Search Results (195)

Background and Objectives: Visceral arterial pseudoaneurysms (VAPAs) are rare vascular lesions characterized by the disruption of partial disruption of the arterial wall, most commonly involving the intima and media. They have an estimated incidence of 0.1–0.2%, with the splenic artery most commonly affected. Their management poses unique challenges due to the high risk of rupture. Timely recognition is crucial, as unmanaged pseudoaneurysms have a mortality rate of 90%. This narrative review aims to synthesize current knowledge regarding the epidemiology, etiology, clinical presentation, diagnostic methods, and management strategies for VAPAs. Materials and Methods: A literature search was performed across Pubmed for articles reporting on VAPAs, including case reports, review articles, and cohort studies, with inclusion of manuscripts that were up to (date). VAPAs are grouped by embryological origin—foregut, midgut, and hindgut. Results: Chronic pancreatitis is a primary cause of VAPAs, with the splenic artery being involved in 60–65% of cases. Other causes include acute pancreatitis, as well as iatrogenic trauma from surgeries, trauma, infections, drug use, and vascular diseases. VAPAs often present as abdominal pain upon rupture, with symptoms like nausea, vomiting, and gastrointestinal hemorrhage. Unruptured pseudoaneurysms may manifest as pulsatile masses or bruits but are frequently asymptomatic and discovered incidentally. Diagnosis relies on both non-invasive imaging techniques, such as CT angiography and Doppler ultrasound, and invasive methods like digital subtraction angiography, which remains the gold standard for detailed evaluation and treatment. A range of management options exists that are tailored to individual cases based on the aneurysm’s characteristics and patient-specific factors. This encompasses both surgical and endovascular approaches, with a growing preference for minimally invasive techniques due to lower associated morbidity. Conclusions: VAPAs are a critical condition requiring prompt early recognition and intervention. This review highlights the need for ongoing research to improve diagnostic accuracy and refine treatment protocols, enhancing patient outcomes in this challenging domain of vascular surgery. Full article

A Sanskrit manuscript of the Prajñāpāramitā or Perfection of Wisdom in eight thousand verses, now in the Cambridge University Library, Add.1643, is one of the most ambitiously designed South Asian manuscripts from the eleventh century, with the highest number of painted panels known among the dated manuscripts from medieval South Asia until 1400 CE. Thanks to the unique occurrence of a caption written next to each painted panel, it is possible to identify most images in this manuscript as representing those of famous pilgrimage sites or auspicious images of specific locales. The iconographic program transforms Add.1643 into a portable device containing famous pilgrimage sites of the Buddhist world known to the makers and users of the manuscript in eleventh-century Nepal. It is one compact colorful package of a book, which can be opened and experienced in its unfolding three-dimensional space, like a virtual or imagined pilgrimage. Building on the recent research focusing on early medieval Buddhist sites across Monsoon Asia and analyzing the representational potentials and ontological values of painting, this essay demonstrates how this early eleventh-century Nepalese manuscript (Add.1643) and its visual program document and remember the knowledge of maritime travels and the transregional and intraregional activities of people and ideas moving across Monsoon Asia. Despite being made in the Kathmandu Valley with a considerable physical distance from the actual sea routes, the sites remembered in the manuscript open a possibility to connect the dots of human movement beyond the known networks and routes of “world systems”. Full article

Plant-growth-promoting fungi (PGPF) play a central role in promoting sustainable agriculture by improving plant growth and resilience. The aim of this literature review is to survey the impacts of Trichoderma spp. and Penicillium spp. on various agricultural and horticultural plants. The information provided in this manuscript was obtained from randomized control experiments, review articles, and analytical studies and observations gathered from numerous literature sources such as Scopus, Google Scholar, PubMed, and Science Direct. The keywords used were the common and Latin names of various agricultural and horticultural species, fungal endophytes, plant-growth-promoting fungi, Trichoderma, Penicillium, microbial biostimulants, and biotic and abiotic stresses. Endophytic fungi refer to fungi that live in plant tissues throughout part of or the entire life cycle by starting a mutually beneficial symbiotic relationship with its host without any negative effects. They are also capable of producing compounds and a variety of bioactive components such as terpenoids, steroids, flavonoids, alkaloids, and phenolic components. Penicillium is extensively known for its production of secondary metabolites, its impact as a bioinoculant to help with crop productivity, and its effectiveness in sustainable crop production. The plant-growth-promotion effects of Trichoderma spp. are related to better absorption of mineral nutrients, enhanced morphological growth, better reproductive potential and yield, and better induction of disease resistance. Both Penicillium spp. and Trichoderma spp. are effective, affordable, safe, and eco-friendly biocontrol agents for various plant species, and they can be considered economically important microorganisms for both agricultural and horticultural sciences. The present review article aims to present the most up-to-date results and findings regarding the practical applications of two important types of PGPF, namely Penicillium spp., and Trichoderma spp., in agricultural and horticultural species, considering the mechanisms of actions of these species of fungi. Full article

Intersectional oppression and invisibility are primary drivers of cognitive and mental health disparities that affect Black women’s wellness. Older Black women additionally experience compounding effects of ageism, which may place them at increased risk for a decline in cognitive functioning and mental wellness. To date, limited strengths-based, culturally relevant programming has focused on aging Black women. Fewer have incorporated Black women elders into conversations on Black liberation and the transformational change needed to create possible futures rooted in equity, healing, and health. This manuscript describes the inception and development of Radical Imagination, a creative aging program for Black women in the San Francisco Bay Area. Over ten weeks, 42 Black women (M age = 73.6, SD = 6.20; range: 58–85 years old) participated in the program, which incorporated brain and mental health education, art-making, storytelling, and photography. Grounded in principles of Afrofuturism and radical healing, participants explored past narratives of Black women and created a collective vision for a future that centers on Black women’s needs. Approximately 54.8% of participants attended more than one workshop. Upon program completion, exit surveys indicated that participants reported a moderate level of hopefulness about their ability to shape the future. Respondents reported overall satisfaction with the workshop series. We conclude with reflections on our process and recommendations for ways to support aging Black women using Afrofuturism and the arts. Full article

Background: Pelvic organ prolapse (POP) and stress incontinence (SUI) are very common medical conditions, affecting women’s quality of life worldwide. Current surgical and conservative therapies often yield variable outcomes and carry risks of complications or recurrence. Platelet-rich plasma (PRP) has emerged as a promising regenerative approach in various medical disciplines. Its application in urogynecology remains relatively new and emerging. The objective of this study was to review and consolidate existing evidence regarding the application of PRP injections for treating POP and/or SUI. Methods: This scoping review was conducted in accordance with the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR). The search strategy included MEDLINE (PubMed), Web of Science, and Scopus databases, covering articles published up to February 2025, with no restrictions on publication date. Results: We included in our review a total of 13 manuscripts and 320 patients at the end of the screening process. A total of ten SUI studies, comprising 273 patients, and three POP studies, involving 47 patients, satisfied all the review criteria. Both clinical entities reported high subjective improvement following PRP treatment. Moreover, PRP appeared to have no significant adverse effects. Conclusions: Our scoping review suggests that PRP may have potential benefits in the treatment of POP and SUI. Nevertheless, the current evidence on its application in this area remains limited. Therefore, well-designed, large-scale randomized controlled trials (RCTs) with extended follow-up periods are urgently needed, in the era of personalized medicine. Full article

The manuscript introduces an innovative framework for expiration date recognition aimed at improving accessibility for visually impaired individuals. The study underscores the pivotal role of convolutional neural networks (CNNs) in addressing complex challenges, such as variations in typography and image degradation. The system attained an F1-score of 0.9303 for the detection task and an accuracy of 97.06% for the recognition model, with a total inference time of 63 milliseconds on a single GeForce GTX 1080 GPU. A comparative analysis of quantized models—FP32, FP16, and INT8—emphasizes the trade-offs in inference speed, energy efficiency, and accuracy on mobile devices. The experimental results indicate that the FP16 model operating in CPU mode achieves an optimal equilibrium between precision and energy consumption, underscoring its suitability for resource-constrained environments. Full article

Buddhist books have always played a central role in the lives of Tibetan people. This is evident by looking at the hundreds of thousands of manuscripts and xylographs produced by Tibetans, and then copied, multiplied, worshipped, spread, and transmitted uninterruptedly from religious masters to disciples over the centuries. Tibetan manuscripts and xylographs have started to be studied in their entirety only recently, and the interest for their visual aspect, material features, and social life has exponentially grown, becoming crucial to progress in different fields of study, to deeply understand the way in which Tibetan Buddhist people interact with such artefacts but also to preserve a disappearing cultural heritage. This essay will focus on a so far neglected element of Tibetan Buddhist manuscripts, namely, decorations of writing frames. Any element found in a Tibetan scripture is essential from care and conservation viewpoints since it contributes to preservation for as long as possible. This is fundamental to spread Buddha’s word and to accumulate spiritual merits to progress on the path towards Enlightenment. The numerous elements exhibited in manuscripts may help locating their provenance and/or narrowing down their dating. This will also lead to a better understanding of the spread of certain scriptures within the various Tibetan areas. This essay attempts to provide a preliminary analysis of decorated writing frames found in Buddhist manuscripts produced in different periods with the twofold aim of tracing their use and codicological aspects and investigating the type of texts that were mostly chosen to be decorated as such. Full article

Increasing long-term observations suggest that coronavirus disease 2019 (COVID-19) vasculopathy may persist even 1.5 years after the acute phase, potentially accelerating the development of atherosclerotic cardiovascular diseases. This study systematically reviewed the variability of brachial flow-mediated dilation (FMD) and carotid-femoral pulse wave velocity (cfPWV) from the acute phase of COVID-19 through 16 months of follow-up (F/U). Databases including PubMed, Web of Science, MEDLINE, and Embase were screened for a meta-analysis without language or date restrictions (PROSPERO reference CRD42025642888, last search conducted on 1 February 2025). The quality of the included studies was assessed using the Newcastle–Ottawa Quality Scale. We considered all studies (interventional pre-post studies, prospective observational studies, prospective randomized, and non-randomized trials) that assessed FMD or cfPWV in adults (aged ≥ 18 years) with or after laboratory-confirmed COVID-19 compared with non-COVID-19 controls or that assessed changes in these parameters during the F/U. Twenty-one studies reported differences in FMD, and 18 studies examined cfPWV between COVID-19 patients and control groups during various stages: acute/subacute COVID-19 (≤30 days from disease onset), early (>30–90 days), mid-term (>90–180 days), late (>180–270 days), and very late (>270 days) post-COVID-19 recovery. Six studies assessed variability in FMD, while nine did so for cfPWV during the F/U. Data from 14 FMD studies (627 cases and 694 controls) and 15 cfPWV studies (578 cases and 703 controls) were included in our meta-analysis. FMD showed a significant decrease compared to controls during the acute/subacute phase (standardized mean difference [SMD]= −2.02, p < 0.001), with partial improvements noted from the acute/subacute phase to early recovery (SMD = 0.95, p < 0.001) and from early to mid-term recovery (SMD = 0.92, p = 0.006). Normalization compared to controls was observed in late recovery (SMD = 0.12, p = 0.69). In contrast, cfPWV values, which were higher than controls in the acute/subacute phase (SMD = 1.27, p < 0.001), remained elevated throughout the F/U, with no significant changes except for a decrease from mid-term to very late recovery (SMD= −0.39, p < 0.001). In the very late recovery, cfPWV values remained higher than those of controls (SMD = 0.45, p = 0.010). In the manuscript, we discuss how various factors, including the severity of acute COVID-19, the persistence of long-term COVID-19 syndrome, and the patient’s initial vascular age, depending on metrics age and cardiovascular risk factors, influenced the time and degree of FMD and cfPWV improvement. Full article

With the ongoing urbanization and densification of cities worldwide, the planning and utilization of urban underground space (UUS) have become crucial for developing urban underground infrastructure. Given the limited construction space within dense urban areas and the influence of declining groundwater levels, technologies such as open caissons and various vertical shaft methods have been introduced for UUS development. However, the dissemination of these technologies remains fragmented across different domains, lacking systematic summarization. A comprehensive, up-to-date overview of open caisson and vertical shaft technologies is essential for their effective application. In the manuscript, a systematic analysis of vertical shaft technologies, specifically focusing on their use in soft ground conditions, is conducted. The analysis is based on an extensive literature review and case study evaluation. It addresses the unique challenges posed by high compressibility, low bearing capacity, and groundwater sensitivity. Conventional shaft technologies and mechanized systems, including open caissons, drilled shafts, and the novel pressed-in ultra-deep assembled shafts (PIAUS), are evaluated systematically. Key aspects such as design principles, construction techniques, and stability in soft soils are discussed. The limitations of conventional methods in soft UUS are highlighted, while the advantages of advanced mechanized systems—such as rapid construction, reduced environmental impact, and improved safety—are emphasized. A detailed comparison of case studies demonstrates that PIAUS construction technology is particularly efficient in urban areas with confined spaces, dense building conditions, and ground conditions up to 200 MPa, with shaft diameters up to 12.8 m and depths of 115.2 m. Additionally, its suitability for rapid construction in soft and medium ground conditions is supported by undrained excavation with parallel excavation and liner sinking techniques. The PIAUS technology shows considerable potential for future projects, including shield construction shafts, ventilation shafts for tunnels, underground parking garages, and stormwater storage wells. This manuscript also highlights emerging mechanized methods in underground space development, their advantages, limitations, and areas for future research and improvement. Full article

Generative AI (GenAI) models are designed to produce realistic and natural data, such as images, audio, or written text. Due to their high computational and memory demands, these models traditionally run on powerful remote compute servers. However, there is growing interest in deploying GenAI models at the edge, on resource-constrained embedded devices. Since 2018, the TinyML community has proved that running fixed topology AI models on edge devices offers several benefits, including independence from internet connectivity, low-latency processing, and enhanced privacy. Nevertheless, deploying resource-consuming GenAI models on embedded devices is challenging since the latter have limited computational, memory, and energy resources. This review paper aims to evaluate the progresses made to date in the field of Edge GenAI, an emerging area of research within the broader domain of EdgeAI which focuses on bringing GenAI on edge devices. Papers released between 2022 and 2024 that address the design and deployment of GenAI models on embedded devices are identified and described. Additionally, their approaches and results are compared. This manuscript contributes to understand the ongoing transition from TinyML to Edge GenAI and provides valuable insights to the AI research community on this emerging, impactful, and quite under-explored field. Full article

Background/Objectives: Hailey–Hailey disease (HHD) is an uncommon genodermatosis with autosomal dominant inheritance caused by loss-of-function mutations in the ATP2C1 gene, which lead to disruption in keratinocyte adhesion and intraepidermal acantholysis. The chronic nature of the disease, its frequent recurrences and the lack of specific treatment pose real challenges in the long-term management of these patients. Recent studies have evaluated the effect of dupilumab, a human monoclonal antibody that blocks interleukin-4 and -13 receptor in refractory HHD, with very promising results. The aim of this study was to review the published data on the use of dupilumab for the treatment of HHD, to present our own experience in the field, and to discuss the mechanisms underlying dupilumab’s beneficial effects in HHD and the future treatment perspectives. Methods: A search of the medical literature on the use of dupilumab in the treatment of HHD was conducted. The terms “Hailey–Hailey disease”, “benign familial pemphigus”, “benign chronic pemphigus”, and “dupilumab” were searched across multiple databases (Medline, Chrocane Library, EMBASE) from inception until 30 September 2024. Results: To date, six manuscripts describing 11 refractory HHD cases treated with dupilumab have been published. All the patients experienced significant clinical improvement. The authors reported sustained disease quiescence in seven patients (64%), monitored for 5 to 24 months. None of the patients experienced adverse effects related to dupilumab. To the existing evidence, we add a new case of recalcitrant HHD successfully treated with dupilumab. Conclusions: Mounting evidence indicates dupilumab as a safe and efficient therapeutic alternative in patients with severe, refractory HHD. However, the long-term efficacy of dupilumab and the optimal therapeutic regimen for HHD are yet to be determined. Full article

Background/Objectives: Ischemic arterial stroke (AIS) is a cerebrovascular event that can occur acutely within the first hours or days of life, presenting as a neurological emergency. To date, clearly defined genetic risk factors for AIS have not been established, although certain genes involved in cerebrovascular regulation mechanisms are suspected to play a role. The Interferon Regulatory Factor 6 (IRF6) gene is a transcription factor involved in craniofacial and epidermal development. Recently, pathogenic variants of IRF6 have been implicated in the cytoprotective pathway of ischemic cerebrovascular disease. The aim of this manuscript is to further support the already-reported association between IRF6 and AIS. Materials and Methods: Genetic counseling and exome sequencing analysis were conducted for diagnostic purposes. Results: We report the case of a female newborn with palatoschisis, cleft palate, sensorineural deafness, facial dysmorphisms, and cutaneous defects who suffered an ischemic stroke in the territory of the left middle cerebral artery on day 1 of life. Family and pregnancy histories revealed no identifiable risk factors, and coagulation studies were normal. Exome sequencing identified a de novo c.1124T>C (p.Phe375Ser) variant in the IRF6 gene. The child developed right spastic hemiplegia and began motor rehabilitation therapy. Recently, a genome-wide association study (GWAS) using m6A-SNPs identified a statistical association between AIS and a single nucleotide polymorphism (SNP) that influences the expression of the IRF6 gene as an expression quantitative trait locus (eQTL). Conclusions: To our knowledge, this is the first report of neonatal ischemic stroke in a child carrying a de novo IRF6 pathogenic variant, further supporting its potential role as a genetic factor influencing cerebrovascular events. Further studies are needed to elucidate the precise relationship between IRF6 and AIS. Full article

This manuscript provides actionable recommendations to enhance user satisfaction and address existing barriers regarding pooled rideshare (PR) in the United States. Despite PR’s intended benefits, such as reduced traffic congestion and cost savings, its adoption remains limited. To identify these actionable items, a U.S. nationwide survey with 5385 participants explored transportation preferences, barriers, and motivators for PR use in the summer of 2021. First, two factor analyses were conducted. The first factor analysis identified the five factors associated with one’s willingness to consider PR (time/cost, traffic/environment, safety, privacy, and service experience). The second factor analysis revealed the four factors related to ways to optimize one’s PR experience (comfort/ease of use, convenience, vehicle technology/accessibility, and passenger safety). Privacy concerns, for instance, were found to reduce the likelihood of PR adoption by 77%, and convenience had the potential to increase it by 156%. A structural equation model evaluated the relationships among these nine key factors influencing PR usage to develop the Pooled Rideshare Acceptance Model (PRAM). The privacy, safety, trust service, and convenience factors each had a significant large effect (Cohen’s f² > 0.35) on the model. PRAM was extended using multigroup analyses to reveal the nuanced impact of 16 demographics, including gender, generation, rideshare experience, etc., highlighting the need for tailored strategies to improve PR acceptance through the Pooled Rideshare Acceptance Model Multigroup Analyses (PRAMMAs). Multiple workshops were held with diverse audiences to translate the team’s findings to date into 84 actionable recommendations, categorized across topical areas like safety, routing, driver and passenger selection, user education, etc. These findings are a foundation for a future study to determine which items resonate with different user groups. In the meantime, the actional items serve as a user-driven resource for policymakers, transportation network companies, and researchers, offering a roadmap to potential improvements to PR services to address existing concerns with the goal of increasing the usage of PR. Full article

Early detection of breast cancer plays a crucial role in reducing the number of cases diagnosed at advanced stages, thereby lowering the high healthcare costs required to achieve disease-free survival and helping to prevent avoidable premature deaths. However, women living in rural and low-income areas face multiple obstacles that limit their access to conventional screening methods, such as mammography, which has been widely proven effective, particularly in high-income countries. The main barriers include a lack of healthcare infrastructure, long distances to medical facilities, high costs associated with large-scale screening programs, and shortages of specialized personnel. In this context, emerging technologies offer innovative solutions with the potential to mitigate these challenges. The development of strategies supported by artificial intelligence and the use of portable devices capable of overcoming geographical and sociocultural barriers represent valuable complementary tools for strengthening community-driven screening programs and expanding the reach of large-scale initiatives. However, to date, no comprehensive analysis has been conducted on the availability of evidence assessing the outcomes of breast cancer screening programs in vulnerable and underserved communities. This manuscript outlines the benefits of emerging portable technologies powered by artificial intelligence for detecting significant breast lesions in low-resource rural areas, where traditional screening methods are often difficult to implement. It also highlights gaps in the current knowledge, drawing on the available evidence. A search using PubMed yielded 7629 articles on breast cancer screening, of which only 59 (0.77%) addressed resource-limited settings and rural populations. Further filtering identified 29 original studies (0.38%) with specific epidemiological designs involving humans as the unit of analysis. The findings revealed significant disparities in evidence availability: nine studies originated from high-income countries, while fewer than half were from low-income or lower middle-income countries. Only two studies were conducted in Latin America, specifically in Peru and Argentina. This limited evidence poses challenges for generalizing and replicating recommendations for unexplored settings. Full article

Among gynecological pathologies, cervical cancer has always represented a health problem with great social impact. The giant strides made as a result of both the screening programs perfected and implemented over the years and the use of new and accurate technological equipment have in fact significantly improved our clinical approach in the management and personalized diagnosis of precancerous lesions of the cervix. In this context, the advent of artificial intelligence and digital algorithms could represent new directions available to gynecologists and pathologists for the following: (i) the standardization of screening procedures, (ii) the identification of increasingly early lesions, and (iii) heightening the diagnostic accuracy of targeted biopsies and prognostic analysis of cervical cancer. The purpose of our review was to evaluate to what extent artificial intelligence can be integrated into current protocols, to identify the strengths and/or weaknesses of this method, and, above all, determine what we should expect in the future to develop increasingly safer solutions, as well as increasingly targeted and personalized screening programs for these patients. Furthermore, in an innovative way, and through a multidisciplinary vision (gynecologists, pathologists, and computer scientists), with this manuscript, we highlight a key role that AI could have in the management of HPV-positive patients. In our vision, AI will move from being a simple diagnostic device to being used as a tool for performing risk analyses of HPV-related disease progression. This is thanks to the ability of new software not only to analyze clinical and histopathological images but also to evaluate and integrate clinical elements such as vaccines, the composition of the microbiota, and the immune status of patients. In fact, the single-factor evaluation of high-risk HPV strains represents a limitation that must be overcome. Therefore, AI, through multifactorial analysis, will be able to generate a risk score that will better stratify patients and will support clinicians in choosing highly personalized treatments overall. Our study remains an innovative proposal and idea, as the literature to date presents a limitation in that this topic is considered niche, but we believe that the union of common efforts can overcome this limitation. Full article