Search Results (269)

While performing a routine anatomical dissection on a male donor, undergraduate medical students observed an uncommon vascular anomaly: a persistent left superior vena cava (LSVC). Prior to the anatomical dissection, computed tomography (CT) images were obtained in an embalmed condition. Relevant anatomical structures were measured using the JiveX DICOM Viewer. The left brachiocephalic vein (LBV) was present as a communicating vessel with a markedly reduced diameter between the LSVC and the right superior vena cava (RSVC). The diameters of RSVC and LSVC averaged 19.4 mm and 15.2 mm, respectively. The LSVC drained into a dilated coronary sinus (CS), which measured 22.7 mm in diameter. In addition, the left accessory hemiazygos vein collected the 2nd to 5th left intercostal veins, forming a small-caliber venous arch (2.1 mm in diameter) at the T5 vertebral level, which crossed anterior to the thoracic aorta, before draining into the LSVC. In comparison, the azygos venous arch on the right side is connected to the RSVC at T4. Knowledge of such venous variations through preoperative imaging—such as CT, MRI, or echocardiography—can be essential for procedural planning and for minimizing inadvertent complications. This case also highlights a dual approach, combining anatomical dissection with detailed CT analysis of the same specimen, which can both enhance undergraduate anatomical education and contribute to high-quality morphological research. Full article

Background and Objectives: The masseteric artery (Ma) enters the masseter muscle (Mm) together with the masseteric nerve (Mn) via the mandibular notch. Morphological detail on the intramuscular course of the Ma and its relationship to the Mn remains scarce to date. When utilizing the Mn in facial reanimation surgery, a constant relationship between the Ma and Mn could be used for intramuscular orientation when preparing the Mn and for an indirect localization via ultrasound. This study examines the intramuscular course of the Ma and its relationship to the Mn. Materials and Methods: Sixty hemicrania obtained from thirty postmortem individuals aged between 54 and 99 years and embalmed using the Thiel methods were examined. Results: Four types of Ma were identified according to their endpoint in the Mm. In 5% of cases, no Ma could be identified (Type 0), 48.3% (Type 1) terminated within the upper third, 41.7% (Type 2) in the middle third, and 5% (Type 3) in the lower third. The Ma consistently entered the Mm inferior and in 85% of cases additionally slightly posterior to the Mn. The main trunk of the Ma crossed the Mn in the upper third of the Mm in 31.7% of cases, in the middle third in 23.3%, and in the lower third in 1.7% of cases. Of these, 13.3% had the Ma crossing the Mn. Smaller branches crossed the Mn in 45% of cases. Conclusions: If an Ma is present, it may be used for intramuscular orientation and indirect location of the Mn via the mandibular notch. Since the Ma reaches the lower third of the muscle in only a few cases, it is unsuitable for intramuscular orientation to locate the Mn via a distal approach. Full article

Background and Objectives: The masseteric nerve (Mn) is increasingly used for facial reanimation because of its reliable location, high axon count, low donor morbidity, and favorable clinical outcomes. Precise topographic knowledge of the Mn relative to reproducible intraoperative landmarks is essential for safe dissection. This study investigated the intramuscular position of the Mn relative to two defined reference lines. Materials and Methods: Seventy-two hemicrania from 36 individuals (aged 54–99 years) embalmed postmortem using the Thiel method were examined. Measurements were referenced to two defined anatomical lines: the angle–canthus line (ACL), extending from the mandibular angle to the lateral canthus of the eye, and the articular eminence line (AEL), extending from the articular eminence to the base of the zygomatic temporal process. Results: The Mn crossed the ACL at an average distance of 39.9 ± 5.9 mm from the mandibular angle with up to four branches. The first intramuscular branch arose 15.6 ± 4.7 mm superior to the ACL. The Mn was located 4.9 ± 1.9 mm anterior to the articular eminence and 4.7 ± 1.5 mm inferior to the AEL, coursing at an average angle of 68.5 ± 11.6° to the AEL. The AEL and ACL provide reliable and clearly defined reference lines for locating the Mn and improve intraoperative reproducibility. The Mn followed a predictable oblique course and was consistently identified in the masseter muscle (Mm) beneath an intramuscular aponeurosis. Nerve diameter varied by site, underscoring the need for standardized measurement locations. Distal localization along the ACL may enable preservation of early intramuscular branches and reduce donor morbidity. Further studies should evaluate axon counts at defined points and clarify the relationship of the Mn to the masseteric artery for better intramuscular orientation during dissection. Conclusions: The Mn can be located within a 63 mm² area beneath the AEL at the masseter entry and more distally on the ACL. ACL-based access may protect the first intramuscular branch of the Mn and the temporal branch of the facial nerve (TBFN), and it represents a potential alternative for smile reconstruction for patients with preserved eye closure. Full article

Objective: Pediatric cancer, though less prevalent than adult malignancies, constitutes a significant public health concern due to its long-term effects on survival, development, and quality of life. This study aimed to investigate spatial patterns and temporal trends of pediatric cancer in Romania over a ten-year period (2008–2017), identifying persistent and emerging geographic hotspots using Geographic Information Systems (GIS)–based modelling and spatial statistics. Methods: A national pediatric cancer registry provided by the Ministry of Health was analyzed for cases among individuals aged 0–18 years, categorized by administrative-territorial units (ATUs), ICD-10 codes, sex, and year. Spatial indicators of persistence (recurrent prevalence across multiple years) and continuity (uninterrupted recurrence) were computed. Hotspot analysis was conducted using Local Moran’s I, and trend patterns were assessed through temporal modeling. Additionally, fractal and complexity metrics were applied to characterize the spatial structure and heterogeneity of cancer persistence and continuity across regions. Results: Although national pediatric cancer prevalence exhibited a modest decline from 3.57‰ in 2008 to 3.44‰ in 2017, GIS-based spatial modeling revealed stable high-risk clusters in Central and South-Eastern Romania, particularly in historically industrialized counties such as Hunedoara, Prahova, and Galați. These correspond to regions with past heavy industry and chemical pollution. Male children presented a higher frequency of malignant tumors (48,502 cases in males vs. 36,034 in females), while benign and uncertain-behavior neoplasms increased more prominently among females (from 3847 to 4116 cases, compared with 3141 to 3199 in males). Several rural localities showed unexpected prevalence spikes, potentially associated with socioeconomic deprivation, limited health literacy, and reduced access to pediatric oncology services. Regional disparities in diagnostic and reporting capacities were also evident. Conclusion: GIS-based spatial epidemiology proved effective in revealing localized, sex-specific, and persistent disparities in pediatric cancer across Romania. The integration of spatial indicators and complexity metrics into national cancer control programs could strengthen early detection, optimize resource allocation, and reduce health inequities. These findings highlight the value of combining geospatial analysis and fractal modeling to guide evidence-based public health strategies for pediatric oncology. Full article

The assessment of forest health and terrain usability is closely tied to slope accessibility. Current methods for evaluating terrain accessibility based solely on slope characteristics often lack precision and fail to capture the combined effects of topography and vegetation. This study introduces succolarity, together with succolarity reservoir and delta (Δ) succolarity, as fractal-based measures for assessing undeveloped land accessibility. The analysis focused on two test areas: the Ceahlău Mountains and the Blaj–Vulpăr Hills. Results revealed lower accessibility values for the Ceahlău Mountains (0.01 to 0.23 for slopes of 0–5° and 0–30°) compared to the Blaj–Vulpăr Hills (0.035 to 0.598 for the same ranges). These significant contrasts demonstrate that terrain fragmentation and compact forests act as decisive constraints, with slope predominating in mountains and vegetation in hilly areas. The findings are valuable for environmental agencies, emergency services, and research groups studying land morphology and mobility. Practical applications include infrastructure planning, sustainable land-use management, and strategic operations in remote terrains. Incorporating additional datasets (e.g., hydrographic networks, seasonal vegetation) and refining methodologies will further enhance succolarity-based assessments, supporting sustainable development in challenging environments. Full article

Electronic stethoscopes address limitations of auscultation with analog stethoscopes, such as the dependency on the physicians’ hearing ability, their experience, and their subjective interpretation. However, electronic stethoscopes currently found on the commercial market fail to exploit the full potential of cutting-edge microphone technology and innovative multi-sensor approaches. Our novel device, called Open-source Modular Electronic Stethoscope (OMES), proposes a modular upgrade to an analog stethoscope that incorporates multiple sensor types and features microphone array capabilities. OMES has been tested for its performance in detecting heart beats but is designed to be applied to other auscultation sites as well. Above that, it can be employed as an educational and potential research platform to promote the development of revolutionary signal processing techniques and artificial intelligence algorithms. Full article

Isovaleric acidemia (IVA, OMIM 243500) is an inherited disorder of leucine metabolism caused by a deficiency of isovaleryl-CoA dehydrogenase (IVD), leading to an accumulation of isovaleric acid and its derivates 3-hydroxyisovaleric acid, isovaleryl (C5)-carnitine and isovalerylglycine in body fluids. The clinical presentation is highly variable, ranging from life-threatening metabolic crises with metabolic acidosis and hyperammonemia to a clinically asymptomatic only biochemical phenotype. Newborn screening for IVA has been established in many countries. Treatment consists of a protein-restricted diet combined with supplementation of carnitine and/or glycine and emergency treatment in catabolic episodes. Still, evidence-based recommendations for the diagnosis and management of IVA patients with various phenotypes are lacking. Therefore, a systematic search and review of the literature was conducted to make suggestions for the care of patients with IVA based on both the available scientific evidence and consensus-derived expert conclusions. Based on a comprehensive set of literature data published between 1966 and 2024, 15 statements were phrased on the presentation, diagnosis, management, and outcome of IVA involving clinical, biochemical, and nutrition expertise. These statements can serve as a basis for more standardized care for IVA. Full article

There are various mechanisms through which water droplets can be present in compressor flows, e.g., rain ingestion in aeroengines or overspray fogging used in heavy-duty gas turbines to boost power output. For the latter, droplet evaporation within the compressor leads to a cooling of the flow as well as to a shift in the fluid properties, which is beneficial to the overall process. However, due to their inertia, the majority of droplets are deposited in the first stages of a multistage compressor. While this phenomenon is generally considered in CFD computations of droplet-laden flows, the subsequent re-entrainment of collected water, the formation of new droplets, and the impact on the overall evaporation are mostly neglected because of the additional computational effort required, especially with regard to the modeling of films formed by the deposited water. The work presented here shows an approach that allows for the integration of the process of droplet deposition and re-entrainment based on relatively simple correlations and experimental observations from the literature. Thus, the two-phase flow in multistage compressors can be modelled and analyzed very efficiently. In this paper, the models and assumptions used are described first, then the results of a study performed based on a generic multistage compressor are presented, whereby the various models are integrated step by step to allow an assessment of their impact on the droplet evaporation throughout the compressor and overall performance. It can be shown that evaporation becomes largely independent of droplet size when deposition on both rotor and stator and subsequent re-entrainment of collected water is considered. In addition, open issues with regard to the future improvement of models and correlations of two-phase flow phenomena are highlighted based on the results of the current investigation. Full article

Our objective was to evaluate the effect of a commercial organic fertilizer and substrate conditioners on the production of Eucalyptus benthamii seedlings. Two experiments were conducted with different doses of organic fertilizer (0, 5, 10, 15, 20, and 25 kg m⁻³) and levels of hydrogel (0 and 3 kg m⁻³) and biochar (0 and 30%). In each experiment, plots were divided into two subplots, with one subplot receiving topdressing with mineral fertilizers. At the end of each experimental period, quality, root morphology, and physiological characteristics of the seedlings were assessed. When only the organic fertilizer was applied with substrate conditioners, seedlings exhibited limited growth, averaging 5.02 cm in height and 0.81 mm in stem diameter. Topdressing fertilization combined with higher organic fertilizer doses (20–25 kg m⁻³) enhanced key traits, such as height (up to 24.15 cm) and stem diameter (up to 2.39 mm). Hydrogel and biochar often reduced seedling quality and root development. Some interactions between factors affected certain root variables, but physiological characteristics remained largely unaffected. Overall, even when combined with a substrate conditioner, the commercial organic fertilizer is insufficient to produce high-quality seedlings. Neither hydrogel nor biochar is recommended under our experimental conditions. However, the commercial organic fertilizer shows potential when used with mineral fertilizers and further should be conducted to explore this possibility. Full article

Apolipoprotein C3 (apoC3) is a key regulator of triglyceride metabolism and has emerged as a potential therapeutic target for reducing the risk of cardiovascular disease. However, its broader physiological functions are not fully understood. This study investigates the role of apoC3 in platelet function and thrombus formation. Interestingly, human apoC3 was found to rapidly inhibit platelet activation over the tested concentration range of 0.1–10 µg/mL, with significant effects observed at low concentrations and brief pre-incubation times (from 1 min). At a concentration of 10 µg/mL, apoC3 suppressed platelet activation by approximately 70% in response to ADP and by approximately 40% in response to collagen stimulation. Depleting apoC3 from human serum enhanced platelet aggregation by more than 25 % (1.28 ± 0.19 vs. vehicle), indicating an endogenous regulatory function of apoC3. Mechanistically, apoC3 binding to platelets reduced both GPIIb/IIIa activation and P-selectin expression by around 20%. ApoC3 binding to platelets increased when platelets were activated by ADP and was partially mediated by GPIIb/IIIa, implicating this integrin as a functionally relevant receptor. Taken together, these findings reveal a novel link between apoC3 and platelet biology with potential implications for thrombotic risk and vascular homeostasis. Full article

Deep learning has shown remarkable success in medical image analysis over the last decade; however, many contributions focused on supervised methods which learn exclusively from labeled training samples. Acquiring expert-level annotations in large quantities is time-consuming and costly, even more so in medical image segmentation, where annotations are required on a pixel level and often in 3D. As a result, available labeled training data and consequently performance is often limited. Frequently, however, additional unlabeled data are available and can be readily integrated into model training, paving the way for semi- or self-supervised learning (SSL). In this work, we investigate popular SSL strategies in more detail, namely Transformation Consistency, Student–Teacher and Pseudo-Labeling, as well as exhaustive combinations thereof. We comprehensively evaluate these methods on two 2D and 3D cardiac Magnetic Resonance datasets (ACDC, MMWHS) for which several different multi-compartment segmentation labels are available. To assess performance in limited dataset scenarios, different setups with a decreasing amount of patients in the labeled dataset are investigated. We identify cascaded Self-Supervision as the best methodology, where we propose to employ Pseudo-Labeling and a self-supervised cascaded Student–Teacher model simultaneously. Our evaluation shows that in all scenarios, all investigated SSL methods outperform the respective low-data supervised baseline as well as state-of-the-art self-supervised approaches. This is most prominent in the very-low-labeled data regime, where for our proposed method we demonstrate $10.17\%$ and $6.72\%$ improvement in Dice Similarity Coefficient (DSC) for ACDC and MMWHS, respectively, compared with the low-data supervised approach, as well as $2.47\%$ and $7.64\%$ DSC improvement, respectively, when compared with related work. Moreover, in most experiments, our proposed method is able to greatly decrease the performance gap when compared to the fully supervised scenario, where all available labeled samples are used. We conclude that it is always beneficial to incorporate unlabeled data in cardiac MRI segmentation whenever it is present. Full article

Background/Objectives: This study aimed to evaluate longitudinal changes in the subgingival microbiome over 12 months following non-surgical periodontal treatment, with or without adjunctive systemic antibiotics, in patients with stage III/IV periodontitis and peripheral artery disease. Materials: After randomizing patients to full-mouth mechanical debridement with/without adjunctive systemic antibiotics (PT1/PT2 group) or no subgingival debridement (control group), periodontal probing depths were measured, scores for ‘periodontal inflamed surface area’ (PISA) obtained, and subgingival plaque samples collected at baseline and during the 3-month and 12-month follow-up visits. Next-generation 16S DNA sequencing was used to characterize the microbiota of the samples for alpha/beta diversity and differentially abundant taxa. Results: Complete data was available for 76 patients. At 3 months, shallow (≤3.4 mm) or advanced (≥5.5 mm) pockets were significantly more, or less, prevalent in the PT1 than in the control group (p = 0.013/0.004). Microbiologically, the PT1 group was even more distinct, being associated with statistically significant changes over time (in alpha/beta diversity and differential taxa abundances) not seen in the PT2 and control groups. Conclusions: Although non-surgical treatment can reduce periodontal inflammation with or without antibiotics, subgingival microbial diversity can only be sustainably affected, and periodontitis-associated microbiota reduced, in the presence of adjunctive systemic antibiotics. Full article

Autosomal recessive types of both syndromic and non-syndromic inherited myopia are common in Saudi Arabia (SA) because many people marry their relatives. The prevalence of syndromic myopathies in SA, like Stickler syndrome (SS), Knobloch syndrome (KS), and Marfan syndrome (MFS), further complicates the disease spectrum. The causative genes linked to the Knobloch, Marfan, and Pierson syndromes are COL18A1, FBN1, and LAMB2, respectively. Additionally, we found recessive types of non-syndromic high myopia that have a high chance of causing retinal detachment, like those linked to LRPAP1 and LEPREL1. In these cases, regular evaluation and early intervention, including prophylactic laser photocoagulation and pars plana vitrectomy, may improve the outcome. Advancements in genetic testing for diagnosis and prevention accelerate detection, facilitate early interventions, and provide genetic counseling. The utilization of artificial intelligence (AI), machine learning (ML), and the advancement of gene therapy offer promising avenues for personalized care. We place a high value on using genetic knowledge to create a national screening program and patient registry aimed at understanding the national burden of myopia, knowing that we have a high rate of consanguinity, which reflects pathogenic homozygous alleles and founder mutations. This initiative will incorporate genetic counseling and leverage innovative technologies, which are crucial for disease management, early identification, and prevention in Saudi Arabia’s healthcare system. Full article

The research reviews and contrasts two studies based on the gas-phase reaction OH + D₂(v, j). In these studies, Quasi-Classical Trajectory (QCT) calculations and the Gaussian Binning (GB) technique were used on the Wu–Schatz–Lendvay–Fang–Harding (WSLFH) potential energy surface. Large sample sizes allow for precise energy state distribution analysis across translational, vibrational, and rotational components in the products. A key observation is the influence of the vibrational and rotational excitation of D₂ on the total angular momentum (J′) of the HOD* product. This study reveals that increasing the vibrational level, vD₂, significantly shifts P(J′) distributions toward higher values, broadening them due to increased isotropy. In contrast, increasing the rotational level, jD₂, results in a smaller shift but introduces greater anisotropy, leading to a more selective distribution of J′ values. The dual Gaussian Binning selection—Vibrational-GB followed by Rotational-GB—further highlights a preference for either odd or even J′ values, depending on the specific excitation conditions. These findings have implications for the development of chemical lasers, as the excitation and emission properties of HOD* can be leveraged in the laser design. Future research aims to extend this study to a broader range of initial conditions, refining the understanding of reaction dynamics in controlled gas-phase environments. Full article

Liver cirrhosis is a complex condition characterized by oxidative stress, inflammation, and metabolic dysfunction, contributing to systemic complications and high mortality. High-density lipoprotein (HDL), particularly its small subclasses, is known for its antioxidant, anti-inflammatory, and cholesterol efflux capacities. This study examined changes in HDL subclass distribution and composition in cirrhosis and assessed their prognostic relevance for mortality. We analyzed HDL profiles using nuclear magnetic resonance spectroscopy in patients with compensated (n = 205) and decompensated (n = 158) cirrhosis, compared to healthy controls (n = 16). Across all HDL subclasses in cirrhotic patients, cholesterol content was decreased, and triglyceride levels were elevated. In particular, compensated cirrhosis was associated with a marked reduction in small and extra-small HDL particles, while large HDL levels remained unchanged. This reduction was even more pronounced in decompensated disease. Small HDL particle levels were inversely correlated with oxidative stress markers and liver dysfunction and independently predicted 12-month mortality in patients with compensated cirrhosis, even after adjusting for MELD score. In conclusion, our findings highlight a substantial depletion of small and extra-small HDL particles as a key feature of cirrhosis, linked to oxidative stress and mortality in the compensated stage. Full article