrasound-guided transthoracic core needle biopsy (USgTTcNB) under OLF for the histological diagnosis of small pulmonary nodules. Methods: In two patients with small pulmonary nodules, a transbronchial/thoracic biopsy was not indicated due to the size and location of the nodules. Following nodule detection under OLF, the USgTTcNB was performed. The biopsy cylinder was immediately examined via the frozen section procedure. After liquid draining and re-ventilation, the patients were extubated in the operation room and monitored in the intermediate care unit. Results: In both patients, a histological diagnosis was achieved. In the case of malignancy, the patient underwent lobectomy during the same session. In the case of a benign diagnosis, a futile operation was avoided. In case two, a small apical pneumothorax occurred. The hemodynamic values during and after the intervention were in the normal range. Lung function on day 2 after the intervention increased compared with that before the intervention. Conclusions: USgTTcNB under OLF is feasible and enables a histological confirmation of small pulmonary nodules. Nevertheless, this new promising technique should be evaluated in a study with a larger cohort. Full article

Background: Fat embolism frequently occurs as a result of trauma, such as long bone fractures and orthopedic surgeries, as well as in certain non-traumatic conditions. The formation can be attributed to mechanical or biochemical processes. According to Hullman’s biochemical hypothesis, elevated C-reactive protein levels facilitate the precipitation of very-low-density lipoproteins and chylomicrons, forming fat globules that may result in fat embolism. Based on the abovementioned hypothesis, this study aims to detect fat embolism in autopsy patients (postmortem) suffering from bronchopneumonia and determine its possible role as a cause of death. Methods: A group of autopsies of deceased individuals with bacterial purulent bronchopneumonia with confirmed or presumed elevated C-reactive protein levels was rigorously selected, excluding those with other potential causes of fat embolism such as cardiopulmonary resuscitation, hypothermia, and diabetes mellitus. Multiple organs were sampled for frozen section analysis using Oil Red O fat staining and assessed for the presence and extent of fat embolism. The Falzi score, as modified by Janssen, was employed for the lung tissue. Results: In 73% of the cases, predominantly sporadic, Grade 0 or Grade I fat embolism was observed; however, in none of the cases was fat embolism identified as the cause of death or as a significant contributing factor. Furthermore, neither fat embolism syndrome nor multiorgan fat embolism were detected. Conclusions: Although an elevated C-reactive protein level facilitates the formation of fat globules and fat embolism, its role as a direct cause of mortality remains uncertain. It may predispose individuals to such conditions and potentially interact with other factors, such as minor soft tissue trauma, to exacerbate the severity of fat embolism or its clinical manifestations. These findings underscore the necessity for further comprehensive investigations within the contexts of infection/inflammation, fat embolism, and dyslipidemia. Full article

Background: Sclerosing perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms, typically benign but occasionally exhibiting aggressive behavior. This study reports a case of sclerosing PEComa of the adrenal gland that was treated with robotic partial adrenalectomy, with 13 years of follow-up and a review of the literature. Methods: A 48-year-old woman presented with abdominal pain. Imaging revealed a 10 × 9 cm adrenal mass displacing adjacent structures. MRI and 18F-FDG PET-CT suggested angiomyolipoma. Robotic partial adrenalectomy was performed. Intraoperative frozen section analysis identified the mass as angiomyolipoma, while final histopathology confirmed it as a sclerosing PEComa. Results: This case highlights the advantages of robotic surgery in the management of large adrenal tumors, allowing complete tumor removal while preserving functional adrenal tissue. The extended 13-year follow-up is significant, given the potential for recurrence or malignant transformation reported in other cases. A literature review identified 39 reported cases of sclerosing PEComas, with few documenting long-term outcomes. Conclusions: This is a documented case of robotic partial adrenalectomy for sclerosing PEComa. The findings support robotic surgery as a safe effective approach for managing this rare tumor, with excellent functional and oncological results. Extended follow-up reinforces the tumor’s benign behavior and the importance of long-term monitoring in PEComas. Full article

Potato starch noodles (PSN), a characteristic gluten-free Asian food, are essentially high-concentration starch gels (about 35% starch) formed through gelatinization and retrogradation. This study systematically investigates freezing temperature effects, particularly across the glass transition temperature, on PSN texture and microstructure. We found that fresh PSN have a freezing point of −1 °C, supercooling temperature of −4.5 °C, and a T_g’ value of −3.1 °C. Freezing significantly reduced the adhesiveness of PSN and increased the hardness. During the 48 h freezing process, noodles frozen at −3 °C, the closest to T_g’, exhibited the highest hardness (14,065.77 g), springiness (0.98), cohesiveness (0.93), chewiness (11,971.06), and resilience (0.84), and the least adhesiveness. PSN frozen within the range near T_g’ (−3 °C) showed superior texture, continuous solid cross-section, and dense surface, attributed to the reverse transformation of starch, high mobility of starch chains, and smaller ice crystals. PSN frozen at −3 °C for 24 h displayed the most compact and desirable texture compared to the other samples. These findings deepen the understanding of the role of glass transition temperature in the texture formation of starch gel during freezing and provide valuable insights for optimizing the frozen processing of starch gel-based food. Full article

Scaffolds are widely used in bioengineering, both as 3D native tissue-mimicking models for investigating mechanisms under physiological and pathological conditions and also as implantable agents in regenerative medicine. Histological approaches, mainly formalin-fixed paraffin-embedded (FFPE) and frozen sample sectioning, are commonly applied to evaluate cell distribution and tissue-like properties of scaffolds. However, standard histological processing is not always compatible with the materials that scaffolds are made of. Thus, some adaptations to protocols are required to obtain intact sections. In this review we discuss challenges related to the histological processing of scaffolds and solutions to overcome them. We sequentially cover processing steps of the three main histological techniques for sample preparation—cryomicrotomy, FFPE samples microtomy and vibrating microtomy. Furthermore, we highlight the critical considerations in choosing the most appropriate method based on scaffold composition, mechanical properties and the specific research question. The goal of this review is to provide practical guidance on choosing reliable histological evaluation of complex scaffold-based systems in tissue engineering research. Full article

Goblet cell adenocarcinomas (GCAs) are an exceedingly rare subtype of tumors, almost exclusively occurring in the appendix, and characterized by features overlapping both adenocarcinomas and neuroendocrine tumors (NETs), which has historically led to confusion and varied nomenclature. This study presents a comprehensive review of the literature highlighting particularities of this type of malignancy, starting from a rare case of a 54-year-old female operated on in our clinic for an appendiceal tumor, initially suspected to be a mucinous neoplasm based on colonoscopic biopsy, which was ultimately confirmed to be goblet cell adenocarcinoma on both intraoperative frozen section and definitive pathological examination. Exhibiting signs and symptoms associated with an abdominal mass, she underwent a right hemicolectomy with partial omentectomy for locally advanced, high-grade, invasive goblet cell adenocarcinoma of the appendix with lymphatic macro metastases and epiploic invasion, categorized as AJCC stage IVb carcinomatosis. The patient received FOLFOX adjuvant. Six months later, she required reoperation due to the progression of carcinomatosis, which was again confirmed histopathologically. A second-line oncological protocol comprising irinotecan, capecitabine, and bevacizumab was initiated. Given the rarity of GCAs and the absence of a consensus on nomenclature, classification, and diagnostic criteria, we conducted a comprehensive literature review to highlight current trends related to this entity, including its classification within different systems (Tang, Yozu, WHO, AJCC), as well as the therapeutic surgical approaches—ranging from simple appendectomy to extensive multiorgan resection, cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC), and the use of systemic therapy. Adhering to these recommendations will enhance communication among pathologists, surgeons, and oncologists regarding the natural history and prognosis of this rare malignancy. Full article

Background: Arterial variations in the upper limb, although infrequent, carry critical clinical implications. The presence of superficial ulnar and radial arteries, especially when originating from high levels, increases the risk of iatrogenic injury, misdiagnosis, and surgical complications. To confirm and describe, through ultrasound and anatomical dissection, the presence of a high-origin superficial ulnar artery and a superficial radial artery in a cadaver, highlighting their anatomical trajectory and clinical relevance. Methods: A cross-sectional ultrasound and anatomical study was conducted on 150 upper limbs from fresh-frozen cadavers. High-frequency ultrasound was used to scan the vasculature from the axilla to the wrist. Subsequently, dissection was performed to confirm sonographic findings. Results: One case (0.66%) of concurrent superficial ulnar artery and superficial radial artery was identified in the left arm of a 79-year-old male cadaver. The superficial ulnar artery originated from the axillary artery and coursed superficially along the forearm, anterior to the flexor muscles. The superficial radial artery emerged from the brachial artery and ran subcutaneously in the distal forearm. These arteries remained in close relation to key neural and venous structures, increasing their vulnerability to clinical error. Conclusions: The identification of high-origin superficial arteries is essential for clinical practice. Ultrasound serves as a reliable, non-invasive method for detecting such variations preoperatively. Awareness of these anomalies can prevent inadvertent vascular injuries, improve diagnostic accuracy, and inform safer surgical and anesthetic approaches in upper limb interventions. Full article

Objectives: This study aimed to determine the factors affecting the diagnostic efficacy of frozen sections for assessing tumor spread through air spaces (STAS) and to provide suggestions for the sampling of these frozen sections. Methods: Cases of invasive adenocarcinoma with a pathological diagnosis of stage IA-IIIB were screened, and frozen and paraffin sections were reviewed. Using paraffin sections as the gold standard, the consistency of frozen pathological diagnosis of STAS was calculated. Factors that may affect STAS diagnosis in frozen sections were screened, and a nomogram was drawn. Results: The sensitivity of frozen sections in STAS diagnosis was 55.4% (108/195), the specificity was 74.5% (254/321), and the kappa value was 0.35. In the subsequent logistic regression, the ratio of the tissue diameters of the frozen and paraffin sections, number of frozen section sheets, clarity of the tumor boundary, and number of alveoli from the peritumoral area to tissue edge were all statistically significantly significant (p < 0.05) factors affecting the frozen STAS diagnostic efficacy. Conclusions: The diagnostic efficacy of frozen sections for STAS is poor. In our study, the tissue diameter ratio of the frozen to paraffin sections, the number of frozen sections, the clarity of the tumor boundary, and the number of alveoli from the peritumoral tissue to the tissue edge were considered independent factors affecting diagnostic consistency. The accuracy of the frozen section analysis in STAS diagnosis can be improved by our reasonable suggestions on frozen sampling, making it a reliable indicator of the surgical method. Full article

Frost heave in seasonally frozen soil surrounding natural gas pipelines (NGPs) can cause severe damage to adjacent infrastructure, including road surfaces and buildings. Based on the stratigraphic characteristics of seasonal frozen soil in Beijing, a soil–natural gas pipeline–heat pipe heat transfer model was developed to investigate the mitigation effect of the soil-freezing phenomenon by transferring shallow geothermal energy utilizing heat pipes. Results reveal that heat pipe configurations (distance, inclination angle, etc.) significantly affect soil temperature distribution and the soil frost heave mitigation effect. When the distance between the heat pipe wall and the NGP wall reaches 200 mm, or when the inclined angle between the heat pipe axis and the model centerline is 15°, the soil temperature above the NGP increases by 9.7 K and 17.7 K, respectively, demonstrating effective mitigation of the soil frost heave problem. In the range of 2500–40,000 W/(m·K), the thermal conductivity of heat pipes substantially impacts heat transfer efficiency, but the efficiency improvement plateaus beyond 20,000 W/(m·K). Furthermore, adding fins to the heat pipe condensation sections elevates local soil temperature peaks above the NGP to 274.2 K, which is 5.5 K higher than that without fins, indicating enhanced heat transfer performance. These findings show that utilizing heat pipes to transfer shallow geothermal energy can significantly raise soil temperatures above the NGP and effectively mitigate the soil frost heave problem, providing theoretical support for the practical applications of heat pipes in soil frost heave management. Full article

Breastmilk is known to provide optimal nutrition for infant growth and development. A cross-sectional analysis of nationally representative US data from 2016 to 2021 revealed that >90% of lactating mothers reported using breast pumps to express milk. We conducted a survey of n = 1049 lactating or recently lactating individuals from a US nationally representative population to explore breastmilk storage practices among this group. The data revealed that 83% of respondents store breastmilk in their homes, with 68% using freezers to do so for >1 month. The lowest available temperature in most household freezers is −20 °C, a temperature that is inadequate to maintain human milk’s emulsified structure, leading to separation, degradation of fats, loss of key vitamins, and changes in palatability. We developed a first-of-its-kind high-throughput screening platform to identify food-derived compounds and combinations of compounds that, when added to human breastmilk, preserve fat content, retain antioxidant capacity, and reduce production of rancid-associated free fatty acids during extended freezer storage. Our screening identified pectin (0.5% w/v) and ascorbic acid (100 μg/mL) as optimal preservation agents. Compared to untreated controls, this formulation reduced glycerol production by approximately 60% and maintained antioxidant capacity after 6 months of storage at −20 °C. Lysozyme and protease activity were maintained at >75% of the levels in fresh breastmilk. This formulation represents a lead for the development of safe and affordable frozen breastmilk shelf-life extenders for at-home use to increase the longevity of stored breastmilk. Full article