Search Results (154)

Small-diameter synthetic grafts often fail from thrombosis, intimal hyperplasia, and compliance mismatch, highlighting the need for alternatives that better support endothelialization and remodeling. Here, we evaluated multilayer plant-based vascular grafts fabricated from decellularized leatherleaf viburnum reinforced with cross-linked gelatin, seeded with vascular smooth muscle cells and endothelial cells, and conditioned in a perfusion bioreactor to mimic physiological shear stress. Pre-implant assays confirmed effective decellularization, low residual detergent, and mechanical integrity suitable for surgical handling. In a rat abdominal aorta interposition model, plant-based grafts remained patent at 1, 4, and 24 weeks and showed higher survival than silicone controls. Ultrasound imaging demonstrated flow patterns and resistance indices similar to native vessels, and plant-based grafts maintained significantly higher endothelial cell coverage than silicone controls, reaching native-like density by 24 weeks. Histology and biochemical assays showed early collagen and elastin coverage comparable to native aorta and increased collagen by 24 weeks. Scanning electron microscopy showed smooth luminal surfaces with minimal thrombus formation, contrasting with the rougher, thrombus-prone surfaces of silicone grafts. These findings indicate that plant-based grafts support endothelialization, maintain long-term patency, and undergo favorable remodeling in vivo, supporting their potential as a biomimetic alternative for small-diameter arterial repair. Full article

Endometriosis is a chronic, estrogen-dependent inflammatory condition associated with severe pelvic pain and infertility. Beyond its somatic manifestations, it is increasingly recognized as a disorder with significant psychological sequelae. This review examines the bidirectional relationship between endometriosis-related chronic pain and mental health disorders, with the aim of highlighting the importance of integrated, multidisciplinary management strategies. Relevant literature was synthesized to explore the pathophysiology of endometriosis, mechanisms of pain chronification, and the prevalence and impact of psychiatric comorbidities, including depression, anxiety, body image disturbance, and sexual dysfunction. Chronic pain and diagnostic delays contribute substantially to psychological distress in patients with endometriosis. High rates of affective disorders have been consistently reported, with significant repercussions on social functioning, intimate relationships, and overall quality of life. Although treatment traditionally focuses on symptom control, evidence supports the efficacy of approaches that concurrently address mental health needs. Endometriosis represents a paradigmatic example of the interplay between chronic somatic illness and mental health. Future research should prioritize the integration of psychological assessment and intervention within endometriosis care pathways, alongside the development of targeted, biopsychosocial treatment models. Full article

Ammonia–coal co-firing is emerging as a promising technological pathway to reduce carbon production during coal-fired power generation. However, the coupling effects of the ammonia energy ratio (E_NH3) and equivalence ratio on the ignition mechanism and emission characteristics—particularly under staged injection conditions—remain insufficiently understood. This study investigates these characteristics in a laboratory-scale furnace. Spontaneous chemiluminescence imaging and flue gas analysis were employed to decouple the effects of aerodynamic interactions and chemical kinetics. The experimental results reveal that the ammonia injection strategy is the critical factor governing coal ignition performance. Compared to the premixed mode, staged injection—which establishes an independent, high-temperature ammonia flame zone—provides a superior thermal environment and circumvents oxygen competition between the fuels, thereby markedly promoting coal ignition. At an E_NH3 of 50%, the staged configuration reduces the ignition delay time of coal volatiles by a striking 60.93%. Within the staged configuration, increasing either the co-firing ratio or the overall equivalence ratio further enhances coal ignition. Analysis of pollutant emissions elucidates that the formation of NO, N₂O, and NH₃ is intimately linked to the local combustion conditions of ammonia. An excessively lean local equivalence ratio leads to incomplete ammonia combustion, thereby increasing N₂O and NH₃ slip. Full article

Background: Computed tomography (CT) angiography is widely regarded as the gold standard for diagnosing acute aortic dissection. However, in patients with contraindications to iodinated contrast media, such as those with renal insufficiency or hemodynamic instability, non-contrast CT may offer a viable alternative for initial evaluation. Understanding the molecular mechanisms underlying aortic dissection, including extracellular matrix degradation, smooth muscle cell apoptosis, and inflammatory pathways, is crucial for developing novel diagnostic and therapeutic approaches. This report describes a single case of acute Stanford type A aortic dissection initially detected on non-contrast CT. Case Presentation: We describe a 74-year-old man who presented to the emergency department with fever and suspected infection, but without chest pain. An incidental finding on non-contrast CT revealed ascending aortic dilatation, pericardial effusion, and a suspected intimal flap. Subsequent CT angiography confirmed a Stanford type A aortic dissection. Conclusions: This case highlights the potential value of non-contrast CT in the early detection of aortic dissection, particularly when CT angiography cannot be performed. Recent advances in artificial intelligence (AI) and radiomic analysis have shown promise in augmenting the diagnostic capabilities of non-contrast CT by identifying subtle imaging features that may correlate with underlying molecular pathology and elude human observers. Emerging evidence suggests that radiomic features may reflect molecular alterations in the aortic wall, including metalloproteinase activity, collagen degradation, and inflammatory cell infiltration. Incorporating AI-assisted interpretation alongside insights into molecular mechanisms could facilitate earlier diagnosis, improve risk stratification, and guide personalized treatment strategies in critically ill patients. Although non-contrast CT has limited sensitivity for aortic dissection, it may still reveal crucial findings in selected cases and should be considered when contrast-enhanced imaging is not feasible. Ongoing progress in AI, radiomics, and molecular biomarker research may further expand the clinical applications of non-contrast CT in emergency cardiovascular care and bridge the gap between imaging phenotypes and molecular endotypes. These findings are hypothesis-generating and require validation in larger cohorts before clinical generalization. Full article

In the twenty-first century, academic approaches to mysticism often risk reducing the Mystery to an object of erudition and historical distance, as if mystical experience belonged solely to a pre-modern past. Yet, when one encounters the “natural metaphors” that emerge within mystical writings—images of rivers, gardens, fire, and wind—it becomes almost impossible to silence the invitation to perceive the sacred as still unfolding in the present. This article proposes an embodied and associative reflection that brings into conversation the poetry of John of the Cross (1542–1591), the intimate diaries of Etty Hillesum (1914–1943), and the musical and visual work of the contemporary artist Björk Guðmundsdóttir (b. 1965). Through this triadic encounter, I argue that natural metaphors are not mere literary ornaments but symbolic languages that articulate the ineffable through the elemental languages of the earth. They sustain a theology of embodiment, relationality, and transformation that traverses epochs and artistic media. The study also seeks to fracture rigid and hegemonic readings that have confined mystical texts within colonial geographies of interpretation—readings that domesticate spiritual experience through rigid doctrinal frameworks. In contrast, this essay advocates for a decolonial hermeneutics of the mystical imagination, one that recognizes how the natural, the esthetic, and the spiritual interweave in the polyphony of the world. By reading John of the Cross, Hillesum, and Björk together, I suggest that mystical experience continues to unfold today through poetry, diary, and sound—where theology becomes not only a matter of thought but of vibration, beauty, and embodied openness to the Mystery. Full article

In coronary artery disease (CAD), the initiation, progression, and regression of atherosclerosis remain incompletely understood, limiting the effectiveness of specific diagnostic and personalized medicine management strategies based on current imaging and assessment methods. In this scientific rationale and study design analysis, the framework conceptualizes the cardiovascular system as an integrated hydraulic network of pumps and pipes, advancing a shift from static imaging of luminal stenosis toward dynamic assessment of coronary flow. Grounded in fluid mechanics and acoustic principles, this analysis establishes a scientific rationale for an angiographic investigation of hemodynamic disturbances that compromise endothelial integrity in coronary arteries. The first section examines injury arising from repetitive flexion and extension of coronary segments driven by left ventricular contraction, most prominent at the transition from diastole to systole. The second section evaluates the hypothetical effects of thickened boundary layers and intimal injury caused by oxygen deprivation along the proximal portion of the outer curvature of side branches. The third section explores the hypothetical role of recirculating flow in accelerating lesion development at these sites. The fourth section presents an acoustic-based diagnostic framework for assessing the hypothetical impact of retrograde pressure-wave propagation associated with water-hammer phenomena. Collectively, these mechanisms establish the systematic codification and spatial delineation of coronary lesions as represented on the coronary acoustic map. Building on these insights, the present analysis proposes a clinical trial framework integrating AI-driven algorithmic protocols to rigorously assess the diagnostic performance and predictive accuracy of the coronary acoustic map. Full article

From a critical feminist perspective, it is hypothesised that the gender digital divide may be related to new forms of virtual gender-based violence that particularly affect girls and young women. If this is the case, these forms of violence would fall within the dimension of exploitation or quality of use of technologies that characterises the digital divide. To test this hypothesis, a documentary analysis of the phenomenon was carried out by reviewing different cases reported in various media outlets, which show that the well-being of girls and adolescents is at risk when technology is involved. Four categories emerge that reflect situations in which technology becomes a tool for promoting self-harm and suicide among minors through exposure to harmful content, grooming, sexting and/or sextortion; the digital sexual exploitation of underage girls through deepfakes or intimate images generated with artificial intelligence; the consumption of violent and hateful content in mass chats; and the incitement of gender-based violence through video games. The results show the reproduction and perpetuation of gender-based violence in the digital world. To guarantee safe, inclusive and equitable digital environments, various measures are essential, including European policies or plans aimed at guaranteeing digital security and rights, and those related to critical digital literacy with a gender perspective in formal education (school and university) and informal education (parents, carers and guardians). Finally, we urge that the focus be placed on personal digital resilience, since thinking of a completely secure digital world is a naive and unattainable utopia. Full article

Background: High-throughput metabolomics studies have promoted the discovery of candidate biomarkers linked to atherosclerosis (AS). This narrative systematic review summarises metabolomics studies conducted in (1) individuals with subclinical AS (assessed by imaging techniques such as carotid intimal media thickness, IMT, and coronary artery calcium, CAC), (2) patients with established atherosclerotic plaques, and (3) individuals with AS risk factors. Methods: The systematic search was conducted in the PubMed database according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The inclusion criteria were as follows: (i) publication date between 2009 and 2024; (ii) identification of potential biomarkers for AS in subjects with a diagnosis of AS or with one or more traits characteristic of the disease (i.e., CAC or IMT); (iii) identification of potential AS biomarkers in subjects with atherogenic clinical conditions (i.e., Down’s syndrome, DS, polycystic ovarian syndrome, PCOS, and systemic lupus erythematosus, SLE); (iv) metabolomic studies; and (iv) studies in human samples. Exclusion criteria comprised the following: (i) studies on lipid metabolic diseases unrelated to AS, (ii) “omics” results not derived from metabolomics, (iii) reviews and studies in animal models or cell cultures, and (iv) systematic reviews and meta-analyses. Of 90 eligible studies screened, 24 met the inclusion criteria. Results: Across subclinical and overt AS, consistent disturbances were observed in amino acid, lipid, and carbohydrate metabolism. Altered profiles included branched-chain amino acids (BCAAs), aromatic amino acids (AACs) and derivatives (e.g., kynurenine–tryptophan pathway), bile acids (BAs), androgenic steroids, short-chain fatty acids (FAs)/ketone intermediates (e.g., acetate, 3-hydroxybutyrate, 3-HB), and Krebs cycle intermediates (e.g., citrate). Several metabolites (e.g., glutamine, lactate, 3-HB, phosphatidylcholines, PCs/lysophosphatidylcholines, lyso-PCs) showed reproducible associations with vascular phenotypes (IMT/CAC) and/or clinical AS. Conclusions: The identification of low-weight metabolites altered in both subclinical and overt AS suggests their potential as candidate biomarkers for early AS diagnosis. Given the steady increase in deaths from cardiovascular disease, a manifestation of advanced AS, this finding could have significant clinical relevance. Full article

Background/Objectives: Hip osteoarthritis (HOA) is a progressive joint disease characterized by cartilage loss, subchondral bone changes, and synovial inflammation. While tumor necrosis factor receptor 1 (TNFR1), interleukin-6 (IL-6), and transforming growth factor-beta 1 (TGF-β1) are recognized as key mediators of joint pathology, their compartment-specific expression in the human hip synovium remains insufficiently characterized. Therefore, we aimed to investigate their localization and expression in the intimal and subintimal compartments of synovial tissue in patients with HOA compared to controls (CTRL). Methods: Synovial membrane samples were obtained from 19 patients with primary HOA undergoing total hip arthroplasty and 10 CTRL subjects undergoing arthroplasty for acute femoral neck fracture without HOA. Specimens were processed for hematoxylin and eosin (H&E) and immunofluorescence staining. Expression of TNFR1, IL-6, and TGF-β1 was quantified in the intima and subintima using ImageJ analysis. Group differences were assessed using two-way Analysis of variance (ANOVA) with Tukey’s test when assumptions were met; for heteroscedastic outcomes we applied Brown–Forsythe ANOVA with Dunnett’s T3 multiple comparisons. Results: Histological analysis confirmed synovitis in HOA samples, with intimal hyperplasia and mononuclear infiltration. IL-6 was significantly upregulated in the intima of HOA synovium compared with CTRLs, while subintimal expression remained unchanged. In contrast, TGF-β1 expression was reduced in the HOA intima, eliminating the normal intima–subintima gradient. For TNFR1, the within-HOA contrast (int > sub) was significant, whereas the intimal HOA vs. CTRL comparison showed a non-significant trend. Transcriptomic analysis supported IL-6 upregulation, while TNFR1 and TGF-β1 did not reach statistical significance at the mRNA level in an orthogonal, non-hip (knee-predominant) dataset. Conclusions: These findings demonstrate compartment-specific cytokine dysregulation in HOA, with increased intimal TNFR1 and IL-6 alongside reduced intimal TGF-β1. The synovial lining emerges as a dominant site of inflammatory signaling, underscoring its importance in disease progression. Full article

Background and Clinical Significance: Fourth ventricular epidermoid cysts are among the least frequently encountered intracranial tumors (less than 1%). Their slow growth pattern along cisternal and subarachnoid spaces, and their close proximity to neurovascular structures (brainstem–cerebellar), create difficulty for surgical treatment. Total removal is often complicated by the capsule’s adherence to eloquent structures and requires a thoughtful surgical approach of weighing radical resection versus neurologic/function preservation. This case description provides an example of using careful clinical–radiological correlation and anatomy-dissecting microsurgery as a method of permanent decompression and neurologic recovery with low operative risk. Case Presentation: A 57-year-old female presented with impaired stability of gait, gaze-evoked nystagmus, appendicular ataxia, minimal ipsilateral hypotonia, and mild bulbar dyscoordination. Imaging (MRI, MRA) revealed a large, lobulated mass that was lobulated and avascular centered in the left cerebellar hemisphere, with an extension into the vermis and cisterna magna, and partial filling of the fourth ventricle with classic epidermoid imaging. Resection was performed via a midline suboccipital telovelar approach with microsurgery, relying on native arachnoid planes and quadrant opportunities of decompression, while preserving critical neurovascular structures. A thin rim of capsule intimately adherent to the floor of the ventricle was intentionally left to minimize irreversible cranial nerve injury. Histology showed keratinizing stratified squamous epithelium with laminated keratin and cholesterol clefts. Following resection, truncal stability, limb coordination, and ocular pursuit improved without additional deficits. Initial and 3-month postoperative MRI showed total decompression, re-established CSF pathways, and no recurrence. Conclusions: This case demonstrates that maximal safe resection (with function preservation) through natural anatomy corridors can achieve excellent neurologic results in fourth ventricular epidermoids. Lifelong MRI surveillance will be needed due to the srisk of delayed recurrence even after near-total resection. Full article

TRIC-A is an intracellular cation channel enriched in excitable tissues that is recently identified as a key modulator of sarcoplasmic reticulum (SR) Ca²⁺ homeostasis through direct interaction with type 2 ryanodine receptors (RyR₂). Given the intimate anatomical and functional coupling between the SR and mitochondria, we investigated whether TRIC-A contributes to SR–mitochondrial crosstalk under cardiac stress conditions. Using a transverse aortic constriction (TAC) model, we found that TRIC-A^−/− mice developed more severe cardiac hypertrophy, underwent maladaptive remodeling, and activated apoptotic pathways compared with wild-type littermates. At the cellular level, TRIC-A-deficient cardiomyocytes were more susceptible to H₂O₂-induced mitochondrial injury and displayed abnormal mitochondrial morphology. Live-cell imaging revealed exaggerated mitochondrial Ca²⁺ uptake during caffeine stimulation and increased propensity for store-overload-induced Ca²⁺ release (SOICR). Complementary studies in HEK293 cells expressing RyR₂ demonstrated that exogenous TRIC-A expression attenuates RyR₂-mediated mitochondrial Ca²⁺ overload, preserves respiratory function, and suppresses superoxide generation. Together, these findings identify TRIC-A as a critical regulator of SR–mitochondrial Ca²⁺ signaling. By constraining mitochondrial Ca²⁺ influx and limiting oxidative stress, TRIC-A safeguards cardiomyocytes against SOICR-driven injury and confers protection against pressure overload-induced cardiac dysfunction. Full article

Digital platforms have become primary channels for cultural heritage transmission, yet how individuals visually represent their personal heritage online remains unexplored. This study investigates the visual patterns in personal heritage representation across digital platforms, examining whether platform affordances or demographics influence these patterns. Through the LAVIS multimodal AI system, we analyzed 588 heritage images from Instagram and “Personas y Patrimonios”, combining automated content, composition, color, and saturation analyses with human validation. Our findings revealed that intimate, portable objects—particularly jewelry (22.79%)—dominate personal heritage representations, with no content differences between platforms or genders. Small but statistically significant platform differences emerged in color patterns (Cohen’s d = −0.215) and compositional attention (Cohen’s d = 0.147), while gender showed no significant differences in any visual dimension. These findings may indicate that personal heritage representation follows universal visual patterns, emphasizing personal bonds that transcend both platform affordances and demographic differences. These results advance understanding of personal digital heritage communication by identifying the universal patterns in its visualization. Beyond establishing a methodological framework for AI-assisted heritage image analysis, this research provides practical insights for heritage educators and digital platform designers while illuminating how biographical objects function in digital environments, ultimately underscoring the pivotal role of imagery in contemporary cultural transmission. Full article

This narrative review has examined the psychological and emotional effects of non-consensual distribution of intimate images, a phenomenon known as Image-Based Sexual Abuse (IBSA). It is an increasingly frequent phenomenon, and in detail, it consists of when a person uploads nude/semi-nude photos of someone online; therefore, it is similar to nonconsensual pornography. According to the scientific literature, this phenomenon has caused victims to experience trust issues, anxiety, depression, suicidal thoughts, social withdrawal, public shame and humiliation, depression, fear, anxiety, stress, inability to find new romantic partners, and several other mental health effects. The aim of this study was to study the psychological consequences of Image-Based Sexual Abuse on victims. This study is a narrative review conducted in accordance with the SANRA guidelines. Findings have shown that revenge pornography and non-consensual intimate images have had devastating impacts on victims’ mental health. Full article

Background and Objectives: In vivo data on healed coronary plaques (HCPs), the hallmark of previous plaque disruption, remains scarce. The study aimed to use optical coherence tomography (OCT) imaging to assess the prevalence, morphological features, and clinical significance of culprit HCPs in patients with acute coronary syndrome (ACS). Materials and Methods: A total of 87 ACS patients (74.3% non-ST-segment elevation ACS) who underwent pre-procedural OCT imaging of the culprit vessel at a single center were retrospectively analyzed. A pilot subgroup of patients with intracoronary thrombi at the culprit site, in various stages of organization and healing, enabled a detailed morphological characterization of HCP despite the absence of histological validation. Three distinct HCP imaging aspects were identified: type I—overlaying fibrous tissue, type II—overlaying lipid tissue, and type III—overlaying calcific tissue. HCP presence was subsequently assessed in the entire population. Clinical correlations included associations with post-stenting outcomes, particularly edge dissections (ED). Results: Culprit HCPs were identified in 78 patients (89.7%): type I—30.8%, type II—51.3%, and type III—17.9%. Regarding the underlying substrate and complication mechanism, type I HCP was associated with pathological intimal thickening (70.8%) and plaque erosion (75%), type II with lipid-rich plaque (80%) and plaque rupture (PR) (82.5%), and type III correlated with calcific plaque (92.9%, p < 0.0001) and both PR and calcified nodule (p < 0.0001). A unique signal-rich ring was observed at the HCP–tissue interface in both type II (77.5%) and type III (78.6%, p < 0.0001). There was a significant correlation between stent ED and HCP presence at landing zones (LZ) (HR 4.14, 95% CI: 1.79–9.55; p < 0.001). Conclusions: OCT analysis of intracoronary organizing fresh thrombi allowed detailed characterization of culprit HCPs and in vivo classification into three imaging types. This approach likely contributed to the high observed detection rate of HCP by enhancing recognition of subtle OCT features. HCP may create mechanical vulnerability if located at the stent LZ. Our improved HCP detection techniques may help optimize stent-related outcomes of OCT-guided procedures by choosing an HCP-free LZ or longer stents. Full article