Search Results (12,587)

The vascular anatomy of the stomach is both complex and highly variable, with direct implications for oncologic, bariatric, esophageal, and interventional procedures. This comprehensive review combines anatomical, radiological, and surgical evidence on arterial and venous variations in the stomach. The left gastric artery, traditionally the first branch of the coeliac trunk, often shows variants such as a direct aortic origin or association with an abnormal left hepatic artery. The right gastric artery most frequently arises from the proper hepatic artery, but its origin can vary significantly. The gastroepiploic arteries exhibit diversity in their origin, size, and connection patterns, with occasional duplication or absence. Additional vessels, including the posterior gastric artery and the short gastric arteries, also contribute to variations in arterial supply. Venous drainage largely follows the arterial pattern. The left and right gastric veins and the gastroepiploic venous arcade are major routes, while variants of the left gastric vein and the gastrocolic trunk (Henle’s trunk) contribute to complexity through different convergence patterns. These vascular variations have significant clinical implications, as they impact the safety of D2 lymphadenectomy, the risk of ischemic complications during laparoscopic sleeve gastrectomy, the success of gastric conduit formation in esophagectomy, and the effectiveness of transarterial embolization for upper gastrointestinal bleeding. Preoperative vascular mapping with multidetector computed tomography angiography and 3D reconstruction reliably defines individual anatomy, allowing for customized surgical planning and reducing operative risks. Recognizing both common and rare gastric vascular variants is essential for safe and effective surgical and endovascular management of gastric disease. Full article

This research evaluates Battery Energy Storage Systems (BESS) and Compressed Air Vessels (CAV) as complementary solutions for enhancing micro-grid resilience, flexibility, and sustainability. BESS units ranging from 5 to 400 kWh were modeled using a Nonlinear Autoregressive Neural Network with Exogenous Inputs (NARX) neural network, achieving high SOC prediction accuracy with R² > 0.98 and MSE as low as 0.13 kWh². Larger batteries (400–800 kWh) effectively reduced grid purchases and redistributed surplus energy, improving system efficiency. CAVs were tested in pumped-storage mode, achieving 33.9–57.1% efficiency under 0.5–2 bar and high head conditions, offering long-duration, low-degradation storage. Waterhammer-induced CAV storage demonstrated reliable pressure capture when Reynolds number ≤ 75,000 and Volume Fraction Ratio, VFR > 11%, with a prototype reaching 6142 kW and 170 kWh at 50% air volume. CAVs proved modular, scalable, and environmentally robust, suitable for both energy and water management. Hybrid systems combining BESS and CAVs offer strategic advantages in balancing renewable intermittency. Machine learning and hydraulic modeling support intelligent control and adaptive dispatch. Together, these technologies enable future-ready micro-grids aligned with sustainability and grid stability goals. Full article

The Strait of Gibraltar (SG) is a key biogeographic and ecological corridor connecting the Mediterranean Sea and the Atlantic Ocean, enabling the seasonal migrations of fin whales (Balaenoptera physalus). The objective of this study was to characterize, for the first time, the spatial and temporal exposure of the species to maritime traffic during its migration through the SG, quantifying movement patterns, individual composition, and collision risk to identify critical areas for conservation. Validated observations collected between April 2016 and October 2024, with additional records in January and March 2025, were integrated with EMODnet vessel density layers to assess monthly distributions of sightings, individuals, calves, migration patterns, and behavior. A total of 347 sightings comprising 692 individuals were recorded, revealing predominantly westward movements between June and August. Spatial overlap analyses indicated that the highest exposure occurred both near the Bay of Algeciras/Gibraltar and in the northern half of the Central SG, where cargo ship and tanker traffic coincides with dense migration routes and where injuries have been documented in the field. These findings delineate high-risk areas for fin whales throughout the SG and provide an empirical basis for spatial management measures, including speed reduction zones, adaptive route planning, and the possible designation of the area as a cetacean migration corridor. The proposed measures aim to mitigate collision risk and ensure long-term ecological connectivity between the Mediterranean and the Atlantic. Full article

Accurate segmentation of navigable waters and obstacles is critical for unmanned surface vessel navigation yet remains challenging in real aquatic environments characterized by complex water textures and blurred boundaries. Current models often struggle to simultaneously capture long-range contextual dependencies and fine spatial details, frequently leading to fragmented segmentation results. In order to resolve these issues, we present a novel segmentation model based on the CoAtNet architecture. Our framework employs an enhanced convolutional attention encoder, where a Fused Mobile Inverted Bottleneck Convolution (Fused-MBConv) module refines boundary features while a Convolutional Block Attention Module (CBAM) enhances feature awareness. The model incorporates a Bi-level Former (BiFormer) to enable collaborative modeling of global and local features, complemented by a Multi-scale Attention Aggregation (MSAA) module that effectively captures contextual information across different scales. The decoder, based on U-Net, restores spatial resolution gradually through skip connections and upsampling. In our experiments, the model achieves 95.15% mIoU on a self-collected dataset and 98.48% on the public MaSTr1325 dataset, outperforming DeepLabV3+, SeaFormer, and WaSRNet. These results show the model’s ability to effectively interpret complex aquatic environments for autonomous navigation. Full article

Accurate coronary artery segmentation from two-dimensional Digital Subtraction Angiography (DSA) images is paramount for robot-assisted percutaneous coronary intervention (PCI). Still, it is severely challenged by complex background artifacts, the intricate morphology of fine vascular branches, and frequent discontinuities in segmentation. These inherent difficulties often render conventional segmentation approaches inadequate for the stringent precision demands of surgical navigation. To address these limitations, we propose a novel deep learning framework incorporating a Composite Feature Extraction Module (CFEM) and a Multi-scale Composite Attention Module (MCAM) within a U-shaped architecture. The CFEM is meticulously designed to capture tubular vascular characteristics and adapt to diverse vessel scales. In contrast, the MCAM, strategically embedded in skip connections, synergistically integrates multi-scale convolutions, spatial attention, and lightweight channel attention to enhance the perception of fine branches and model long-range dependencies, thereby improving topological connectivity. Additionally, a combined Dice-Focal loss function is employed to optimize segmentation boundary accuracy and mitigate class imbalance jointly. Extensive experiments on the public ARCADE dataset demonstrate that our method significantly outperforms state-of-the-art approaches, achieving a Dice coefficient of 76.74%, a clDice of 50.30%, and an HD95 of 57.84 pixels. These quantitative improvements in segmentation accuracy, vascular connectivity, and edge precision underscore its substantial clinical potential for providing robust vascular structure information in robot-assisted interventional surgery. Full article

With the development and widespread application of information technology, cybersecurity has become a focal point in all industry sectors. The maritime sector is no exception, with both physical and cyber threats. This survey first highlights, from a system engineering and information technology perspective, the specific architectures of on-vessel and in-port systems, as well as the communication equipment connecting them. Subsequently, cyber attacks in maritime and port domains and their potential consequences are described from various angles. Examples of real cases of cyber attacks are also reported. An overview of current key techniques used in vulnerability analysis, attack detection, and security protection is proposed before discussing cybersecurity issues in the maritime and port sectors from the particular perspective of discrete event systems. Various systems used in maritime and port domains are modeled as automata or Petri nets. Some analysis, detection, and protection approaches are then proposed to illustrate the potential of discrete event systems in this domain. Full article

Unmanned surface vessels may encounter unknown surface obstacles when sailing. Accurate detection has a significant impact on the subsequent decision-making process. In order to deal with the complex water environment, this paper proposes an object detection framework based on the fusion of LiDAR and camera. The detection framework can achieve real-time and accurate water surface object detection without training, and has strong anti-interference ability. The detection framework achieves the data fusion of LiDAR and camera through external calibration and then uses the detection algorithm of sky–sea boundary (SSB) to establish a clear search area for LiDAR. Then, a two-stage clustering algorithm based on point cloud attributes and distribution information achieves more accurate segmentation. The region of interest (RoI) is obtained from the detection results by image projection. Finally, the region of interest is finely segmented by the saliency object detection algorithm. The experimental results show the effectiveness and robustness of the algorithm. Full article

Background and Objectives: Age-related macular degeneration (AMD) is an age-associated retinal disorder characterized by blood–retinal barrier (BRB) breakdown and pathological angiogenesis, leading to vascular leakage. The intravitreal administration of anti-VEGF agents remains the most effective treatment for neovascular AMD. However, repetitive intravitreal injections have risks, causing side effects such as cataracts, bleeding, retina damage, and, in severe cases, post-injection endophthalmitis. Hence, the development of innovative drug delivery systems is essential to minimize the risks and discomfort associated with intravitreal injections. Materials and Methods: We developed a microemulsion (ME)-based topical drug delivery system incorporating α-linolenic acid (ALA). In brief, pseudo-ternary phase diagrams were constructed by the water titration method using different combinations of surfactants and cosurfactants (S_mix-Cremophor RH 40: Span 80: Transcutol P in ratios of 1:1.05, 1:1:1, 1:1:1.5) containing ALA as the oil phase. Three blank microemulsions (ME1, ME2, and ME3) were prepared and characterized based on the optimized pseudo-ternary phase equilibrium with a S_mix ratio of 1:1:1. Results: ME3, with an average particle size of 38.59 nm, was selected as the optimized formulation for developing drug-loaded ME containing Fenofibrate, Axitinib, and Sirolimus. The drug-loaded ME showed particle size (46.94–56.39 nm) and in vitro release displayed sustained and longer time drug release for 240 h. The irritation and antiangiogenic activities were evaluated using the hen’s egg chorioallantoic membrane (HET-CAM) assay employing the optimized ME loaded with each drug. Among the three drug-loaded ME, the Sirolimus ME showed a reduction in blood vessel sprouting in the HET-CAM assay, indicating strong antiangiogenic activity. Treatment with the optimized blank ME and Sirolimus ME significantly (p < 0.05) reduced COX-2 protein expression in LPS-stimulated RAW 264.7 cells, suggesting their potential anti-inflammatory effects. Conclusions: Overall, we suggest that the α-linolenic acid-based Sirolimus microemulsion may serve as a promising topical therapeutic approach for managing AMD and offering a potential alternative to invasive intravitreal injections. Full article

Accurate segmentation of coronary artery calcifications (CAC) from cardiac CT is challenged by class imbalance, small lesion size, and anatomical ambiguity. We present an anatomically guided, cascaded framework that couples heart and vessel priors with a heterogeneous U-Net ensemble for robust, vessel-aware CAC segmentation. First, a ResU-Net trained on MM-WHS isolates the heart region of interest (ROI). Second, a ResU-Net trained on ASOCA—using Frangi vesselness enhancement—segments the coronary arteries, yielding vessel masks that constrain downstream lesion detection. Third, calcifications are segmented within the vessel-constrained ROI using an ensemble of U-Net variants (baseline U-Net, Residual U-Net, Attention U-Net, UNet++). At inference, a rank-based selective fusion strategy prioritizes predictions with strong morphological consistency and vessel conformity, suppressing false positives. On the Stanford COCA gated dataset, the proposed ensemble outperforms individual models (Dice 84.25%, sensitivity 87.10%, specificity 98.00%), with ablations demonstrating additional gains when vessel priors are integrated into selective fusion (Dice 85.50%, sensitivity 88.53%). Results confirm that combining dataset-specific anatomical priors with selective ensembling improves boundary sharpness, small-lesion detectability, and anatomical plausibility, supporting reliable CAC segmentation in clinical imaging workflows. Full article

Background/Objectives: The C-reactive protein-to-lymphocyte ratio (CLR) has emerged as an inflammatory biomarker reflecting innate and adaptive immune responses. Its prognostic value in acute ischemic stroke patients undergoing mechanical thrombectomy remains unclear. This study investigated whether CLR predicts functional outcome, mortality, and symptomatic intracranial hemorrhage (sICH). Methods: In this multicenter retrospective study, 714 patients with anterior circulation large-vessel occlusion treated with mechanical thrombectomy between January 2024 and January 2025 were analyzed. Clinical, angiographic, and laboratory data, including CLR, were collected. CLR was calculated as CRP divided by lymphocyte count/1000. Outcomes were 90-day modified Rankin Scale (mRS; poor outcome = 3–6; mortality = 6) and sICH per ECASS II. Receiver operating characteristic (ROC) analyses identified optimal CLR cut-offs. Logistic regression analyses determined independent predictors of outcomes. Results: sICH occurred in 39 patients (5.5%). CLR correlated with higher baseline NIHSS and lower ASPECTS. ROC analyses showed that CLR predicted poor functional outcome and mortality with an identical cut-off (≥7.51; AUCs 0.634 and 0.664), and demonstrated strong discrimination for sICH (cut-off ≥ 10.64; AUC 0.855). In multivariable analyses, CLR remained an independent predictor across all outcomes (ORs 1.02, 1.02, and 1.03, all p < 0.001), in addition to established clinical factors. Conclusions: Admission CLR was independently associated with poor outcomes, mortality, and sICH after mechanical thrombectomy. As an easily obtainable marker from routine laboratory tests, CLR may provide additional prognostic information and complement established predictors, but prospective validation is required. Full article

Objectives: The aim of this study was to determine which color imaging facilitated easier detection of the persistent avascular retina (PAR) in ultra-widefield (UWF) fundus imaging in children undergoing retinopathy of prematurity (ROP). Methods: A total of 20 eyes of 10 children aged between 6 and 9 who underwent diagnostic and therapeutic procedures for ROP were included. Fundus images were obtained using Optos confocal scanning laser ophthalmoscopy (cSLO; Optos PLC, Daytona, Dunfermline, UK). The images were divided and recorded into three groups as original imaging (composite), red reflectance imaging, and green reflectance imaging. These images were prepared as a slideshow for 10 ophthalmology specialists and they were surveyed to determine in which color imaging the peripheral avascular area was more easily detected. The results were evaluated. Results: The rate of detecting the PAR in green reflectance imaging by the participants included in the study was found to be statistically higher compared to other colors of imaging (composite 0.63 ± 0.09 (0.5–0.8), red 0.12 ± 0.05 (0.05–0.2), and green 0.94 ± 0.06 (0.85–1), p < 0.0001). All respondents reported that the boundaries of the peripheral avascular area were more clearly defined in the UWF (Optos PLC, Daytona, Dunfermline, UK) green reflectance imaging. Conclusions: Each color imaging used in UWF fundus imaging helps to visualize different layers of the retina. Our study showed that retinal vascular endings appear more distinct due to the lower penetration of the green laser into the choroidal vessels. Based on these findings, we believe that UWF fundus green reflectance imaging is more useful for detecting and monitoring PAR. Full article

The application of intravascular optical coherence tomography (IV-OCT) in neurovascular interventions is constrained by the mechanical inadequacy of conventional catheters in navigating the complex intracranial vasculature. To address this, we modified a coronary IV-OCT catheter, enhancing its mechanical performance for neurovascular applications. The modified catheter featured a 300 mm over-the-microwire segment and a dual-structured shaft (distal 50 mm nonbraided, proximal 250 mm braided) to improve trackability and pushability. We compared the modified and conventional catheters using a benchtop model with a simulated vessel path and an in vivo swine model. Trackability and pushability were quantitatively measured using resistance (N) and advancement distance (mm) in the simulated path. In the animal model, indirect performance metrics included the catheter tension angle (CTA) and pass of catheter (POC) through the fourth curvature of the external carotid artery (ECA). The modified catheter demonstrated superior pushability (172.9 ± 1.96 mm vs. 127.9 ± 2.86 mm, p < 0.05) and increased resistance (1.47 ± 0.036 N vs. 0.69 ± 0.032 N, p < 0.05). In vivo analysis further showed a significantly greater CTA (115.8 ± 8.5° vs. 77.6 ± 10.3°, p < 0.05) and higher POC success rate (83.3% vs. 11.1%, p < 0.05). These results indicate that the modified coronary IV-OCT catheter offers enhanced mechanical performance, suggesting its potential for safe and effective use in neurovascular procedures. Full article

The hydrodynamic performance of a rudder behind a propeller is critical for determining vessel maneuvering stability. During navigation, the coupled effects of the oblique flow angle (β) and the rudder angle (δ) significantly alter the wake velocity field and vortex patterns aft of the rudder. However, the synergistic control mechanism of these two variables requires further quantitative investigation. This study employs the RANS method with the SST k-ε turbulence model to numerically simulate flow under advance coefficients (J) ranging from 0.3 to 0.9, oblique flow angles (β) from 0° to 15°, and rudder angles (δ) from 0° to 35°. Hydrodynamic coefficients, including the lift coefficient, drag coefficient, and lift-to-drag ratio, were calculated for the rudder. The evolution of the horizontal velocity and vortex fields was captured, with the model validated through localized flow field visualization. The results reveal that when β ≤ 3°, δ is the dominant factor influencing rudder hydrodynamics. Conversely, when β ≥ 9°, β becomes the primary regulating factor. The coupling effect induces significant asymmetry in the velocity distribution across the rudder surfaces and pronounced flow separation on the windward side, generating a complex vortex system (including primary and secondary vortices) on the leeward side. This research elucidates the coupled control mechanism of oblique flow and rudder angle, providing insights for enhancing steering margins and a quantitative foundation for optimizing rudder profiles in challenging sea environments characterized by high oblique flow and large rudder angles. Full article

A 60-year-old woman with hypertension and hyperlipidemia was referred for an incidentally detected gastric subepithelial mass during screening endoscopy. Esophagogastroduodenoscopy revealed a 10 mm dimple in the antrum, and contrast-enhanced CT showed a 2.5 cm enhancing oval lesion. Laparoscopic partial gastrectomy with intraoperative endoscopic guidance was performed. Gross examination revealed a 3.0 × 2.0 × 1.0 cm pale, firm nodule. Histology showed small round cells arranged in nests and trabeculae within the muscularis propria, with numerous vessels and focal calcification. Immunohistochemistry was negative for CD117, HMB45, and chromogranin A, but demonstrated strong smooth muscle actin positivity, weak synaptophysin reactivity, and focal CD56 staining. The findings confirmed a gastric glomus tumor with neuroendocrine features. Smooth muscle actin immunostaining is essential to distinguish gastric glomus tumors from neuroendocrine tumors when biopsy material is limited, ensuring accurate diagnosis and appropriate management. Full article

Background: Patients with acute anterior circulation large-vessel occlusion (AC-LVO) stroke frequently experience poor outcomes despite successful mechanical thrombectomy (MT). Heparin-binding protein (HBP), a neutrophil-derived mediator of inflammation and vascular permeability, may contribute to neuroinflammation and prognosis; however, its role in stroke remains unclear. Methods: In this retrospective study, 163 patients with AC-LVO stroke who underwent MT were enrolled. Plasma HBP levels were measured within 24 h after thrombectomy. Functional outcomes were evaluated using the modified Rankin Scale (mRS) at 90 days, with an mRS score 3–6 suggesting a poor outcome. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were performed to assess associations between HBP and outcomes. Results: Of the 163 patients, 88 (54.0%) had poor functional outcomes. The median plasma HBP level of patients with poor outcomes was significantly higher than that of patients with good outcomes (28.80 vs. 18.42 ng/mL; p < 0.001). HBP remained independently associated with poor outcome (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01–1.07; p = 0.002) after adjusting for demographic, clinical, procedural, and laboratory covariates. ROC analysis showed a modest predictive value of HBP alone (area under the curve [AUC] = 0.671), whereas adding HBP to clinical models improved prognostic accuracy (AUC = 0.835 for model 2; AUC = 0.889 for model 3). Conclusions: For patients with AC-LVO stroke, elevated plasma HBP within 24 h after MT serves as an independent predictor of unfavorable functional outcomes at 90 days. Thus, HBP may serve as a prognostic biomarker and potential target for immunomodulatory therapy. Full article