This study aimed to systematically evaluate the risk factors associated with the failure of separated instrument removal. A comprehensive search of PubMed, Embase and the Cochrane Library was performed to identify studies reporting on the success rates of separated instrument removal, covering the period from 1988 to 2025. The meta-analysis was performed using Stata 17.0. Seven studies encompassing 922 patients with separated instruments were included. The pooled success rate of separated instrument removal was 66%. Meta-analysis identified several significant risk factors for removal failure: instrument location in posterior teeth, mandibular teeth, the apical third of the canal, the apical side of a curved canal, and root curvature exceeding 30°. Current evidence indicates that unfavourable anatomical factors significantly increase the likelihood of failed instrument retrieval. These findings underscore the importance of preoperative assessment and careful case selection when planning separated instrument removal procedures.

Deep brain stimulation (DBS) is a widely used treatment for movement disorders. While bilateral implantation is common, whether to implant electrodes in separate (staged) procedures or in a single (simultaneous) session remains debated. In this retrospective matched cohort study, 252 patients who underwent staged bilateral DBS were propensity matched to 252 who underwent simultaneous procedures (n = 504) based on age, sex, and diagnosis. Demographic, clinical, and operative data were extracted from the electronic medical record. Staged patients were older (71.7 ± 6.4 vs 65.6 ± 6.9 years, P < .0001) and had lower body mass index (27.4 ± 5.4 vs 29.1 ± 6.5 kg/m2, P = .003). Parkinson's disease predominated in staged cases (54%) and essential tremor in simultaneous (69%) (P < .001); dystonia was rare and similarly distributed (P = .261). DBS targets differed: subthalamic nucleus and globus pallidus internus were more common in staged cases and ventral intermediate nucleus in simultaneous (P < .0001). Sex, race, American Society of Anesthesiologists status classification system scores, and major comorbidities were similar (P > .05). Staged DBS was associated with greater anesthesia utilization, operating room time, and hospital days (all P < .0001). After adjustment for covariates, there were no significant differences in intraoperative complications, postoperative complications, postoperative delirium, 30-day readmissions, medication dose reduction at 1 year, or reoperation within 5 years (odds ratios 0.81-1.44, all P > .5). Staged and simultaneous bilateral DBS yield similar clinical outcomes; however, staged procedures require significantly greater resource utilization and subject patients to a more prolonged treatment course.

Determination of ultra-trace rare earth elements in urine samples by photo-Fenton-coprecipitation-plasma mass spectrometry.

Speciation analysis of 129I in spent nuclear fuel solutions.

Optical tweezers technology has the characteristics of non-contact manipulation in three-dimensions and steerable separation in solutions, and could be applied to obtain a separated sperm with high quality for intracytoplasmic sperm injection (ICSI). However, the effects of optical tweezers on sperm motility are still unclear. To elucidate the effects on sperm motility for optical tweezers, we systematically investigated the correlation between motility parameters and the parameters of optical tweezers (wavelength, power, trapping duration, and trapping orientation). Under three systems of optical tweezers with different laser wavelengths (1064 nm, 850 nm, and 785 nm), the nine motility parameters of free swimming mainly affected by trapping orientation (vertical/horizontal) and trapping duration. When 850-nm laser and 1064-nm laser are used, vertical trapping significantly reduces sperm free-swimming capability with prolonged exposure time, whereas horizontal trapping exhibits relatively minor interference on sperm motility. Notably, the 785-nm laser does not induce statistically significant changes in key parameters of sperm motility under any experimental conditions (trapping orientation and duration). For the rolling frequency of trapped sperm, horizontal trapping for three wavelengths has neglectful effect compared with vertical trapping, especially for 785-nm laser. In conclusion, horizontal trapping can preserve sperm motility under low power (below 140 mW@1064 nm, below 100 mW @850 nm, below 60mW @ 785 nm) and short duration (below 4 minutes). This trapping duration is sufficient for separation procedure of single live sperm in ICSI. This study provides critical parameter optimization guidelines for the safe application of optical tweezers technology in reproductive medicine.

This study addresses the issue of adapting the thermal drilling process for joining dissimilar thin-walled materials—sheets made of non-ferrous metal alloys and polymer composites with a thermoplastic matrix reinforced with glass and carbon fibers—without the use of connecting elements and without disrupting the continuity of the reinforcing fibers. An extensive metallographic study was conducted on bushings formed in thin metal sheets made of EN AW 6082 T6 aluminum alloy and AZ91 magnesium alloy obtained during separate drilling procedures. Experiments were also performed where the metal sheet and composite material overlapped, using both direct and sequential drilling above the melting point of the polymer matrix, applying various process parameters. The dimensions of the resulting bushings and the suitability of their profile for joining with composites were evaluated. The results suggest the possibility of joining metals and fiber composites through thermal drilling, and suitable joining process parameters and conditions are specified. To limit composite delamination, it is advisable to make a hem flange on the reverse side of the joints. CT scans confirmed the deflection of fibers around the hole in the composite without compromising their integrity. The load-bearing capacity of the joints and the possibility of creating hybrid mechanical–adhesive joints between these materials are the subject of Part Two of this study.

The present paper aims to provide an analysis of the effect of the border, the social practices related to it and their consequences on the ethnic and national identification and categorization mechanisms that exist within the two biggest communities living in Transylvania. The paper examines the manners of crossing the border in any direction in the case of the Hungarian and Romanian speakers residing in Transylvania, inquires into the distinction and separation procedures as regards the existing borders and into the cultural consequences of travelling across the border. We use the following research questions to develop this study: What kind of identity categories appear when crossing the border? What types of transnational discourses of power are evoked that may qualify the Romanian speakers at the border crossing? What is the message that reaches the Hungarian speakers during the border crossing experiences? Can we identify any hybridization in the border zone of Transylvania?

The concept of servicing maintenance implies implementation of routine technical inspection, checkup and carrying out of repair work applying spare parts and accessories. In conditions of increasing sanctions pressure, organization of supplies of component parts and accessories became complicated. As a result, delivery time and cost of such component parts increased. Because of the fact that most of medical equipment on balance sheet of medical institutions is imported, current situation affected process of servicing maintenance of medical equipment used in routine medical services in hospitals and polyclinics. Actually, main regulations of technical servicing of medical devices are established by single state standard specifying category of medical device that includes such types of goods as medical technique and medical equipment. Along with this, above-mentioned document contains enumeration of works related to servicing maintenance: unscheduled and periodic technical maintenance and diagnostics, control of technical condition, installation, dismantling, tooling, repair work. From numbered enumeration of realizing works follows that their implementation requires usage of complementary depot units and accessories, which, according to requirements of legislation in action, are to be provided from foreign builder. Consequently, such an order, in view of established circumstances, is significantly burdened by measures of sanctions impact. Whereas, vast majority of different medical institutions run into problems of organization of servicing maintenance of medical equipment on the balance sheet. Such a situation requires permission at legislative level, since at present time carrying out servicing maintenance is allowed only with consideration of usage of original components. Therefore, establishment of separate procedure of usage of analog component parts would be a constructive solution of revealed problematic aspect.

Weaning represents a major developmental milestone for foals, especially when 4- to 7-month-old foals are abruptly separated from their dams. Studies have shown that the post-weaning period is associated with physiological and psychological stress, which may affect immune function. The present study aimed to describe and analyze the pattern of blood inflammatory biomarkers related to the innate immune system. A gradual foal-dam separation procedure was chosen, which included post-weaning social buffering by a familiar adult horse. Twelve Thoroughbred foals (six fillies, six colts) aged 4-6 months were enrolled and divided into a colt and a filly group, and after weaning, were kept as such. Blood samples were collected before and up to 7 days after weaning. Serum cortisol and cytokines (IL-2, IL-6, IL-10, TNF-α, IFN-γ) were quantified using equine-specific ELISA kits. Routine descriptive statistics were used to present the data, and inferences were drawn using a two-way repeated measures ANOVA. The level of significance was set at p < 0.05. Results showed significant differences in the concentrations of IL-10 (p < 0.001), IFN-γ (p < 0.01), and TNF-α (p < 0.01) on various days post-weaning. An apparent significant sex effect was not shown, but IL-10 peaked on day 3 in fillies. IFN-γ decreased significantly by day 5 in both sexes. Conversely, TNF-α levels increased significantly by day 5. No significant changes were observed for cortisol.

Development of non-carrier added Au-199 production procedure from neutron-irradiated Pt targets.

Separation of terbium from proton-irradiated gadolinium oxide targets - development of an effective, scalable and automatable process.

The key stage of processing high-cellulose hemp raw materials is delignification—the removal of lignin and hemicelluloses to obtain strong cellulose fibers. This study experimentally demonstrated the effectiveness of using the electrohydraulic effect (EHE) to delignify high-cellulose hemp raw material, which can then be used as a base for composite materials. Hemp raw material, in the form of 50 mm-long straws, was placed in a water-filled chamber and exposed to a shock wave generated in the water by an electric discharge with an energy of 1.6 kJ at a voltage of 50 kV. The tensile strength of the treated fibers after combined processing (NaOH/EHE) and after EHE reached 262 MPa and 201 MPa, correspondingly, which are 5% and 37% higher than after chemical delignification in a NaOH medium (191 MPa). Cellulose materials obtained from cellulose fiber after EHE exhibit higher strength properties compared to materials based on cellulose obtained by delignification in a NaOH medium. Thus, the tensile strength (σ) of materials made from fibers after EHE was 4.37 MPa, after combined NaOH/EHE treatment 1.94 MPa, and after alkaline treatment 3.95 MPa. EHE reduced delignification time by 2–20 times compared to NaOH treatment and eliminates the need for an additional fiber separation procedure. The use of EHE is proposed as a highly cost-effective, technologically and environmentally sound solution for producing hemp fiber for use in biocomposites, woven, and non-woven materials.

For commercial lithium-ion batteries (LIBs), safety is a top priority, as it directly affects reliability. However, LIB performance inevitably degrades over time due to factors such as electrode aging and electrolyte decomposition, which can lead to safety issues. Therefore, accurate diagnosis of these changes is crucial for ensuring long-term stability. Traditionally, measuring ohmic (Rohm ), charge transfer (Rct ), and diffusion resistance (Rdiff ) requires separate experimental procedures, making the diagnostic process cumbersome. In contrast, Electrochemical Impedance Spectroscopy (EIS), which utilizes an AC current to induce small perturbations, enables simultaneous acquisition and separation of these electrochemical processes within a single measurement. [1] In this study, we developed a physics-based EIS model for LIBs using the P2D framework [2,3], allowing extraction of key internal physical parameters from each process (e.g., I0*, Cdl*, Kel*, Del*, Ds*, Av*). Additionally, we further incorporated the Distribution of Relaxation Times (DRT)[4] for charge transfer processes and the Distribution of Diffusion Times (DDT)[5] for mass transport phenomena into P2D model. This integration significantly enhanced the accuracy of the model, provided insights into electrode uniformity, and enabled precise parameter extraction through fitting to EIS data. To validate the versatility of the proposed framework, we applied the model to various Designs of Experimental (DOE), successfully extracting relevant parameters. Our framework quantitatively assesses design variable effects and provides a direct means of evaluating cell states, offering a powerful tool for LIB diagnosis and prognosis.I0*: Exchange current densityCdl*: Double layer capacitanceKel*: Electron conduction of electrolyteDel*: Solution diffusion coefficientDs*: Solid diffusion coefficientAv*: Specific surface area of electrode[1] Marco Crescentini. IEEE TRANSACTIONS ON INSTRUMENTATION AND MEASUREMENT, VOL. 70, 2021[2] Vincent Laue. J.Appl. Electrochem Volume 51, pages 1253–1265, (2021)[3] Godfrey sikha. Journal of The Electrochemical Society, 151 (7) A1104-A1114 (2004)[4] Leo Wildfeuer. Batteries 2021, 7(3), 52[5] Francesco Ciucci. Current Opinion in Electrochemistry 2019, 13:132–139Figure 1. (a) Zoomed-in view of the semicircle region in the fitting results of the Single P2D model and the P2D + DRT + DDT model. (b) The same results shown in the original scale. Each DRT and DDT component contributes to the semicircle and diffusion region, respectively. (c) Separation of impedance elements corresponding to each electrochemical process after fitting. Figure 1

Human milk is a uniquely tailored source of nutrition that offers a multitude of benefits for both the infant and the mother. Rich in antibodies, enzymes, and essential nutrients, human milk supports the infant's immune system, promotes optimal growth and brain development, and reduces the risk of infections, allergies, and chronic conditions such as obesity and diabetes. For the mother, breastfeeding facilitates uterine contraction, aiding postpartum recovery, and is associated with a reduced risk of breast and ovarian cancers, type 2 diabetes, and cardiovascular disease. Moreover, breastfeeding fosters a strong emotional bond between mother and child, promoting psychological well-being and long-term attachment. The dynamic composition of human milk, which adapts to the changing needs of the growing infant, highlights its irreplaceable role in early-life health and development.Accessible analysis in breast milk can support breastfeeding and enhance the benefits of milk for infants. Analysis of biomarkers such as vitamins, sugars, minerals can assist the mother in adjusting diet to meet the infant needs. Analysis of medications in milk can help with lactating individual perform informed pump and dump to minimize the exposure of infant to medication. Despite widespread advancement of wearable devices and point-of-care sensors, very few tools have been developed for accessible analysis of human milk. The only accessible tool is a colorimetric alcohol test strip. In our work, we have developed a range of electrochemical sensors for analysis of various biomarkers in human milk. Our electrochemical sensors are developed using direct laser engraving on a polyimide film and carbonizing the material to form conductive graphitic carbon (referred to as LIG or laser-induced graphene). The LIG electrodes are compact and flexible and can be produced at scale without the need for lithography or printing methods. We have developed methods for changing surface properties of LIGs to tune capacitance and wettability to engineer the surface for different sensing designs.A wide range of sensors are developed in our work through modification of LIG surface with enzymes, nanoparticles, and ion sensing membrane.1,2 Extensive characterization of sensors is performed in milk collected from different lactation stages (1 month, 6 month, and 12 month postpartum). To enhance the adoption for a busy parent, our sensors are integrated or coupled with a lactation pad. We present a novel approach to monitoring breast milk by embedding advanced sensing technology directly into a lactation pad, transforming it into a smart, wearable platform for real-time, on-body analysis. Lactation pads are commonly used by breastfeeding individuals to manage milk leakage and maintain comfort throughout the day. By incorporating microfluidic systems and electrochemical sensors into this familiar item, our design enables passive, continuous collection and monitoring of breast milk biomarkers without disrupting the user's daily routine. This seamless integration eliminates the need for separate sampling procedures, offering an effortless and non-invasive method for frequent health assessment of both mother and infant. Mom and Baby Wellness with a Smart Lactation Pad: A Wearable Sensor-Embedded Lactation Pad for on-Body Quantification of Glucose in Breast Milk, Advanced Functional Materials, 2025, 2420973. https://doi.org/10.1002/adfm.202420973.Safer breastfeeding with a wearable sensor for monitoring maternal acetaminophen transfer through breast milk, Device (Cell Press), 2025, accepted. Figure 1

There is increasing interest in measuring the effect of microplastics and nanoplastics (MNPs) in the environment, but it is difficult to compare the results obtained in these studies due to variations in the extraction and characterization techniques, as well as the variability of the matrices analyzed. Here we provide a workflow consisting of three separate procedures for (1) preprocessing of different environmental samples, (2) methods for MNP extraction (four-step extraction method) and (3) techniques for qualitative and quantitative characterization of MNPs. The four-step extraction method (FSEM) involves predigestion, predensity separation, postdigestion and postdensity separation. This process has been optimized to maximize recovery (between 83.7% and 100% for polyethylene, polyethylene terephthalate, polypropylene, polystyrene and polymethyl methacrylate) and purity while minimizing artefactual changes to the particles. It is crucial to characterize the MNPs extracted using the FSEM to understand their chemical composition and other physicochemical properties such as quantity, particle size and morphology. We provide guidance on the use of different fit-for-purpose analytical technologies, including attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR), laser direct infrared spectroscopy (LDIR) and optical photothermal infrared microspectroscopy (O-PTIR). These techniques can be combined to characterize MNPs with particle sizes of 0.5-5,000 µm. We provide advice on how to optimize the sample preparation methods by adding or removing extraction steps based on the complexity of the matrix and purpose of the analysis. The suggested validation workflow also uses additional analytical techniques (for example, atomic force microscopy and flow cytometry) to evaluate efficiency, feasibility and reliability. We provide experimental detail for analysis using micro-FTIR, which can be used instead of LDIR and O-PTIR to characterize microplastics with particle sizes larger than 10 µm. Execution of this workflow takes 7-30 d and can be performed by researchers, technicians and students in the environmental field if they have access to the required equipment.

Abstract INTRODUCTION Approximately 3.7–42% of cerebellopontine angle (CPA) lesions may present with symptomatic or asymptomatic Hydrocephalus (HCP), often due to cerebrospinal fluid blockage at the fourth ventricle. The optimal management strategy remains a topic of debate. This study aims to investigate the occurrence of HCP, persistence following surgery, and the factors affecting their surgical outcomes. METHODS This retrospective observational study included patients aged over 13 with CPA lesions who underwent surgical resection, while those with secondary CPA tumors or who had only CSF diversion without resection were excluded. Data was extracted from patients’ medical records and analyzed using SPSS 21. RESULTS A total of 141 patients with CP angle lesions were identified, among which 46.8% (n=66) had preoperative HCP as diagnosed by an Evans ratio greater than 0.3. The mean age at diagnosis was 41.81 years (±14.21). Persistent HCP was observed in 19 patients (those who required permanent postoperative CSF diversion and/or with Evans ratio≥3). Among the patients with HCP, 6.06% (4/66) had severe HCP (Evans ratio &amp;gt; 0.4). Only 3 out of 75 patients without pre-op HCP developed new-onset Post-op HCP. Persistent HCP was significantly correlated with pre-resection external ventricular drainage (EVD), whether as a separate procedure (p=0.002) or performed in the same setting (p=0.0001). Intraoperative lumbar drainage, however, was not correlated with persistent HCP (p=0.360). Preoperative HCP resolved significantly in those who achieved gross total resection, as the extent of resection was significantly correlated with HCP persistence (p=0.013). CONCLUSIONS EVD, whether placed emergently before or during surgical resection, is correlated with a risk of persistent postoperative HCP, often necessitating permanent CSF diversion. A higher extent of tumor resection reduces the likelihood of persistent postoperative HCP. Since over 56% of preoperative HCP cases resolve following lesion resection, permanent CSF diversion before surgery can be avoided when possible.

A retrospective analysis of the safety and effectiveness of recombinant von willebrand factor in children with von willebrand disease undergoing surgery

Introduction/Purpose Subdural hematomas (SDHs) are among the most common neurosurgical conditions, particularly affecting the elderly. Standard treatment paradigms include surgical evacuation and, more recently, middle meningeal artery embolization (MMAe) to prevent recurrence. These interventions are typically performed as separate procedures by different teams, often under general anesthesia. This fragmented approach introduces inefficiencies, procedural risks, and access barriers—especially for frail or medically complex patients.To address these limitations, we developed the first endovascular system enabling single‐session , fully transvascular treatment of non‐acute SDH. The procedure integrates MMA embolization and catheter‐based subdural evacuation through the same arterial access, obviating the need for craniotomy. A proprietary system of devices allow controlled perforation of the arterial wall and dura, enabling catheter navigation into the subdural space for drainage. Materials and Methods In a prospective, single‐arm, first‐in‐human study (EMBODRAIN), we enrolled 16 consecutive patients with symptomatic non‐acute SDH. Two patients were excluded due to anatomical reasons (diminutive MMA in one case, and MMA emerging from ophthalmic artery in one case). Patients were followed clinically and radiographically for 30 days. Results All fourteen treated patients (mean age 73.6 years; 80% male) underwent successful MMA embolization and transvascular subdural drainage without intraoperative complications or need for surgical backup. SDH volume was reduced by &gt;65% in average. Midline shift improved from 9.7 ± 3.8 mm to 4.2 ± 2.1 mm. Functional status also improved rapidly: Modified Rankin Scale (mRS) scores decreased from a mean of 2.7 to 1.3, and Markwalder Grading Scale scores from 1.9 to 0.7 within 72 hours. There were no hemorrhagic complications, neurologic deteriorations, or radiographic reaccumulations. No patients required ICU admission or anticoagulation reversal. Conclusions This first‐in‐human experience establishes the safety, technical feasibility, and early clinical effectiveness of fully endovascular treatment of non‐acute SDH. The approach provides a streamlined, minimally invasive solution that integrates embolization and hematoma evacuation into a single transvascular session. Beyond SDH, this technology lays the foundation for transvascular neurosurgery —a new paradigm that utilizes endovascular access to treat traditionally non‐vascular intracranial pathologies. Its potential to transform intracranial therapeutics, improve access, and reduce treatment morbidity is significant and warrants further clinical investigation. image FundingSupportResearch : National Institutes of Health (NIH)

Electroamalgamation-and Chromatography-Based Eu/Tb Separation Procedures as a Proof of Concept for Separating 155Tb from Alpha-Irradiated 153Eu

A label-free colorimetric biosensor based on Au@Ag@AgCl core-shell nanomaterials has been developed. The biosensor operated through a unique mechanism where Au@Ag@AgCl nanoparticles were progressively etched by ammonia produced during urease-catalyzed urea decomposition. This etching process induced a distinct color transition of the colloidal solution from orange to pink and ultimately to red, enabling quantitative determination of urease concentration. The multi-core-shell design of Au@Ag@AgCl provided highly enriched color gradients and significantly enhanced visual resolution, achieving a detection limit of 0.147 U/mL, which was 85 times lower than that of the commercial urease test strips. Notably, the assay required no complex surface modifications or separation procedures, offering high operational simplicity which could be accomplished within 15min. All these advantages greatly facilitated in-situ and in-time detection of urease. Finally, this assay was applied to the detection of simulated saliva samples with recoveries ranging from 104.4% to 123.0%, thereby validating its robust anti-interference capability and potential application in practice. Thus, the proposed Au@Ag@AgCl core-shell nanostructure-based label-free biosensor might provide a rapid, quantitative, and user-friendly alternative approach for monitoring Heliobacter pylori infection.