Search Results (89)

Background: Visceral pleural invasion (VPI) has traditionally been regarded as a negative prognostic indicator in non-small-cell lung cancer (NSCLC). However, with the increasing adoption of sublobar resection for small-sized NSCLC, the clinical significance of VPI is being fundamentally reassessed. Specifically, it remains uncertain whether VPI is indicative of tumor size or represents distinct metastatic behavior. Methods: We conducted a retrospective comprehensive multicenter study involving 2464 patients with pathologically confirmed NSCLC ≤ 3 cm who underwent complete resection at three Japanese institutions. The prevalence, metastatic patterns, and prognostic impact of VPI were systematically evaluated, with particular focus on histological growth patterns. Results: VPI was identified in 370 patients (15%). Notably, VPI-positive tumors demonstrated a doubled incidence of lymph node metastasis (31% vs. 15%, p < 0.001) and a distinct metastatic profile characterized by preferential hilar spread (#12, 16.9%) and an increased risk of skip N2 metastasis (4.0% vs. 2.0%). Five-year recurrence-free survival was significantly reduced in the VPI group (33.7% vs. 50.6%, respectively). Conversely, adenocarcinomas with lepidic characteristics demonstrated a minimal risk of VPI or nodal metastasis, with incidences of 2% and 1%, respectively. This finding highlights the heterogeneity in the biological aggressiveness of small-sized NSCLC. Conclusions: Our findings suggest that VPI is not merely a histopathological descriptor but also acts as a clinically significant indicator of aggressive metastatic behavior, potentially enhancing surgical and staging approaches beyond just considering tumor size. With the increasing adoption of sublobar resection for small-sized NSCLC, recognizing that VPI appears to be associated with predominant hilar involvement and an elevated risk of skip N2 metastasis may help refine decisions on the extent of lung and lymph node resection. Full article

Background: The optimal surgical approach for malignant pleural mesothelioma (PM) remains a topic of debate. While extrapleural pneumonectomy (EPP) offers radical resection, it is associated with significant morbidity. Pleurectomy/decortication (P/D) is less extensive but may offer comparable oncologic outcomes with reduced perioperative risk. This study aimed to conduct a comprehensive systematic review and meta-analysis to systematically evaluate and quantitatively compare survival outcomes, 30-day postoperative mortality, and baseline characteristics between patients undergoing P/D and EPP for PM. Methods: A systematic review was conducted in accordance with the PRISMA guidelines. MEDLINE, Embase, and Scopus were searched up to May 2025. Studies comparing EPP and P/D in PM that reported on survival, mortality, or baseline demographics were included. Data from 24 retrospective studies were extracted. Pooled estimates were calculated using random-effects models. Meta-regression and subgroup analyses were performed by geographic region and publication year. Results: P/D was associated with a significantly improved overall survival compared to EPP in the primary analysis (mean difference = 7.01 months; 95% CI: 1.15–12.86; p = 0.018), with substantial heterogeneity (I² = 98.5%). In a sensitivity analysis excluding one statistical outlier, the survival benefit remained significant (mean difference = 4.31 months; 95% CI: 1.69–6.93), and heterogeneity was markedly reduced. The 30-day mortality rate was also significantly lower for P/D (odds ratio = 0.34; 95% CI: 0.13–0.88; p = 0.027). Patients undergoing P/D were, on average, 3.78 years older than those undergoing EPP (p < 0.001), whereas no significant difference was observed in the sex distribution between groups. Subgroup analyses by region and publication year confirmed the robustness of the findings. Meta-regression did not reveal substantial modifiers of survival. Conclusions: P/D demonstrates superior overall survival and reduced perioperative mortality compared to EPP, without evidence of baseline demographic confounding. These findings, derived from retrospective comparative studies, support the preferential use of P/D in eligible patients, particularly in high-volume centers, given its favorable safety profile and superior median survival. However, the absence of randomized trials directly comparing P/D and EPP and the potential influence of patient selection warrant cautious interpretation, and surgical decisions should be tailored to individual patient factors within a multidisciplinary setting. Full article

With the increasing complexity of grid project systems, it is difficult for an individual project management perspective to meet the macro management needs of the project, unapplicable to overall project layout management. However, the current grid project portfolio management (PPM) configuration lacks systematic methodological support, and the synergistic relationships between projects in terms of resources, strategy, and other aspects have not been effectively utilized, making it difficult to optimize the effectiveness of management and investment schemes. Therefore, in this paper, we propose a method called CNMI-PGPC, which combines complex networks and multidimensional indicators to explore the correlations among grid projects, deeply mines the key grid project clusters and the optimal allocation strategy, and is devoted to improving the comprehensive efficiency of grid projects. The methodology was validated on data derived from the Grid Multi-Category Reserve Project (including grid infrastructure, production technology improvement, and grid digitization). The results show that the proposed method can effectively provide a scientific basis for configuring and managing grid projects, support the preferential decision-making tasks of projects, and optimize the layouts of grid projects. We shift from single-project optimization to global synergy, quantify the comprehensive benefits of the project team in terms of economics, strategy, and other dimensions, bridge the gap between the previous individual project assessment perspectives, and provide a systematic decision-making basis for grid project portfolio planning. Full article

The geological structural complexity and microscale heterogeneity of shale reservoirs, characterized by the brittleness index and natural fracture density, exert a decisive effect on hydraulic fracturing’s effectiveness. However, the mechanisms underlying the true microscale heterogeneity of shale structures, which is neglected in conventional models and influences fracture evolution, remain unclear. Here, high-resolution scanning electron microscopy (SEM) was employed to obtain realistic distributions of mineral components and natural fractures, and hydraulic–mechanical coupled simulation models were developed within the Realistic Failure Process Analysis (RFPA) simulator using digital rock techniques. The analysis examined how the brittleness index and natural fracture density affect the fracture morphology’s complexity, mineral failure behavior, and flow conductivity. Numerical simulations show that the main fractures preferentially propagate toward areas with high local brittleness and dense natural fractures. Both the fracture’s fractal dimension and the stimulated reservoir volume increased with the brittleness index. A moderate natural fracture density promotes the fracture network’s complexity, whereas excessive densities may suppress the main fracture’s propagation. Microscopically, organic matter and silicate minerals are more prone to damage, predominantly tensile failures under external loading. These findings highlight the dominant role of microscale heterogeneity in shale fracturing and provide theoretical support for fracture control and stimulation optimization in complex reservoirs. Full article

Background/Objectives: Myelodysplastic syndrome (MDS) is a heterogeneous clonal hematopoietic disorder characterized by ineffective hematopoiesis and leukemic transformation risk. Current therapies show limited efficacy, with ~50% of patients failing hypomethylating agents. This review aims to synthesize recent discoveries through an integrated network model and examine translation into precision therapeutic approaches. Methods: We reviewed breakthrough discoveries from the past three years, analyzing single-cell multi-omics technologies, epitranscriptomics, stem cell architecture analysis, and precision medicine approaches. We examined cell-type-specific splicing aberrations, distinct stem cell architectures, epitranscriptomic modifications, and microenvironmental alterations in MDS pathogenesis. Results: Four interconnected mechanisms drive MDS: genetic alterations (splicing factor mutations), aberrant stem cell architecture (CMP-pattern vs. GMP-pattern), epitranscriptomic dysregulation involving pseudouridine-modified tRNA-derived fragments, and microenvironmental changes. Splicing aberrations show cell-type specificity, with SF3B1 mutations preferentially affecting erythroid lineages. Stem cell architectures predict therapeutic responses, with CMP-pattern MDS achieving superior venetoclax response rates (>70%) versus GMP-pattern MDS (<30%). Epitranscriptomic alterations provide independent prognostic information, while microenvironmental changes mediate treatment resistance. Conclusions: These advances represent a paradigm shift toward personalized MDS medicine, moving from single-biomarker to comprehensive molecular profiling guiding multi-target strategies. While challenges remain in standardizing molecular profiling and developing clinical decision algorithms, this systems-level understanding provides a foundation for precision oncology implementation and overcoming current therapeutic limitations. Full article

Urban expansion in coastal areas involves infrastructure development, industrial growth, and mining activities. These coastal environments face various environmental and geological hazards that require geo-engineers to devise solutions. An integrated geophysical approach aims to address such complex challenges as sea level rise, sea water intrusion, shoreline erosion, landslides and previous anthropogenic activity in coastal settings. In this study, the proposed methodology involves the systematic application of geophysical methods (FDEM, 3D GPR, 3D ERT, seismic), starting with a broad-scale survey and then proceeding to a localized exploration, in order to identify lithostratigraphy, bedrock depth, sea water intrusion and detect anthropogenic buried features. The critical aspect is to leverage the unique strengths and limitations of each method within the coastal environment, so as to derive valuable insights for survey design (extension and orientation of measurements) and data interpretation. The coastal zone of Throrikos valley, Attica, Greece, serves as the test site of our geophysical investigation methodology. The planning of the geophysical survey included three phases: The application of frequency-domain electromagnetic (FDEM) and 3D ground penetrating radar (GPR) methods followed by a 3D electrical resistivity tomography (ERT) survey and finally, using the seismic refraction tomography (SRT) and multichannel analysis of surface waves (MASW). The FDEM method confirmed the geomorphological study findings by revealing the paleo-coastline, superficial layers of coarse material deposits and sea water preferential flow due to the presence of anthropogenic buried features. Subsequently, the 3D GPR survey was able to offer greater detail in detecting the remains of an old marble pier inland and top layer relief of coarse material deposits. The 3D ERT measurements, deployed in a U-shaped grid, successfully identified the anthropogenic feature, mapped sea water intrusion, and revealed possible impermeable formation connected to the bedrock. ERT results cannot clearly discriminate between limestone or deposits, as sea water intrusion lowers resistivity values in both formations. Finally, SRT, in combination with MASW, clearly resolves this dilemma identifying the lithostratigraphy and bedrock top relief. The findings provide critical input for engineering decisions related to foundation planning, construction feasibility, and preservation of coastal infrastructure. The methodology supports risk-informed design and sustainable development in areas with both natural and cultural heritage sensitivity. The applied approach aims to provide a complete information package to the modern engineer when faced with specific challenges in coastal settings. Full article

The formation of aqueous pores through the interaction of amphipathic peptides is a process facilitated by the conformational dynamics typical of these biomolecules. Prior to their insertion with the membrane, these peptides go through several conformational states until they finally reach a stable α-helical structure. The conformational dynamics of these pore-forming peptides, α-PFP, is, thus, encoded in their amino acid sequence, which also predetermines their intrinsic flexibility. However, although the role of flexibility is widely recognized as fundamental in their bioactivity, it is still unclear whether this parameter is indeed decisive, as there are reports favoring the view of highly disruptive flexible peptides and others where relative rigidity also predetermines high rates of permeability across membranes. In this review we discuss in depth all those aspects linked to the conformational dynamics of these small biomolecules and which depend on the composition, sequence and dynamic performance both in aqueous phase and in close interaction with phospholipids. In addition, evidence is provided for the contribution of the known carboxyamidation in some well-studied α-PFPs, which are preferentially associated with sequences intrinsically more rigid than those not amidated and generally more flexible than the former. Taken together, this information is of great relevance for the optimization of new antibiotic peptides. Full article

In this study, the systemic challenges of water governance in Guanajuato, Mexico, are examined through a political ecology framework, identifying how governance failures, power asymmetries, and socio-environmental inequalities contribute to water scarcity and mismanagement. Guanajuato, a key agricultural and industrial hub in Mexico’s semi-arid Bajío region, faces severe aquifer depletion, pollution, and institutional fragmentation, disproportionately affecting rural and marginalized communities. Using a qualitative research design, 25 semi-structured expert interviews and a case study analysis were conducted, applying thematic coding and content analysis to examine governance structures, regulatory gaps, and socio-environmental conflicts. The findings revealed that institutional fragmentation, preferential water allocation to industry, and weak enforcement mechanisms perpetuate governance failures, with community resistance and alternative governance strategies emerging as key responses. The results of this study emphasize the need for adaptive governance reforms, including measures such as integrating local knowledge, strengthening participatory decision-making, and fostering cross-sector collaboration to ensure equitable resource distribution and environmental sustainability. Guanajuato’s case offers critical insights for improving water governance in arid regions globally, demonstrating the relevance of political ecology in analyzing and addressing governance asymmetries in water management. Full article

Background: While NPM1-mutated AML in the absence of FLT3-ITD generally carries a favorable prognosis, large registry studies suggest the positive prognostic benefit may not extend to patients > 65 years of age. We examined this preferential, age-dependent prognostic impact through a real-world analysis of 2811 adult AML patients. Results: The median overall survival (OS) was significantly better in NPM1^MT compared to NPM1^WT patients [20.86 vs. 17 mo., p = 0.003]. When stratified by age, NPM1^MT patients had higher OS than NPM1^WT patients in the 55–65-year age group (28.62 vs. 16.3 mo., p ≤ 0.0001). This OS benefit was heterogenous and prevailed most strikingly in the 55–60 (68.3 vs. 15.6 mo., p = 0.002), and up to the 60–65-year group (mOS not estimable vs. 20 mo., p = 0.007), but not beyond 65 y. Notably, the ≤65 cohort was more enriched with dominant NPM1 (21% vs. 15%, p ≤ 0.001), while the >65 cohort was enriched with abnormal karyotype (20% in >65 years vs. 16% in ≤65 years, p = 0.001), and co-occurring SRSF2 and ASXL1 mutations (18.7% vs. 7.5%, p ≤ 0.0001 and 13.5% vs. 4.1%, p ≤ 0.0001 resp.). Conclusions: We demonstrate that in a real-world setting, the prognostic benefit of NPM1 does not extend beyond age 65, underscoring the need for age-adapted risk stratification models. This granular approach could prevent the potential overestimation of prognosis in older patients with NPM1^MT AML and inform therapeutic decision making. Full article

Landslides are a major global threat, endangering lives, infrastructure, and economies. This paper introduces the Geohazard plugin, an open-source tool for QGIS, designed to support medium–small-scale landslide analysis and management. The plugin integrates several algorithms, including the Groundmotion–C index for evaluating SAR data reliability, Landslide–Shalstab for assessing shallow landslide susceptibility, and Rockfall–Droka for estimating rockfall invasion areas and the rockfall relative (spatial) hazard. An application example is provided for each module to facilitate validation and discussion. A case study from the Western Italian Alps highlights the practical application of the Rockfall–Droka modules, showcasing their potential to identify critical zones by integrating the results on affected areas, process intensity, and preferential paths. Emphasis is given to the calibration of model parameters, a critical aspect of the analysis, achieved through a back-analysis of a rockfall event that occurred in June 2024. The Geohazard plugin streamlines geohazard assessments, providing land managers with actionable insights for decision-making and risk mitigation strategies. This user-friendly GIS tool contributes to enhancing resilience in landslide-prone regions. Full article

Grid-cell data are increasingly used in research due to the growing availability and accessibility of remote sensing products. However, grid-cell data often fails to represent the actual decision-making unit, leading to biased estimates in socio-economic analysis. To this end, this paper presents a comprehensive parcel-level dataset for Salt Lake County, Utah, spanning from 2008 to 2018. This dataset combines detailed spatial and temporal data on land ownership, land use, and preferential farmland tax assessments under the Greenbelt program. Compiled from multiple geospatial sources, the dataset includes nearly 200,000 parcel-year observations, providing valuable insights into landowner decision-making and the impact of tax abatement incentives at the decision-making level. This resource is beneficial for researchers, educators, and practitioners in sustainable development, environmental studies, and farmland conservation. Full article

Groundwater-dependent vegetation (GDV) is threatened globally by groundwater abstraction. Water resource managers require maps showing its distribution and habitat preferences to make informed decisions on its protection. This study, conducted in the southeast Pilbara region of Western Australia, presents a novel approach based on metrics summarising seasonal phenology (phenometrics) derived from Sentinel-2 imagery. We also determined the preferential habitat using ecological niche modelling based on land systems and topographic derivatives. The phenometrics and preferential habitat models were combined using a framework that allows for the expression of different levels of uncertainty. The large integral (LI) phenometric was capable of discriminating GDV and reduced the search space to 111 ha (<1%), requiring follow-up monitoring. Suitable habitat could be explained by a combination of land systems and negative topographic positions (e.g., valleys). This designated 13% of the study area as requiring protection against the threat of intense bushfires, invasive species, land clearing and other disturbances. High uncertainty represents locations where GDV appears to be absent but the habitat is suitable and requires further field assessment. Uncertainty was lowest at locations where the habitat is highly unsuitable (87%) and requires infrequent revisitation. Our results provide timely geospatial intelligence illustrating what needs to be monitored, protected and revisited by water resource managers. Full article

Starting from a symmetrical multiple-choice individual, I build a sociophysics model of decision-making. Reducing the choices to two and interactions to pairs recovers the Ising model from physics at zero temperature. The associated equilibrium state results from a spontaneous symmetry breaking, with the whole group sharing a unique choice, which is selected at random. However, my focus departs from physics, which aims at identifying the true equilibrium state, discarding any possible impact of the initial conditions, the size of the sample, and the update algorithm used. Memory of past history is erased. In contrast, I claim that dealing with a social system, the history of the system must be taken into account in identifying the relevant social equilibrium state, which is always biased by its history. Accordingly, using Monte Carlo simulations, I explore the spectrum of non-universal equilibrium states of the Ising model at zero temperature. In particular, I show that different initial conditions with the same value of the order parameter lead to different equilibrium states. The same applies for different sizes and different update algorithms. The results indicate that in the presence of a social network composed of agents sharing different initial opinions, it is their interactions that lead them to share a unique choice and not their mere membership in the network. This finding sheds a new light on the emergence of echo chambers, which appear to be the end of a dynamical process of opinion update and not its beginning with a preferential attachment. Furthermore, polarization is obtained as a side effect of the random selection of the respective unanimous choices of the various echo chambers within a social community. The study points to social media exchange algorithms, which are purely technical levers independent of the issue and opinions at stake, to tackle polarization by either hindering or accelerating the completion of symmetry breaking between agents. Full article

World’s Best Practice management of locusts and grasshoppers requires accurate forecasting that helps determine where and when surveys are preferentially conducted so that infestations can be found quickly as part of ensuring early intervention treatments. Using survey data downloaded directly into a Geographic Information System (GIS), as well as rainfall and other factors important in the population dynamics of the species concerned, models within the GIS provide forecasts of future developments. The GIS provides forecasts of likely events and is used by locust and grasshopper experts to make decisions; that is, the forecasting is part of a Decision Support System for improved locust and grasshopper management. Surveys are generally conducted by ground vehicles, but for locusts, surveys by aircraft can be an important way to rapidly find bands. In Australia, dense bands can often be seen from an aircraft flying overhead at a height of 300 m, and similar detection of bands of the desert locust by aircraft has been conducted in Somalia. Swarms can be detected by ground vehicles, but because swarms move, surveying by aircraft is also an important way of locating swarms for treatment. When locust infestations are found, they are rapidly treated as part of early intervention preventive management. However, it is generally recognized that it is extremely difficult for landholders alone to protect crops against locusts and grasshoppers, so government intervention is often necessary. These organizations use a variety of treatment techniques to reduce the amount of chemical pesticide applied either by strip spraying or treating very dense infestations, such as roosting swarms, or using biopesticides. These techniques, as used in a number of countries, have proven to be very effective in managing locust populations while reducing the risk to the natural environment and human health. Full article

Aiming to address the problem of regional dynamic target search under weak communication conditions, this paper proposes a UUV cluster search method based on cumulative probability optimization. First, by estimating the probability distribution of the initial target location, an initial probability map is established. Then, based on the Bayesian model and Markov decision model, the target probability distribution is periodically updated, and based on the cumulative detection probability optimal principle of the UUV cluster, the UUV cluster is guided to search the region with high detection probability preferentially. Finally, we implement the simulation experiment and compare with the random search method. The results verify that the proposed method has higher search efficiency in the cases of without prior information and with prior information. Full article