Search Results (18,740)

Hepatocellular carcinoma (HCC) is a hypervascular malignancy commonly treated with transarterial chemoembolization (TACE), in which success relies on the accurate identification and embolization of tumor feeding arteries while sparing the nontumorous liver parenchyma. This review introduces the concept of selective angiographic roadmap analysis (SARA), a systematic and stepwise approach to evaluating hepatic arterial supply in HCC, with the aim of standardizing angiographic planning and improving TACE outcomes. SARA emphasizes recognition of typical and variant hepatic arterial anatomy, systematic identification of accessory and extrahepatic feeders, and integration with intraprocedural cone-beam computed tomography (CBCT) to enhance feeder detection and reduce nontarget embolization. Although primarily applied in TACE, the principles of SARA are equally relevant to transarterial radioembolization (TARE) where precise arterial mapping is critical. Embolization strategies are discussed across different levels of selectivity, from lobar to superselective techniques. The complementary role of advanced imaging modalities, such as CT angiography (CTA), MR angiography (MRA), and artificial intelligence-assisted vessel tracking, is also explored. Adopting the SARA framework in conjunction with these technologies may improve technical success and tumor control and preserve liver function in patients undergoing intra-arterial therapies. Full article

Background: Failure to rescue (FTR), defined as death after major postoperative complications, is a critical quality indicator in pancreatic cancer surgery. Despite advances in surgical techniques and perioperative care, FTR rates remain high and vary across institutions. Methods: This systematic review uses a narrative synthesis followed by PRISMA 2020. A PubMed search (1992–2025) identified 83 studies; after screening, 52 studies (2010–2025) were included. Eligible designs were registry-based, multicenter, single-center, or prospective audits. Given substantial heterogeneity in study designs, FTR definitions, and outcome measures, a narrative synthesis was performed; no formal risk-of-bias assessment or meta-analysis was conducted. Results: Definitions of FTR varied (in-hospital, 30-day, 90-day, severity-based, and complication-specific cases). Reported rates differed by definition: average reported rates were 13.2% for 90-day CD ≥ III (G1); 10.3% for in-hospital/30-day CD ≥ III (G3); and 7.4% for 30-day “serious/major” morbidity (G8). Absolute differences were +3.0 and +2.9 percentage points (exploratory, descriptive comparisons). Five domains were consistently associated with lower FTR: (i) centralization to high-volume centers; (ii) safe adoption/refinement of surgical techniques; (iii) optimized perioperative management including early imaging and structured escalation pathways; (iv) patient-level risk stratification and prehabilitation; and (v) non-technical skills (NTSs) such as decision-making, situational awareness, communication, teamwork, and leadership. Among NTS domains, stress and fatigue management were not addressed in any included study. Limitations: Evidence is predominantly observational with substantial heterogeneity in study designs and FTR definitions; the search was limited to PubMed; and no formal risk-of-bias, publication-bias assessment, or meta-analysis was performed. Consequently, estimates and associations are descriptive/associative with limited certainty and generalizability. Conclusions: NTSs were rarely used or measured across the included studies, with validated instruments; quantitative assessment was uncommon, and no study evaluated stress or fatigue management. Reducing the FTR after pancreatic surgery will require standardized, pancreas-specific definitions of FTR, process-level rescue metrics, and deliberate strengthening of NTS. We recommend a pancreas-specific operational definition with an explicit numerator/denominator: numerator = all-cause mortality within 90 days of surgery; denominator = patients who experience major complications (Clavien–Dindo grade III–V, often labeled “CD ≥ 3”). Addressing the gaps in stress and fatigue management and embedding behavioral metrics into quality improvement programs are critical next steps to reduce preventable mortality after complex pancreatic cancer procedures. Full article

The selection of an appropriate formwork system represents a critical decision in the planning of reinforced concrete multi-story buildings. While this decision has traditionally been deferred to the construction phase, increasing evidence of time and cost overruns in construction projects has highlighted the necessity of addressing it during earlier stages, particularly in design and planning. Early identification and selection of the optimal formwork system enhances the likelihood of achieving significant improvements in both time efficiency and cost effectiveness. To facilitate this process, a decision-support framework based on the Analytic Hierarchy Process (AHP) and Simple Additive Weighting (SAW) methods has been developed. This framework provides decision-makers with a structured and systematic approach for evaluating alternatives and selecting the most suitable formwork system for a given project. By offering an analytical foundation for the decision-making process, the framework assists designers and engineers in mitigating risks associated with delays and potential standstills during construction. The findings indicate that the proposed decision-support framework ensures both clarity and consistency in decision-making outcomes, irrespective of the analytical method employed. Consequently, it contributes to more robust planning and execution of construction projects. Full article

Arabidopsis thaliana is a widely used model in plant biology, where histology (HT), histochemistry (HC), immunohistochemistry (IHC), and immunofluorescence (IF) are applied to study cellular structures, macromolecules, and antigens. Despite their extensive use, protocols lack standardization and exhibit substantial variability in critical aspects such as reagent handling, exposure times, and the proper use of controls. This methodological heterogeneity represents a major gap, limiting reproducibility and comparability between studies. Unlike previous methodological reviews, this work focuses exclusively on A. thaliana, systematically identifies reporting omissions, and proposes a roadmap for standardization. A narrative review of literature retrieved from Scopus and Web of Science was conducted with the aim of analyzing methodological approaches, identifying inconsistencies, and offering recommendations for improved laboratory practices. The analysis revealed frequent omissions in the reporting of critical steps such as dehydration, clearing, antigen retrieval, enzyme blocking, and the incorporation of positive and negative controls, which compromise the reliability of results and hinder inter-laboratory validation. Based on this evidence, three key recommendations are emphasized: (i) organ-specific selection and explicit justification of fixatives and stains; (ii) mandatory incorporation of positive and negative controls in IHC and IF; and (iii) adoption of a minimum reporting checklist to enhance reproducibility. Beyond cell morphology, the reviewed studies demonstrate applications in plant physiology, phytogenetics, and pathophysiology. By combining critical analysis with actionable guidelines, this review contributes a practical reference to strengthen methodological rigor in histological and immunological studies of plants. Full article

Microwave pretreatment (MWP) has emerged as a promising strategy to enhance the pyrolysis of lignocellulosic biomass due to its rapid, volumetric, and selective heating. By disrupting the recalcitrant structure of cellulose, hemicellulose, and lignin, MWP improves biomass deconstruction, increases carbohydrate accessibility, and enhances yields of bio-oil, syngas, and biochar. When combined with complementary pretreatments—such as alkali, acid, hydrothermal, ultrasonic, or ionic-liquid methods—MWP further reduces activation energies, facilitating more efficient saccharification and thermal conversion. This review systematically evaluates scientific progress in this field through bibliometric analysis, mapping research trends, evolution, and collaborative networks. Key research questions are addressed regarding the technical advantages of MWP, the physicochemical transformations induced in biomass, and associated environmental benefits. Findings indicate that microwave irradiation promotes hemicellulose depolymerization, reduces cellulose crystallinity, and weakens lignin–carbohydrate linkages, which facilitates subsequent thermal decomposition and contributes to improved pyrolysis efficiency and product quality. From an environmental perspective, MWP contributes to energy savings, mitigates greenhouse gas emissions, and supports the integration of renewable electricity in biomass conversion. Full article

Alkali resistance is a critical factor for the long-term performance of glass fibers in cementitious composites. While zirconium oxide doping has proven effective in enhancing the durability of basalt fibers, its high cost and limited solubility motivate the search for viable alternatives. This study presents the first systematic investigation of titanium dioxide (TiO₂) doping in basalt-based glasses across a wide compositional range (0–8 mol%). X-ray fluorescence and diffraction analyses confirm complete dissolution of TiO₂ within the amorphous silicate network, with no phase segregation. At low concentrations (≤3 mol%), Ti⁴⁺ acts as a network modifier in octahedral coordination ([TiO₆]), reducing melt viscosity and lowering processing temperatures. As TiO₂ content increases, titanium in-corporates into tetrahedral sites ([TiO₄]), competing with Fe³⁺ for network-forming positions and displacing it into octahedral coordination, as revealed by Mössbauer spectroscopy. This structural redistribution promotes phase separation and triggers the crystallization of pseudobrukite (Fe₂TiO₅) at elevated temperatures. The formation of a protective Ti(OH)₄ surface layer upon alkali exposure enhances chemical resistance, with optimal performance observed at 4.6 mol% TiO₂—reducing mass loss in NaOH and seawater by 13.3% and 25%, respectively, and improving residual tensile strength. However, higher TiO₂ concentrations (≥5 mol%) lead to pseudobrukite crystallization and a narrowed fiber-forming temperature window, rendering continuous fiber drawing unfeasible. The results demonstrate that TiO₂ is a promising, cost-effective dopant for basalt fibers, but its benefits are constrained by a critical solubility threshold and structural trade-offs between durability and processability. Full article

Rejuvenating aged asphalt is critical for sustainable road construction and resource utilization. This paper systematically reviews the current research on rejuvenators, focusing on their classification and the micro-, and macro-properties of rejuvenated asphalt. Rejuvenators are categorized into mineral oil-based, bio-based, and compound types. Each type offers distinct advantages in recovering the performance of aged asphalt. Mineral oil-based rejuvenators primarily enhance low-temperature cracking resistance through physical dilution, while bio-based rejuvenators demonstrate superior environmental sustainability and stability. Compound rejuvenators, particularly those incorporating reactive compounds, show the best results in repairing degraded polymer modifiers and improving both low- and high-temperature properties of aged, modified asphalt. Atomic Force Microscopy (AFM), Fluorescence Microscopy (FM), and Scanning Electron Microscopy (SEM) have been applied to analyze the micro-properties of rejuvenated asphalt. These techniques have revealed that rejuvenators can restore the microstructure of aged asphalt by dispersing agglomerated asphaltenes and promoting molecular mobility. Functional groups and molecular weight changes, characterized by Fourier Transform Infrared Spectroscopy (FTIR) and Gel Permeation Chromatography (GPC), indicate that rejuvenators effectively reduce oxidation products and molecular weight of aged asphalt, restoring its physicochemical properties. Macro-property evaluations show that rejuvenators significantly improve penetration, ductility, and fatigue resistance. Finally, this review identifies the key characteristics and challenges associated with rejuvenator applications and provides an outlook on future research directions. Full article

Traditional Chinese medicine-derived carbon dots (TCM-CDs) are prepared by top-down or bottom-up synthesis methods using TCM or their active ingredients as precursors, and the size of TCM-CDs is usually less than 10 nm. It has the advantages of easy preparation, low toxicity, and high compatibility. Compared with traditional Chinese medicines, it shows more outstanding performance in antioxidant, hemostatic, antibacterial, and other aspects, thus having good development prospects. This paper systematically reviews the synthesis methods of carbon dots, focusing on the influence of different traditional Chinese medicine precursors on the formation of carbon dots during the processing process, and analyzes the performance of carbon dots in enhancing the efficacy of original medicinal materials, exerting multi-target synergistic effects, improving bioavailability, and generating new medicinal effects. It is expected to provide a theoretical basis and reference direction for the in-depth research and development of traditional Chinese medicine carbon dots in the field of medicinal value. Full article

Introduction: Concussions are a growing concern in professional football due to their potential short- and long-term neurological consequences. Despite increasing global awareness, data on the epidemiology and clinical management of concussions in Portuguese football remain scarce. This preliminary exploratory study aimed to characterize the incidence, mechanisms, symptomatology, and medical response to concussions in Portugal’s Professional Football Leagues during the 2023/2024 season, based on reported cases. Methods: A retrospective observational analysis was conducted on head injuries reported by club medical teams during official matches in Liga Portugal First and Second Leagues. Collected variables included player position, time of injury, mechanism, symptoms, medical interventions and hospital referral. Results: Only six concussions were reported during official matches, with an overall incidence of 0.60 per 1000 player-hours. Most occurred in defenders, primarily due to head-to-head collisions, followed by ball impact, falls, and maxillofacial trauma. Injuries were more frequent during the final third of matches. Common symptoms included loss of consciousness, headache, and amnesia. Half of the players were referred to hospital care and underwent cranial CT scans. Among all variables analyzed, a statistically significant association was found between mechanism of injury and occurrence of amnesia (p = 0.014), with non-head-to-head impacts more frequently associated with amnesia. However, given the extremely limited sample size, this finding should be interpreted with extreme caution and requires replication in larger cohorts. Conclusions: This preliminary study suggests that defenders face a higher risk of head injuries, particularly from head-to-head impacts occurring late in matches. The prevalence of severe symptoms and the potential association between non-head-to-head impacts and amnesia highlight the need for more robust injury surveillance systems and underscore the importance of improved sideline assessment and return-to-play protocols. The findings emphasize the urgent need for comprehensive, standardized reporting mechanisms for concussions. Further research should explore long-term neurological effects and the effectiveness of preventive measures such as rule modifications, protective measures, and enhanced concussion management protocols, supported by more extensive and systematically collected data. Full article

The concentration characteristics of SO₂, NO₂, O₃, and CO in the marine atmosphere are of great significance for understanding air–sea interactions and regional atmospheric chemical processes. However, due to the challenging conditions of marine monitoring, long-term continuous observational data remain scarce. To address this gap, this study proposes a Transfer Learning–Convolutional Neural Network (TL-CNN) model that integrates ERA5 meteorological data, EAC4 atmospheric composition reanalysis data, and ground-based observations through multi-source data fusion. During data preprocessing, the Data Interpolating Empirical Orthogonal Function (DINEOF), inverse distance weighting (IDW) spatial interpolation, and Gaussian filtering methods were employed to improve data continuity and consistency. Using ERA5 meteorological variables as inputs and EAC4 pollutant concentrations as training targets, a CNN-based inversion framework was constructed. Results show that the CNN model achieved an average coefficient of determination (R²) exceeding 0.80 on the pretraining test set, significantly outperforming random forest and deep neural networks, particularly in reproducing nearshore gradients and regional spatial distributions. After incorporating transfer learning and fine-tuning with station observations, the model inversion results reached an average R² of 0.72 against site measurements, effectively correcting systematic biases in the reanalysis data. Among the pollutants, the inversion of SO₂ performed relatively poorly, mainly because emission reduction trends from anthropogenic sources were not sufficiently represented in the reanalysis dataset. Overall, the TL-CNN model provides more accurate pollutant concentration fields for offshore regions with limited observations, offering strong support for marine atmospheric environment studies and assessments of marine ecological effects. It also demonstrates the potential of combining deep learning and transfer learning in atmospheric chemistry research. Full article

Background: Mandibular advancement devices (MADs) are widely used for mild-to-moderate obstructive sleep apnea (OSA). We aimed to synthesize recent evidence on their clinical effectiveness and tolerability. Methods: A systematic review was conducted. Ten studies were included, evaluating MAD therapy in adults with mild-to-moderate OSA. The review reported on standard outcomes, including the apnea-hypopnea index (AHI), oxygenation, daytime sleepiness (Epworth Sleepiness Scale, ESS), quality of life, adherence, and adverse events. Risk of bias was also assessed. Results: Across the included studies, MADs consistently reduced AHI from baseline and improved ESS and/or snoring. In head-to-head comparisons, MADs generally yielded smaller reductions in AHI than CPAP but achieved comparable improvements in symptoms and quality of life, with higher nightly adherence. Reported adverse effects were mostly mild and transient. Conclusions: MAD therapy is an effective and generally well-tolerated option for adults with mild-to-moderate OSA and for the patients intolerant to CPAP, although average AHI reduction is smaller than with CPAP. Given the low certainty and heterogeneity of current evidence, high-quality randomized trials with objective adherence tracking and standardized titration are needed. Full article

Cancer is a major challenge to global health, and its incidence rate and mortality are expected to continue to rise in the coming decades. Traditional treatment methods such as surgery, radiotherapy, and chemotherapy have limitations, which has prompted people to explore new treatment strategies. As a promising therapeutic approach, oncolytic viruses can selectively target and lyse tumor cells while avoiding damage to normal tissues. This article systematically reviews the mechanisms by which oncolytic viruses induce various forms of cell death, including apoptosis, autophagy, pyroptosis, necroptosis, and ferroptosis. We explored the direct killing effect of oncolytic viruses and their ability to activate local and systemic antitumor immunity, with a focus on the latest developments in the clinical application of oncolytic viruses, such as the development of novel recombinant viruses. In addition, we also analyzed strategies to enhance the efficacy of oncolytic viruses through gene modification, combination therapy, and targeted delivery systems. A deeper understanding of the multiple mechanisms of action of oncolytic viruses can help us develop more effective and personalized cancer treatment plans. Future research should focus on optimizing oncolytic viruses to overcome tumor drug resistance and improve patient prognosis, making them an important pillar of cancer treatment. Full article

G-quadruplex (G4) ChIP-Seq data are critical for studying the roles of G4 structures in various biological processes, yet their reproducibility remains systematically uncharacterized. In this study, we evaluated the consistency of in vivo G4 peaks across multiple replicates in three publicly available datasets. We observed considerable heterogeneity in peak calls, with only a minority of peaks shared across all replicates. To address this challenge, we compared three computational methods—IDR, MSPC, and ChIP-R—for assessing reproducibility and found that MSPC is the optimal solution in reconciling inconsistent signals in G4 ChIP-Seq data. We further demonstrated that employing at least three replicates significantly improved detection accuracy compared to conventional two-replicate designs, while four replicates proved sufficient to achieve reproducible outcomes, with diminishing returns beyond this number. Moreover, we showed that the reproducibility-aware analytical strategies can partially mitigate the adverse effects of low sequencing depth, though they do not fully substitute for high-quality data. Based on our findings, we recommend 10 million mapped reads as a minimum standard for G4 ChIP-Seq experiments, with 15 million or more reads being preferable for optimal results. Our study provides practical guidelines for experimental design and data analysis in G4 studies, emphasizing the importance of replication and robust bioinformatic strategies to enhance the reliability of genome-wide G4 mapping. Full article

Background: Depression has been identified as an important determinant of outcomes in hip and knee arthroplasty, but its impact on total ankle arthroplasty (TAA) remains unclear. Given the growing use of TAA as a treatment for end-stage ankle arthritis, understanding psychosocial risk factors is critical for optimizing surgical outcomes. This study aims to assess the effect of preoperative depression on clinical and functional outcomes following total ankle arthroplasty. Methods: A systematic review was conducted in accordance with PRISMA guidelines and prospectively registered with the Open Science Framework. PubMed, Cochrane Library, and CINAHL were searched through August 2025 for studies reporting outcomes of TAA stratified by depression status. Eligible designs included randomized trials, cohort studies and case series. Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS). Given heterogeneity in study designs, depression definitions, and outcome measures, findings were synthesized narratively and summarized using a revised effect-direction plot. Results: Six unique studies involving approximately 9000 patients met inclusion criteria. Five studies were rated as good quality on the Newcastle–Ottawa Scale, while one study was judged to be of moderate quality. Four studies assessing pain outcomes consistently demonstrated worse postoperative pain or less improvement in patients with depression. Three of five studies assessing functional or disability outcomes reported reduced improvement, while two studies found no independent association. Two studies evaluating complications showed higher risks of adverse events, including prolonged hospital stay, non-home discharge, osteophytosis, and implant subsidence, among depressed patients. Revised effect-direction synthesis confirmed a consistent trend toward poorer outcomes across pain, function, and complication domains. Conclusions: Depression is associated with worse pain and higher complication rates following TAA, while its influence on functional recovery was not demonstrated uniformly. These findings support the importance of routine preoperative screening and targeted management of depression. Further prospective, multicenter studies and interventional trials are needed to clarify causality and optimize perioperative care. Full article

Anticoagulation therapy with unfractionated heparin (UHF) is a mandatory treatment for many critically ill patients. While the gold standard for monitoring this therapy remains the laboratory-based aPTT (aPTT-lab), the need for immediate results has led to an increase in the development of point-of-care (POC) measurement systems. This study assessed the correlation and agreement between activated clotting time-low range (ACT-LR) and aPTT-POC measurements using aPTT-lab in a cohort of critically ill patients requiring anticoagulation. This prospective cohort study involved patients admitted to the intensive care unit (ICU) who were treated with UFH between January 2022 and January 2024. We performed simultaneous measurements of aPTT-lab, aPTT-POC, and ACT-LR and analyzed 14 samples from healthy volunteers (the control group) to determine the range of normality and mean aPTT-POC. The aPTT-lab value was considered the gold standard measure of coagulation. A poor correlation was observed between ACT-LR and aPTT-lab in the global sample (r = 0.51), which improved slightly when excluding patients with invasive devices (r = 0.61). aPTT-POC showed moderate agreement (bias of 10.4%) but underestimated the aPTT ratio (bias = −0.23), which was similar in patients with and without devices. Agreement was very high in the control group (bias = −0.003). The accuracy of POC anticoagulation monitoring systems is limited in critically ill patients. The aPTT-POC measurements showed better agreement than the ACT-LR measurements. A clinical validation study is needed to adjust for systematic bias in patients with aPTT-POC. Full article