Search Results (665)

Background and Clinical Significance: Local recurrence of extremity leiomyosarcoma after multiple operations and radiotherapy presents a major therapeutic challenge. Adequate oncologic clearance must be balanced against preservation of skeletal stability and reliable wound coverage within a scarred and poorly vascularized tissue bed; Case presentation: A 78-year-old woman presented with a painful recurrent leiomyosarcoma of the anterior proximal third of the right leg after three previous operations and adjuvant radiotherapy. Preoperative magnetic resonance imaging demonstrated a recurrent soft-tissue lesion extending to the anterior surface of the proximal tibia. Staging computed tomography of the chest, abdomen, and pelvis showed no distant metastatic disease before definitive surgery. A one-stage limb-sparing procedure was performed, including resection of the recurrent tumor bed and an approximately 7-cm anterior cortical lamella of the proximal tibia containing an area considered suspicious for neoplastic involvement. A locking tibial plate was applied prophylactically to reduce the risk of pathological fracture. The approximately 12 × 10-cm soft-tissue defect was covered with a muscle flap from the medial head of the gastrocnemius and a free skin graft harvested from the paraumbilical region. Gross pathological examination identified an 8-cm subcutaneous tumor formation. Histopathological examination demonstrated well-differentiated leiomyosarcoma; the spindle cells expressed vimentin, actin, and desmin. All examined resection lines were free of tumor infiltration. No pathogenic microorganism was isolated, and no early postoperative complication was documented. The patient mobilized with walking aids and protected weight bearing for 30 days. At approximately 16 months, the flap and skin graft provided stable coverage, no postoperative tibial fracture or clinically apparent implant-related complication had occurred, and the patient was independently ambulatory. Postoperative MRI demonstrated expected postoperative changes and a small indeterminate subcutaneous focus without diffusion restriction, requiring continued surveillance; Conclusions: This case illustrates the feasibility of combining oncologic resection, prophylactic tibial stabilization, and vascularized soft-tissue reconstruction in a previously irradiated extremity. The documented early functional and reconstructive outcome supports this individualized limb-sparing approach, although longer oncologic surveillance is required. Full article

Continuous cropping in tropical protected cultivation can impair soil health and increase the risk of soil-borne disease. We conducted a single-season field comparison in Hainan (October 2025–February 2026) to characterize the performance and rhizosphere microbial profiles of the mini-watermelon cultivar ‘Meiyue’ grown either on its own roots or grafted onto Cucurbita ficifolia. Plant growth, leaf gas exchange, fruit quality, and the field incidence of Fusarium wilt-like symptoms were recorded, and bacterial 16S V3-V4 and fungal ITS2 amplicons from the rhizosphere were sequenced. Grafted plants were taller and had thicker stems and longer internodes. Leaf chlorophyll content, stomatal conductance, and intercellular CO₂ concentration were higher in grafted plants, whereas net photosynthetic rate did not differ between treatments. Wilt-like symptoms occurred in 55.41% of own-rooted plants, while no grafted plants developed symptoms during the trial. Mean single-fruit weight was 2.8-fold higher in the grafted treatment; grafted fruits were also larger and had a higher central soluble solids content. Bacterial and fungal beta diversity did not differ significantly between treatments (PERMANOVA, p = 0.100), although several taxa differed in relative abundance and LEfSe identified treatment-associated biomarkers. An exploratory functional-profile sensitivity analysis, performed after excluding one high-leverage own-rooted replicate, indicated modest differences in predicted nitrogen-transformation functions and fungal trophic modes; these predictions were not subjected to inferential testing. Correlations between microbial relative abundance and fruit traits were interpreted as associations rather than evidence of function. Within the constraints of a single-season, two-treatment study, watermelon grafted onto C. ficifolia showed better field performance and treatment-associated shifts in selected rhizosphere taxa under continuous-cropping conditions. Full article

Bardet–Biedl syndrome (BBS) is a genetically heterogeneous ciliopathy associated with hyperphagic obesity and kidney disease. Evidence on setmelanotide after pediatric kidney transplantation is limited. We evaluated two children with BBS treated with setmelanotide after kidney transplantation, collecting anthropometric, hunger, metabolic, graft-function, cyclosporine and genetic data. Patient 1, a 17-year-old boy with a homozygous pathogenic SDCCAG8 exon deletion, improved over 12 months: weight 55.6 to 48.0 kg, BMI 26.6 to 23.0 kg/m², BMI-for-age z-score +1.60 to +0.43, maximal-hunger score 8/10 to 5/10, and HbA1c 6.5% to 5.1%. Patient 2, an 8-year-old girl with a homozygous likely pathogenic BBS5 splice-site variant and a heterozygous PCSK1 N221D variant, showed reduced hunger and an initial z-score fall from +6.10 to +5.69 by month 2.5, meeting the 0.2-point threshold for clinically meaningful change; this was not sustained, and BMI rose from 38.0 to 42.7 kg/m² by eight months despite a dose of 3 mg/day. Graft function and cyclosporine trough concentrations remained stable, and skin hyperpigmentation was the only treatment-related adverse effect. In these two patients, setmelanotide was not associated with graft deterioration or altered cyclosporine trough concentrations, although two cases cannot establish safety. The divergent trajectories highlight interindividual variability; the role of PCSK1 N221D remains uncertain, and these observations are hypothesis-generating. Full article

Background/Objectives: Direct comparative evidence regarding aortic root and pulmonary artery venting during on-pump coronary artery bypass grafting (CABG) remains limited. We evaluated whether pulmonary artery venting was associated with improved early postoperative respiratory recovery compared with aortic root venting. Methods: This single-center retrospective cohort included 488 adults undergoing on-pump CABG between January 2020 and January 2025 (aortic root vent, n = 316; pulmonary artery vent, n = 172). The primary outcome was delayed extubation beyond 8 h. Propensity-score overlap weighting based on 22 covariates addressed baseline confounding. Confidence intervals and p values were obtained from 5000 stratified nonparametric bootstrap samples with refitting of the propensity-score model and recalculation of overlap weights in each sample. Results: Extubation-time data were available for 486 patients. As expected with overlap weighting based on a logistic propensity-score model, exact mean balance was achieved for the covariates included in the model (absolute standardized mean differences < 0.001). The overlap-weighted risk of delayed extubation was 51.4% in the aortic root vent group and 41.1% in the pulmonary artery vent group; the adjusted association was not statistically significant (odds ratio [OR] 0.66, 95% confidence interval [CI] 0.37–1.10; p = 0.110). Pulmonary artery venting was associated with lower odds of fast-track failure (OR 0.53, 95% CI 0.30–0.89), the respiratory composite outcome (OR 0.35, 95% CI 0.17–0.64), and postoperative inotrope requirement (OR 0.39, 95% CI 0.14–0.87), together with a higher arterial oxygen partial pressure (PaO2) at extubation (mean difference 7.08 mmHg, 95% CI 0.72–12.89). Conclusions: The primary outcome of delayed extubation did not differ significantly between venting strategies after overlap weighting. Favorable associations across several secondary outcomes suggest a possible improvement in broader early postoperative recovery with pulmonary artery venting; these exploratory findings require prospective confirmation. Full article

Polymeric antistatic additives offer improved resistance to migration compared with low-molecular-weight agents, but high loadings are generally required to establish effective charge-dissipation pathways in nonpolar polypropylene (PP). Herein, a series of quaternary ammonium salt-functionalized polyamide 6/polyethylene glycol elastomers (QASPA6PEG) was synthesized by melt copolymerization and used as multifunctional antistatic additives for PP. Increasing the nominal QAS content decreased the surface resistivity of the elastomers from 3.24 $\times$ 10⁹ Ω to 9.71 × 10⁸ Ω. The elastomers were subsequently melt-blended with PP at loadings of 10–20 wt% using maleic-anhydride-grafted polypropylene as a compatibilizer. The surface resistivity of the blends decreased with increasing QAS content and elastomer loading, consistent with the formation of increasingly interconnected ion-conducting domains. The blend containing 20 wt% 0.4QASPA6PEG exhibited surface resistivities of 3.64 $\times$ 10¹¹ Ω and 4.69 $\times$ 10¹⁰ Ω on days 0 and 60, respectively. Its saturated water absorption reached 4.38%, compared with 0.27% for neat PP, supporting a moisture-assisted ionic conduction mechanism. The measured bromine content remained nearly unchanged after 60 days of storage, indicating limited loss of the QAS-containing component. In addition to improving charge dissipation, QASPA6PEG enhanced the ductility and impact resistance of PP. At a loading of 20 wt%, 0.4QASPA6PEG increased the elongation at break from 358 ± 23% to 690 ± 81% and the notched impact strength from 3.16 ± 0.37 to 4.93 ± 0.45 kJm⁻². These results demonstrate that covalently introducing ionic structures into PA6/PEG elastomers is an effective strategy for coupling antistatic modification with toughening in PP. Full article

Background: Acute kidney injury (AKI) is a common complication following cardiac surgery and is associated with increased morbidity and mortality. Contemporary national estimates of its clinical and economic burden in the United States remain limited. Methods: We conducted a retrospective cross-sectional study using the Nationwide Inpatient Sample (NIS) for 2022–2023. Adult hospitalizations undergoing coronary artery bypass grafting (CABG), valve surgery, or combined CABG and valve surgery were identified using ICD-10-PCS codes. Hospitalizations with end-stage kidney disease were excluded. The primary exposure was AKI. Outcomes included in-hospital mortality, length of stay (LOS), non-home discharge, and hospitalization cost. Survey-weighted multivariable regression models were used to evaluate the independent association between AKI and study outcomes. Results: The final cohort included 133,801 hospitalizations, representing an estimated 669,005 cardiac surgery hospitalizations nationally. AKI occurred in 123,240 weighted hospitalizations (18.4%). Compared with hospitalizations without AKI, those with AKI had higher unadjusted mortality (7.21% vs. 0.71%), longer LOS (14.4 vs. 6.3 days), greater rates of non-home discharge (68.1% vs. 41.2%), and higher hospitalization costs ($97,452 vs. $56,253). After adjustment for demographic, socioeconomic, clinical, and procedural characteristics, AKI remained independently associated with in-hospital mortality (adjusted odds ratio [aOR] 9.91, 95% confidence interval [CI] 8.95–11.00), non-home discharge (aOR 2.52, 95% CI 2.42–2.63), prolonged LOS (adjusted rate ratio [aRR] 1.88, 95% CI 1.85–1.91), and increased hospitalization costs (cost ratio 1.59, 95% CI 1.56–1.61). AKI was associated with an adjusted incremental cost of $33,497 per hospitalization, corresponding to an estimated national attributable cost burden of $4.13 billion during the study period. Conclusions: AKI complicates nearly one in five cardiac surgery hospitalizations in the United States and is associated with substantially increased mortality, healthcare utilization, and hospitalization costs. These findings highlight the significant clinical and economic burden of cardiac surgery–associated AKI and support continued efforts to improve prevention, risk stratification, and perioperative management. Full article

Cellulose acetate (CA) is a promising bio-derived membrane material for water treatment; however, its limited availability of active functional sites can restrict its affinity toward dissolved pollutants. In this study, a cellulose acetate membrane was fabricated by phase inversion and subsequently functionalized through novel direct graft copolymerization with bio-based itaconic acid (IA) using potassium persulfate (KPS) as an initiator in an aqueous medium. The grafting approach introduced carboxylic functional groups into the CA matrix, providing additional active sites for pollutant removal. The successful grafting was confirmed by UV–Vis and 1H NMR spectroscopy, while XRD indicated changes in the structural organization of the polymer matrix. SEM/EDS characterization further revealed morphological changes associated with grafting, and cross-sectional SEM showed the development of finger-like, continuous pore channels within the modified membrane. The effects of reaction time, IA concentration, and KPS concentration on the grafting percentage were systematically evaluated, with grafting increasing up to an optimum range before declining at excessive monomer or initiator concentrations. Thermal analysis demonstrated improved stability after grafting, with the 6.6% grafted CA-g-IA membrane exhibiting an initial decomposition temperature of 351 °C and a reduced weight loss of 85% at 500 °C, compared with 344 °C and 91%, respectively, for pristine CA. The 6.6% CA-g-IA membrane was subsequently evaluated for the removal of Cu(II) and methylene blue (MB) from aqueous solutions. Cu(II) uptake was strongly influenced by contact time, solution pH, initial concentration, and grafting percentage, with the highest performance observed around pH 6 and 240 min contact time. The membrane also maintained its Cu(II)-binding performance over four regeneration cycles following HNO₃ treatment. Overall, direct IA grafting provides a simple bio-based functionalization strategy for enhancing the pollutant-binding functionality of cellulose acetate membranes, demonstrating potential for the removal of metal ions and cationic dyes from contaminated water. Full article

Background/Objectives: Obesity and diabetes mellitus coexist, but the association of obesity with invasive management and in-hospital outcomes in acute myocardial infarction (AMI) complicated by cardiogenic shock is uncertain. We evaluated these associations among adults with diabetes mellitus. Methods: We performed a retrospective discharge-level analysis of the National Inpatient Sample for 2016–2021. Obesity was identified from ICD-10-CM codes. Survey-design logistic regression accounted for weights, strata, hospital clusters, and prespecified covariates. Results: The cohort comprised 19,399 discharges, representing 96,995 hospitalizations; 24.1% had obesity. Angiography and coronary artery bypass grafting (CABG) were more frequent with obesity, whereas percutaneous coronary intervention (PCI) was less frequent. After adjustment, obesity was associated with higher odds of angiography (adjusted odds ratio [aOR] 1.12, 95% confidence interval [CI] 1.03–1.21) and CABG (aOR 1.49, 95% CI 1.35–1.63), lower odds of PCI (aOR 0.90, 95% CI 0.84–0.97), and similar odds of circulatory support (aOR 1.00, 95% CI 0.93–1.07). Adjusted odds were lower for major adverse cardiovascular and cerebrovascular events (aOR 0.88, 95% CI 0.82–0.95), in-hospital mortality (aOR 0.90, 95% CI 0.83–0.98), acute ischemic stroke (aOR 0.78, 95% CI 0.64–0.95), and major bleeding (aOR 0.86, 95% CI 0.76–0.98). Procedure adjustment attenuated mortality and major bleeding. Conclusions: Obesity was associated with a different invasive-management pattern and lower adjusted odds of several short-term outcomes, consistent with an apparent in-hospital obesity paradox in this high-risk population. Full article

Glioblastoma remains the most lethal primary malignancy of the central nervous system, and the modest gains achieved with maximal surgery, radiotherapy and temozolomide have not been matched by the immune checkpoint inhibitors and antigen-specific vaccines that reshaped the treatment of many extracranial cancers. The recurrent disappointment of these approaches has been attributed less to a single molecular lesion than to a confluence of obstacles: profound intratumoural heterogeneity, a densely immunosuppressive and myeloid-rich microenvironment, sequestration and exhaustion of conventional T cells, and the practical difficulty of delivering effectors across the blood–brain barrier. Against this background, γδ T cells have attracted interest as an unconventional effector population that recognises transformed cells through stress-associated and metabolic cues rather than peptide–major histocompatibility complex (MHC) complexes, that kills in an MHC-unrestricted manner, and that can be expanded from healthy donors for allogeneic, off-the-shelf use with little expectation of graft-versus-host disease. This narrative review examines, with a deliberately critical lens, the biological rationale and the experimental evidence for γδ T cell-based immunotherapy of glioblastoma. We summarise the developmental biology and functional subsets of human γδ T cells, the natural killer group 2 member D (NKG2D)-, DNAX accessory molecule 1 (DNAM-1)- and T-cell-receptor-dependent mechanisms through which they engage glioblastoma cells and glioma stem-like cells, and the in vitro and animal-model studies that underpin the field, taking care not to overstate efficacy that has so far been demonstrated only in preclinical or early-phase settings. We then weigh the principal opportunities—locoregional and repeated dosing, combination with chemoradiotherapy, checkpoint blockade and antibody-based redirection—against barriers that include limited persistence, uncertain intratumoural trafficking, donor and manufacturing variability, and the unsettled requirements of potency testing and trial design. We give particular weight to what becomes of γδ T cells inside a hostile tumour—the exhaustion-like dysfunction that follows chronic stimulation, the oxygen and glucose dependence of their effector programme, the interleukin-17-polarising signals generated by activated microglia and by genotoxic therapy, and the confounding effect of corticosteroids—together with the engineering and pharmacological strategies proposed to counter them. The first peer-reviewed phase 1 report of intracranially delivered, drug-resistant γδ T cells has now appeared and documents tolerability in a small, single-arm cohort without establishing survival benefit. Throughout, γδ T cells are presented as a biologically plausible but still investigational strategy whose clinical value will be determined by adequately powered trials rather than by mechanistic appeal alone. Full article

Background: Simultaneous pancreas–kidney transplantation (SPKT) restores both renal function and endogenous insulin secretion in selected patients with type 1 diabetes mellitus (T1DM) and end-stage renal disease (ESRD). Whether SPKT provides superior patient survival, kidney graft outcomes and cardiovascular benefit compared with kidney transplantation alone (KTA) remains debated, particularly when KTA is performed from a living donor. Methods: A systematic review was conducted according to PRISMA 2020 guidelines. PubMed/MEDLINE was searched using a predefined strategy including terms related to pancreas transplantation, kidney transplantation alone, T1DM, and ESRD/chronic kidney disease. Eligible studies included adult T1DM/ESRD populations comparing SPKT with KTA, including living-donor kidney transplantation (LDKT) and deceased-donor kidney transplantation (DDKT) and reporting clinically relevant outcomes. Full texts were reviewed and categorized as core comparative evidence, secondary/supportive evidence or excluded records. A quantitative synthesis was additionally performed for studies reporting directly comparable adjusted hazard ratios for patient mortality and kidney graft failure in the SPKT versus LDKT comparison. Results: Nineteen observational studies met the inclusion criteria and were included in the qualitative synthesis. SPKT consistently provided superior metabolic control and insulin independence when pancreas graft function was maintained. Compared with deceased-donor or mixed KTA cohorts, SPKT was frequently associated with more favorable long-term patient survival and cardiovascular outcomes in selected recipients. However, comparisons with LDKT yielded less consistent results, with several registry-based analyses reporting equivalent or superior kidney graft and survival outcomes after living-donor transplantation. Quantitative synthesis of the two studies providing directly comparable adjusted hazard ratios demonstrated a higher risk of patient mortality (HR 1.30, 95% CI 1.10–1.54) and kidney graft failure (HR 1.43, 95% CI 1.24–1.66) following SPKT compared with LDKT. Formal meta-analysis of SPKT versus DDKT was not feasible because of substantial heterogeneity in outcome definitions, statistical reporting methods and follow-up duration across studies. Conclusions: In adults with T1DM and ESRD, successful SPKT provides a durable metabolic advantage and may improve long-term outcomes compared with deceased-donor KTA in selected patients. Across analyses that included all transplanted recipients from the time of surgery (intent-to-treat), early perioperative risk is higher after SPKT but may be offset over time when pancreas graft function is maintained. Evidence does not support a universal survival superiority of SPKT over living-donor kidney transplantation. Our quantitative synthesis of intent-to-treat, transplant-date analyses indicates that LDKT is associated with lower risks of patient mortality and kidney graft failure compared with SPKT when a suitable living donor is available. Treatment decisions should be individualized, considering living-donor availability, anticipated waiting time and dialysis exposure, cardiovascular and surgical risk, and the likelihood of durable pancreas graft function, with greater weight given to contemporary cohorts. Full article

Background: Volumetric evaluation is critical in living donor liver transplantation. Liver volume, depending on body weight and height, and radiological estimates have made important contributions, but some inconsistencies remain. We aimed to assess the estimated and radiological liver volumes with respect to actual graft weight and potential factors contributing to inaccuracy. Method: A total of 623 donors were evaluated in this retrospective study. The estimated liver volumes were calculated with the Vauthey formula. The laboratory and liver biopsy results were obtained. Three-dimensional liver tomography was used to assess liver volume. Actual graft weight was measured on the back table after perfusion. Graft types were recorded. A discrepancy of more than 10% is accepted as discordant. The possible reasons were evaluated. Results: The mean estimated liver volume and radiological liver volume were 1216 cm³ and 1290 cm³, respectively. The mean radiological right lobe volume and the actual right lobe graft weight were 815 and 846, respectively. Liver density, liver steatosis percentage, blood cholesterol levels, blood triglyceride levels, and blood total bilirubin levels are factors contributing to the disparity between the estimated and radiological volume differences. Vitamin B12 and albumin levels were associated with the discrepancy between radiological liver volume and actual graft weight. Underestimation was significant in the left lateral lobe. Conclusions: Three-dimensional volumetry is useful for size matching. Discrepancies of more than 10% are attributable to liver steatosis or splitting lines. Full article

Background: Erectile dysfunction and cardiovascular disease share common pathophysiological mechanisms, yet little is known about the postmortem cardiac profile of men with detectable sildenafil use. This study investigated whether postmortem sildenafil positivity is associated with acute or chronic cardiac pathological findings in men who died of ischemic heart disease. Methods: In a sample of 154 male decedents who died of ischemic heart disease, postmortem cardiac and toxicological findings in 77 sildenafil-positive cases were compared with those of age-matched controls. Heart weight z-scores were calculated based on 27,645 reference autopsies. Multivariable logistic regression analyses were performed to identify independent associations. Results: No significant differences were observed between groups regarding acute ischemic pathologies. However, chronic cardiac findings were more prevalent in the sildenafil-positive group, including coronary artery disease (96.1% vs. 85.7%; p = 0.025), congestive heart failure (40.3% vs. 24.7%; p = 0.039), prior coronary artery bypass grafting (24.7% vs. 11.7%; p = 0.037), increased heart weight (547.7 gr vs. 507.5 gr; p = 0.037) and z-score (+1.63 vs. 1.08; p = 0.040), and coronary calcification (88.3% vs. 74.0%; p = 0.023). After adjustment for cardiovascular comorbidities, only coronary calcification remained independently associated (adjusted OR: 2.586; 95% CI: 1.076–6.215; p = 0.034). Conclusions: Sildenafil-positive cases showed no excess of acute ischemic pathology. However, sildenafil-positive cases had a greater burden of chronic cardiac pathology, particularly coronary calcification. These findings are consistent with the proposed role of coronary artery calcification as a surrogate marker of erectile dysfunction and cardiovascular disease. They also underscore the importance of cardiovascular risk assessment in sildenafil users and support a cautious approach in individuals with poor cardiac reserve. Full article

Background: Postoperative antiplatelet selection after coronary artery bypass grafting (CABG) in adults aged ≥70 years requires balancing ischemic protection against bleeding risk. Methods: We conducted a single-center retrospective cohort study of adults aged ≥70 years who underwent isolated CABG for unstable angina between 2017 and 2021. The exposure was the initial discharge antiplatelet pathway: aspirin 100 mg once daily or indobufen 100 mg twice daily as the cyclooxygenase-inhibitor component, combined with a P2Y12 inhibitor during the first postoperative year and followed by the same cyclooxygenase inhibitor during the second year. Propensity scores were estimated using multivariable logistic regression with 16 prespecified baseline covariates, and stabilized inverse probability of treatment weighting (IPTW) was applied. The primary analyses used IPTW-weighted Cox models. Results: Among 336 screened patients, 79 were included in the final analytic cohort (aspirin-based pathway, n = 49; indobufen-based pathway, n = 30). After weighting, measured covariate balance improved, although residual imbalance remained for prior myocardial infarction and prior percutaneous coronary intervention. At 24 months, no statistically significant association was observed between pathway and MACCE (HR 0.858, 95% CI 0.257–2.866; p = 0.803), BARC grade ≥2 bleeding (HR 0.359, 95% CI 0.093–1.385; p = 0.137), or NACE (HR 0.526, 95% CI 0.204–1.360; p = 0.185). Graft surveillance was evaluable in 77/79 patients at 1 year and 71/79 at 2 years and was analyzed descriptively. Conclusions: In this real-world cohort of older patients undergoing CABG for unstable angina, an initial indobufen-based discharge pathway was not statistically significantly associated with 24-month MACCE, BARC grade ≥2 bleeding, or NACE compared with an aspirin-based pathway after stabilized IPTW. These findings add exploratory CABG-specific data on indobufen in older patients and should be confirmed in larger prospective studies. Full article

A 64-year-old woman presented with recurrent abdominal pain and rapid weight loss of 10 kg. Five years prior, an abdominal endovascular aneurysm repair (EVAR) was performed, followed by an open repair with proximal graft interposition due to an endoleak type IA two years ago. Laboratory tests revealed only moderately elevated infection markers (CrP 66 mg/L, WBC 14 GPt/L). ¹⁸F-FDG PET/CT showed a hypermetabolic peri-aortic mass initially suspected to be inflammatory. However, the patient did not exhibit signs of fever. Because of the equivocal constellation, a fine-needle biopsy was conducted, revealing malignant cells. The patient underwent complete tumor resection including aortic replacement. Histopathology confirmed the diagnosis of an angiosarcoma. The treatment was then supplemented with chemotherapy using doxorubicin and ifosfamide. Full article

We evaluated moderate cluster-zone warming in field-grown Monastrell grafted onto 110R and 140Ru over two seasons (2020–2021) in a semi-arid vineyard in south-eastern Spain. From pea-size to harvest, an open warming system increased cluster-zone air temperature by 1.15 °C on average. Warming increased cluster-zone mean and maximum temperatures, but berry temperature responses depended on year and rootstock because berry–air temperature differences and also time above thresholds changed. Berry weight increased in harvest in both years, and technological ripening advanced, with higher total soluble solids and maturity index, especially during ripening. Acid composition responded differently between rootstocks: under warming, 140Ru maintained higher malic acid and lower tartaric acid than 110R, resulting in a lower tartaric/malic ratio. Phenolic and colour responses were clearest at mid-ripening. Warming reduced must total phenolic index (TPI), skin-related phenolics, anthocyanins, and must colour more strongly in 140Ru, while 110R retained a more stable phenolic and colour profile. Exposure–response analyses showed that time in the 25–35 °C range and berry thermal time were more closely related to technological and phenolic variation than time above 35 °C. These results suggest that, under the warming conditions imposed in this study, 110R offered a better compromise than 140Ru between ripening advancement and the preservation of phenolic and colour-related traits. Full article