Search Results (921)

Mercury (Hg) is a global pollutant that poses a serious threat to ecosystems and human health. Biochar has shown great potential for mercury removal due to its porous structure and abundant surface functional groups. However, redox-active moieties on biochar can reduce adsorbed Hg²⁺ to volatile Hg⁰, leading to secondary mercury dispersion. To suppress this reduction, this study proposes a strategy of co-pyrolyzing coal gangue with rice husk to prepare composite biochars (RHB/CG), leveraging the abundant metal oxides in coal gangue to tailor the surface chemistry of biochar. The materials were characterized by FTIR, Raman, and XRD; static adsorption, mercury speciation analysis, and kinetic experiments were conducted. The results show that coal gangue incorporation significantly enhances the Hg²⁺ adsorption capacity of biochar, with the equilibrium adsorption capacity calculated by the pseudo-second-order kinetic model, increasing from 20.6 mg/g for pristine RHB to 38.7 mg/g for RHB/CG-1:1. More importantly, RHB/CG composites effectively suppress the reduction of Hg²⁺ to Hg⁰, and the amount of Hg⁰ accumulated in the system is 57.1% lower than that of pristine RHB. Mechanistic studies reveal that coal-gangue-derived basic functional groups (e.g., C–O–C, Si–O–M) inhibit reduction via sequestering Hg²⁺ through coordination and disruption of electron transfer pathways. PHREEQC simulations (pe = 6.0) confirm the decreased tendency of Hg²⁺ reduction to Hg⁰ with increasing pH, in good agreement with the experimental results showing reduced Hg²⁺ reduction. The corresponding results provide a green and sustainable solution for mercury-contaminated water and soil remediation. Full article

Cholangiocarcinoma (CCA) in Northeast Thailand is characterized by late diagnosis and poor prognosis, creating a critical need for effective early-detection biomarkers. This study utilized a multi-omics approach to identify novel diagnostic targets and improve CCA screening. Initial serum proteomic and transcriptomic analyses revealed significant upregulation of the luteinizing hormone/choriogonadotropin receptor (LHCGR) in CCA patients, correlating with advanced disease stages. Interaction network analysis subsequently identified its circulating ligand, beta-human chorionic gonadotropin (β-hCG), as a highly translatable clinical target. The protein expression of β-hCG was assessed via immunohistochemistry (IHC) in 100 tissue samples, and serum levels of β-hCG, alongside routine markers (CA19-9, AFP, and CEA), were quantified in a cohort of 405 individuals, including 153 CCA patients. IHC confirmed significantly higher β-hCG expression in tumor tissues compared to adjacent areas (p < 0.0001). Serum β-hCG levels were significantly elevated in CCA patients and correlated with tumor volume and reduced overall survival. Diagnostically, a combined multiparameter panel (β-hCG, carbohydrate antigen 19-9, carcinoembryonic antigen, and alpha-fetoprotein) yielded excellent accuracy in distinguishing CCA from healthy controls (AUC: 0.962) and hepatocellular carcinoma cases (AUC: 0.890). However, discriminatory efficiency was notably lower when differentiating CCA from benign biliary diseases (AUC: 0.680) and liver metastases (AUC: 0.705). In conclusion, activation of the LHCGR signaling axis is a novel pathophysiological feature in CCA. When integrated into a multi-marker blood panel, circulating β-hCG serves as a valuable complementary risk-stratification and prognostic tool, though further optimization is required to overcome limited specificity in the presence of confounding liver pathologies before routine clinical implementation. Full article

Normogonadotropic azoospermia (NOAN) represents a diagnostic and therapeutic challenge in male infertility, affecting men with normal gonadotropin levels but absent sperm in the ejaculate. Emerging evidence has identified 17-hydroxyprogesterone (17OHP) as a potential biomarker for detecting reduced intratesticular testosterone (ITT) levels, and the presence of round spermatids in ejaculate as an indicator of residual spermatogenic activity. This report synthesizes current evidence on a proposed hypothesis-generating diagnostic framework that utilizes these markers to guide hormonal treatment strategies. Specifically, patients with elevated 17OHP levels (>1.18 ng/mL) and detectable round spermatids may benefit from combined human chorionic gonadotropin (hCG) and follicle-stimulating hormone (FSH) therapy at doses lower than those used for hypogonadotropic hypogonadism. However, this cutoff has not been prospectively validated in NOAN-specific cohorts, and the evidence supporting this approach remains preliminary, derived from small heterogeneous cohorts. Alternative therapeutic strategies, including FSH monotherapy and non-hormonal pharmacological treatments, are also discussed. This framework requires rigorous prospective validation before clinical implementation. Full article

Background and Clinical Significance: Placental site trophoblastic tumour (PSTT) is a malignant tumour of the implantation site intermediate trophoblasts. It has historically been described using terms such as atypical chorioepithelioma, atypical choriocarcinoma, syncytioma, and chorioepitheliosis. It belongs to one of the heterogeneous spectrums of gestational trophoblastic disease. It accounts for about 0.25 to 5% of all gestational trophoblastic neoplasia. The typical clinical presentation is alternating menorrhagia and amenorrhea, mildly elevated β-hCG, and radiological findings of a uterine mass. Case Presentation: A 32-year-old woman presented with a history of intermittent menorrhagia and amenorrhea, with a persistent mildly raised β-hCG level. Ultrasonography showed a hypoechoic lesion on the right side of the posterior wall of the uterus. She was diagnosed with a missed miscarriage, and an evacuation of the products of conception was performed. Histologically, the tissue fragments comprised cords and sheets of atypical intermediate trophoblast cells, with characteristic features of myometrial smooth muscle infiltration, vascular invasion, and vascular wall replaced by the neoplastic cells. Immunohistochemically, these cells are positive for β-hCG and GATA3, while negative for P63. Conclusions: PSTT is a rare form of gestational trophoblastic neoplasia. Early recognition of PSTT is essential because its clinical presentation may mimic benign pregnancy-related conditions, and diagnosis relies heavily on histopathological and immunohistochemical evaluation. Full article

Background and Objectives: The optimal oocyte yield in gonadotropin-releasing hormone (GnRH) antagonist in vitro fertilization (IVF) cycles remains debated, and data specific to antagonist protocols are limited. This study evaluated the discriminative and independent predictive performance of oocyte count for clinical pregnancy in GnRH antagonist IVF cycles. Materials and Methods: This retrospective cohort included 1171 women undergoing their first GnRH antagonist IVF cycle with fresh embryo transfer at a single tertiary center (September 2007–December 2021). The primary outcome was an institutional composite pregnancy outcome (sustained β-hCG positivity with subsequent ongoing intrauterine pregnancy or live birth; biochemical and ectopic pregnancies were negative). Patients were grouped by oocytes retrieved (1–5, 6–10, 11–15, ≥16). Performance was assessed with logistic regression, ROC with 2000-iteration bootstrap, integrated discrimination improvement (IDI), continuous net reclassification improvement (NRI), and restricted cubic spline. Predefined subgroup analyses by age, regimen, and antral follicle count tertile were performed. Results: A positive outcome occurred in 430 patients (36.7%). After adjustment, oocyte count was not an independent predictor (adjusted odds ratio 0.999, 95% CI 0.979–1.020; p = 0.96). The full model (AUC 0.564, 95% CI 0.529–0.598) did not outperform oocyte count alone (AUC 0.532; bootstrap p = 0.11). IDI (0.011) and NRI (0.135) were statistically detectable but clinically trivial. Spline regression showed no non-linearity (p = 0.47). Findings were consistent across subgroups, and the narrow confidence interval excluded per-oocyte effects ≥1.10. Conclusions: In GnRH antagonist IVF cycles, oocyte count showed weak discriminatory performance and was not independently associated with fresh-cycle pregnancy. Oocyte yield should be interpreted alongside—rather than as a substitute for—established parameters such as age and ovarian reserve. The principal clinical value of a higher oocyte response may lie in cumulative rather than fresh-cycle success. Live-birth outcomes were not available, and the source institution was permanently closed in 2025; these limitations define the boundary of inference. Full article

Resistance training (RT) can help with injury recovery and the healing process. Still, high-intensity exercise can cause ischemia and reperfusion, resulting in exacerbated production of reactive oxygen species and oxidative stress. This study aimed to evaluate the effects of RT with progressive loads on markers of tissue damage and oxidative stress in rats subjected to skin lesions. Forty male Wistar rats were used, divided into four groups (n = 10): Control (CG): no intervention; Sedentary Injury (SHAM): subjected to injury, no training; Training + Injury 1 (G1): injury after one week of training; Training + Injury 2 (G2): injury followed by training. The protocol consisted of climbing a vertical ladder three times a week, 48 h apart, using progressive loads (50%, 65%, and 80%). After euthanasia, markers of tissue damage (CK, LDH, ALT, AST), oxidative stress (MDA/TBARS, SH, uric acid), and histological analysis of collagen deposition in the injured tissue were assessed. Groups G1 and G2 showed a significant increase (p < 0.0001) in CK, LDH, ALT, and AST levels compared to GC and SHAM. Oxidative stress markers, such as MDA and SH, were also elevated in the G1 and G2 groups (p < 0.0001). Uric acid concentrations increased significantly in the exercised groups compared to the controls (p < 0.0001). Histology revealed an inflammatory infiltrate and disorganized collagen fibers in the SHAM group, while G1 and G2 showed tissue with greater cellular maturity and organization. Although RT induced muscle damage and an increase in pro-oxidant markers, it also favored cellular organization and scar tissue quality. Full article

Three WC-10Co-4Cr coatings with different WC grain sizes were prepared by high-velocity air-fuel (HVAF) spraying. The corrosion behaviors were systematically evaluated in 0.2 mol/L H₂SO₄ and 0.4 mol/L HNO₃ solutions through immersion tests and electrochemical measurements. The results reveal that WC grain size governs coating microstructural integrity, mechanical properties, and corrosion resistance. Among the three coatings, the medium-grained (MG) coating exhibits an optimized balance between compact microstructure, high microhardness, superior fracture toughness, and the best corrosion resistance in both acidic environments. The coarse-grained (CG) coating exhibits the worst corrosion resistance owing to its wide grain boundaries and high porosity, while the fine-grained (FG) coating is similarly compromised by slightly higher porosity and residual stress-induced microcrack networks that facilitate electrolyte penetration. The corrosion proceeds via preferential dissolution of Co in the CoCr binder phase driven by micro-galvanic coupling with WC, followed by WC particle detachment and pit formation. In a 0.4 mol/L HNO₃ solution, the strong oxidizing nature accelerates both binder dissolution and direct WC oxidation. Full article

Background: Ectopic pregnancy remains a significant cause of maternal morbidity in early pregnancy. While most ectopic pregnancies happen within the fallopian tube, implantation may rarely occur in atypical locations such as the ovary or abdominal cavity. These rare forms often present with nonspecific clinical findings and may represent a considerable diagnostic challenge. Methods: We report a case series of three rare ectopic pregnancies managed at a tertiary referral center. Two cases involved ovarian pregnancy, and one case represented an exceptionally rare hepatic ectopic pregnancy. Clinical presentation, diagnostic pathway, surgical management, and outcomes were analyzed and compared with available literature. Results: In the first two cases, ovarian pregnancy was confirmed intraoperatively and treated surgically, with ovarian preservation in one patient and adnexectomy in the other due to active bleeding. The third case had an unusual course: initial surgery was performed for hemoperitoneum caused by a ruptured corpus luteum cyst, while persistent β-hCG elevation later led to identification of hepatic ectopic pregnancy, confirmed by imaging and surgery. All patients recovered favorably, with complete β-hCG negativization. Conclusions: Rare ectopic implantation sites may mimic acute abdominal conditions and remain difficult to diagnose preoperatively. High clinical suspicion, serial β-hCG monitoring, and appropriate imaging are essential. Surgical management remains central, particularly in life-threatening bleeding. Standard algorithms for tubal ectopic pregnancy may not be fully applicable and should be adapted to the clinical context. Full article

Background: Interstitial ectopic pregnancy (IEP) is a rare but potentially life-threatening form of ectopic pregnancy because rupture can result in catastrophic hemorrhage. Accurate diagnosis is particularly challenging when implantation occurs near a previously operated interstitial/cornual region, where postoperative scarring and anatomical distortion may mimic recurrent IEP. We report a case of two surgically managed interstitial/cornual pregnancies at the same anatomical site, followed by a third pregnancy that initially appeared to be recurrent IEP but ultimately progressed to term delivery. Case Presentation: A 35-year-old woman underwent IVF-ET after unsuccessful intrauterine insemination and a prior failed IVF-ET attempt. After a missed abortion from the second IVF-ET cycle requiring dilatation and curettage, she conceived again through a third IVF-ET cycle. Transvaginal ultrasound demonstrated a gestational sac in the right interstitial/cornual region with outward bulging, thinning of the overlying myometrium, and delayed embryonic growth. Because of the high risk of rupture, laparoscopic wedge-shaped excision of the bulging gestational sac with uterine repair was performed. Three months later, she conceived spontaneously, and the gestational sac again developed at the previous interstitial/cornual surgical site. The surrounding myometrium was extremely thin, and serum β-hCG increased despite methotrexate treatment. Laparoscopic cornuostomy with right salpingectomy was therefore performed. After another 3-month recovery period, she conceived spontaneously again. The third pregnancy was initially suspected to represent recurrent IEP because the gestational sac was located near the same right posterior interstitial/cornual region. However, unlike the previous pregnancies, the gestational sac maintained broad contact with the endometrial cavity, showed no narrowed connection, preserved myometrial thickness of at least 5 mm, and expanded inward toward the uterine cavity rather than outward. With intensive ultrasound surveillance and fully informed consent, expectant management was continued. A healthy male infant weighing 2930 g was delivered by planned cesarean section at 37 + 0 weeks of gestation. Conclusions: This case highlights the importance of serial sonographic assessment in pregnancies suspected to be recurrent IEP. In a surgically altered cornual region, eccentric intrauterine implantation may mimic recurrent interstitial ectopic pregnancy at initial presentation. Broad communication with the endometrial cavity, absence of a narrowed connection, maintained myometrial thickness, and inward progression may help distinguish such cases from true recurrent IEP. Expectant management should be considered only in exceptional cases with hemodynamic stability, intensive imaging surveillance, immediate surgical availability, and fully informed patient consent. Full article

Background/Objectives: Immune checkpoint inhibitors targeting the PD-1/PD-L1 axis have transformed cancer treatment, yet therapeutic responses remain limited in many solid tumors due to poor and uneven drug distribution within the tumor microenvironment (TME). Here, we evaluated whether co-formulation of an anti-PD-1 antibody (RMP1-14, murine surrogate for pembrolizumab) with Imagent^® microbubble/liposome (MBLP) complexes and ultrasound activation could enhance tumor-specific delivery while reducing systemic exposure. Methods: Immunocompetent MC-38 colorectal tumor-bearing mice (B6(Cg)-Tyrc-2J/J, 7-week-old females) received isotype control, isotype/MBLP/US, RMP1-14 alone, RMP1-14/MBLP, or RMP1-14/MBLP/US. Survival was analyzed by Kaplan–Meier curves, tumor necrosis by H&E staining, antibody biodistribution by immunohistochemistry, and tumor perfusion by laser speckle imaging. Results: No significant differences in tumor size or body weight were observed between groups. Survival analysis showed significant improvements in the RMP1-14 (p = 0.013) and RMP1-14/MBLP/US (p = 0.047) groups versus isotype controls, with the RMP1-14/MBLP/US group achieving the longest mean survival (57.8 days vs. 26.5 days for RMP1-14 alone) and complete tumor regression in 2/8 mice. The RMP1-14/MBLP/US group demonstrated significantly greater tumor necrosis than all other groups. Immunohistochemical analysis confirmed a 6.1-fold increase in intratumoral antibody accumulation with MBLP/US versus RMP1-14 alone (p = 0.0003), alongside significantly reduced off-target exposure in spleen, liver, kidney, and heart. Laser speckle imaging revealed a transient ~30% increase in tumor perfusion during MBLP/US treatment, consistent with cavitation-mediated hemodynamic effects. Conclusions: These findings demonstrate that MBLP/US co-formulation enhances intratumoral delivery of checkpoint inhibitors, improves survival, and reduces systemic organ exposure, representing a promising platform to improve the efficacy and safety profile of antibody-based immunotherapy. Full article

Vaquejada (VQ) is a traditional Brazilian sport demanding high performance from Quarter Horse (QH) athletes. This study aimed to identify modifications in hematological, biochemical, inflammatory, and oxidative stress biomarkers associated with VQ training, comparing conditioned and non-conditioned horses. Blood samples were collected at rest from 70 healthy QH horses: 60 athletes (VQ-conditioned athlete group—AG) and 10 sedentary controls (breeding horses—CG). Using Linear Mixed Models alongside comprehensive hematological and biochemical analyses, the study found that AG horses exhibited an altered homeostatic profile, characterized by significant reductions in erythrocytes (7.0 [2.7] vs. 8.0 [1.6]; p = 0.021), lymphocytes (33.0 [21.0] vs. 41.0 [25.0]; p = 0.028), and the antioxidant enzymes catalase (1.5 [0.5] vs. 2.4 [1.4]; p = 0.026) and myeloperoxidase (141.5 [53.9] vs. 235.6 [30.4]; p = 0.022) relative to CG. Conversely, marked increases were observed in band neutrophils (59.0 [16.0] vs. 49.0 [27.0]; p = 0.028), platelets (276.0 [115.0] vs. 160.0 [113.6]; p = 0.026), and malondialdehyde levels (177.5 [211.8] vs. 1475.0 [802.5]; p < 0.001), evidencing lipid peroxidation. These findings indicate that VQ induces severe oxidative stress and compromises immune functions, with horses presenting oxidative rather than inflammatory damage. Dietary monitoring is therefore recommended to mitigate such effects at 96 h post-exercise. Full article

Human follicular development depends on coordinated communication between granulosa cells (GCs) and oocytes through endocrine cues, direct contacts, and extracellular vesicles (EVs). Exosomes are key EV mediators of intrafollicular signaling, but their cargo and functions in gonadotropin-stimulated GCs remain poorly defined. The human granulosa-like tumor cell line KGN was used to investigate exosome secretion and protein composition following human chorionic gonadotropin (hCG) stimulation. Exosomes were isolated by ultracentrifugation, characterized via nanoparticle tracking analysis (NTA), Scanning Electron Microscopy (SEM) and Western blotting, and analyzed using high-resolution mass spectrometry. Comparative proteomics integrating exosomal profiles with the whole secretome were performed, followed by bioinformatic analyses of protein networks, gene ontology, and pathway enrichment. hCG reshaped exosomal cargo, identifying 59 proteins enriched in exosomes, including Integrin α3 (ITGα3), Galectin-3-binding protein (LGALS3BP), tetraspanins (CD63, CD151), and proteasome subunits. Functional enrichment indicated roles in extracellular matrix remodeling, integrin signaling, proteostasis, and steroidogenesis. Comparison with the secretome revealed distinct protein distributions, supporting selective exosomal packaging. Western blot confirmed increased ITGα3 and LGALS3BP levels in exosomes upon hCG treatment. In conclusion, hCG modulates exosome cargo composition in granulosa cells, uncovering a novel mechanism of extracellular regulation. Full article

Background: Cervical pregnancy and cesarean scar pregnancy are rare forms of non-tubal ectopic pregnancy associated with a high risk of severe hemorrhage, surgical intervention, and potential loss of fertility. We describe a unique case of sequential abnormal implantation in which a cervical pregnancy was followed by a cesarean scar pregnancy one year later. The occurrence of two distinct forms of non-tubal ectopic pregnancy in a single patient represents an exceptionally uncommon clinical scenario, underscoring the importance of early diagnosis and carefully planned treatment. Case presentation: A 39-year-old woman, gravida 4 para 3, was diagnosed with two distinct non-tubal ectopic pregnancies over a 1-year period. The first pregnancy was implanted in the cervical canal, whereas the second was located within the cesarean section scar. In each episode, the diagnosis was established early by transvaginal ultrasound. As the patient was hemodynamically stable and wished to preserve fertility, minimally invasive hysteroscopic evacuation was performed in both pregnancies. The procedures were completed without significant intraoperative bleeding, and no additional hemostatic interventions were required. Follow-up serum β-hCG levels became negative after treatment, confirming complete resolution of pregnancies. Conclusions: This case demonstrates that early ultrasonographic diagnosis and careful individualized management may enable successful fertility-preserving treatment even in exceptionally rare cases. It also supports the potential role of minimally invasive approaches in selected hemodynamically stable patients and highlights the need for standardized management protocols for cervical and cesarean scar pregnancy. Full article

Successful embryo implantation requires dynamic, bidirectional communication between a developmentally competent blastocyst and a receptive endometrium, integrating hormonal, molecular, and immunologic signals. Increasing evidence indicates that endometrial receptivity is critically dependent on a specialized immune microenvironment that supports trophoblast invasion while maintaining maternal tolerance. This review synthesizes current knowledge on the immunologic regulation of implantation, with emphasis on uterine natural killer (uNK) cells, regulatory T cells (Tregs), macrophages, dendritic cells, and cytokine networks. We further examine intracellular signaling pathways—including JAK/STAT, PI3K/AKT, NF-κB, and MAPK—that integrate immune and decidual responses. The bidirectional embryo–endometrium dialogue is explored through embryo-derived mediators such as human chorionic gonadotropin (hCG), cytokines, growth factors, and extracellular vesicles. The endometrium is increasingly recognized as a biosensor of embryo quality, selectively supporting viable embryos. Disruption of this complex communication network is implicated in recurrent implantation failure and early pregnancy loss. Despite substantial mechanistic advances, clinical translation remains limited. Emerging strategies, including immune profiling, microbiome modulation, and extracellular vesicle-based diagnostics, hold promise for precision reproductive medicine. Full article

Yersinia enterocolitica strains of biotype 4 (BT4) are the most prevalent in human cases in France, followed by biotype 2 (BT2). We evaluated four BT4 porcine (P) isolates and four BT2 bovine (B) isolates for their ability to survive at 4 °C in culture broth and on meat, exhibit motility at 4 °C and 12 °C, adhere to stainless steel at 12 °C, resist five biocides, and infect human intestinal Caco-2 cells. The objective was to determine whether animal isolates that genetically cluster with human (H) isolates (P+H+, B+H+) differ phenotypically from non-clustering isolates (P+H−, B+H−), based on core genome multi-locus sequence typing (cgMLST) using allelic distance thresholds of ≤5 for BT4 and ≤3 for BT2 isolates. No significant difference was observed for BT4 between P+H+ and P+H− isolates, nor for BT2 between B+H+ and B+H− isolates, for any test, except for motility. Porcine isolates clustering with human isolates (H+) exhibited a significantly reduced motility compared with non-clustering isolates (H−) (p-value < 0.05). In contrast, bovine isolates clustering with human isolates (H+) showed a significantly higher motility than non-clustering isolates (H−). Motility plays a role in the early stages of biofilm formation but is not directly involved in virulence, as Y. enterocolitica becomes non-motile at 37 °C. Animal isolates that did not cluster with human isolates displayed traits enabling their transmission along the food chain, suggesting potential low-level human exposure, asymptomatic carriage, or links to unreported infections. Full article