Search Results (47)

Type A aortic dissection represents one of the most life-threatening cardiovascular emergencies, with management strategies evolving toward hybrid and endovascular approaches, particularly in high-risk patients. The Ascyrus Medical Dissection Stent (AMDS) is an emerging adjunctive technology designed to promote true lumen expansion and facilitate favorable aortic remodeling during open repair of acute Type A dissection. We present the first reported case of AMDS deployment in secondary Type A dissection following prior thoracic endovascular aortic repair (TEVAR). An 83-year-old female with extensive aortic history—including TEVAR in 2012 for intramural hematoma with chimney stenting to the left subclavian artery and carotid–subclavian bypass in 2013—developed acute Type A dissection extending into the existing stent graft in 2024. Emergency surgical intervention included ascending aortic replacement, aortic arch repair with AMDS implantation, aortic valve resuspension, and left atrial appendage resection under cardiopulmonary bypass and hypothermic circulatory arrest. Postoperative imaging confirmed appropriate AMDS positioning, false lumen exclusion, and preservation of prior endograft integrity. The patient tolerated the procedure well and was discharged in stable condition with favorable early follow-up outcomes. This case demonstrates the potential role of hybrid surgical strategies and adjunctive endovascular devices in managing complex, multi-stage aortic disease. Full article

Background: Intraventricular tumors represent a minority in the context of brain tumors, but their surgical treatment is particularly complex due to their vascularization and visualization, especially in deep localization. The characteristics of these tumors make them ideal candidates for minimally invasive surgical strategies such as the tubular retractor technique, above all in the elderly population. Objectives: A 1-year multi-center, retrospective case series was performed: the authors describe their preliminary experience using a neuronavigated tubular retractor in the management of 11 cases of intraventricular meningiomas. Methods: Clinical and radiological findings were examined to define the outcomes. We used an alternative tubular retractor system obtained using a modified preexisting general surgery trocar (ENDOPATH XCEL 15 mm trocar) or the NICO System BrainPath. Results: Gross total resection, defined as the removal of all the tumor visible from the brain scans, was achieved in all cases. Ten out of eleven of the patients did not experience major complications or permanent neurological deficits. Four patients presented transitory post-operative agitation, visual blurring and transient hemiparesis. All patients (mean age 72.6 years) were discharged from the hospital in 5–7 days. Conclusions: Our preliminary experience suggests that the use of navigated tubular retractors, by displacing the fibers and hence minimizing the damage to the surrounding cerebral parenchyma, is feasible and safe, representing a minimally invasive technique for a personalized and patient-tailored approach. The use of the selective ultrasonic aspirator makes it possible to excise the tumor through the narrow corridor of the tubular lumen of around 2 cm, and this technique can also be improved using both endoscope and microscope guidance. Full article

The development of high-performance wood-based materials has attracted increasing interest as a means of enhancing the mechanical properties of wood for structural applications. Mechanical densification combined with chemical pretreatment is an effective approach; however, many reported methods rely on complex multi-component chemical systems or severe chemical conditions designed to dissolve lignin or hemicelluloses. In this study, a simplified NaOH-only pretreatment followed by hot-press densification was investigated, targeting selective cell-wall plasticization rather than extensive polymer dissolution. Juniper (Juniperus communis), hawthorn (Crataegus monogyna), and birch (Betula pendula) were used as samples of softwood and hardwood species. Wood specimens were pretreated in 1 M NaOH at 145 °C for 10–30 min and subsequently densified by radial compression. Changes in chemical composition were evaluated by HPLC after acid hydrolysis and FTIR spectroscopy, while microstructural changes were examined using SEM. Physical and mechanical properties were assessed through density measurements and three-point bending tests. The results show that NaOH-only pretreatment induces hemicellulose deacetylation and modification of interpolymer linkages without substantial changes in the main wood polymer contents. Densification resulted in effective lumen collapse and a compact microstructure, leading to a significant increase in density and mechanical properties. Overall, the results demonstrate that efficient wood densification and mechanical enhancement can be achieved by promoting polymer mobility through selective cleavage of interpolymer bonds, using a simplified, single-alkali pretreatment that reduces chemical complexity and material loss while avoiding extensive lignin or hemicellulose dissolution. Full article

Emerging research indicates that neuronal activity is maintained by an architectural system of protons in a multi-scale fashion. Proton architecture is formed when organelles (such as mitochondria, endoplasmic reticulum, lysosomes, synaptic vesicles, etc.) are coupled together to produce dynamic energy domains. Techniques have been developed to visualize protons in neurons; recent advances include near-atomic structural imaging of organelle interfaces using cryo-tomography and nanoscale resolution imaging of organelle interfaces and proton tracking using ultra-fast spectroscopy. Results of these studies indicate that protons in neurons do not diffuse randomly throughout the neuron but instead exist in organized geometric configurations. The cristae of mitochondrial cells create oscillating proton micro-domains that are influenced by the curvature of the cristae, hydrogen bonding between molecules, and localized changes in dielectric properties that result in time-patterned proton signals that can be used to determine the metabolic load of the cell and the redox state of its mitochondria. These proton patterns also communicate to the rest of the cell via hydrated aligned proton-conductive pathways at the mitochon-dria-endoplasmic reticulum junctions, through acidic lipid regions, and through nano-tethered contact sites between mitochondria and other organelles, which are typically spaced approximately 10–25 nm apart. Other proton architectures exist in lysosomes, endosomes, and synaptic vesicles. In each of these organelles, the V-ATPase generates steep concentration gradients across their membranes, controlling the rate of cargo removal from the lumen of the organelle, recycling receptors from the surface of the membrane, and loading neurotransmitters into the vesicles. Recent super-resolution pH mapping has indicated that populations of synaptic vesicles contain significant heterogeneity in the amount of protons they contain, thereby influencing the amount of neurotransmitter released per vesicle, the probability of vesicle release, and the degree of post-synaptic receptor protonation. Additionally, proton gradients in each organelle interact with the cytoskeleton: the protonation status of actin and microtubules influences filament stiffness, protein–protein interactions, and organelle movement, resulting in the formation of localized spatial structures that may possess some type of computational significance. At multiple scales, it appears that neurons integrate the proton micro-domains with mechanical tension fields, dielectric nanodomains, and phase-state transitions to form distributed computing elements whose behavior is determined by the integration of energy flow, organelle geometry, and the organization of soft materials. Alterations to the proton landscape in neurons (e.g., due to alterations in cristae structure, drift in luminal pH, disruption in the hydration-structure of the cell, or imbalance in the protonation of cytoskeletal components) could disrupt the intracellular signaling network well before the onset of measurable electrical or biochemical pathologies. This article will summarize evidence indicating that proton–organelle interaction provides a previously unknown source of energetic substrate for neural computation. Using an integrated approach combining nanoscale proton energy, organelle interface geometry, cytoskeletal mechanics, and AI-based multiscale models, this article outlines current principles and unresolved questions related to the subject area as well as possible new approaches to early detection and precise intervention of pathological conditions related to altered intracellular energy flow. Full article

Fire retardancy and thermal management are critical for energy-efficient, fire-safe buildings. Natural wood, a mainstream construction material, possesses inherent advantages but lacks such dual functionality. Silicified wood was fabricated via multi-cycle silicification of native wood, where SiO₂ uniformly infiltrates and fills the lumens. The treated wood material displays an improved limiting oxygen index (LOI) from 21.9% to 36.0%, and delayed ignition from 15 s to 50 s, compared to untreated wood. It demonstrates a low thermal conductivity of 0.074 W·m⁻¹·K⁻¹, showing enhanced emissivity. When heated on a 75 °C hot plate, the silicified wood surface reaches ~50 °C after 5 s, versus ~60 °C for native wood. These enhancements collectively improve thermal management performance, achieving insulation through reduced thermal conduction and passive cooling via optimized infrared regulation. Ultimate tensile stress remains nearly unchanged post-treatment, while toughness is significantly improved. This work advances wood as a sustainable building material, with promising potential for fire-safe, energy-efficient construction applications. Full article

Background: Peripancreatic collections (PPCs) are a frequent and severe complication of acute and chronic pancreatitis, as well as pancreatic surgery, often requiring interventions to treat and prevent infection, gastric obstruction, and other complications. Endoscopic ultrasound (EUS)-guided drainage has emerged as a minimally invasive alternative to surgical and percutaneous approaches, offering reduced morbidity and shorter recovery times. However, the effectiveness of EUS-guided drainage in post-surgical PPCs remains underexplored. Methods: This retrospective, single-center study evaluated the technical and clinical outcomes of EUS-guided drainage in patients with PPCs between October 2021 and December 2024. Patients were categorized as having post-pancreatitis or post-surgical PPCs. Technical success, clinical success, complications, recurrence rates, and the need for reintervention were assessed. Results: A total of 50 patients underwent EUS-guided drainage, including 42 (84%) with post-pancreatitis PPCs and 8 (16%) with post-surgical PPCs. The overall technical success rate was 100%, with clinical success achieved in 96% of cases. Lumen-apposing metal stents (LAMSs) were used in 84% of patients, including 7.1% as a dual-gate salvage strategy after the failure of double-pigtail drainage. The complication rate was 24%, with infection being the most common (16%). The recurrence rate was 25%, with no significant difference between post-pancreatitis and post-surgical cases. Patients with walled-off necrosis had a significantly higher reintervention rate (35%) than those with pseudocysts (18%; p = 0.042). Conclusions: EUS-guided drainage is a highly effective and safe intervention for PPCs, including complex post-surgical cases. The 100% technical success rate reinforces its reliability, even in anatomically altered post-surgical collections. While recurrence rates remain a consideration, EUS-guided drainage offers a minimally invasive alternative to surgery, with comparable outcomes in both post-pancreatitis and post-surgical patients. Future multi-center studies should focus on optimizing treatment strategies and reducing recurrence in high-risk populations. Full article

Copper pyrithione (CuPT), an emerging biocide used in ship antifouling coatings, may accumulate in marine sediments and pose risks to non-target organisms. However, current research on CuPT toxicity remains limited. Litopenaeus vannamei, one of the world’s most important aquaculture shrimp species, relies heavily on its hepatopancreas for energy metabolism, detoxification, and immune responses. Due to their benthic habitat, these shrimps are highly vulnerable to contamination in sediment environments. This study investigated the toxicological response in the hepatopancreas of L. vannamei exposed to CuPT (128 μg/L) for 3 and 48 h. Terminal deoxynucleotidyl transferase dUTP Nick-End Labeling (TUNEL) fluorescence staining revealed increased apoptosis, deformation of hepatic tubule lumens, and the loss of stellate structures in the hepatopancreas after CuPT 48 h exposure. A large number of differentially expressed genes (DEGs) were identified by transcriptomics analysis at 3 and 48 h, respectively. Most of these DEGs were related to detoxification, glucose transport, and immunity. Metabolomic analysis identified numerous significantly different metabolites (SDMs) at both 3 and 48 h post-exposure, with most SDMs associated with energy metabolism, fatty acid metabolism, and related pathways. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of metabolomics and transcriptome revealed that both DEGs and SDMs were enriched in arachidonic acid metabolism, fatty acid biosynthesis, and glycolysis/gluconeogenesis pathways at 3 h, while at 48 h they were enriched in the starch and sucrose metabolism, amino sugar and nucleotide sugar metabolism, and galactose metabolism pathways. These results suggested that CuPT disrupts the energy and lipid homeostasis of L. vannamei. This disruption compelled L. vannamei to allocate additional energy toward sustaining basal physiological functions and consequently caused the accumulation of large amounts of reactive oxygen species (ROS) in the body, leading to apoptosis and subsequent tissue damage, and ultimately suppressed the immune system and impaired the health of L. vannamei. Our study elucidates the molecular mechanisms of CuPT-induced metabolic disruption and immunotoxicity in L. vannamei through integrated multi-omics analyses, providing new insights for ecological risk assessment of this emerging antifoulant. Full article

Background: Urethral stricture disease involves fibrotic scarring that narrows the urethral lumen and can occur at any site. Sonourethrography (SUG) is increasingly used because it depicts both luminal anatomy and periurethral fibrosis, yet little is known about patient or lesion features that influence its diagnostic performance. Methods: We conducted a prospective single-center study of 170 men who underwent SUG before anterior urethroplasty between May 2016 and May 2021. Anthropometric data, comorbidities, and detailed ultrasonographic measurements were recorded and compared with intra-operative findings, which served as the reference standard. Accuracy was analyzed with Wald chi-square testing and Spearman correlation. Results: SUG length estimates matched intra-operative measurements in 139/170 strictures (81.8%). Length accuracy was higher in patients ≥ 60 years (89.2% vs. 77.0%, p = 0.03) and in those with type 2 diabetes (92.3% vs. 80.9%, p = 0.02) in conditions associated with pronounced spongiofibrosis that enhances echo contrast. Among stricture-specific factors, proximal location (63.6% vs. 84.5%, p = 0.01) and complete luminal occlusion (68.8% vs. 84.8%, p = 0.02) reduced precision, largely because deeper anatomy and absent saline flow hinder acoustic delineation. The Chiou ultrasonographic grade was the strongest determinant of performance; higher grades yielded clearer margins and better length estimation (p < 0.001). Conclusions: SUG is a reliable bedside technique for assessing anterior urethral strictures, but its accuracy varies with age, diabetes status, stricture site, degree of occlusion, and fibrosis grade. Recognizing these determinants allows clinicians to judge when SUG alone is sufficient and when complementary imaging or heightened caution is warranted. The findings support tailored imaging protocols and underscore the need for multi-center studies that include operators with diverse experience to confirm generalisability. Full article

Flax fiber reinforcements weaken with aging and microstructural changes, limiting their applications. Here, we examine the effects of microstructure and aging on flax fiber elements’ performance by using 4000-year-old and modern Egyptian flax as references through multi-scale numerical modeling. This study introduces a novel investigation into the tensile stress distribution behavior of archaeological and modern flax yarns. The finite element (FE) model is derived from 3D volumes obtained via X-ray microtomography and tensile testing in the elastic domain. At the microscale, fibers exhibit higher axial stress concentrations around surface defects and pores, particularly in regions with kink bands and lumens. At the mesoscale, fiber bundles show increased stress concentrations at inter-fiber voids and lumen, with larger bundles exhibiting greater stress heterogeneity, especially around pores and surface roughness. At the macroscale, yarns display significant stress heterogeneity, especially around microstructural defects like pores and fiber–fiber cohesion points. Aged fibers from ancient Egyptian cultural heritage in particular demonstrate large fiber discontinuities due to long-term degradation or aging. These numerical observations highlight how porosity, surface imperfections, and structural degradation increase stress concentration, leading to fiber rupture and mechanical failure. This insight reveals how aging and defects impact flax fiber performance and durability. Full article

The automatic segmentation technique for colorectal polyps in colonoscopy is considered critical for aiding physicians in real-time lesion identification and minimizing diagnostic errors such as false positives and missed lesions. Despite significant progress in existing research, accurate segmentation of colorectal polyps remains technically challenging due to persistent issues such as low contrast between polyps and mucosa, significant morphological heterogeneity, and susceptibility to imaging artifacts caused by bubbles in the colorectal lumen and poor lighting conditions. To address these limitations, this study proposed a novel pyramid vision transformer-based hierarchical path aggregation network (HPANet) for polyp segmentation. Specifically, firstly, the backward multi-scale feature fusion module (BMFM) was developed to enhance the ability of processing polyps with different scales. Secondly, the forward noise reduction module (FNRM) was designed to learn the texture features of the upper and lower layers to reduce the influence of noise such as bubbles. Finally, in order to solve the problem of boundary ambiguity caused by repeated up and down sampling, the boundary feature refinement module (BFRM) was developed to further refine the boundary. The proposed network was compared with several representative networks on five public polyp datasets. Experimental results show that the proposed network achieves better segmentation performance, especially on the Kvasir SEG dataset, where the mDice and mIoU coefficients reach 0.9204 and 0.8655. Full article

Background/Objectives: Multi-lumen devices that limit physicochemical incompatibilities (PCIs) are frequently used in neonatal intensive care units where premature infants receive numerous infusions. The aim of the study was to investigate a PCI that occurred despite the use of a device of this type (EDELVAISS^® Multiline NEO, Doran International, Toussieu, France). Case Summary: A 7-week-old preterm infant received ganciclovir at therapeutic dosage for cytomegalovirus (CMV) infection. After the fifth administration of ganciclovir, a PCI occurred, leading to a white precipitate. The peripheral inserted central catheter (PICC) (PREMICATH^®2Fr, Vygon, Ecouen, France) had to be replaced. Laboratory reproduction of the administrations during 72 h, nuclear magnetic resonance (NMR) analysis and particle counting were carried out to analyse the occurrence of events leading to PCIs. The precipitate was linked to a PCI of parenteral nutrition associated with a dilution error of ganciclovir (omission of a 10-fold dilution step, resulting in ganciclovir being administered at 30 mg/L instead of 3 mg/L). Due to the presence of lipids in the parenteral nutrition, visual detection of the white precipitate was difficult. Conclusions: Multi-lumen infusion devices limit but do not prevent the occurrence of PCIs, particularly in the event of a preparation error. Despite the use of this type of device, great vigilance is still required, particularly with regard to prescription analysis and reconstitution procedures. Full article

Fiber optics is a cutting-edge technology with boundless potential for transmitting natural light inside buildings. Imaging Solar concentrators are very efficient in focusing light within the approximate numerical aperture of fiber optics. The proof-of-concept of fiber optics concentration daylight systems was investigated and elaborated for only single-mode step-index fibers, and none of the previous studies had explored the full sun spectrum meticulously, the overall transmission efficiency, and the luminous output of such a system. The present research elaborates a detailed and exclusive numerical investigation of multi-mode-indexed fiber optics daylight systems. The proposed design consists of subsequent optical stages that focus light into the fiber optic cable, filter unwanted infrared wavelength radiation, and uniformly collimate visible light onto the fiber optics. The ray path and ray power intensities were traced and computed using the ray tracing technique. The obtained simulation results demonstrated an overall optical transmission efficiency of 32% along a 10 m length. The luminous efficacy of visible light transmission was evaluated based on the average illuminance levels inside buildings, indicating a substantial indoor lighting enhancement of 92 lumens/watt. The proof-of-concept was validated by building a laboratory scale of the proposed system; the tests have shown the technical feasibility of the system and the effective material integrity for practical applications Full article

Objective: Coronary atherosclerosis (CAD) is characterized by arterial intima lipid deposition, chronic inflammation, and fibrous tissue proliferation, leading to arterial wall thickening and lumen narrowing. As the primary cause of coronary heart disease and acute coronary syndrome, CAD significantly impacts global health. Recent genetic studies have demonstrated CAD’s polygenic and multifactorial nature, providing molecular insights for early diagnosis and risk assessment. This review analyzes recent advances in CAD-related genetic markers and evaluates their diagnostic potential, focusing on their applications in diagnosis and risk stratification within precision medicine. Methods: We conducted a systematic review of CAD genomic studies from PubMed and Web of Science databases, analyzing findings from genome-wide association studies (GWASs), gene sequencing, transcriptomics, and epigenomics research. Results: GWASs and sequencing studies have identified key genetic variations associated with CAD, including JCAD/KIAA1462, GUCY1A3, PCSK9, and SORT1, which regulate inflammation, lipid metabolism, and vascular function. Transcriptomic and epigenomic analyses have revealed disease-specific gene expression patterns, DNA methylation signatures, and regulatory non-coding RNAs (miRNAs and lncRNAs), providing new approaches for early detection. Conclusions: While genetic marker research in CAD has advanced significantly, clinical implementation faces challenges including marker dynamics, a lack of standardization, and integration with conventional diagnostics. Future research should prioritize developing standardized guidelines, conducting large-scale prospective studies, and enhancing multi-omics data integration to advance genomic diagnostics in CAD, ultimately improving patient outcomes through precision medicine. Full article

The development of modern reusable launchers, such as the Themis project with its LOX/LCH4 Prometheus engine, CALLISTO—a reusable VTVL-launcher first-stage demonstrator with a LOX/LH2 RSR2 engine, and SpaceX’s Falcon 9 with its Merlin 1D engine, underscores the need for advanced control algorithms to ensure reliable engine operation. The multi-restart capability of these engines imposes additional requirements for throttling, necessitating an extended controller-validity domain to safely achieve low thrust levels across various operating regimes. This capability also increases the risk of component failure, especially as engine parameters evolve with mission profiles. To address this, our study evaluates the dynamic reliability of reusable rocket engines (RREs) and their subcomponents under different failure modes using multi-physics system-level modelling and simulation, with a particular focus on turbopump components. Transient condition modelling and performance analysis, conducted using EcosimPro-ESPSS software (version 6.4.34), revealed that turbopump components maintain high reliability under nominal conditions, with turbine blades demonstrating significant fatigue life even under varying thermal and mechanical loads. Additionally, the proposed predictive model estimates the remaining useful life of critical components, offering valuable insights for improving the longevity and reliability of turbopumps in reusable rocket engines. This study employs deterministic, thermally dependent structural simulations, with key control objectives including end-state tracking of combustion chamber pressure and mixture ratios and the verification of operational constraints, exemplified by the LUMEN demonstrator engine and the LE-5B-2 engine class. Full article

Thrombus formation plays a crucial role in the clinical treatment of certain diseases. In conditions such as aortic dissection and cerebral aneurysm, complete thrombus occlusion in the affected region is desired to reduce blood flow into the false lumen or aneurysm sac, leading to a decrease in the tension exerted on the vascular wall and making it less likely to rupture. However, desired thrombosis sometimes fails to occur. Predicting thrombus formation can provide valuable information in such cases. This article offers a comprehensive review of conventional methods for predicting thrombus formation. In reviews conducted from the year 2000 to the present, the number of published related papers every five years has increased more than tenfold. We also found that the predictive methods can be classified into two categories: those based on the hemodynamic evaluation parameters and those based on hemodynamic and mathematical models that simulate the transport and reaction of blood components. Through our discussions, we identified several challenges that need to be resolved, including predictions based on patient-specific condition, model validation, multi-scale problems, the mechanisms of thrombus formation, and ensuring cost effectiveness. This review aims to guide researchers interested in exploring thrombus formation prediction within clinical treatments. Full article