The present study provides a comprehensive analysis of the chemical composition of essential oils from species of the Myrcia genus and their applications. The compiled results highlight the chemical diversity and biological activities of these oils, emphasizing their potential importance for various therapeutic and industrial applications. The findings reveal that Myrcia essential oils present a variety of bioactive compounds, such as monoterpenes and sesquiterpenes, which demonstrate antimicrobial activities against a range of microorganisms, including Gram-positive and Gram-negative bacteria, as well as yeasts. Furthermore, this study highlights the phytotoxic activity of these oils, indicating their potential for weed control. The results also point to the insecticidal potential of Myrcia essential oils against a range of pests, showing their viability as an alternative to synthetic pesticides. Additionally, species of the genus Myrcia have demonstrated promising hypoglycemic effects, suggesting their potential in diabetes treatment. This comprehensive synthesis represents a significant advancement in understanding Myrcia essential oils, highlighting their chemical diversity and wide range of biological activities. However, the need for further research is emphasized to fully explore the therapeutic and industrial potential of these oils, including the identification of new compounds, understanding of their mechanisms of action, and evaluation of safety and efficacy in different contexts. Full article

Exploring periodic dry–wet changes is an important topic in climate change research due to its impact on drought and flood disasters. The purpose of this research was to determine the occurrence law of dry–wet changes in China on a scale of several hundred years, using the example of transitional zones. In this study, we analyzed typical areas of the ecotone between agricultural land and pasture along the Great Wall of China. The ring width index of Carya cathayensis was fitted with the March–August Palmer drought severity index (PDSI₃₈). The PDSI₃₈ was divided into different periods using the stepwise function fitting method. The results indicated that there were two dry periods and one wet period in the region from 1543 to 2019. In each dry and wet period, there were also different temporal periods, including long (decades), intermediate (ten years), and short periods (several years). Drought represents a significant threat to agricultural production in China. In the first dry period (1543–1756), four periods with low PDSI₃₈ values (1633–1635, PDSI₃₈ = −1.71; 1636–1939, PDSI₃₈ = −3.35; 1640–1642, PDSI₃₈ = −4.68; and 1643–1645, PDSI₃₈ = −2.92) occurred, during which severe droughts (PDSI₃₈ < −4) lasted for 13 years. The dry–wet change showed the characteristics of a 12-year or multiple 12-year cycle. The results can be used to prepare to effectively address extreme drought scenarios worldwide in the future. Full article

The integration of sustainable indicators into supply-chain management (SCM), including cost, innovation capability, quality, service capability, long-term cooperation, environmental management system, pollution reduction, green image, social responsibility, and employment practices, has become essential for conducting strategic analyses of the entire supply-chain process competitive advantage. This study proposes a fuzzy integration multi-criteria decision-making (MCDM) method to solve SCM issues. To navigate this complexity, a multi-criterion decision-making (MCDM) framework is employed, integrating MCDM methods with fuzzy logic to effectively address subjective environmental criteria. This innovative approach not only enhances supply-chain management (SCM) but also emphasizes the necessity for ongoing innovation in tackling contemporary supply-chain challenges. It serves as a cornerstone for sustainable supplier selection practices and optimizing SCM processes. In this study, a hybrid fuzzy MCDM method is proposed for supplier selection. The method addresses supplier selection by utilizing evaluations from expert decision-makers based on predetermined criteria. This comprehensive approach ensures that all relevant factors are considered, promoting sustainable and efficient supply-chain management. Full article

Patients with chronic kidney disease (CKD) suffer disproportionately from a high burden of cardiovascular disease, which, despite recent scientific advances, remains partly understood. Vascular calcification (VC) is the result of an ongoing process of misplaced calcium in the inner and medial layers of the arteries, which has emerged as a critical contributor to cardiovascular events in CKD. Beyond its established role in blood clotting and bone health, vitamin K appears crucial in regulating VC via vitamin K-dependent proteins (VKDPs). Among these, the matrix Gla protein (MGP) serves as both a potent inhibitor of VC and a valuable biomarker (in its inactive form) for reflecting circulating vitamin K levels. CKD patients, especially in advanced stages, often present with vitamin K deficiency due to dietary restrictions, medications, and impaired intestinal absorption in the uremic environment. Epidemiological studies confirm a strong association between vitamin K levels, inactive MGP, and increased CVD risk across CKD stages. Based on the promising results of pre-clinical data, an increasing number of clinical trials have investigated the potential benefits of vitamin K supplementation to prevent, delay, or even reverse VC, but the results have remained inconsistent. Full article

COVID-19, caused by the SARS-CoV-2 virus, is a highly pathogenic emerging infectious disease. Healthcare personnel (HCP) are presumably at higher risk of acquiring emerging infections because of occupational exposure. The prevalence of COVID-19 in HCP is unknown, particularly in low- to middle-income countries like El Salvador. The goal of this study was to determine the seroprevalence of anti-SARS-CoV-2 antibodies among HCP in El Salvador just prior to vaccine rollout in March 2021. We evaluated 2176 participants from a nationally representative sample of national healthcare institutions. We found 40.4% (n = 880) of the study participants were seropositive for anti-spike protein antibodies. Significant factors associated with infection included younger age; living within the central, more populated zone of the country; living in a larger household (≥7 members); household members with COVID-19 or compatible symptoms; and those who worked in auxiliary services (i.e., housekeeping and food services). These findings provide insight into opportunities to mitigate SARS-CoV-2 risk and other emerging respiratory pathogens in HCP in El Salvador. Full article

Turfgrass irrigation consumes a large amount of the scarce freshwater in arid/semi-arid regions. Approximately 50% of this irrigation water is wasted. It has been suggested that determining patterns of spatial variability in soil moisture to modify applications with valve-in-head sprinkler technology can greatly reduce waste. Variable rate irrigation (VRI) studies in traditional agricultural settings have shown that VRI zones do not stay static temporally and need to be frequently redetermined. Electrical conductivity (ECa) data from Geonics EM38 surveys and data from Red, Green, Blue (RGB) and Thermal Infra-Red (Th.IR) drone surveys are less time-consuming and therefore expensive to collect than a dense field survey of soil moisture and grass health to produce accurate geostatistical maps. Drone flights and ECa surveys are compared here for their ability to accurately estimate spatial patterns of soil volumetric water content (VWC) using simple linear regression and z-score transformations for prediction—non-geostatistical approaches that require less data. Overall, ECa readings collected in the horizontal mode were the most consistent at capturing spatial patterns in soil moisture. Predictions from regression produced lower root mean squared errors (RMSEs) for the larger datasets. However, z-score transformation produced lower RMSEs when the sample number was very small and preserved the scale of values better than the regression approach. The results suggested that predictions from ECa and drone data were useful for capturing key features in soil moisture patterns for 2–3 weeks, suggesting that a periodic reassessment of zones is needed. Using ECa and drone data in an urban environment is more labor-intensive than in an agricultural field, so it is likely that automating periodic re-surveying of ECa data for zone definition would only be cost-effective for golf courses or high-income sports fields. Elsewhere, using static zones with variable rates applied to each zone may be more efficient. Full article

The tree fern Culcita macrocarpa, a threatened Iberian–Macaronesian endemism, represents the sole European species of the order Cyatheales. Considered a Tertiary relict of European Palaeotropical flora, its evolutionary history and genetic diversity, potentially influenced by presumed high clonal propagation, remain largely unknown. This study elucidates the phylogeographic history of C. macrocarpa, assessing the impact of vegetative reproduction on population dynamics and genetic variability. We provide genetic data from eight newly identified nuclear microsatellite loci and one plastid DNA region for 17 populations spanning the species’ range, together with species distribution modeling data. Microsatellites reveal pervasive clonality in C. macrocarpa, which has varied among populations. We assess the impact of clonality on genetic diversity and evaluate how estimates of intra-population genetic diversity indices and genetic structuring are affected by the chosen definition of “individual” (focusing exclusively on genetically distinct individuals, genets, as opposed to considering all independent clonal replicates, ramets). We identify two main population groups, one in the northern Iberian Peninsula and the other in the Macaronesian archipelagos and southern Iberian Peninsula. Within each group, we found relict populations (in the Azores and the Cantabrian Cornice) as well as recent originated populations. This population structure suggests colonization dynamics in which recent populations originated from one or a few genets of relict populations and became established through intra-gametophytic self-fertilization and vegetative expansion. DAPC analysis facilitated the identification of alleles that most significantly contributed to the observed population structure. The current Andalusian populations appear to have originated from colonization events from the Azores and the Cantabrian Cornice. Our findings suggest that C. macrocarpa persisted through the Last Glacial Maximum in two refugia: the Azores and the Cantabrian Cornice. Colonization into new areas occurred presumably from these refuges, generating two large population groups with structured genetic diversity. This study underscores the significance of clonality in establishing new populations and shaping genetic structure. Full article

The Chinese mitten crab (Eriocheir sinensis), a species unique to Chinese aquaculture, holds significant economic value in the seafood market. In response to increasing concerns about the quality and safety of Chinese mitten crab products, the high traceability costs, and challenges for consumers in verifying the authenticity of individual crabs, this study proposes a lightweight individual recognition model for Chinese mitten crab carapace images based on an improved MobileNetV2. The method first utilizes a lightweight backbone network, MobileNetV2, combined with a coordinate attention mechanism to extract features of the Chinese mitten crab carapace, thereby enhancing the ability to recognize critical morphological features of the crab shell while maintaining the model’s light weight. Then, the model is trained using the ArcFace loss function, which effectively extracts the generalized features of the Chinese mitten crab carapace images. Finally, authenticity is verified by calculating the similarity between two input images of Chinese mitten crab carapaces. Experimental results show that the model, combined with the coordinate attention mechanism and ArcFace, achieves a high accuracy rate of 98.56% on the Chinese mitten crab image dataset, surpassing ShuffleFaceNet, MobileFaceNet, and VarGFaceNet by 13.63, 11.1, and 6.55 percentage points, respectively. Moreover, it only requires an average of 1.7 milliseconds per image for verification. While maintaining lightness, this model offers high efficiency and accuracy, offering an effective technical solution for enhancing the traceability of Chinese mitten crab products and combating counterfeit goods. Full article

We sought to investigate the lower-extremity biomechanics underlying increased gait velocity following high-cadence cycling. Ground reaction forces (GRF) and lower-extremity kinematics and kinetics were recorded as 15 healthy adults walked at a self-selected pace prior to and immediately following a 15 min bout of cycling at a cadence of 75 rotations per minute. Propulsive GRF and stance-phase peak dorsiflexion and knee extension angles increased, while peak plantarflexion and hip extension angles decreased. Swing-phase peak dorsiflexion, plantarflexion, knee flexion, and hip flexion angles increased, while peak knee extension angle decreased. Peak dorsiflexion, knee extension, and hip extension angular velocity also increased during swing. No changes in peak joint moments were observed; however, peak positive ankle, knee, and hip joint power generation increased following cycling. Completing high-cadence cycling improves gait velocity by increasing propulsive GRF; increasing joint angular velocity during the swing phase of gait for the ankle, knee, and hip; and increasing positive power production by the ankle, knee, and hip during the stance phase. Increased gait velocity post cycling exercise did not increase lower-extremity joint moments. Cycling may be a viable exercise-based modality for increasing gait velocity, especially in populations where gait ability or joint loading is of particular concern. Full article

Inter-frame tampering in surveillance videos undermines the integrity of video evidence, potentially influencing law enforcement investigations and court decisions. This type of tampering is the most common tampering method, often imperceptible to the human eye. Until now, various algorithms have been proposed to identify such tampering, based on handcrafted features. Automatic detection, localization, and determine the tampering type, while maintaining accuracy and processing speed, is still a challenge. We propose a novel method for detecting inter-frame tampering by exploiting a 2D convolution neural network (2D-CNN) of spatiotemporal information and fusion for deep automatic feature extraction, employing an autoencoder to significantly reduce the computational overhead by reducing the dimensionality of the feature’s space; analyzing long-range dependencies within video frames using long short-term memory (LSTM) and gated recurrent units (GRU), which helps to detect tampering traces; and finally, adding a fully connected layer (FC), with softmax activation for classification. The structural similarity index measure (SSIM) is utilized to localize tampering. We perform extensive experiments on datasets, comprised of challenging videos with different complexity levels. The results demonstrate that the proposed method can identify and pinpoint tampering regions with more than 90% accuracy, irrespective of video frame rates, video formats, number of tampering frames, and the compression quality factor. Full article

Accurate prediction of taxiing time is important in ensuring efficient and safe operations on the airport surface. It helps improve ground operation efficiency, reduce fuel waste, and improve carbon emissions at the airport. In actual operations, taxiing time is influenced by various factors, including a large number of categorical features. However, few previous studies have focused on selecting such features. Additionally, traditional taxiing time prediction methods are often black-box models that only provide a single prediction result; they fail to provide effective practical references for controllers. Therefore, this paper analyses the features that affect taxiing time from different data types and forms a taxi feature set consisting of nine key features. We also propose a taxiing time prediction method based on adaptive scenario matching rules. This process classifies the scenarios into multiple typical historical scenario sets and adaptively matches the current target scenario to a typical scenario set based on quantified rules. Then, based on the matching results, a pre-trained model obtained from the corresponding scenario set is used to predict the taxiing time of an aircraft in the target scenario, aiming to mitigate the impact of data heterogeneity on prediction results. Experimental results show that compared to baseline methods, the mean absolute error and root mean square error of the proposed method decreased by 4.8% and 12.6%, respectively. This method significantly reduces the fluctuations in results caused by sample heterogeneity and enhances controllers’ acceptance of prediction results from the model. It can be used to further improve auxiliary decision making systems and enhance the precise control capabilities of airport surface operations. Full article

The Doctrine of Signatures (DoS) figures prominently in both contemporary and historic herbal traditions across a diversity of cultures. DoS—conceptualized beyond its conventional interpretation as “like cures like”, which relies solely on plant morphology—can be viewed as a type of ecosemiotic communication system. This nuanced form of interspecies communication relies on the presence of “signatures”, or signs, corresponding to the therapeutic quality of different plants based on their morphology but also their aroma, taste, texture, and even their context in the landscape. Despite its widespread contemporary dismissal by mainstream science as overly simplistic, childlike, primitive, and generally of limited value, we suggest that the recognition of “signatures” in plants may be considered as a form of communication between humans and plants. Drawing upon Indigenous thought, ecosemiotic theory, and lyric philosophy, we posit that understanding “signatures” metaphorically, as a reflection of the “shape of the world”, offers insights into the interconnectedness of all life forms—a profound affirmation of relational coherence between humans and the more-than-human. We advocate for another perspective on DoS: one which holds potential towards reorienting and restoring our relationships in the vibrant world of the Anthropocene. Full article

Many semiparametric spatial autoregressive (SSAR) models have been used to analyze spatial data in a variety of applications; however, it is a common phenomenon that heteroscedasticity often occurs in spatial data analysis. Therefore, when considering SSAR models in this paper, it is allowed that the variance parameters of the models can depend on the explanatory variable, and these are called heterogeneous semiparametric spatial autoregressive models. In order to estimate the model parameters, a Bayesian estimation method is proposed for heterogeneous SSAR models based on B-spline approximations of the nonparametric function. Then, we develop an efficient Markov chain Monte Carlo sampling algorithm on the basis of the Gibbs sampler and Metropolis–Hastings algorithm that can be used to generate posterior samples from posterior distributions and perform posterior inference. Finally, some simulation studies and real data analysis of Boston housing data have demonstrated the excellent performance of the proposed Bayesian method. Full article

Testicular development and spermatogenesis are tightly regulated by both coding and non-coding genes, with mRNA and lncRNA playing crucial roles in post-transcriptional gene expression regulation. However, there are significant differences in regulatory mechanisms before and after sexual maturity. Nevertheless, the mRNAs and lncRNAs in the testes of Mongolian horses have not been systematically identified. In this study, we first identified the testicular tissues of sexually immature and sexually mature Mongolian horses at the tissue and protein levels, and comprehensively analyzed the expression profiles of mRNA and lncRNA in the testes of 1-year-old (12 months, n = 3) and 10-year-old (n = 3) Mongolian horses using RNA sequencing technology. Through gene expression analysis, we identified 16,582 mRNAs and 2128 unknown lncRNAs that are commonly expressed in both sexually immature and sexually mature Mongolian horses. Meanwhile, 9217 mRNAs (p < 0.05) and 2191 unknown lncRNAs (p < 0.05) were identified as differentially expressed between the two stages, which were further validated by real-time fluorescent quantitative PCR and analyzed using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG). The analysis results showed that genes in the sexually immature stage were mainly enriched in terms related to cellular infrastructure, while genes in the sexually mature stage were enriched in terms associated with hormones, metabolism, and spermatogenesis. In summary, the findings of this study provide valuable resources for a deeper understanding of the molecular mechanisms underlying testicular development and spermatogenesis in Mongolian horses and offer new perspectives for future related research. Full article

Background: Gender-affirming mastectomy (GAM) improves the psychosocial functioning and quality of life of transgender and non-binary (TGNB) individuals. However, the perioperative period is often marked by emotional stress, concerns about surgical outcomes, and physical discomfort. While inpatient procedures provide multiple opportunities to engage with and educate patients, outpatient surgeries, such as GAM, pose a unique challenge as patients are followed for <24 h postoperatively. Given the heightened emotional and psychological distress related to gender dysphoria TGNB individuals often experience, addressing these gaps can significantly improve outcomes. This study aims to characterize patient and surgical characteristics associated with patient-initiated communication (PIC) frequency in this population. Methods: A single-center retrospective review of TGNB patients undergoing GAM from February 2018 to November 2022 was conducted. Demographics, surgical characteristics, and frequency of and reasons for perioperative PIC (30 days before and after surgery) were recorded. The primary outcome was the incidence of perioperative PIC. The secondary outcomes included (1) the rationale for PIC and (2) patient and surgical characteristics associated with PIC. Results: A total of 352 patients were included. Of these, 285 (74.6%) initiated communication in the perioperative period, totaling 659 PICs. The median age was 25.0 (interquartile range [IQR]: 9.0) years. The median body mass index (BMI) was 28.5 (IQR: 8.5) kg/m². The mean number of PICs was 0.7 ± 1.3 preoperatively and 1.3 ± 1.7 postoperatively (p < 0.001). The most frequent preoperative PIC subjects were administrative issues (AI; n = 66, 30.7%), preoperative requirements (n = 43, 20.0%), and cost and insurance (n = 33, 15.0%). The most frequent postoperative PIC subjects were wound care (n = 77, 17.3%), AI (n = 70, 15.0%), activity restrictions (n = 60, 13.5%), drainage (n = 56, 12.6%), and swelling (n = 37, 8.3%). Collectively, older patients (β = 0.234, p = 0.001), those with a history of major depressive disorder or generalized anxiety disorder (2.4 ± 3.0 vs. 1.7 ± 1.9; p = 0.019), and those without postoperative drains (n = 16/17, 94.1% vs. n = 236/334, 70.7%; p = 0.025) engaged in higher levels of PIC. There were no significant associations between other patient characteristics, perioperative details, or complications and PIC frequency. Conclusions: Perioperative PIC is prevalent among the majority of GAM patients at our institution, with age, psychiatric diagnosis, and postoperative drain use identified as significant predictors. To mitigate PIC frequency, it is crucial to ensure adequate support staffing and provide comprehensive postoperative instructions, particularly concerning activity restrictions and drainage management. These interventions may reduce PICs in high-volume centers. Further research should investigate targeted interventions to further support TGNB patients during the perioperative period. Full article

Background: Investigations have shown the different impacts that ACEs have on an individual’s adult life, on both physical and mental health, but they have not yet shown the issue of the influence of ACEs on adults and young adults. Objective/Participants and Setting: This systematic review, performed according to the PRISMA norms and guidelines, intended to understand the most frequent outcomes of adverse childhood experiences in the life of young adults and adults. Methods: Studies were identified through multiple literature search databases at EBSCOhost, Web of Science, and PubMed April 2023, and a total of 279 studies, published between 1999 and 2002, were excluded, 256 because of multiple factors: being duplicates, showing statistical analysis with correlations only, being systematic reviews or case studies, comprising individuals under the age of 18, and not meeting the intended theme; ultimately, we selected for the review a total of 23 studies. Results and Conclusions: The impacts of the various articles are subdivided into three main themes: antisocial and criminal behaviour; sexual Behaviour and intimate partner violence; and attachment, quality of life, and therapeutic alliance. Full article

Robust evidence suggests that the glymphatic system plays a key role in preserving brain health. Indeed, its activity in maintaining homeostasis by clearing neurotoxic proteins such as beta-amyloid from the human brain is essential. Sleep represents the factor that mainly influences this system, since it is selectively active during the night, in particular during non-rapid eye movement (NREM) sleep. This is true, since the sleep head position, in particular the supine position for its relationship to the status of opening/closing of the jugular veins, appears to be determinant for the development of future neurodegeneration. Growing evidence from human and animal models highlights the neurobiological link between sleep, glymphatic dysfunction and neurodegeneration. On the other hand, several modifiable factors have been recently identified modulating (improve/reduce) glymphatic system activity, such as Omega-3 polyunsaturated fatty acids, stress, hypertension, physical activity, alcohol, gender and genetic predisposition, in particular variants of aquaporin-4 (AQP4). From this viewpoint, our ambition is to discuss how the glymphatic system works in the brain, what factors mainly impact on this activity and its strict relation with the neurodegeneration. Future directions might include the analysis of factors modulating glymphatic system activity and a personalized glymphatic profile, “glymphatom”, as a natural target for preventive neurodegenerative treatment. Full article

Background and Objectives: As brain lesions present complex diagnostic challenges, accurate tissue sampling via biopsy is critical for effective treatment planning. Traditional frame-based stereotactic biopsy has been complemented by navigated biopsy techniques, leveraging advancements in imaging and navigation technology. This study aims to compare the navigated and frame-based stereotactic biopsy methods in a clinical setting, evaluating their efficacy, safety, and diagnostic outcomes to determine the optimal approach for precise brain lesion targeting. Materials and Methods: retrospective analysis was conducted on patients who underwent brain biopsies between January 2017 and August 2023 at an academic medical center. Data on patient demographics, clinical characteristics, biopsy technique (navigated vs. frame-based), and outcomes including accuracy, complications, and hospital stay duration were analyzed. Results: The cohort comprised 112 patients, with no significant age or gender differences between groups. Symptoms leading to biopsy were predominantly diminished muscle strength (42.0%), cognitive issues (28.6%), and aphasia (24.1%). Tumors were most common in the deep hemisphere (24.1%). The median hospital stay was 5 days, with a rehospitalization rate of 27.7%. Complications occurred in 4.47% of patients, showing no significant difference between biopsy methods. However, navigated biopsies resulted in fewer samples (p < 0.001) but with comparable diagnostic accuracy as frame-based biopsies. Conclusions: Navigated and frame-based stereotactic biopsies are both effective and safe, with comparable accuracy and complication rates. The choice of technique should consider lesion specifics, surgeon preference, and technological availability. The findings highlight the importance of advanced neurosurgical techniques in enhancing patient care and outcomes. Full article

Liposarcomas are some of the most challenging soft tissue tumors and are subclassified into multiple subtypes with special histologic and molecular features. The peculiarities of each histopathological subtype influence the clinical behavior, management, and treatment of these neoplasms. For instance, well-differentiated liposarcomas are common soft tissue malignancies and usually display a favorable outcome. On the other hand, pleomorphic liposarcoma is the rarest, yet the most aggressive subtype of liposarcoma. This histopathological diagnosis may be challenging due to the scarce available data and because pleomorphic liposarcomas can mimic other pleomorphic sarcomas or other neoplasms of dissimilar differentiation. Nevertheless, the correct diagnosis of pleomorphic liposarcoma is of utmost importance as such patients are prone to develop local recurrences and metastases. Treatment usually consists of surgical excision along with radiotherapy and follow-up of the patients. Therefore, this review aims to assess the complex clinical, histological, and immunohistochemical features of liposarcomas in order to establish how these characteristics influence the management and prognosis of the patients, emphasizing the particularities of pleomorphic liposarcoma. Full article

Background and Objectives: Patients with human epidermal growth factor receptor 2 (HER2) -positive, hormone receptor-positive (HR-positive) metastatic breast cancer (MBC) usually undergo trastuzumab emtansine (T-DM1) therapy in subsequent lines. Combining endocrine therapy (ET) with T-DM1 can improve treatment outcomes in this subtype. Therefore, this study aimed to investigate the benefits of using T-DM1 with ET in HER2-positive and HR-positive MBC. This study was the first to investigate the benefits of combining ET with T-DM1. Material and Methods: This study analyzed the medical records of patients with HER2-positive and HR-positive MBC who were treated with T-DM1 from June 2010 to December 2021. The patients were divided into groups based on whether they received concomitant ET with T-DM1. The primary endpoint was to determine the progression-free survival (PFS), while the secondary endpoints were overall survival (OS), objective response rate, and safety of the treatment. Results: Our analysis examined 88 patients, of whom 32 (36.4%) were treated with T-DM1 in combination with ET. The combination therapy showed a significant improvement in median PFS (15.4 vs. 6.4 months; p = 0.00004) and median OS (35.0 vs. 23.1 months; p = 0.026) compared to T-DM1 alone. The ORR was also higher in the combination group (65.6% vs. 29.3%; p = 0.026). Patients treated with pertuzumab priorly had reduced median PFS on T-DM1 compared to those who were not treated with pertuzumab (11.7 vs. 5.4 months, respectively; p < 0.01). T-DM1 demonstrated better median PFS in HER2 3+ patients compared to HER2 2+ patients, with an amplification ratio of >2.0 (10.8 vs 5.8 months, respectively; p = 0.049). The safety profiles were consistent with previous T-DM1 studies. Conclusions: The combination of T-DM1 with ET can significantly improve PFS and OS in patients with HER2-positive and HR-positive MBC. Our study suggests that prior pertuzumab treatment plus trastuzumab treatment might decrease T-DM1 efficacy. Full article

Manufacturing processes have always played a pivotal role in the life cycle assessment of products, necessitating focused efforts to minimize their impact on the environment. Thermoplastic composite manufacturing is no exception to this concern. Within thermoplastic composite manufacturing, the preheating process stands out as one of the most energy-intensive stages, significantly affecting the environment. In this study, a theoretical analysis is conducted to compare three modes of preheating: conductive, radiative, and convective modes, considering their energy consumption and environmental impact. The analysis reveals the potential for substantial energy savings and emissions reduction through the selection of a proper preheating mode. Since the analysis used in this study is theoretical, it facilitates a parametric study of different modes of preheating to assess how process parameters impact the environment. Moreover, this study includes a comparison between emissions from material production and the preheating process, highlighting the substantial contribution of the preheating process to the overall product life cycle assessment. Full article