Search Results (431)

(1) Background: Atherosclerosis is a complex chronic inflammatory disease characterized by the plaque-induced thickening of medium-sized and large arterial walls. Chronic inflammation, lipid accumulation, and endothelial dysfunction play a critical role in pathophysiology of atherosclerosis. Along with immune cells, vascular smooth muscle cells, endothelial cells, and platelets play a critical role in the pathogenesis of atherosclerosis. Targeting platelet-related molecular mechanisms has emerged as a promising therapeutic strategy in treating atherosclerosis. However, potential targets are not clearly understood. This review discusses the multifaceted role of platelets in the pathogenesis of atherosclerosis and ischemic disease followed by the potential of targeting platelets. (2) Methods: Articles related to the role of platelets in atherosclerosis and underlying molecular mechanisms were searched from PubMed and Google Scholar using search terms atherosclerosis, platelets, therapeutics, targets; alone or in combination; (3) Results: Current research suggest that platelet-related molecular mechanisms play a critical role in plaque development, progression, and rupture. The mediators involved may serve as therapeutic targets; (4) Conclusions: Targeting platelets can attenuate atherosclerosis by interfering with platelet functions beyond blood clotting, such as promoting vascular inflammation and platelet adhesion. Full article

Abdominal aortic aneurysm (AAA) is a dilatation of the distal aorta to a diameter of 50% or more of its normal size of about 2 cm. Risk of aortic rupture can be nearly eliminated with either open surgery or endovascular repair. Procedural risks limit the value of these interventions unless the diameter of the aneurysm has reached a critical threshold (established as 5.5 cm in men or 5.0 cm in women). Thus, patients are monitored until this threshold is reached. Approximately 80% of small AAA will grow and exceed the threshold, providing a therapeutic window for altering this natural history and reducing the risk of rupture. Previous work in our lab has utilized adipose-derived mesenchymal stem cells (ASCs) to treat AAA in vivo, preserving elastic fibers and slowing aneurysm expansion. This work sought to create a delivery system for therapeutic extracellular vesicles (ASC-EVs) secreted by ASCs. Our delivery system incorporated the biocompatibility of regenerated silk fibroin (RSF), the magnetic moveability of iron oxide nanoparticles (IONPs), and the regenerative nature of ASC-EVs to create silk-iron packaged extracellular vesicles (SIPEs). Using this system, we tested the ability to magnetically localize the SIPEs and release their encapsulated ASC-EVs to exert their regenerative effects in vitro. We were successful in magnetically localizing the SIPEs in vitro and silk-iron microparticles (SIMPs) in vivo and in detecting their releasates via flow cytometry and cellular uptake assays. However, while their releasates were detected, their biological effects were diminished compared to unencapsulated controls. Thus, additional optimization related to loading efficiency is needed. Full article

Background/Objectives: The anterior communicating artery (AcomA) is one of the most common sites of intracranial aneurysms. We aimed to investigate the effect of routine extradural anterior clinoidectomy (EAC) and extradural lamina terminalis fenestration (ELTF) on the incidence of shunt-dependent hydrocephalus (SDH) and gyrus rectus injury in patients undergoing microsurgical clip reconstruction. Methods: This matched case–control study included 15 patients treated with routine EAC/ELTF between July 2023 and June 2025, matched 1:2 to 30 historical controls (2000–2019) by aneurysm size, location, dome-to-neck ratio, and rupture status. The primary outcome was the incidence of SDH. The secondary outcomes included the incidence of gyrus rectus hypodensity/injury and clinical outcomes, as assessed by the modified Rankin Scale (mRS) at discharge and follow-up. Results: Among 15 cases, 6 had ruptured aneurysms, 4 had unruptured aneurysms, and 5 were recanalized post-endovascular treatment. EAC was performed in all cases; ELTF was performed in 83% of ruptured cases. SDH occurred in 33% of ruptured cases versus 90% in controls (p = 0.02). Gyrus rectus hypodensity occurred in 13% of cases vs. 50% of controls (p = 0.01). EAC/ELTF was associated with reduced odds of SDH (OR: 0.06; 95% CI: 0.004–0.80; p = 0.03) and gyrus rectus hypodensity (OR: 0.15; 95% CI: 0.03–0.80; p = 0.03). A poor outcome (mRS >2) was seen in 27% at discharge, improving to 14% at follow-up (with a median of 11 months). Delayed cerebral ischemia occurred in 33% of ruptured cases. Conclusions: Routine EAC/ELTF may reduce SDH and gyrus rectus injury after AComA aneurysm clip reconstruction, particularly in ruptured cases. Prospective multi-center studies are needed to validate these preliminary findings. Full article

Background: Dyslipidaemia promotes atherosclerotic plaque formation. Plaques that are vulnerable to rupture have a higher proportion of inflammatory (M1:CD86) macrophages in their cap. Many plaque macrophages are derived from blood monocytes which have been exposed to elevated blood lipid levels. Here, we explored whether the inflammatory state of monocyte-derived macrophages is associated with blood lipid levels and assessed whether oxidised low-density lipoprotein (oxLDL) directly induces some of the observed changes. Method: Blood was collected from 20 individuals. Lipid profiles were measured, and monocytes differentiated into macrophages. Macrophage inflammatory state was assessed by flow cytometry for phenotypic markers (e.g., CD86 and CD163) and cytokine production: TNF, IL-1β, and IL-6. Furthermore, monocytes were isolated from 6 normo-lipidaemic individuals and cultured with oxLDL, followed by stimulation with LPS/IFNγ and assessment of the cytokine response. Results: The inflammatory phenotype acquired by macrophages (ex vivo) was related to levels of in vivo circulating lipids. Correlations for CD86/CD163 were found with CVD risk markers; most strongly with triglycerides (TG) and TG/HDL-C, but also with cholesterol/HDL-C and ApoB/ApoA1 and inversely with LDL particle size. Functionally, macrophage production of inflammatory cytokines (TNF and IL-1β) correlated with oxLDL levels and inversely with ApoA1. Macrophages differentiated from monocytes cultured with oxLDL produced significantly higher IL-1β but lower IL-10 (in response to LPS/IFNγ), compared to control cells. Conclusions: Monocyte-derived macrophages adopt an inflammatory phenotype relative to the levels of circulating lipid factors that are characteristic of atherogenic dyslipidaemia (such as high TG, TG/HDL-C and low LDL particle size), but not LDL-C. Full article

An ascending aortic aneurysm is a localized dilation of the ascending aorta, which poses a high risk of aortic dissection or rupture, with surgery recommended at diameters > 5.5 cm. However, events also occur at smaller sizes, suggesting additional factors—such as stenosis—may significantly influence aneurysm severity. To investigate this, a computational fluid dynamics (CFD) analysis was conducted using a patient-specific ascending aortic model (aneurysm diameter: 5.28 cm) under three aortic stenosis severities: mild, moderate, and severe. Results showed that the severe stenosis condition led to the formation of prominent recirculation zones and increased peak velocities, 2.36 m·s⁻¹ compared to 1.53 m·s⁻¹ for moderate stenosis and 1.37 m·s⁻¹ for mild stenosis. A significantly increased pressure loss coefficient was observed for the severe case. Additionally, the wall shear stress (WSS) distribution exhibited higher values along the anterior region and lower values along the posterior region. Peak WSS values were recorded at 43.46 Pa in the severe stenosis model, compared to 21.98 Pa and 13.87 Pa for the moderate and mild cases, respectively. Velocity distribution and helicity analyses demonstrate that increasing stenosis severity amplifies jet-induced flow disturbances, contributing to larger recirculation zones and greater helicity heterogeneity in the ascending aorta. Meanwhile, WSS results indicate that greater stenosis severity is also associated with elevated WSS magnitude and heterogeneity in the ascending aorta, with severe cases exhibiting the highest value. These findings highlight the need to incorporate hemodynamic metrics, alongside traditional diameter-based criteria, into rupture risk assessment frameworks. Full article

The aorta, once viewed as a passive conduit, is now recognized as an active organ crucial for hemodynamic regulation and vascular homeostasis. Thoracic aortic aneurysms (TAAs), particularly those involving the ascending aorta, often remain silent until life-threatening complications such as dissection or rupture occur. Current management primarily relies on aortic diameter criteria, yet up to 60% of type A dissections occur at sizes below the 5.5 cm surgical threshold, revealing the limitations of this approach. This narrative review summarizes recent advances in understanding ascending aortic aneurysms, including insights into their genetic and degenerative mechanisms, the role of novel morphological and hemodynamic markers, and the potential of advanced imaging techniques. It also explores evolving surgical strategies, from conventional open repair, still the gold standard, to minimally invasive and investigational endovascular approaches. By integrating biological, morphological, and clinical factors, emerging strategies aim to move beyond diameter alone toward more personalized risk assessment. This paradigm shift may improve early detection, optimize surgical timing, and ultimately enhance outcomes for patients with ascending aortic aneurysms. Full article

Faults are the primary drivers of earthquakes and exert a strong control on rupture mechanisms, earthquake magnitude, and the spatial distribution of coseismic landslides (CLs). However, how CL spatial distribution patterns vary with faulting style remains poorly constrained. Here, we compiled a catalog of CLs associated with 18 global major earthquakes (M_W > 6.0) within continental regions since 1900 and explored the distribution patterns of CLs associated with the three major earthquake types: oblique-slip, dip-slip, and strike-slip. Our results reveal two distinct spatial distribution patterns of CLs: a hanging-wall distribution for oblique-slip and dip-slip earthquakes and a bell-shaped distribution for strike-slip earthquakes. The orientation of CLs is closely related to fault geometry and slip type. Specifically, in oblique-slip, strike-slip, and dip-slip earthquakes, CLs predominantly develop parallel, perpendicular, or perpendicular to the fault strike, respectively. In terms of slip rake, CLs are mainly aligned perpendicular, parallel, and parallel to the fault slip direction for oblique-slip, strike-slip, and dip-slip events, respectively. Importantly, the distribution patterns of CLs encode information about ground movement during an earthquake. While Peak Ground Acceleration (PGA) serves as an indicator of ground motion intensity, a comprehensive characterization of CLs—including their size and predominant movement direction—requires consideration of both the earthquake type and the local slope conditions. Full article

Background: Intracranial aneurysms of the posterior circulation are of particular clinical significance due to their higher risk of rupture-associated morbidity and mortality compared to anterior circulation aneurysms. Moreover, they exhibit an increased tendency for recurrence, posing challenges for long-term management. The purpose of this study is to identify key risk factors and define criteria for the early detection of high-risk aneurysms with a machine learning-based analysis. Methods: This study employs machine learning (ML), which, unlike traditional statistical methods, can detect complex, previously unrecognized patterns without predefined hypotheses to predict recurrence and rupture in patients with intracranial aneurysms of the posterior circulation. A total of 229 patients were retrospectively screened (2008–2020), and the data set was analyzed using ML algorithms. To avoid bias, a 10-fold cross-validation was employed, and the model performing best in terms of the Area Under the Curve (AUC) was selected. In addition, the sensitivity, specificity, and accuracy of the model were computed as secondary metrics. Results: A total of 229 patients were included, with over 70% being female, older than 50 years, and diagnosed with arterial hypertension. The most significant predictors of aneurysm recurrence identified by the ML model (AUC of 0.74 with a sensitivity of 0.76, a specificity of 0.70, and an accuracy of 0.76) were age, aneurysm size, arterial hypertension, and a history of nicotine consumption. The DeLong test confirmed that the ML model performed significantly better than random classification with an AUC of 0.5 (p < 0.001). Further analysis revealed that the presence of multiple aneurysms and localization at the basilar artery were independent risk factors for early recurrence within six months. For aneurysm rupture, key predictive features included advanced age, basilar artery localization, atherosclerosis, irregular aneurysm morphology, and familial predisposition. Conclusions: ML algorithms identified several risk factors for recurrence and rupture of intracranial aneurysms of the posterior circulation, aligning with previously established risk factors. These findings are intended to serve as a basis for further research in clinical use and prospective studies. Full article

Background and Objectives: Achilles tendon ruptures in middle-aged individuals with systemic comorbidities represent a growing clinical challenge. Revision surgery, indicated in cases of tendon re-rupture, remains technically demanding and lacks standardized treatment protocols. This comprehensive review aimed to summarize current evidence regarding indications, outcomes, and complications associated with the most commonly employed revision techniques and explores the potential of artificial intelligence (AI) in improving management and outcomes. Materials and Methods: A literature review was performed in accordance with PRISMA guidelines. The PubMed, MEDLINE, and Cochrane Central databases were used to search keywords. We included articles (1) reporting indications, outcomes, and/or complications of revision surgery for Achilles tendon rupture; (2) reporting a minimum mean follow-up of >12 months; and (3) written in English. Six studies met the inclusion criteria, with a total of 3250 patients analyzed. A methodological quality assessment using the Modified Newcastle–Ottawa Quality Assessment Scale was performed, and all articles were found to be of high quality. Results: Surgical strategies were stratified based on defect size: <2 cm: end-to-end anastomosis; 2–5 cm: V-Y myotendinous lengthening, often combined with tendon transfer; and >5 cm: fascial turndown flaps, autografts (e.g., semitendinosus), or allografts. Tendon transfers showed satisfactory functional outcomes but varied in complication rates. Allografts offered reduced donor site morbidity. The use of AI and wearable sensors has demonstrated potential in preoperative planning, complication prediction, and real-time rehabilitation monitoring. Conclusions: Achilles tendon revision surgery requires a patient-specific, defect-oriented approach. Combined surgical techniques are often necessary for large or non-viable lesions. The integration of AI represents a promising advancement in enhancing surgical decision-making, optimizing rehabilitation, and improving long-term clinical outcomes. Full article

In this study, aluminium matrix hybrid composites reinforced with boron carbide (B₄C) and silicon carbide (SiC) were fabricated using the direct hot-pressing technique under 35 MPa pressure at 600 °C for 5 min. Particle size distribution and scanning electron microscope analysis were conducted for the input powders. The microstructure, mechanical properties, and drillability of the fabricated composites were examined. As the SiC content increased, the density decreased, hardness improved, and transverse rupture strength declined. Drilling experiments were performed based on the Taguchi L₁₈ orthogonal array. The control factors included cutting speed (25 and 50 m/min), feed rate (0.08, 0.16, and 0.24 mm/rev), point angle (100°, 118°, and 136°), and SiC content (0%, 5%, and 10%). Quality characteristics such as thrust force, torque, surface quality indicators, diameter deviation, and circularity deviation were evaluated. The Taguchi method was applied for single-response optimization, while the Entropy-weighted, Taguchi-based CoCoSo method was used for multi-response optimization. Analysis of Variance was conducted to assess factor significance, and regression analysis was used to model relationships between inputs and responses, yielding high R² values. The optimal drilling performance was achieved at 50 m/min, 0.08 mm/rev, 136°, and 10% SiC, and the confirmation tests verified these results within the 95% confidence interval. Full article

Background: Unruptured cerebral aneurysms pose a significant neurosurgical challenge due to their potential for rupture, which can lead to devastating subarachnoid hemorrhage. Advances in imaging have increased incidental detection of multiple unruptured aneurysms, necessitating tailored management strategies to balance rupture risk against treatment complications. Methods: We retrospectively analyzed 41 patients with 101 unruptured cerebral aneurysms, assessing demographics, aneurysm size and location, treatment modalities, and clinical outcomes. Descriptive statistics and correlation analyses examined associations between aneurysm characteristics, comorbidities, and post-treatment complications. Results: Most aneurysms were small (<10 mm, 48.5%), primarily located at the Middle Cerebral Artery Bifurcation (27.7%). Hypertension (56.1%) and smoking (53.7%) were prevalent risk factors. Clipping was the most common intervention (81.2%), with 41.4% of patients experiencing post-operative complications and 36.6% developing neurological deficits. Conclusions: This study underscores the difficulties in managing multiple unruptured cerebral aneurysms owing to diverse aneurysm characteristics and patient risk factors such as hypertension, hyperlipidaemia, and smoking. Clipping was the predominant intervention, with time customized for each individual case. Despite the occurrence of problems such as vasospasm and neurological difficulties, the majority of patients maintained functional independence. The results provide significant insights into the clinical attributes, therapeutic strategies, and outcomes for this patient cohort. Full article

This study proposed a surface modification method, based on petal-shaped micro-pit texture, allowing to solve the problem of significant wear of the stator caused by the oil film rupture in the metal-rubber friction pair of the screw pump under complex conditions in the later stages of oilfield extraction. A geometric model of the petal-shaped micro-pit texture on the stator rubber surface and a mathematical model of the hydrodynamic lubrication flow field based on the Reynolds equation were developed. Computational Fluid Dynamics (CFD) simulations and friction tests were conducted to systematically study the influence of the medium flow direction, texture area ratio, and texture size on the lubrication performance. The obtained results showed that compared with the flow in the x-direction, the load-carrying capacity of the oil film was increased by more than 0.93% when the medium flowed in y-direction, and it reached its optimal value at an area of 10%. When the area ratio reached 60%, the interference effect of the flow field reduced the pressure by 6.98%. The increase of the size of the petals allowed to expand the positive pressure zone and increase the net load-carrying capacity. Furthermore, friction tests demonstrated that the friction coefficient was decreased with the increase of the texture size and increased with the increase of the texture area ratio. The petal-shaped micro-pit texture with size of 350 μm and an area ratio of 10% demonstrated the lowest friction coefficient and highest wear resistance. Full article

Background: Long-term follow-up after endovascular aortic repair (TEVAR) is crucial to detect adverse aortic remodeling, even with modern stent grafts offering enhanced flexibility and durability. Conventional imaging, based on diameter measurements, may fail to identify complications such as endograft migration. Methods: We conducted a longitudinal 3D geometric analysis of thoracic aortic and stent-graft evolution over 10 years in a patient treated for descending thoracic aortic aneurysm (DTAA) by endovascular treatment. A three-dimensional morphological analysis (length, tortuosity, angulation, and diameter) was carried out using advanced imaging software (EndoSize, MATLAB) to track aortic geometry and stent-graft behavior over time. A focused review of the literature on stent-graft migration, its risk factors, complications, and surveillance strategies was also performed. Results: This case illustrates how progressive geometric remodeling—including aortic elongation and increased tortuosity—can lead to delayed stent-graft migration and late type III endoleaks, with an elevated risk of rupture. The 3D analysis revealed early morphological changes that were undetectable using standard diameter-based follow-up. These observations are consistent with published data showing higher migration rates over time, particularly in tortuous anatomies. The literature review further emphasizes the clinical relevance of geometric surveillance, given the high rates of reintervention, morbidity, and mortality associated with stent-graft migration. Conclusions: This study underlines the importance of personalized and geometry-based surveillance after TEVAR. Advanced morphological assessment tools provide valuable insights for the early detection of complications and tailored patient management. Their integration into routine follow-up could help optimize long-term outcomes and prevent life-threatening events such as rupture. Full article

Intracranial aneurysms are a serious cerebrovascular condition with a risk of subarachnoid hemorrhage due to rupture, leading to high mortality and morbidity. Flow Diverter Stents (FDSs) have become an important endovascular treatment option for unruptured large or wide-neck aneurysms. Hemodynamic factors significantly influence treatment outcomes in aneurysms treated with FDSs, and Computational Fluid Dynamics (CFD) has been widely used to evaluate post-deployment flow characteristics. However, conventional wire-resolved CFD methods require extremely fine meshes to reconstruct individual FDS wires, resulting in prohibitively high computational costs. This severely limits their feasibility for use in clinical treatment planning, where fast and robust simulations are essential. To address this limitation, we developed a computationally efficient CFD method that incorporates a porous media model accounting for local variations in wire density after FDS deployment. Based on Virtual Stent Simulation, the FDS region was defined as a hollow cylindrical domain with spatially varying resistance derived from cell-specific wire density. We validated the proposed method using 15 clinical cases, demonstrating close agreement with conventional wire-resolved CFD results. Relative errors in key hemodynamic parameters, including velocity, shear rate, inflow rate, and turnover time, were within 5%, with correlation coefficients exceeding 0.98. The number of grid elements, the data size, and total analysis time were reduced by over 90%. The method also allowed comparison between Total-Filling (OKM Grade A) and Occlusion (Grade D) cases, and evaluation of different FDS sizing, positioning, and coil-assisted strategies. The proposed method enables practical and efficient CFD analysis following FDS treatment and supports hemodynamics-based treatment planning of aneurysms. Full article

The destabilizing damage of rock structures in coal beds engineering is greatly influenced by the bearing rupture features and energy evolution laws of rock–coal assemblages with varying height ratios. In this study, we used PFC3D to create rock–coal assemblages with rock–coal height ratios of 2:8, 4:6, 6:4, and 8:2. Uniaxial compression simulation was then performed, revealing the expansion properties and damage crack dispersion pattern at various bearing phases. The dispersion and migration law of cemented strain energy zoning; the size and location of the destructive energy level and its spatiotemporal evolution characteristics; and the impact of height ratio on the load-bearing characteristics, crack extension, and evolution of multiple energies (strain, destructive, and kinetic energies) were all clarified with the aid of a self-developed destructive energy and strain energy capture and tracking Fish program. The findings indicate that the assemblage’s elasticity modulus and compressive strength slightly increase as the height ratio increases, that the assemblage’s cracks begin in the coal body, and that the number of crack bands inside the coal body increases as the height ratio increases. Also, the phenomenon of crack bands penetrating the rock through the interface between the coal and rock becomes increasingly apparent. The total number of cracks, including both tensile and shear cracks, decreases as the height ratio increases. Among these, tensile cracks are consistently more abundant than shear cracks, and the proportion between the two types remains relatively stable regardless of changes in the height ratio. The acoustic emission ringing counts of the assemblage were not synchronized with the development of bearing stress, and the ringing counts started to increase from the yield stage and reached a peak at the damage stage (0.8${\sigma }_{\mathrm{c}}$) after the peak of bearing stress. The larger the rock–coal height ratio, the smaller the peak and the earlier the timing of its appearance. The main body of strain energy accumulation was transferred from the coal body to the rock body when the height ratio exceeded 1.5. The peak values of the assemblage’s strain energy, destructive energy, and kinetic energy curves decreased as the height ratio increased, particularly the energy amplitude of the largest destructive energy event. In order to prevent and mitigate engineering disasters during deep mining of coal resources, the research findings could serve as a helpful reference for the destabilizing properties of rock–coal assemblages. Full article