Search Results (263)

Background: Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, with a 5-year survival rate of 10%. Irreversible electroporation (IRE), a non-thermal ablative technique, may improve outcomes in locally advanced (LAPC) and borderline resectable pancreatic cancer (BRPC). This multi-center retrospective study aims to evaluate postoperative complications, 90-day mortality, and survival following IRE. Methods: 35 pancreatic cancer patients were treated with IRE between 2015 and 2023 across three Belgian hospitals. IRE was performed for tumor destruction in unresectable LAPC (n = 13) (IRE-LAPC) and for margin accentuation during resection in BRPC (n = 22) (IRE-MA). Primary endpoints were 90-day mortality, complications, and survival (only 33 patients included); secondary endpoints included metastases, local recurrence, and R0-resection rates. Results: Postoperative complications occurred in 23.1% (IRE-LAPC) and 68.2% (IRE-MA) of patients. Overall survival at 24 months was 27.3% (IRE-LAPC) and 27.3% (IRE-MA). Median survival time was 12.7 months (IRE-LAPC) and 13.3 months (IRE-MA). Six patients (17.1%) died within 90 days. Metastasis occurred in 51.5% of patients after a median time of 9.8 months. Local recurrence was seen in 24.2% of patients after a median time of 7.5 months. R0 resection was achieved in 63.6% (IRE-MA). Discussion: IRE for margin accentuation in BRPC is associated with relatively high morbidity and mortality rates and cannot be considered beneficial. In unresectable LAPC, IRE appears relatively safe for local disease control. Further research should clarify patient selection and optimize its therapeutic role. Full article

Histotripsy is a novel, non-invasive ultrasound-based ablative therapy that destroys tissue through focused cavitation. As solid tumors continue to be a major global health burden, there is interest in image-guided ablation techniques that reduce collateral damage and promote immune activation. This narrative review aims to synthesize current advancements, clinical applications, limitations, and future directions of histotripsy in both oncologic and non-oncologic contexts. A comprehensive literature search was conducted from database inception to July 2025. Search terms included combinations of subject headings and keywords such as “histotripsy,” “mechanical ablation,” “ultrasound,” and “solid tumors.” Boolean operators and truncation were used to increase sensitivity. Peer-reviewed studies were included, encompassing preclinical, clinical, and review articles. Reference lists of relevant articles were examined to identify additional sources. Histotripsy has shown strong potential in the treatment of tumors involving the liver, pancreas, kidney, brain, and cardiovascular system. It offers real-time imaging guidance, sharp lesion boundaries, and minimal damage to surrounding structures. Early clinical trials have demonstrated encouraging safety and efficacy, particularly in liver and kidney tumors. Its ability to preserve critical anatomy and stimulate innate and adaptive immune responses through the release of cellular debris and cytokines offers advantages over thermal ablation. Limitations include acoustic aberration, motion-related targeting challenges, and the need for further long-term clinical data. Histotripsy represents a promising advancement in noninvasive tumor ablation. Continued clinical investigation and technological refinement are necessary to validate its therapeutic value and define its role within comprehensive cancer care. Full article

With continued improvements in systemic cancer therapies, there has been an increase in the survivorship of patients with spinal metastases. However, many patients with spinal metastases are frail and may not be able to tolerate the morbidity of open surgery. For these patients, percutaneous ablation techniques offer a minimally invasive approach that can facilitate local tumor control and pain relief. Here we describe the currently employed modalities—radiofrequency ablation (RFA), microwave ablation (MWA), cryoablation, and laser interstitial thermal therapy (LITT)—summarize the clinical support for their use, and overview the relative risks and benefits for each. All these technologies offer to help improve local tumor control and improve oncologic pain associated with vertebral metastases, and they have become a staple of multidisciplinary spine metastasis care at many centers. As clinical experience with these technologies continues to grow, their use will likely become more widely adopted, and so understanding of their indications, risks, and benefits will become increasingly important to the practicing spine oncologist. Full article

Histotripsy is a novel, noninvasive, non-thermal technology invented in 2004 for the precise destruction of biologic tissue. It offers a powerful alternative to more conventional thermal or surgical interventions. Using short-pulse, low-duty cycle ultrasonic waves, histotripsy creates cavitation bubble clouds that selectively and precisely destroy targeted tissue in a predefined volume while sparing critical structures like bile ducts, ureters, and blood vessels. Such precision is of value when treating tumors near vital structures. The FDA has cleared histotripsy for the treatment of all liver tumors. Major medical centers are currently spearheading clinical trials, and some institutions have already integrated the technology into patient care. Histotripsy is now being studied for a host of other cancers, including primary kidney and pancreatic tumors. Preclinical murine and porcine models have already revealed promising outcomes. One of histotripsy’s primary advantages is its non-thermal mechanical actuation. This feature allows it to circumvent the limitations of heat-based techniques, including the heat sink effect and unpredictable treatment margins near sensitive tissues. In addition to its non-invasive ablative capacities, it is being preliminarily explored for its potential to induce immunomodulation and promote abscopal inhibition of distant, untreated tumors through CD8+ T cell responses. Thus, it may provide a multilayered therapeutic effect in the treatment of cancer. Histotripsy has the potential to improve precision and outcomes across a multitude of specialties, from oncology to cardiovascular medicine. Continued trials are crucial to further expand its applications and validate its long-term efficacy. Due to the speed of recent developments, the goal of this review is to provide a comprehensive and updated overview of histotripsy. It will explore its physics-based mechanisms, differentiating it from similar technologies, discuss its clinical applications, and examine its advantages, limitations, and future. Full article

Despite advances in surgery, chemotherapy, and radiation treatments for pancreatic ductal adenocarcinoma (PDAC), 5-year survival rates remain at nearly 11%. Cholangiocarcinoma, while not as severe, also possesses similar survival rates. Fewer than 20% of patients are surgical candidates at time of diagnosis; therefore, it is imperative that alternative therapies are effective for non-surgical patients. There are several thermal ablative techniques, including radiofrequency ablation (RFA), high-intensity focused ultrasound (HIFU), microwave ablation (MWA), alcohol ablation, stereotactic body radiotherapy (SBRT), cryoablation, irreversible electroporation (IRE), biliary intraluminal brachytherapy, and biliary photodynamic therapy (PDT). Emerging literature in animal models and human patients has demonstrated that endoscopic ultrasound (EUS)-guided RFA (EUS-RFA) prevents tumor progression through coagulative necrosis, protein denaturation, and activation of anticancer immunity in local and distant tumor tissue (abscopal effect). RFA treatment has been shown to not only reduce tumor-associated immunosuppressive cells but also increase functional T cells in distant tumor cells not treated with RFA. The remarkable ability to reduce tumor progression and promote tumor microenvironment (TME) remodeling makes RFA a very promising non-surgical therapy technique that has the potential to reduce mortality in this patient population. EUS-RFA offers superior precision and safety compared to other ablation techniques for pancreatic and biliary cancers, due to real-time imaging capabilities and minimally invasive nature. Future research should focus on optimizing RFA protocols, exploring combination therapies with chemotherapy or immunotherapy, and expanding its use in patients with metastatic disease. This review article will explore the current data and underlying pathophysiology of EUS-RFA while also highlighting the role of ablative therapies as a whole in immune activation response. Full article

The production of Fiore Sardo cheese is regulated by the specification of the Protected Designation of Origin (PDO), which aims to guarantee the specific area of production, the know-how of local producers, and the specific use of raw milk from Sarda sheep. The thermization of milk is a sub-pasteurization process that is commonly used in cheese-making to lower the bacterial load and increase the shelf life of the product; it is therefore a cause of non-compliance with the PDO specification of Fiore Sardo cheese, allowing producers to gain practical and economic advantages. In this work, NIR spectroscopy coupled with multivariate discriminant analysis was used to identify the thermal treatment of milk in Fiore Sardo cheese samples. Cheeses were produced using raw milk (38 °C), low-thermized milk (57 °C for 30 s), and high-thermized milk (68 °C for 30 s). The NIR spectra of the cheeses were used to build discriminant models for individuating the thermal treatment of the processed milk. The obtained discriminant models were able to correctly classify about 90% of the Fiore Sardo cheese samples. This method could be suitable as a screening technique to authenticate Fiore Sardo PDO cheese. Full article

Ablative fractional CO₂ laser is an established tool for dermatologic and aesthetic indications. Non-ablative wavelengths, such as 1540 and 1570 nm, are increasingly being combined with CO₂ laser to optimise the results while reducing the recovery time. A narrative review of the literature was conducted, including ex vivo, in vivo, and in vitro studies, as well as human clinical trials that evaluated the efficacy, safety, and histological impact of dual-laser systems. Preclinical studies have shown that sequential application of fractional CO₂ followed by 1540/1570 nm expands the thermal coagulation zone without increasing the ablation depth. At the histological level, the dual protocol promotes collagen remodelling with greater thermal precision. On a clinical level, a combined treatment has shown efficacy in improving scars, striae distensae, skin laxity, and wrinkles, with reduced recovery times compared to CO₂ monotherapy. Preliminary data also suggest potential benefits in inflammatory conditions such as hidradenitis suppurativa. The sequential CO₂ + 1540/1570 nm combination represents an effective and well-tolerated approach in regenerative dermatology. Current evidence supports its use as a versatile, safe, and reproducible technique for skin rejuvenation and scar modulation; however, further comparative studies are needed to standardise protocols. Full article

This article aimed to incorporate the coordinated construction of classifiers to develop a model for predicting the pyrolysis of loose biomass. For the purposes of application, the ground form of pine cone was used to perform the thermogravimetric analysis at heating rates of 5, 10, and 15 °C∙min⁻¹. The supervised machine learning technique was considered to estimate the kinetic parameters associated with the thermal decomposition of the material. Here, the integral as well as differential form of the isoconversional method was used along with the Kissinger method for the maximum reaction rate determination. Python (version 3.13.2), along with PyCharm (2024.3.3) as an integrated development environment (IDE), was used to develop code for the given problem. The TG model obtained through the boosting technique provided the best fitting for the experimental dataset of raw pine cone, with the root squared error varying from ±1.82 × 10⁻³ to ±1.84 × 10⁻³, whereas it was in the range of ±1.78 × 10⁻³ to ±1.83 × 10⁻³ for processed pine cone. Similarly, the activation energies derived through the trained models of Friedman, OFW, and KAS were 176 kJ-mol⁻¹, 151.60 kJ-mol⁻¹, and 142.04 kJ-mol⁻¹, respectively, for raw pine cone. It was seen that the boosting technique did not provide a reasonable fit if the number of features was increased in the kinetic models. This happened owing to an inability to maintain a tradeoff between variance and bias. Moreover, the multiclassification in pyrolysis kinetics through the proposed scheme was not able to capture the distribution pattern of target values of the differential method. With the increase in the heating rates, the noise level in the predicted model was also relatively increased. Full article

Vanadium and oxygen form a complex system of vanadium oxides with multiple phases and mixed valency, increasing the difficulty of characterization. In this work, amorphous vanadium oxide thin films with mixed valence states were fabricated by atomic layer deposition, and then post-annealing was conducted for crystalline films. For the surface analysis of this mixed-valence system, X-ray photoelectron spectroscopy (XPS) and Auger electron spectroscopy (AES) were employed. However, XPS is only able to quasi-quantitatively determine the surface-proximity oxidation states. To account for the inadequacy of surface-sensitive XPS and AES techniques, a surface oxidation model (SOM) was proposed for the ellipsometric modeling of the mixed-valence system. Furthermore, by conducting air thermal oxidation (ATO) experiments, the four sets of fitting parameters of SOM were decreased to three, lowering the system complexity. This study is expected to help with the analysis of vanadium oxide mixed-valence systems and other multivalent metal oxide systems. Full article

The cornerstone of ablative therapy for atrial fibrillation (AF) is pulmonary vein isolation (PVI). Whether PVI should be added with additional lesions in persistent atrial fibrillation (PerAF) or for any post-ablative recurrent AF is a matter of debate. Whatever the ablative strategy, it must determine the choice of energy source to achieve the most durable lesion sets with the least likelihood of complications. Radiofrequency (RF) is the most studied thermal ablation technique. It can be combined with high-density electroanatomic mapping and can be used for both pulmonary and extrapulmonary atrial ablation. Cryoenergy is at least as effective as radiofrequency for PVI; it is rapid, relatively safe, and has a steep learning curve. Therefore, it has been proposed as a first-line approach for PVI-only procedures. More recently, a non-thermal technique based on the application of pulsed direct current (Pulsed Field Ablation—PFA) has been introduced. PFA causes cell death by opening cell membrane pores (electroporation) without a significant increase in tissue temperature. It is fast and does not alter the extracellular matrix as thermal techniques do, although it ends up causing long-lasting, transmural lesions. Most importantly, it is relatively selective on cardiac myocytes and therefore potentially safer than thermal techniques. Some PFA systems can be combined with electroanatomic mapping systems. However, as of now, it appears that these ablation technologies should be considered complementary rather than alternative for a number of practical and theoretical reasons. Full article

Wire and arc additive manufacturing (WAAM) stands out from other deposition techniques for being able to produce bigger parts and with higher deposition rates. However, due to the high thermal input, it is necessary to carefully select the deposition strategy and parameters to achieve good geometry, low defects and adequate mechanical properties. As a recent technology, different studies have been developed comprehending the deposition approach, aiming to achieve parts with specific characteristics, usually evaluating the geometry, microstructure and mechanical properties, such as yield and tensile strengths, residual stresses and microhardness; however, the last is usually presented by mean values, requiring more details to comprehend its behavior further. In this sense, this work aims to evaluate the microhardness variation on walls of ER70S-6 deposited by WAAM-CMT in detail, with different deposition strategies, unidirectional and bidirectional, and with and without interlayer temperature control. The wall’s geometry was also assessed in terms of height and width. The results showed that both bidirectional deposition and temperature control contributed to improving the wall’s geometry. Combining methods led to a 26% increase in the wall width and 9% in the height; combining both methods also led to a more homogeneous distribution of microhardness throughout the wall with less than 15 HV variation. For all the deposition strategies, the wall region influenced the microhardness, and relatively higher values were obtained on the upper region of the wall, followed by the central and lower regions. Full article

Aceclofenac (ACF), a non-steroidal anti-inflammatory drug, was obtained in its amorphous state by cooling from melt. The glass transition was investigated using dielectric and calorimetric techniques, namely, dielectric relaxation spectroscopy (DRS), thermally stimulated depolarization currents (TSDC), and conventional and temperature-modulated differential scanning calorimetry (DSC and TM-DSC). The dynamic behavior in both the glassy and supercooled liquid states revealed multiple relaxation processes. Well below the glass transition, DRS was able to resolve two secondary relaxations, γ and β, the latter of which was also detectable by TSDC. The kinetic parameters indicated that both processes are associated with localized motions within the molecule. The main (α) relaxation was clearly observed by DRS and TSDC, and results from both techniques confirmed a non-Arrhenian temperature dependence of the relaxation times. However, the glass transition temperature (T_g) extrapolated from DRS data significantly differed from that obtained via TSDC, which in turn showed reasonable agreement with the calorimetric T_g (T_g-DSC = 9.2 °C). The values of the fragility index calculated by the three experimental techniques converged in attributing the character of a moderately fragile glass former to ACF. Above the α relaxation, TSDC showed a well-defined peak. In DRS, after “removing” the high-conductivity contribution using ε’ derivative analysis, a peak with shape parameters α_HN = β_HN = 1 was also detected. The origin of these peaks, found in the full supercooled liquid state, has been discussed in the context of structural and dynamic heterogeneity. This is supported by significant differences observed between the FTIR spectra of the amorphous and crystalline samples, which are likely related to aggregation differences resulting from variations in the hydrogen bonds between the two phases. Additionally, the pronounced decoupling between translational and relaxational motions, as deduced from the low value of the fractional exponent x = 0.72, derived from the fractional Debye–Stokes–Einstein (FDSE) relationship, further supports this interpretation. Full article

The thermal characterisation and toxicity profile of a class of disubstituted heterofused triazinones were revealed in this article for the first time. The thermal behaviour of molecules 1–12 was investigated by means of TG and DSC analyses performed in an air atmosphere and by the coupled TG/FTIR technique in a nitrogen atmosphere. The heating atmosphere affects both the stability of compounds and the degradation mechanism. A two-step degradation occurs in air, while a one-step degradation takes place in nitrogen, both preceded by a melting process. Compound 3 shows the highest thermal stability, while molecule 10—the lowest. The thermal decomposition of the studied heterocyclic molecules begins with the degradation of the bicyclic system, resulting in the formation of volatile gaseous products such as ammonia/hydrazine, hydrogen cyanide, carbon dioxide, and isocyanates. In the further stage, mainly aromatic compounds are released, and their chemical composition depends on the presence and type of substituents at the phenyl and benzyl moieties. In addition, the toxicity profiles of molecules were assessed in the animal (zebrafish) and cellular (erythrocytes) models, and the antihaemolytic activity was evaluated in the AAPH- and H₂O₂-induced haemolysis inhibition assays. It was found that all the tested compounds are safe for the developing zebrafish and red blood cells, and they are able to effectively protect erythrocytes from oxidative damage. These favourable properties make them promising drug candidates suitable for further in vivo studies. Full article

An Energy Hub (EH) is able to manage several types of energy at the same time by aggregating resources, storage devices, and responsive loads. Therefore, it is expected that energy efficiency is high. Hence, the optimal operation for smart EHs in energy (gas, electrical, and thermal) networks is discussed in this study based on their contribution to reactive power, the energy market, and day-ahead reservations. This scheme is presented in a smart bi-level optimization. In the upper level, the equations of linearized optimal power flow are used to minimize energy losses in the presented energy networks. The lower level considers the maximization of profits of smart EHs in the mentioned markets; it is based on the EH operational model of resource, responsive load, and storage devices, as well as the formulation of the reserve and flexible constraints. This paper uses the “Karush–Kuhn–Tucker” method for single-level model extraction. An “unscented transformation technique” is then applied in order to model the uncertainties associated with energy price, renewable energy, load, and energy consumed in mobile storage. The participation of hubs in the mentioned markets to improve their economic status and the technical status of the networks, modeling of the flexibility of the hubs, and using the unscented transformation method to model uncertainties are the innovations of this article. Finally, the extracted numerical results indicate the proposed model’s potential to improve EHs’ economic and flexibility status and the energy network’s performance compared to their load flow studies. As a result, energy loss, voltage, and temperature drop as operation indices are improved by 14.5%, 48.2%, and 46.2% compared to the load flow studies, in the case of 100% EH flexibility and their optimal economic situation extraction. Full article

In reconstructive surgery, flaps are the cornerstone for repairing tissue defects, but postoperative monitoring of their viability remains a challenge. Among the imagistic techniques for monitoring flaps, the thermal camera has demonstrated its value as an efficient indirect method that is easy to use and easy to integrate into clinical practice. This provides a narrow color spectrum image that is amenable to the development of an artificial neural network in the context of current technological progress. In the present study, we introduce a novel attention-enhanced recurrent residual U-Net (AER2U-Net) model that is able to accurately segment flaps on thermographic images. This model was trained on a uniquely generated database of thermographic images obtained by monitoring 40 patients who required flap surgery. We compared the proposed AER2U-Net with several state-of-the-art neural networks used for multi-modal segmentation of medical images, all of which are based on the U-Net architecture (U-Net, R2U-Net, AttU-Net). Experimental results demonstrate that our model (AER2U-Net) achieves significantly better performance on our unique dataset compared to these existing U-Net variants, showing an accuracy of 0.87. This deep learning-based algorithm offers a non-invasive and precise method to monitor flap vitality and detect postoperative complications early, with further refinement needed to enhance its clinical applicability and effectiveness. Full article