Measured VD angles of L1, and constructed QCT-FEA models of L1 with the minimum (0.59°), median (5.79°) and maximum (11.15°) VD angles, respectively. Loads in two directions were applied on the upper edge of L1 with a force of 700 N, and vertebral stiffness (VS) was defined as the ratio of 700 N and displacement at the superior reference point: (1) perpendicular to the upper edge of L1 (defined as VS-U); (2) perpendicular to the lower edge of L1(defined as VS-L).P < 0.05). VS-U was significantly different among three VD angles, so was VS-L (P < 0.001). VS-U was higher than VS-L in 5.79° and 11.15° VD angles (P < 0.05), however no difference in 0.59° VD angles (P > 0.10).Age was very weak positively correlated with VD angle, moderate negatively correlated with vBMD, and moderate negatively correlated with VS (VD angle of L1 was slightly increased with age and not correlated with vBMD, and VS was moderate negatively correlated with age, showing that the vertebral body was more likely to fracture with aging. VS-U and VS-L were gradually decreased with the increase of VD angle, and VS-L was lower than VS-U with the increase of VD angle, which showed that vertebral body was more prone to fracture when the load was perpendicular to the lower edge of the vertebral body as the VD angle increasing.The online version contains supplementary material available at 10.1186/s12891-022-05518-z. Vertebral deformity (VD) is mainly attributable to osteoporosis and classical hallmark of osteoporosis, associated with marked increase in morbidity, mortality and health economic burden . There aQuantitative computed tomography (QCT) has become the most common tool for measuring volume bone mineral density (vBMD), which can avoid the influence of vertebral osteophyte, facet degeneration, intervertebral disc stenosis, endplate sclerosis and abdominal aortic wall calcification –19. Howest lumbar vertebral body (L1) in elderly women, and investigate the influence of VD angle on VS by biomechanical analysis using QCT-FEA.The purpose of our study was to explore the vertebral deformity angle (VD angle) of 12).We retrospectively reviewed a single-center database of QCT examination from January 2017 to December 2019 with approval from the local institutional review board (2018–036-1). Written informed consent was provided to all participants before QCT examination. Inclusion criteria: women from 50 to 80 years old and underwent MRI examination within one week interval from QCT to exclude L1 vertebral compression fracture. Exclusion criteria: vertebral fracture and/or surgery, and biconcave or crush deformity of L1. Age, height and weight were recorded, and height and weight were measured by standard method. Body mass index (BMI) was defined as weight (kg) divided by height squared (mth thoracic to 2nd lumbar vertebra) in the supine position by using CT scanner  with hands above the head and a solid Mindways QCT phantom  closely dorsal side of each participant simultaneously. CT scan was performed using the following parameters: 120 kV, 125 mAs, 168 cm table height, 512 × 512 matrix, 1 mm slice thickness, and 500 mm field of view.All participants underwent cross-sectional CT scan of L1 . Regions of interest (ROI) about 250 mm3) has been assumed linear [We constructed QCT-FEA models of L1 using the Mimics program  and Geomagic Studio 2013 . Three-dimensional finite element models were built by converting each voxel in the QCT images directly into a linear cube-shaped tetrahedral element. QCT images of DICOM format were imported into Mimics, vertebral bone was segmented out, and then coronal, sagittal and axial images of lumbar vertebra were obtained. Threshold, split mask, edit masks, calculate three dimensions and other steps were performed of L1 to fill the holes and remove the sharp angles, and then a preliminary three-dimensional geometric model was obtained. The preliminary three-dimensional geometric model was imported into Geomagic Studio of STL format, smoothened, and then exported into STP/STEP format. The spine structure is complex, so in this study, the vertebral body accessory, intervertebral disc, ligament muscle and other structures were removed, and only the vertebral body was analyzed for the need to simplify the models. In Abaqus software, material properties of L1 were endowed. The material property  of each element was automatically mapped from the corresponding voxel of the CT dataset based on its Hounsfield unit (HU) , 26. Thed linear , 28, andAn empirical relationship between BMD and elastic modulus , which was previously established based on mechanical testing of the human vertebral cadavers, was used to determine the material properties of the bone elements , 30:\docThe Poisson’s ratio was set to 0.3, as commonly used in bone QCT-based finite element models , 31.Abaqus software  was used for biomechanical analysis of three angles QCT-based finite element model among each participant, respectively. The boundary was set, and freedom of all nodes on the lower surface of L1 was set to 0. Loads in two directions were applied on the upper edge of L1 with a force of 700 N centrally:(1) perpendicular to the upper edge of L1; (2) perpendicular to the lower edge of L1  and its resulted displacement at the superior reference point . VS whenP < 0.05 was considered significant. Statistical description of the quantitative variables was expressed as mean ± standard deviation (SD) or median . Pearson or spearman correlation test was used to test the correlation among age, BMI, VD angle, vBMD and VS, and P < 0.05 was considered significant. Kruskal–Wallis H test was used to test the difference of VS-U among three VD angles (P < 0.05 was considered significant), and then Mann–Whitney U test for pairwise comparison, and statistical test criteria for pairwise comparison was calibrated as α’ = α/3, that was 0.05/3. Statistical analysis method of VS-L is the same as that of VU-U. Two independent Mann–Whitney U test was used to compare the difference between VS-U and VS-L of the same VD angle, and P < 0.05 was considered significant.Statistical analyses were performed using SPSS version 26.0. Shapiro–Wilk (SW) test was used to test whether the data accorded with normal distribution, and Two hundred seventy eight female participants were included Table .Table 1Dr = -0.012, P = 0.842), very weak positively correlated with VD angle , moderate negatively correlated with vBMD , and moderate negatively correlated with VS .Age was not correlated with BMI , not correlated with vBMD , and not correlated with VS .BMI was not correlated with VD angle , and not correlated with VS .VD angle was not correlated with vBMD , and then for pairwise comparison, there were difference between 0.59° and 5.79°, between 0.59° and 11.15°, and no difference between 5.79° and 11.15° VD angles , and then for pairwise comparison, there were difference between 0.59° and 5.79°, between 0.59° and 11.15°, and between 5.79° and 11.15° VD angles , however no difference in 0.59° VD angles (P > 0.10, Fig. VS-U was higher than VS-L in 5.79° and 11.15° VD angles (Present study showed that age was very weak positively correlated with VD angle, consistent with previous study, which showed that VD was increased with age and was more marked in women . Age wasThe density-modulus relationship was directly adopted from a previous study where mechanical testing was conducted on vertebral bone of white subjects; thus, the predictive abilities of our QCT-FEA models for stiffness are well validated , 29, 30.Several limitations should be discussed. Firstly, the vertebral body accessory, intervertebral disc, ligament muscle and other structures were removed, and only the vertebral body was analyzed for QCT-FEA models. Secondly, only three VD angles of QCT-FEA models were reconstructed. While now, FEA of each patient’s clinical-resolution computed tomography scan, accounting for variations in geometry, cortical thickness, and material properties to assess bone stiffness and bone strength , is now We demonstrated that VD angle of L1 was slightly increased with age and not correlated with vBMD, and VS was moderate negatively correlated with age, showing that the vertebral body was more likely to fracture with aging. VS-U and VS-L were gradually decreased with the increase of VD angle, and VS-L was lower than VS-U with the increase of VD angle, which showed that vertebral body was more prone to fracture when the load was perpendicular to the lower edge of the vertebral body as the VD angle increasing.Additional file 1.


Clinical Neuroradiology had seen over the course of the past three decades [Last year, we reported on the enormous success  decades . The jouJournal metrics, such as article accesses and submissions, showcase a journal’s development within its field; as such, the journal impact factor receives much attention as one of the most prominent journal metrics.Clinical Neuroradiology has risen continuously in recent years, we are seeing a drop for the first time on publication of the journal impact factors in mid-2022 , the number of citable items, while additional citations stem from the inclusion of additional early access content in 2021 contributing to the numerator [Clinical Neuroradiology this year, we are positive that the quality of our submissions and publications continues to increase.This change in calculation, along with the enormous impact of COVID-19 on publications and citations has caused many shifts in citation numbers and rankings. While this has affected a dip in impact factor and ranking for We are looking forward to your continued support of the journal as readers, authors and reviewers and will take all measures to continue to offer a just and profound peer review process and to serve as an excellent publication home for research of the international neuroradiological community.László SolymosiEditor-in-Chief


In this work, a valorization of the starch stemming from downgraded potatoes was approached through the preparation of starch nanoparticles using different physical methods, namely liquid and supercritical carbon dioxide, high energy ball milling (HEBM), and ultrasonication on the one hand and enzymatic hydrolysis on the other hand. Starch nanoparticles are beneficial as a reinforcement in food packaging technology as they enhance the mechanical and water vapor resistance of polymers. Also, starch nanoparticles are appropriate for medical applications as carriers for the delivery of bioactive or therapeutic agents. The obtained materials were characterized using X-ray diffraction as well as scanning and transmission electron microscopies (SEM and TEM), whereas the hydrolysates were analyzed using size exclusion chromatography coupled with pulsed amperometric detection (SEC-PAD). The acquired results revealed that the physical modification methods led to moderate alterations of the potato starch granules’ size and crystallinity. However, enzymatic hydrolysis conducted using Pullulanase enzyme followed by nanoprecipitation of the hydrolysates allowed us to obtain very tiny starch nanoparticles sized between 20 and 50 nm, much smaller than the native starch granules, which have an average size of 10 μm. The effects of enzyme concentration, temperature, and reaction medium pH on the extent of hydrolysis in terms of the polymer carbohydrates’ fractions were investigated. The most promising results were obtained with a Pullulanase enzyme concentration of 160 npun/g of starch, at a temperature of 60 °C in a pH 4 phosphate buffer solution resulting in the production of hydrolysates containing starch polymers with low molecular weights corresponding mainly to P-10, P-5, and fractions with molecular weights lower than P-5 Pullulan standards. Agri-food sector activities generate large volumes of various by-products which must be disposed of judiciously to preserve the environment on the one hand and to give added value to this biomass on the other hand. This is the case with downgraded potatoes, rich in starch, which represents a valuable resource for a successful industrial recovery. Starch is a polysaccharide composed of glucose units, stored in several plants’ reserve organs such as cereals (30–70% of dry matter), tubers (60–90%), and legumes 25–50%). It is the major source of carbohydrates in animal and human food . Starch 5–50%. Itα-D-glucopyranose: (i) amylose, a linear polymer composed of glucose units linked by α-(1–4) bonds, and (ii) amylopectin, a highly branched polymer made of glucose units with α-(1–6) bonds [Starch consists of two homopolymers of 6) bonds . Potato d by α-1– bonds, a6) bonds . The braAfter extraction, native potato starch granules are in the form of a white powder that is insoluble in cold water and their grain size varies between 5 and 100 μm . In fact2 treatment, ultrasonication, and high-energy ball milling [Several methods were employed for the preparation of starch nanoparticles with different physicochemical and mechanical properties . Among t milling ,14. In a milling .2 is the most used supercritical fluid because it has moderate critical conditions, can readily be separated from solutes, poses no environmental problems, and is non-flammable, non-toxic, as well as inexpensive. The low critical temperature (304.15 K) and pressure (72.8 atm) of CO2 make it the ideal solvent for natural products, which tend to be susceptible to thermal degradation during processing [Supercritical COocessing .Ball milling entails several mechanical actions encompassing collision, friction, shearing, impingement, and grinding. It is regarded as an environmentally friendly and green non-chemical low-cost treatment ,18. BallHigh-intensity ultrasound is a physical treatment without any chemical reaction. Recently, it has attracted great interest in many food applications, such as emulsifying, sterilizing, extracting, degassing, filtrating, drying, and enhancing oxidation ,24. HighAcid hydrolysis has been used to modify starch granule structure and produce “soluble starch” or glucose syrup for many years . The lim2), high energy ball milling (HEBM), ultrasonication (US), as well as enzymatic hydrolysis. The investigation aims to understand how the selected treatment method influences the molecular weight and the structural changes of starch granules.The present investigation focuses on the valorization of potato starch from downgraded potatoes through the preparation of starch nanoparticles using different methods, namely supercritical carbon dioxide . Pullulanase enzyme (E2412) and a phosphate buffer solution at a pH of 4 were acquired from Sigma-Aldrich and used without further purification.Starch extraction from the downgraded potatoes was conducted as reported by Kim et al. . In a ty2 procedure was conducted in a one-liter stainless-steel high-pressure autoclave mounted with a diaphragm-type compressor  operating at up to 6000 psi, and a thermostatic bath to achieve and maintain the CO2 supercritical conditions (P > 1073 psi and T > 31 °C) as previously reported by Nlandu et al. [2 to reach the desired temperature. Thermostated liquid jacket was used to control the reactor temperature. All lines were electrically heated and insulated to keep the fluid temperature constant along the different sections. Pressures were measured by manometers and temperatures by thermocouples. In a typical run, the reactor was charged with native potato starch (1 g) and hermetically closed. The CO2 was aspirated from a cylinder furnished with a dip tube, pressurized to 2500 psi, and conducted to the reactor vessel. The reactor was heated to the desired temperature. Additional CO2 was regularly added to obtain the pre-set pressure value. After 4–8 h, the pressure was released to atmospheric pressure, and the solid product was collected. The tests were conducted under different conditions as presented in The supercritical COu et al. . The preThe high-energy ball milling (HEBM) of potato starch was performed using the planetary ball milling system Emax from Retsch Company . Potato starch granules were placed in a 50 mL stainless-steel reactor previously filled with 30 g of stainless-steel spherical balls with 5 mm diameters, either under dry conditions or in the presence of water (20 mL of distilled water). The high-energy ball milling treatment was performed at a rotation speed of 1100 r/min for 30 min at 75 °C as reported by Liu et al.  and VertThe high-intensity ultrasonic processor  from Branson Ultrasonics Corporation  was used for the ultrasonication of the starch. In a typical test, starch (200 mg) and distilled water (4 mL) were mixed in a glass vial, then the ultrasonic radial probe  was immersed in the starch suspension as reported in previous works ,30. Testθ were 5–55°, with a scan speed of 2 degrees/minute, covering all the significant diffraction peaks of starch crystallites. Duplicate measurements were made at ambient temperatures.The powder XRD patterns of native and treated potato starch samples were obtained using a Rigaku D-Max-Ultima III  diffractometer with nickel-filtered Cu Kα radiation of wavelength 1.5406 Å. The X-ray generator was operated at 40 kV and 44 mA. The scanning regions of the diffraction angle 2θ of 55° and 5° was taken as the amorphous section. The upper diffraction peak area and total diffraction area over the diffraction angle of 5–55° 2θ were integrated on Smadchrom software . The relative crystallinity was quantitatively estimated as a ratio of the crystalline area to the total area between 5–55° (2θ) [aI is the amorphous area and cI is the crystalline area on the X-ray diffractogram.The degree of crystallinity of starch samples was quantitatively estimated as the ratio of the area of crystalline reflections to the overall diffraction area as previously reported ,35,36. A55° (2θ) . The per55° (2θ) :CrystallThe surface morphology of the native and different pretreated starches was examined using a scanning electron microscope  operated at an accelerating voltage of 10 to 20 kV. Before analysis, the samples were prepared via sputter coating with platinum to obtain conductive surfaces. The microstructure and sizing of the potato starch samples recovered from the hydrolysates were investigated using a transmission electron microscope  at an accelerating voltage of 80 kV. Before analysis, each representative sample was suspended in ethanol and sonicated for 5 min. Then, a drop of the suspension was placed on a carbon microgrid and dried at a temperature of 60 °C for 20 min.2O, then, 500 μL of the starch solution (10 mg starch) was mixed with a predetermined volume of Pullulanase solution corresponding to 40–320 npun/g starch. The mixture was agitated at 130 rpm for a total duration of 6 h. New Pullulanase Unit Novo (npun) was defined as the amount of enzyme, that, under standard conditions, hydrolyzes pullulan, liberating reducing carbohydrates with reducing power equivalent to 1 µmole glucose per minute [Enzymatic hydrolysis was performed on different starch samples. The effects of Pullulanase concentration , temperature , and pH  on the extent of starch hydrolysis were investigated. In a typical run, potato starch (100 mg) was mixed with 5 mL Hr minute . Aliquotr minute . Hence, Size-exclusion chromatography (SEC) was performed using a Dionex chromatographic system ICS 2500  consisting of a gradient pump GP50, an electrochemical detector ED50, and a thin-layer type amperometric cell outfitted with a gold electrode and Ag/AgCl reference electrode. Pulsed amperometric detection (PAD) utilized a repeating sequence of three potentials, which were applied for specific durations. PAD is most sensitive to carbohydrates at a pH of 12 or greater, but a mobile phase of this pH would quickly destroy the polymer-based size-exclusion columns. Instead, a buffered mobile phase was used and sodium hydroxide was added post column to raise the pH. Two TSKgel size-exclusion columns G6000PWxl and G4000PWxl were used in tandem at 40 °C. The eluent was 10 mM acetate buffer  at a flow rate of 0.35 mL/min and stored in a pressurized bottle with argon. The post column reagent was 300 mM sodium hydroxide (15 mL sodium hydroxide solution (50%) diluted to 1 L with 18-MΩ water) at 0.65 mL/min flow rate and stored in a pressurized bottle with argon. The sample volume injected was 25 μL. The Chromeleon software  performed the calibration curve and integrated all the chromatographic data. The PeakFit software was used in the deconvolution procedure to automatically locate hidden peaks through a Gaussian response function with a Fourier deconvolution/filtering algorithm.θ, and the d spacing was used to discriminate the planes of different sites. Native and CO2-treated potato starches, as well as starch treated with HEBM, gave rise to the strongest diffraction peaks at around 17° 2θ (d = 5.058 Å) and a few small peaks at around 2θ values of 20° (d = 4.448 Å), 22° (d = 4.037 Å), and 23° (d = 3.855 Å). The X-ray powder diffraction patterns of 2 treatment compared to the native starch, as the major peaks were similar. However, the relative intensity of the predominant diffraction peaks of starch granules decreased slightly after supercritical CO2 treatment at 70 °C corresponding to a decrease in crystallinity (The starch granules are semi-crystalline white particles, insoluble in water at room temperature. The size and shape of the granules are specific to each plant species. In a very simplified way, the organization of the starch grain results from the arrangement of amylose and amylopectin in amorphous and crystalline zones arranged concentrically from the hilum. The crystallinity of the starches is mainly due to the double helix chains of amylopectin and the cohesion of the crystalline zones is ensured by intermolecular hydrogen bonds . The X-rallinity . There wallinity . This ma2 exhibited irregularly shaped granules; however, the B-type form of the granules was maintained (2 at 40 °C, consisting of small irregularly shaped granules with defects on the surface (2 at 70 °C evidenced the formation of some cracks and pores on the granule surface (The scanning electron micrographs of native potato starch of the Gabrielle variety are presented in intained a. Morpho surface b. The st surface c. Some oHEBM treatment led to the breakage of the granules as depicted in The potato starch granules treated with ultrasonication under dry as well as wet conditions followed by different drying techniques exhibited various morphologies . Under dThe chromatograms in The pH of the solution is an important parameter in the investigated enzymatic hydrolysis of potato starch. Indeed, pH greatly influences the activity of the enzyme. In the present investigation, the effects of pH on the activity of Pullulanase for potato starch hydrolysis were studied using phosphate buffer solutions at pH 4 and 10 as well as distilled water. No activity of the Pullulanase enzyme was noticed at pH 10 in agreement with previously reported findings stating that Pullulanase performs best at pH 4–6 . As disp2, ultrasonication, and HEBM under dry and wet conditions. As seen, spherical-like particles with very tiny diameters ranging from 20 to 50 nm were obtained.The TEM images of the potato starch particles recovered by the nanoprecipitation of the hydrolysates obtained after 6 h of reaction at 60 °C using Pullulanase at a concentration of 160 npun/g starch in a pH 4 buffer solution are illustrated in 2 treatments, XRD analysis revealed that the crystalline patterns of the treated potato starches were mainly unaffected. The effect of HEBM on the starch crystallinity was dependent on the conditions of milling. Dry conditions led to a decrease in crystallinity, whereas wet conditions resulted in the opposite effect. Ultrasonication caused an almost complete loss of starch crystallinity, which was confirmed by the drastic change in the starch morphology as revealed by SEM, which evidenced the formation of an unprecedented foamy morphology that could be useful for several innovative applications, such as the synthesis of biodegradable cushion packaging materials, medical tissue engineering, and drug delivery. As for the enzymatic hydrolysis of the starch using Pullulanase, it resulted in the production of hydrolysates containing starch polymers with low molecular weights corresponding mainly to P-10, P-5, and P < 5 Pullulan standards. The best results were obtained with a Pullulanase enzyme concentration of 160 npun/g of starch at a temperature of 60 °C in a pH 4 phosphate buffer solution. Among the different treatments investigated in the present work, only the enzymatic hydrolysis allowed the production of nanoparticles sized between 20 and 50 nm, which can be potentially useful for advanced applications, such as reinforcement in food packaging technology and carriers for the delivery of bioactive or therapeutic agents in the medical domain. This represents a judicious valorization of downgraded potatoes.The physical modification of potato starch granules was achieved using liquid and supercritical carbon dioxide, high-energy ball milling, and ultrasonication under dry and wet conditions. The differently treated potato starch granules were characterized morphologically using SEM and structurally using XRD. Following the supercritical and liquid CO


Zirconia has recently become a popular material for fixed restorations. The purpose of this study was to use a digital workflow to fabricate monolithic zirconia fixed dental prostheses (FDPs) and assess the connection between variable connector sizes compared to their clinical performance.2 for the 3-unit restorations (pontic to retainer) and ≥12 mm2 for the 4-unit restorations (pontic to pontic). Biological an technical outcomes of the FDPs were performed at 1 week, 6 months and then annually for 6 consecutive years.Clinicians evaluated monolithic zirconia FDPs in 58 patients. After definitive impressions were made, stone casts were obtained. The stone casts were scanned to a standard triangle language (STL) file. A digital wax up was fabricated, and corresponding provisional restorations were milled. Final FDPs were fabricated from a high-translucent zirconia material. During digital fabrication, the connector area of each FDP was recorded while meticulous attention was paid to ensure that the connector cross-sectional area was ≥9 mm2 in the two broken 4-unit FDPs.A total of 23 men and 35 women received a total of 63 full-contour zirconia FDPs in the posterior regions and were observed for a time period ranging between 50 and 70 months. No decementation occurred and no caries were detected during the observation period, however signs of gingivitis were detected in 4 patients. The dimension of the connector areas was 12 mmThe results of this study suggest that the use of digital scanning and milling to fabricate monolithic zirconia FDPs of posterior regions may be an acceptable alternative restorative approach to traditional metal-ceramic restorations. This precise and accurate data gives clinicians the ability to draw more understanding for any objective they may have set out to study. At this point it may be seen that as the span of scanning for an arch, the accuracy does decrease,,Of course, as with all novel concepts, accurate implementation, and use of said workflow is key. If used incorrectly a clinician or patient will not be able to benefit from the techniques provided. There is a learning curve and an initial investment of time and money that is needed in order to implement these tools into everyday practice.Through scanning, digitization and milling, this study aimed to evaluate the clinical performance of monolithic zirconia fixed dental prostheses with variable connector sizes and determine if there was a connection between the contact area and fracture resistance for the FDPs under different contributing variables.This study was performed in February 2022 and run retrospectively in a dental faculty practice to evaluate monolithic zirconia multiunit FPDs. Authors evaluated the records of 58 patients who had received monolithic zirconia FPDs to replace one or two missing teeth during the time span of January 2016 to December 2017. An approval for this study was obtained from our school's Institutional Review Board (Number: GO 22/285). Prior to treatment, the participants were informed about the other alternative treatments and the advantages and disadvantages of the monolithic zirconia material and allowed to choose if they wished to move forward with this treatment. Each participant signed an informed consent form for this study.Patient selection was based on the following inclusion criteria: (1) 1 or 2 missing posterior teeth  requiring replacement by means of FDPs of between 3 and 4 units; (2) abutment teeth presenting stable periodontal health; no signs of active bone resorption, furcation involvement, or periapical pathology; (3) moderate to good oral hygiene and low caries risk; (4) good general health without severe physiologic or psychologic conditions. Excessive parafunctional habits were not considered an exclusion criterion.The following data were considered: age, sex, number of prosthetic units, location of abutments and pontics, existing condition of abutment teeth , opposing dentition, zirconia and luting cement trademark, use of an occlusal splint or signs of bruxism, dimensions of connector cross-sectional area of each bridge (abutment to pontic and pontic to pontic), time in mouth from placement to the last examination. Each restoration was assessed by an experienced clinician (GA), who was not involved in patient treatment, in terms of marginal integrity, surface, color, and anatomic form. Evaluation of each category was rated as excellent, acceptable, or unacceptable according to the California Dental Association (CDA) quality evaluation system. All the complications leading to a replacement of the restoration  were defined as a failure.A consistent team of one skilled clinician (MBG) and a one dental technician provided patient care adhering to strict prosthodontic protocols. Occlusal surface reduction of abutment teeth ranged from 1.5 to 2 mm, and axial reduction ranged from 1 to 1.5 mm, with a convergence angle of 10- to 20-degrees. A 1.4 mm round-end cylinder diamond bur  was utilized to create a 0.7 mm chamfer finish line in the preparations. After all line angles were rounded off, gingival displacement was achieved, then definitive impressions were made with polyvinyl siloxane impression material . Temporary restorations were fabricated by using a bis-acrylic resin  and a matrix, and then cemented with a eugenol-free temporary cement . Impressions of the counter arch were made with the same impression material and interocclusal bite registration records were made . The working casts and the abutment dies were fabricated with a Type IV dental stone . Each stone cast was then scanned to an STL file. The file was then uploaded to a programming software that allowed the practitioner to create a digital wax up. Provisional restorations were milled from each corresponding digital wax up and then temporarily cemented.The workflow of the fabrication of FPDs was as follows; firstly the provisional restorations that were milled from an acrylic material in a laboratory served to check esthetics and function. The anterior guidance and occlusal balance were both adjusted intraorally to establish the simultaneous bilateral contacts of opposing teeth during eccentric movements. After the temporary restorations were sent back to the dental laboratory, the technician rescanned and virtually superimpositioned them onto the previous design by using the same software . A 80-micron space was added into the design for cement space.2 for the 3-unit restorations (pontic to retainer) and ≥12 mmDefinitive FDPs were fabricated as full-contour zirconia restorations from a presintered high translucent zirconia material . During the designing, each connector's cross-sectional area of the restorations was recorded. Meticulous attention was paid to ensure that connector cross-sectional area was ≥9 mmThe thickness of the restorations was at least 1 mm. The sintering procedure was performed strictly adhering to the manufacturer's instructions. By a single clinician, restorations were evaluated intraorally to ensure accurate seating by using fit checker, and proper occlusal contacts by using articulating paper. If necessary, occlusal adjustments were done with a fine diamond zirconia intraoral polishing rotary instrument under water cooling.Paste-type surface staining  material was applied for the characterization of full-contour zirconia. FPDs were glazed (Cerabien Zr) according to the manufacturer's recommendation at 850 °C. The bonding surface of the abutment tooth was rinsed with water spray and a conditioner  was applied for 20 s. After ultrasonically cleaned in 95% ethyl alcohol for 5 min, restorations were cemented with a resin-modified glass ionomer cement (Fuji Plus).After delivery of the FDPs, a skilled clinician (G.A.) without any prior involvement with the experiment was chosen to evaluate the biological and the technical outcomes at 1 week, 6 months and then annually for 6 subsequent years. The esthetics and function of the prostheses were evaluated in terms of marginal integrity, surface, color, and anatomic form according to the California Dental Association (CDA) quality evaluation system as excellent, acceptable, and unacceptable (correction or replacement).P-value < 0.05 was considered statistically significant.The data for 63 full-contour zirconia FDPs were statistically analyzed with a software . For each FDP, the time to failure and complications were recorded. The survival of the restorations compared to subcategories of number of units, bruxism, jaw, antagonist and pontic location were displayed using Kaplan–Meier survival curves. The significance of differences between survival curves was determined with the log-rank test. A Fifty-eight patients  between the ages of 24 and 72 (mean age 47 ± 11.7) received 63 full-contour zirconia posterior FDPs . The obsP > 0.05)  the CDA scores of the remaining ones were as follows; 52 (87%) were rated as excellent and 8 (13%) acceptable for marginal integrity. Anatomic form was noted as 39 (65%) excellent, 21 (35%) acceptable. Color and surface texture was rated as 17 (28%) excellent, 43 (72%) acceptable. Survival rate of 3- and 4- unit FDPs were 97.7% and 89.5% respectively, which indicated no statistical difference ( > 0.05) . After a2 (Two of the 4-unit bridges were broken at the pontic–pontic connector area. It was noted that on both broken bridges the dimension of connector area was 12 mm2 . The disPreviously performed studies have attempted to assess the validity of monolithic zirconia FDPs. Many have demonstrated that monolithic zirconia as the sole restorative material result in successful treatment. Although monolithic zirconia FDPs in the posterior region has already been deemed a viable alternative treatment option, additional information must be gathered as the us of monolithic zirconia is becoming increasingly popular and may possibly replace previously used alternative restorative materials.Although direct comparisons between the present study and previous studies can not be made as they used different materials and workflows, following studies can be mentioned here. A study by Pelaez et al.,Another study by Pontevedra et al.,While these studies have suggested that the use of zirconia is an appropriate material for the fabrication of an FDP, additional considerations are needed to determine if this restorative method is case specific or can be generalized as the new gold standard of FDP restorations. Other parameters such as increasing span of restoration, connector size design, as well as overall success of restorations in patients who display parafunctional habits need to be considered in order to generalize the claim the monolithic zirconia is a satisfactory restorative material alternative.2.,2 and 16 mm2. Not one of these FDPs fractured, indicating that the clinically accepted value of 9 mm2 may be better suited to start at a value closer to those reported in this study. The two 4-unit FDPs that did happen to fracture were in patients who displayed parafunctional habits of bruxism, and the connector size were around 12 mm2 and 13 mmThe connector areas of these FDPs are a factor that may be considered for design flaws. Previous studies have claimed clinical acceptable values in connector size for the posterior regions of 3-unit FDPs to be no less than 9 mm2, 12.00 ± 0.00 mm2, and finally, 13.00 ± 0.00 mm2 (2 in the posterior region may be too low. It is also possible to claim in cases that restorations are fabricated for patients with bruxism, the minimum connector size for posterior regions needs to be greater than 12 mm2. Instances where excessive or even general occlusal loads cause compressive stress directly to the connectors of the FDP causing microcracks and ultimately leading to fracture of the FDP was also found in the study performed by Hamza et al.A statistical significance was noted in this study for patients who experienced bruxism. In the case of patients with parafunctional habits, out of 27, two of the 4-unit FDPs did fracture resulting in a statistically significant survival rate of 88.9%. It is also noteworthy to reiterate that the connector size of those 4-unit FDPs for the mesial, pontic to pontic, and distal connector area were as follows: 12.50 ± 0.71 mm0.00 mm2 . This prIn certain cases where patients have parafunctional habits or have different restorations on opposing dentition of the FDP, what was once established as general clinical acceptance may not directly apply to everyday practice. As new considerations are put into practice, the continual successful use of this material with a digital workflow of intraoral scanners and milling machines may lead to conclusive evidence supporting monolithic zirconia FDPs as an acceptable alternative restorative material to the traditional all metal-ceramic and veneered-zirconia.The authors have no conflicts of interest relevant to this article.


Loss of PTST2, a protein involved in starch granule initiation, had highly variable effects between three grass species on carbohydrate metabolism and physiology of leaves and granule morphology of seeds. Hordeum vulgare (barley), Triticum turgidum (durum wheat), and Brachypodium distachyon defective in PROTEIN TARGETING TO STARCH 2 (PTST2), a key granule initiation protein. We report striking differences across species and organs. Loss of PTST2 from leaves resulted in fewer, larger starch granules per chloroplast and normal starch content in wheat, fewer granules per chloroplast and lower starch content in barley, and almost complete loss of starch in Brachypodium. The loss of starch in Brachypodium leaves was accompanied by high levels of ADP-glucose and detrimental effects on growth and physiology. Additionally, we found that loss of PTST2 increased granule initiation in Brachypodium amyloplasts, resulting in abnormal compound granule formation throughout the seed. These findings suggest that the importance of PTST2 varies greatly with the genetic and developmental background and inform the extent to which the gene can be targeted to improve starch in crops.Recent work has identified several proteins involved in starch granule initiation, the first step of starch synthesis. However, the degree of conservation in the granule initiation process remains poorly understood, especially among grass species differing in patterns of carbohydrate turnover in leaves, and granule morphology in the endosperm. We therefore compared mutant phenotypes of  Starch is a major storage carbohydrate in leaves and non-photosynthetic organs of plants. Transitory starch accumulates in leaf chloroplasts during the day and is degraded at night to provide substrates for growth and maintenance . Storageptst2 mutants contain a single, large granule in place of multiple smaller granules, suggesting that PTST2 promotes granule initiation. It may do so by delivering maltooligosaccharides as substrates for another granule initiation protein, STARCH SYNTHASE 4 (SS4) (Oryza sativa) and barley (Hordeum vulgare) are known as FLOURY ENDOSPERM 6 (OsFLO6 and HvFLO6), while orthologues in durum (Triticum turgidum) and bread wheat (Triticum aestivum) are named B-GRANULE CONTENT 1 (TtBGC1/TaBGC1). Leaves of rice mutants deficient in OsFLO6 also have reduced numbers of enlarged starch granules per chloroplast (Osflo6 mutant) results in heterogenous amyloplasts with highly variable numbers of initiations within each compound granule  results in A-type granules with abnormal morphology and failure to produce B granules  . PTST2 i 4 (SS4) . Ortholoptst2 mutant of Brachypodium distachyon and compared its leaf and seed phenotypes with those of mutants of wheat and barley lacking PTST2 orthologues. Although all three species are in the family Pooideae, Brachypodium differs from wheat and barley in both its diel carbohydrate metabolism in leaves and its granule initiation pattern in seeds. Although leaves of all three species turn over both starch and sucrose over the day–night cycle, Brachypodium turns over approximately equal amounts of starch and sucrose  was sourced from the Joint Genome Institute Brachypodium T-DNA collection , 247 nucleotide bases downstream of the start site (B. distachyon wild-type control. The Hordeum vulgare (barley) mutant was Franubet (Hvflo6), which contains a premature stop codon mutation in PTST2 (Triticum turgidum (tetraploid durum wheat) mutant was bgc1-3  (bgc1-3 line was used as the wild type for wheat.The art site  within tart site . Plants Bdptst2 mutant contained a single insertion at the BdPTST2 locus (B. distachyon v3.1 reference genome (http://picard.sourceforge.net). T-DNA insert locations were identified using VirusFinder  were made to determine if 1500 μmol m−2 s−1 represented saturating light for each species under our growth conditions. The responses of the CO2 assimilation rate to step increases in light intensity (AQ) were measured under constant conditions of 400 ppm CO2, leaf temperature 24 °C. AQ measurements were taken after an acclimation time of 60–120 s at increasing light intensities .Gas exchange measurements were taken using a 6400XT portable photosynthesis system (Li-COR) 26–30 d after germination on young fully expanded leaves. Measurements of the CO2 assimilation rate to step increases of intracellular CO2 (A/Ci) was measured at a saturating light intensity of 1500 µmol m−2 s−1, and leaf temperature 24 °C. The A/Ci curves were carried out using the exact CO2 step increases and decreases outlined in Vcmax) and electron transport (Jmax) were calculated from A/Ci curves using the ‘Plantecophys’ package in R by fitting the raw data to a Farquhar, von Caemmerer, and Berry photosynthesis model  ethanol and resuspended in water. The starch in the pellet was gelatinized at 95 °C for 15 min and digested to glucose at 37 °C using α-amylase and amyloglucosidase (Roche) for 2 h. Starch content  was determined by glucose assay with a hexokinase/glucose-6-phosphate dehydrogenase-based spectrophotometric method (Roche). For sugar measurements the supernatant was neutralized to pH 6–7 using 2 M KOH, 400 mM MES. Glucose was assayed as above, then fructose and sucrose were assayed by successive additions of phosphoglucose isomerase (Roche) and invertase (Sigma).The method used for leaf starch quantification was previously described in Chlorophyll content was quantified 21 d after germination. Leaf segments (2 cm) from the middle of a young fully expanded leaf were harvested. Samples were weighed, and then placed into 80% acetone at 4 °C for 3 d. Chlorophyll content was quantified by measuring the UV-vis of the acetone solution at wavelengths of 645 nm and 663 nm using a spectrophotometer . Total chlorophyll content was calculated based on sample absorbance at 645 nm and 663 nm as outlined in 2O at 4°C, then homogenized in a ball mill at 30 Hz for 1 min. The homogenates were filtered through a 20 µm nylon mesh then centrifuged at 3000 g for 5 min. The pellet was resuspended in ddH2O and centrifuged at 2500 g for 5 min over a cushion of 90% (v/v) Percoll, 50 mM Tris–HCl, pH 8. The pellet was washed twice in 50 mM Tris–HCl, pH 6.8, 10 mM EDTA, 4% SDS (v/v), 10 mM DTT, while removing any remaining debris using selective resuspension. Finally, the pellet was washed twice with ddH2O.Starch granules were purified from mature seeds that were soaked overnight in 0.5 ml of ddHg for 10 min to separate insoluble material. Glucose was measured in the supernatant as described above and starch content calculated in glucose equivalents.For seed starch quantification, grains were ground to a powder using a ball mill at 30 Hz for 1 min. The powder (5–10 mg) was suspended in 80% ethanol, and starch was hydrolysed to glucose using reagents from the Total Starch Assay kit . Briefly, thermostable α-amylase in 100 mM sodium acetate, pH 5, was added and incubated at 99 °C for 7 min. Amyloglucosidase (Roche) was added before further incubation at 50 °C for 35 min. The sample was then centrifuged at 20 000 For analysis of granule size distributions, the starch was suspended in Isoton II (Beckman Coulter), and relative volume versus diameter plots were generated using a Multisizer 4e Coulter counter (Beckman Coulter) with a 30 µm aperture tube. A minimum of 50 000 granules were measured per sample.n=4) of 30-day-old plants were harvested 15–30 min prior to the end of the day. Care was taken not to shade leaves prior to snap-freezing using liquid nitrogen. Metabolites were extracted using chloroform/methanol as previously described  of the hydrogen adduct ([M+H](+) 590.0895) were taken for external standard quantification. Identity was confirmed using data-dependent MS2 with an isolation width of m/z 4.0 and 30 + 50% collision energies (combined in one scan). The instrument was calibrated according to the manufacturer’s instructions, and spray chamber conditions were 3000 V spray voltage, 350 °C capillary temperature, 35 units of sheath gas, 10 units of aux gas.The youngest fully expanded leaves . LR White blocks were polymerized at 60 °C for 16 h. For light microscopy, semi-thin sections (~0.5 µm) from the blocks were stained with periodic acid–Schiff’s reagent as described in For observation of granule morphology using SEM, mature seed sections were first fixed in 2.5% (v/v) glutaraldehyde in 0.05 M sodium cacodylate, pH 7.3 at 4 °C. Samples were then dehydrated in ethanol before critical point drying. Once dried, samples were mounted onto stubs and sputter coated with gold prior to imaging in a Nova NanoSEM 450 (FEI). For sections of leaves/developing grains: leaf segments were excised from approximately halfway along the length of the youngest fully expanded leaf at 30 d after germination and fixed in 2.5% (v/v) glutaraldehyde in 0.05 M sodium cacodylate, pH 7.3 at 4 °C. Developing grains [3 and 6 days post-anthesis (DPA)] were cut in half before immersion in the same fixative solution. Using an EM TP embedding machine , samples were post-fixed in 1% (w/v) OsOSpikelets were harvested at 6 DPA from plants at the middle of the light period and snap-frozen in liquid nitrogen. Seeds were extracted on dry ice. The lemma was not removed to limit damage to the seed and avoid excessive thawing. RNA was extracted using the RNeasy PowerPlant kit (Qiagen), incorporating an on-column DNase digest. Following quality control, library preparation with poly(A) selection was carried out at Novogene . RNA sequencing was then carried out using a NovaSeq 6000 machine (Illumina), returning ~30 million 150 bp paired-end reads per sample.B. distachyon v3.1 reference transcriptome (2 fold change (FC) >1. To assess functional enrichment of the differentially expressed transcripts, over-representations of Gene Ontology (GO) categories were assigned using AgriGo v.2.0  GO categories were identified using REVIGO and discarded to remove redundancy , durum wheat , and Brachypodium distachyon (Bd). The barley (Hvflo6) and wheat mutants (Ttbgc1) are those described in Brachypodium Bdptst2 mutant carrying an insertion in exon 1 was isolated from a T-DNA mutant collection  and had pale leaves , but effects on the starch:sucrose ratio were relatively minor in both species. In contrast, loss of PTST2 in Brachypodium caused a 10-fold reduction of starch content (P≤0.05) and no change in sucrose content. This led to a strong shift in the starch:sucrose ratio in favour of sucrose, and the total amount of starch and sucrose in Bdptst2 was less than half of that in the wild type. Since most defects in granule initiation in Arabidopsis lead to ADP-glucose accumulation  . In addition, a wide range of granule size within each Bdptst2 biological replicate was noted.To discover the impact of loss of PTST2 on starch granule initiation, we measured starch granule number per chloroplast and size  in leaf sections at the end of the day . Loss ofHvflo6 . In addie leaves . Again,  to >10) . In addin Hvflo6 . Granuleptst2 mutations had diverse effects on leaf starch across the three grass species. In barley, the loss of PTST2 reduced the numbers of granules and starch content but did not affect granule size. In wheat, the loss of PTST2 reduced granule numbers but increased granule size, and there was no effect on starch content. In the Brachypodium mutant, although granule size was increased relative to the wild type, granule numbers and starch content were strongly reduced.In summary, Bdptst2 had a decreased assimilation rate when compared with the wild type under growth conditions  curves were used to calculate the maximum rate of carboxylation (Vcmax) and maximum rate of electron transport (Jmax)  . Both Vc P≤0.05; , L. No s P≤0.05; . In addi P≤0.05; .Brachypodium seed development, starch accumulates in the maternally derived pericarp. At later stages, starch declines in the pericarp and storage starch accumulates in the endosperm , with the average seed length in the mutant (6.6 ± 0.1 mm) being ~12% shorter than in the wild type (7.5 ± 0.1 mm). Interestingly, despite the changes in seed size and starch morphology in the mutant, almost complete germination rates were observed in both genotypes.In the early stages of ar shape . Granulear shape . Similar in Bdptst2 seeds. Five starch synthase genes were also significantly down-regulated (FDR ≤0.05) in Bdptst2 seeds. In addition, SUBSTANDARD STARCH GRAIN4 (SSG4), which is known to affect compound granule morphology in rice (Bdptst2 seeds (FDR ≤0.05). While relatively strong log2 FCs were also observed for GWD and SBEIII, these were not significant at FDR ≤0.05.To investigate genes directly related to starch granule synthesis and regulation, transcript abundance of orthologues from known genes involved in these processes in Arabidopsis and rice were extracted . The corHvflo6 and Ttbgc1 mutants had distinct starch phenotypes in the leaves. Despite strong reductions in starch granule number per chloroplast, Ttbgc1 maintained a similar starch content to the wild type, a phenotype that is likely to be linked to the production of larger granules   . Therefoild type . The reaBrachypodium has severe, deleterious consequences. Bdptst2 plants were pale, slow growing, and almost starchless, and they accumulated large amounts of ADP-glucose (ss4 and ss3 ss4) has deleterious consequences, including pale leaves and slow growth. These effects are attributed to limitation of adenylates available for photophosphorylation and hence reduced chloroplast function . SSG4 encodes the rice orthologue of Arabidopsis TIC236 that links the protein import translocons on the inner and outer plastid membranes. Mutants deficient in SSG4 have highly abnormal compound granules (Brachypodium.A remaining question from our study is how granules initiate in the absence of PTST2 in the endosperm. In Arabidopsis, rice, and wheat, PTST2 is proposed to act in granule initiation with SS4 (ng seeds , 7. Desptiations . In factThe following supplementary data are available at Brachypodium distachyon ptst2 mutant.Fig. S1. Confirmation of the ptst2 plants.Fig. S2. Chlorophyll content of leaves of wild-type and Bd and Bdptst2.Fig. S3. Light microscope images of pericarp development for Bd and Bdptst2.Fig. S4. Light microscope images of grain development for Bd and Bdptst2 seeds at 6 DAF.Table S1. Transcript abundance changes between Brachypodium distachyon IDs for known starch genes of interest.Table S2. erac268_suppl_Supplementary_FiguresClick here for additional data file.erac268_suppl_Supplementary_TablesClick here for additional data file.


To improve the dispersion stability of phenol-formaldehyde resin (PFR) particles in simulated oilfield injection water and their propagation ability in petroleum reservoir, a hydrophobically associating polymer (HAP) was employed as a stabilizer in this paper. The dispersion stability of PFR in the injection water was studied by measuring turbidity as a function of time. In addition, the migration property of the PFR/HAP dispersion was evaluated by both cellulose membrane filtration and sand packs-flooding experiments. The results show that HAP can stabilize the PFR dispersion prepared with the simulated injection water by forming PFR/HAP complex molecular aggregates. These aggregates can migrate in sand packs with strong flow resistance due to deformation or disaggregation of the aggregates when passing through the pore throat. Oil recovery was improved by up to 21.1% on the basis of water flooding, and the higher the concentration of PFR/HAP dispersion system, the better the oil recovery effect. Moreover, the cycle of log-jamming/dispersion of the aggregates leads to their penetrations through the bigger pores in the sand packs with a higher flow resistance than water. This process can improve the conformance of water in high permeability sand packs on a micro/macro scale and thus divert more water into low permeability sand packs. Therefore, more oil could be recovered from the low permeability sand packs. Moreover, the bigger the sand pack’s permeability ratio, the lower the oil recovery rate by waterflood, and the more the incremental oil can be recovered by the PFR/HAP flood. Petroleum resources are still the main source of global energy and play an important role in all of the aspects of people’s daily lives and social development. The average oil recovery rate is between 30% and 60% with current development technology ,2. WaterIn recent years, nanomaterials have attracted people’s attention because of their unique physical and chemical properties ,15. NanoAfter extensive research and testing, the nanomaterials based on the particles formed by PFR molecular aggregates were proposed for enhanced oil recovery (EOR) ,19. PFR Hydrolyzed polyacrylamide (HPAM) is the most commonly used polymer in enhanced oil recovery (EOR) applications. In EOR, the polymers are added to the displacement water to increase its flow resistance, resulting in a favorable mobility ratio . HAP is In this work, the HAP was used to increase PFR dispersion in simulated injection water. The effect of the HAP on the dispersion stability of the PFR molecules in water was investigated by measuring the turbidity of the dispersion system. The microporous membrane filtration experiments were conducted to evaluate the plugging characteristics of the PFR/HAP dispersion. The transport characteristics in the porous media of the PFR/HAP dispersion were studied in the packed sand-pack which has three pressure sensors. Parallel sand-tube flooding experiments were carried out, to inspect the oil displacement effect of the PFR/HAP dispersion.3 at 45 °C. The cellulose membrane was purchased from China Nantong Longjin Membrane Technology Co., LTD., with a diameter of 47 mm and an average aperture of 5 μm. Phenol-formaldehyde resin 20 wt.%) was synthesized in our lab, and the chemical properties of the PFR were reported in our previous work [ wt.% wasThe turbidity of PFR solutions was measured by a turbidity meter  at 25 °C. The measurement principle of turbidity is based on light scattering. A tungsten lamp was used as a light source with a measurement range from 0.01 to 1000 NTU.A schematic diagram of the membrane filtration device is shown in 3. The permeability of the sand pack was measured with the injection of the simulated injection water at 0.4 mL/min. The permeability of the sand pack can be calculated, according to Darcy’s law:A is the sand pack cross-section area (cm2); Q is the fluid injection flow rate(cm3/s); μ is fluid viscosity (mPa·s); ΔP is the differential pressure at both ends of the sand pack; and L is sand pack length (cm).A sand pack of 50 cm in length and 2.5 cm in the inner diameter of a steel tube was used in this study, which has three pressure sensors monitoring the pressure gradient along with the sand pack. The first sensor was located at the entrance of the sand pack and the other two were installed on the sand pack, which equally divided the sand pack into three parts. Two of the sand pack experiments were performed to evaluate the blocking and penetration properties of the PFR/HAP dispersion in porous media at room temperature. For each experiment, the sand pack was injected with the simulated injection water at 0.4 mL/min until the injection pressure was stable. Then, the sand pack was injected with the PFR/HAP dispersion at 0.4 mL/min for about 0.5 pore volume (PV). Finally, the simulated injection water was injected at the same flow rate for at least 2 PV. The injection pressure at each pressure sensor along the sand pack was monitored by a computer throughout the whole experiment.Five parallel sand packs were conducted in this study, to evaluate the oil displacement performance of the PFR/HAP dispersion in the heterogeneous reservoirs. The schematic diagram of the parallel sand packs is shown in After being saturated with the oil, two sand packs with different permeabilities were installed, according to the setup shown in Dispersion stability is an important factor for evaluating the profile control agents because it can influence the blocking and penetration performance when migrating in porous media. The turbidity evaluation over time was conducted to figure out the dispersion stability of the PFR solution in the simulated injection water with the PFR concentration in the range of 150~1200 mg/L, as shown in To study the effect of the HPA on the PFR dispersion stability, the turbidity of the PFR/HAP mixture solution prepared with simulated injection water versus time was evaluated, as shown in The membrane filtration experiment is an effective and convenient method for evaluating the blocking property of the chemical agents in porous media . Figure Two sand pack experiments were conducted to evaluate the flow behavior of the PFR/HAP dispersion prepared by simulated injection water in porous media. The sand pack permeability was 380 mD and 1000 mD flooded with the PFR/HAP dispersion at a concentration of 300/100 mg/L and 1200/400 mg/L, respectively. To study the oil displacement performance of the PFR/HAP dispersion prepared with the simulated injection water, five parallel sand packs with different permeability ratios  were conducted at 45 °C. Comparing test4 with test5, both of the tests have almost the same permeability ratio of the sand packs and permeability of the low-perm sand packs. However, test4 had a higher incremental oil recovery rate of 21.1% with a higher concentration of PFR/HAP solution (1800:600 mg/L) flooding. The polymer flooding has been used in the Daqing oilfield in northeast China since 1996, and the enhanced oil recovery rate is about 13~14% . At a hiIn the deep profile control system, the deep migration capacity is an important guarantee for improving oil recovery. The attraction between the PFR molecules in an aqueous solution includes the hydrogen bond, π–π interaction and the van der Waals interaction, and the repulsive interaction includes electrostatic repulsion . The mutThe HAP can stabilize the PFR prepared with the simulated injection water by the formation of PFR/HAP complex molecular aggregates. The PFR/HAP mixed dispersion system can effectively block the microporous membrane, but the polymer solution with the same polymer concentration cannot block the membrane. The aggregates can migrate into sand packs with high resistance due to the deformation or disaggregation of the aggregates when passing through the pore throat. The cycle of the log-jamming/dispersion of the aggregates leads to the aggregates penetrating through the bigger pores in the sand packs with a higher flow resistance than water. This process can improve the flow profile of water in the high-perm sand packs on a micro/macro scale and divert more water into low-perm sand packs, therefore, there was more oil that flooded out from the low-perm sand packs. When the permeability ratio was 11.3, the oil displacement increased up to 21.1% in the parallel sand packs with a high concentration (PFR:HAP 1800:600 mg/L). The higher the sand packs’ permeability ratio, the lower the oil recovery rate by waterflood, and the more the incremental oil that was recovered with the PFR/HAP flood.


Perigraft seroma is a persistent and sterile fluid confined within a fibrous pseudomembrane surrounding a graft that develops after graft replacement. Development of perigraft seroma is an uncommon complication that occurs after the surgical repair of the thoracic aorta using woven polyester grafts. mechanism underlying perigraft seroma formation remains unclear.Herein, we describe the case of 77-year-old man who underwent repeat sternotomy for the treatment of large perigraft seroma 1 year after ascending aorta replacement for acute type A dissection. After removing a cloudy yellow fluid, we covered the prosthetic graft with fibrin glue and wrapped it with a new graft. Bacterial culture and laboratory examination of the fluid confirmed the final diagnosis of perigraft seroma, and there was no evidence of recurrence. The area in which fluid accumulated around the graft shrunk 1 year after surgery.The cause of a expanding perigraft after repair of the thoracic aorta remains unknown. Physicians should be aware that chronic expanding mediastinal seroma with Dacron grafts is one of the rare postoperative complications of thoracic aortic surgery. Applying fibrin glue to the graft surface might effectively prevent the recurrence of perigraft seroma.The online version contains supplementary material available at 10.1186/s13019-022-02018-y. Perigraft seroma (PGS) is a persistent, sterile fluid collection that can develop after various vascular procedures. Development of PGS is relatively common in superficially placed graft , abdominal aortic aneurysm (AAA), and modified Blalock–Taussig shunts, whereas mediastinal PGSs occur less frequently. Moreover, PGS requiring repeat sternotomy after thoracic aortic surgery with a polyester graft is extremely rare. We present a case of PGS that developed after a polyester graft was used for ascending aorta replacement for acute type A dissecting aneurysm.The patient has provided permission to publish these features of his case, and the identity of the patient has been protected. A 77-year-old man underwent emergency ascending aorta replacement with a polyester woven graft  for Stanford type A aortic dissection Fig. A, B. PosSundaram et al. reported the spectrum of CT findings and clinical outcomes among patients with thoracic aortic graft complications detected on CT . CT-evidd-glucan, which may cause a sterile inflammatory response around the graft. Whether the graft serves as a predisposing factor for PGS formation is controversial. Knitted Dacron grafts were most frequently used, followed by polytetrafluoroethylene [Identifying PGS in the clinical setting is difficult, and the differential diagnoses include infection, pseudoaneurysm, postoperative hematoma, and lymphatic fluid collection. The accumulation of low-attenuation perigraft fluid is most often caused by infection, which must be ruled out. Bleeding because of anastomotic dehiscence without infection is a less frequent cause that is more frequently encountered in the early postoperative period and needs to be ruled out as well. In approximately 50% of the cases, the cause of low-attenuation perigraft fluid collection is not identified , and theethylene  reportedAlthough the success rate of surgical intervention is unclear because of the rarity of PGS, several cases of successful surgical intervention have been reported. Ohtake et al.  reportedPhysicians should be aware that chronic expanding mediastinal seroma with Dacron grafts is one of the rare postoperative complications of thoracic aortic surgery. Applying fibrin glue to the graft surface might effectively prevent the recurrence of PGS.Additional file 1: Video 1. Cloudy yellow fluid around the graft was drained. The new graft was wrapped tightly after applying fibrin glue.


C-type starches with different proportions of A- and B-type crystallinities have different intensities and crystallinities of X-ray diffraction peaks. In this study, the intensities and crystallinities of X-ray diffraction peaks, molecular components and heat properties of C-type starches were investigated in seven sweet potato varieties, and their relationships were analyzed. The intensity and crystallinity of a diffraction peak at 5.6° were significantly positively correlated to the DP6-12 branch-chains of amylopectin and significantly negatively correlated to the true amylose content (TAC) determined by concanavalin A precipitation, gelatinization temperature, gelatinization enthalpy, water solubility at 95 °C, and pasting temperature. The intensity of diffraction peaks at 15° and 23° were significantly positively correlated to the gelatinization temperature and pasting temperature and significantly negatively correlated to the pasting peak viscosity. The significantly positive relationships were detected between the crystallinity of a diffraction peak at 15° and the DP13-24 branch-chains of amylopectin, gelatinization conclusion temperature and water solubility, between the crystallinity of diffraction peak at 17–18° and the TAC, gelatinization onset temperature, water solubility and pasting temperature, between the crystallinity of a diffraction peak at 23° and the gelatinization conclusion temperature and pasting peak time, and between the total crystallinity and the TAC, gelatinization conclusion temperature, water solubility and pasting temperature. The score plot of principle component analysis showed that the molecular components and heat property parameters could differentiate the C-type starches and agreed with their characteristics of X-ray diffraction peaks. This study provides some references for the utilizations of C-type starches. Starches are semi-crystalline granules and have A- and B-type crystallinities ,2. The AA-, CC- and CB-types according to the ratio of A- and B-type crystallinities from high to low [Apios fortunei has A- and B-type starch granules, meaning that the A- and B-type crystallinities are distributed in the different granules [The C-type starches are more complex than A- and B-type starches, and can be further classified into Ch to low ,2. In fah to low , but theh to low . For theh to low . The C-tgranules . The difIpomoea batatas) has high starch content (about 15–30% wet weight and 50–80% dry weight) [The root tuber of sweet potato ( weight) ,11, and  weight) ,17,18. T weight) . The C-t weight) ,14,17. G weight) ,11. Howe weight) , it is uIn this study, C-type starches were isolated from seven sweet potato varieties, the XRD patterns, molecular components, and heat properties were investigated, and their relationships were analyzed. The objective of this study was to provide some information for the utilizations of C-type starches through investing their XRD patterns.A-, CC- and CB-type according to the ratio of A- to B-type crystallinity in C-type starch from high to low. The CB-type starch has diffraction peaks at 22° and 24°, and the CA-type starch has a diffraction peak at 18° [C-type to CA-type from SY192 to SY6, SY148, SY175, SY4, SY19 and Kokei 14  ranged from 21.96% (SY6) to 25.93% (SY19) among seven starches. The RC is affected by amylose content, amylopectin structure, crystallinity type, and granule size [Sweet potatoes have Ct tubers ,16,17,18t tubers ,14,16,17t tubers  concludeallinity . The C-tallinity , indicatule size ,22,23,24The starch–iodine absorption spectrum was detected (data not shown). The data of optical density (OD) at 620 nm (OD620) and 550 nm (OD550) were obtained from the spectrum, and their ratio (OD620/550) reflects the relative proportion of long chains in starch . The OD6The molecular weight distribution of isoamylase-debranched starch is presented in In order to reveal the relationships between X-ray diffraction peaks and molecular components of C-type starches, the Pearson correlation coefficients between the intensities/crystallinities of X-ray diffraction peaks and the molecular components were evaluated . The TACThe gelatinization properties of starch are analyzed with DSC. The DSC thermograms of seven starches exhibited significant differences in peak shapes, widths, and gelatinization temperatures , Table 5Temp) (81.4 °C) than the other starches, SY6 starch had the highest HV (3220 mPa·s) and FV (3993 mPa·s), and the SY148 starch had the highest PV (5152 mPa·s). The breakdown viscosity (BV) was the lowest for SY4 (1173 mPa·s) and the highest for SY148 (2503 mPa·s), and the setback viscosity (SV) was the lowest for SY148 (500 mPa·s) and the highest for SY6 (773 mPa·s). The peak time (PTime) was the lowest for SY192 (4.18 min). The PV and HV are the maximum and lowest viscosity of the heating starch paste, respectively, and they reflect the ability of binding water and granule swelling of starch [Time reflects the rate of starch swelling during heating [Temp is the critical temperature. Before the PTemp, starch granules in an excess of water continue to swell with increasing heat temperature, and mainly amylose but also some amylopectin leach out of the granules; after reaching the PTemp, starch granules begin to lose their granular shapes, and both the increased surface interactions between the swelling granules and the leached-out starch components will lead to a rise in viscosity [The swelling power (SP) and water solubility (WS) at 95 °C ranged from 24.0 Kokei 14) to 27.6 g/g (SY148) and from 10.4% (SY192) to 12.4% (Kokei 14), respectively, among seven sweet potato starches . Colladoghest HV 20 mPa·s f starch . The BV  heating . The PTeiscosity . The aboghest HV 20 mPa·s iscosity ,34. Guo  to 27.6 Temp. The intensity of the diffraction peak at 15° was significantly negatively correlated to the PV, HV and FV, but significantly positively correlated to the PTemp. The intensity of diffraction peak at 23° was significantly negatively correlated to the PV and significantly positively correlated to the PTime and PTemp. The total crystallinity was positively correlated to the PTemp, and the crystallinity of diffraction peak at 17–18° was negatively correlated to the FV and SV and positively correlated to the PTemp  were selected as plant materials due to the fact that their starches exhibited different C-type XRD patterns according to our previous study . These g2O were smashed and homogenized in a home blender. The starch-water slurry was filtered through 150, 75 and 50 μm sieves successively, and centrifuged  in a centrifuge . The dirty surface layer above precipitated starch was removed off. The starch was washed successively with H2O (5 times) and anhydrous ethanol (3 times), and dried at 40 °C. The starch was filtered through 50 μm sieve, and stored at 4 °C.Starches were isolated from fresh root tubers after harvest following the method of Guo et al.  with som2 and 2% KI) in 50 mL volumetric flask containing 1 mL starch sample, 1 mL iodine solution, and 48 mL H2O. The sample was scanned using a spectrophotometer . The absorbance data at 550 and 620 nm were obtained from the starch–iodine spectrum. The OD620 was used to measure the apparent amylose content (AAC). In order to avoid the effects of amylopectin and lipid on amylose content, the ratio of amylose to both amylose and amylopectin  was determined with the concanavalin A precipitation method using an amylose/amylopectin assay kit .The starch–iodine absorption spectrum was analyzed following the procedures of Man et al. . Brieflyg, 10 min). The supernatant was precipitated with anhydrous ethanol. The precipitated starch was dissolved and debranched with isoamylase . The sample was freeze-dried. The dry starch powder was dissolved in DMSO and analyzed with GPC system with three columns of PL110-6100, 6300 and 6525 and a differential refractive index detector.The isoamylase-debranched starch was analyzed with a gel permeation chromatography (GPC) system  following the procedures of Lin et al.  exactly.The above isoamylase-debranched starch was labeled with the fluorophore APTS  following the method of Lin et al. . The samThe dry starch powder was treated to absorb some moisture in a sealed container with a saturated NaCl solution for maintaining a 75% relative humidity at 25 °C for 10 d. The sample was detected using an X-ray diffractometer  at 40 kV, 40 mA, and 0.02° step size from 3° to 40° 2θ. The relative crystallinity (RC) was evaluated using the area percentage of crystalline peaks and total diffraction peaks between 4° to 30° 2θ following the method of Wei et al. [Five mg starch and 15 μL water were mixed and sealed in an aluminum pan. The sample was equilibrated at 4 °C overnight and 25 °C for 2 h before analysis, and detected using a differential scanning calorimeter . The heating rate was 10 °C/min from 25 to 130 °C.v/v) starch-water slurry was incubated in a ThermoMixer . The sample was centrifuged  after cooling at 25 °C for 10 min. The carbohydrates in the supernatant were quantified with an anthrone-H2SO4 method to measure the water solubility (WS), and the precipitation was weighed to measure the swelling power (SP) following the method of Guo et al. [The 2%  and water (25 mL) slurry was analyzed using a rapid visco analyzer . The programmed heating process included at 50 °C for 1 min, from 50 to 95 °C for 3.75 min (heating rate of 12 °C/min), at 95 °C for 2.5 min, from 95 to 50 °C for 3.75 min (cooling rate of 12 °C/min), and at 50 °C for 1.4 min. The pasting parameters including PV, HV, BV, FV, SV, PThe starch property parameters with significance of normal distribution over 0.05 were used for PCA with Minitab V.16.0 software .The statistical differences, normal distribution, and Pearson correlation of data were evaluated with SPSS 16.0. Only the data with significance of normal distribution over 0.05 were used for Pearson correlation analysis.Temp. The intensity of diffraction peak at 15° was significantly positively correlated to the To, Tp, Tc and PTemp and significantly negatively correlated to the PV, HV and FV. The intensity of the diffraction peak at 23° was significantly positively correlated to the TAC, To, Tp, Tc, ΔH, WS, PTime and PTemp and significantly negatively correlated to the PV. The crystallinity of diffraction peak at 5.6° was significantly positively correlated to the DP6-12 and significantly negatively correlated to the TAC, To, Tp, Tc, ΔH, WS and PTemp. The crystallinity of diffraction peak at 15° was significantly positively correlated to the DP13-24, Tc and WS. The crystallinity of diffraction peak at 17–18° was significantly positively correlated to the TAC, To, WS and PTemp and significantly negatively correlated to the FV and SV. The crystallinity of the diffraction peak at 23° was significantly positively correlated to the Tc and PTime. The total crystallinity was significantly positively correlated to the TAC, Tc, WS and PTemp. The score plot of PCA based on molecular components and heat properties could differentiate the type of C-type starches.The intensity of diffraction peak at 5.6° was significantly positively correlated to the DP6-12, HV and FV and significantly negatively correlated to the TAC, DP13-24, To, Tp, Tc, ΔH, WS and P


MRE-based liver stiffness and size measurements were evaluated in tumorous lesions and in healthy liver lobe controls. PLC showed a significantly larger tumor size compared to SLC  and a higher degree of stiffness . Both tumors decreased in size during the cycles (PLC: p = 0.8 and SLC: p < 0.0001) and lesions showed an increase in stiffness (PLC: p = 0.002 and SLC: p = 0.006). MRE demonstrates that PLC and SLC have similar responses to TACE therapy. PLC had a greater increase in stiffness and SLC got smaller. An increasing stiffness and decrease in size could show a good response.The aim of this study was to detect a response difference in primary (PLC) and secondary liver tumors (SLC) with magnetic resonance elastography (MRE) after TACE therapy. Thirty-one patients  with repeated TACE therapy of HCC were compared with twenty-seven patients  with repeated TACE therapy of metastatic liver disease due to breast cancer. Both groups underwent either one ( Liver metastases by other tumor entities are even more common than PLC2 and are led by breast cancer metastases. Up to 5.2% of patients with breast cancer develop SLC3. In general, liver tumors are difficult to treat. Surgery and local therapies such as radiofrequency ablation (RFA) or microwave ablation (MWA) are possible treatment options. Transarterial chemoembolization (TACE) is an established alternative7. TACE is treating the tumor by injecting chemotherapy (CTx) medication into the arteries feeding the tumor with additional vessel closing agents to withdraw oxygen and nutrients. Thereby, it promotes the degree of necrosis and apoptosis in the tumor cells8. If the tumor decreases in size, it’s a response to the therapy. Therefore, it can be used both as bridging strategy for transplantation or as an effective non-curative palliative treatment approach to PLC10. In addition, SLC can be downsized for resection or relief of symptoms and improvement of quality of life. Imaging modalities are important for both therapy assessment and follow-up. Magnetic resonance imaging (MRI) and computed tomography (CT) scans are commonly used in daily clinical routine. In addition, magnetic resonance elastography (MRE) represents an innovate imaging technique to quantify TACE efficacy that showed higher accuracy compared to sonography-based elastographic measurements12. In 2020, Vogl et al. investigated 42 patients with colorectal liver metastases treated with TACE and then examined by MRE. They demonstrated a significant increase of stiffness during the TACE cycles with a parallel decrease in size12. Other studies showed a difference of stiffness in cancer cells after different kind of treatments18. One study in 2017 reported a significant correlation between tumor stiffness, necrosis, and enhancement in HCC after loco-regional therapy (with TACE)15. Praktjknjo et al.19 demonstrated that a responding HCC after TACE had a significantly higher stiffness compared to non-responding HCC after a short period of time (three days). However, limitations of the above-mentioned studies were small study populations and up to date there has been no direct comparison of PLC and SLC. The aim of our study was to investigate differences in PLC and SLC response to TACE therapy regarding stiffness using MRE as a noninvasive method. Difference in response to TACE could have a major therapeutic impact. Therefore, MRE may provide an added value for evaluation of treatment response in terms of increasing stiffness.Liver cancer can be classified in primary (abbr. PLC) and secondary tumors (abbr. SLC). The most common type of adult PLC is hepatocellular carcinoma (HCC), which is one of the most common cancers worldwide. It has a higher prevalence in developing countries with increasing number of casesFrom 04/2017 to 10/2017, 58 patients with PLC or SLC underwent TACE at our institution and were included in this retrospective study.All patients fulfilled our inclusion criteria: age between 18 and 85 years, histopathological and/or radiological evidence of HCC or breast cancer metastases in the liver, current therapy with TACE, and additional MRI and MRE series. Exclusion criteria were liver cancer of different origin, inflammation in the liver or gall bladder, deviations from the standard TACE or MRI/MRE protocol, or exceeding the time limit of 48 h between TACE and MRE acquisitioning.31 patients suffered from HCC representing the PLC group, whereas 27 women with breast cancer and liver metastases represented the SLC group.n = 56) or within 48 h (n = 2). The maximum time between TACE and imaging lay within a range of 0–2 days. To avoid bias in case of inconsistencies in timing in between TACE and MRE snapshots and varying treatment effects after 48 h, patients exceeding this time limit were excluded. The patients underwent TACE and MRE in 4- to 6-week intervals.All patients underwent standardized TACE  with following MRI and MRE of the main tumor . For both unifocal and multifocal lesions a (multi-)segmental, in extreme cases a lobar approach was appropriate for treatment. The image acquisitioning occurred directly after the TACE therapy  were used to prevent vasospasms. After verification of the correct catheter positioning, the cytostatic agents were administered under imaging control . For emulsification a suspension consisting of a fixed dosage of Mitomycin C (10 mg) and a maximum dose of 10 ml Lipiodol was injected, which capitation was not correlated with the efficacy of TACE because of the frequently inhomogeneous appearance. At the end of the administration of anticancer-in-oil emulsion 5 ml universal temporary embolic agents such as Embocept® (starch microspheres) were regularly applied to achieve temporary arterial embolization. All TACE interventions were performed using a robot-supported angiography system  , total liver stiffness (kPa) , total liver MAP T1 (ms) and MAP T2 (ms), left and right lobe separated area, stiffness, and MAP T1/T2 measurement, metastasis area, stiffness, and MAP T1/T2. Additionally, measurements in the healthy liver tissue were performed as control.Directly after the intervention, unenhanced and contrast-enhanced MRI was performed using gadobutrol . There were T1- and T2-weighted MRI and MRE scans acquired in both transverse and sagittal orientation with 5 mm slice thickness using a common 1.5-T system . For MRE measurements, a commercially available system was used which consisted of an active driver located outside the scan room connected to passive actuators in the scan room. The time of vibrations was calculated with 15 s for five slices of EPI (WIP measurement) and 23 s for a single slice of GRE, so that a median time of 18 min could be fulfilled for the MRE measurement including patient and system preparation. As previously published, a special sequence protocol was appliedp < 0.05 and was conducted with SPSS Statistics Version 22.0 .Data is shown as mean ± standard deviation if normally distributed or as median range if not normally distributed. Continuous variables were tested for normal distribution with the use of the Kolmogorov–Smirnov-test. A Student’s t-test was performed for continuous variables if normally distributed and a Mann–Whitney U test was performed for continuous variables if not normally distributed for comparison between two groups. Categorial variables are given as frequencies and percentages. Spearman´s test was used to assess correlation. Statistical significance was assumed when the null hypothesis could be rejected at The investigators initiated the study, had full access to the data, and wrote the manuscript. All authors vouch for the accuracy and completeness of the data and all analyses and confirm that the study was conducted according to the protocol.All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from all subjects and/or their legal guardian(s).n = 31) or SLC  underwent TACE therapy following the same protocol. Patients with PLC were mainly represented by male , while all patients with SLC were of female gender . In the majority of patients, cancer had affected the right liver lobe (RLL) . The number of performed TACE cycles before the first MRE acquisition was on average 3.7 (range 0–17) in the PLC group and 3.0 (range 0–15) in the SLC group. Before the first MRE imaging, there were 3.3 TACE interventions performed on average.Baseline characteristics of the study cohort are shown in Table 12, the complete procedure including installing the catheter tips, positioning checks and chemoembolization took 35 min in median (data not shown).As previously published2 and a total liver stiffness  of 3.6 ± 1 kPa. The RLL (114.7 ± 36.9 cm2) was larger than the left liver lobe (LLL) (54.6 ± 13.8 cm2), but the stiffness of the RLL (3.3 ± 1.2 kPa) was comparable to the stiffness of the LLL (3.2 ± 1.4 kPa). The PLC averagely showed a size of 26.4 ± 27.2 cm2 and a cancer stiffness of 5.8 ± 1.2 kPa with a MAP T1 of 776 ± 157.4 ms and a MAP T2 of 80.7 ± 26.1 ms. The reference elastography in healthy liver tissue in this group was 2.1 ± 0.5 kPa on average.The results of the MRE measurements are listed in Table 2 and a total liver stiffness of 2.8 ± 0.7 kPa. The RLL (88.5 ± 17.4 cm2) was larger than the LLL (36 ± 10.6 cm2) and the stiffness of the RLL (2.8 ± 0.8 kPa) was similar to the values measured in the LLL (2.8 ± 1.4 kPa). The SLC averagely showed a size of 11 ± 8.7 cm2 and a cancer stiffness of 5.1 ± 1.4 kPa with a MAP T1 of 773.4 ± 243 ms and a MAP T2 of 73.4 ± 15.9 ms. The reference elastography in healthy liver tissue in this group was 1.8 ± 0.3 kPa  and total liver elastography significantly increased from 3.6 ± 1 to 4.1 ± 1.1 kPa; p < 0.001). Further, total liver MAP T1 and MAP T2 measurements showed significant changes: while MAP T1 decreased , MAP T2 increased . From the first to the second TACE cycle, most of the tumorous lesions  showed a trend to decrease in size   .When comparing tumor progression between the first and second TACE cycle in the PLC group (2 (p < 0.001) whereas stiffness in tumorous tissue increased from 5.1 ± 1.4 to 5.4 ± 1.8 kPa (p = 0.006)   (see Table 2) than in SLC group , whereas relevant differences were found in favor of MAP T2 imaging . With respect to cancer area, the PLC group showed larger tumorous lesions (26.4 ± 27.2 cm2) than the SLC group   .When comparing PLC and SLC measurements, a common increase in cancer stiffness  and th001 Fig. b). As a 19, we reproduced comparable findings emphasizing the effectiveness and reliability of this innovative imaging technique. It remains unclear why MRE provided better results in PLC than in SLC. A possible explanation could be the volume and composition of the PLC cancer itself, especially its vascular network formation. Accumulation of lipidol in tumorous tissue might lead to a substantial reduction of blood circulation. Furthermore, it is conceivable that a curbed blood supply in turn might result in various modifications of the biomechanical properties, which consequently might affect tissue constitution and ultimately stiffness. As HCCs are very diverse in aggressive behavior, the treatment response might be affected20. As shown in a study from Kim, the wide dispersion of stiffness possibly reflects the different biological entities of HCC21.The present study investigated the effectiveness of MRE as an imaging technique to compare PLC and SLC in addition to conventional MRI and to uncover potential therapy response differences. During therapy, stiffness of tumorous lesions increased from cycle to cycle. This effect was more prominent in PLC. In addition, in most cases a reduction in size was measured. Therefore, MRE may provide an added value for evaluation of treatment response, as an increasing stiffness indicates a response to TACE. In comparison to previous studies15. However, it should be noted that the same methodology was not applied to measure stiffness, making comparison difficult. Pelegrina et al.14 only involved a well-established ultrasound-based elastography (Fibroscan) to determine liver stiffness; an assessment of liver stiffness by MRE was not performed. A study by Oki et al. took a similar approach using elastography by Fibroscan to evaluate stiffness before and after CTx treatment. Focusing on the short-term outcome, stiffness of tumorous tissue generally increased after CTx within 48 h, and hepatic stiffness was normalized in most cases after 2 weeks15. Similar to our results, tumor-free liver elastography was clearly lower, even though a different method was used for measurements. Gordic et al. examined 63 HCC patients with MRE, of which 52 patients underwent Yttrium-90 radioembolization (RE), TACE, or RFA and 11 patients were untreated due to newly diagnosed HCC. After treatment they measured a decrease in cancer stiffness16. As opposed to our study, here the decrease in stiffness could be explained by the different therapeutic approaches. Not only liver fibrosis leads to higher liver stiffness22, but also necroinflammation that occurs in tumor cells25. In 2018, Kennedy et al.22 published a review about current evidence and future directions in elastography methods in liver disease. Kennedy et al. reported a common trend to an increased stiffness in malignant cells such as HCC. Recently, a higher tumor stiffness was reported in well or moderately differentiated HCCs compared with poorly differentiated HCCs or remaining liver26. The pathophysiology to why tumors grow stiffer post-TACE remains unclear. In 2020, Perfahl et al.27 reported an unstable tumor state directly after TACE, where regrowth and total tumor death had the same probability. Further, in a study by Motosugi et al.28 showed in 2013, liver stiffness in HCC patients was higher than in patients without HCC.International studies relating to this topic are scarce; there are some studies comparing the degree of stiffness in patients with, inter alia, colorectal liver metastases under CTx with oxaliplatin  compared to those without29 took a similar approach using MRE to differentiate between malignant , and metastases) or benign  focal liver lesions, whereas we used it to distinguish between PLC and SLC. They were able to demonstrate that malignant focal liver lesions showed significantly higher mean stiffness than benign focal liver lesions. Comparing PLC and SLC, the mean stiffness of HCC was not significantly different from that of CCAs or metastases, establishing a clear trend towards an accentuated increase in stiffness in PLC. Thus their results match what we discovered.Venkatesh et al.30 emphasized the importance of MRI, CT and ultrasound in diagnosis and imaging of PLC and SLC, with recommendation for their effective use. While CT is a common imaging technique for HCC screening31, ultrasound is a fast and cost effective way of imaging with a great plane resolution, but is dependent on both the quality of ultrasound equipment and experience of the examining physician and very limited in depth32. The MRI is increasingly used for liver screening with a T1-weighted breath-hold gradient technique as the most sensitive method for HCC detection. The CT angiography is still the preferred method for complete staging of potential tumorous lesion prior to surgery30. As common CT and MRI are in black and white film, even when using contrast enhanced agents, elastography measurements are superior in detecting small lesions as they are colored. Also, the MRE measurement took, on average, only 30 min (acquisition of EPI data 15–23 s for 1–5 slices (WIP measurement)) and can be performed on every 1.5-T MR scanner with the use of dedicated hardware and software packages12.Today, there are various imaging strategies available aiding in the diagnosis and monitoring of treatment success. Fielding et al.22 claimed, that more research needs to investigate how study results can be used to enhance healthiness. MRE is one of those promising tools. To avoid limited spatial resolution and coverage of current 2D MRE, nonlinear inversion algorithms paired with 3D MRE may help to improve these issues34.Of course, problems in differentiation between PLC and SLC remain due to a high variance in their appearance. Therefore, new imaging techniques are needed to distinguish between the various entities of liver malignancies. MRE may therefore provide an added value for evaluation of treatment response in terms of increasing stiffness. Furthermore, in their review about quantitative elastography methods in liver disease Kennedy et al.21, as stiffness of in vivo biological tissue is very dynamic.Sample size, single-center character and the retrospective design are limitations. For further verification and applicability of our results, larger and prospective studies with a control group are needed. There is a potential selection bias because all included patients of the present study cohort were preselected for the TACE procedure itself without conservative or RE-/RFA-counterparts. Also, patients with PLC and SLC at different tumor stages were included, which may affect the accuracy of the measurements. Apart from this, the potential gender bias (only women in the SLC group) is a further limitation of our study. Finally, our results showed a dispersion in stiffness that possibly reflects the different biological entities of HCCMRE is a feasible and useful imaging tool to evaluate the response to TACE of PLC and SLC and to allow a differentiation between these entities.