Search Results (20,429)

Hodgkin’s Lymphoma (HL) affects approximately 8500 individuals annually in the United States. The 5-year relative survival rate has improved to 88.5%, driven by transformative advances in immunotherapy and precision oncology. The integration of Brentuximab vedotin (BV) and immune checkpoint inhibitors (ICIs) has redefined treatment paradigms. The phase III SWOG S1826 trial established nivolumab plus doxorubicin, vinblastine, and dacarbazine (N + AVD) as an emerging new standard for advanced-stage HL, achieving a 2-year progression-free survival (PFS) of 92% compared to 83% for BV plus AVD (HR 0.48, 95% CI: 0.33–0.70), with superior safety, particularly in patients over 60. In relapsed/refractory HL, pembrolizumab outperforms BV, with a median PFS of 13.2 versus 8.3 months (HR 0.65, 95% CI: 0.48–0.88), as demonstrated in the KEYNOTE-204 trial. Emerging strategies, including novel ICI combinations, minimal residual disease (MRD) monitoring via circulating tumor DNA (ctDNA), and artificial intelligence (AI)-driven diagnostics, promise to further personalize therapy. This review synthesizes HL’s epidemiology, pathogenesis, diagnostic innovations, and therapeutic advances, highlighting the role of precision medicine in addressing unmet needs and disparities in HL care. Full article

In this study, an effective strengthening method was investigated to improve the seismic performance of masonry brick walls. The strengthening method comprised the use of shotcrete, which was applied in both glass fiber-reinforced and unreinforced forms for steel plates and tie rods. Thirteen wall specimens constructed with vertical perforated masonry block bricks were tested under diagonal compression in accordance with ASTM E519 (2010). Reinforcement plates with different thicknesses (1.5 mm, 2 mm, and 3 mm) were anchored using 6 mm diameter tie rods. A specially designed steel frame and an experimental loading program with controlled deformation increments were employed to simulate the effects of reinforced concrete beam frame system on walls under the effect of diagonal loads caused by seismic loads. In addition, numerical simulations were conducted using three-dimensional finite element models in Abaqus Explicit software to validate the experimental results. The findings demonstrated that increasing the number of tie rods enhanced the shear strength and overall behavior of the walls. Steel plates effectively absorbed tensile stresses and limited crack propagation, while the fiber reinforcement in the shotcrete further improved wall strength and ductility. Overall, the proposed strengthening techniques provided significant improvements in the seismic resistance and energy absorption capacity of masonry walls, offering practical and reliable solutions to enhance the safety and durability of existing masonry structures. Full article

Background: In high-risk and frail patients with multivessel coronary artery disease (MV CAD), guidelines indicated complete revascularization with or without the use of cardiopulmonary bypass (CPB) bears a high morbidity and mortality risk. In cases where catheter interventions were deemed unsuitable and conventional coronary artery bypass grafting (CABG) posed an unacceptable perioperative risk, patients were scheduled for minimally invasive direct coronary artery bypass (MIDCAB) grafting or minimally invasive multivessel coronary artery bypass grafting (MICS-CABG). We called this approach “palliative revascularization.” This study assesses the safety and impact of palliative revascularization on clinical outcomes and overall survival. Methods: A consecutive series of 57 patients undergoing MIDCAB or MICS-CABG as a palliative surgery between 2008 and 2018 was included. The decision for palliative surgery was met in heart team after carefully assessing each case. The patients underwent single or double-vessel revascularization using the left internal thoracic artery and rarely radial artery/saphenous vein segments, both endoscopically harvested. Inpatient data could be completed for all 57 patients. The mean follow-up interval was 4.2 ± 3.7 years, with a follow-up rate of 91.2%. Results: Mean patient age was 79.7 ± 7.4 years. Overall, 46 patients (80.7%) were male, 26 (45.6%) had a history of atrial fibrillation and 25 (43.9%) of chronic kidney disease. In total, 13 patients exhibited a moderate EuroSCORE II, while 27 were classified as high risk, with a EuroSCORE II exceeding 5%. Additionally, 40 patients (70.2%) presented with three-vessel disease, 17 (29.8%) suffered an acute myocardial infarction within three weeks prior to surgery and 50.9% presented an impaired ejection fraction. There were 48 MIDCAB and nine MICS CABG with no conversions either to sternotomy or to CPB. Eight cases were planned as hybrid procedures and only 15 patients (26.3%) were completely revascularized. During the first 30 days, four patients (7%) died. A myocardial infarction occurred in only one case, no patient necessitated immediate reoperation. The one-, three- and five-year survival rates were 83%, 67% and 61%, respectively. Conclusions: MIDCAB and MICS CABG can be successfully conducted as less invasive palliative surgery in high-risk multimorbid patients with MV CAD. The early and mid-term results were better than predicted. A higher rate of hybrid procedures could improve long-term outcome in selected cases. Full article

Coal mining can cause the rupture of the overlying strata, and the energy released by large-scale fractures can therefore induce earthquake disasters, which in turn can cause more secondary disasters. In the past 50 years, countless earthquakes induced by coal mining have been reported. In this paper, the main factors relating to the mining-induced seismicity, including the mechanical properties, geometry of the space, excavation advance, and excavation rate, are investigated using both experimental and numerical methods. The sensitivity of these factors behaves differently with regard to the stress distribution and failure mode. Space geometry and excavation advances have the highest impact on the surface settlement and the failure, while the excavation rate in practical engineering projects has the least impact on the failure mode. The numerical study coincides well with the experimental observation. The result indicates that the mechanical properties given by the geological survey report can be effectively used to assess the risk of mining-induced seismicity, and the proper adjustment of the tunnel geometry can largely reduce the surface settlement and improve the safety of mining. Full article

Due to the complex spatial structure, dense tree distribution, and narrow passages in orchard environments, traditional path planning algorithms often struggle with large path deviations, frequent turning, and reduced navigational safety. In order to overcome these challenges, this paper proposes a hybrid path planning algorithm based on improved D* Lite for narrow forest orchard environments. The proposed approach enhances path feasibility and improves the robustness of the navigation system. The algorithm begins by constructing a 2D grid map reflecting the orchard layout and inflates the tree regions to create safety buffers for reliable path planning. For global path planning, an enhanced D* Lite algorithm is used with a cost function that jointly considers centerline proximity, turning angle smoothness, and directional consistency. This guides the path to remain close to the orchard row centerline, improving structural adaptability and path rationality. Narrow passages along the initial path are detected, and local replanning is performed using a Hybrid A* algorithm that accounts for the kinematic constraints of a differential tracked robot. This generates curvature-continuous and directionally stable segments that replace the original narrow-path portions. Finally, a gradient descent method is applied to smooth the overall path, improving trajectory continuity and execution stability. Field experiments in representative orchard environments demonstrate that the proposed hybrid algorithm significantly outperforms traditional D* Lite and KD* Lite-B methods in terms of path accuracy and navigational safety. The average deviation from the centerline is only 0.06 m, representing reductions of 75.55% and 38.27% compared to traditional D* Lite and KD* Lite-B, respectively, thereby enabling high-precision centerline tracking. Moreover, the number of hazardous nodes, defined as path points near obstacles, was reduced to five, marking decreases of 92.86% and 68.75%, respectively, and substantially enhancing navigation safety. These results confirm the method’s strong applicability in complex, constrained orchard environments and its potential as a foundation for efficient, safe, and fully autonomous agricultural robot operation. Full article

To enhance road-testing safety for autonomous driving robotic vehicles (ADRVs), collision avoidance with sudden obstacles is essential during testing processes. This paper proposes an upper-level collision avoidance strategy integrating model predictive control (MPC) and improved artificial potential field (APF). The kinematic model of the driving robot is established, and a vehicle dynamics model considering road curvature is used as the foundation for vehicle control. The improved APF constraints are constructed. The boundary constraint uses a three-circle vehicle shape suitable for roads with arbitrary curvatures. A unified obstacle potential field constraint is designed for static/dynamic obstacles to generate collision-free trajectories. An auxiliary attractive potential field is designed to ensure stable trajectory recovery after obstacle avoidance completion. A multi-objective MPC framework coupled with artificial potential fields is designed to achieve obstacle avoidance and trajectory tracking while ensuring accuracy, comfort, and environmental constraints. Results from Carsim-Simulink and semi-physical experiments validate that the proposed strategy effectively avoids various obstacles under different road conditions while maintaining reference trajectory tracking. Full article

Blast-induced airblast poses a significant environmental and operational issue for surface mining, affecting safety, regulatory adherence, and the well-being of surrounding communities. Despite advancements in machine learning methods for predicting airblast, present studies neglect essential geomechanical characteristics, specifically rock mass strength (RMS), which is vital for energy transmission and pressure-wave attenuation. This paper presents a capuchin search algorithm-optimized multilayer perceptron (CapSA-MLP) that incorporates RMS, hole depth (HD), maximum charge per delay (MCPD), monitoring distance (D), total explosive mass (TEM), and number of holes (NH). Blast datasets from a granite quarry were utilized to train and test the model in comparison to benchmark approaches, such as particle swarm optimized artificial neural network (PSO-ANN), multivariate regression analysis (MVRA), and the United States Bureau of Mines (USBM) equation. CapSA-MLP outperformed PSO-ANN (RMSE = 1.120, R² = 0.904 compared to RMSE = 1.284, R² = 0.846), whereas MVRA and USBM exhibited lower accuracy. Sensitivity analysis indicated RMS as the main input factor. This study is the first to use CapSA-MLP with RMS for airblast prediction. The findings illustrate the significance of metaheuristic optimization in developing adaptable, generalizable models for various rock types, thereby improving blast design and environmental management in mining activities. Full article

Background: Mediastinal staging plays a critical role in guiding treatment decisions for non-small cell lung cancer (NSCLC). While mediastinoscopy has been the gold standard for assessing mediastinal lymph node involvement, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a minimally invasive alternative with comparable diagnostic accuracy. This systematic review evaluates the diagnostic performance, safety, cost-effectiveness, and feasibility of EBUS-TBNA versus mediastinoscopy for mediastinal staging. Methods: A systematic literature review was conducted in accordance with PRISMA guidelines, including searches in Medline, Scopus, EMBASE, and Cochrane databases for studies published from 2010 onwards. A total of 1542 studies were identified, and after removing duplicates and applying eligibility criteria, 100 studies were included for detailed analysis. The extracted data focused on sensitivity, specificity, complications, economic impact, and patient outcomes. Results: EBUS-TBNA demonstrated high sensitivity (85–94%) and specificity (~100%), making it an effective first-line modality for NSCLC staging. Mediastinoscopy remained highly specific (~100%) but exhibited slightly lower sensitivity (86–90%). EBUS-TBNA had a lower complication rate (~2%) and was more cost-effective, while mediastinoscopy provided larger biopsy samples, essential for molecular and histological analyses. The need for general anaesthesia, longer hospital stays, and increased procedural costs make mediastinoscopy less favourable as an initial approach. Combining both techniques in select cases enhanced overall staging accuracy, reducing false negatives and improving diagnostic confidence. Conclusions: EBUS-TBNA has become the preferred first-line mediastinal staging method due to its minimally invasive approach, high diagnostic accuracy, and lower cost. However, mediastinoscopy remains crucial in cases requiring posterior mediastinal node assessment or larger tissue samples. The integration of both techniques in a stepwise diagnostic strategy offers the highest accuracy while minimizing risks and costs. Given the lower hospitalization rates and economic benefits associated with EBUS-TBNA, its widespread adoption may contribute to more efficient resource utilization in healthcare systems. Full article

Smart safety helmets equipped with vision systems are emerging as powerful tools for industrial infrastructure inspection. This paper presents a comprehensive state-of-the-art review of such VSLAM-enabled (Visual Simultaneous Localization and Mapping) helmets. We surveyed the evolution from basic helmet cameras to intelligent, sensor-fused inspection platforms, highlighting how modern helmets leverage real-time visual SLAM algorithms to map environments and assist inspectors. A systematic literature search was conducted targeting high-impact journals, patents, and industry reports. We classify helmet-integrated camera systems into monocular, stereo, and omnidirectional types and compare their capabilities for infrastructure inspection. We examine core VSLAM algorithms (feature-based, direct, hybrid, and deep-learning-enhanced) and discuss their adaptation to wearable platforms. Multi-sensor fusion approaches integrating inertial, LiDAR, and GNSS data are reviewed, along with edge/cloud processing architectures enabling real-time performance. This paper compiles numerous industrial use cases, from bridges and tunnels to plants and power facilities, demonstrating significant improvements in inspection efficiency, data quality, and worker safety. Key challenges are analyzed, including technical hurdles (battery life, processing limits, and harsh environments), human factors (ergonomics, training, and cognitive load), and regulatory issues (safety certification and data privacy). We also identify emerging trends, such as semantic SLAM, AI-driven defect recognition, hardware miniaturization, and collaborative multi-helmet systems. This review finds that VSLAM-equipped smart helmets offer a transformative approach to infrastructure inspection, enabling real-time mapping, augmented awareness, and safer workflows. We conclude by highlighting current research gaps, notably in standardizing systems and integrating with asset management, and provide recommendations for industry adoption and future research directions. Full article

Avocado (Persea americana), originally from Mesoamerica, has emerged as a focus of intense scientific and industrial interest due to its unique combination of nutritional richness, bioactive potential, and technological versatility. Its pulp, widely consumed across the globe, is notably abundant in monounsaturated fatty acids, especially oleic acid, which can comprise over two-thirds of its lipid content. In addition, it provides significant levels of dietary fiber, fat-soluble vitamins such as A, D, E and K, carotenoids, tocopherols, and phytosterols like β-sitosterol. These constituents are consistently associated with antioxidant, anti-inflammatory, glycemic regulatory, and cardioprotective effects, supported by a growing body of experimental and clinical evidence. This review offers a comprehensive and critical synthesis of the chemical composition and functional properties of avocado, with particular emphasis on its lipid profile, phenolic compounds, and phytosterols. It also explores recent advances in environmentally sustainable extraction techniques, including ultrasound-assisted and microwave-assisted processes, as well as the application of natural deep eutectic solvents. These technologies have demonstrated improved efficiency in recovering bioactives while aligning with the principles of green chemistry. The use of avocado-derived ingredients in nanostructured delivery systems and their incorporation into functional foods, cosmetics, and health-promoting formulations is discussed in detail. Additionally, the potential of native cultivars and the application of precision nutrition strategies are identified as promising avenues for future innovation. Taken together, the findings underscore the avocado’s relevance as a high-value matrix for sustainable development. Future research should focus on optimizing extraction protocols, clarifying pharmacokinetic behavior, and ensuring long-term safety in diverse applications. Full article

Cholangiocarcinoma (CCA) is highly prevalent in the Greater Mekong sub-region, especially northeastern Thailand, where infection with the liver fluke Opisthorchis viverrini is a major etiological factor. Limited therapeutic options and the absence of reliable early diagnosis tools impede effective disease control. Atractylodes lancea (Thunb.) DC.—long used in Thai and East Asian medicine, contains atractylodin (ATD), a potent bioactive compound with anticancer potential. Here, we developed ATD-loaded poly(lactic co-glycolic acid) nanoparticles (ATD PLGA NPs) and evaluated their antitumor efficacy against CCA. The formulated nanoparticles had a mean diameter of 229.8 nm, an encapsulation efficiency of 83%, and exhibited biphasic, sustained release, reaching a cumulative release of 92% within seven days. In vitro, ATD-PLGA NPs selectively reduced the viability of CL-6 and HuCCT-1 CCA cell lines, with selectivity indices (SI) of 3.53 and 2.61, respectively, outperforming free ATD and 5-fluorouracil (5-FU). They suppressed CL-6 cell migration and invasion by up to 90% within 12 h and induced apoptosis in 83% of cells through caspase-3/7 activation. Micronucleus assays showed lower mutagenic potential than the positive control. In vivo, ATD-PLGA NPs dose-dependently inhibited tumor growth and prolonged survival in CCA-xenografted nude mice; the high-dose regimen matched or exceeded the efficacy of 5-FU. Gene expression analysis revealed significant downregulation of pro-tumorigenic factors (VEGF, MMP-9, TGF-β, TNF-α, COX-2, PGE₂, and IL-6) and upregulation of the anti-inflammatory cytokine IL-10. Collectively, these results indicate that ATD-PLGA NPs are a promising nanotherapeutic platform for targeted CCA treatment, offering improved anticancer potency, selectivity, and safety compared to conventional therapies. Full article

Accurately identifying driver fatigue in complex driving environments plays a crucial role in road traffic safety. To address the challenge of reduced fatigue detection accuracy in complex cabin environments caused by lighting variations, we propose YOLO-FDCL, a novel algorithm specifically designed for driver fatigue detection under complex lighting conditions. This algorithm introduces MobileNetV4 into the backbone network to enhance the model’s ability to extract fatigue-related features in complex driving environments while reducing the model’s parameter size. Additionally, by incorporating the concept of structural re-parameterization, RepFPN is introduced into the neck section of the algorithm to strengthen the network’s multi-scale feature fusion capabilities, further improving the model’s detection performance. Experimental results show that on the YAWDD dataset, compared to the baseline YOLOv8-S, precision increased from 97.4% to 98.8%, recall improved from 96.3% to 97.5%, mAP@0.5 increased from 98.0% to 98.8%, and mAP@0.5:0.95 increased from 92.4% to 94.2%. This algorithm has made significant progress in the task of fatigue detection under complex lighting conditions. At the same time, this model shows outstanding performance on our self-developed Complex Lighting Driving Fatigue Dataset (CLDFD), with precision and recall improving by 2.8% and 2.2%, respectively, and improvements of 3.1% and 3.6% in mAP@0.5 and mAP@0.5:0.95 compared to the baseline model, respectively. Full article

Dose-dense chemotherapy shortens the interval between chemotherapy cycles and has shown improved outcomes in high-risk breast cancer patients. We retrospectively evaluated the efficacy and safety of dose-dense chemotherapy in 80 breast cancer patients treated at our hospital from 2020 to 2024. The regimen included epirubicin and cyclophosphamide followed by paclitaxel or docetaxel, with pegfilgrastim support. The overall treatment completion rate was 82.5%. Of the 80 patients, 55 underwent neoadjuvant chemotherapy, and the pathological complete response rate was significantly higher in triple-negative breast cancer (59.1%) compared to that in luminal-type cancer (9.1%). Common adverse events included anemia, liver dysfunction, myalgia, and peripheral neuropathy. Febrile neutropenia occurred in 8.8% of patients, with some cases linked to pegfilgrastim body pod use, particularly in individuals with low subcutaneous fat. Notably, two patients developed pneumocystis pneumonia, potentially associated with steroid administration. Despite these toxicities, most were manageable and resolved after treatment. Our findings support the efficacy of dose-dense chemotherapy, particularly in triple-negative breast cancer, while highlighting the importance of individualized supportive care and vigilance regarding hematologic and infectious complications. Full article

This paper showcases current developments in the use of carbon nanotube (CNT) and nanoparticle-based materials for electromagnetic radiation shielding. Electromagnetic radiation involves different types of radiation covering a wide spectrum of frequencies. Due to their good electrical conductivity, small diameter, and light weight, individual CNTs are good candidates for shielding radio and microwaves. CNTs can be organized into macroscale forms by dispersing them in polymers or by wrapping CNT strands into fabrics or yarn. Magnetic nanoparticles can also be incorporated into the CNT fabric to provide excellent shielding of electromagnetic waves. However, for shielding higher-frequency X-ray and gamma ray radiation, the situation is reversed. Carbon’s low atomic number means that CNTs alone are less effective than metals. Thus, different nanoparticles such as tungsten are added to the CNT materials to provide improved shielding of photons. The goal is to achieve a desired combination of light weight, flexibility, safety, and multifunctionality for use in shielding spacecraft, satellites, nuclear reactors, and medical garments and to support lunar colonization. Future research should investigate the effect of the size, shape, and configuration of nanoparticles on radiation shielding. Developing large-scale low-cost methods for the continuous manufacturing of lightweight multifunctional nanoparticle-based materials is also needed. Full article

Background: Neurogenic bladder (NB) in children may lead to recurrent urinary tract infections (UTIs), renal deterioration, and a reduced quality of life. Clean intermittent catheterization (CIC) is the standard of care, but in some patients, CIC may be unfeasible due to anatomical, sensory, or compliance issues. Button cystostomy (BC) has emerged as a minimally invasive, bladder-preserving alternative. This study aimed to assess the feasibility, safety, and outcomes in the long-term of BC in pediatric NB patients. Methods: Retrospective analysis was conducted on children with NB who underwent endoscopic BC placement between January 2020 and December 2024 in a tertiary pediatric center. Demographic data, operative time, complications, and follow-up outcomes were collected. All procedures used an endoscopic approach with cystoscopic guidance for safe device placement. Results: Thirty-three patients (25 males; median age 7.96 years) underwent BC placement. Most had spinal dysraphism (63.6%). The mean operative time was 48.5 ± 6 min. During a mean follow-up of 2.1 ± 1.4 years, five patients (15.2%) had febrile UTIs and two had minor leakage. No major complications occurred. Four buttons were removed due to clinical improvement (N = 1), the fashioning of a continent derivation (N = 1) and implantation of a sacral neuromodulator (N = 2); two patients accepted CIC. Satisfaction was reported by 93.9% of families. Conclusions: BC is an effective, minimally invasive alternative for urinary drainage in children with NB, even when compared to continent diversion techniques such as the Mitrofanoff, due to its lower invasiveness, greater feasibility, and lower complication rate. Broader adoption may be warranted, but prospective studies are needed to confirm long-term outcomes. Full article