Search Results (2,971)

Background/Objectives: Stereotactic body radiation therapy (SBRT) is a therapeutic option for hepatocellular carcinoma (HCC). This study reviewed outcomes and toxicities of SBRT for HCC using a gimbal-mounted linear accelerator and real-time monitoring system. Methods: A single-institution, retrospective review of SBRT for HCC using DTT between January 2018 and December 2020 was undertaken. Endpoints included local control (LC) and overall survival (OS). Results: A total of 74 patients with 82 tumors treated were identified. Median follow-up was 40.8 months. LC at 1, 3, and 5 years was 89.6%, 71.0%, and 59.9%, respectively. Median time to local failure was not reached. Median OS was 41.3 months (95% CI 30.7–51.8 months). OS at 1, 3, and 5 years was 89.2%, 60.6%, and 33.9%, respectively. On UVA, GTV ≥ 30 cm³ (p = 0.038), and PTV ≥ 150 cm³ (p = 0.010) were associated with an absolute drop in platelet count by ≥50,000/mm³ within six weeks of SBRT, while prior focal liver treatment (p = 0.097) showed a trend toward significance. Underlying viral cirrhosis (p = 0.033), A6 or higher pre-SBRT Child–Pugh score (p = 0.010), and pre-SBRT platelet count <100,000/mm³ (p = 0.017) were significant for a rise in Child–Pugh score of 2 points or more, and the volume of liver-GTV <1000 cm³ (p = 0.093) approached significance. Conclusions: SBRT using DTT is an effective therapeutic option for selected patients with HCC, providing acceptable local control and toxicity. Full article

Ischemic stroke is a neurological disorder resulting from localized brain injury due to focal cerebral ischemia, typically caused by the blockage of one or, in some cases, a few cerebral arteries. This arterial obstruction leads to hypoxia and energy failure, culminating in primary brain damage. Although reperfusion is critical to salvage viable tissue, it often intensifies injury through oxidative stress, inflammation, and cell death—a phenomenon called ischemia–reperfusion (I/R) injury. Milk fat globule-EGF factor 8 (MFG-E8), a multifunctional glycoprotein secreted by stem and immune cells, is a key regulator of inflammation and tissue repair. By modulating microglial activation, attenuating proinflammatory cytokine releases, and preserving neuronal integrity, MFG-E8 mitigates ischemia–reperfusion injury and emerges as a novel therapeutic target for ischemic stroke. Full article

The reactivation of the Longdongpo ancient colluvial landslide in Sinan County, Guizhou Province represents a typical multi-factor coupled failure. Based on detailed geological investigations and FLAC^3D fluid–solid coupling numerical simulations, this study reveals its complex reactivation mechanisms. The analysis demonstrates that long-term groundwater action has significantly weakened the slip zone at the soil–bedrock interface, causing strength degradation and inducing prolonged quasi-stable creep deformation of the slope. The artificial cut slopes formed in the middle-to-lower sections disrupted the original stress field and induced localized plastic deformation. Crucially, the numerical simulation identified a 5 m rainfall infiltration depth as the threshold triggering abrupt instability; when exceeding this critical value (simulated as 10 m and 16 m infiltration depths), pore water pressure surged (>2.7 MPa) and displacement dramatically increased (>2.2 m), reducing shear strength along the potential failure surface to critical levels. This process culminated in the full connection of the shear surface and the landslide’s catastrophic reactivation. This work quantitatively elucidates the chain-reaction mechanism of “long-term groundwater weakening → engineering disturbance initiation → critical-depth rainfall infiltration triggering”, providing vital quantitative evidence for regional ancient landslide risk prevention. Full article

Immune dysregulation is being increasingly recognized as a leading sign of a wide spectrum of inborn errors of immunity (IEIs). Therefore, patients with IEIs are frequently managed in non-immunological settings, including hematology and oncology units, during the diagnostic process or follow-up. The most relevant hematological signs associated with IEIs comprise autoimmune cytopenia (AIC), lymphoproliferative diseases (LPD), malignancies, hemophagocytic lymphohystiocitosis (HLH), bone marrow failure (BMF), myelodysplastic syndromes (MDS), and peripheral or tissue eosinophilia. The prognosis of patients with IEIs can significantly improve when a molecular diagnosis is established, as it can allow the use of targeted treatments, guide appropriate follow-up strategies and, in some cases, support the rationale for hematopoietic stem cell transplantation or gene therapy. Therefore, there is an urgent need to recognize the warning signs suggestive for an underlying IEI among patients presenting with common hematological features and to ensure an appropriate diagnostic approach. As a general rule, clinicians should always provide a clinical alert in the presence of two or more IEI-associated hematological signs, as well as a positive familial history for IEI or hematologic immune dysregulation, a personal history of severe infections, and other signs of immune dysregulation. Concerning AIC, an increased likelihood of IEI is characteristic of patients with treatment refractoriness, autoimmune hemolytic anemia, or multilineage cytopenia. In the case of LPD, the main elements of suspicion are represented by the chronic or recurrent disease course, the persistence of Epstein–Barr Virus (EBV) infection, and the development of lymphoproliferation in atypical localizations. Among patients with malignancy, clinicians should investigate for IEI those with rare neoplasia, virus-associated tumors, and an association with syndromic features, while patients with HLH should always receive an immunological assessment when a clear rheumatologic trigger, underlying malignancy, or well-recognized cause is not evident. The case of MDS and BMF is complex, as new monogenic entities are continuously being described. However, it is pivotal to consider the presence of monocytopenia, warts, vasculitis, and neurological disease, as well as specific cytogenetic abnormalities, such as chromosome 7 monosomy, as warning sings for IEIs. Finally, the main red flags for IEIs in patients with eosinophilia are skeletal/facial abnormalities, recurrent abscesses, refractory eczema, organomegaly, or thrombocytopenia. Full article

Accurate data on solar photovoltaic (PV) generation is essential for the effective prediction of energy production and the effective management of distributed energy resources (DERs). Such data also plays a crucial role in ensuring the operation of DERs within modern power distribution systems is both safe and economical. Missing values, which may be attributed to faults in sensors, communication failures or environmental disturbances, represent a significant challenge for distribution system operators (DSOs) in terms of performing state estimation, optimal dispatch, and voltage regulation. This paper proposes a Pattern-Aware Bidirectional Long Short-Term Memory (PA-BiLSTM) model for solar generation imputation to address this challenge. In contrast to conventional convolution-based approaches such as the Convolutional Autoencoder and U-Net, the proposed framework integrates a 1D convolutional module to capture local temporal patterns with a bidirectional recurrent architecture to model long-term dependencies. The model was evaluated in realistic block–random missing scenarios (1 h, 2 h, 3 h, and 4 h gaps) using 5 min resolution PV data from 50 sites across 11 regions in South Korea. The numerical results show that the PA-BiLSTM model consistently outperforms the baseline methods. For example, with a time gap of one hour, it achieves an MAE of 0.0123, an R² value of 0.98, and an average MSE, with a maximum reduction of around 15%, compared to baseline models. Even under 4 h gaps, the model maintains robust accuracy (MAE = 0.070, R² = 0.66). The results of this study provide robust evidence that accurate, pattern-aware imputation is a significant enabling technology for DER-centric distribution system operations, thereby ensuring more reliable grid monitoring and control. Full article

Super high-rise buildings of 400 m and above are currently rare globally, making their design and construction data invaluable. Due to their enormous size, the structural safety, architectural effect, and construction cost are key concerns of all parties. This study employs parametric analysis to research the lateral force-resisting system and key local structural issues of a 400 m under-construction super-high-rise structure. The overall analysis results show that the 8-mega-column scheme can relatively well balance architectural effect and structural performance; the 5-belt truss design minimizes the steel consumption. The local research results indicate that the inward inclination of bottom columns leads to increased axial forces in floor beams significantly, necessitating reinforcement; horizontal braces directly connected to the core tube enhance folded belt truss integrity under rare earthquakes; failure of bottom gravity columns in the folded secondary frame increases beam bending moments and axial forces substantially. Steel consumption sensitivity analysis shows that when the structural first-order period is reduced by 0.1 s, adjusting the section sizes of the members in the belt truss minimizes the increase in steel consumption, while adjusting steel beams maximizes it. These findings provide essential design insights for similar super-high-rise projects. Full article

Chronic respiratory diseases claim nearly four million lives annually, making them the third leading cause of death worldwide. Extracorporeal membrane oxygenation (ECMO) is often the last line of support for patients with severe lung failure. Still, its performance is limited by an incomplete understanding of gas exchange in hollow fiber membrane (HFM) oxygenators. Computational fluid dynamics (CFD) has become a robust oxygenator design and optimization tool. However, most models oversimplify O₂ and CO₂ transport by ignoring their physiological coupling, instead relying on fixed saturation curves or constant-content assumptions. For the first time, this study introduces a novel physiologically informed CFD model that integrates the Bohr and Haldane effects to capture the coupled transport of oxygen and carbon dioxide as functions of local pH, temperature, and gas partial pressures. The model is validated against in vitro experimental data from the literature and assessed against established CFD models. The proposed CFD model achieved excellent agreement with experiments across blood flow rates (100–500 $\mathrm{mL}/\min$ ), with relative errors below 5% for oxygen and 10–15% for carbon dioxide transfer. These results surpassed the accuracy of all existing CFD approaches, demonstrating that a carefully formulated single-phase model combined with physiologically informed diffusivities can outperform more complex multiphase simulations. This work provides a computationally efficient and physiologically realistic framework for oxygenator optimization, potentially accelerating device development, reducing reliance on costly in vitro testing, and enabling patient-specific simulations. Full article

Closing resistors in ultra-high-voltage (UHV) gas-insulated circuit breakers (GCBs) are critical components designed to suppress inrush currents and transient overvoltages during switching operations. However, in practical service, these resistors are subjected to repeated mechanical impacts and transient electrical stresses, leading to degradation of their electrical contact interfaces, fluctuating resistance values, and potential failure of the entire breaker assembly. Existing studies mostly simplify the closing resistor as a constant resistance element, neglecting the coupled electro-thermal–mechanical effects that occur during transient events. In this work, a comprehensive modeling framework is developed to investigate the dynamic electrical contact characteristics of a 750 kV GCB closing resistor under transient closing impacts. First, an electromagnetic transient model is built to calculate the combined inrush and power-frequency currents flowing through the resistor during its pre-insertion period. A full-scale mechanical test platform is then used to capture acceleration signals representing the mechanical shock imparted to the resistor stack. These measured signals are fed into a finite element model incorporating the Cooper–Mikic–Yovanovich (CMY) electrical contact correlation to simulate stress evolution, current density distribution, and temperature rise at the resistor interface. The simulation reveals pronounced skin effect and current crowding at resistor edges, leading to localized heating, while transient mechanical impacts cause contact pressure to fluctuate dynamically—resulting in a temporary decrease and subsequent recovery of contact resistance. These findings provide insight into the real-time behavior of closing resistors under operational conditions and offer a theoretical basis for design optimization and lifetime assessment of UHV GCBs. Full article

In this article, I argue that the state creates legal advice deserts in immigration and asylum by designing law and policy which drive up legal need, driving down provision through unfavourable conditions for providers, and by placing people in need into areas from which they have no realistic prospect of accessing legal advice and representation. I draw on frameworks of spatial justice and of demand to analyse the impact of the legislative and policy developments in the Special Issue’s focal period of 2022–24 on legal aid in each of the UK’s three legal aid systems: England and Wales, Scotland, and Northern Ireland. The legislative changes included introducing new stages into asylum law, which created new legal needs. Policy changes drove a wholesale geographical shift in demand as all local authorities in the UK (except Scilly) now host people in the asylum process. The changes depended upon the involvement of legal aid lawyers in order to be workable, but the marketised model of legal aid provision in England and Wales, and the low-paid laissez faire model in Northern Ireland, are fundamentally incompatible with that demand. I conclude by arguing that legal aid cannot be an afterthought. Asylum policy should be shaped to reduce failure demand, while legal aid policy should be funded and designed so as to pay for the necessary provision, with interventions to remove the spatial inequalities in access to (legal) justice. Full article

This study develops a thermo-mechanical damage (TMD) model for predicting damage evolution in heterogeneous rock materials after heat treatment. The TMD model employs a Weibull distribution to characterize the spatial heterogeneity of the mechanical properties of rock materials and develops a framework that incorporates thermal effects into a nonlocal gradient damage model, thereby overcoming the mesh dependency issue inherent in homogeneous local damage models. The model is validated by numerical simulations of a notched cruciform specimen subjected to combined mechanical and thermal loading, confirming its capability in thermo-mechanical coupled scenarios. Sensitivity analysis shows increased material heterogeneity promotes localized, X-shaped shear-dominated failure patterns, while lower heterogeneity produces more diffuse, network-like damage distributions. Furthermore, the results demonstrate that thermal loading induces micro-damage that progressively spreads throughout the specimen, resulting in a significant reduction in both overall stiffness and critical strength; this effect becomes increasingly pronounced at higher heating temperatures. These findings demonstrate the model’s ability to predict the mechanical behavior of heterogeneous rock materials under thermal loading, offering valuable insights for safety assessments in high-temperature geotechnical engineering applications. Full article

The Archimedes spiral hydrokinetic turbine (ASHT), an innovative horizontal-axis design, holds significant potential for harvesting energy from localized ocean and river currents. However, prolonged operation can result in blade erosion, which reduces efficiency and may lead to operational failures. To ensure reliability and prevent damage, it is essential to accurately identify the locations and progression of wear caused by sand particle impacts. Using a CFD–DPM approach, this study systematically investigates the effects of sand concentration and particle size on erosion rates and distribution across nine ASHT configurations, along with the underlying physical mechanisms. The results indicate that erosion rate increases linearly with sand concentration due to higher particle impact frequency. Erosion zones expand from the blade tip edges toward mid-span regions and areas near the hub as concentration increases. Regarding particle size, the erosion rate increases rapidly and almost linearly for diameters below 0.6 mm, but this growth slows for larger particles due to a “momentum–quantity trade-off” effect. Blade angle also exerts a tiered influence on erosion, following the pattern medium angles > small angles > large angles. Medium angles enhance the synergy between normal and tangential impact components, maximizing erosion. Erosion primarily initiates at the blade tips and edges, with the most severe wear concentrated in these high-impact zones. The derived erosion patterns provide valuable guidance for predicting erosion, optimizing ASHT blade design, and developing effective anti-erosion strategies. Full article

Bolted connections are extensively utilized in aerospace, civil, and mechanical systems for structural assembly. However, inevitable structural vibrations can induce bolt loosening, leading to preload reduction and potential structural failure. Early-stage preload degradation, particularly during initial loosening, is often undetectable by conventional monitoring methods due to limited sensitivity and poor noise resilience. To address these limitations, this study proposes an intelligent bolt preload monitoring framework that combines electromechanical impedance (EMI) signal analysis with a parallel deep learning architecture. A multiphysics-coupled model of flange joint connections is developed to reveal the nonlinear relationships between preload degradation and changes in EMI conductance spectra, specifically resonance peak shifts and amplitude attenuation. Based on this insight, a parallel convolutional neural network (P-CNN) is designed, employing dual branches with 1 × 3 and 1 × 7 convolutional kernels to extract local and global spectral features, respectively. The architecture integrates dilated convolution to expand frequency–domain receptive fields and an enhanced SENet-based channel attention mechanism to adaptively highlight informative frequency bands. Experimental validation on a flange-bolt platform demonstrates that the proposed P-CNN achieves 99.86% classification accuracy, outperforming traditional CNNs by 20.65%. Moreover, the model maintains over 95% accuracy with only 25% of the original training samples, confirming its robustness and data efficiency. The results demonstrate the feasibility and scalability of the proposed approach for real-time, small-sample, and noise-resilient structural health monitoring of bolted connections. Full article

Local scour around bridge piers is one of the primary causes of structural failure in bridges. Therefore, this study focuses on addressing the estimation of maximum scour depth (d_sm), which is essential for safe and resilient bridge design. Many studies in the last eight decades have included metadata collection and developed around 80 empirical formulas using various scour-affecting parameters of different ranges. To date, a total of 33 formulas have been comparatively analyzed and ranked based on their predictive accuracy. In this study, novel formulas using semi-empirical methods and gene expression programming (GEP) have been developed alongside an artificial neural network (ANN) model to accurately estimate d_sm using 768 observed data points collected from published work, along with eight newly conducted experimental data points in the laboratory. These new formulas/models are systematically compared with 74 empirical literature formulas for their predictive capability. The influential parameters for predicting d_sm are flow intensity, flow shallowness, sediment gradation, sediment coarseness, time, constriction ratio, and Froude number. Performances of the formulas are compared using different statistical metrics such as the coefficient of determination, Nash–Sutcliffe efficiency, mean bias error, and root-mean-squared error. The Gauss–Newton method is employed to solve the nonlinear least-squares problem to develop the semi-empirical formula that outperforms the literature formulas, except the formula from GEP, in terms of statistical performance metrics. However, the feed-forward ANN model outperformed the semi-empirical model during testing and validation phases, respectively, with higher CD (0.790 vs. 0.756), NSE (0.783 vs. 0.750), lower RMSE (0.289 vs. 0.301), and greater prediction accuracy (64.655% vs. 61.935%), providing approximately 15–18% greater accuracy with minimal errors and narrower uncertainty bands. Using user-friendly tools and a strong semi-empirical model, which requires no coding skills, can assist designers and engineers in making accurate predictions in practical bridge design and safety planning. Full article

On 6 February 2023, two devastating earthquakes struck the Kahramanmaraş region in southeastern Türkiye, causing widespread destruction across multiple provinces. Among the most severely affected areas was Hatay, where this study conducted a comprehensive post-earthquake field investigation. The research integrates tectonic, geological, and seismic analyses with structural performance assessments of reinforced concrete and masonry buildings. Particular attention is given to the influence of local soil conditions and geomorphological features on damage distribution. Ground motion records are evaluated alongside observed structural failures to identify key vulnerability factors. The findings highlight critical deficiencies in construction practices and regulatory compliance, and the study concludes with recommendations aimed at enhancing seismic resilience through improved code enforcement, site-specific design strategies, and rigorous quality control during construction to reduce future loss of life and property. Full article

Background: Right free wall (RFW) accessory pathways (APs) represent a relatively rare form of AP, and transcatheter (TC) ablation of these APs carries high procedural failure rates, both with radiofrequency (RF) and cryoenergy. The aim of this study was to report the outcomes of a minimally invasive approach in non-fluoroscopic 3D TC ablation of RFW APs, comparing cryoenergy and RF. Methods: Between March 2010 and March 2024, 62 consecutive patients with RFW APs underwent transcatheter ablation at our institution with a minimally invasive approach. The ablation results were analyzed and compared. Results: The overall acute success rate was 83.9% [52/62 patients; 25/28 (89.3%) for right lateral (RL) APs, 18/19 (94.7%) for right anterior–lateral (RAL) APs, and 9/15 (60.0%) for right posterior–lateral (RPL) APs, p = 0.014], with very limited fluoroscopy use and no complications. There were no significant differences in the acute success rates between the RF and cryoablation groups (32/37 vs. 20/25, p = 0.506). The median follow-up was 24.8 months (IQR 12.5–49.8), and 16 recurrences (30.8%) were observed (3 in the cryoablation group and 13 in the RF group, p = 0.068). The RAL localization of the AP and age > 12 years were predictors of ablation success in multivariate regression analysis. Conclusions: In children, a minimally invasive 3D TC ablation of RFW APs is a completely safe and quite effective approach, with better results for RAL and RL APs, poorer results for RPL APs, and no significant differences between cryoenergy and RF. Full article