Search Results (11,910)

Coal spontaneous combustion (CSC) remains a major hazard in coal mining. Research on CSC has largely focused on macromolecular structures, while the behavior of low-molecular-weight compounds remains unclear. Using B3LYP/6-311G density functional theory, this study systematically reveals thirteen microscopic reaction pathways, active sites, and the energy barrier order of pentanol during coal spontaneous combustion. The oxidation proceeds via thirteen multi-step pathways involving bond breaking and formation, with the dominant reaction being oxygen attack on the -CH₂OH group to produce pentanal (CH₃CH₂CH₂CH₂CHO) and water as the main products. The priority order of thirteen reaction pathways between pentanol and oxygen was established as: Path 6 > Path 3 > Path 8 > Path 5 > Path 4 > Path 1 > Path 11 > Path 10 > Path 9 > Path 12 > Path 7 > Path 2. The results reveal the multi-step bond-breaking and formation mechanism at the molecular level, providing a fundamental theoretical framework for understanding the radical chain oxidation mechanism of low molecular weight compounds in CSC. Full article

The adsorption of aromatic hydrocarbons from liquid paraffin is essential because of their harmful nature, long-lasting presence, and detrimental effects on the quality of the product. In this study, we investigated the adsorption of naphthalene from liquid paraffin by using a nanoclay-based adsorbent prepared from boron enrichment process waste. The characterization of the prepared adsorbent was carried out by using X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), X-ray Photoelectron Spectroscopy (XPS) and N₂ adsorption–desorption techniques, which confirmed the development of a layered nanostructure containing boron that possesses a porous and high-surface-area format appropriate for the adsorption. The hydrothermal treatment significantly increased the BET surface area from 35.42 to 112.15 m²/g, indicating the successful formation of a porous nanostructure. The kinetic and isotherm parameters of the adsorption process were calculated from experimental data. The adsorption of naphthalene followed pseudo-second-order kinetics and the isotherm fit well to the Langmuir model. Adsorption experiments revealed that the optimum adsorption performance was achieved at pH 4.0, and equilibrium was reached within 90 min. The adsorption kinetics were best described by the pseudo-second-order model (R² > 0.99), while the equilibrium data showed excellent agreement with the Langmuir isotherm model (R² = 0.995), suggesting monolayer adsorption. The maximum adsorption capacity of BNC was determined as 365.20 mg/g, which was more than twice that of the raw BEW (247.59 mg/g). Thermodynamic analysis indicated that the adsorption process was spontaneous at lower temperatures and exothermic, with a ΔH° value of −15.42 kJ/mol for BNC. The results suggest that the adsorption occurs through a multi-step process, beginning with external film diffusion, followed by pore diffusion and surface interaction. Based on the kinetic, isotherm, and spectroscopic data, a supramolecular adsorption mechanism is suggested, which encompasses π-π interactions, van der Waals forces, and surface complexation between naphthalene and the nanoclay structure. These results indicate that boron enrichment process waste-derived nanoclay is a sustainable, economical, and efficient adsorbent for removing naphthalene from liquid paraffin. Full article

Background/Objectives: Immune checkpoint inhibitors (ICIs) have changed the treatment landscape for several advanced malignancies, but their use is accompanied by immune-related adverse events, including liver injury. Some cases resemble autoimmune hepatitis (AIH), although many are more accurately described as AIH-like immune-mediated hepatitis rather than classical AIH. This distinction matters, as diagnosis is often based on exclusion and management must balance hepatic recovery against interruption of potentially life-prolonging cancer therapy. This systematic review summarised the clinical phenotype, diagnostic assessment, treatment strategies, treatment response, ICI discontinuation, and rechallenge outcomes in patients with ICI-associated AIH-like liver injury. Methods: A systematic PubMed search was performed for English-language human studies reporting autoimmune hepatitis, AIH-like liver injury, or immune-mediated hepatitis following exposure to ICIs. Eligible studies included case reports, case series, retrospective cohorts, prospective cohorts, and pharmacovigilance-type studies with extractable clinical, treatment, or outcome data. Reviews, guidelines, non-original articles, animal studies, non-English publications, and reports without usable liver injury data were excluded. The review followed PRISMA principles. Risk of bias was assessed using Joanna Briggs Institute tools and summarised with ROBVIS. Given the heterogeneity of study design, diagnostic criteria, treatment definitions, and outcome reporting, formal meta-analysis was not appropriate; results were therefore synthesised descriptively. Results: Twenty-two studies were included, comprising 195 patients with ICI-associated AIH-like or immune-mediated hepatitis. Of these, 140 patients received active treatment, and 133/140 achieved clinical or biochemical recovery with varying therapies. Corticosteroids were the most frequently used first-line therapy, with recovery reported in 102/105 patients treated with corticosteroids alone. Mycophenolate mofetil was the main second-line agent for steroid-refractory disease, with response reported in 9/10 treated patients. Other therapies, including tacrolimus, azathioprine, ursodeoxycholic acid, bezafibrate, tocilizumab, basiliximab, infliximab, budesonide, and double plasma molecular adsorption system with or without plasma exchange, were described only in small numbers or isolated cases. Spontaneous recovery without pharmacological treatment was reported in 19 patients. ICI interruption or discontinuation occurred in 141 patients, and rechallenge was reported in 55 patients after recovery, with no recurrent hepatic toxicity documented in the extracted dataset. Conclusions: ICI-associated AIH-like liver injury is an important immune-related toxicity, but the available literature remains fragmented and methodologically heterogeneous. Most reported patients recovered, particularly with corticosteroids, and MMF appears to be the most consistently used escalation therapy in steroid-refractory cases. However, the strength of evidence is limited by uncontrolled designs, variable terminology, inconsistent diagnostic work-up, and non-standardised outcome definitions. Future studies should separate classical AIH from AIH-like immune-mediated hepatitis, use uniform criteria for severity and response, and report treatment denominators clearly, especially for rechallenge and steroid-refractory disease. Full article

Background: mRNA vaccines, first approved in December 2020, have been used globally to prevent infectious diseases, and those for treating cancers are being developed. Safety-related labelling changes of Comirnaty and Spikevax were made in June 2025; however, concerns remain. This study assessed the potential risks associated with mRNA vaccines on the indications previously approved, utilizing Real-World Data (RWD) of Adverse Events Following Immunization (AEFIs) derived from the Vaccine Adverse Event Reporting System (VAERS) and Academic Literature Databases (ALD). Methods: A Disproportionality Analysis (DPA) was performed using the Reporting Odds Ratio (ROR) and the Bayesian Confidence Propagation Neural Network (BCPNN) algorithm on spontaneous case reports from VAERS. Statistical positive signals were cross-validated with literature case reports from ALD to provide more comprehensive medical descriptions and clearer causal assessments, and compared with safety information documented in clinical trials and on vaccine labelling. Time-to-onset, stratified, and immunization schedule analyses were conducted to characterize the safety profiles of mRNA vaccines. Results: In total, 5,040,725 spontaneous case reports and 4,387 literature case reports were analyzed. In both VAERS and ALD, new signals involving blood and lymphatic system disorders (e.g., thrombotic thrombocytopenic purpura) and ear and labyrinth disorders (e.g., deafness) were detected from Comirnaty as Designated Medical Events (DMEs), while blood and lymphatic system disorders (e.g., thrombotic thrombocytopenic purpura) from Spikevax in ALD only. No new signals were detected from other vaccines on the DMEs list. In VAERS, Serious Adverse Events (SAEs) were more common in females, while death risk was higher in males. In ALD, SAEs were more common in males for most mRNA vaccines, except Comirnaty. Medical history emerged as a key risk factor for SAEs, particularly among older adults. Conclusions: Statistically significant safety signals were detected across all mRNA vaccines based on five-year cumulative RWD, indicating the need of intensified monitoring of specific populations, including older adults and individuals with medical histories, alongside further optimization of vaccination strategies. Full article

Objectives: Endocrine neoplasms, as a general rule, show systemic, neuro-inflammatory and metabolic consequences, known as paraneoplastic syndrome. The comorbidity of thyroid tumors with neurological and autoimmune diseases prompt looking for common neuro-immuno-endocrine mechanisms of these disorders. While most TCs are well described, there is a gap in the literature after the isolation of oncocytic/Hürthle cell carcinoma (HCC), as a unique type due to immunoendocrine and metabolic features (low TSH-receptor expression and radioiodine avidity). The aim of this study was to collect clearly defined reports of HCC (as a separate entity) and to attempt determining common clinical symptoms and the usefulness of various diagnostic techniques (comprehensive critical review). This may be an introduction to modern treatment (patient-centered care) since the main cause of mortality is not local progression or metastases. Results: Until now, due to misnomenclature and data misinterpretation, HCC has been treated according to general standards (with overuse of TSH-ST and RIA). High thyroglobulin level, decreased total thyroxin (with normal FT3 and spontaneous decrease in TSH), hypercalcemia, as well as the “reverse flip-flop” phenomenon, as common symptoms, indicate the neuroendocrine origin of HCC. Sparse, well-documented lymph node metastases are another feature, although from few studies. Most studies omit the N stage. Whole-body ¹³¹iodine and ¹⁸F-fluorodeoxyglucose scintigraphy may be useful before FNAB. Fine-needle aspiration biopsy (FNAB), as a “gold standard” in early diagnosis of thyroid nodules, delays HCC diagnosis because of the inability to determine a benign/malignant nature. Conclusions: Final HCC outcome may be affected by various overlapping immunoendocrine factors (paraneoplastic effects). Due to very few thyroid function tests performed in HCC, we have proposed a set of basic laboratory analyses, core biopsy in HCC differentiation, and diagnostic chain for standardization. According to the review, adaptation and treatment of HCC based on existing standards for other thyroid cancers seem to be insufficient, and the risks outweigh the benefits. The key recommendations resulting from the 5th edition of the WHO Classification of Endocrine Neoplasms are only the beginning of refuting many myths and biases. Full article

Background and Clinical Significance: Spontaneous renal forniceal rupture is an uncommon complication of obstructive uropathy and is classically associated with ureteric calculi rather than distal urinary retention. Bilateral retention-related rupture appears to be exceptionally rare and may be diagnostically challenging when renal function begins to improve after bladder decompression; Case Presentation: An 82-year-old man with a history of prostate cancer treated five years earlier with external beam radiotherapy and androgen deprivation therapy presented with acute abdominal pain radiating to both flanks and inability to void. Bedside ultrasonography showed urinary retention and bilateral hydronephrosis, and a 16-Fr Foley catheter drained 900 mL of urine. Admission evaluation showed severe acute kidney injury, microscopic hematuria, minimal leukocyturia, and elevated inflammatory markers. Post-obstructive diuresis developed after bladder decompression. CT urography with excretory-phase imaging on hospital day 3 demonstrated severe bilateral hydroureteronephrosis with bilateral renal forniceal rupture and associated urinomas, including a larger left-sided collection extending toward the psoas compartment. Bilateral percutaneous nephrostomies were placed on hospital day 4 for upper-tract diversion. Immediate nephrostography showed no active contrast extravasation. At one-month follow-up, combined CT and nephrostographic assessment confirmed complete resolution of the bilateral urinomas without persistent leak, and the nephrostomy tubes were removed; Conclusions: This case suggests that urinary retention in an older man with prior prostate radiotherapy may reflect radiation-associated outlet pathology and/or impaired detrusor function rather than simple prostate enlargement. Delayed-phase CT urography was essential for diagnosis, and active bilateral diversion was justified by bilateral rupture, acute kidney injury, and the extent of urinary extravasation. The report expands the limited PubMed-indexed literature on retention-related upper urinary tract rupture and supports cautious follow-up aimed at defining the underlying mechanism of retention. Full article

Background: Restless legs syndrome (RLS) is very common among pregnant women; its prevalence corresponds to parity and occurs more frequently in the later stages of pregnancy. It is associated with numerous adverse pregnancy outcomes such as an increased risk of Caesarean section, preeclampsia, insomnia, and depression. Medical treatment of RLS during pregnancy is challenging considering the risks to both the mother and fetus. Case Description: In this report, we describe the case of a 44-year-old, seventh-time multiparous woman with a positive family history of RLS who presented with severe symptoms in her 24th week of pregnancy. She has had symptoms of RLS in every pregnancy thus far, usually starting in the second trimester, with an ineffective therapeutic response to diazepam and uncomfortable sensations, which usually resolve spontaneously a few weeks after delivery. After replacing diazepam with low-dose clonazepam, the patient reported complete disappearance of unpleasant sensations in her legs, with a significant improvement in her quality of life. Conclusions: A low dose of clonazepam is a good therapeutic option for the treatment of RLS during pregnancy and, if necessary, can also be considered the therapy of choice during lactation. Full article

Lead-based alloy has received widespread attention as a coolant in nuclear reactors. However, there is limited research on pure lead after solidification. In this study, a systematic investigation was conducted on the long-term evolution of the microstructure and physical properties of pure lead samples solidified under different cooling rates, with a comparative analysis against of lead–bismuth eutectic (LBE). Microscopic detection (using optical and electron microscopes), density measurement, and compressive mechanical testing were carried out. The study results show that during the long-term evolution process after solidification (at room temperature of 27 °C), pure lead samples spontaneously undergo recovery and recrystallization, with larger grain size and more uniform microstructure. The density of samples remains within a stable range. The yield strength of samples after solidification will gradually decrease over time. For example, after 180 days of evolution, the yield strength of the rapidly cooled sample (10 K/min) decreased from 4.879 MPa to 3.766 MPa. Full article

Reliable monitoring of spontaneous affect is essential in biomedical sensing, where involuntary facial signals serve as objective indicators of physiological states. Micro expression recognition (MER) is particularly challenging due to the sub-second, low amplitude nature of these signals. Many existing MER methods rely on apex (peak) frame detection, making them sensitive to temporal localization errors and difficult to deploy in unconstrained settings. To address this, we propose an apex-free framework that analyzes facial dynamics by structuring motion-magnified features along a newly introduced magnification intensity axis. By applying Eulerian motion magnification across multiple discrete levels and collapsing the sequences into single accumulation images, we generate a multi-level representation of subtle facial dynamics without requiring frame-level annotations. A lightweight shared temporal mixer (STM) is employed to analyze the dynamic evolution of motion across the magnification intensity axis. Subsequently, a dual-branch convolutional neural network (CNN), processing low- and high-amplification regimes respectively, integrates a convolutional block attention module (CBAM) to capture subtle facial motion while effectively filtering out irrelevant noise. Our model is highly efficient, requiring only 0.94 M parameters and 262 MFLOPs, which is significantly lower than the computational demands of standard backbones such as ResNet18 or VGG16. To ensure the model generalizes to new individuals, we evaluated it by testing on subjects whose data was entirely excluded from the training process. Under this rigorous setup, the proposed method achieves approximately 80% and 70% accuracy on the CASME II and SMIC datasets respectively, showing performance comparable to, or in some cases, slightly above current state-of-the-art methods. Considering both the competitive accuracy and high computational efficiency, the proposed framework holds significant potential for practical integration into real-time affect monitoring systems, particularly within biomedical applications. Full article

Background/Objectives: This study evaluated whether sequential changes in cervical length (CL) can predict spontaneous preterm birth (sPTB) before 34 weeks of gestation in twin pregnancies. Methods: This retrospective study from a single tertiary-care center analyzed 349 twin pregnancies with deliveries between January 2019 and December 2023. Cervical length assessments began at 18–21 weeks, followed by biweekly serial measurements. The primary outcome was sPTB before 34 weeks. CL changes were assessed descriptively using data from patients with and without sPTB before 34 weeks. We defined the high-risk status for sPTB based on our assessment. Logistic regression models were used to compute the odds ratios (ORs) and 95% confidence intervals (CIs) to quantify the relationship between these predictors and sPTB. Diagnostic accuracy was assessed from the area under the curve using receiver operating characteristic curve analysis. Results: The sPTB rate before 34 weeks of gestation was 8.5% (18/212). In the group without -sPTB before 34 weeks of gestation, the 5th percentile CL was approximately 20 mm at 25 weeks and 15 mm at 26–27 weeks of gestation. Sequential CL measurements revealed that a rapid shortening of ≥10 mm within 2 weeks significantly predicted sPTB before 34 weeks. A decrease in CL of ≥10 mm in a 2-week interval was associated with increased odds for sPTB before 34 weeks of gestation [adjusted OR (95% CI): 6.66 (2.32–19.14)]. Conclusions: In twin pregnancies, measuring CL every 2 weeks after approximately 20 weeks of gestation may facilitate sPTB detection before 34 weeks. Full article

This study investigates the charging behaviors, routines, and perceptions of Swedish electric vehicle (EV) users who lack access to home charging, a group that remains underrepresented in the EV adoption literature. Based on an online survey of 250 EV users—primarily located in Gothenburg—respondents were divided into two groups: those with and those without home charging availability. Nearly half of the sample (47.6%) reported not having access to charging at home. Comparative analyses, including linear regression models, were conducted to examine differences in sociodemographic characteristics, charging patterns, and perceptions of public charging. While the two groups were similar in terms of age, gender, vehicle type, charging frequency, and minimum state of charge preferences, significant differences emerged in perceived convenience, distance, and freedom to charge. Users without home charging availability reported lower access to workplace charging and evaluated public charging as less convenient and less accessible. Charging behavior in both groups was primarily goal-oriented and triggered by minimum state of charge rather than spontaneous opportunities. The findings highlight the structural disadvantages faced by users without home charging and underline the importance of adapting public charging infrastructure and policy strategies to support a broader and more equitable transition to electric mobility. Full article

Catamenial pneumothorax is a rare form of recurrent spontaneous pneumothorax occurring in women in temporal association with the menstrual cycle, most commonly within 72 h before or after the onset of menstruation, and is frequently encountered as part of thoracic endometriosis syndrome. Thoracic endometriosis represents an extrapelvic manifestation of endometriosis in which ectopic endometrial tissue may involve the pleura, diaphragm, lung parenchyma, or airways, leading to cyclic pleuropulmonary symptoms. The clinical spectrum includes catamenial pneumothorax, catamenial hemothorax, catamenial hemoptysis, and pulmonary endometriotic nodules. This narrative review critically analyzes the diagnostic challenges and limitations of imaging modalities in thoracic endometriosis, with particular emphasis on diagnostic delay, radiological pitfalls, and the discrepancy between morphological detection and etiological confirmation. Chest radiography and computed tomography are useful for documenting acute thoracic events, whereas magnetic resonance imaging may provide additional tissue characterization in selected cases, particularly when hemorrhagic or diaphragmatic lesions are suspected. However, imaging findings are often nonspecific, temporally variable, and insufficient to establish the diagnosis when interpreted in isolation. Recognition of thoracic endometriosis therefore requires correlation of imaging findings with menstrual cyclicity, gynecological history, clinical phenotype, and, when indicated, surgical and histopathological assessment. The available evidence remains limited by retrospective designs, small case series, inconsistent diagnostic criteria, and lack of validated thoracic-specific imaging pathways. Accordingly, an integrated clinical–radiological–surgical approach should be regarded as a pragmatic diagnostic framework rather than a validated algorithm. Such an approach may improve clinical suspicion, reduce diagnostic delay, and support more appropriate multidisciplinary management of this underrecognized condition. Full article

Background and Clinical Significance: Torsion of the vermiform appendix is a rare condition with a clinical presentation closely resembling acute appendicitis, while preoperative investigations are of limited value in distinguishing between the two entities. In most cases, the definitive diagnosis is made incidentally during surgery. Case Presentation: The authors present the case of an 18-day-old female neonate who presented with marked abdominal distension, diffuse spontaneous and palpation-induced abdominal pain, guarding, and signs of peritoneal irritation. The clinical manifestations and paraclinical findings mimicked a neonatal intestinal obstruction; however, intraoperative exploration revealed a gangrenous vermiform appendix twisted 240° anticlockwise, associated with a fibrinous pseudomembrane and multiple enlarged mesenteric lymph nodes. Although the initial therapeutic strategy was to perform a laparoscopy, severe abdominal distension caused by marked aerocolia necessitated conversion to a supra- and infraumbilical midline laparotomy. We thus describe, to the best of our knowledge, one of the youngest neonatal cases of appendiceal torsion reported in the literature. Conclusions: Although rare, appendiceal torsion should be considered in the differential diagnosis of neonatal acute abdomen, and timely surgical exploration is key to achieving a favorable outcome. Full article

Background/Objectives: Predictors of left atrial appendage thrombus (LAAT) in adequately anticoagulated patients with atrial fibrillation (AF) referred for direct current cardioversion (DCCV) remain insufficiently defined, particularly in populations with a high prevalence of cardiac implantable electronic devices (CIEDs). The aim of this study was to identify clinical and echocardiographic determinants of LAAT and/or dense spontaneous echocardiographic contrast (SEC) in patients with persistent AF referred for DCCV. Methods: This prospective observational study included 510 consecutive patients with persistent AF who had received at least 3 weeks of effective anticoagulation and underwent transthoracic and transesophageal echocardiography prior to elective DCCV. The primary endpoint was the presence of LAAT and/or dense SEC (Fatkin grade 3–4). Independent predictors were identified using multivariable logistic regression. Results: LAAT and/or dense SEC were detected in 192 patients (37.6%)—of whom 73 had overt LAAT, 19 had borderline LAAT, and the remainder had dense SEC (Fatkin grade 3–4). Independent predictors included lower left ventricular ejection fraction (OR 0.95 per 1% increase, 95% CI 0.94–0.97, p < 0.0001), reduced right ventricular fractional area change (OR 0.93 per 1% increase, 95% CI 0.91–0.94, p < 0.0001), larger left atrial area (OR 1.05 per 1 cm² increase, 95% CI 1.01–1.09, p = 0.011), and female sex (OR 1.78, 95% CI 1.14–2.79, p = 0.012). Moderate or greater mitral regurgitation was associated with a lower risk (OR 0.50, 95% CI 0.30–0.82, p = 0.007). The CHA₂DS₂-VASc score and the presence of right ventricular leads were not independently associated with LAAT/SEC. The model showed good discrimination (AUC 0.81, 95% CI 0.77–0.84). Conclusions: In anticoagulated patients with persistent AF, LAAT and/or dense SEC remain common and are primarily driven by echocardiographic markers of biventricular dysfunction and left atrial remodeling rather than by traditional clinical risk scores or the presence of cardiac devices. Full article

Hypoxic–ischemic brain injury remains the leading cause of death and neurological disability after cardiac arrest. Although targeted temperature management (TTM) and other neuroprotective strategies have demonstrated promising results in preclinical studies, large randomized controlled trials have largely failed to show consistent clinical benefit. This review examines two major limitations that may contribute to these translational failures: delayed initiation of therapy beyond a time-limited therapeutic window and the lack of baseline injury severity stratification. Evidence from both experimental and clinical studies suggests that the opportunity to modify neurological injury may be confined to the first few hours after return of spontaneous circulation (ROSC). Delayed intervention may occur after irreversible neuronal injury, microvascular dysfunction, and impaired cerebrovascular autoregulation have already become established. In addition, cardiac arrest survivors represent a heterogeneous population. Patients with minimal injury may recover with standard supportive care, whereas those with severe irreversible injury are unlikely to benefit from neuroprotective interventions. Patients with moderate-severity brain injury may represent the subgroup most likely to respond to targeted therapies. Ultra-early stratification using neuroimaging, electroencephalography, circulating biomarkers, and clinical risk scores may help identify patients with therapeutic potential. This review proposes that future post-cardiac arrest research should integrate both time-sensitive intervention strategies and early injury severity stratification. Large prospective studies and randomized controlled trials are needed to determine not only whether interventions are effective, but also when they should be initiated and which patients are most likely to benefit. Full article