This article delves into the principle, essence, definitions, classifications, fundamentals, and industrial applications of staged gasification for biomass, offering an insightful exploration into its multifaceted dimensions. By segmenting the gasification process based on its intricate reaction network into distinct sub-processes implemented in separate reactors or reaction zones, staged gasification facilitates nuanced reaction control and sub-process intensification. It aims to optimize the gasification process by minimizing inhibitory effects and maximizing promotional interactions among chemical reactions, intermediates, or targeted products. This approach has been extensively tested, yielding significant technical benefits such as in-situ tar component conversion and efficiency enhancements. A clear categorization of the diverse staged gasification processes documented in literature is presented, distinguishing them based on the nature of interactions among separated stages, namely, chemical interaction, thermal interaction, and sequential staging. Definitions are provided for key concepts such as decoupling gasification, dual-bed or twin-bed gasification, and gasification with in-situ tar removal. Core fundamentals discussed include the reaction characteristics and kinetics of sub-processes, in-situ conversion of heteroatomic components, reactor configuration, and reaction regulation strategies. The article also presents an analysis of several industrial applications to elucidate the technical characteristics of staged gasification. Concluding with a discussion on prospective research concerns, this review underscores the evolving landscape of staged gasification technology and its pivotal role in advancing biomass conversion efficiencies.

The history of ventral hernia repair techniques has seen substantial evolution, from primary suture repair to the introduction of mesh-based procedures, aiming to reduce recurrence rates. Notable advancements include the anterior and posterior component separation techniques. The Transversus Abdominis Release (TAR) technique, a refinement of the posterior approach, emerged to address challenges associated with complex ventral hernias. The TAR technique facilitates midline reconstruction, allowing large mesh placement while minimizing the need for subcutaneous dissection. Despite its benefits, TAR presents potential complications, emphasizing the necessity for meticulous preoperative assessment and training. The paper reviews the historical progression of hernia repairs, details the TAR technique, highlights indications, perioperative care strategies, surgical steps, postoperative management, technical challenges, and emphasizes the critical role of expertise in achieving successful outcomes in complex abdominal wall reconstruction.

OBJECTIVE: Given its potential advantages, open Transversus Abdominis Release (oTAR) has been proposed as a durable solution for complex AWR. However, its applicability in different scenarios remains uncertain. We aimed to analyze the current available evidence and determine surgical outcomes after oTAR.
METHODS: We performed a systematic electronic search on oTAR in PubMed/Medline, Embase, and Cochrane Central Register of Controlled Trials databases. Postoperative morbidity and recurrence rates were included as primary endpoints and Quality of life (QoL) was included as secondary endpoint. A random-effect model was used to generate a pooled proportion with 95% confidence interval (CI) between all studies.
RESULTS: A total of 22 studies with 4,910 patients undergoing oTAR were included for analysis. Mean hernia defect and mesh area were 394 (140-622) cm2 and 1065 (557-2206) cm2, respectively. Mean follow-up was 19.7 (1-32) months. The weighted pooled proportion of recurrence, overall morbidity, surgical site occurrences (SSO), surgical site infection (SSI), surgical site occurrences requiring procedural intervention (SSOPI), major morbidity and mortality were: 6% (95% CI, 3-10%), 34% (95% CI, 26-43%), 22% (95% CI, 16-29%), 11% (95% CI, 8-16%), 4% (95% CI, 3-7%), 6% (95% CI, 4-10%) and 1% (95% CI, 1-2%), respectively. A significant improvement in QoL after oTAR was reported among studies.
CONCLUSIONS: Open TAR is an effective technique for complex ventral hernias as it is associated with low recurrence rate and a significant improvement in QoL. However, the relatively high morbidity rates observed emphasize the necessity of further patients\' selection and optimization to improve outcomes.

OBJECTIVE: This study aimed to investigate the association between glucose metrics and diabetic retinopathy in type 1 diabetes (T1D) patients using flash continuous glucose monitoring (FGM) systems, including those maintaining glycated hemoglobin (HbA1c) within the target range.
METHODS: We conducted a cross-sectional study involving 1070 T1D patients utilizing FGM systems. Data on clinical, anthropometric, and socioeconomic characteristics were collected and retinopathy was classified based on international standards.
RESULTS: Patients\' mean age was 47.6 ± 15.0 years, with 49.4% of them being females. Within the cohort, 24.8% of patients presented some form of retinopathy. In the analysis involving the entire sample of subjects, male gender (OR = 1.51, p = 0.027), Time Above Range (TAR) > 250 mg/dL (OR = 1.07, p = 0.025), duration of diabetes (OR = 1.09, p < 0.001), smoking (OR = 2.30, p < 0.001), and history of ischemic stroke (OR = 5.59, p = 0.025) were associated with diabetic retinopathy. No association was observed between the coefficient of variation and diabetic retinopathy (p = 0.934). In patients with HbA1c < 7%, the highest quartile of TAR > 250 was independently linked to diabetic retinopathy (OR = 8.32, p = 0.040), in addition to smoking (OR = 2.90, p = 0.031), duration of diabetes (OR = 1.09, p < 0.001), and hypertension (OR = 2.35, p = 0.040).
CONCLUSIONS: TAR > 250 mg/dL significantly emerges as a modifiable factor associated with diabetic retinopathy, even among those patients maintaining recommended HbA1c levels. Understanding glucose metrics is crucial for tailoring treatment strategies for T1D patients.

BACKGROUND: Transversus abdominis release (TAR) is an effective technique for treating large midline and off-midline hernias. Recent studies have demonstrated that robotic TAR (rTAR) is technically feasible and associated with improved outcomes compared to open surgery. There is no published experience to date describing abdominal wall reconstruction using the novel robotic platform HUGO RAS System (Medtronic®).
METHODS: All consecutive patients who underwent a rTAR in our institution were included. Three of the four arm carts of the HUGO RAS System were used at any given time. Each arm configuration was defined by our team in conjunction with Medtronic® personnel. rTAR was performed as previously described. Upon completion of the TAR on one side, a redocking process with different, mirrored arms angles was performed to continue with the contralateral TAR. Operative variables and early morbidity were recorded.
RESULTS: Ten patients were included in this study. The median BMI was 31 (21-40.6) kg/m2. The median height was 1.6 m (1.5-1.89 m). A trend of decreased operative time, console time, and redocking time was seen in these consecutive cases. No intraoperative events nor postoperative morbidity was reported. The median length of stay was 3 (1-6) days.
CONCLUSIONS: Robotic TAR utilizing the HUGO RAS system is a feasible and safe procedure. The adoption of this procedure on this novel platform for the treatment of complex abdominal wall hernias has been successful for our team.

BACKGROUND: Incisional hernias with a defect width of more than10 cm are considered complex. The European Hernia Society guidelines recommend that such hernias should only be repaired by surgeons with experience of component separation. The standard component separation technique now is posterior component separation with transversus abdominis release (PCSTAR). Questions are raised about the limits of this technique.
METHODS: A literature search of publications on PCSTAR was performed for any references to the limits of this technique in open incisional hernia repair. We found 26 publications relevant to answer this research questions.
RESULTS: The standard PCSTAR can generally be used for a defect width of up to 15-17 cm. For defects greater than 17 cm problems must be expected with procedural tasks involving closure of the posterior layer and anterior fascia. No data are available in the literature on the bridging rate for the posterior layer. However, our own experiences show that gaps (holes) occur in the very thin peritoneum/fascia transversalis during dissection and these must be carefully closed. Furthermore, bridging with an absorbable synthetic mesh is needed not so rarely. Closure of the anterior fascia is successful in 81.0-97.2% of cases. In addition to a further mesh for anterior fascial closure, the hernia sac bound with multiple, accordion-like stitches can also be used. For a defect width greater than 17 cm, the limits of PCSTAR become increasingly evident and can be overcome through special technical solutions for closure of the posterior layer and the anterior fascia.

Viruses provide vital insights into gene expression control. Viral transactivators, with other viral and cellular proteins, regulate expression of self, other viruses, and host genes with profound effects on infected cells, underlying inflammation, control of immune responses, and pathogenesis. The multifunctional Tat proteins of lentiviruses (HIV-1, HIV-2, and SIV) transactivate gene expression by recruiting host proteins and binding to transacting responsive regions (TARs) in viral and host RNAs. SARS-CoV-2 nucleocapsid participates in early viral transcription, recruits similar cellular proteins, and shares intracellular, surface, and extracellular distribution with Tat. SARS-CoV-2 nucleocapsid interacting with the replication-transcription complex might, therefore, transactivate viral and cellular RNAs in the transcription and reactivation of self and other viruses, acute and chronic pathogenesis, immune evasion, and viral evolution. Here, we show, by using primary and secondary structural comparisons, that the leaders of SARS-CoV-2 and other coronaviruses contain TAR-like sequences in stem-loops 2 and 3. The coronaviral nucleocapsid C-terminal domains harbor a region of similarity to TAR-binding regions of lentiviral Tat proteins, and coronaviral nonstructural protein 12 has a cysteine-rich metal binding, dimerization domain, as do lentiviral Tat proteins. Although SARS-CoV-1 nucleocapsid transactivated gene expression in a replicon-based study, further experimental evidence for coronaviral transactivation and its possible implications is warranted.

This study proposed an innovative strategy of catalytic cracking of tar during biomass pyrolysis/gasification using furfural residue derived biochar-based catalysts. Fe, Co, and Ni modified furfural residue char (FRC-Fe, FRC-Co, and FRC-Ni) were prepared by one-step impregnation method. The influences of cracking temperature and metal species on the tar cracking characteristics were investigated. The results showed that the tar conversion efficiency for all catalysts were improved with the cracking temperature increasing, the higher tar conversion efficiency achieved at 800 °C were 66.72 %, 89.58 %, 84.58 %, and 94.70 % for FRC, FRC-Fe, FRC-Co, and FRC-Ni respectively. FRC-Ni achieved the higher gas (H2, CO, CH4, CO2) yield 681.81 mL/g. At 800 °C, the catalyst (FRC-Ni) still reached a high tar conversion efficiency over 85.90 % after 5 cycles. SEM-EDS results showed that the distribution of Ni particles on the biochar support was uniform. TGA results demonstrated that FRC-Ni exhibited better thermal stability. XRD results indicated that there was no significant change in the grain size of Ni before and after the reaction. The FRC-Ni catalyst was reasonably stable due to its better anti-sintering and coke-resistant capabilities.

OBJECTIVE: To review the first robotic hernia repairs performed at the Ilyinsky Hospital, evolution of this technology, learning curve and early outcomes.
METHODS: There were 17 procedures at the Ilyinskaya Hospital between 2021 and 2023 (13 men and 4 women). Mean age was 60 years, body mass index 28 kg/m2. ASA grade 1 was observed in 1 patient, grade 2 - 14 ones, grade 3 - 2 patients. Ventral, inguinal and umbilical hernias were diagnosed in 7, 8 and 2 cases, respectively. Ventral hernias required IPOM+ procedure in 3 cases, eTEP-RS procedure in 2 cases and eTEP-RS-TAR procedure in 2 cases. Patients with inguinal hernia underwent transabdominal preperitoneal hernia repair. In case of umbilical hernia, TARUP procedure was performed in 1 case and vTAPP procedure in 1 case.
RESULTS: Mean surgery time was 2 hours 38 min (min 1 hour 35 min, max 10 hours 11 min). There was one intraoperative complication (bleeding from epigastric artery). The follow-up period ranged from 3 months to 3 years. There were no recurrent hernias. Postoperative complications were noted in 2 cases. One patient was diagnosed with epididymitis after TAPP, 1 patient - with seroma after eTEP-RS procedure. All complications were relieved by conservative treatment. Bleeding from a. epigastrica inferior was diagnosed after removal of the trocar at the end of surgery. This event required suturing.
CONCLUSIONS: Robotic hernia repair appears to be technically feasible and safe. This approach provides favorable results regarding quality of life and recurrence rate.
Минимально инвазивная герниопластика имеет доказанные преимущества перед открытыми операциями, включая сниженный болевой синдром и более раннюю активизацию пациентов. Часть экспертов считает, что результаты операций можно улучшить, используя роботические хирургические комплексы, за счет улучшенной эргономики, трехмерной оптики высокого разрешения и изгибающихся инструментов, которые способны преодолеть ограничения лапароскопического доступа. Настоящий обзор первых 17 роботизированных герниопластик, выполненных в Ильинской больнице, описывает эволюцию технологии, кривую обучения и первые результаты пациентов.
UNASSIGNED: Продемонстрировать безопасный способ внедрения новой технологии, робота Da Vinci, в устоявшуюся лапароскопическую практику.
UNASSIGNED: В период с 2021 по 2023 г. в Ильинской больнице было выполнено 17 операций. Из 17 пациентов 13 больных были мужчины и 4 женщины. Средний возраст — 60 лет. Средний индекс массы тела 28 кг/м2. Большинство больных имели хороший физический ASA 1 — 1, ASA 2 — 14, у 2 пациентов — ASA 3. Из них оперированы по поводу вентральной грыжи в 7 случаях, паховой грыжи — в 8 случаях, пупочной грыжи — в 2 случаях. При вентральной грыже выполнены следующие операции: IPOM+ — в 3 случаях, 2 операции выполнены по методике eTEP-RS и в 2 случаях — eTEP-RS-TAR. При паховых грыжах пациенту выполняли трансабдоминальную преперитонеальную герниопластику ТАРР. При пупочных грыжах выполнили в 1 случае TARUP и в 1 случае vTAPP.
UNASSIGNED: Среднее время операции составило 2 ч 38 мин, минимальное время операции было 1 ч 35 мин, максимальное — 10 ч 11 мин. Интраоперационное осложнение было в одном случае — кровотечение из надчревной артерии. Сроки наблюдения пациентов составили от 3 мес до 3 лет. Ни в одном случае не выявлено рецидива грыж. Послеоперационные осложнения отмечены в 2 случаях, у одного пациента диагностирован эпидидимит после ТАРР и у 1 пациента отмечена серома после eTEP-RS, все осложнения купированы консервативным лечением. Интраоперационные осложнения были в 1 случае — кровотечение из a. epigastrica inferior, — диагностированное после удаления троакара в конце операции и остановленное прошиванием кровоточащего сосуда.
UNASSIGNED: Наши результаты подтверждают, что роботизированная герниопластика представляется технически осуществимой и безопасной в опытных руках с хорошими результатами, обеспечивающими высокое качество жизни, связанное со здоровьем, и низкую частоту рецидива в краткосрочной и долгосрочной перспективе.

Introduction: Large hernia defects are a challenge for general and specialized hernia surgeons. The transversus abdominis release (TAR) technique has revolutionized the treatment of complex hernias since it allows the closure of large midline hernias, as well as hernias in different locations. This study aims to report the experience with the TAR technique and mid-term results in the first 101 patients. Methods: Non-concurrent cohort review of our prospectively collected electronic database. All patients submitted to a TAR (open or minimally invasive eTEP-TAR) from 2017 to 2020 were included. Demographic data, comorbidities, hernia characteristics, preoperative optimization, intraoperative variables, and clinical outcomes were gathered. The main outcomes of this study are hernia recurrences and surgical morbidity. Results: A total of 101 patients were identified. The median follow-up was 26 months. Mean age and body mass index was 63 years and 31.4 Kg/m2, respectively. Diabetes was present in 22% of patients and 43% had at least one previous hernia repair. Nineteen patients had significant loss of domain. Mean hernia size and area were 13 cm and 247 cm2, respectively. Ninety-six percent of cases were clean or clean-contaminated. The mean operative time was 164 min and all patients received a synthetic mesh. We diagnosed two hernia recurrences and the overall (medical and surgical) complication rate was 32%. The hernia-specific complication rate was 17%, with seven surgical site infections and seven surgical site occurrences requiring procedural interventions. Notably, weight loss was associated with a lower risk of SSOPI and reoperations. Conclusion: We show an encouraging 2% of recurrences in the mid-term follow-up in the setting of clinically complex hernia repair. However, we observed a high frequency of overall and hernia-specific complications pointing to the complexity of the type of surgery itself and the patients we operated on.