Search Results (23,160)

Background: Thoracoamniotic shunting (TAS) is a well-established fetal therapy for severe pleural effusions complicated by hydrops. Although survival in selected cases exceeds 60%, retained or migrated shunts can pose significant postnatal management challenges. Case presentation: We report a neonate with intrathoracic migration of a Somatex^® shunt placed at 26 weeks’ gestation for hydropic pleural effusion. Although initially asymptomatic, the infant developed recurrent pleural effusions requiring multiple readmissions. Thoracoscopic retrieval on day 76 of life allowed safe removal despite dense adhesions, leading to complete clinical resolution. Discussion: Retained thoracoamniotic shunts may remain asymptomatic or cause recurrent effusions, pneumothorax, or other complications. This case highlights the limitations of conservative management in the presence of clinical deterioration and supports timely surgical removal. Standardized criteria for intervention are lacking and urgently needed. Conclusions: In infants with retained TAS, recurrence of effusions or respiratory compromise should prompt active removal. Thoracoscopic retrieval is a safe and effective minimally invasive option. Full article

The Zhundong coalfield in Xinjiang contains vast reserves and is a crucial source of thermal coal. However, the Zhundong coal has a high content of alkali and alkaline earth metals, which makes it prone to ash deposition and slagging in boilers, thereby limiting its large-scale utilization. Fluidized-bed preheating is an emerging clean combustion technology that can reduce the slagging and fouling risks associated with high-alkali coal by modifying its fuel properties. This study employs circulating fluidized-bed preheating technology to treat high-alkali coal, with a focus on investigating the effect of the preheated air equivalence ratio on fuel preheating modification. Through microscopic characterization of both the raw coal and preheated char, the release and transformation behaviors of elements and substances during the preheating process are revealed. The results demonstrate that fluidized preheating promotes alkali metal precipitation, and increasing the preheated air equivalence ratio (λ_Pr) enhances gas production and elemental release, with a volatile fraction mass conversion of up to 84.57%. As the λ_Pr value increased from 0.28 to 0.40, the average temperature in the preheater riser increased from 904 °C to 968 °C. Compared to the raw coal, the specific surface area of the preheated char was enhanced by a factor of 3.6 to 9.1 times, with a more developed pore structure and less graphitization, thus enhancing the surface reactivity of the preheated char. The increase in λ_Pr also facilitated the conversion from pyrrolic nitrogen to pyridinic nitrogen, thus improving combustion performance and facilitating subsequent nitrogen removal. These findings provide essential data support for advancing the understanding of preheating characteristics in high-alkali coal and for promoting the development of efficient and clean combustion technologies tailored for high-alkali coal. Full article

Background/Objectives: Emerging evidence suggests that enlarged perivascular spaces (EPVS), which play a significant role in brain fluid exchange and waste removal, may be involved in the pathogenesis of amyotrophic lateral sclerosis (ALS). In this study, we aimed to explore the shared genetic link and causal effect between EPVS and ALS. Methods: This study used publicly available summary data from the largest and most recent genome-wide association studies (GWAS) on EPVS (n = 40,095) and ALS (n = 138,086) in European populations. EPVS were assessed in the hippocampus (EPVS-HIP), basal ganglia (EPVS-BG), and white matter (EPVS-WM). We used linkage disequilibrium score regression (LDSC) to investigate the genetic correlation. Multi-trait analysis of GWAS (MTAG), Cross-Phenotype Association (CPASSOC) analysis, and genetic colocalization analysis were performed to identify shared risk loci. Bidirectional Mendelian randomization analysis was used to investigate the causal relationship. Results: A negative genetic correlation was observed between EPVS-WM and ALS after Bonferroni correction (rg = −0.24, p < 0.01). No significant correlations were observed between ALS and EPVS-HIP (rg = −0.03, p = 0.79) or EPVS-BG (rg = 0.01, p = 0.91). Four significant loci including rs113247976 in KIF5A and rs118082508 in SDR9C7 were identified as potential pleiotropic loci of the relationship. None of these loci demonstrated evidence of genetic colocalization. Furthermore, Mendelian randomization analysis revealed no causative effect in either direction. Conclusions: EPVS-WM and ALS may share part of their genetic architecture, but no evidence for a causal relationship was observed. Future research is needed to further refine these relationships. Full article

Electrochemical advanced oxidation processes based on peroxymonosulfate (PMS-EAOPs) have shown great promise for eliminating organic pollutants from water. However, earlier research primarily concentrated on pollutant degradation at the cathode, with little attention given to the anode’s role in PMS-EAOPs. In this work, we developed a PMS-EAOP system using nitrogen-doped carbon nanotubes (N-CNTs) as the electrocatalyst and examined the degradation of pollutants (acetamiprid (ATP) and sulfamethoxazole (SMX)) at both the cathode and anode. Our findings indicate that SMX was rapidly degraded at both electrodes, while ATP was effectively broken down only at the cathode, demonstrating the selective nature of PMS-EAOP. At a voltage of −2 V and 2.5 mM PMS, the pseudo-first-order rate constant (k_obs) for ATP at the cathode reached 0.122 min⁻¹, with over 92% removal within 30 min. In contrast, the anode exhibited high selectivity, removing ~75% of SMX (k_obs = 0.041 min⁻¹) while less than 20% of ATP was degraded. Analysis of reactive oxygen species showed that hydroxyl and sulfate radicals were produced and contributed to pollutant degradation at the cathode. In contrast, selective oxidation occurred at the anode, likely driven by direct electrolysis-induced nonradical oxidation responsible for the selective degradation. Phosphates and bicarbonates significantly inhibited the degradation of pollutants in the PMS-EAOP process (31.7–76.4%). In contrast, chloride ions exhibited an electrode-dependent effect, with the anode being less susceptible to interference from common water anions. Overall, this study highlights that while PMS-EAOP can selectively remove contaminants, the influence of water matrix components must be taken into account when treating real wastewater. Full article

Cardiovascular diseases remain the leading cause of mortality worldwide, underscoring the urgent need for reliable in vitro models that recapitulate the complexity of the native myocardium. Conventional two-dimensional (2D) cultures lack structural and biochemical complexity, whereas in vivo models are costly, raise ethical concerns, and have poor translational potential. In this study, we developed a novel hydrogel scaffold derived from decellularized porcine ventricular myocardium (dECM). A newly optimized decellularization strategy effectively removed cellular and nuclear components while preserving essential extracellular matrix proteins. The dECM-based hydrogel exhibited reproducible self-crosslinking, gelation kinetics, and stability. Cytocompatibility assays using human bone marrow-derived mesenchymal stem cells demonstrated excellent viability and proliferation upon contact with the biomaterial. Multidimensional hydrogel applications (2.5D and 3D) in vitro revealed higher cell densities than those observed under 2D conditions. Moreover, using human umbilical vein endothelial cells, the dECM-based hydrogel proved to be a valid tool for fabricating cardiovascular in vitro models. As such, this cardiac dECM-based hydrogel is a structurally preserved, biocompatible platform that supports both short- and long-term cell culture. The scaffold has the potential to serve promising applications in cardiac tissue engineering, disease modeling, and cardiotoxicity screening by offering a closer mimicry of the native myocardial environment. Full article

Background: Deep infiltrating endometriosis (DIE) and, in particular, bowel endometriosis stand out for their complexity. While surgery for bowel endometriosis has proven to be effective, there is a lack of standardization concerning the technique used and the reported outcomes. Objectives: The objective is to perform a review aiming to summarize the state of the art of bowel endometriosis and to point out the gaps to be addressed by future research. We also propose a novel classification of surgical procedures to fill these gaps and improve management. Methods: A literature search was performed on PubMed from inception to October 2025. Results: The following three major procedures for the excision of bowel endometriosis have been proposed: the nodule shaving, the discoid excision, and the segmental intestinal resection. One further technique, NOSE (natural orifice specimen extraction), can be applied for the removal of the specimen in cases of discoid or segmental resection. To reduce surgical morbidity, current data support the choice of most conservative surgical options, namely nodule dissection and discoid resection, as well as the use of nerve-sparing techniques in case of segmental resection. Nonetheless, there is little evidence concerning the indication and the most appropriate technique to be used, including their relative risks and benefits in terms of pain control, urinary and gastrointestinal function, risk of future relapse, and fertility outcomes. Conclusions: Significant barriers in comparing surgical outcomes due to unclear definitions, lack of standardization, and incomplete reporting are some of the most relevant issues frequently encountered. To fill these gaps, we propose a new classification system for bowel surgery that describes the dimension and the number of the lesions, as well as the type of surgical technique used, supplemented by the information if vaginal opening was necessary for complete lesion resection. This proposition aims to open a discussion on this topic and boost focused research to evaluate the utility of a new classification in clinical practice. Full article

This study reports the sustainable synthesis and thermal, morphological, and structural characterization of multifunctional silver/hydroxyapatite nanocomposite prepared from recycled caprine bone. The organic extract from caprine bone was characterized using Fourier Transform Infrared (FTIR) and Ultraviolet–Visible Spectroscopy (UV-Vis). The biogenic hydroxyapatite (CHAP) and its silver composite (Ag@CHAP) were characterized using thermal gravimetric analysis (TGA), Raman spectra, X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray (EDX), and transmission electron microscope (TEM). The photocatalytic activity of Ag@CHAP was quantitatively confirmed through the degradation of Crystal Violet (5 ppm) under sunlight, achieving a high removal efficiency of 99.8% under optimum conditions, demonstrating significant potential for wastewater remediation. Ag@CHAP also demonstrated enhanced antimicrobial activity compared with CHAP and showed broad-spectrum efficacy against clinical human isolates P. aeruginosa ATCC 10145, E. coli ATCC 35218, S. aureus ATCC 25923, and C. albicans (human isolate). The in vitro hemolytic-activity assays revealed that both CHAP and Ag@CHAP had no hemolytic activity after 24 h of red blood cells incubation and effectively reduced lead-induced hemolysis from 86.73% to 39.35% and 49.13%, respectively. These findings confirm CHAP and Ag@CHAP as stable, biocompatible, and high-performance materials with promising applications in the sustainable water-treatment and biomedical fields. Full article

Background/Objectives: Titanium fixation remains the gold standard for stabilizing mandibular fractures; however, associated complications often necessitate a second surgery for hardware removal. Consequently, biodegradable systems were introduced, though questions persist regarding their mechanical reliability and potential for tissue reactions. This systematic review and meta-analysis was conducted to compare the efficacy and morbidity of biodegradable versus titanium osteosynthesis systems for the treatment of mandibular fractures. Methods: Following PRISMA guidelines, a systematic literature search was conducted in MEDLINE, Embase, and CENTRAL. Comparative studies, such as randomized controlled trials (RCTs) and non-randomized studies, were included. The primary outcome was the rate of hardware removal; therefore, a random-effects meta-analysis was performed to calculate a pooled Odds Ratio (OR), while the risk of bias was assessed using the Cochrane RoB 2 and ROBINS-I tools. Results: Eight studies, including four RCTs, comprising a total of 369 patients, were included, with most studies judged to be at a high or serious risk of bias due to inadequate randomization, lack of blinding, and confounding co-interventions. The meta-analysis of four RCTs on hardware removal revealed no statistically significant difference between the biodegradable and titanium groups (pooled OR 0.28, 95% CI 0.04 to 1.90), with substantial and statistically significant heterogeneity observed (I² = 66.1%). Qualitative synthesis indicated that biodegradable systems were associated with higher rates of intraoperative screw breakage and longer operative times, while rates of successful bone union were comparable between the two groups. Conclusions: Biodegradable osteosynthesis systems represent a viable alternative to titanium for mandibular fracture fixation, demonstrating similar efficacy in achieving bone union, which is counterbalanced by higher rates of screw breakage and longer operative times. The decision to use a biodegradable system involves a critical trade-off that should be designed for the specific clinical scenario. The high risk of bias and significant heterogeneity limit the certainty of these findings, underscoring the imperative for future high-quality, long-term RCTs. Full article

Inorganic arsenic species, As(V) and As(III), present significant toxicity and carcinogenic risks in water, making their effective removal critical for global water safety. This study introduces Fe-Ti-Mn/chitosan composite xerogel beads (FTMO/chitosan) designed to overcome the limitations of conventional single-component adsorbents, particularly for simultaneous removal of As(V) and As(III), and to address solid–liquid separation challenges common with powdered adsorbents. The xerogel beads feature a rough, porous surface composed of agglomerated nanoparticles. Batch tests demonstrated that the Freundlich model provided a better fit for the adsorption process, with max uptake capacities of 22.6 mg/g and 16.2 mg/g for As(III) and As(V) at 25 °C, respectively, outperforming most reported adsorbents. Adsorption kinetics were fast, reaching equilibrium within 24 h and fitting well with a pseudo-second-order kinetic model. The adsorption efficiency was strongly influenced by solution pH and the existence of minor coexisting anions. Mechanistically, As(V) removal occurred via inner-sphere surface complexation through the substitution of surface hydroxyl groups, whereas As(III) removal involved a coupled oxidation-adsorption process: MnO₂ oxidized As(III) to As(V), which was then adsorbed onto the material surface. Furthermore, the adsorbent confirmed excellent regeneration capacity and operational stability, illuminating its promising potential for frequent utilization in water treatment and environmental remediation applications. Full article

Introduction: Nursing informatics aims to improve patient care through rapid access to patient data, systematic assessment, a reduction in clinical errors, evidence-based practice, cost-effectiveness, and improved patient outcomes and safety. Background: Despite being the largest workforce in healthcare, nurses are not being adequately prepared to use nursing informatics, and this has been attributed to poor digital literacy, limited professional development, and a lack of undergraduate informatics education. Objectives: This scoping review aims to review contemporary published literature on the benefits, barriers, and enablers for embedding nursing informatics into undergraduate nursing education with a focus on the Australian healthcare context. Methods: A scoping review was conducted using the PRISMA-ScR checklist and the JBI Manual for evidence synthesis in adherence with an a priori scoping review protocol. A comprehensive search of JBI, Cochrane, CINAHL, Ovid, ProQuest, PubMed, and Scopus databases was performed. Two reviewers independently screened the results via Covidence, with discrepancies resolved via a third reviewer. Results: Two searches were conducted for this scoping review. In the first search, a total of 3227 articles were identified through database searches, with an additional 76 articles identified through bibliographic and grey literature searches. Following duplicate removal and screening, 46 articles met the inclusion criteria. In the second search, a total of 1555 articles were identified, and after duplicate removal and screening, 16 articles met the inclusion criteria. Duplicate removal during the second search round included those articles identified in the first search. The combined searches resulted in a total of 62 sources for this review. Conclusions: Despite the early adoption of nursing informatics in Australia in the 1980s, barriers remain to effective nursing informatics engagement and proficiency, including a lack of understanding of nursing informatics, limited infrastructure and resources, inadequate digital literacy of students and faculty, and the evolving nature of nursing informatics. Definitions of nursing informatics and associated fields, development of university faculty competency, access to digital health technologies, competency standards, digital literacy of the student cohort, faculty digital proficiency, and leadership from professional nursing bodies are all viewed as integral foundations for the development of student competency in nursing informatics. Full article

We study a hybrid stochastic SIS co-infection model for two primary strains and a co-infected class with Crowley–Martin incidence, Markovian regime switching, and Lévy jumps. The model is a four-dimensional regime-switching Lévy-driven SDE system with state-dependent diffusion and jump coefficients. Under natural integrability conditions on the jumps and a mild structural assumption on removal rates, we prove uniform high-order moment bounds for the total population, establish pathwise sublinear growth, and derive strong laws of large numbers for all Brownian and Lévy martingales, reducing the long-time analysis to deterministic time averages. Using logarithmic Lyapunov functionals for the infective classes, we introduce four noise-corrected effective growth parameters ${\lambda }_1,\dots ,{\lambda }_4$ and two interaction matrices $A,B$ that encode the combined impact of Crowley–Martin saturation, regime switching, and jump noise. In terms of explicit inequalities involving ${\lambda }_k$ and the entries of $A,B$, we obtain sharp almost-sure criteria for extinction of all infectives, persistence with competitive exclusion, and coexistence in mean of both primary strains, together with the induced long-term behaviour of the co-infected class. Numerical simulations with regime switching and compensated Poisson jumps illustrate and support these thresholds. This provides, to our knowledge, the first rigorous extinction-exclusion-coexistence theory for a multi-strain SIS co-infection model under the joint influence of Crowley–Martin incidence, Markov switching, and Lévy perturbations. Full article

Tetracycline is a low-cost broad-spectrum antibiotic and widely used in medicine and aquaculture. Its residues are usually released into the environment through wastewater, which may lead to the spread of antibiotic resistance genes and pose ecological risks. To address this environmental issue, a hierarchical lignin-derived porous carbon (LPHC) was synthesized using renewable biomass lignin as the precursor through a combined phosphoric acid-activated hydrothermal pretreatment. The resulting LPHC was used to effectively remove tetracycline from aqueous solutions. Characterization results indicated that LPHC had a high specific surface area (1157.25 m²·g⁻¹), a well-developed micro-mesoporous structure, and abundant surface oxygen-containing functional groups, which enhanced its interaction with target pollutants. Adsorption experiments showed that LPHC exhibited excellent adsorption performance for tetracycline, with a maximum adsorption capacity of 219.81 mg·g⁻¹. The adsorption process conformed to the Langmuir isotherm model, indicating that monolayer chemical adsorption was dominant. Mechanism analysis further confirmed that the adsorption process was controlled by multiple synergistic interactions, including pore filling, π-π electron donor–acceptor interactions, hydrogen bonding, and electrostatic attraction. This work proposes a feasible strategy to convert waste biomass into high-performance and environmentally friendly adsorbents, which provides technical feasibility for sustainable water purification technologies. Full article

Severe permeability reduction caused by drilling-fluid contamination has significantly impaired injectivity and deliverability in the K gas storage reservoir. This study aims to restore reservoir performance through the optimization and application of a composite acid system. A series of laboratory evaluations combined with core-flow experiments, continuous core scanning, and NMR T₂ analysis were conducted to assess acid performance and elucidate damage-removal mechanisms and pore–throat evolution. The results show that the optimized composite acid exhibits favorable compatibility, effective corrosion and precipitation control, a strong clay-stabilization capacity, and high permeability restoration. Core-scale experiments and NMR analyses indicate that the acid selectively removes near-wellbore and deep plugging while restoring pore–throat connectivity without inducing excessive dissolution or framework damage. Field application further confirms the laboratory findings, demonstrating substantial improvements in gas injection and production performance, along with enhanced reservoir energy retention and recovery. Overall, the proposed composite acid system provides an effective and practical solution for mitigating formation damage and improving the long-term injectivity and deliverability of gas storage reservoirs. Full article

Introduction: The metabolic complications and poor biocompatibility of conventional glucose-based (GLU) peritoneal dialysis fluid (PDF) have driven the need for improved alternatives. To address this, we developed and evaluated a novel PDF utilizing succinylated gelatin (GEL) as osmotic agent and citrate as buffer, designed to provide effective solute clearance while offering enhanced biocompatibility. Methods: Physicochemical parameters (pH and osmolality) of the novel GEL-PDF were measured. Its performance was assessed in rats with chronic kidney disease. A total of 20 rats were randomized into short-term experiments to evaluate 4 h creatinine clearance and ultrafiltration (UF). A 12-week long-term experiment (n = 35) compared the GEL-PDF against normal saline (NS), GLU, and icodextrin-based (ICO) PDFs, monitoring survival, biochemical parameters, peritoneal membrane histology, and kidney histology. Results: The GEL-PDF demonstrated a neutral pH (7.30) and lower osmolality (317 mOsm/L) compared to GLU-PDF. In the short-term experiment, GEL-PDF achieved effective creatinine clearance by 4 h and provided higher 4 h UF than NS and GLU, comparable to ICO. However, during prolonged dwells (6–16 h), its UF was inferior to ICO. In the long-term experiment, GEL-PDF preserved peritoneal membrane structure, showing the least thickness and collagen deposition. Furthermore, the GEL-PDF demonstrated superior preservation of serum albumin compared to the GLU-PDF. It also exhibited a more favorable lipid profile, as evidenced by significantly lower total cholesterol levels than the ICO group at 12 weeks (p = 0.035), with no adverse effects on electrolytes, liver function, or glucose metabolism. Conclusions: The novel GEL and citrate-based PDF provide effective short-dwell UF and solute removal while exhibiting superior biocompatibility, as evidenced by significant protection against peritoneal membrane injury and favorable metabolic profiles. Although its long-duration UF was lower than that of ICO, it substantially outperformed GLU-PDF. These properties position the GEL-PDF as a promising candidate for short- to medium-dwell exchanges, particularly for daytime use, where it could fill an important clinical gap by providing enhanced UF without the high GLU exposure associated with conventional PDF. Full article

Underwater robots demonstrate significant potential for hull biofouling removal. However, achieving uniform and damage-free cleaning remains a persistent challenge. The fixed arrangement of cleaning mechanisms, combined with the inherent non-uniformity of cavitation jet energy distribution, frequently results in inconsistent removal depths, leading to local over-cleaning or under-cleaning. To address this, this paper proposes an optimization framework to coordinate the robot’s motion with its cleaning mechanism. First, the flow field dynamics of the cavitation nozzle are elucidated using the Stress-Blended Eddy Simulation (SBES) turbulence model. Based on the Computational Fluid Dynamic (CFD) data, a Gaussian mapping model is constructed to quantify the relationship between jet erosion efficiency and robotic motion parameters. Furthermore, to resolve the multi-objective coverage parameter optimization problem, an improved hybrid metaheuristic algorithm—the Composite Cycloid Subtraction-Average-Based Optimizer (CCSABO)—is introduced to determine the optimal synchronization of forward and lateral velocities. Numerical simulations demonstrate the framework’s robustness across various fouling thickness scenarios and nozzle parameters. Notably, the CCSABO algorithm achieves a coverage rate of 99% and minimizes the uniformity index to 0.011, demonstrating superior consistency compared to traditional PSO and GWO methods. This improvement effectively mitigates the risk of hull damage while ensuring cleaning quality. Full article