Search Results (2,303)

Dibutyl phthalate (DBP) is used as a plasticizer to enhance flexibility in several household products, cosmetics, and food-contact materials. Due to its harmful effects, DBP is restricted or banned in children’s products and food items, particularly in Europe. Due to its endocrine disruptor properties and considering its ability to cross the placental barrier, it is imperative to study DBP’s vascular effects in pregnancy, given the vulnerability of this period. Thus, this study investigated the potential effects of DBP on the cardiovascular system using umbilical arteries from healthy pregnant women. Specifically, the impact of DBP on the vascular reactivity after both rapid and 24 h DBP exposure was analyzed, as well as the contractility and the cell viability of vascular smooth muscle cells (VSMC). DBP did not exhibit overt cytotoxic effects on VSMCs, possibly due to its adsorption onto polystyrene surfaces, potentially limiting bioavailability. Interestingly, DBP induced vasorelaxation in a concentration-dependent manner. Although mechanistic insights remain to be fully elucidated, the results suggest the involvement of pathways associated with nitric oxide signaling and calcium handling. Overall, DBP exposure appears to modulate arterial tone regulation, which may have implications for vascular function during pregnancy. Full article

Lung cancer remains one of the most prevalent and lethal malignancies worldwide. Although conventional treatments such as surgery, chemotherapy, and radiotherapy have modestly improved patient survival, their overall efficacy remains limited, and the prognosis is generally poor. In recent years, immunotherapy, particularly immune checkpoint inhibitors, has revolutionized cancer treatment. Nevertheless, the immunosuppressive tumor microenvironment, tumor heterogeneity, and immune escape mechanisms significantly restrict the clinical benefit, which falls short of expectations. Within this context, cancer vaccines have emerged as a promising immunotherapeutic strategy. By activating the host immune system to eliminate tumor cells, cancer vaccines offer high specificity, low toxicity, and the potential to induce long-lasting immune memory. These advantages have positioned them as a focal point in cancer immunotherapy research. This paper provides a comprehensive overview of recent clinical advances in lung cancer vaccines, discusses the major challenges impeding their clinical application, and explores potential strategies to overcome these barriers. Full article

The availability of detritus is a key factor influencing aquatic biota and can significantly affect decomposition processes. In this study, we investigated how varying quantities of surrounding detritus impact leaf litter decay rates. It was tested in flowing and still-water microcosms to highlight context-dependent effects of surrounding detritus on leaf litter decomposition. To isolate the effect of detritus amount, experiments were conducted in laboratory microcosms simulating lotic and lentic ecosystems, each containing leaf fragments for decomposition assessments. Four detritus quantities were tested, with invertebrates either allowed or restricted from moving among detritus patches. Leaf decomposition rates were influenced by the amount of surrounding detritus, with slower decay observed at higher detritus conditions, regardless of invertebrate mobility. Detritivore distribution responded to both detritus quantity and oxygen availability, showing a preference for high detritus conditions. Additionally, detritus quantity affected microbial activity with a quadratic response, as indicated by leaf respiration rates. Overall, our findings indicate that the amount of surrounding detritus modulates leaf litter decomposition independently of invertebrate density, by influencing oxygen dynamics and, consequently, the activity of biological decomposers. Full article

Against the backdrop of China’s fast-growing digital economy and its financial inclusion agenda, there is still little city-level evidence on whether the e-CNY pilot accelerates financial deepening at the grassroots. Using a balanced panel of 271 prefecture-and-above cities for 2016–2022, this study employs a staggered difference-in-differences (SDID) design augmented by the synthetic control method (SCM) to rigorously identify the policy effect of the e-CNY pilot. The results show that the pilot program significantly improves urban financial inclusion, contributing to more equitable access to financial services and supporting inclusive socio-economic development. Mechanism analysis suggests that the effect operates mainly through two channels, a merchant-coverage channel and a transaction-scale channel, with the former contributing the majority of the overall effect. Incorporating a migration-based mobility index shows that most studies’ focus on the merchant-coverage effect is amplified in cities under tight mobility restrictions but wanes where commercial networks are already saturated, whereas the transaction-scale channel is largely insensitive to mobility shocks. Heterogeneity tests further indicate stronger gains in non-provincial capital cities and in the eastern and central regions. Overall, the study uncovers a “penetration-inclusion” network logic and provides policy insights for advancing sustainable financial inclusion through optimized terminal deployment, merchant incentives, and diversified scenario design. Full article

Background/Objectives: Brainstem ischemic strokes comprise 10% of ischemic strokes and are challenging to diagnose due to small lesion size and complex presentations. Diffusion-weighted imaging (DWI) is crucial for detecting ischemia, yet it can miss small lesions, especially when only axial slices are employed. This study investigated whether ischemic lesions visible in a single imaging plane correspond to smaller volumes and whether coronal DWI enhances detection compared to axial DWI alone. Methods: This retrospective single-center study examined 134 patients with brainstem ischemic strokes between December 2018 and November 2023. All patients underwent axial and coronal DWI. Clinical data, NIH Stroke Scale (NIHSS) scores, and modified Rankin Scale (mRS) scores were recorded. Diffusion-restricted lesion volumes were calculated using multiple models (planimetric, ellipsoid, and spherical), and lesion visibility per imaging plane was analyzed. Results: Brainstem ischemic strokes were detected in 85.8% of patients. Coronal DWI alone identified 6% of lesions that were undetectable on axial DWI; meanwhile, axial DWI alone identified 6.7%. Combining both improved overall sensitivity to 86.6%. Ischemic lesions visible in only one plane were significantly smaller across all volume models. Higher NIHSS scores were strongly correlated with larger diffusion-restricted lesion volumes. Coronal DWI correlated better with clinical severity than axial DWI, especially in the midbrain and medulla. Conclusions: Coronal DWI significantly improves the detection of small brainstem infarcts and should be incorporated into routine stroke imaging protocols. Infarcts visible in only one plane are typically smaller, yet still clinically relevant. Combined imaging enhances diagnostic accuracy and supports early and precise intervention in posterior circulation strokes. Full article

Urban subsurface pipeline bursts can induce catastrophic cascading effects, including ground collapse, infrastructure failure, and socioeconomic losses. However, stratum responses during the erosion cavity expansion phase and corresponding disaster mitigation strategies have rarely been researched. In this study, a numerical model validated through experimental tests was employed to investigate the effects of internal water pressures, burial depths, and different geotextile-based disaster mitigation strategies. It was revealed that a burial depth-dependent critical internal water pressure governed the erosion cavity expansion, and a predictive equation was derived based on the limit equilibrium theory. Higher internal water pressure accelerated the erosion cavity expansion and amplified the stratum stress within a range of twice the diameter D. Increased burial depth $d$ reduced peak ground heave but linearly expanded the heave zone range, concurrently elevating the overall stratum stress level and generating larger stress reduction zones (i.e., when $d/D$ = 3.0, the range of the stress reduction zone was 8.0D). All geotextile layout configurations exhibited different disaster mitigation effects (the peak ground heave was reduced by at least 15%). The semi-circular closely fitted configuration (SCCF) optimally restricted the expansion of the erosion cavity, reduced the stratum displacement (i.e., 39% reduction in the peak ground heave), and avoided stress concentration. Comprehensive analysis indicated that SCCF was suited for low-pressure pipelines in deformation-sensitive stratum and semi-circular configuration (SC) was suitable for deformation-insensitive pipeline sections. These findings provide actionable insights for tailoring mitigation strategies to specific operational risks. Full article

This study focuses on the clastic reservoir in the first member of Yaojia Formation within Qijia-Gulong Sag, Songliao Basin. The results indicate that the reservoir in the study area develops within a shallow-water delta sedimentary system. The dominant sedimentary microfacies comprise underwater distributary channels, mouth bars, and sheet sands. Among these, the underwater distributary channel microfacies exhibits primary porosity ranging from 15.97% to 17.71%, showing the optimal reservoir quality, whereas the sheet sand microfacies has a porosity of only 7.45% to 12.08%, indicating inferior physical properties. During diagenesis, compaction notably decreases primary porosity via particle rearrangement and elastic deformation, while calcite cementation and quartz overgrowth further occlude pore throats. Although dissolution can generate secondary porosity (locally up to 40%), the precipitation of clay minerals tends to block pore throats, leading to “ineffective porosity” (permeability generally < 5 mD) and overall low-porosity and low-permeability characteristics. Carbon–oxygen isotope analysis reveals a deficiency in organic acid supply in the study area, restricting the intensity of dissolution alteration. Reservoir quality evolution is dominantly governed by the combined controls of sedimentary microfacies and diagenesis. This study emphasizes that, within shallow-water delta sedimentary settings, the material composition of sedimentary microfacies and the dynamic equilibrium of diagenetic processes jointly govern reservoir property variations. This insight provides critical theoretical support for understanding diagenetic evolution mechanisms in clastic reservoirs and enabling precise prediction of high-quality reservoir distribution. Full article

The fourth member of the Shahejie Formation in the Leijia area of the western depression of the Liaohe Oilfield represents a typical shale oil reservoir. However, post-hydraulic fracturing operations in this region are often hindered by significant discrepancies in well productivity, low fracturing fluid flowback efficiency, and an unclear understanding of reservoir damage mechanisms during fracturing. These challenges have become major bottlenecks restricting the efficient exploration and development of shale oil in this block. In this study, a series of laboratory-simulated experiments were conducted to investigate the primary mechanisms of formation damage induced by fracturing fluids in shale oil reservoirs. An experimental methodology for evaluating reservoir damage caused by fracturing fluids was developed accordingly. Results indicate that guar gum-based fracturing fluids exhibit good compatibility with formation-sensitive minerals, resulting in relatively minor damage. In contrast, capillary trapping of the aqueous phase leads to moderate damage, while polymer adsorption and retention cause low to moderate impairment. The damage associated with fracturing fluid invasion into fractures is found to be moderately high. Overall, the dominant damage mechanisms of guar gum fracturing fluids in the Shahejie Member 4 shale oil reservoir are identified as aqueous phase trapping and polymer adsorption. Based on the identified damage mechanisms, corresponding optimization strategies for fracturing fluid formulations are proposed. The findings of this research provide critical insights for improving shale oil development strategies in the Leijia area. Full article

Background: Anastomotic leak (AL) is a serious complication after gastrectomy. It is associated with prolonged hospital stay, greater expenses, and increased risk for 90-day mortality. Currently, there is no consensus regarding the effect of AL on OS in patients with GC undergoing gastrectomy. This study was designed to investigate the effect of AL on long-term survival after gastrectomy for gastric cancer. Methods: PubMed, Embase, Scopus, Google Scholar, and Cochrane Library were queried during the search process. The literature search started in January 2025 and was updated in May 2025. The studies analyzed the impact of AL on long-term survival, with the primary outcome being long-term overall survival. Pooled effect size measures included restricted mean survival time difference (RMSTD), hazard ratio (HR), and 95% confidence intervals (CIs). Results: Ten studies (11,862 patients) were included. Overall, 338 (2.9%) patients experienced AL. The RMSTD analysis indicates that at 12, 24, 36, 48, and 60 months, patients with AL tend to live 1.1, 3.1, 5.2, 8.1, and 10.6 months shorter, respectively, compared to those who did not develop AL. All results were statistically significant with p < 0.0001. The time-dependent HRs analysis for AL versus no AL shows a higher mortality hazard in patients with AL at 12 (HR 1.32, 95% CI 1.11–1.58), 24 (HR 1.61, 95% CI 1.34–1.92), 36 (HR 1.55, 95% CI 1.27–1.91), 48 months (HR 1.22, 95% CI 1.02–1.53), and 60 months (HR 0.79, 95% CI 0.59–1.10). Conclusions: This research appears to indicate a clinical impact of AL on long-term OS after gastrectomy. Patients experiencing AL appear to have an increased risk of mortality within the initial four years of follow-up. Full article

Background/Objectives: Overt hypothyroidism during pregnancy has been linked to adverse outcomes, including preterm birth, low birth weight, and impaired fetal neurocognitive development. This study aimed to evaluate pregnancy complications in women with overt hypothyroidism (TSH ≥ 10) through a cross-sectional study. Methods: Data from 259,897 live-birth pregnancies (2013–2022) from Clalit Health Services (CHS) were analyzed. The study included all CHS-insured women aged ≥ 18 years with available TSH results during pregnancy. Overt hypothyroidism was defined as a mean TSH ≥ 10 mIU/L, while the euthyroid reference group had TSH levels < 4 mIU/L and no history of hypothyroidism or levothyroxine use. Cases of overt hypothyroidism were matched with 15 controls using propensity score-based matching. Covariates included maternal age, ethnicity, socioeconomic status, IVF use, recurrent pregnancy loss, and smoking. Pregnancy complications were compared between groups using descriptive statistics and univariate analysis. A quasi-Poisson regression model was used to assess complication risk in overt hypothyroidism versus matched controls. Results: The final analysis included 9125 euthyroid and 611 overt hypothyroid pregnancies, with comparable baseline characteristics between groups. No significant differences were found in maternal age, ethnicity, socioeconomic scores, IVF rates, recurrent pregnancy loss, diabetes, smoking, gestational age at delivery, or rates of preterm birth, pre-eclampsia, gestational diabetes, cesarean section, and intrauterine growth restriction. Overall, overt hypothyroidism was not associated with increased complications. Sensitivity analyses using maximum TSH levels during pregnancy showed a slightly elevated risk for pregnancy complications (IRR 1.1, CI 1.04–1.18; p = 0.002). Conclusions: Overt hypothyroidism was not associated with an increased risk of adverse pregnancy outcomes when adjusted for confounding factors, suggesting that treatment decisions should be made on an individual basis. Full article

The demand for plant-based fermented beverages is being driven by dietary restrictions, health concerns, and environmental concerns. However, the use of plant substrates, such as oats, presents challenges in terms of fermentation and texture formation. The effects of enzymatic hydrolysis, homogenization and the addition of 1% pectin on oat-based beverages fermented with Lactobacillus delbrueckii subsp. bulgaricus were evaluated in this study. The samples were evaluated for a number of characteristics, including physicochemical, rheological, antioxidant and sensory properties. After 6 h fermentation, pectin-containing samples showed a statistically significant decrease in pH (to 3.91) and an increase in titratable acidity (to 92 °T). Homogenization and the addition of pectin were found to significantly increase viscosity (by 1.5–2 times) and water-holding capacity (by 2 times) while reducing syneresis by 96%. The antioxidant activity of L. bulgaricus-fermented samples increased significantly: the radical scavenging activity (RSA) and OH-radical inhibition increased by 40–60%, depending on the treatment. Extractable polysaccharides (PSs) inhibited lipase and glucosidase by 90% and 85%, respectively; significantly higher inhibition was observed in the fermented and pectin-containing groups. Sensory evaluation showed that the homogenized, pectin-enriched samples (Homog+) scored highest for consistency (4.5 ± 0.2), texture (4.9 ± 0.2), and overall acceptability (4.8 ± 0.2); these scores were all statistically higher than those for the untreated samples. These results suggest that combining enzymatic hydrolysis, homogenization and fermentation with L. bulgaricus significantly improves the structural, functional and sensory properties of oat-based beverages, providing a promising approach to producing high-quality, functional non-dairy products. Full article

The spatial distribution of ephemeral and perennial dryland plant species is increasingly modified and restricted by ever-changing climates and development expansion. At the interface of biodiversity conservation and developmental planning in desert landscapes is the growing need for adaptable tools in identifying and monitoring these ecologically fragile plant assemblages, habitats, and, often, heritage sites. This study evaluates usage of Sentinel-2 time series composite imagery to discriminate vegetation assemblages in a hyper-arid landscape. Spatial predictor spaces were compared to classify different vegetation communities: spectral components (PCs), vegetation indices (VIs), and their combination. Further, the uncertainty in discriminating field-verified vegetation assemblages is assessed using Shannon entropy and intensity analysis. Lastly, the intensity analysis helped to decipher and quantify class transitions between maps from different spatial predictors. We mapped plant assemblages in 2022 from combined PCs and VIs at an overall accuracy of 82.71% (95% CI: 81.08, 84.28). A high overall accuracy did not directly translate to high class prediction probabilities. Prediction by spectral components, with comparably lower accuracy (80.32, 95% CI: 78.60, 81.96), showed lower class uncertainty. Class disagreement or transition between classification models was mainly contributed by class exchange (a component of spatial allocation) and less so from quantity disagreement. Different artefacts of vegetation classes are associated with the predictor space—spectral components versus vegetation indices. This study contributes insights into using feature extraction (VIs) versus feature selection (PCs) for pixel-based classification of plant assemblages. Emphasising the ecologically sensitive vegetation in desert landscapes, the study contributes uncertainty considerations in translating optical satellite imagery to vegetation maps of arid landscapes. These are perceived to inform and support vegetation map creation and interpretation for operational management and conservation of plant biodiversity and habitats in such landscapes. Full article

Background: MRI-based radiomics has emerged as a promising approach to enhance the non-invasive, presurgical assessment of lymph node staging in rectal cancer (RC). However, its clinical implementation remains limited due to methodological variability in published studies. We conducted a systematic review and meta-analysis to synthesize the diagnostic performance of MRI-based radiomics models for predicting pathological nodal status (pN) in RC. Methods: A systematic literature search was conducted in PubMed, Web of Science, and Scopus for studies published until 31 December 2024. Eligible studies applied MRI-based radiomics for pN prediction in RC patients. We excluded other imaging sources and models combining radiomics and other data (e.g., clinical). All models with available outcome metrics were included in data analysis. Data extraction and quality assessment (QUADAS-2) were performed independently by two reviewers. Random-effects meta-analyses including hierarchical summary receiver operating characteristic (HSROC) and restricted maximum likelihood estimator (REML) analyses were conducted to pool sensitivity, specificity, area under the curve (AUC), and diagnostic odds ratios (DORs). Sensitivity analyses and publication bias evaluation were also performed. Results: Sixteen studies (n = 3157 patients) were included. The HSROC showed pooled sensitivity, specificity, and AUC values of 0.68 (95% CI, 0.63–0.72), 0.73 (95% CI, 0.68–0.78), and 0.70 (95% CI, 0.65–0.75), respectively. The mean pooled AUC and DOR obtained by REML were 0.78 (95% CI, 0.75–0.80) and 6.03 (95% CI, 4.65–7.82). Funnel plot asymmetry and Egger’s test (p = 0.025) indicated potential publication bias. Conclusions: Overall, MRI-based radiomics models demonstrated moderate accuracy in predicting pN status in RC, with some studies reporting outstanding results. However, heterogeneity in relevant methodological approaches such as the source of MRI sequences or machine learning methods applied along with possible publication bias call for further standardization and preclude their translation to clinical practice. Full article

Background/Objectives: Acute myeloid leukemia (AML) with FLT3 internal tandem duplication (FLT3-ITD) mutations carries a poor prognosis. While FLT3 inhibitors like midostaurin show benefits in combination with chemotherapy, the role of allelic ratio (AR), NPM1 mutation status, and hematopoietic stem cell transplantation (HSCT) remains uncertain. Real-world data can help refine prognostic classification and treatment strategies. Methods: We retrospectively analyzed 37 fit patients with FLT3-ITD AML treated with standard “7+3” chemotherapy, with and without midostaurin, between 2013 and 2022. Patients were stratified by FLT3-ITD AR, NPM1 status, and treatment approach. Outcomes assessed included complete remission (CR), disease-free survival (DFS), and overall survival (OS). Results: Overall, 67.6% achieved CR/CRi. Response rates did not differ significantly by AR (low vs. high: 66.7% vs. 69.2%) or midostaurin use (72.6% vs. 60%; p = 0.49). NPM1 mutations were associated with improved DFS (10.3 vs. 3 months, p = 0.036) but not OS. HSCT, performed in 54.1% of patients, mainly in first remission (CR1), significantly prolonged DFS (not reached vs. 5.3 months, p = 0.005) and remained an independent predictor in multivariate analysis (HR: 0.160, p = 0.039). OS (median 15.1 months) did not vary significantly across subgroups. Among patients achieving CR1, OS was significantly longer in those who underwent HSCT after midostaurin-based induction compared to those not transplanted (median OS not reached vs. 12.8 months; 95% CI, 6.9–18.7; p = 0.045), whereas no significant benefit was observed after standard induction. In a landmark analysis restricted to patients transplanted in CR1, those who had received midostaurin-based induction showed a trend toward improved OS compared to those treated with standard induction (median OS not reached vs. 11.5 months; 95% CI, 0.5–25.0; p = 0.086). Conclusions: This real-life study supports the importance of NPM1 mutations and HSCT in CR1, especially in the midostaurin era, for improving DFS in FLT3-ITD AML. These findings support updated guidelines for reducing the prognostic weight of AR and highlight the need for improved post-remission strategies in this setting. Full article

Background: Dynamic computer-aided navigation systems are a real-time motion tracking technology widely applied in oral implantology and endodontics to enhance precision and reduce complications. However, their reliability, accuracy, and usability in dentoalveolar surgery and maxillary bone augmentation remain underinvestigated. Methods: A systematic review following PRISMA guidelines was conducted and registered on PROSPERO (CRD42024610153). PubMed, Scopus, Web of Science, and Cochrane Library databases were searched until October 2024 to retrieve English eligible studies, without restrictions on the publication year, on dynamic computer-assisted navigation systems in dentoalveolar and bone augmentation surgeries. Exclusion criteria were surgery performed without dynamic computer-assisted navigation systems; dental implant placement; endodontic surgery; and maxillo-facial surgery. The outcomes were reliability, accuracy, post-operative course, surgical duration, complications, patient- and clinician-reported usability, acceptability, and satisfaction. Included studies were qualitatively synthetized and judged using dedicated tools for the different study designs. Results: Twenty-nine studies with 214 patients were included, showing high reliability in dentoalveolar and bone augmentation surgeries comparable to or superior to freehand surgeries, higher accuracy in dentoalveolar surgery compared to maxillary bone augmentation, and reduced complication rates across all surgeries. While overall surgical duration slightly increased due to technology installation, operative time was reduced in third molar extractions. Patient-reported outcomes were poorly investigated. Clinician-reported outcomes were mixed, but difficulties in the differentiation of soft tissue from hard tissue were recorded, especially in sinus floor elevation. Conclusions: Dynamic computer-assisted navigation systems enhance accuracy and safety in dentoalveolar and bone augmentation surgery. Further studies are needed to assess the underinvestigated patient-reported outcomes and standardize protocols. Full article