Search Results (943)

We address the paradoxical transformation of a classical-mechanical particle motion when the space and time scales of observation pass below the uncertainty principle threshold. This is analyzed in the language of classical statistical mechanics, considering specifically many-particle systems inhomogeneous along one spatial direction. We employ the density functional formalism in its square-gradient form and find: (i) The macroscopic solution is analogous to the classical trajectory of a particle under a potential of force given by (minus) the free energy density. Whereas, (ii) fluctuations around the solution in (i) are equal to the quantum-mechanical wave functions of a particle under a potential given by the curvature of the free energy density. We illustrate this situation with three textbook examples: A particle in a box, the harmonic oscillator, and the hydrogen atom. We show that their time-independent Schrödinger equation wave functions describe, respectively, the fluctuations of a fluid interface, of critical point fluctuations, and of a confined ideal gas. At large scales, sharp probability distributions make fluctuations irrelevant; the vanishing of the first variation yields the macroscopically observable statistical-mechanical non-uniformity, equivalent to the classical particle trajectory. But at sufficiently small scales, with necessarily very few particles, distributions appear much wider, fluctuations dominate, and one obtains the Schrödinger equation (for the microscopic potential). Full article

Fiber contamination originating from disposable dental microapplicators has received limited attention despite its potential influence on adhesive procedures. The aim of this pilot in vitro study was to evaluate fiber-like structure release associated with different microapplicator types during the application of universal adhesive systems. Three universal adhesives (Clearfil Universal Bond Quick, Gluma Universal, and G-Premio BOND) and five microapplicator types (X-Slim, Clinique, Prima, Single TIM, and ZerofloX silicone-bristle microapplicators) were evaluated. A total of 75 adhesive applications were performed on standardized sandblasted glass substrates under controlled laboratory conditions. Adhesives were actively applied for 10 s, and fiber-like structures were quantified microscopically using ImageJ software. Statistical analysis included descriptive statistics, two-way ANOVA, and Tukey post hoc testing (α = 0.05). Significant differences were observed among microapplicator types. X-Slim applicators produced the highest fiber counts, whereas Single TIM applicators demonstrated substantially lower values. No detectable fiber-like structures were observed in specimens treated with the ZerofloX silicone-bristle microapplicator. Adhesive system type showed a comparatively smaller influence on fiber counts than microapplicator design. Within the limitations of this pilot in vitro study, microapplicator type appeared to be the primary factor influencing visible fiber contamination during adhesive application. Further studies are required to determine whether the contamination patterns observed influence adhesive performance under clinically relevant conditions. Full article

Objective: This study aimed to compare the clinical and radiological outcomes between microscopic and unilateral biportal endoscopic (UBE) posterior cervical foraminotomy (PCF). Methods: This study included 73 patients who underwent microscopic PCF (n = 40) or UBE PCF (n = 33) for single-level cervical foraminal disc herniation or stenosis between January 2018 and December 2021. Clinical outcomes were measured using the Visual Analog Scale (VAS) and Neck Disability Index (NDI). Radiologic outcomes were evaluated with cervical range of motion (ROM) using computed tomography and flexion-extension dynamic radiography. Results: The mean follow-up period for microscopic and UBE PCF was 33.0 ± 7.6 months and 29.9 ± 5.9 months, respectively. The postoperative neck VAS until postoperative 2 weeks was significantly lower in the UBE PCF group than in the microscopic PCF group (p < 0.05). The estimated blood loss and operative time were significantly lower in the UBE PCF group than in the microscopic PCF group, while the length of hospital stay was numerically shorter but did not reach statistical significance. The two groups had no significant difference in the NDI on the preoperative and postoperative 3 months. The recurrence occurred in 1 patient (2.5%) of the microscopic PCF group and 1 patient (3%) of the UBE PCF group. The revision surgery was performed in 2 patients (5%) of the microscopic PCF group and in 1 patient of the UBE PCF group. There were no significant differences in motion and instability between the two groups. Conclusions: Both microscopic and UBE PCF are effective and safe procedures for treating cervical radiculopathy due to cervical foraminal disc herniation or stenosis. The UBE approach may provide advantages mainly in early postoperative recovery, including lower early postoperative neck pain, while long-term clinical and radiologic outcomes appear comparable to those of microscopic PCF. Full article

Background and Clinical Significance: Spontaneous renal forniceal rupture is an uncommon complication of obstructive uropathy and is classically associated with ureteric calculi rather than distal urinary retention. Bilateral retention-related rupture appears to be exceptionally rare and may be diagnostically challenging when renal function begins to improve after bladder decompression; Case Presentation: An 82-year-old man with a history of prostate cancer treated five years earlier with external beam radiotherapy and androgen deprivation therapy presented with acute abdominal pain radiating to both flanks and inability to void. Bedside ultrasonography showed urinary retention and bilateral hydronephrosis, and a 16-Fr Foley catheter drained 900 mL of urine. Admission evaluation showed severe acute kidney injury, microscopic hematuria, minimal leukocyturia, and elevated inflammatory markers. Post-obstructive diuresis developed after bladder decompression. CT urography with excretory-phase imaging on hospital day 3 demonstrated severe bilateral hydroureteronephrosis with bilateral renal forniceal rupture and associated urinomas, including a larger left-sided collection extending toward the psoas compartment. Bilateral percutaneous nephrostomies were placed on hospital day 4 for upper-tract diversion. Immediate nephrostography showed no active contrast extravasation. At one-month follow-up, combined CT and nephrostographic assessment confirmed complete resolution of the bilateral urinomas without persistent leak, and the nephrostomy tubes were removed; Conclusions: This case suggests that urinary retention in an older man with prior prostate radiotherapy may reflect radiation-associated outlet pathology and/or impaired detrusor function rather than simple prostate enlargement. Delayed-phase CT urography was essential for diagnosis, and active bilateral diversion was justified by bilateral rupture, acute kidney injury, and the extent of urinary extravasation. The report expands the limited PubMed-indexed literature on retention-related upper urinary tract rupture and supports cautious follow-up aimed at defining the underlying mechanism of retention. Full article

Ensuring the cleanliness of precision components is critical in Hard Disk Drive (HDD) manufacturing, where microscopic dust contamination on the Voice Coil Motor Assembly (VCMA) can lead to positioning errors, unstable head movement, and long-term reliability failures. However, automated inspection of such contamination remains challenging because dust particles are extremely small, visually irregular, and often appear under complex microscopic backgrounds. This study presents an explainable hybrid deep learning framework for microscopic dust inspection by integrating object detection for precise localization and image classification for defect confirmation. Three YOLO architectures, namely YOLOv5, YOLOv8, and YOLOv11, were comparatively evaluated for dust detection, while three convolutional neural network (CNN) models, ResNet50, EfficientNetB0, and MobileNetV2, were implemented using transfer learning with frozen feature extraction layers for Good (G) and Not Good (NG) image-level classification. The experimental dataset consisted of annotated microscopic VCMA images, with data augmentation applied to the training subset to mitigate limited sample size and class imbalance. Experimental results showed that YOLOv8 achieved the strongest overall aggregate detection performance, whereas YOLOv5 was selected as the preferred detector for subsequent hybrid integration because it produced fewer false positives under reflective and textured microscopic backgrounds. YOLOv11 exhibited lower detection performance in the present setting, likely due to its architectural characteristics being less suited to the limited-data and high-background-complexity conditions of this study. In the present experimental setting, YOLOv5 achieved mAP@0.5 = 0.62, precision = 0.75, and recall = 0.69. For image-level classification, EfficientNetB0 achieved the highest classification accuracy of 93.10%, with F1-score = 0.932 and AUC = 0.986. In addition, Grad-CAM visualizations demonstrated that EfficientNetB0 consistently focused on physically meaningful dust-contaminated regions, thereby enhancing the interpretability of the classification results. Overall, the proposed hybrid framework integrating YOLOv5-based localization with EfficientNetB0-based defect confirmation showed promising potential for improving inspection reliability, false-alarm control, and explainability in automated VCMA quality inspection. These findings support the feasibility of explainable deep learning for microscopic defect inspection in HDD manufacturing and suggest its potential applicability to other precision manufacturing environments. Full article

Background: Fatal sand burial is a rare and diagnostically challenging entity in forensic practice. In such cases, death may result from thoracic or thoracoabdominal compression, airway obstruction by particulate material, massive inhalation of sand or soil, or a combination of these mechanisms. External signs may be subtle or absent, making postmortem interpretation highly dependent on a comprehensive, multilevel assessment. Case Presentation and Methods: We report the case of a 17-year-old male who died following accidental sand burial caused by the collapse of a self-excavated beach tunnel. External examination, autopsy, histological and toxicological analyses were performed. A review of the literature was also conducted to identify published forensic cases of fatal sand or soil burial and to compare circumstantial, macroscopic, microscopic, and ancillary findings. Results: Autopsy revealed marked pulmonary edema and congestion, multivisceral congestion, scattered sand granules within the larynx, and epicardial petechiae. Histological examination demonstrated acute pulmonary emphysema, edema, vascular congestion, and hemorrhagic laterocervical lymph nodes. Overall, the findings were considered most consistent with mechanical asphyxia due to thoracic compression. The literature review identified six eligible studies describing eight fatal cases. Despite the limited sample size and marked heterogeneity, two main diagnostic patterns emerged: compression-related deaths, usually associated with tunnel or beach-hole collapse and minimal or absent particulate material within the airways, and aspiration-/obstruction-related deaths, characterized by abundant or compact sand or soil material within the airways. In cases without massive aspiration, mixed mechanisms may coexist. Pulmonary edema and congestion were the most frequently reported autopsy findings. When available, histological examination appeared useful in distinguishing antemortem from postmortem burial. Conclusions: Fatal sand burial should not be regarded as a uniform forensic entity. External examination alone is often insufficient, and accurate diagnosis requires a comprehensive, multidisciplinary approach integrating scene reconstruction, autopsy data, histopathological findings, and ancillary analyses. Hemorrhagic involvement of the laterocervical lymph nodes may represent a potentially relevant but currently underexplored finding, whose diagnostic significance warrants further investigation in analogous cases. Full article

Background Granulomatous lung diseases include a spectrum of disorders, both infectious and noninfectious, unified by the presence of granulomas in the lung parenchyma. Granulomas are microscopic, organized collections of immune cells that arise as a response to persistent antigenic stimulation. Infectious granulomatous lung diseases arise from a variety of microbial agents, that include most frequently Mycobacterium tuberculosis, non-tuberculous mycobacteria, Nocardia, and Borrelia, as well as a wide range of fungal pathogens including Histoplasma, Cryptococcus, Pneumocystis, and Aspergillus species. Methods and Results: Definitive diagnosis is achieved through direct identification and subsequent culture of the causative pathogen in appropriate clinical specimens, including sputum, bronchoscopic samples, gastric aspirates, or pleural fluid. Imaging is fundamental for the detection and characterization of pulmonary granulomas. HRCT allows precise assessment of the number, size, and distribution of granulomatous lesions, can suggest an infectious etiology based on specific imaging patterns, and is essential for monitoring response to therapy over time. Differential diagnosis is challenging due to the numerous different imaging appearances with whom granulomatous lung diseases may manifest. Conclusions: The purpose of our review is to describe the spectrum of infectious granulomatous lung diseases caused by bacterial pathogens, highlighting their diverse radiologic presentations in order to assist radiologists in recognizing these entities and improving diagnostic accuracy. Full article

The corrosion behavior and time-dependent mechanism of 22MnB5 steel featuring a thinned Al-Si coating (60 g/m²) were systematically investigated in a chloride ion wet–dry cyclic environment, motivated by the demand for thinning and toughening development of aluminum-silicon coatings. A periodic immersion accelerated corrosion test using 3.5% NaCl solution was conducted, together with macro/microscopic morphology observation (SEM/EDS), phase analysis (XRD, FTIR), and electrochemical measurements (polarization curves, EIS). The Al-Si coated steel was studied over corrosion periods of 1, 8, 10, and 20 days to elucidate its corrosion behavior, interfacial evolution, and failure mechanism. The results indicated that the corrosion process exhibited a three-stage evolution: stable protection, rapid failure, and dynamic equilibrium. At the initial stage (1 day), a dense Al₂O₃ passive film formed on the coating surface, providing excellent substrate protection, with a corrosion current density of only 1.77 µA/cm² and a maximum charge-transfer resistance (R₂) of 652 Ω·cm². In the middle stage (8 days), Cl⁻ permeated through the cracked film, triggering selective dissolution of Al, while Si was enriched in situ to form a porous residual layer; the corrosion current density (I_corr) sharply increased to 13.25 µA/cm², and R₂ dropped to its minimum of 156.6 Ω·cm². Corrosion products at this stage were mainly Al₂O₃ and SiO₂, accompanied by small amounts of iron oxyhydroxides and hydroxides, and local coating failure began to appear. During the later stage (10–20 days), the corrosion products evolved into γ-FeOOH, α-FeOOH, and Fe₂O₃, which, together with an amorphous SiO₂ gel network enriched at the interface, formed a dual-layer composite rust layer. R2 consequently recovered from 156.6 Ω·cm² at 8 days to 424 Ω·cm² at 20 days, indicating a reduced corrosion rate and entry into a stable inhibition stage. The critical failure mechanism is that Cl⁻ preferentially penetrates the surface of the Al₂O₃ passive film, disrupting the metastable state of the coating and thereby creating pathways for corrosive media intrusion. The findings of this study can provide technical support for the safe application of such as-received coatings in non-load-bearing components with heat and corrosion resistance requirements. Full article

Excessive glucocorticoids induced by stress trigger hepatic lipid metabolism disorder and oxidative stress in poultry, impairing growth performance and welfare. At the same time, resveratrol (RSV) has antioxidant and lipid-regulating properties, but the protective mechanisms in corticosterone (CORT)-challenged broilers remain unclear. This study investigated RSV’s effects on CORT-induced hepatic damage in AA broilers, with 240 one-day-old broilers randomized into three groups: control (basal diet), CORT (basal diet + 4 mg/kg BW CORT intraperitoneal injection), and RSV (400 mg/kg RSV-supplemented diet + CORT injection). Growth performance, hepatic redox status, serum biochemistry, liver histopathology, and gene/protein expression related to antioxidant/lipid metabolism were determined. The growth performance of AA broilers injected with CORT was significantly affected, showing reduced body weight gain (p < 0.05), increased abdominal fat content (p < 0.05), and hepatomegaly (p < 0.05). The addition of RSV in the diet significantly reduced abdominal fat accumulation and hepatomegaly (p < 0.05), improving the growth performance of broilers; Effects of RSV on liver function and lipid metabolism of CORT-treated AA broilers: After CORT injection, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) activity and total bile acid (TBA) content significantly increased (p < 0.05). Hepatic total cholesterol (TC) and triglycerides (TG) increased after CORT injection (p < 0.05), causing severe liver damage. RSV supplementation could reverse the increases in serum ALP, ALT, and AST activity (p < 0.05) and reduce TBA content in stressed broilers (p < 0.05). TC and TG levels in the liver decreased under the alleviation of RSV (p < 0.05), and serum TG levels declined (p < 0.05). Microscopic and ultrastructural observations showed that after CORT injection, hepatic tissue cells were swollen, scattered fat vacuoles were present, pores were enlarged, and intracellular lipid droplets appeared. The RSV group significantly alleviated hepatocyte damage, reduced vacuolation, showed uniform chromatin, and decreased lipid droplets. RSV significantly mitigated the CORT-induced increase in SREBP-1 mRNA and protein expression and the decrease in PPARα protein expression; CORT caused a decline in the antioxidant function of AA broiler livers, with significant decreases in SOD and GSH-PX (p < 0.05), and the expression of Nrf2 and its downstream genes also showed a decreasing trend. Compared to the CORT group, the RSV group exhibited significant increases in liver CAT, SOD, and GSH-PX (p < 0.05), and Nrf2 protein expression was elevated (p < 0.05). In summary, resveratrol can alleviate the decline in growth performance, liver steatosis, and hepatic oxidative stress in AA broilers induced by CORT, downregulate lipogenic genes such as SREBP-1c, regulate liver lipid metabolism, and mitigate CORT-induced hepatic oxidative stress in broilers by upregulating the Nrf2 pathway. Full article

Diabetic cardiomyopathy (DC) is a serious health issue. MicroRNA-155b expression dysregulation might be involved in the fibrotic cycle in DC. L-Arginine (l-arg) is reported to have a preferable impact on the cardiovascular system. We aimed to understand the pathogenesis of DC and to detect the potential protective effect of l-arg through modulation of apoptosis, inflammation, fibrosis, and miR-155b expression. This study comprised four groups of forty adult male rats (10 rats in each group): diabetics, l-arg diabetics, l-arg, and controls. Blood glucose, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), body weight, and cardiac hypertrophy index (HW/BW ratio) were assessed. Echocardiographic assessment of left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) was done. Expressions of toll-like receptor-4 (TLR4), pro-inflammatory interleukin 1 beta (IL-1β), interleukin 6 (IL-6), anti-inflammatory interleukins (IL-4, IL-13), apoptotic markers (bcl-2, bax) and microRNA-155b were measured by real-time PCR. Myocardial light, electron microscopic and morphometric studies were performed. Results showed a significant decrease in cardiac hypertrophy (HW/BW = 0.0030 ± 0.0002 mg/g), echocardiographic parameters (LVEF = 54.12 ± 1.628% and LVFS = 20.40 ± 0.541%), hemodynamic parameters (HR = 411.0 ± 9.684 bpm, SBP/DBP = 84 ± 4.998/60 ± 3.062 mmHg) and downregulation of the expression of IL-4, IL-13, IL- 1β, IL-6 and TLR4 in the l-arg diabetic group compared to diabetic rats. Additionally, restoration of normal appearance of most cardiac myofibrils, intact blood vessels, decreased cardiac fibrosis and upregulation of bax expression were observed. Expression of microRNA-155b increased by 0.007 for each gram increase in blood glucose (>1.45, it showed 100% specificity and 96.7% sensitivity). In conclusion, microRNA-155b upregulation is associated with enhancement of the transcription of inflammatory cytokines and apoptotic genes. L-arginine may be a useful protective strategy for DC through modulation of apoptosis, inflammation, and fibrosis, in addition to regulating the expression of miR-155b. Full article

The electronic properties of high-temperature superconducting cuprates are encoded in NMR data. Without microscopic theory, reliable NMR phenomenologies are in demand. Here we make use of the extensive literature data to develop a different understanding of the cuprates from the shifts of the ${\mathrm{CuO}}_2$ plane. The Cu shift analysis is based only on the symmetry of the two Cu hyperfine couplings, without assumptions about their size. We use an anisotropic $A_{\alpha }$ and isotropic B, as from atomic Cu orbitals, and find two spin components (A- and B-spins) that explain all the shift data. The components differ in size and temperature dependence according to simple rules. Upon doping the cuprates, metallic B-spin appears above a pseudogap temperature, which is shared with the A-spin. Further doping decreases the pseudogap temperature and increases the B-spin, but less so the A-spin. The apparent linear rate of increase in the density of states of the B-spin with doping is nearly threefold above $x=0.20$, where the pseudogap disappears. The pseudogap temperature is a measure of the coupling between A and B, which suppresses the shifts but not nuclear relaxation. Spin-singlet pairing involves A and B according to three simple condensation rates, which will be discussed. The optimal $T_{\mathrm{c}}$ demands a special match between A and B. However, the shifts do not simply predict the highest $T_{\mathrm{c}}$ of all cuprates, in contrast to nuclear relaxation anisotropy and charge sharing between planar Cu and O. Relations to other probes are discussed. Full article

Baltic amber exhibits a wide range of colors and has attracted considerable attention in materials science. Previous studies have mainly focused on the origin and formation characteristics of beeswax-amber, while the relationship between beeswax-amber color and the microstructural characteristics of internal bubbles remains poorly understood. Ten beeswax-amber specimens exhibiting a color gradient from yellow to white were selected. Scanning electron microscopy (SEM) was used to examine and analyze their internal structures, with a focus on documenting bubble size, number, and density characteristics. Ultraviolet (UV) illumination was employed for qualitative optical observation, and Fourier-transform infrared (FTIR) spectroscopy was conducted to identify component phase and spectra. The correlation between bubbles and color was analyzed to infer the origin of white beeswax-amber’s coloration and explore the mechanisms underlying beeswax-amber’s color variation. Results indicate that beeswax-amber coloration is closely linked to its microscopic bubble characteristics. The microstructure satisfies conditions for Mie scattering, some white beeswax-amber samples contain abundant nanoscale bubbles, triggering a combined effect of Rayleigh and Mie scattering. These results demonstrate that the color of Baltic amber is governed not only by its intrinsic body color but also by the synergistic optical effects arising from internal bubble microstructures, providing a physically grounded explanation for its diverse appearances. Full article

Background: Pancreatic neuroendocrine neoplasms (PanNENs) represent a heterogeneous tumor entity with a steadily rising incidence, mainly due to advances in imaging and growing diagnostic awareness. In pancreatic ductal adenocarcinoma (PDAC), the mesopancreas (MP) has been identified as a frequent site of microscopic tumor spread and a key determinant of circumferential resection margin (CRM) status, leading to the concept of standardized mesopancreatic excision (MPE). While its oncological relevance in PDAC is increasingly recognized, the role of the mesopancreas in PanNENs remains unclear. This study aimed to systematically evaluate mesopancreatic infiltration in PanNENs and to identify associated clinicopathological predictors. Methods: Consecutive patients undergoing oncological pancreatoduodenectomy, spleen-preserving distal pancreatectomy, or distal splenopancreatectomy for PanNENs and PanNECs were included. The mesopancreas was histopathologically examined for tumor infiltration within CRM assessment. Results: MP infiltration was detected in 60% of patients. It was associated with higher Ki-67 index, larger tumor size, lymph node involvement, venous invasion, and positive CRM status. A Ki-67 index ≥ 5% and tumor size ≥ 21.5 mm were identified as predictors of MP infiltration. Higher T stage predicted reduced overall survival (OS), whereas MP infiltration, lymphatic (L1) and venous (V1) invasion, and Ki-67 ≥ 5% were associated with impaired disease-free survival (DFS). Conclusions: Mesopancreatic infiltration is frequently present in PanNENs and correlates with aggressive tumor characteristics. Given its association with CRM positivity and reduced DFS, consideration of the mesopancreas in staging and surgical strategies appears oncologically justified. Larger studies are required to validate these findings. Full article

In the hepatobiliary system, the majority of neoplasms grow within the hepatic parenchyma; however, some arise, grow, and/or spread within the lumen of the intrahepatic large bile ducts and the perihilar/distal bile ducts (collectively referred to as large bile ducts), representing specialized ductal organs associated with unique peribiliary glands and being distinct from the intrahepatic small bile ducts and bile ductules embedded within the hepatic parenchyma. Precursors of cholangiocarcinoma (CCA) arising within the lumen of large bile ducts have recently been proposed. Neoplasms growing and spreading within the lumen of large bile ducts have been categorized into four groups and are discussed here in light of updated pathological findings. (i) Precursor(s) of CCA arising in the large bile ducts (large-duct-type intrahepatic CCA and perihilar/distal CCA): These precursors include high-grade biliary intraepithelial neoplasia (BilIN), intraductal papillary neoplasm of the bile duct (IPNB), and intraductal oncocytic papillary neoplasm (IOPN). High-grade BilIN presents as a flat, microscopic lesion with dysplastic cytoarchitectural alterations and grows along the luminal surface of large bile ducts, whereas the latter two present as grossly visible polypoid or tumorous lesions composed of papillary, villous, or tubular proliferation of neoplastic epithelium with delicate fibrovascular cores. These lesions may eventually progress to invasive CCA. Intraductal tubulopapillary neoplasm of the bile duct (ITPN), previously categorized as another precursor of CCA arising in large bile ducts, appears to represent a heterogeneous group of neoplasms with respect to progression and presumed cell of origin. Some ITPNs are frequently associated with nodular invasive carcinoma resembling small-duct-type intrahepatic CCA (SD-iCCA) and share genetic alterations with SD-iCCA; such cases may arise in association with small bile ducts or bile ductules. In contrast, other ITPNs exhibit cystic changes with tubulopapillary features and may arise in association with peribiliary glands or cysts. (ii) Secondary growth and spread of biliary neoplasms: This category comprises several patterns. First, intraepithelial neoplastic spread directly and continuously from the primary neoplastic lesion is observed in almost all cases of high-grade BilIN, IPNB, and IOPN; it spreads laterally along the luminal surface of the proximal and distal bile ducts and extends vertically into the adjacent peribiliary glands. Intraluminal cast-like spread in the bile ducts adjacent to the primary neoplastic lesion also occurs in some precursor lesions, particularly in ITPN. Implantation of a biliary neoplasm from one part of the biliary tract to another results in discontinuous, multifocal biliary neoplasms, particularly in IPNB, and occurs mainly in the distal bile ducts relative to the main tumor. Multicentric tumorigenesis may contribute to the multifocal development of precursors and CCA in the bile ducts. The accumulation of additional genetic alterations, beyond the common mutations detected in primary tumors, may contribute to metachronous recurrence of CCA after curative resection of the primary biliary tumor. Cancerization of the duct (COD) by CCA may also contribute to secondary growth and spread within the bile duct lumen. Specifically, flat-type cancerization of pre-existing non-neoplastic bile ducts, resembling high-grade BilIN, occurs in approximately one-third of hilar CCA cases. Intraductal polypoid, cast-like cancerization within the lumen of adjacent bile ducts, resembling polypoid precursors of CCA, can also occur in approximately one-tenth of SD-iCCA. (iii) Prominent intraductal polypoid growth of invasive CCA: Invasive CCA rarely presents with predominant intraductal polypoid carcinoma that is continuous with periductal infiltrating CCA; this pattern can be referred to as polypoid invasive CCA. (iv) Nonbiliary neoplasms presenting bile duct tumor thrombus (BDTT): BDTT associated with hepatocellular carcinoma and with extrahepatic malignancies extending into the bile duct lumen can mimic the intraluminal growth and spread patterns of the above-mentioned biliary neoplasms. In conclusion, intraluminally growing biliary neoplasms in the large bile ducts comprise a heterogeneous group that can be reasonably classified into four categories. This categorization may facilitate understanding of these intrabiliary growing neoplasms. Full article

Context: In numerous low- and middle-income nations, malaria remains a significant issue due to the challenges associated with diagnosing it through thin blood smears. The appearance of images can vary significantly depending on the microscope type, magnification, lighting conditions, slide preparation methods, and staining techniques. Due to the delicate morphology of parasites, false negatives might adversely affect patient care. Objective: To achieve optimal outcomes from validation, it is essential to construct a robust and easily replicable process. This pipeline should integrate the optimal elements of classical machine learning and end-to-end deep learning, enhance reliability by pairwise ensembling, and select ensemble weights in a logical, data-driven manner. Method: To achieve our objective, we propose two tracks. The initial track encompasses real-time augmentation, convolution-based feature extraction, and the training of calibrated classical classifiers. The second module focuses on training many convolutional networks from inception to completion. Subsequently, we construct paired ensembles and employ a hybrid methodology to select convex weights for combining the findings. This method initially evaluates a set of candidate weights and then refines them to maximise validation accuracy. Results: The precision of the two-track architecture consistently improves, transitioning from conventional baselines to end-to-end models. Optimal and consistent enhancements are achieved through weighted ensembling. Utilising optimised fusion reduces the incidence of false negatives for subtle parasites and false positives caused by staining artefacts. This yields an accuracy of 96.35% on the reserved data and reduced variance across folds. Conclusions: The integration of augmentation, multiple modelling tracks, and optimal pairwise ensembling yields the highest accuracy in categorising malaria smears. It facilitates further enhancements by incorporating supplementary models, multi-class extensions, and operating-point calibration. Full article