Understanding the interplay among organophosphorus flame retardants (OPFRs), microplastics, and freshwater organisms is crucial for unravelling the dynamics within freshwater environments and foreseeing the potential impacts of organic pollutants and plastic contamination. For that purpose, the present research assessed the exposure impact of 10 mg L⁻¹ flame-retardant aluminium diethylphosphinate (ALPI), 10 μg mg⁻¹_liver microplastics polyurethane (PU), and the combination of ALPI and PU on the freshwater planarian Girardia tigrina. The exposure to both ALPI and PU revealed a sequential effect, i.e., a decrease in locomotor activity, while oxidative stress biomarkers (total glutathione, catalase, glutathione S-transferase, lipid peroxidation) and metabolic responses (cholinesterase activity, electron transport system, and lactate dehydrogenase) remained unaffected. Despite this fact, it was possible to observe that the range of physiological responses in exposed organisms varied, in particular in the cases of the electron transport system, cholinesterase activity, glutathione S-transferase, catalase, and levels of total glutathione and proteins, showing that the energetic costs for detoxification and antioxidant capacity might be causing a lesser amount of energy allocated for the planarian activity. By examining the physiological, behavioural, and ecological responses of planarians to these pollutants, insights can be gained into broader ecosystem-level effects and inform strategies for mitigating environmental risks associated with OPFRs and microplastic pollution in freshwater environments. Full article

Cancer is ranked among lethal diseases globally, and the increasing number of cancer cases and deaths results from limited access to effective therapeutics. The use of plant-based medicine has been gaining interest from several researchers. Carvacrol and its isomeric compound, thymol, are plant-based extracts that possess several biological activities, such as antimalarial, anticancer, antifungal, and antibacterial. However, their efficacy is compromised by their poor bioavailability. Thus, medicinal scientists have explored the synthesis of hybrid compounds containing their pharmacophores to enhance their therapeutic efficacy and improve their bioavailability. Hence, this review is a comprehensive report on hybrid compounds containing carvacrol and its isomer, thymol, with potent anticancer and antibacterial agents reported between 2020 and 2024. Furthermore, their structural activity relationship (SAR) and recommended future strategies to further enhance their therapeutic effects will be discussed. Full article

Introduction: Magnesium is a vital intracellular cation crucial for over 320 enzymatic reactions related to energy metabolism, musculoskeletal function, and nucleic acid synthesis and plays a pivotal role in human physiology. This study aimed to explore the prevalence of dysmagnesemia in patients with diabetes mellitus and evaluate its correlations with glycemic control, medication use, and diabetic complications. Methods: A cross-sectional study was conducted at Sultan Qaboos University Hospital, including 316 patients aged 18 years or older with diabetes mellitus. Data included demographics, medical history, medications, and biochemical parameters. Serum total magnesium concentrations were measured, and dysmagnesemia was defined as magnesium ≤ 0.69 mmol/L for hypomagnesemia and ≥1.01 mmol/L for hypermagnesemia. Results: The prevalence of hypomagnesemia in patients with diabetes was 17.1% (95% CI: 13.3–21.7%), and hypermagnesemia was 4.1% (95% CI: 2.4–7.0%). Females were significantly overrepresented in the hypomagnesemia group, while the hypermagnesemia group showed a higher prevalence of hypertension, retinopathy, an increased albumin/creatinine ratio, chronic kidney disease (CKD), elevated creatinine levels, and a lower adjusted calcium concentration. The multinominal logistic regression exhibited that the female sex and higher serum-adjusted calcium were independent risk factors of hypomagnesemia. In contrast, the presence of hypertension, higher levels of albumin/creatinine ratio, and stage 5 CKD were independent risk factors of hypermagnesemia. Conclusions: Hypomagnesemia was common among patients with diabetes mellitus; however, hypermagnesemia was associated with microvascular complications. Full article

Specialized cancer treatments have the potential to exploit glutamine dependence to increase patient survival rates. Glutamine diagnostics capable of tracking a patient’s response to treatment would enable a personalized treatment dosage to optimize the tradeoff between treatment success and dangerous side effects. Current clinical glutamine testing requires sophisticated and expensive lab-based tests, which are not broadly available on a frequent, individualized basis. To address the need for a low-cost, portable glutamine diagnostic, this work engineers a cell-free glutamine biosensor to overcome assay background and signal-to-noise limitations evident in previously reported studies. The findings from this work culminate in the development of a shelf-stable, paper-based, colorimetric glutamine test with a high signal strength and a high signal-to-background ratio for dramatically improved signal resolution. While the engineered glutamine test is important progress towards improving the management of cancer and other health conditions, this work also expands the assay development field of the promising cell-free biosensing platform, which can facilitate the low-cost detection of a broad variety of target molecules with high clinical value. Full article

The Maedi-visna virus (MVV) causes a persistent infection in small ruminants, and its high genetic heterogeneity affects the performance of diagnostic tests when used in different populations. Therefore, the aim of this study was to develop a bead-based multiplex immunoassay tailored to detect antibodies against a Norwegian MVV strain. We used tissue samples from 14 PCR-positive sheep from a recent MVV outbreak in Norway to sequence the viral strain and produced recombinant antigens based on sequences from one animal. The assay included commercial TM-A and recombinant Norwegian p25, p16–25 and SU5 antigens. Cut-off values for each antigen were determined using receiver operating characteristic curves on 40 ELISA-negative and 67 ELISA-positive samples from the outbreak. The intraplate and interplate repeatability were investigated by testing a quadruplicate of five samples over three days, while the analytical sensitivity (aSe) and specificity (aSp) were measured in comparison to a commercial ELISA. The repeatability showed a coefficient of variation below 15% for most positive samples. The aSe was equal or higher for the multiplex assay than the ELISA, and the aSp of each antigen was 91.7, 93.3, 95.0 and 93.3% for p25, p16–25, SU5 and TM-A, respectively. The assay shows promising results; however, further evaluations of diagnostic characteristics are necessary before implementation in the Norwegian surveillance programme. Full article

Since power transformers are the most important pieces of equipment in electricity transmission and distribution systems, special attention must be paid to their maintenance in order to keep them in good condition for a long time. This paper reviews the main steps in the process of diagnosing the health of power transformer insulation, which involves the science of analysing the gases dissolved in power transformer oil for effective identification of faults. An accurate diagnosis of incipient faults is favourable to sustainable development and necessary to maintain a reliable supply of electricity. The methods presented for fault diagnosis in mineral-oil-immersed power transformers are divided into analytical and graphical methods and have been found to be simple, economical and effective. After describing the methods, both their strengths and weaknesses were identified, and over the years, the methods were complemented to provide highly accurate information, validated by field inspections. This paper focuses on practical information and applications to manage maintenance based on accurate and up-to-date data. The contents of this paper will be of particular use to engineers who manufacture, monitor and/or use high-power transformers in the energy sector, as well as to undergraduate, master’s and PhD students interested in such applications. Full article

Background: In previous studies, denosumab, a RANKL human monoclonal antibody used in osteoporosis treatment, has shown efficacy in tendon healing after rotator cuff repair. This prospective study investigated the effects of denosumab on tendon healing, re-tear rates, and clinical outcomes post rotator cuff repair in women with osteoporosis. Method: This was a prospective, observational study, employing propensity score matching for the control group. From March 2018 to March 2023, female patients over the age of 60 with normal bone density undergoing arthroscopic rotator cuff repair were selected as controls through propensity score matching (PSM) and compared with female patients of the same age group with osteoporosis who were receiving denosumab treatment. The control group was matched using 1-to-2 propensity score matching. Radiological examinations and functional outcomes were assessed preoperatively and at 6 months postoperatively. Results: In the final analysis, the study comprised 34 patients in the denosumab treatment group (Group 1) and 68 patients in the control group (Group 2). The functional scores showed significant improvement at 6 months post-surgery in both groups. No significant difference in the functional scores was observed among the groups. The re-tear rate, defined according to Sugaya’s classification (types IV and V) as re-tear, was slightly higher in Group 1 at 16.7% (6 of 34) compared to Group 2 at 11.7% (8 of 68), but the difference was not statistically significant (p = 0.469). The re-tear patterns, classified according to Rhee’s classification, also showed no significant difference among the groups (Group 1: 2/4 of 6; Group 2: 4/4 of 8; p = 0.571). The occurrence of type I re-tear exhibited no significant difference between the two groups (5.9% vs. 5.9%; p = 1.000). Conclusions: The administration of denosumab following arthroscopic rotator cuff repair in women aged 60 and over with osteoporosis resulted in a re-tear rate that was similar to that observed in patients without osteoporosis. This result suggests that denosumab administration might be beneficial for rotator cuff healing, particularly in the context of osteoporosis, a known risk factor for increased retear rates. Therefore, comprehensive osteoporosis screening and treatment should be considered in conjunction with rotator cuff repair surgery in middle-aged women. Full article

We have recently demonstrated that the 3D shape of micro-parts can be measured using LED illumination based on speckle contrast evaluation in the recently developed SPICE profilometry (shape measurements based on imaging with spatially partially coherent illumination). The main advantage of SPICE is its improved robustness and measurement speed compared to confocal or white light interferometry. The limited spatial coherence of the LED illumination is used for depth discrimination. An electrically tunable lens in a $4f$-configuration is used for fast depth scanning without mechanically moving parts. The approach is efficient, takes less than a second to capture required images, is eye-safe and offers a depth of focus of a few millimeters. However, SPICE’s main limitation is its assumption of a small illumination aperture. Such a small illumination aperture affects the axial scan resolution, which dominates the measurement uncertainty. In this paper, we propose a novel method to overcome the aperture angle limitation of SPICE by illuminating the object from different directions with several independent LED sources. This approach reduces the full width at half maximum of the contrast envelope to one-eighth, resulting in a twofold improvement in measurement accuracy. As a proof of concept, shape measurements of various metal objects are presented. Full article

In this work, hierarchically porous composites were prepared in the form of activated carbon cloth (CC) Busofit T–1–055 filled with an electrically conductive polymer, polyaniline (PANI), for use as pseudocapacitive electrodes of electrochemical supercapacitors (SCs). CC fibers have high nanoporosity and specific surface area, so it was possible to deposit (via the chemical oxidative polymerization of aniline) a significant amount of PANI on them in the form of a thin layer mainly located on the inner surface of the pores. Such morphology of the composite made allowed the combining of the high capacitive characteristics of PANI with the reversibility of electrochemical processes, high columbic efficiency and cyclic stability rather typical for carbon materials of double-layer SCs. The highest capacitance of composite electrodes of about 4.54 F/cm² with high cyclic stability (no more than 8% of capacity loss after 2000 charge–discharge cycles with a current density of 10 A/cm²) and columbic efficiency (up to 98%) was achieved in 3 M H₂SO₄ electrolyte solution when PANI was synthesized from an aniline hydrochloride solution with a concentration of 0.25 M. Trasatti analysis revealed that 27% of specific capacitance corresponded to pseudocapacitance, and 73% to the double-layer capacitance. Full article

Wastewater-based epidemiology has garnered considerable research interest, concerning the COVID-19 pandemic. Restrictive public health interventions and mobility limitations are measures to avert a rising case prevalence. The current study integrates WBE monitoring strategies, Google mobility data, and restriction information to assess the epidemiological development of COVID-19. Various SARIMAX models were employed to predict SARS-CoV-2 cases in Liechtenstein and two Austrian regions. This study analyzes four primary strategies for examining the progression of the pandemic waves, described as follows: 1—a univariate model based on active cases; 2—a multivariate model incorporating active cases and WBE data; 3—a multivariate model considering active cases and mobility data; and 4—a sensitivity analysis of WBE and mobility data incorporating restriction policies. Our key discovery reveals that, while WBE for SARS-CoV-2 holds immense potential for monitoring COVID-19 on a societal level, incorporating the analysis of mobility data and restriction policies enhances the precision of the trained models in predicting the state of public health during the pandemic. Full article

The muscle contraction during voluntary movement is controlled by activities of alpha- and gamma-motoneurons (αMNs and γMNs, respectively). In spite of the recent advances in research on molecular markers that can distinguish between αMNs and γMNs, electrophysiological membrane properties and firing patterns of γMNs have remained unknown, while those of αMNs have been clarified in detail. Because of the larger size of αMNs compared to γMNs, blindly or even visually recorded MNs were mostly αMNs, as demonstrated with molecular markers recently. Subsequently, the research on αMNs has made great progress in classifying their subtypes based on the molecular markers and electrophysiological membrane properties, whereas only a few studies demonstrated the electrophysiological membrane properties of γMNs. In this review article, we provide an overview of the recent advances in research on the classification of αMNs and γMNs based on molecular markers and electrophysiological membrane properties, and discuss their functional implication and significance in motor control. Full article

High-voltage electrical injuries, especially from lightning strikes, can cause life-threatening complications due to extreme temperature and voltage exposure. While burns and cardiac complications have been widely described, the documentation of metabolic imbalances, particularly hypokalemia, has not been as prevalent. This report focuses on a patient with profound transient hypokalemia following a lightning strike, alongside a review of three similar cases of transient hypokalemia from the literature. Our patient, a previously healthy young man, was struck by lightning and subsequently suffered transient hypokalemia with lower extremity sensory changes, which resolved after the normalization of serum potassium levels. While the exact underlying mechanisms of transient hypokalemia following high-voltage electrical injuries are unknown, we propose a multifactorial mechanism, which includes massive intracellular shifts of potassium due to elevated epinephrine levels and the prevention of potassium efflux through the electrical disruption of voltage-gated potassium channels. Our report underscores the importance of recognizing hypokalemia in patients with high-voltage electrical injuries and contributes to the understanding of the complex mechanisms involved. Further research is necessary to understand the connection between cellular changes induced by high-voltage exposure and their effects on metabolism, particularly in relation to hypokalemia. Full article

The dynamic behavior of a pile-supported structure with a base isolator was investigated by using 1 g shaking table model tests considering soil–structure interaction (SSI). The emphasis was placed on evaluating the effect of the with/without developed base isolator on the dynamic behavior of end-bearing piles and structures. The experiment was performed through sweep tests and sinusoidal wave tests. As a result of the tests, the developed base isolator was found to effectively reduce the structure’s resonant frequencies and damped the response acceleration under resonance frequencies. According to sweep tests, the base shear force of the pile-supported structure system tends to decrease as the relative density of the soil increases during resonance. It showed that the base isolator tends to reduce significantly the response acceleration of not only the rigid-based structure but also the pile-supported structure. It was shown that although the isolated superstructure recorded large horizontal displacements, piles experienced reduced horizontal displacement and bending moments, regardless of soil conditions. Full article

Insulin receptor signaling promotes cell differentiation, proliferation, and growth which are essential for oocyte maturation, embryo implantation, endometrial decidualization, and placentation. The dysregulation of insulin signaling in women with metabolic syndromes including diabetes exhibits poor pregnancy outcomes that are poorly understood. We utilized the Cre/LoxP system to target the tissue-specific conditional ablation of insulin receptor (Insr) and insulin-like growth factor-1 receptor (Igf1r) using an anti-Mullerian hormone receptor 2 (Amhr2) Cre-driver which is active in ovarian granulosa and uterine stromal cells. Our long-term goal is to examine insulin-dependent molecular mechanisms that underlie diabetic pregnancy complications, and our conditional knockout models allow for such investigation without confounding effects of ligand identity, source and cross-reactivity, or global metabolic status within dams. Puberty occurred with normal timing in all conditional knockout models. Estrous cycles progressed normally in Insr^d/d females but were briefly stalled in diestrus in Igf1r^d/d and double receptor (DKO) mice. The expression of vital ovulatory genes (Lhcgr, Pgr, Ptgs2) was not significantly different in 12 h post-hCG superovulated ovaries in knockout mice. Antral follicles exhibited an elevated apoptosis of granulosa cells in Igf1r^d/d and DKO mice. However, the distribution of ovarian follicle subtypes and subsequent ovulations was normal in all insulin receptor mutants compared to littermate controls. While ovulation was normal, all knockout lines were subfertile suggesting that the loss of insulin receptor signaling in the uterine stroma elicits implantation and decidualization defects responsible for subfertility in Amhr2-Cre-derived insulin receptor mutants. Full article

This study focuses on optimizing the ultrasound-assisted extraction (UAE) of bioactive compounds from purple-fleshed sweet potatoes (PFSP) for potential use as natural colorants. Factors such as time, temperature, and solid-to-liquid ratio were varied using a Box–Behnken Design. The optimal conditions were determined as 75 min, 70 °C, and a 1:15 m/v solid-to-liquid ratio, resulting in 18.372 mg/100 g total anthocyanin (TA) and 151.160 mg GAE/100 g total phenolic content (TPC). The validation yielded 18.822 mg/100 g for total anthocyanin and 162.174 mg GAE/100 g for total phenolic content, showing a 7% difference from predictions. UAE significantly increased TA extraction by 81% and TPC by 93% compared with the conventional method, with a notable reduction in process time from 24 h to 75 min. Additionally, three kinetic models were tested to compare extraction mechanisms, confirming the efficiency of UAE for PFSP bioactive compound recovery. This study proposes the UAE technique as a highly effective means of extracting bioactive compounds from PFSP, offering promising applications across multiple industries. Full article

This study aimed to examine the potential impact of the intervention of Lactiplantibacillus plantatum HFY11 (LP-HFY11) on colitis using in vivo animal trials. The impact of LP-HFY11 intervention on colitis was determined by measuring the levels of relevant indicators in the intestine, colon, and blood after oxazolone-induced colitis in BALB/c mice. The results of the trial show that LP-HFY11 improved the colon weight-to-length ratio, reduced the colitis-induced colon length shortening, and reduced colonic abstinence. Furthermore, it decreased the levels of myeloperoxidase, nitric oxide, and malondialdehyde activities while increasing the glutathione content in the colon tissue of colitis-affected animals. LP-HFY11 lowered the interleukin-10 (IL-10) level and increased the IL-2 level in the serum of colitis mice. LP-HFY11 also upregulated the expression of neuronal nitric oxide synthase, endothelial nitric oxide synthase, c-Kit, and stem cell factor (SCF), and downregulated the expression of IL-8, C-X-C chemokine receptor type 2 (CXCR2), and inducible nitric oxide synthase (iNOS) in the colon tissue of mice with colitis. LP-HFY11 decreased the expression of Firmicutes in the gut while increasing the expression of Bacteroidetes, Bifidobacteria, and Lactobacillus. This indicates that LP-HFY11 could control physiological alterations in the serum and colon tissue, as well as the expression of gut microorganism. Full article

This scoping review aims to outline key discoveries, gaps in knowledge, and potential future directions in the field of forest therapy research in Europe. Clinical studies investigating the effects of forest therapy sessions in Europe were systematically screened through PubMed, Embase, Cochrane Library, the Directory of Open Access Journals (DOAJ), and Google Scholar (search date: January 2024). This review encompasses 26 selected studies, collectively engaging 2775 participants across various European countries, including Italy, Poland, Spain, Germany, Finland, Hungary, Sweden, Iceland, and Switzerland. These studies predominantly measured psychological outcomes such as mood states, affect, attention levels, subjective wellbeing, and quality of life. Additionally, physiological assessments were conducted, covering vital signs, salivary cortisol, body composition, and blood count. Notably, most of the investigation sites were covered by evergreen forests. Forest therapy practices in Europe demonstrated significant benefits in psychological aspects, including relaxation, mood enhancement, and improved wellbeing, accompanied by physiological improvements, particularly in asthma patients. While a fair-to-good methodological quality was identified in randomized controlled trials, the acknowledged weaknesses point towards a need for more rigorous and standardized research approaches. In conclusion, this comprehensive scoping review provides valuable insights into the current landscape of forest therapy research in Europe, highlighting its potential to positively impact both physical and mental wellbeing. The findings underscore the need for further research addressing methodological limitations and exploring gaps in understanding, thereby contributing to the continued advancement of forest therapy as a holistic wellbeing intervention within the European context. Full article

The co-processing of different wastes as fuels in the manufacture of cement clinker not only meets the objectives of a circular economy but also contributes to the reduction in CO₂ emissions in the manufacture of Portland cement. However, waste used as alternative fuels, such as sludge or organic-rich residues, may contain naturally occurring radionuclides that can be concentrated during the combustion process. In this study, the presence of natural radionuclides (radioactive series of uranium, thorium, and ⁴⁰K) and anthropogenic radionuclides (¹³⁷Cs) in these wastes has been investigated by gamma spectrometry. Possible relationships between the radioactive content and the obtained chemical composition, determined by X-ray fluorescence, have also been studied by applying a principal component analysis (PCA). The results showed that the wastes with the highest radioactive content were sewage sludge with activity concentrations of ²³⁸U and ²¹⁰Pb of 321 ± 38 Bq kg⁻¹ and 110 ± 14 Bq kg⁻¹, respectively. A correlation between radioactive content and Fe₂O₃ concentration was also observed. The annual effective dose rates to workers for the ashes estimated from the ash content ranged from 0.0033 mSv to 0.092 mSv and therefore do not pose a risk to workers as they are lower than the 1 mSv per year limit for the general public (DIRECTIVE 2013/59/EURATOM). Full article

Tree cover is a crucial vegetation structural parameter for simulating ecological, hydrological, and soil erosion processes on the Chinese Loess Plateau, especially after the implementation of the Grain for Green project in 1999. However, current tree cover products performed poorly across most of the Loess Plateau, which is characterized by grasslands with sparse trees. In this study, we first acquired high-accuracy samples of 0.5 m tree canopy and 30 m tree cover using a combination of unmanned aerial vehicle imagery and WorldView-2 (WV-2) imagery. The spectral and textural features derived from Landsat 8 and WV-2 were then used to estimate tree cover with a random forest model. Finally, the tree cover estimated using WV-2, Landsat 8, and their combination were compared, and the optimal tree cover estimates were also compared with current products and tree cover derived from canopy classification. The results show that (1) the normalized difference moisture index using Landsat 8 shortwave infrared and the standard deviation of correlation metric calculated by means of gray-level co-occurrence matrix using the WV-2 near-infrared band are the optimal spectral feature and textural feature for estimating tree cover, respectively. (2) The accuracy of tree cover estimated using only WV-2 is highest (RMSE = 7.44%), indicating that high-resolution textural features are more sensitive to tree cover than the Landsat spectral features (RMSE = 11.53%) on grasslands with sparse trees. (3) Textural features with a resolution higher than 8 m perform better than the combination of Landsat 8 and textural features, and the optimal resolution is 2 m (RMSE = 7.21%) for estimating tree cover, whereas the opposite is observed when the resolution of textural features is lower than 8 m. (4) The current global product seriously underestimates tree cover on the Loess Plateau, and the tree cover calculation using the canopy classification of high-resolution imagery performs worse than the method of directly using remote sensing features. Full article

As the imbalance between power demand and load capacity in electrical systems becomes increasingly severe, investigating the temperature variations in transformers under different load stresses is crucial for ensuring their safe operation. The thermal analysis of converter transformers poses challenges due to the complexity of model construction. This paper develops a full-scale model of a converter transformer using a multi-core high-performance computer and explores its thermal state at 80%, 100%, and 120% loading ratios using the COUPLED iteration method. Additionally, to validate the simulation model, 24 FBGs are installed in the experimental transformer to record the temperature data. The results indicate a general upward trend in winding the temperature from bottom to top. However, an internal temperature rise followed by a decrease is observed within certain sections. Moreover, as the loading ratio increases, both the peak temperature and temperature differential of the transformer windings rise, reaching a peak temperature of 107.9 °C at a 120% loading ratio. The maximum discrepancy between the simulation and experimental results does not exceed 3.5%, providing effective guidance for the transformer design and operational maintenance. Full article

Neovascular age-related macular degeneration (AMD) is a major cause of irreversible blindness in elderly populations in developed countries. AMD’s etiopathology is multifactorial, with strong environmental and genetic components, but the exact molecular pathomechanisms underlying the disease are still unknown. In this study, we analyzed blood serum collected from 74 neovascular AMD patients and 58 healthy controls to identify proteins that may serve as potential biomarkers and expand our knowledge about the etiopathogenesis of the disease. The study revealed 17 differentially expressed proteins—11 up-regulated and 6 down-regulated—in neovascular AMD, which are involved in the biological processes previously linked with the disease—oxidative stress and persistent inflammation, impaired cellular transport, lipid metabolism and blood coagulation. In conclusion, the differences in the expressions of the proteins identified in this study may contribute to our understanding of the mechanisms underlying AMD and possibly serve in future as promising biomarkers. Full article

Surgical resection is the gold standard for treating synchronous colorectal liver metastases (CRLM). The resection of the primary tumor and metastatic lesions can follow different sequences: “simultaneous”, “bowel-first”, and “liver-first”. Conservative approaches, such as parenchymal-sparing surgery and segmentectomy, may serve as alternatives to major hepatectomy. A comprehensive search of Medline, Epistemonikos, Scopus, and the Cochrane Library was conducted. Studies evaluating patients who underwent surgery for CRLM and reported survival results were included. Other secondary outcomes were analyzed, including disease-free survival, perioperative complications and mortality, and recurrence rates. Quality assessment was performed using the AMSTAR-2 method. No significant differences in overall survival, disease-free survival, and secondary outcomes were observed when comparing simultaneous to “bowel-first” resections, despite a higher rate of perioperative mortality in the former group. The 5-year OS was significantly higher for simultaneous resection compared to “liver-first” resection. No significant differences in OS and DFS were noted when comparing “liver-first” to “bowel-first” resection, or anatomic to non-anatomic resection. Our umbrella review validates simultaneous surgery as an effective oncological approach for treating SCRLM, though the increased risk of perioperative morbidity highlights the importance of selecting suitable patients. Non-anatomic resections might be favored to preserve liver function and enable future surgical interventions. Full article