Efficient data compression is crucial for reducing storage and transmission costs associated to vast volumes of nanopore raw sequencing data. Surpassing the state-of-the-art compression performance has been challenging, and all recent progress in this direction either incur a computational performance over-cost or resort to lossy compression schemes, which are not always desirable. In this article, we present PDZ, a lossless compression algorithm that outperforms VBZ, the current defacto standard, both in compression performance and computational efficiency. In our experimental evaluation, the compression ratio improvement ranges from 0.87% to 2.84% depending on the dataset, the compression speed is 1.09× to 2.25× faster depending on the hardware, and the decompression speed is 1.01× to 1.52× faster depending on the hardware. Compared to EX-ZD, a compression algorithm with similar compression performance, the speedup factor for both compression and decompression goes from approximately 1.39 × to 1.83 × , depending on the hardware. PDZ is implemented in C++ as a new compression method within the POD5 format. The source code is available as a fork of the open-source NanoporeTech library at https://github.com/Rafael-Cast/Piecewise-Differential-Zstd-Coder-POD5-Demo.
Reconstructing high-quality images under low bitrate conditions has long been a challenging task. Previous studies have made this task feasible by leveraging the prior knowledge of diffusion models. However, in image compression tasks, the diffusion model baseline fails to adequately integrate advanced semantic information, and the alignment between the diffusion priors and the learning objectives of the compressor is also lacking. To address this issue, we propose the Diffusion Prior Refinement for Efficient Low-rate Image Compression (DiRIC), an image compression scheme based on Stable Diffusion. DiRIC can efficiently encode low-level image information and achieve a highly realistic reconstruction of the original image by leveraging high-level semantic features and the prior knowledge inherent in diffusion models. Specifically, DiRIC employs a multi-feature compressor to represent crucial low-level information with ex tremely low bitrates; meanwhile, it acquires more robust hy brid semantics through a pre-embedding mechanism, providing abundant contextual support for the decoding end. Furthermore, we design a consistency skip module to enhance and refine the diffusion prior. To further improve decoding efficiency, we employ a noise-level estimator to reduce the number of sampling steps, aiming to achieve high-fidelity and efficient decoding. Extensive experimental results show that this method not only achieves the current state-of-the-art perceptual fidelity but also significantly outperforms previous perceptual image compression methods in terms of statistical fidelity. In comparison to SoTA diffusion baselines [1], we have achieved a 147.44% and 84.63% BD Rate improvement in terms of FID and PSNR, alongside a 19× increase in decoding speed.
Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting toxicity of taxane-based chemotherapy with limited preventive options. We evaluated whether dual-site mechanical compression during paclitaxel infusion reduces CIPN in women with gynecologic cancers. In this prospective, intraindividual, self-controlled study, patients receiving carboplatin-paclitaxel underwent compression of the nondominant hand (two surgical gloves) and ipsilateral lower limb (Class II stocking), while contralateral limbs served as controls. CIPN was assessed using CTCAE v5.0 and EORTC QLQ-CIPN20 at baseline, Cycle 3, end of treatment (EOT), and 3- and 6-month follow-up. Among 76 patients (median age, 61 years), moderate-to-severe CIPN was observed less frequently in compression limbs than in control limbs at Cycle 3 (35.5% vs. 53.9%; p = 0.001), EOT (59.2% vs. 69.7%; p = 0.021), 3 months (28.9% vs. 52.6%; p = 0.015), and 6 months (20.3% vs. 33.8%; p = 0.002). Repeated-measures analyzes showed significant time-by-limb interactions for sensory (p = 0.003), lower-extremity sensory (p = 0.018), and motor domains (p = 0.041). Sensory CIPN20 scores were lower in compression limbs in the upper extremities from EOT onward (7.5 vs. 10.2; p < 0.001) and in the lower extremities at 3-month (8.7 vs. 10.7; p < 0.001) and 6-month follow-up (7.0 vs. 10.0; p < 0.001). EORTC QLQ-CIPN20 sensory scores identified grade ≥ 2 neuropathy with AUC values > 0.92 at all time points. Dual-site mechanical compression was associated with reduced incidence and persistence of CIPN. As a low-cost and scalable intervention, this strategy may improve treatment tolerability and survivorship outcomes. Trial Registration: ClinicalTrials.gov identifier: NCT07105553.
Adenosine-induced transient cardiac asystole is used in intracranial aneurysm surgery to achieve flow arrest and facilitate clipping, particularly when proximal control is unavailable. Inadequate asystole duration or refractory responses can limit its utility, especially during intra-operative rupture. We describe a 48-year-old man with subarachnoid haemorrhage from a ruptured left supraclinoid internal carotid artery aneurysm and an unruptured right supraclinoid aneurysm. Both were approached via single left craniotomy. After uneventful clipping of the left aneurysm, clipping of the right aneurysm was attempted with 12 mg and 18 mg of adenosine, resulting in brief (8 s and 11 s, respectively) periods of asystole. During the rupture, carotid compression combined with 24 mg adenosine achieved asystole lasting 30 s with return of electrical activity only upon release of carotid compression, enabling safe clipping within 25 s of asystole onset. Hypotension persisted for an additional 60 s, after which the patient fully recovered. Combining mechanical carotid compression with adenosine synergistically prolonged asystole beyond that expected from adenosine alone, likely via enhanced parasympathetic effects on sino-atrial and atrioventricular nodes.
Although rare, dilation of the pulmonary artery, which can be present in patients with pulmonary arterial hypertension (PAH), can cause compression of the left main coronary artery (LMCA), leading to progressive dyspnoea, fatigue, syncope, and angina. Over time, this rare complication might lead to acute coronary syndrome. A 63-year-old White female with a background of systemic hypertension and mild obstructive sleep apnoea was admitted to the emergency unit because of gradually worsening shortness of breath and generalized weakness, without associated anginal symptoms. Blood gas evaluation demonstrated impaired oxygenation, with a partial pressure of oxygen of 6.8 kPa and an oxygen saturation of 87.9%. Transthoracic echocardiography demonstrated marked right ventricular strain along with features consistent with pulmonary arterial hypertension. A CT pulmonary angiographic study showed pronounced enlargement of the pulmonary trunk, measuring 62 mm in diameter. Subsequent coronary angiography combined with intravascular ultrasound identified greater than 50% narrowing of the left main coronary artery due to extrinsic compression, which was corroborated by dynamic CT imaging. The patient underwent IVUS-guided percutaneous revascularization of the left main coronary artery with placement of a drug-eluting stent. One week post-discharge, prior to additional diagnostic evaluation and management of pulmonary arterial hypertension, the patient reported significant symptomatic relief, with functional status improving from New York Heart Association (NYHA) class III to class II. This case underscores that extrinsic compression of the LMCA due to pulmonary artery dilatation warrants consideration as a potential aetiology of symptoms, even in the absence of angina.
A 7-year-old male intact German shorthaired pointer was referred to a board-certified veterinary neurologist for further evaluation of a chronic (> 6 months) history of gradually progressive paraparesis, limp tail, and spinal pain despite medical management of these clinical signs and presumptive neurologic disease with the family veterinarian. Radiographs revealed evidence of intervertebral disc space collapse, endplate sclerosis, and bridging spondylosis at L7-S1, and the patient was presumptively diagnosed with degenerative lumbosacral stenosis (DLSS). Initial medical management included oral analgesics, oral anti-inflammatories, lifestyle changes, and epidural steroid injections. Ultimately, progression of the patient's clinical signs resulted in referral to a board-certified veterinary neurologist. Magnetic resonance imaging revealed marked bilateral L7 nerve root enlargement with L7-S1 foraminal widening and concurrent L7-S1 intervertebral disc extrusion, causing moderate to severe left-sided compression of the cauda equina. Given the marked changes of nerve roots on imaging and foraminal widening, consideration was given to a neoplastic process versus inflammatory neuritis. A lumbosacral dorsal laminectomy, partial discectomy, and left L7 nerve biopsy were performed. Histopathology of the L7 nerve root revealed chronic neural fibrosis with atrophy and mild neuritis, consistent with the chronic, progressive nature of the patient's clinical signs and severe compression of the cauda equina. These dramatic and irreversible changes may have been avoidable or at least minimized with earlier diagnosis and aggressive surgical intervention, highlighting the importance of developing standardized, evidence-based recommendations for management of dogs with DLSS similar to the framework that exists in human intervention for treatment of cauda equina syndrome (CES).
This study aims to experimentally investigate the performance, combustion, emissions, and vibration characteristics of a single-cylinder, four-stroke, water-cooled variable compression ratio (VCR) diesel engine fueled with diesel and Karanja biodiesel blends (B20 and B30). Experiments were conducted under varying engine load, compression ratio (CR), and hot exhaust gas recirculation (EGR-HOT) conditions. Engine vibration was evaluated using root mean square acceleration (RMS Accel), and a novel integrated approach was adopted to correlate vibration behavior with performance and emission characteristics. The results show that vibration increases with engine load but decreases with higher compression ratios, while under EGR conditions it initially decreases and then rises at higher rates. The results show that vibration increases with engine load but decreases with higher compression ratios, while under EGR-HOT conditions it initially decreases and then rises at higher rates. Compared to diesel, RMS acceleration decreased by 4.3 and 8.49% under load variation, 3.01 and 7.18% under CR variation, and 2.66 and 6.75% under EGR-HOT conditions for B20 and B30, respectively. Emission analysis revealed reductions of 13.3% in hydrocarbon (HC), 6.58% in carbon monoxide (CO), and 17.98% in smoke opacity for B30, although nitric oxide (Nox) increased by 15.8% as compared to diesel. Combustion analysis indicated a 3.43% increase in maximum cylinder pressure (CPMax) and a 14.94% decrease in net heat release (NHR). In terms of performance, brake thermal efficiency (BTHE) decreased by 10.74%, while brake-specific fuel consumption (BSFC) increased by 18.52%. Overall, the study demonstrates that biodiesel blends improve emission and vibration characteristics but slightly compromise performance, while the integrated analysis provides deeper insight into combustion behavior and engine condition.
Cauda equina syndrome (CES) is an uncommon but severe neurological condition resulting from compression of the lumbosacral nerve roots, leading to motor, sensory, and autonomic dysfunction. Despite its low incidence, CES carries a high risk of permanent disability and medico-legal consequences due to the narrow therapeutic window for intervention. This narrative review synthesizes current evidence on the anatomical basis, pathophysiology, etiology, clinical presentation, diagnostic pathways, classification systems, and management strategies for CES. Particular emphasis is placed on the prognostic distinction between incomplete CES (CES-I) and CES with urinary retention (CES-R), as well as the ongoing debate surrounding the optimal timing of surgical decompression. Long-term outcomes, rehabilitation principles, and emerging neuroprotective strategies are also discussed. Early recognition, prompt imaging, and urgent decompression remain central to improving neurological recovery and quality of life in affected patients.
Thoracic spinal tuberculosis (TSTB) can lead to vertebral destruction, spinal instability, and neurological deficits. Paraplegia is one of its most severe manifestations, yet a concise and clinically interpretable framework for assessing neurological severity at presentation remains lacking. We retrospectively reviewed 148 patients with thoracic spinal tuberculosis who underwent surgery at a tertiary referral centre between 2019 and 2024. Clinical, laboratory, and imaging variables associated with paraplegia at presentation were evaluated using logistic regression analysis. A clinical-imaging severity stratification framework was subsequently developed using routinely available preoperative variables. Model discrimination and calibration were assessed using receiver operating characteristic analysis and bootstrap resampling, and LASSO regression was performed as a sensitivity analysis. Among 148 patients, 54 (36.5%) presented with paraplegia. In complete-case multivariable analysis (n = 113), lower body mass index (BMI) (OR 0.79, 95% CI 0.67-0.92; P = 0.004), longer duration of neurological impairment (OR 1.06 per week, 95% CI 1.01-1.11; P = 0.010), and higher compression grade (OR 2.47, 95% CI 1.50-4.07; P < 0.001) were independently associated with paraplegia. A framework incorporating age, BMI, duration of neurological impairment, and compression grade demonstrated acceptable discrimination (AUC 0.903, 95% CI 0.85-0.96) and calibration within the development cohort. Internal validation showed generally consistent performance. In surgically treated patients with thoracic spinal tuberculosis, prolonged neurological symptom duration, greater compression severity, and lower BMI were independently associated with paraplegia at presentation. The proposed framework, based on routinely available variables, may support structured assessment of neurological severity in patients with thoracic spinal tuberculosis.
Seat cushion materials affect the mechanical demands of sit-to-stand (STS) movements; however, the effects of specific material properties, such as resilience and hardness, remain unclear. Understanding how these factors influence lower-limb joint moments and movement strategies during STS may contribute to the development of seat designs that assist individuals with reduced lower-limb strength. Therefore, this study aimed to clarify the fundamental mechanical effects of seat cushion resilience and hardness on STS. Fifteen healthy young adults performed STS from five polyurethane foam cushions that differed in resilience (14-55%) and 40% compression hardness (66-336 N). The material ranges were determined with reference to technical documents and a published patent specification to ensure they were within the range commonly used in everyday seating products. Kinematic and kinetic data were collected using a motion capture system and two force plates. Net joint moments were calculated via inverse dynamics, and differences among seat conditions were analyzed using repeated-measures ANOVA or the Friedman test, with Bonferroni-adjusted pairwise comparisons (α = 0.05). Seat resilience significantly affected the peak hip and knee extensor moments (p < 0.01, η² = 0.35-0.48). High-resilience cushions delayed seat-off timing and maintained greater seat reaction force at the timings of peak hip and knee extensor moments. In contrast, seat hardness mainly influenced horizontal center-of-mass (COM) velocity and hip joint moment (p < 0.01, η² = 0.31-0.37), with softer seats producing larger values. High-resilience cushions delayed seat-off and maintained buttock support for a longer duration, thereby reducing the peak hip and knee extensor moments. In contrast, softer seats promoted a strategy involving greater horizontal momentum generation by the upper body, which consequently required an increased hip extensor moment to decelerate this momentum. Cushions with a resilience of ≥ 53% and 40% compression hardness of ≥ 180 N effectively reduced lower-limb joint loading. The results of this study provide fundamental insights that may contribute to future research on chair design and cushion selection in clinical and caregiving environments. Not applicable.
Immobilized neurosurgical patients are at high risk for deep vein thrombosis (DVT). While routine prophylaxis exists, a systematic, nurse-led bundle of care may offer a more comprehensive and effective approach to prevention. To evaluate the effectiveness of a nurse-led, multifaceted bundled care intervention on the incidence of DVT, patient compliance, and clinical outcomes in immobilized neurosurgical patients. This quasi-experimental study with a historical control group was conducted in the Department of Neurosurgery, Xichang People's Hospital. Adult neurosurgical patients requiring immobilization for at least 72 h were enrolled. The control group (n = 1,163, recruited January 2021-September 2022) received standard neurosurgical care. The intervention group (n = 1,625, recruited January 2023-December 2024) received a nurse-led bundled care protocol consisting of: (1) dynamic Caprini risk assessment; (2) standardized mechanical prophylaxis with graduated compression stockings (GCS) and intermittent pneumatic compression (IPC); (3) structured health education; and (4) individualized early mobilization. The primary outcome was symptomatic ultrasound-confirmed DVT incidence. Secondary outcomes included compliance, DVT-related knowledge, limb circumference difference, pain scores (Visual Analogue Scale, VAS), and patient satisfaction. Multivariable logistic regression was used to adjust for potential confounders. Baseline characteristics were comparable between groups. The incidence of DVT was significantly lower in the intervention group (1.66% vs. 2.75%, p = 0.041). Intervention group patients demonstrated significantly higher compliance with GCS/IPC use (76.5% vs. 58.1%, p < 0.001) and early mobilization (72.1% vs. 51.5%, p < 0.001), as well as significantly greater DVT-related knowledge (85.2 ± 8.5 vs. 62.1 ± 10.2, p < 0.001). The intervention group showed significantly greater reduction in limb circumference difference (1.2 ± 0.8 cm vs. 2.1 ± 1.1 cm, p < 0.001) and lower pain scores (2.3 ± 1.2 vs. 4.1 ± 1.6, p < 0.001). Patient satisfaction was significantly higher in the intervention group (94.1 ± 3.3 vs. 85.6 ± 4.8, p < 0.001). Pulmonary embolism (PE) incidence was low in both groups (0.12% vs. 0.17%, p = 0.715). After adjustment for age, sex, diagnosis, type of surgery, Caprini score, pharmacological prophylaxis, and calendar year, the intervention remained independently associated with lower DVT risk (adjusted OR = 0.54, 95% CI 0.32-0.92, p = 0.023). This nurse-led bundled care intervention was associated with a significantly lower DVT incidence and improved clinical outcomes in immobilized neurosurgical patients. The protocol's structured, evidence-based approach provides a practical model for VTE prevention in neurosurgical settings.
Aging is known to influence recovery following spinal cord injury (SCI) however its specific impact on locomotor outcomes remains underexplored. Understanding these age-related differences is critical for developing targeted rehabilitation strategies and improving the translational relevance of SCI research. This systematic review aimed to evaluate the effect of aging on locomotor recovery in animal models of traumatic SCI. A systematic search of MEDLINE and Embase was conducted to identify studies assessing the impact of aging on post-SCI locomotor outcomes. Inclusion criteria encompassed preclinical studies comparing locomotor recovery between young and aged animals following SCI. Extracted data included sample characteristics, SCI model, locomotor outcome measures, timing of evaluation, and key findings. Risk of bias was assessed using the SYRCLE checklist. Of 3,118 unique records screened, nine studies met inclusion criteria. Included animals were grouped into young (mean 2.5 months), intermediate (mean 11.4 months), and aged (mean 21.5 months) categories, with individual ages ranging from 4 weeks to 28 months. Six studies used rats and three studies used mice. In total, more than 340 animals were studied. SCI models included cord contusion (6/9, 66.7%), hemisection (2/9, 22.2%), and clip compression (1/9, 11.1%). Seven (7/9, 77.8%) studies employed the Basso, Beattie, Bresnahan (BBB) locomotor score as the primary outcome measure. Older animals demonstrated significantly lower BBB scores post-injury compared to younger counterparts in 100% (7/7) of studies using this outcome. Other measures of locomotor outcomes included the Basso Mouse Scale, CatWalk, and Digigait. Notably, one study reported that pre-injury and post-injury exercise improved locomotor recovery in aged rats to levels comparable with young rats. Aging is associated with poorer locomotor recovery following traumatic SCI in preclinical models. These findings underscore the importance of age as a biological variable in SCI research and suggest that rehabilitative interventions, such as exercise, may have potential to mitigate age-related deficits. Future studies should seek to define the mechanistic pathways underlying impaired recovery with age and evaluate targeted therapies that enhance neuroplasticity and functional recovery. https://www.crd.york.ac.uk/PROSPERO/view/CRD42022230021.
• Abnormal PV Doppler flow can be the first clue to extracardiac disease. • Routine PV assessment should be part of every comprehensive TEE. • TEE can detect thoracic pathology not directly related to the primary cardiac indication. • Small cell carcinoma may present with PV compression and Doppler turbulence. [Figure: see text]
Literature values of disjoining pressure in liquid nanofilms from different molecular simulation methods show significant discrepancies. We demonstrate that these arise from neglecting long-range dispersion interactions and inconsistent definitions of film thickness in the original Peng method. A key insight is that long-range dispersion affects surface tension in a thickness-dependent manner, increasing it at large thickness but suppressing its enhancement at small thickness due to disjoining-pressure-induced normal compression and lateral expansion. This even gives rise to a crossover behavior in the surface tension of water nanofilms simulated with the flexible SPC/E potential, although the crossover is not clearly observed in the rigid SPC/E and TIP4P/2005 models at the same temperature. Since disjoining pressure is obtained from the derivative of surface tension with respect to thickness, this nontrivial dependence strongly impacts its accuracy. With proper treatment of dispersion interactions and a consistent thickness definition, the revised Peng method agrees with the Bhatt method and yields more accurate Hamaker constants.
IgA multiple myeloma can present with atypical and misleading clinical features, delaying diagnosis when more common conditions dominate the initial presentation. We report the case of a 50-year-old male with a history of recurrent gastrointestinal bleeding who presented with severe symptomatic anemia requiring transfusion. Initial evaluation focused on suspected acute blood loss; however, persistent cytopenias and markedly elevated total protein with a preserved albumin level raised concern for an underlying systemic process. Further laboratory evaluation revealed a significant globulin gap, with total protein levels exceeding 10 g/dL and markedly elevated immunoglobulin A (IgA) at 6,318 mg/dL. Serum free light chain analysis demonstrated elevated kappa chains with a profoundly abnormal kappa/lambda ratio. Imaging studies identified multiple vertebral compression fractures and diffuse osteopenia, while endoscopic evaluation revealed severe esophagitis without active bleeding to fully account for the degree of anemia. Bone marrow biopsy confirmed clonal plasma cell proliferation consistent with IgA multiple myeloma. This case underscores the diagnostic importance of recognizing hyperproteinemia and the globulin gap as early indicators of plasma cell dyscrasia, particularly in patients with competing clinical diagnoses such as gastrointestinal bleeding. It further highlights how multiple myeloma may present without classic features such as renal dysfunction or hypercalcemia, instead manifesting through indirect findings, including skeletal fragility and unexplained cytopenias. Early recognition of these subtle but critical clues can facilitate timely diagnosis and initiation of therapy, ultimately improving patient outcomes.
Intermetallics are highly attractive for their exceptional strength and high melting points, offering significant potential as advanced structural materials. However, their inherent brittleness at room temperature severely limits practical applications. In this work, we introduce a structure of framework of amorphous interfaces (FAIs) and preexisting dislocations into nanocrystalline (NC) CoAl intermetallics to synergistically enhance both strength and plasticity. Micropillar compression tests reveal a high yield strength exceeding 6 gigapascals, a sustained work hardening to approximately 8.5 gigapascals, and a compressive plastic strain exceeding 15%. The FAIs accommodate the plastic deformation of NC CoAl grains, preventing intergranular fracture while promoting dislocation emission and propagation into CoAl through deformation-induced crystallization. Molecular dynamics (MD) simulations confirm that dislocations are emitted from crystalized regions (BCC-like local motifs) and reveal that preexisting dislocations impede dislocation motion via interactions and multiplication, promoting dislocation storage. Together, these mechanisms enable enhanced work hardening and large plasticity. This strategy offers an approach to achieving room temperature plasticity in brittle materials, which often show limited dislocation activity.
Geotechnical construction activities, such as shield tunneling and pile foundation construction, generate large amounts of high-water-content waste slurry, making its disposal and resource utilization challenging. This paper introduces a CO2-foamed carbonation solidification technique using a composite binder system made of reactive magnesium oxide (MgO), slag, and calcium carbide slag. The mechanical behavior of the lightweight carbonated slurry was investigated through Unconsolidated Undrained (UU) triaxial compression tests under various confining pressures. Quantitative results indicate that the reactive MgO dosage significantly governs strength evolution; an optimum MgO dosage of 10% yielded the highest peak stress of 190.8 kPa (at 50 kPa confining pressure), while the softening coefficient peaked at 0.46 with a 13% dosage. Regarding the CO2 foam impact, varying the foam content from 36% to 52% resulted in softening coefficients ranging between 0.20 and 0.50. The 36% foam dosage provided the optimal structural stability with a peak stress of 179 kPa, whereas excessive foam leads to greater pore connectivity, worsening strain-softening. Confining pressure significantly affects the material's hardening and residual strength. Based on these findings, an improved constitutive model was developed using damage evolution and a modified Duncan-Chang framework, providing accurate descriptions of the material's elastic, hardening, post-peak softening, and residual characteristics. This study advances our understanding of CO2-foamed carbonated MgO-based slurry, offering new insights for both solidification/stabilization and carbon sequestration of high-water-content waste slurry.
Median arcuate ligament syndrome (MALS) is an uncommon condition characterized by chronic and intermittent abdominal pain, typically postprandial, and weight loss, caused by extrinsic compression of the celiac trunk by the median arcuate ligament. The pathophysiology of the disease is not fully understood. Diagnosis is challenging due to nonspecific symptoms, and requires a careful correlation between clinical findings and imaging studies. To demonstrate the feasibility, safety, and technical aspects of robotic median arcuate ligament release using a case-based approach with detailed imaging correlation. The authors report the technical aspects in an elderly male patient with typical symptoms of MALS, who underwent robotic-assisted median arcuate ligament release using the da Vinci X platform. Preoperative evaluation included CT angiography and color Doppler ultrasound, demonstrating focal proximal celiac trunk stenosis. The robotic approach allowed precise dissection and complete decompression of the celiac trunk without intraoperative complications. Postoperative imaging demonstrated resolution of the stenosis and normalization of Doppler flow parameters. The patient experienced complete symptom resolution, and remained asymptomatic after one year of follow-up. Robotic median arcuate ligament release is a safe and effective minimally invasive option, providing excellent visualization and precise dissection in a challenging anatomical region. This technique should be considered a valuable approach for selected patients with MALS. Robotic surgery, due to the surgeon's ergonomics and the stability of the arms and instruments, wrist movement, and magnified threedimensional vision, allows for facilitated and safe access to the origin of the celiac artery as well as the dissection of fibrous tissues, innervation, and lymphatic vessels surrounding it. Given this, robotic surgery becomes feasible, effective, and safe for treating this syndrome, and it should be considered a preferred option in selected patients. The median arcuate ligament syndrome should be considered in cases of abdominal pain with no defined causes. A high index of suspicion can diagnose and treat more cases. Moreover, it is expected that robotic surgery will become increasingly accessible, allowing for an expansion of its indications. A síndrome do ligamento arqueado mediano (SLAM) é uma condição incomum caracterizada por dor abdominal crônica e intermitente, tipicamente pós-prandial, com perda de peso, causada pela compressão extrínseca do tronco celíaco pelo ligamento arqueado mediano. A fisiopatologia da doença não é totalmente compreendida. O diagnóstico é desafiador devido aos sintomas inespecíficos e requer uma correlação cuidadosa entre os achados clínicos e os exames de imagem. Demonstrar a viabilidade, segurança e aspectos técnicos da liberação robótica do ligamento arqueado mediano utilizando uma abordagem baseada em casos clínicos com correlação detalhada por imagem. Os autores relatam os aspectos técniocos em um paciente idoso do sexo masculino com sintomas típicos de SLAM foi submetido à liberação robótica do ligamento arqueado mediano utilizando a plataforma da Vinci X. A avaliação pré-operatória incluiu angiotomografia computadorizada e a ultrassonografia Doppler colorida, demonstrando estenose focal proximal do tronco celíaco. A abordagem robótica permitiu a dissecção precisa e a descompressão completa do tronco celíaco sem complicações intraoperatórias. Os exames de imagem pós-operatórios demonstraram a resolução da estenose e a normalização dos parâmetros de fluxo Doppler. O paciente apresentou resolução completa dos sintomas e permaneceu assintomático, após um ano de acompanhamento. A liberação robótica do ligamento arqueado mediano é uma opção minimamente invasiva segura e eficaz, proporcionando excelente visualização e dissecção precisa em uma região anatômica complexa. Essa técnica deve ser considerada uma abordagem valiosa para pacientes selecionados, com síndrome do ligamento arqueado mediano.
Controllably achieving multicolor emission from single-molecule-based organic solids is of great significance, yet it remains a challenge because of the inherent complexity of molecular packing motifs. Herein, multicolor emission is governed by tailoring the geometries of π-π dimers. Using perylene (PE) as a planar π-fluorophore, we strategically design a compound, 3-(4-(1,2,2-triphenylvinyl)phenyl)perylene (pTPE-PE), which integrates a tetraphenyl ethylene (TPE) substituent with multiple rotatable phenyl rings to modulate the PE-based π-π dimer formation. On the one hand, pTPE-PE crystallization produces four polymorphs exhibiting green, yellow, orange, and red emission color, which are static presentations of the dimer model. This static multicolor emission is directly linked to π-π interactions within the dimers: a smaller interplanar distance and a larger overlap ratio between π-π PE units result in more strengthened interactions and more red-shifted emission. On the other hand, the observed multicolor transitions under pressure (yellow → orange → red) via dimer compression and thermal stimuli (sky-blue → green → orange) through dimer (dis)assembly provide dynamic presentation of the dimer model. Consequently, polymorphism/piezochromism/thermochromism not only provides direct experimental evidence for exciton modulation from the perspective of the simplest supramolecular dimer model, but also offers insights for designing intelligent optical materials.
The advancement of modern electronic devices toward lightweighting, high-frequency, and integrated designs has escalated the demand for multifunctional materials that can combine microwave and thermal management capabilities with mechanical load-bearing capacity. However, inherent trade-offs exist between electrical conductivity and thermal insulation, as well as between mechanical strength and lightweight properties. Herein, attempts have been made to innovatively embed lightweight, high-strength dielectric shells and highly conductive, low-infrared-emissivity metallic shells into hollow structure design. Specifically, heterogeneous dual-shell hollow microspheres (DSHM) were constructed using glass as the model dielectric material and copper as the conductive material. By optimizing the ratio of dielectric-to-conductive phases, the shell microstructure, and macroscopic structural parameters, we achieved a synergistic combination of lightweight and high strength (density: 0.4456-1.0991 g cm- 3, survival rate under 2 MPa uniaxial compression: 87.1%. Crucially, leveraging the distinct structural dependence of conductive and thermal networks, the integration of low thermal conductivity (0.1134-0.1478 W m- 1 K- 1) with broadly tunable electrical conductivity (299.6-2625.7 S cm- 1) and infrared emissivity (0.218-0.493) in a single microsphere was achieved for the first time. These properties endow the hollow microspheres with exceptional microwave attenuation and thermal regulation performance.