Search Results (2,813)

Background/Objectives: Although the Spinal Instability Neoplastic Score (SINS) is widely used to estimate spinal metastases fracture risk and guide decisions on stabilisation procedures, prior studies have demonstrated mixed results. Patients with the same score exhibit clinically heterogeneous outcomes, with some SINS criteria correlating less well with the estimated fracture risk than others. There are also barriers to implementation such as the time burden required for manual calculation and interobserver variability associated with qualitative morphological criteria. SINS also lacks sensitivity for detecting latent structural compromise in treatment-naive patients and those susceptible to the iatrogenic effects of stereotactic body radiation therapy. This review aims to evaluate emerging imaging, biomechanical, and microstructural markers with the potential to improve fracture risk stratification and prognostication for spinal oncology patients. Methods: We synthesise evidence across three innovative frontiers: (1) biomechanical modelling, including CT-derived finite element analysis and failure-load pattern models; (2) radiomics, utilizing radiomics features from radiological imaging to develop a predictive model; and (3) microstructural MRI biomarkers, exploring the translatability of the Vertebral Bone Quality score, fat fraction, and paraspinal muscle atrophy from osteoporosis to the metastatic spine. Results: Emerging biomechanical, radiomic and microstructural imaging markers show potential in addressing some limitations of traditional SINS criteria for fracture risk stratification across the spinal oncology treatment continuum, from initial diagnosis to post-radiation surveillance, thereby facilitating more precise risk assessment. However, current evidence remains largely retrospective and heterogeneous, and further validation is required before clinical adoption. Conclusions: We propose a framework that shifts the paradigm from conventional morphological scoring toward a multiparametric assessment of spinal stability. Full article

Background: Coronary bifurcation lesions represent one of the most technically demanding scenarios in coronary artery disease (CAD), associated with higher procedural complexity, restenosis, and periprocedural complications. Recent advances in coronary computed tomography angiography (CCTA) have markedly improved its ability to visualize complex coronary anatomy, assess plaque morphology, and guide revascularization. Objectives: This review summarizes (1) technological advances in CCTA over the last decade, (2) its role in evaluating bifurcation stenosis, (3) assessment of plaque morphology and distribution, (4) quantification of bifurcation geometry, and (5) emerging evidence supporting its application in revascularization planning and guidance. Findings: Modern wide-detector and dual-source CT systems, iterative and deep-learning reconstruction algorithms, and photon-counting CT (PCCT) have significantly improved temporal and spatial resolution, reduced blooming artifacts, and lowered radiation dose. CCTA now reliably quantifies bifurcation stenosis and plaque distribution, characterizes high-risk plaque features, and accurately measures bifurcation angles. The integration of CT-derived fractional flow reserve (FFR-CT) and artificial intelligence (AI)-based plaque quantification further strengthens its diagnostic and prognostic performance. CCTA-derived bifurcation scores and 3D modelling support procedural strategy selection, stent sizing, and side-branch (SB) protection. Conclusions: CCTA has evolved into a comprehensive tool for non-invasive diagnosis, physiological assessment, and pre-procedural planning of bifurcation disease. With the advent of PCCT and AI-enhanced quantitative tools, CCTA is poised to become a central component of revascularization decision-making in complex coronary bifurcations. Full article

Carotid artery disease has traditionally been assessed according to luminal stenosis, although plaques with similar narrowing may differ substantially in biological activity and clinical risk. Intraplaque neovascularization is a key feature of plaque vulnerability, reflecting microvascular proliferation and its association with inflammation, hemorrhage, and structural destabilization. Dynamic contrast-enhanced ultrasound (DCE-US) offers a real-time, radiation-free method for evaluating intraplaque enhancement kinetics using strictly intravascular microbubble agents. However, its broader use in carotid plaque imaging remains limited by variability in acquisition protocols, contrast administration, signal processing, curve fitting, and parameter interpretation. This technical review clarifies the main analytical approaches used in carotid DCE-US, distinguishing bolus-based wash-in/wash-out analysis from destruction–replenishment modeling. Bolus analysis describes first-pass microbubble transit through the plaque microvasculature and commonly provides parameters such as peak intensity, wash-in slope, area under the curve, and time to peak. Destruction–replenishment analysis evaluates post-destruction refill under stable or quasi-stable contrast conditions and relies on model-based estimation of plateau intensity and the replenishment rate. Because these approaches interrogate different kinetic regimes, their outputs should not be considered interchangeable, even when similar terms are used across studies. Particular emphasis is placed on the operational meaning of quantitative and semi-quantitative parameters, the assumptions underlying curve modeling, and the methodological consequences of ROI placement, motion correction, acoustic settings, and fitting constraints. Rather than proposing a universal acquisition protocol, this article provides practical principles for acquisition, analysis, and reporting, helping radiologists, neuroradiologists, neurologists, and vascular imaging specialists understand the processing steps, algorithmic assumptions, and model-dependent choices underlying software-derived curves and parameters. By making this analytical layer more explicit, the review seeks to support a transparent, reproducible, and biologically coherent approach to quantitative carotid plaque characterization. Full article

Background: Long-duration spaceflight (LDSF) poses unique challenges to ocular health as microgravity, radiation, and environmental changes can cause lasting visual and structural impairments that affect astronaut performance. Objective: This review synthesises current evidence on in- and post-flight ocular complications. It integrates clinical findings, terrestrial analogues, animal studies, and theoretical models to characterise the pathophysiology, risk factors, and countermeasures associated with spaceflight-induced ocular changes. Methods: A review of peer-reviewed literature was conducted, focusing on dry eye disease, corneal edema, ocular biometric shifts, spaceflight associated neuro-ocular syndrome (SANS), and radiation-induced cataractogenesis. Data from in-flight imaging, post-flight assessments, and ground-based analogues were analysed. Results: Spaceflight induces multifactorial ocular changes, including tear film instability, optic disc edema, posterior globe flattening, and hyperopic refractive shifts. These effects are thought to result from cephalad fluid shifts compartmentalised cerebrospinal fluid pressure, venous congestion, and impaired glymphatic system. Long-term risks, such as cataractogenesis, are linked to radiation exposure and genetic susceptibility. Although several countermeasures are being explored, no single approach fully prevents these complications. Conclusions: Ocular complications during LDSF remain a significant challenge for astronaut health and mission performance. A multimodal approach combining mechanical, nutritional, and diagnostic strategies will be essential for future exploration-class missions. Further research is needed to refine countermeasures and preserve astronauts’ visual function. Full article

Against the background of observed climate change, which increases the risk of glacier-system degradation and the formation of hidden crevasses, the development of lightweight, wideband, and highly directional antenna systems has become a key factor in ensuring the safety of logistics operations and enhancing the spatial resolution and interpretability of ground-penetrating radar monitoring of near-surface snow–ice layers. The effectiveness of such systems is largely determined by the characteristics of the antenna unit, including the operating frequency band, gain, radiation pattern, weight, and resilience under extreme climatic conditions. The aim of this review is to provide a systematic analysis of modern Vivaldi antenna designs and Vivaldi-based antenna arrays, as well as to assess their prospects for application in X-band ground-penetrating radar systems for probing Antarctic snow-ice media. The paper considers the main types of ground-penetrating radar (GPR) antennas, their advantages and limitations, substantiates the priority of detecting hazardous near-surface inhomogeneities, and analyzes the capabilities of the X-band for the high-resolution identification of these inhomogeneities. Particular attention is paid to modern modifications of Vivaldi antennas, including antipodal, balanced, director-loaded, metamaterial-based, and array configurations. The analysis shows that Vivaldi antennas represent a promising basis for lightweight, wideband, and directional GPR systems; however, they require further improvement in terms of gain enhancement, sidelobe and back-lobe suppression, radiation-pattern stabilization, and adaptation to Antarctic operating conditions. Future research should focus on the development of adaptive and phased Vivaldi arrays, the use of metamaterials, Electromagnetic Band-Gap/Frequency-Selective Surfaces (EBG/FSS) structures, and director elements, the creation of lightweight, frost-resistant substrate materials, the advancement of multi-polarization multiple-input multiple-output (MIMO) systems, and the integration of antenna arrays with synthetic aperture radar (SAR) processing adapted to a multilayer snow–ice medium. Full article

Background: Cancer-associated thrombosis (CAT) is a leading cause of morbidity and mortality in cancer patients. Although international guidelines provide comprehensive recommendations for venous thromboembolism (VTE) prevention and treatment, the degree to which clinicians adhere to these guidelines in routine practice remains unclear, particularly in countries with limited national data such as Turkey. Methods: A cross-sectional, descriptive survey was conducted among oncology specialists (medical oncologists, radiation oncologists, and surgical oncologists) and cardiologists practicing across Turkey. A structured, case-based questionnaire comprising 21 multiple-choice questions was distributed electronically via SurveyMonkey. The questionnaire assessed perioperative VTE prophylaxis approaches, VTE risk assessment practices in ambulatory patients, primary and long-term secondary thromboprophylaxis preferences, acute VTE treatment strategies, and management of special clinical scenarios. Responses were analyzed using descriptive statistics and compared between oncologist and cardiologist groups. Results: A total of 84 physicians participated (34 oncologists [40.5%], 50 cardiologists [59.5%]). Perioperative and inpatient VTE prophylaxis practices were largely concordant with guideline recommendations, with 67.9% individualizing prophylaxis decisions and 66.7% initiating prophylaxis in hospitalized immobile patients when not contraindicated. However, only 33.7% routinely performed VTE risk assessment in ambulatory patients, and 64.6% did not use any validated risk scoring system. Low-molecular-weight heparin (LMWH) was the preferred agent for acute VTE treatment (72.6%), while direct oral anticoagulants (DOACs) gained preference in long-term secondary thromboprophylaxis (42.2%). No statistically significant differences were observed between oncologists and cardiologists across all survey items (all p > 0.05). Notably, 94.1% of respondents expressed a need to update their knowledge regarding CAT management. Conclusions: While oncologists and cardiologists in Turkey demonstrate general awareness of CAT guidelines, significant gaps persist in VTE risk stratification and primary prophylaxis for ambulatory cancer patients. The near-universal self-reported need for knowledge updates highlights the urgency for structured multidisciplinary education programs, integration of validated risk scoring tools into clinical workflows, and development of nationally adapted clinical practice guidelines. These findings reflect self-reported practices and may not fully represent actual clinical behavior; future studies incorporating medical record reviews or prescription data are needed to validate these observations. Full article

This study investigates the dyke swarms of the Um Dwiela area in the southern Egyptian Shield through a combined approach of remote sensing, field investigations and laboratory analyses, including mineralization and radioactive prospecting. Radioelements laboratory measurements and optical remote sensing datasets are combined to detect the bostonite rocks and their radioactive mineralization. The processing of Landsat-8, Sentinel-2 and ASTER data effectively delineated the country rocks, bostonite dykes and structural elements. Field observations indicate that the dykes trend NE-SW, extending approximately 12 km with widths ranging from 1 to 13 m. These dykes have experienced multiple alteration phases, pointing to the influence of hydrothermal fluids. Uranium mineralization is structurally controlled, occurring within fractures at the contact between bostonite and metasedimentary rocks. Average measurements obtained using a NaI(Tl) analyzer reveal elevated and variable radionuclide concentrations [²³²Th (442.25 Bq/kg), ²³⁸U (608.43 Bq/kg), and ⁴⁰K (1141.41 Bq/kg)], all exceeding internationally permissible safety limits. Multiple radiological hazard indices further indicate a substantial radiation risk, with all values classified as high according to global standards. Consequently, the associated gamma radiation exposure poses an elevated radiological hazard concern. Full article

Radiation-induced biological responses emerge through complex interactions across multiple biological scales, ranging from molecular damage to tissue remodeling and organism-level outcomes. Although traditional radiobiology has primarily focused on DNA damage and linear dose–response relationships, increasing evidence suggests that radiation responses are highly context-dependent and cannot be fully explained by genomic alterations alone. In particular, low-dose and chronic radiation exposures often induce biological effects that involve dynamic regulatory processes beyond direct mutational burden. The narrative review proposes a conceptual multiscale framework for predictive radiobiology that integrates genomic damage, post-transcriptional regulation, network rewiring, and tissue microenvironmental interactions. Within this framework, “predictive radiobiology” refers to the integrative prediction of radiation-induced outcomes, including radiosensitivity, tissue remodeling, fibrosis progression, therapeutic response, and long-term carcinogenic risk. We discuss how radiation-induced signaling extends beyond DNA double-strand breaks to include RNA-binding protein-mediated regulation, adaptive network responses, and extracellular matrix-dependent cellular plasticity. Recent advances in multi-omics, single-cell analysis, spatial biology, and three-dimensional organotypic models have revealed that radiation responses are governed by interconnected molecular and tissue-level processes. Furthermore, artificial intelligence and systems-level computational approaches provide new opportunities for modeling non-linear and context-dependent radiation effects across biological scales. We further discuss current limitations, including data integration challenges, reproducibility issues, and the translational gap between experimental models and clinical applications. Collectively, this conceptual framework highlights the need for integrative and multiscale approaches to improve mechanistic understanding and predictive modeling in modern radiobiology. Full article

Background/Objectives: Malignant transformation of soft tissue lesions is uncommon but represents a significant diagnostic challenge with substantial clinical consequences. This spectrum encompasses four interrelated processes but biologically distinct processes: (1) true malignant transformation of benign lesions; (2) dedifferentiation of low-grade or intermediate malignancies; (3) secondary malignancy arising in chronic inflammatory or non-neoplastic conditions; and (4) apparent progression related to tumor heterogeneity and sampling error. Although these four entities involve biologically distinct mechanisms, they are grouped under “malignant progression” for conceptual clarity. While this umbrella approach has limitations due to biological heterogeneity, this unified radiologic framework aims to supplement, rather than oversimplify, their distinct biological behaviors. Representative examples include neurofibroma and epidermal inclusion cyst among benign lesions; atypical lipomatous tumor/well-differentiated liposarcoma, dermatofibrosarcoma protuberans, and solitary fibrous tumor among lesions showing dedifferentiation or malignant progression; and chronic inflammatory or scar-related conditions and previously irradiated tissue associated with secondary malignancy. Some lesions that appear to progress during follow-up may represent initial underdiagnosis rather than true biologic progression. Methods: This narrative review summarizes current imaging features, underlying pathologic mechanisms, and clinical risk factors associated with these processes in soft tissue lesions. Particular emphasis is placed on radiologic–pathologic correlation and conditions prone to histopathologic misinterpretation. Results: Imaging red flags—including interval or rapid growth, deep fascial invasion, heterogeneous enhancement, perilesional edema, and necrosis—should raise concern for malignant progression across these categories. However, overlapping imaging features and sampling errors may result in pathologic misdiagnosis and delayed treatment. Particularly, atypical lipomatous tumors are frequently misdiagnosed as simple lipomas, while fibrosarcomas may be erroneously interpreted as aggressive fibromatosis. Advanced imaging and multidisciplinary review may help reduce diagnostic errors. Patients with predisposing factors such as genetic syndromes, chronic inflammation, prior burns, or previous radiation exposure warrant close surveillance. Conclusions: Accurate diagnosis of soft tissue lesions with true malignant transformation, dedifferentiation, or secondary malignancy—as well as recognition of diagnostic pitfalls—is essential for appropriate management. Integrated radiologic–pathologic assessment may help improve diagnostic accuracy and clinical decision-making in soft tissue oncology. Full article

Background: Neoadjuvant partial breast irradiation using stereotactic body radiotherapy (SBRT) has emerged as a strategy to induce tumor and immune responses in early-stage, low-risk breast cancer. While prior studies have demonstrated encouraging response rates and evidence of immune modulation, the optimal radiotherapy regimen for immune priming remains unclear. SIGNAL 2.0 is a randomized phase II trial designed to compare the biological and immunological impact of a single-fraction versus three-fraction neoadjuvant SBRT. Materials and Methods: Sixty-one postmenopausal patients ≥ 50 years with unifocal, hormone positive, node-negative invasive ductal carcinoma < 3 cm were randomized 1:1 to receive either 21 Gy in one fraction or 30 Gy in three fractions, delivered to the tumor in the prone position. Core biopsies were collected pre-SBRT and 14–20 days post-SBRT at the time of surgery. Immune markers were assessed using tumor-infiltrating lymphocyte (TIL) scoring, NanoString nCounter PanCancer Immune Profiling, and NanoString GeoMx Digital Spatial Profiling (DSP). Results: Available tumor samples from 47 patients underwent paired tissue analysis. Three-fraction SBRT induced 200 differentially expressed genes, including enrichment of pathways related to adaptive immune activation, with significant increases in expression levels of macrophages, dendritic cells, neutrophils and CD8 T-cells. Proteomic profiling also identified a significant increase in the expression levels of neutrophils, Treg cells, macrophages, and NK cells in the tumor microenvironment of the samples from patients receiving the three-fraction regimen. Conclusions: Neoadjuvant SBRT induces measurable immune activation, with three-fraction regimens generating more extensive transcriptional, proteomic, and cellular immune changes than a single fraction. Three-fraction neoadjuvant SBRT may provide superior immune priming, providing a foundation for future trials integrating neoadjuvant radiotherapy with immunomodulatory therapies. Full article

Background: Manually contouring the organs at risk (OARs) is a time-consuming process with significant variability. Multiple commercial options are available to streamline this process by utilizing artificial intelligence. This study compares the performance of two commercially available systems, MIM Contour ProtégéAI v4.0.0 (MIM) and Radformation/Limbus AI v1.7.0 (Limbus), in auto-contouring head and neck (H&N) OARs. Methods: We conducted a retrospective single-institution study with 20 patients who received curative-intent H&N radiation therapy. Seventeen OARs, bilateral where applicable, were manually contoured for each patient, which established a reference for comparison. Dice coefficient (DC), mean Hausdorff distance (HD_mean), and maximum Hausdorff distance (HD_max) were compared relative to the manual reference. Subjective contour quality was graded on a Likert scale. Wilcoxon signed-rank test with Benjamini–Hochberg false discovery rate procedures were used to compare outcomes. Results: Twenty patients were selected with a variety of H&N primary sites. The total number of OARs used for comparison was 480. Three quarters of patients were male, the mean age was 60.5 years (SD = 12.8), and the mean BMI was 23.53 kg/m² (range 16.9–42.4). MIM performed more consistently with the manual reference (adjusted p < 0.05) compared to Limbus when contouring the bilateral brachial plexus and mandible. Limbus performed more consistently than MIM when contouring the left lacrimal gland, larynx, optic chiasm, bilateral optic nerves, right parotid, and esophagus. The DC, HD_mean, and HD_max were not statistically different between MIM and Limbus for the remaining structures. Both AI algorithms had high performance on the mandible, eyes, thyroid, and salivary glands, and poor performance on the optic chiasm, lacrimal glands, and brachial plexuses. The subjective quality of the auto-contours from both systems were good, with most structures requiring no or minor changes only. The structures most likely to require revisions were the pharyngeal constrictors, larynx, and submandibular glands. Limbus achieved better subjective scores than MIM for four of seventeen structures. Conclusions: This comparison of two AI auto-contouring systems demonstrated performance consistent with the manual reference for most H&N OARs. Each system had strengths and weaknesses in auto-contouring specific OARs. Full article

Islands have high ecological and tourism value; however, owing to their remoteness and limited accessibility, environmental radioactivity is often less systematically evaluated than in mainland regions. This study investigates the distribution, source partitioning, and radiological implications of multi-radionuclides (⁷Be, ¹³⁷Cs, ²¹⁰Pb, ²³⁸U, ²²⁶Ra, ²³²Th, and ⁴⁰K) in surface soils of Zhoushan Island, a representative tourism-oriented island in the East China Sea. Activity concentrations of ⁷Be, ¹³⁷Cs, ²¹⁰Pb, ²³⁸U, ²²⁶Ra, ²³²Th, and ⁴⁰K ranged from 3.4 to 585.5, below detection limit −5.7, 45–1490, 33.3–72.4, 32.3–58.9, 37.8–91.7, and 439.6–872.3 Bq/kg, respectively. Using multivariate statistics and geochemical interpretation, we classified radionuclides into three groups: (i) atmospheric deposition-driven nuclides (⁷Be, ²¹⁰Pb_ex), (ii) lithogenic background-controlled nuclides (²³⁸U−²²⁶Ra−²³²Th), and (iii) the alkali-metal-like behavior group (¹³⁷Cs−⁴⁰K). This shows that soil radionuclide patterns result from atmospheric inputs, geological inheritance, and land-use disturbance, rather than simple concentration variability. Spatial analysis revealed that agricultural disturbance enhances ¹³⁷Cs redistribution, low-lying terrains preferentially accumulate atmospheric fallout nuclides, and lithogenic radionuclides are higher in the northern island due to parent material and weathering. No significant ⁴⁰K enrichment was observed in cultivated soils, indicating limited fertilizer influence. Although radiological indices remain within international safety thresholds, several parameters exceed global background levels, indicating elevated natural radiation driven primarily by thorium-rich lithology. Importantly, we show that radiological risk assessments based solely on bulk activity may overestimate environmental significance without considering process controls. This study provides a process-informed radiological assessment for island systems, offering insights for environmental monitoring and risk evaluation in similar coastal and tourism-dominated regions. Full article

Background and Objectives: Lung ultrasound (LUS) has fundamentally transformed neonatal respiratory diagnostics, offering a radiation-free, bedside-applicable modality capable of guiding surfactant therapy, characterizing pulmonary pathology, and monitoring treatment response in real time. While surfactant replacement therapy is firmly established for neonatal respiratory distress syndrome (RDS), its role in acute complications—specifically pulmonary hemorrhage (PH) and pneumothorax (PTX)—remains uncertain and heterogeneous in clinical practice. This review examines how LUS-based phenotyping can improve the diagnostic precision and therapeutic sequencing of surfactant administration in these high-risk scenarios, and how comorbidities such as hemodynamically significant patent ductus arteriosus, persistent pulmonary hypertension, sepsis, and coagulopathy modulate clinical outcomes. Materials and Methods: We conducted a structured narrative review of studies published from 2020 onward, sourced from PubMed, Web of Science, Semantic Scholar, and Mendeley, using PRISMA-inspired selection principles. The search combined terms including “lung ultrasound,” “neonatal POCUS,” “surfactant therapy,” “pulmonary hemorrhage,” “neonatal pneumothorax,” and “LUS score.” Studies focusing on neonatal populations, clinical LUS applications, and surfactant use in PH and PTX were prioritized. Results: Quantitative LUS scoring systems (range 0–18) predict surfactant need and re-dosing with AUC values of 0.85–0.87, outperforming clinical estimates alone. In PH, LUS reveals dense consolidation with alveolar flooding patterns, guiding the timing of rescue surfactant after hemodynamic stabilization; response monitoring via serial LUS is feasible and informative. In PTX, hallmark signs—absent lung sliding, loss of B-lines, and the pathognomonic lung point—allow diagnosis within seconds, guiding immediate thoracentesis and subsequent surfactant administration if underlying RDS is confirmed. Nationally implemented LUS protocols in neonatal intensive care units have demonstrated significant reductions in radiation exposure without compromising diagnostic accuracy. Conclusions: LUS-guided decision algorithms—integrating ultrasonographic phenotyping, quantitative scoring, and hemodynamic assessment—represent the current best framework for individualizing surfactant therapy in neonatal PH and PTX. Standardization of POCUS training and protocol implementation in neonatal units is essential. Prospective multicenter trials are urgently needed to define optimal indications, timing, and dosing in these vulnerable populations. Full article

Background/Objectives: Cancer incidence and mortality are key epidemiological indicators for evaluating the long-term biological effects of chronic low-dose radiation exposure. The aim of this study was to assess the incidence, structure, and relative risk of digestive tract cancers (ICD-10 C15–C26) among populations exposed and not exposed from uranium waste storage site in North Kazakhstan over a 10-year period (2014–2023). Methods: A retrospective population-based analysis was conducted using national cancer registry data, including data for residents of Stepnogorsk and nearby settlements (exposed group) and Akkol (control group). Results: A total of 588 cases were identified, including 465 in the exposed group and 123 in the control group. The mean age at diagnosis was similar (~65 years), and most cases were diagnosed at advanced stages (III–IV: ~58–60%). The leading cancer types were colorectal (38–40%) and stomach (29–31%) in both groups. The incidence rates were comparable (85.27 vs. 87.40 per 100,000), with an overall relative risk (RR) of 0.98 (95% confidence interval [CI]: 0.80–1.19), indicating no significant difference. Site-specific analysis showed no significant variation for esophageal, stomach, or colorectal cancers. A higher, but not statistically significant, risk was observed for pancreatic cancer (RR = 1.61; 95% CI: 0.90–2.89). Temporal analysis demonstrated similar trends in both populations, with incidence rates decreasing from 91.37 to 79.08 per 100,000 in the exposed group and from 97.40 to 78.13 per 100,000 in the control group between 2014–2018 and 2019–2023. Conclusions: Overall, digestive tract cancer incidence and structure were comparable between groups, with no statistically significant increase in the exposed population. Full article

The Northern Tibetan Plateau is among the most climate-sensitive alpine regions globally. To address the limited applicability of the traditional Remote Sensing Ecological Index (RSEI) in sparsely vegetated areas, this study developed a Soil-Adjusted Remote Sensing Ecological Index (SRSEI) tailored to cold and arid environments. The ecological quality of the Northern Tibetan Plateau from 2000 to 2025 was systematically evaluated and analyzed. The results indicate that: (1) The improved SRSEI achieved a first principal component (PC1) contribution of 72.76%, a significant enhancement over traditional models that effectively mitigates noise from soil backgrounds and anthropogenic features. (2) Between 2000 and 2025, ecological quality was predominantly moderate, following a characterized east-to-west declining spatial gradient. Overall mean SRSEI values fluctuated between 0.420 and 0.476, exhibiting a marginal downward trend. (3) Ecological degradation affected 50.17% of the region, with 26.14% facing risks of sustained decline. Conversely, 40.11% of the area displayed potential recovery trends, suggesting potential spatial divergence in future ecological trajectories. (4) Regional ecological dynamics are governed by a topographic-thermal compound driving mechanism. Elevation (DEM), temperature (TEMP), and surface shortwave radiation (SRAD) emerged as the dominant explanatory variables. Furthermore, dual-factor interactions exhibited significant enhancement effects, while the influence of anthropogenic factors was comparatively weak at the regional scale. These findings provide a scientific basis for the long-term monitoring of fragile alpine ecosystems and the strategic development of the Qiangtang National Park. Full article