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Background and aims Although adjuvant transcatheter arterial chemoembolization (TACE) for resected hepatocellular carcinoma (HCC) may improve survival for some patients, identifying which patients can benefit remains challenging. The present study aimed to construct a survival prediction calculator for individualized estimating the net survival benefit of adjuvant TACE for patients with resected HCC. Methods From a multicenter database, consecutive patients undergoing curative resection for HCC were enrolled and divided into the developing and validation cohorts. Using the independent survival predictors in the developing cohort, two nomogram models were constructed for patients with and without adjuvant TACE, respectively, which predictive performance was validated internally and externally by measuring concordance index (C-index) and calibration. The difference between two estimates of the prediction models was the expected survival benefit of adjuvant TACE. Results A total of 2514 patients met the inclusion criteria for the study. The nomogram prediction models for patients with and without adjuvant TACE were, respectively, built by incorporating the same eight independent survival predictors, including portal hypertension, Child–Pugh score, alpha-fetoprotein level, tumor size and number, macrovascular and microvascular invasion, and resection margin. These two prediction models demonstrated good calibration and discrimination, with all the C-indexes of greater than 0.75 in the developing and validation cohorts. A browser-based calculator was generated for individualized estimating the net survival benefit of adjuvant TACE. Conclusions Based on large-scale real-world data, an easy-to-use online calculator can be adopted as a decision aid to predict which patients with resected HCC can benefit from adjuvant TACE.

In this work, by applying a transfer method simultaneously with a solution doping process for graphene as top electrodes, we demonstrate a solution-processed semitransparent organic photovoltaics (OPV). The work function of doped graphene under various doping conditions was investigated via photoemission spectroscopy. The transparent device was fabricated using PEDOT-doped graphene as electrodes, which provide an energetically favorable band alignment for carrier extractions. The solution-processed semitransparent organic photovoltaics exhibit the power conversion efficiency (PCE) of 4.2%, which is 85.7% of the PCE of control devices based on metallic reflecting electrodes, while maintaining good transparency at most visible wavelengths.

Microplastics (MPs) and nanoplastics (NPs) have emerged as ubiquitous environmental contaminants that pose significant threats to human health, with multiple exposure pathways (e.g., ingestion and inhalation) contributing to systemic exposure. Although growing evidence highlights their biological effects, the underlying mechanisms by which these particles induce cellular dysfunction remain incompletely understood. This review synthesizes current knowledge on the MPs/NPs-induced cellular toxicity mechanisms, including investigations into cellular uptake pathways, disruption of molecular signaling, oxidative stress, inflammatory responses, and genotoxic effects. MPs/NPs contamination can arise from consumer products and clinical procedures, with estimated Daily Microplastic Emission (DME)-based national totals (India) ranging from ~0.36 to 74 billion particles/day across oral-care product categories. At the cellular level, MPs and NPs trigger interconnected toxicological cascades, including impaired endocytosis, mitochondrial dysfunction, chronic inflammation, genotoxicity, endoplasmic reticulum (ER) stress, and accelerated cellular senescence. These mechanisms act in concert to compromise epithelial barrier integrity. Overall, MPs/NPs present substantial risks to health through multiple interconnected pathways. Local and systemic effects are plausible across exposed tissues which may also serve as a gateway for systemic distribution by these contaminants. These findings highlight the urgent need for coordinated global efforts, including restrictions on intentionally added MPs, improvements in product design, development of advanced removal technologies, and implementation of clinical prevention strategies.

The jet formation and penetration behaviors of shaped charge with a reactive material double-layered liner (RM-DLL) are presented in this paper based on the AUTODYN-2D code. Numerical results show that the wall thickness ratio of the RM-liner to the metal liner has a significant influence on the formation and penetration characteristics of composite jet. As the wall thickness ratio increases, the tip velocity of composite jet, the pressure on the RM-liner, and the temperature of RM-elements decrease. The effect of the wall thickness ratio on the penetration performance of RM-DLL shaped charges against steel targets significantly depends on the RM-initiation delay time ( τ ). The penetration depth (PD) of the composite jet with titanium liner into the steel target is limited. In the case of the RM-tungsten liner, the RM-mass following into the penetration crater is very small. In the case of the RM-copper liner, the penetration capability of composite jet is well matched with the mass of follow-thru RMs. Compared with the PD, the standoff has a more significant impact on the RM-mass entering the penetration hole.

Background The incidence of hepatocellular carcinoma (HCC) in non-alcoholic fatty liver disease (NAFLD) is increasing worldwide. Higher perioperative risks may be anticipated due to underlying steatohepatitis, while long-term outcomes after liver resection are unknown. We sought to investigate outcomes after liver resection for NAFLD-HCC versus hepatitis B virus (HBV)-HCC using propensity score matching (PSM). Methods Consecutive patients who underwent liver resection for HCC between 2003 and 2014 were identified from a multicenter database. Patients with NAFLD-HCC were matched one-to-one to patients with HBV-HCC. Results Among 1483 patients identified, 96 (6.5%) had NAFLD-HCC and 1387 (93.5%) had HBV-HCC. Patients with NAFLD-HCC were older (median age 57 vs. 50 years), more often overweight (50.0% vs. 37.5%), less often to have cirrhosis (30.2% vs. 72.5%) and liver dysfunction (Child-Pugh B: 4.2% vs. 10.7%), had larger tumor size (median 7.2 vs. 6.2 cm) yet had better tumor differentiation (27.1% vs. 17.6%) compared with patients with HBV-HCC (all P  < 0.05). Perioperative mortality and morbidity were comparable between the two groups (1.0% vs. 1.4% and 20.8% vs. 23.2%, both P  > 0.05). No differences were noted in median OS and RFS among patient with NAFLD-HCC versus HBV-HCC before or after PSM. Conclusion While patients with NAFLD-HCC had different clinical characteristics than patients with HBV-HCC, liver resection resulted in similar perioperative outcomes and comparable OS and RFS among patients with NAFLD-HCC and HBV-HCC.

The Albumin-Bilirubin (ALBI) score, widely used in predicting long-term prognosis for patients with hepatocellular carcinoma (HCC), has limitations due to serum albumin variability. This study aimed to develop and validate the Prealbumin-Bilirubin (preALBI) score as a reliable alternative. A multicenter cohort of HCC patients who underwent hepatectomy was randomly divided into the training and validation cohorts. The preALBI score was developed using Cox regression models within the training cohort, incorporating serum prealbumin and bilirubin levels as crucial determinants. The survival predictive accuracy was evaluated and compared between the preALBI score with two other staging systems, including the ALBI score and the Child-Pugh grade. A total of 2409 patients were enrolled. In the training cohort, the preALBI score demonstrated superior performance in predicting long-term survival after hepatectomy. The preALBI score was associated with the best monotonicity of gradients (linear trend χ2: 72.84) and homogeneity (likelihood ratio χ2: 74.69), and the highest discriminatory ability (the areas under curves for 1-, 3-, and 5-year mortality: 0.663, 0.654, and 0.644, respectively). In addition, the preALBI was the most informative staging system in predicting survival (Akaike information criterion: 11325.65).The results remained consistent in both training and validation cohorts, indicating its reliable performance across different populations. The preALBI score, leveraging the stability of prealbumin, represents a promising tool for better patient stratification, providing more accurate prognostic predictions than the ALBI score and the Child-Pugh grade. •Prealbumin, with more robust hazard ratios, narrower confidence intervals, may be a better predictive factor compared to albumin for patients after surgical resection of hepatocellular carcinoma.•The preALBI score was associated with the best monotonicity of gradients and homogeneity.•The preALBI score represents a promising tool for better patient stratification, providing more accurate prognostic predictions.

The burgeoning demand for hepatectomy in elderly patients with hepatocellular carcinoma (HCC) necessitates improved perioperative care. Geriatric populations frequently experience functional decline and frailty, predisposing them to adverse postoperative outcomes. The Barthel Index serves as a reliable measure for assessing functional capacity, and this study evaluates its impact on surgical textbook outcomes (TOs) in elderly HCC patients. A multicenter retrospective cohort study analyzed elderly patients (≥70 years) following hepatectomy for HCC between 2013 and 2021. Utilizing a Barthel Index cut-off value of 85, patients were divided into two groups: with and without preoperative functional decline and frailty. The primary outcome was the rate of TO, encompassing seven criteria. TO rates were compared between groups, and multivariate logistic regression analyses identified independent risks for achieving TOs. Of 497 elderly patients, 157 (31.6 ​%) exhibited preoperative functional decline and frailty (Barthel Index score <85). The overall TO rate was 58.6 ​%. Patients with preoperative Barthel Index score <85 had significantly lower TO rates compared to patients with score ≥85 (29.3 ​% vs. 72.1 ​%, P ​< ​0.001). Multivariate analysis revealed preoperative Barthel Index score <85 as an independent risk for achieving TO (odds ratio 3.413, 95 ​% confidence interval 1.879–6.198, P ​< ​0.001). Comparable results were observed in the subgroups of patients undergoing open and laparoscopic hepatectomy. Preoperative Barthel Index-based assessment of functional decline and frailty significantly predicts TOs following hepatectomy in elderly HCC patients, enabling identification of high-risk patients and informing preoperative management and postoperative care within geriatric oncology. [Display omitted] •Only 2 in 5 elderly patients achieved Textbook Outcome following hepatectomy for hepatocellular carcinoma.•Preoperative Barthel Index-based assessment of functional decline and frailty predicts Textbook Outcome following hepatocellular carcinoma resection.•The association between Barthel index and Textbook Outcomes was consistent across surgical modalities (open or laparoscopic hepatectomy).

Background Previous studies have typically focused on the effect of high preoperative serum creatinine (SCr) levels on the prognosis of hepatocellular carcinoma (HCC) patients but have often ignored the role of low SCr levels. This study aimed to assess the impact of low SCr levels on HCC patient prognosis. Methods 3857 patients who underwent primary liver resection from seven centers were divided into low, normal and high SCr groups according to their baseline SCr levels. Factors independently associated with textbook outcome (TO) and overall survival (OS) were analyzed. Propensity score matching (PSM) was used to balance the baseline characteristics between the low- and normal-SCr groups, as well as between the high- and normal-SCr groups. Results TO was observed in 2403 (62.3%) patients. The TO rate in the normal SCr group was 63.4%, which was significantly higher than that in the low (48.5%, P  < 0.001) and high (53.3%, P  = 0.017) SCr groups in the whole cohort. Multivariate analysis confirmed that both low and high SCr levels independently contributed to non-TO achievement. The 5-year OS was 67.6% for the normal SCr group, which was significantly better than that of the low SCr group (51.1%, P  < 0.001) but similar to that of the high SCr group (66.4%, P  = 0.697) in the whole cohort. Similar results were observed after PSM. Multivariate analysis suggested that a low SCr level (HR = 1.328, 95% CI = 1.076–1.639, P  = 0.008) was independently associated with OS, whereas a high SCr level (HR = 1.173, 95% CI = 0.870–1.583, P  = 0.294) was not. Conclusions Low SCr levels could affect both TO achievement and OS in HCC patients after liver resection. A low SCr level offers useful information for preoperative risk stratification, optimizes perioperative care and improves the prognosis of HCC patients. We should not ignore the effect of low preoperative SCr levels on HCC patient prognosis.

We report a 23- gene-classifier profiled from Asian women, with the primary purpose of assessing its clinical utility towards improved risk stratification for relapse for breast cancer patients from Asian cohorts within 10 years’ following mastectomy. Four hundred and twenty-two breast cancer patients underwent mastectomy and were used to train the classifier on a logistic regression model. A subset of 197 patients were chosen to be entered into the follow-up studies post mastectomy who were examined to determine the patterns of recurrence and survival analysis based on gene expression of the gene classifier, age at diagnosis, tumor stage and lymph node status, over a 5 and 10 years follow-up period. Metastasis to lymph node (N2-N3) with N0 as the reference (N2 vs. N0 hazard ratio: 2.02 (1.05–8.70), N3 vs. N0 hazard ratio: 4.32 (1.41–13.22) for 5 years) and gene expression of the 23-gene panel (P=0.06, 5 years and 0.02, 10 years, log-rank test) were found to have significant discriminatory effects on the risk of relapse (HR (95%CI):2.50 (0.95–6.50)). Furthermore, survival curves for subgroup analysis with N0-N1 and T1-T2 predicted patients with higher risk scores. The study provides robust evidence of the effectiveness of the 23-gene-classifier and could be used to determine the risk of relapse event (locoregional and distant recurrence) in Asian patients, leading to a meaningful reduction in chemotherapy recommendations.

To improve the damage performance of the shaped charge when damaging the concrete target, a new structure of shaped charge with reactive material composite liner was proposed. The behavior of reactive material composite liner-shaped charge penetrating the concrete target was researched by numerical simulation in the finite element simulation platform Autodyn-2D. The effects of the ratio of liner diameter and the ratio of the liner thickness of the inner liner to the composite liner on the penetration depth, hole diameter, and the following behavior of reactive materials were obtained. Numerical simulations show that, with increasing the liner diameter ratio and the liner thickness ratio, the penetration depth and hole diameter of the composite jet into concrete first increase and then gradually decrease. However, the increase of the liner diameter ratio and thickness ratio also means a decrease in the reactive materials’ total mass, which will significantly affect the following reactive materials into the penetration hole. Simulated results further show that it is better to find out that the liner diameter ratio is 0.7 and the liner thickness ratio is 0.2~0.4. The penetration depth and hole diameter of the composite jet into the concrete match well with the quality of the following reactive materials.