Search Results (137)

Background: Endonasal endoscopic approaches to the skull base are still under investigation, with research aiming to achieve minimally invasive procedures that maximize resection while minimizing complications. This study shares our experience with a mononostril technique and compares it with the existing literature on mononostril approaches for sellar lesions. Methods: A systematic review of eight large series, totaling 1520 patients who underwent endoscopic mononostril transsphenoidal surgery, was performed. The surgical technique was detailed, and parameters such as resection completeness, operative time, complications, and nasal symptoms were analyzed. Results: Gross total resection ranged from 56% to 100% for non-functioning adenomas, 54% to 89% for hormone-secreting adenomas, and 83% to 100% for other sellar lesions. The most common complications were CSF leaks (1.5–4.1%) and nasal issues, such as epistaxis or sinusitis (0–6%). Internal carotid artery injury occurred in 0–1% of cases. The average surgical duration was 87 to 168 min. Conclusions: The mononostril approach offers comparable resection rates, CSF leak risks, and morbidity to binostril or microsurgical methods. The mononostril approach is fast, minimally invasive, and preserves the nasal mucosa, making it a viable option for many sellar lesions. Full article

Background/Objectives: Colorectal anastomotic leak (CAL) is one of the most severe postoperative complications in colorectal surgery, impacting patient morbidity and mortality. Current risk assessment methods rely on clinical and intraoperative factors, but no real-time predictive tool exists. This study aimed to develop an artificial intelligence model based on intraoperative laparoscopic recording of the anastomosis for CAL prediction. Methods: A convolutional neural network (CNN) was trained with annotated frames from colorectal surgery videos across three international high-volume centers (Instituto Português de Oncologia de Lisboa, Hospital das Clínicas de Ribeirão Preto, and Royal Liverpool University Hospital). The dataset included a total of 5356 frames from 26 patients, 2007 with CAL and 3349 showing normal anastomosis. Four CNN architectures (EfficientNetB0, EfficientNetB7, ResNet50, and MobileNetV2) were tested. The models’ performance was evaluated using their sensitivity, specificity, accuracy, and area under the receiver operating characteristic (AUROC) curve. Heatmaps were generated to identify key image regions influencing predictions. Results: The best-performing model achieved an accuracy of 99.6%, AUROC of 99.6%, sensitivity of 99.2%, specificity of 100.0%, PPV of 100.0%, and NPV of 98.9%. The model reliably identified CAL-positive frames and provided visual explanations through heatmaps. Conclusions: To our knowledge, this is the first AI model developed to predict CAL using intraoperative video analysis. Its accuracy suggests the potential to redefine surgical decision-making by providing real-time risk assessment. Further refinement with a larger dataset and diverse surgical techniques could enable intraoperative interventions to prevent CAL before it occurs, marking a paradigm shift in colorectal surgery. Full article

The aging of dry meat enhances its flavor and tenderness; however, continuous internal quality monitoring throughout the aging process is challenging. We developed and validated a novel electromagnetic response measurement system for meat aging that enables continuous bioimpedance monitoring under stable, optimal temperature/humidity conditions. The system comprises a temperature-controlled dry aging fridge and a newly designed puncture-type semi-rigid coaxial probe, allowing for minimally invasive internal measurements over a broad frequency range. The probe achieved stable measurements across 10 kHz to 10 MHz, and its small diameter (1.25 mm) enabled almost non-destructive internal sensing. Beef and pork samples were monitored over 14 days via multi-channel bioimpedance measurements. After an initial stabilization period, bioimpedance steadily decreased throughout aging. This decline reflected progressive increases in tissue conductivity as cell membranes broke down and intracellular fluids leaked out. High-frequency measurements (e.g., around 10 MHz) were more sensitive to environmental disturbances. Periodic defrost cycles in the chamber caused temporary impedance dips at these frequencies, highlighting the influence of short-term temperature/humidity fluctuations. The system enables long-term continuous measurement without removing samples from the fridge, thus maintaining aging conditions during monitoring. Overall, the system enables the stable, long-term, and multi-channel electromagnetic monitoring of meat quality under optimal aging conditions—a capability not achieved in previous studies. This new method offers a minimally invasive, frequency-resolved approach for assessing meat quality evolution during aging. This advance demonstrates a new approach for tracking meat quality changes during dry aging. Full article

With the widespread use of Internet technologies, the protection of personal data to ensure cyber security and privacy compliance has become a major challenge for not only enterprises but also governments. Traditional Data Loss Prevention (DLP) systems primarily focus on preventing internal data from leaking out. However, there is a lack of effective solutions to proactively detect sensitive images already exposed on the Internet. To address these challenges, we developed an automatic sensitive image search system to identify data leaks on the Internet. Our system utilizes artificial intelligence (AI) to automatically search, detect and flag potential privacy-leaking data that contains personal data. We first analyze the sensitive data, such as identification (ID) cards, driver’s licenses, passports, and financial statements, to obtain the standardized document layouts and their personal data elements. Then, our system uses generative AI (GenAI) to generate an example image of user-defined sensitive data. This example image is applied to search target images from the Internet. As there may be lots of target images, we propose AI-driven methods to effectively suppress meaningless matches and then analyze the meaningful images to identify sensitive content. At last, remediation recommendations for cyber security and privacy compliance are then provided by large language models (LLMs). To demonstrate the real value of our system, we have shown some examples of searching data leaks on the Internet. Our system does discover some significant issues. Full article

With the introduction of the “dual carbon” strategy, public attention to green energy has surged, leading to a notable increase in the demand for natural gas. Consequently, the storage and transportation of liquefied natural gas (LNG) have emerged as critical aspects to ensure its safe and cost-effective utilization. For onshore LNG storage, LNG storage tanks play a pivotal role. However, in extreme scenarios such as fires, these tanks may be exposed to radiant heat, which not only jeopardizes their structural integrity but could also result in LNG leaks, triggering severe safety incidents and environmental disasters. Against this backdrop, this study delves into the evaporation characteristics of large-scale LNG storage tanks under fire radiation conditions. Given the unique properties of LNG and the similarity between the bubble-point lines and heat exchange curves of nitrogen and LNG, liquid nitrogen is employed as a substitute for LNG in experimental investigations to observe evaporation behaviors. Furthermore, the FLUENT 2022R1 software is utilized to conduct numerical simulations on a 160,000-cubic-meter LNG storage tank, aiming to model the intricate process of internal evaporation and the impact of environmental factors. The findings of this research aim to furnish a scientific basis for enhancing the storage safety of large-scale LNG storage tanks. Full article

Land Degradation Neutrality (LDN) is an ambitious initiative by the United Nations Convention to Combat Desertification (UNCCD) to tackle land degradation. Inspired by the “no net loss” concept, LDN seeks to counterbalance unavoidable land degradation—primarily driven by food systems—through targeted regenerative actions at multiple scales—such as regenerative agriculture or grazing practices that simultaneously support production and preserve land fertility. The objective is to ensure that degradation does not surpass the 2015 baseline. While the UNCCD’s Science–Policy Interface provides guidance and the LDN Target Setting Programme has led many countries to define baselines using agreed indicators (soil organic carbon, land use change, and primary productivity), concrete intervention strategies often remain poorly defined. Moreover, the voluntary nature of LDN has limited its effectiveness. A key shortcoming is the lack of integrated planning. LDN should function as a “Plan of Plans”—a coordinating framework to align policies across sectors and scales, reconciling conflicting agendas in areas such as food, energy, and water. To this end, we advocate for a systemic approach to uncover synergies, manage trade-offs, and guide decision-making in complex socio-ecological landscapes. Land degradation is intricately linked to issues such as food insecurity, land acquisitions, and transboundary water stress. Although LDN is implemented at the national level, its success also depends on accounting for global dynamics—particularly “LDN leaks”, where land degradation is outsourced through international trade in food and raw materials. In an increasingly complex world shaped by globalization, resource depletion, and unpredictable system dynamics, effective responses demand an integrated socio-ecological management approach. LDN is not simply a strategy to address desertification. It offers a comprehensive framework for sustainable resource management, enabling the balancing of trade-offs and the promotion of long-term resilience. Full article

Purpose: Urinary incontinence (UI) significantly impacts the quality of life, necessitating a range of treatments, from behavioral changes to surgical interventions. Electromagnetic muscle stimulation (HIFEM™) therapy presents an innovative, non-invasive approach to strengthening pelvic floor muscles (PFMs). Subjects and Methods: This retrospective, non-interventional case series study explores the efficacy and safety of HIFEM™ treatment in parous women experiencing stress (SUI) and mixed urinary incontinence (MUI). Nineteen women (mean age 54 ± 16) underwent six HIFEM™ sessions, with symptom progression tracked using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), along with comfort and satisfaction questionnaires. Results: At baseline, the mean ICIQ-UI SF score was 7.9 ± 4.2 points. By the final questionnaire administration, the average score had dropped to 4.7 ± 3.5, reflecting a 50.6% reduction from baseline (p < 0.001). According to ICIQ-UI SF Item 6, 21% of subjects achieved complete continence. Additionally, the percentage of subjects experiencing urine leakage before reaching the toilet declined by 40% after the sixth treatment. Post treatment, the number of subjects who leaked urine while coughing or sneezing decreased by 50%. Conclusions: The treatment has shown high efficacy in lowering the ICIQ-SF scores across the study group, with a significant number of subjects regaining entire continence. Full article

Introduction: Hemangioblastomas (HBs) are benign, highly vascular tumors that can be found intracranially or in the spinal region, representing around 2–15% of primary intramedullary tumors. They can occur sporadically or in association with Von Hipple–Lindau (VHL) disease. Despite recent of advancement of nonsurgical treatments, complete surgical resection remains the gold standard of care for the spinal HBs. Materials and Methods: We conducted an international multicenter retrospective analysis of adult patients surgically treated for spinal HBs in four European referral centers between January 2000 and September 2024, with a minimum post-operative follow-up duration of 6 months. Patients’ sex and age at surgical intervention, clinical presentation, and duration symptoms prior to clinical diagnosis were identified. The pre- and post-operative neurological status at 1 and 6 months and at the last visit was assessed using the modified McCormick score (MCS). The extent of surgical resection was divided into gross total resection (GTR) and subtotal resection (STR). Finally, post-operative complications were inspected as well, namely cerebrospinal fluid leaks, infections, hemorrhages and post-operative spinal stability. Results: A total of 35 patients were included in the cohort, with an age median of 52 years (34.5–60) and a slight male predominance (21/35, i.e., 60%). The median follow-up period was 37.5 months (12–75). More than half were located in the cervical region, making it the most common (54.3%). Syrinxes were observed in 23 cases (72%), and HBs were more commonly intramedullary (80%). GTR was achievable in around 88% of cases. Post-operative complications were observed in nine patients (25.7%). Nearly half of patients were discharged into rehabilitations centers (48.5%). Tumor recurrence was seen in 10.3% only. At the last follow-up, an excellent overall post-operative neurological status (positive ∆ McCormick) was observed in most of patients (88%) and was found to be associated with a relatively younger age group. Tumor location and presence of syrinxes did not show any statistical significance regarding clinical outcome. In patients having benefited from intra-operative monitoring, only D-wave changes showed statistical significance regarding post-operative outcome (p < 0.05). Conclusions: A large majority of patients operated for a spinal HB demonstrated favorable outcome after surgery, with unchanged or improved neurological status. Advanced age could have an impact on the post-operative neurological outcome. Other factors such as tumor size, location, and the presence of syrinx did not seem to significantly impact the neurological outcome. Finally, the surgery of these vascular lesions with no possibility of debulking or piece-meal removal and requiring “en bloc” resection is technically demanding and should be performed by experienced teams in spine and spinal cord surgery only. Full article

Numerical simulations reveal the combustion dynamics of hydrogen-blended natural gas (H-BNG) in semi-open spaces. In the typical semi-open space scenario, increasing the hydrogen blending ratio from 0% to 60% elevates peak internal pressure by 107% (259.3 kPa → 526.0 kPa) while reducing pressure rise time by 56.5% (95.8 ms → 41.7 ms). A vent size paradox emerges: 0.5 m openings generate 574.6 kPa internal overpressure, whereas 2 m openings produce 36.7 kPa external overpressure. Flame propagation exhibits stabilized velocity decay (836 m/s → 154 m/s, 81.6% reduction) at hydrogen concentrations ≥30% within 2–8 m distances. In street-front restaurant scenarios, 80% H-BNG leaks reach alarm concentration (0.8 m height) within 120 s, with sensor response times ranging from 21.6 s (proximal) to 40.2 s (distal). Forced ventilation reduces hazard duration by 8.6% (151 s → 138 s), while door status shows negligible impact on deflagration consequences (412 kPa closed vs. 409 kPa open), maintaining consistent 20.5 m hazard radius at 20 kPa overpressure threshold. These findings provide crucial theoretical insights and practical guidance for the prevention and management of H-BNG leakage and explosion incidents. Full article

Emergency endoscopy is an activity that must be guaranteed 7 days a week and 24 h a day. The pathologies of endoscopic interest that require emergency intervention are mainly hemorrhages of the upper digestive tract, the removal of foreign bodies, and the ingestion of caustics. The emergency endoscopist must therefore be experienced in the management of these pathologies. Nowadays, however, we know that even some biliary tract pathologies must be managed within a variable period between 12 and 72 h, in particular acute cholangitis (Ach), acute biliary pancreatitis (ABP), biliary duct leaks (BDLs), and acute cholecystitis (AC). If, on one hand, there is little awareness among doctors about which pathologies of the biliary tract really deserve urgent treatment, on the other, the international guidelines, although not uniformly, have acquired the results of the studies and have clarified that only severe Ach should be treated within 12 h; in other cases, endoscopic treatment can be delayed up to 72 h according to the specific condition. This obviously has a significant organizational implication, as not all endoscopists have training in biliary tract endoscopy, and guaranteeing the availability of a biliary endoscopist 24/7 may be incompatible with respecting the working hours of individual professionals. This review aims to evaluate which pathologies of the biliary tract really require an endoscopic approach in emergency or urgency and the organizational consequences that this can determine. Based on the guidelines, we can conclude that a daytime availability for urgent biliary tract procedures 7 days a week should be provided for the management of severe ACh. Patients with ABP, AC unfit for surgery, and not responsive to medical therapy or BDLs can be treated over a longer period, allowing its scheduling on the first available day of the week. Full article

Endoscopic management of benign pancreaticobiliary disorders encompasses a range of procedures designed to address complications in gallstone disease, choledocholithiasis, and pancreatic disorders. Acute cholecystitis is typically treated with cholecystectomy or percutaneous drainage (PT-GBD), but for high-risk or future surgical candidates, alternative decompression methods, such as endoscopic transpapillary gallbladder drainage (ETP-GBD), and endoscopic ultrasound (EUS)-guided gallbladder drainage (EUS-GBD), are effective. PT-GBD is associated with significant discomfort as well as variable adverse event rates. EUS-GBD leverages lumen-apposing metal stents (LAMS) for direct access to the gallbladder, providing the ability to treat an inflamed GB internally. Choledocholithiasis is primarily managed with ERCP, utilizing techniques to include balloon extraction, mechanical lithotripsy, or advanced methods such as electrohydraulic or laser lithotripsy in cases of complex stones. Altered anatomy from bariatric procedures like Roux-en-Y gastric bypass may necessitate specialized approaches, including balloon-assisted ERCP or EUS-directed transgastric ERCP (EDGE). Post-operative complications, including bile leaks and strictures, are managed endoscopically using sphincterotomy and stenting. Post-liver transplant anastomotic and non-anastomotic strictures often require repeated stent placements or advanced techniques like magnetic compression anastomosis in refractory cases. In chronic pancreatitis (CP), endoscopic approaches aim to relieve pain and address structural complications like pancreatic duct (PD) strictures and calculi. ERCP with sphincterotomy and stenting, along with extracorporeal shock wave lithotripsy (ESWL), achieves effective ductal clearance for PD stones. When traditional approaches are insufficient, direct visualization with peroral pancreatoscopy-assisted lithotripsy is utilized. EUS-guided interventions, such as cystgastrostomy, pancreaticogastrostomy, and celiac plexus blockade, offer alternative therapeutic options for pain management and drainage of peripancreatic fluid collections. EUS plays a diagnostic and therapeutic role in CP, with procedures tailored for high-risk patients or those with complex anatomy. As techniques evolve, endoscopic management provides minimally invasive alternatives for patients with complex benign pancreaticobiliary conditions, offering high clinical success and fewer complications. Full article

This paper introduces a novel thermoelectric generator (TEG)-powered Industrial Internet of Things (IIoT) device that addresses key limitations in the detection of steam leaks in industrial steam pipelines, particularly in steam traps. Existing solutions often rely on battery-powered or wired sensors, which are limited by high maintenance costs, short lifespans, or significant infrastructure investments. The proposed device operates without batteries, using waste heat to provide continuous power, and leverages LoRaWAN for long-range wireless communication, minimizing reliance on costly internal infrastructure. Additionally, the device integrates temperature differential (ΔT) and ultrasonic sensors with edge computing capabilities to enhance real-time leak detection and reduce dependency on cloud computing. By enabling precise, low-maintenance monitoring of steam systems in energy-intensive industries (e.g., petrochemical, pharmaceutical), this technology can significantly reduce energy losses, operational costs, and greenhouse gas emissions. Initial testing demonstrates the device’s ability to detect leaks accurately under varying industrial conditions, offering a robust, scalable solution for Industry 4.0 applications. Full article

Background and Objectives: The temporoparietal fascia flap (TPFF) has recently emerged as an option for skull base reconstruction in endoscopic transnasal surgery when vascularized nasal flaps are not available. This study provides a systematic literature review of its use in skull base surgery and describes a novel cohort of patients. Methods: PRISMA guidelines were used for the review. Patients undergoing skull base reconstruction with TPFF in our center from May 2022 to April 2024 were retrospectively included. Data were collected on pre- and post-operative clinical and radiological features, histology, surgical procedures, and complications. Results: Sixteen articles were selected, comprising 42 patients who underwent TPFF reconstruction for treatment of complex skull base pathologies. In total, 5 of 358 patients (0.9%) who underwent tumor resection via endoscopic transanal surgery in the study period in our institution required TPFF. All had been previously treated with surgery and radiation therapy for different pathologies (three chordomas, one giant pituitary neuroendocrine tumor (PitNET), and one sarcoma). Post-operative complications included CSF leak, which resolved after flap revision, and an internal carotid artery pseudoaneurysm requiring endovascular embolization. Conclusions: TPFF is an effective option for skull base reconstruction in complex cases and should be part of the armamentarium of the skull base surgeon. Full article

Climate change stands out as a significant environmental issue on a global scale, with greenhouse gases being one of its primary drivers. The greenhouse gas process provides a critical framework for understanding the sources, emissions, and environmental impacts of these gases. This article presents an overview of the fundamental elements of the greenhouse gas process in the textile sector and discusses how it should be managed in line with sustainability goals. Carbon dioxide (CO₂), methane (CH₄), nitrous oxides (N₂O), and fluorinated gases are the most common greenhouse gases, each derived from different sources. The textile sector is particularly associated with high greenhouse gas emissions, especially in areas such as energy consumption, water usage, and waste management. Therefore, measurements taken in factories are crucial for identifying emission sources and developing reduction strategies. This article examines in detail the greenhouse gas emissions resulting from various activities at Kıvanç Textile. Energy consumption, particularly the emissions resulting from the fuels used in electricity and heating processes, is evaluated. Additionally, emissions from other important sources such as refrigerant gas leaks, waste management, and transportation are analyzed. The measurement process was carried out in accordance with national and international standards. The greenhouse gas inventory includes data on energy consumption, fuel consumption, refrigerant gas usage, transportation, production process management, and waste management throughout the factory. Based on these data, the total amount and sources of emissions were determined. This study presents a systematic method for calculating a company’s carbon footprint, with data collected in accordance with national and international standards. Such data can provide a reference point for other companies when making similar calculations. All of the businesses of the facility where the study was conducted were examined and calculations were made on a total of 1350 employees. As a result of the detailed study, Kıvanç Textile’s corporate carbon footprint for 2023 was calculated as a total of 68,746.86 tons ${\mathrm{C}\mathrm{O}}_2\mathrm{e}$. According to this data obtained, Kıvanç Textile emitted 50.92 tons of ${\mathrm{C}\mathrm{O}}_2\mathrm{e}$ greenhouse gases per employee. At the same time, it was determined that the production in 2023 was 4,427,082 tons and a greenhouse gas emission of 15.53 tons of ${\mathrm{C}\mathrm{O}}_2\mathrm{e}$ per production (ton) was calculated. This study also includes proposed strategies for reducing emissions. These strategies include energy efficiency measures, the use of renewable energy sources, waste reduction, and the adoption of efficient production processes. In conclusion, this article emphasizes the importance of efforts to measure and reduce greenhouse gas emissions in textile factories. Kıvanç Textile’s greenhouse gas measurements provide a fundamental reference for achieving sustainability goals in the sector. The data obtained will support the factory’s efforts to reduce its carbon footprint and minimize its environmental impacts. Full article

Hazardous substances such as hydrogen and chlorine are used in semiconductor manufacturing. When these gasses are discharged, they are mixed with outside air and are connected to a treatment facility through a duct inside a gas box. This study investigated an optimal exhaust design to prevent fire explosions and toxic exposure by optimizing the exhaust volume when hazardous substances leak from the gas box of semiconductor manufacturing equipment. In this study, carbon monoxide was used for modeling. A 75 mm duct was used, and the tracer gas was released into the gas box at 15.4 LPM. The concentrations were measured at nine points inside and outside the gas box. According to the test results, in an experiment designed with 0% air intake, the internal leakage concentration was measured to be more than 25% of the LEL (lower explosive limit) for 10 min when leakage occurred due to stagnant flow, and the outside toxicity concentration was also measured to be more than 50% of the TWA (time-weighted average) value. When the air intake ratio was designed to be 100%, there was a point on the outside that exceeded 50% of the TWA, confirming that excessive air intake could also cause gas to leak outside. Finally, when the intake ratio was designed to be 50% in both directions, it was confirmed that the airflow was maintained smoothly, and the hazardous gasses were safely diluted and discharged through the duct. This study was conducted to improve the safety of workers in the field in the event of leakage of flammable and toxic gasses by testing the location and area of the air intake hole in the gas box exhaust port. Through this effort, the aim is to present specific standards for gas box design and to assist in establishing a legal framework or standardized guidelines. Full article