Search Results (401)

This paper introduces a new conceptual framework for interpreting urethral retro-resistance pressure (URP) as a dynamic, intra-procedural tool—ΔURP—for evaluating external urethral sphincter (EUS) engagement during injection therapy. With renewed interest in therapies that directly target the EUS, there is a critical need for real-time functional feedback at the site of action. This conceptual review re-examines URP in the context of emerging EUS-targeted treatments—such as bulking agents, regenerative injections, and neuromodulatory interventions—and proposes a dynamic model (ΔURP) to measure changes in sphincteric resistance as a functional biomarker during intervention. We review the anatomical, neurophysiological, and histological features of the EUS complex; trace the clinical rise and decline of URP; and compare its utility to conventional diagnostic tools. ΔURP, defined as the change in URP from baseline, is explored as an objective measure of EUS function. We outline its potential applications in guiding therapy, evaluating response, and standardizing outcomes across treatments. Conventional urodynamic measures fail to isolate distal sphincter function. In contrast, URP directly challenges the EUS and, when combined with imaging or procedural tools, may provide real-time feedback on sphincter engagement. When reframed as a dynamic, motion-based readout, URP may fill a critical gap in procedural urology—offering a physiologic signal of therapeutic engagement during EUS-targeted interventions. ΔURP has the potential to revive and repurpose a once-abandoned method into a clinically actionable biomarker for next-generation continence care. Full article

Background: Obstructive Sleep Apnea (OSA) is a common occurrence in the perioperative patient population but is often undiagnosed. Point-of-Care Ultrasound (POCUS) has emerged as a promising tool for perioperative assessment; however, its effectiveness in detecting the presence or severity of OSA needs to be evaluated. Objective: We assessed the ability of airway POCUS as a screening and severity evaluation tool for OSA by examining its correlation with STOP-BANG scores and the Apnea–Hypopnea Index (AHI). Design: Cross-sectional observational study. Setting: A single-center study in a tertiary care hospital between June 2020 to May 2021. Patients: Adult patients aged 18–65 with prior Polysomnography (PSG) for OSA workup were screened. Interventions: The participants completed the STOP-BANG questionnaire and subsequently underwent POCUS examinations, either pre- or post-surgery. Ten different POCUS views previously used for evaluating OSA were acquired in a predefined sequence, with subsequent measurements of airway parameters. Outcome measures: Generalized linear modeling was used to explore and assess the relationships between the measured parameters, STOP-BANG, and AHI scores (modeled continuously and categorized into risk levels of STOP-BANG and AHI). Results: A total of 260 patients were screened, of which 142 were enrolled and 127 completed the scanning studies. The median AHI was 16.71, while the STOP-BANG scores were mostly between 5 and 6, indicating a moderate-to-high OSA risk in the study population. Notably, only neck circumference was significantly associated with AHI severity (p = 0.012), whereas none of the other POCUS measures were. Among the POCUS measures, significant associations with STOP-BANG scores were observed for the Tongue Cross-Sectional Area (T-CSA) (p = 0.002), Retro-Palatal Diameter (RPD) (p = 0.034), Distance Between Lingual Arteries (DLA) (p = 0.034), and Geniohyoid Muscle Thickness (GMT) (p = 0.040). Conclusions: Neck circumference is a more reliable predictor of OSA severity (AHI) compared to other POCUS measurements. Many of the POCUS measures had a good correlation with the STOP-BANG scores, highlighting the utility of POCUS as a screening tool for OSA rather than as a severity evaluation tool. Full article

Heavier element analogues of a ketone, a C=O double-bond compound, have been fascinating compounds from the viewpoint of main-group element chemistry because of their unique structural features and reactivity as compared with those of a ketone, which plays an important role in organic chemistry. We will report here the synthesis of diorgano-stannanethione and stannaneselone featuring tin–chalcogen double bonds, which are the heavy-element analogues of a ketone. The newly obtained stannaneselone has been structurally characterized by spectroscopic analyses and single-crystal X-ray diffraction (SC-XRD) analysis, showing the short Sn–Se bond length featuring π-bond character. The obtained bis(ferrocenyl)stannanechalcogenones were found to undergo [2+4]cycloaddition reactions with 2,3-dimethyl-1,3-butadiene, affording the corresponding six-membered ring compound. Notably, thermolysis of the [2+4]cycloadduct of the stannaneselone regenerated the stannaneselone via the retro[2+4]cycloaddition, whereas the sulfur analogue was thermally very stable. Full article

The development of reversible animal models for the study of intestinal pathologies is essential to reduce the number of animals used in research and to better understand disease mechanisms. In this study, we present a reversible model of intestinal malabsorption through the administration of sublethal doses of ebulin-f, a ribosome-inactivating protein, and validate its usefulness by monitoring vitamin C absorption. The scientific community increasingly recognizes the importance of rationalizing experimental designs, optimizing treatment protocols, and minimizing the use of animals in research models. Thus, new methodologies are needed to minimize invasive sampling and to develop reversible animal models that recover physiologically post-study. Such models are essential for in vivo studies of human pathologies. Sublethal doses of ebulin-f (2.5 mg/kg) administered intraperitoneally to female Swiss CD1 mice (n = 6 per group) can cause reversible intestinal alterations in the small intestine, which offer the possibility of having a valuable reversible study model of malabsorption for the investigation of this syndrome. To verify whether nutrient absorption is altered, we used vitamin C as a traceable nutrient that can be quantified in the blood. Peripheral blood samples were collected through the retro-orbital area at 30, 80, 120, 180, and 1440 min post-administration, treated with DTT and MPA, and analyzed using a validated UV/Vis–HPLC method to indirectly determine vitamin C absorption by enterocytes. Pharmacokinetic analysis revealed significantly increased vitamin C absorption on days 1 and 3 post-treatment (AUC values of 3.65 × 10⁴ and 7.10 × 10⁴, respectively) compared to control (0.94 × 10⁴), with partial recovery by day 22 (3.27 × 10⁴). Blood concentration profiles indicate that intestinal damage peaks at day 3, followed by significant regeneration by day 22, establishing this as a viable reversible model for inflammatory bowel disease research. Full article

Background/Objectives. With a rapid palatal expander (RPE) is reported to be effective in increasing the volume of nasal cavities, with a restoration of physiological nasal airflow. The purpose of this retrospective clinical study was to evaluate, using Cone Beam Computed Tomography (CBCT), the volumetric changes and airflow velocity changes in the nasal cavities, retro-palatal and retro-glossal airways, resulting from the use of RPE with dental anchorage (group A), also comparing these data with patients non treated with RPE (group B). Methods. Sixteen subjects (aged 9.34 years) with transverse maxillary deficiency and unilateral posterior crossbite were treated with RPE with dental anchorage. Additionally, 8 patients (aged 11.11 years) with juvenile idiopathic arthritis, who did not undergo any orthodontic treatment, were selected as a control group. Expansion was performed until overcorrection was achieved, and the device was left in place for 6 months as fixed retention, followed by another 6 months of night-time removable retention. From the retrospective evaluation, all patients presented two CBCT scans at baseline (T0) and 1-year follow-up (T1). The 3D-Slicer software was used for each CBCT to measure the nasal (VN), retropalatal (VRP), and retroglossal (VRG) volumes, while an iterative Excel spreadsheet allowed for a pilot approximated modeling and calculation of airway flow-related data. Results. Regarding mean age, a statistically significant difference (p = 0.01 *) was found between groups, suggesting that group B is closer to the pubertal growth peak. Analysis between T0 and T1 revealed: (i) a statistically significant increase for volumes VN, VRP and VRG in group A; (ii) a statistically significant increase for VN in group B; (iii) a statistically significant decrease for all variables related to airflow velocity in both groups. Furthermore, comparison between group A and B, regarding variations between T0 and T1, found a statistically significant difference only for VN. Conclusions. Within the limitations of this pilot evaluation, the treatment with RPE revealed promising outcomes for retro-palatal, retro-glossal and nasal volumes, together with clinical changes in airflow velocities. Full article

Background: A pseudotumor adjacent to the odontoid has been reported to be a non-neoplastic mass that is mainly associated with atlantoaxial instability. Methods: Case report. Results: A 72-year-old woman presented to our clinic with a chief complaint of bilateral fine motor dysfunction and gait disturbance. She had rheumatoid arthritis as a comorbidity. Physical examination revealed bilateral hand fine motor dysfunction and signs of myelopathy, including hyperreflexia of the deep tendon reflexes in the lower extremities. Magnetic resonance imaging (MRI) showed a retro-odontoid pseudotumor. Surgery was proposed to the patient, but she did not wish to undergo surgery at this time. At a follow-up visit approximately one year after the initial visit, she complained of the progression of the bilateral hand fine motor dysfunction and gait disturbance. MRI demonstrated a pseudotumor in the space anterior to the odontoid process, indicating that the localization of the pseudotumor around the odontoid process changed from the posterior space to the anterior space in its natural course. Conclusions: The speculated sequential mechanism of the change in the location of the pseudotumor from the posterior space to anterior space to the odontoid process in the natural course is as follows: As the rheumatoid arthritis progressed, the C1-2 joint was immobilized in the dislocated position, and as a result, the retro-odontoid pseudotumor disappeared due to immobilization of the C1-2 joint. Following the disappearance of the retro-odontoid pseudotumor, the odontoid process shifted backward owing to rupture of the transverse annular ligament. Consequently, a new space appeared in front of the odontoid process. Subsequently, damage to the apical and alar ligaments resulted in pseudotumor formation in the new space. Considering our case, the formation of an antero-odontoid pseudotumor occurs only in limited cases, with extreme progression of the pathology. Most cases of retro-odontoid pseudotumors are treated by surgery before such a progression; therefore, we consider that such a case has not yet been reported in the literature. Full article

Background: Target enhancement and non-target suppression are two critical mechanisms underlying representational prioritization in visual working memory (VWM). However, it remains unclear how VWM load modulates these prioritization mechanisms. Methods: Using EEG combined with a retro-cue paradigm, this study investigated how representational prioritization emerges under low (Experiment 1) and high (Experiment 2) memory load conditions. Methods: Behavioral results showed that under low load, both target and non-target items benefited from retro-cue. ERP analyses revealed significantly larger P2 and P3b amplitudes in response to valid compared to neutral retro-cues, whereas no significant contralateral delay activity (CDA) component was observed. Under high load, cueing benefits were restricted to target items, whereas non-target items suffered impaired performance. ERP analyses again showed enhanced P2 and P3b amplitudes for valid compared to neutral retro-cues, but a significant CDA component was also observed. Time–frequency analyses further revealed frontal theta synchronization (ERS) and posterior alpha desynchronization (ERD) under both load conditions. Notably, theta–alpha phase–amplitude coupling (PAC) was significantly stronger for valid than neutral retro-cues under low load, whereas under high load, PAC did not significantly differ between cue conditions. Conclusions: Together, these findings suggest that target enhancement serves as a stable mechanism for representational prioritization, whereas non-target suppression critically depends on resource availability. VWM load systematically shapes representational prioritization through modulation of oscillatory timing characteristics and inter-regional neural coordination. Full article

A four-year-old female patient was admitted for evaluation after a mass on the right side of her neck was noticed during straining (Valsalva maneuver). The family first observed the mass when the patient was one year old, and noted that it gradually increased in size over time. A family history assessment revealed no known genetic disorders. The patient underwent neck ultrasonography and computed tomography angiography (CTA), which revealed two aneurysms in a right-sided communicating vein. One aneurysm was located above the jugular notch, and the other was located in the retro-parotid region. The presence of two venous aneurysms in a right-sided communicating vein—one above the jugular notch and the other in the retro-parotid region—suggests a rare and apparently benign congenital anomaly. The progressive enlargement of these malformations warrants close monitoring and surgical intervention, and long-term follow-up may be necessary to prevent complications such as thrombosis, rupture, or compression of adjacent structures. Full article

With the rapid development of radical initiation technologies such as photocatalysis and electrocatalysis, radical reactions have become an increasingly attractive approach for constructing target molecules. However, designing efficient synthetic routes using radical reactions remains a significant challenge due to the inherent complexity and instability of radical intermediates. While computer-aided synthesis planning (CASP) has advanced retrosynthetic analysis for polar reactions, radical reactions have been largely overlooked in AI-driven approaches. In this study, we introduce RadicalRetro, the first deep learning-based retrosynthesis model specifically tailored for radical reactions. Our work is distinguished by three key contributions: (1) RadicalDB: A novel, manually curated database of 21.6 K radical reactions, focusing on high-impact literature and mechanistic clarity, addressing the critical gap in dedicated radical reaction datasets. (2) Model Innovation: By pretraining Chemformer on ZINC-15 and USPTO datasets followed by fine-tuning with RadicalDB, RadicalRetro achieves a Top-1 accuracy of 69.3% in radical retrosynthesis, surpassing the state-of-the-art models LocalRetro and Mol-Transformer by 23.0% and 25.4%, respectively. (3) Interpretability and Practical Utility: Attention weight analysis and case studies demonstrate that RadicalRetro effectively captures radical reaction patterns (e.g., cascade cyclizations and photocatalytic steps) and proposes synthetically viable routes, such as streamlined pathways for Tamoxifen precursors and glycoside derivatives. RadicalRetro’s performance highlights its potential to transform radical-based synthetic planning, offering chemists a robust tool to leverage the unique advantages of radical chemistry in drug synthesis. Full article

This case report describes a unique ocular finding in a 64-year-old male with a history of central serous chorioretinopathy with choroidal neovascular membrane, treated with intravitreal injections of Aflibercept. The patient was found to have an iatrogenic retro-lenticular non-pigmented cystic formation in the left eye, an anomaly not previously documented in the literature. Comprehensive imaging included ultrasound biomicroscopy and anterior segment optical coherence tomography. This report emphasises a rare ocular finding and the significance of recognising iatrogenic cataracts following intravitreal injections. It also highlights the necessity of individualised patient management and preoperative evaluations to prevent surgical complications. Full article

Osteoarthritis (OA) is the most prevalent rheumatologic disease and a leading cause of years lived with disability worldwide. There are no disease-modifying drugs available to treat it. This study aimed to evaluate the effect of a single dose of 100U botulinum neurotoxin-A (BoNT-A) in patients with early knee OA. We designed a single-arm preliminary clinical trial in patients diagnosed with knee OA (KOA) grades I and II. 45 Patients received a single dose of 100U IncobotulinumtoxinA in the retro-patellar bursa and received nutritional and physical rehabilitation indications. Patients were evaluated at baseline and at days 5, 30, 60, and 90 after injection. The primary outcome was the reduction in pain using the visual analog scale (VAS). Knee function was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). We assessed secondary adverse effects and measured muscular strength in every consultation. Descriptive endpoint summaries and a generalized linear random-effect model were used to evaluate changes in each follow-up time compared to baseline. IncobotulinumtoxinA treatment significantly (p < 0.001) reduced pain in all treated patients at day 90 compared to day 0. Patients showed a significant reduction in total WOMAC score (p < 0.001), from a mean baseline of 44.6 (95% CI; 41.4, 47.8) to 4.4 at day 90 (95% CI; 0.2, 0.3). Our results show that IncobotulinumtoxinA applied in the retro-patellar bursa is a safe and effective treatment for pain in patients with early-stage KOA, offering a potential alternative for symptomatic control in KOA. Full article

This paper presents an autonomous end-to-end guidance, navigation, and control (GNC) solution for a reusable launcher, addressing the challenges of precision pinpoint landing and reusability. The proposed GNC system integrates advanced onboard trajectory optimization and $H_{\infty }$ control to ensure robust performance across re-entry, aerodynamics, and landing phases. This work discusses the GNC design and definition and introduces the strategies adopted both for the guidance and the control design to handle rapidly varying dynamic environments and strict landing requirements. Particular attention is given to design choices in the guidance optimization problem and the control definition for each phase, which were made to enhance the harmonization of the guidance and control (G&C) system. The proposed GNC is integrated in a high-fidelity Functional Engineering Simulator (FES) and its robustness is assessed in a real-world scenario, considering a downrange landing mission of the RETALT1 (RETro propulsion Assisted Landing Technologies Two-Stage-To-Orbit vehicle) rocket. Full article

Spectrum conversion is one of the important applications in the non-linear electromagnetic (EM) field, which is widely used in antennas, wireless communication, radar imaging, etc. However, controlling spectrum conversion with excellent retrospective characteristics at oblique incidence directions remains a major issue in microwave systems. In this paper, a time-modulated Van Atta array is proposed to manipulate the spectral distribution of the echo signal. The array prototype experiments are conducted to demonstrate the variation properties of the monostatic radar cross section (RCS) at oblique incidence directions. On this basis, the periodic modulation model of the retrospective signal is established for the time-modulated Van Atta array. Several discrete harmonic components are symmetrically distributed on both sides of the original spectra. The influence of modulation parameters on the generated harmonics is analyzed in detail. The array prototype experiment is carried out, and the variation characteristics of the monostatic RCS in the oblique incidence direction are verified. Full article

Background: The concept of mesopancreas is frequently discussed in the surgical literature as the neural pathway for metastatic spread in pancreatic head cancer. It generally refers to a retro-pancreatic plane that should be resected to reduce the incidence of regional metastases. However, this concept remains poorly defined, both embryologically and anatomically. Our objective was to establish a clear embryological and anatomical definition of the mesopancreas, making anatomical data more applicable in surgical practice. Methods: We examined seven cadavers (5 males, 2 females, aged 62–71) with no medical or surgical history, preserved in 9% formalin at Carol Davila University’s Anatomy Department. Regional dissections were performed in successive planes, highlighting the celiac ganglia and the associated network of neural connections that comprise the mesopancreas. Results: Our study defines the “mesopancreas” as remnants of primordial mesenteries that coalesced into the Treitz fascia. We identified its functional components as nerve fibers linking the celiac ganglia and superior mesenteric plexus to the pancreas, along with vascular structures, lymphatics, and connective and adipose tissue. These components likely contribute to regional metastasis in pancreatic head cancer. While resection of the mesopancreas could help prevent metastasis, its complex anatomy and proximity to major vessels pose significant surgical challenges. Conclusions: Based on our findings, we propose a plausible definition for the term “mesopancreas”. It encompasses the structures that originated as part of the primordial mesenteries, which subsequently coalesced, resulting in the formation of the Treitz fascia. In essence, the mesopancreas is the functional content of a former mesentery. Full article

The catalytic production of lactic acid from carbohydrates was considered a green way to efficiently utilize renewable biomass resources. In this study, an easy post-synthesis method was used to prepare a Sn-Beta catalyst for the production of lactic acid from glucose at 180 °C, 2 MPa, and 30 min. With optimized reaction time, temperature, pressure, and the ratio of raw material to catalyst, the yield of lactic acid reached an astonishingly high level of 76.0%. In addition, the catalyst characterizations were performed in-depth, revealing the intrinsic relationship between catalyst performance and structure, proving that the 2 wt% Sn was uniformly dispersed in the skeleton of Beta zeolite, which significantly increased the density of Lewis acid. Thus, the enhanced isomerization and retro-aldol condensation processes over the Lewis acid sites led to the high yield of lactic acid. This catalytic system kept stable after five cycles at mild conditions, showing high potential for industrial biomass utilization. Full article