An intraosseous pneumatocyst is a gas-containing cystic bone lesion that is not associated with infection or bone necrosis due to vertebral compression fracture. The most common sites are the pelvis and spine, but it is reported rarely in other sites. To our knowledge, only two cases of intraosseous pneumatocyst in the scapula have been reported. Herein, we report two cases of intraosseous pneumatocyst of the scapula, in a 41-year-old woman and a 51-year-old man. Neither patient had shoulder symptoms, and the lesions were found incidentally during imaging studies. Plain X-rays revealed cystic lesions with sclerotic rims, located from the scapular neck to the glenoid, adjacent to the shoulder joint. Plain X-rays of the 51-year-old male patient showed osteoarthritis of the shoulder, including joint space narrowing and osteophyte formation. CT was used for diagnosis in both cases. The patients remained pain-free throughout the follow-up period (10 years and 6 months, respectively). Their lesion sizes were unchanged, and radiolucency was reduced at the final follow-up. The shoulder joint has the largest range of motion in the human body; thus, the vacuum phenomenon may occur when the shoulder is elevated or externally rotated. We speculate that gas was produced in an intraosseous ganglion or subchondral cyst, the likely pre-existing lesions, after the vacuum phenomenon occurred in the shoulder joints of these patients.
Parkinson's disease (PD) is a progressive neurodegenerative disorder that causes debilitating symptoms in both the motor and cognitive domains. The neurophysiological markers of PD include 'oscillopathies' such as diffuse neural oscillatory slowing, dysregulated beta band activity, and changes in interhemispheric functional connectivity; however, the relative importance of these markers as determinants of disease status is unclear. In this case-control study, we used resting state magnetoencephalography (MEG) data (n = 199 participants, 78 PD, 121 controls) from the OMEGA repository to investigate changes in spectral power and functional networks in PD. Using a Contrast of Parameter Estimates approach, we modelled the effects of PD while controlling for population-level confounds. Permutation testing revealed significant increases in theta (p = 0.0001) and decreases in gamma band spectral power (p = 0.0001). We also used a partial least squares-based classifier to find linear combinations of MEG features which independently predict PD. We found MEG-based predictions to be highly sensitive and specific, reaching an optimal AUC-ROC of 0.87 ± 0.04. Interpretation of the model indicates oscillatory slowing can be separated into components that can robustly identify individual cases of PD. This suggests MEG can reveal dissociable, complementary neural processes which contribute to PD.
Retrograde type A aortic dissection (RTAD) after thoracic endovascular aortic repair (TEVAR) is a rare but potentially fatal complication. We report a case of very late-onset RTAD occurring 9 years after hybrid aortic arch repair. An 81-year-old man with a history of TEVAR with cervical debranching for subacute thrombosed RTAD, which later developed an ulcer-like projection, presented with dizziness and back pain. Acute RTAD with cardiac tamponade was diagnosed, and emergent ascending aortic replacement with resection of the entry tear-located at the proximal edge of the stent on the lesser curvature-was performed. Postoperatively, the patient required prolonged ventilatory support for respiratory failure and developed pyothorax secondary to aspiration pneumonia. He was ultimately discharged home on postoperative day 188 after rehabilitation. This case underscores the importance of a distinct pathophysiology in late RTAD, in which progressive aortic wall degeneration and biomechanical fatigue over time-rather than procedural factors-may contribute to dissection. Continuous imaging surveillance and strict cardiovascular risk factor management are essential, even in the absence of early complications.
A 40-year-old man with acquired immunodeficiency syndrome (AIDS) presented with severe thrombocytopenia and disseminated Kaposi's sarcoma (KS). Initially diagnosed with immune thrombocytopenic purpura (ITP), he was treated with corticosteroids and antiretroviral therapy; however, his condition worsened. He met the criteria for Kaposi's sarcoma-associated inflammatory cytokine syndrome (KICS) and received liposomal doxorubicin, showing temporary improvement. KS progression was observed after immune recovery, suggesting KS-associated immune reconstitution inflammatory syndrome. Rituximab was administered, but the patient deteriorated and died. This case highlights the difficulty in distinguishing KICS from ITP, and the importance of an early diagnosis and multidisciplinary care in advanced AIDS.
Treatment-emergent neuroendocrine prostate cancer (t-NEPC) is an aggressive variant arising from lineage plasticity after androgen receptor pathway inhibitor therapy. We report an 80-year-old man with metastatic prostate adenocarcinoma treated with enzalutamide who developed lung lesions despite stable prostate-specific androgen levels. A transbronchial lung biopsy revealed poorly differentiated carcinoma without confirmation of the primary site. Suspecting t-NEPC based on his treatment history, a prostate rebiopsy confirmed the diagnosis. He was treated with carboplatin, etoposide, and durvalumab, but he later succumbed to carcinomatous meningitis. This case highlights the limitations of small metastatic biopsies and the importance of considering phenotypic transformation during prostate cancer treatment.
Asbestos is a risk factor for occupational lung cancer. This article reported a case of asbestosis. During regular chest CT scans, an enlargement of nodules in the left lower lobe was observed. After undergoing relevant examinations, the patient underwent left lower lobe resection. Postoperative pathology confirmed the diagnosis as SMARCA4-deficient undifferentiated tumor. The patient was subsequently treated with immunotherapy, radiotherapy and chemotherapy and currently has a good prognosis. 石棉是导致职业性肺癌的危险因素。本文报道1例石棉肺患者，定期复查胸部CT时发现左肺下叶结节增大，完善相关检查后行左肺下叶切除术，根据术后病理确诊为：SMARCA4缺陷型未分化肿瘤，术后给与免疫治疗、放疗及化疗等治疗，患者目前预后良好。.
Mitochondrial complex III deficiency nuclear type 2 (MC3DN2) is a rare inherited neurometabolic disease. A 34-year-old male had neuropsychiatric episodes, progressive cerebellar degeneration, myopathy, polyneuropathy, and brain stem and basal ganglion lesions since childhood. Muscle biopsy revealed mitochondrial abnormalities. Two novel TTC19 pathogenic variants were detected. To analyze phenotypic characteristics of MC3DN2 related to clinical onset age, neurological presentation and brain MRI regarding infantile and childhood-onset (ICO) and adolescent and adult-onset (AAO) disease in a cohort composed of our patient and the cases reported in the literature were compared. It revealed that, clinically, cerebellar ataxia was common in both groups, nystagmus was more frequently noted in AAO patients, and psychiatric disturbances were more common in ICO patients. Regarding MRI findings, basal ganglion lesions were more prevalent in ICO patients, and inferior olive lesions were more frequent in AAO patients. These conspicuous phenotypic features of MC3DN2 may suggest diagnosis of this distinctive disease. The differences in clinical features and brain lesions associated with clinical onset age could provide crucial insights into the phenotypic landscape of MC3DN2.
Spinocerebellar ataxia type 8 (SCA8) is a relatively rare type of autosomal dominant hereditary spinocerebellar degeneration. Previously reported imaging findings have shown isolated cerebellar atrophy. We herein report the case of a patient with a genetically confirmed diagnosis of SCA8 who exhibited T2 hyperintensity in the inferior olivary and dentate nuclei in addition to cerebellar atrophy. To the best of our knowledge, this is the first report of this specific imaging finding associated with SCA8, which may represent a characteristic imaging feature of the disease.
Super-resolution microscopy has emerged as a groundbreaking tool in microbiology, enabling the visualization of structures and molecules far below the diffraction limit of light. We provide an overview of the various techniques employed in super-resolution microscopy, including deterministic (scanning and structured illumination) and stochastic (single-molecule localization microscopy and fluctuation-based computation) methods, summarizing their respective advantages and limitations. Applications in microbiology are presented, including investigations of cellular processes, physiology, cell wall biology, and elucidation of bacterial toxin pathogenesis mechanisms at nanoscale resolution. New and emerging uses of super-resolution microscopy are also explored, focusing on addressing critical challenges in the field: pathogen-host interactions, antibiotic resistance, mode of action of bacterial toxins, and nanoscale detail of bacterial secretion systems and their translocated effectors. With the expanding accessibility of resources and increasing availability of open-source software to democratize data analysis, super-resolution microscopy is poised to revolutionize our understanding of the nanoscale world in microbiology, paving the way for new discoveries.
Patients with acquired idiopathic generalized anhidrosis (AIGA) present with reduced sweating and impaired thermoregulation, which causes body temperature to increase quickly during exercise or in a hot environment. A 14-year-old girl was admitted with a variety of symptoms and prolonged fever of unknown origin. AIGA was diagnosed because of a discrepancy between deep body temperature (tympanic membrane) and body surface temperature (axillary), and she was treated. Careful history taking and physical examination are essential for patients with fever of unknown origin.
Pulmonary aspergillosis is a fatal disease with high mortality in captive penguins in zoos and aquariums; however, antemortem identification of Aspergillus spp. remains challenging. A gentoo penguin (Pygoscelis papua) exhibiting respiratory clinical signs showed fluid accumulation in the interclavicular air sac on computed tomography (CT). The fluid was aspirated via puncture using a sterile needle in the prone position, as during CT. The fluid sample was positive for A. fumigatus in fungal culture. After the penguin died, infection of A. fumigatus was confirmed in the air sac fluid collected postmortem pathological examination. These findings suggest that combining computed tomography and air sac aspiration is a promising approach for the antemortem diagnosis of aspergillosis in penguins.
In view of the geological disasters caused by the deterioration of rock mass in the fluctuation zone of the Three Gorges Reservoir area, the marl of the Wuxia section was selected as the object, and laboratory acid corrosion and wet-dry cyclic tests were conducted to reveal the damage and deterioration mechanism of marl in the fluctuation zone with acidic environment. The results show that: (1) When the pH was 3, 5 and 7, the mass loss rate was 0.019%~0.066%, 0.010%~0.029% and 0.006%~0.017% with 5 ~ 15 circles, respectively. (2) When the pH values were 3, 5 and 7, after 15-time acidic erosion and dry-wet cycles, the average porosity increment of the samples was 0.104%, 0.093% and 0.092%, respectively, and the initial porositywas found to influence the rate of porosity increase during the early stage of the experiment. (3) At the microscopic level, the pore volume and crack length were increased, and the number of pores and cracks increased under the scanning election microscope analysis, which revealed the damage and deterioration mechanism of samples. (4) The uniaxial compressive test of the sample was inversely proportional to the number of acidic erosion and dry-wet cycles. At pH values of 3, 5, and 7, the reduction rate of rock uniaxial compressive strength ranged from 5.65% to 28.25% after 5, 10, and 15 cycles of acid corrosion-drying-wetting, respectively. (5) The variation range of the mass loss rate, pore growth rate and the uniaxial compressive strength reduction rate of rock samples were all initially slow, later fast and then slow, and finally tended to be stable. (6) The error between the result of calculation with uniaxial compressive strength fitting formula and the test is less than 10%, which could prove the fit is reasonable, universally. The research could provide theoretical support for unstable rocks mass of geological disasters in the Three Gorges Reservoir area.
This study develops and evaluates a data-leak-safe, monthly forecasting framework for the City of Ekurhuleni, South Africa, covering rainfall and municipal water demand. Here "leak-safe" means that all predictors are built from information that would have been available at the forecast month, with feature engineering, scaling and model validation performed strictly on the training window only. The results are situated within demographic change, addressing the gap in decision-grade monthly forecasts that jointly consider rainfall and municipal demand for planning. Monthly datasets (2011-2025) were cleaned and engineered using past-only features (fixed lags; trailing 3/6/12-month statistics; harmonic month terms; simple trend). Models were trained using MATLAB with 5-fold cross-validation (PCA capped at 95% variance when applied) and benchmarked against persistence, seasonal-naïve, and monthly climatology on a sealed test window. For rainfall, a bagged-trees ensemble achieved strong generalization (test RMSE ≈ 9.13 mm; R2 ≈ 0.96), capturing wet-season peaks (Dec-Feb) and dry-season minima (Jun-Aug). For demand, a Matérn-5/2 Gaussian Process delivered positive out-of-sample skill (test RMSE ≈ 17.05 ML/day; R2 ≈ 0.76; MAPE ≈ 1.39%), tracking month-to-month movements with mild amplitude damping. A 36-month recursive rollout indicates stable consumption within a narrow band (approximately 995-1025 ML/day) and a seasonal rainfall envelope consistent with historical patterns. Census-based trends, growth in formal residential areas, and increased in-dwelling/yard tap access support a rising, more metered base load with localized variability. The synthesis suggests prioritizing reliability, active leakage control, targeted equity upgrades, and routine re-forecasting over large capacity expansion, while using rainfall-conditioned scenarios and uncertainty bands for procurement and risk planning. The contribution is a reproducible, decision-grade pipeline that pairs rigorous baselines with actionable 36-month forecasts for urban water resources management.
Metallodrugs have long occupied a significant position in medicinal chemistry, yet their application to infectious diseases has historically lagged the extensive development observed in cancer therapy. The COVID-19 pandemic, together with the increased spread of parasitic diseases driven by climate change and human migration, has renewed interest in metal-based compounds as antiviral and antiparasitic agents. These efforts have been further enabled by advances in computational modeling and mechanistic analysis, allowing rational design strategies that extend beyond in vitro drug screening. This focused review traces a coherent body of work, including studies developed by our research group, illustrating how fundamental coordination chemistry principles can be progressively integrated to address infectious disease challenges. Viral molecular targets, exemplified by the HIV-1 nucleocapsid protein NCp7, a zinc finger protein essential for multiple stages of retroviral replication, demonstrate how combined spectroscopic, mass-spectrometric, and computational approaches enable molecular-level understanding of metal-mediated zinc finger inhibition. Similar principles have been extended to neglected and emerging viral pathogens, including arboviruses such as Zika and chikungunya, where metal-based compounds can be modulated to interfere with different steps of replication cycle. In contrast, kinetoplastids such as Leishmania spp. present a complex intracellular environment in which the biological activity of metal complexes is governed predominantly by redox perturbation, disruption of thiol-dependent metabolism, and mitochondrial dysfunction. By following a continuous methodological and conceptual progression from drug-screening to mechanistic approach and in vivo models, this review highlights this transition and underscores the potential of metallodrugs in infectious disease agents.
A 19-year-old male sea otter (Enhydra lutris) exhibited systemic seizures, declining consciousness, temporary cardiopulmonary arrest, and right-side rotation. The sea otter died approximately one month after its initial seizure. Postmortem magnetic resonance imaging examination revealed a high-intensity region in the left frontal lobe. At necropsy, a gelatinous lesion in the left frontal lobe of the brain was revealed. Histopathologically, the lesion consisted of neoplastic proliferation of round to polyhedral monomorphic cells with a honeycomb growth pattern, small round nuclei, and cytoplasmic halos. The neoplastic cells were immunopositive for oligodendrocyte transcriptional factor-2 (OLIG2) and immunonegative for glial fibrillary acidic protein (GFAP). In this study, we describe the clinical signs and histopathological features of oligodendroglioma, which have rarely been reported in sea otters.
Robotic ventral hernia repair (VHR) has enabled minimally invasive management of complex abdominal wall hernias. As robotic procedures involve distinct technical demands and require progressive skill acquisition, understanding learning curves (LCs) is essential to define proficiency thresholds, optimize surgical training, and ensure safe implementation of these techniques. This systematic review compared LCs in robotic VHR across surgical techniques. A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of major medical databases (PubMed/MEDLINE, EMBASE, Web of Science, Lilacs, and the Cochrane Library) was performed through August 2025, including cohort studies on adult patients undergoing elective robotic VHR. Seven retrospective cohort studies were included, comprising six single-surgeon series: one robotic intraperitoneal underlay mesh (rIPUM), one robotic transversus abdominis release (rTAR), one robotic transabdominal preperitoneal (rTAPP), three robotic enhanced-view totally extraperitoneal (r-eTEP), and one population-based analysis including 12,609 cases. The single-surgeon series predominantly involved patients with class I obesity (mean body mass index range: 31.0-33.0 kg/m2). LC assessment was heterogeneous, employing cumulative sum (CUSUM), risk-adjusted CUSUM (RA-CUSUM), chronological case grouping, and multivariable regression modeling. Across single-surgeon studies, operative efficiency improved earlier than complication-adjusted or technical quality outcomes. Operative-time (OT) proficiency thresholds were reported at 26 cases for rIPUM, 29-38 for r-eTEP, 46 for rTAPP, and 49 cases for rTAR. However, stabilization of complication-adjusted performance required higher volumes, ranging from 51 to 64 cases. Prior experience substantially shortened the LC, reducing OT proficiency for r-eTEP to just 8 cases. In contrast, population-level analysis suggested that 16-19 robotic cases were required to achieve recurrence-related reoperation rates comparable to open or laparoscopic repair. LCs in robotic VHR follow a two-phase, technique-dependent pattern. While operative efficiency is achieved earlier, optimal patient outcomes require higher case volumes.
Advances in systemic cancer therapies such as immune checkpoint inhibitors (ICIs), tyrosine kinase inhibitors (TKIs), and anti-angiogenic agents have markedly improved survival in patients with solid and hematologic malignancies. As survivorship increases, oral rehabilitation with dental implants is increasingly sought to restore quality of life. However, these therapies may adversely affect bone healing, angiogenesis, and immune regulation, raising concerns regarding implant-related complications. This systematic review aimed to evaluate reported dental implant outcomes and complications in patients receiving novel systemic cancer therapies, emphasizing the implications for supportive oncology. This review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD420251142681). PubMed/MEDLINE, Scopus, ScienceDirect, and the Cochrane Library were searched for English-language clinical reports describing dental implant outcomes in patients treated with ICIs, TKIs, or anti-angiogenic agents. Study selection, data extraction, and quality appraisal using the Joanna Briggs Institute checklist for case reports were performed independently by two reviewers. Seven case reports (2017-2024) were included, representing Level IV evidence. Two cases involving TKIs reported successful osseointegration and long-term survival. In contrast, five cases described adverse outcomes including early failure and MRONJ predominantly associated with anti-angiogenic agents, either alone or in combination with ICIs and antiresorptive agents. These complications often resulted in significant functional morbidity and the need for invasive surgical intervention. Based on limited case report evidence, anti-angiogenic therapies were more frequently observed in cases with adverse outcomes, including implant-related MRONJ and failure, while TKIs were associated with favorable outcomes in limited cases. The role of ICIs remains unclear due to sparse data, particularly regarding monotherapy effects. Given the preliminary nature of current evidence derived from case reports, prospective studies with appropriate control groups are urgently needed to establish evidence-based guidelines. CRD420251142681; 08/09/2025.
The malicious URLs have been a constant threat to cybersecurity because hackers are constantly creating phishing, malware, spam, and defacement links that resemble authentic Web layouts and bypass static security measures. Despite very promising results of machine learning (ML) and deep learning (DL) models in URL classification, the effectiveness of these models is usually limited by high dimensional spaces of features that have redundant and irrelevant qualities, which leads to increased computation costs and potentially less generalization ability. To cope with this, this study will present a wrapper-based Bat Algorithm (BA) feature selection model to determine small and discriminative subsets of features in detecting malicious URLs. The bio-inspired metaheuristic BA offers a good tradeoff of exploration and exploitation in high dimensional optimization issues and thus is useful in feature subset selection. The proposed BA model is tested on ensemble ML (XGBoost, AdaBoost, Gradient Boosting, CatBoost and LightGBM) and DL (CNN, RNN, LSTM and CNN-LSTM) architectures with two datasets the multi-class ISCX-URL-2016 dataset and the more recent URL Phishing (2026) dataset. Experiments results indicate that BA has a significant dimensionality reduction: It reduces original feature space on ISCX-URL-2016 by 51.90% in the case of Defacement, by 67.09% in the case of Malware, by 49.37% in the case of Phishing, by 59.49% in the case of Spam, and 45.91% in the case of Phishing on URL Phishing (2026). This reduction notwithstanding, BA shows consistent improvements in the classification of both datasets. BA-enhanced LightGBM had the best overall results of all the tested models, with an accuracy of 99.92% on ISCX-URL-2016 and 98.17% on URL Phishing (2026), and high values of ROC-AUC and good computational efficiency. A statistical analysis also supports the fact that the improvements noticed are significant. Altogether, the proposed BA-based feature selection model is an efficient, scalable, and reliable solution to malicious URL detection intelligent, with good possibilities of being implemented into real-world systems in terms of cybersecurity.
Abdominal organ injuries in children are usually caused by traffic accidents, which are typically defined as high-energy injuries. We report abdominal organ injury cases not attributed to high-energy blunt trauma but seemingly minor blunt trauma with focal impact.Case 1:A 6-year-old patient was running in a park and slipped one day before. The FAST examination was positive, revealing hepatic injury. Computed tomography demonstrated a massive subcapsular hemorrhage of the liver.Case 2:A 6-year-old patient fell in a room the day before. She experienced trauma to the epigastrium after hitting a water bottle during the fall. The FAST examination was positive, revealing pancreatic injury. Computed tomography was performed and showed a hematoma anterior to the pancreas.Case 3:A 7-year-old girl was practicing bar pullovers one day before. FAST examination was negative;however, targeted ultrasonography revealed a hyperechoic lesion, and computed tomography revealed a hematoma in the duodenal wall.These cases had abdominal organ injury caused by seemingly minor blunt trauma with focal impact. Physical examination and abdominal ultrasound examination, including FAST and targeted ultrasonography, are essential for the early identification of pediatric patients requiring computed tomography.
The improved management of craniosynostosis has let emerge concomitant anatomical, functional and clinical features that are frequently faced later in life (especially by syndromic patients) and might variably encompass the cranial nerves due to stenosis of bone foramina, abnormal intracranial pressure, or anomalous gene-driven development. Clinical consequences vary according to the affected nerves, the severity and the pathogenesis of nerve involvement but also might depend on early appropriate treatment. Vision, smell and hearing, but also feeding, swallowing and facial mimic or esthesia might be affected with a possible dramatic impact on the overall development of the child and on its quality of life. A systematic literature review regarding cranial nerves involvement in craniosynostosis was performed, including case series and case reports. According to PRISMA criteria, PubMed and Scopus were searched up to February 2025 by two independent reviewers. Relevant English-language case reports and case series were included, while duplicate or aggregated data were excluded. Reference lists were screened, and disagreements were resolved by consensus. Sixty-three papers were considered. Data extracted from the papers were subjected to statistical analysis only for the optic nerve, owing to the paucity of data concerning the other cranial nerves. Optic nerve involvement was reported in 140 patients (44 papers) and included papilledema (69 patients), optic nerve atrophy (69 patients), and optic nerve hypoplasia (5 patients). Visual function was reduced in 65 patients, normal in 9. In sixty-eight patients (49%) an underlying syndrome was specified, most commonly Crouzon syndrome (27/68, 39.7%) and Apert syndrome (23/68, 33.8%); 5/140 (4%) had a secondary craniosynostosis. When reported, there was a prevalence of male sex (43/67 males; 65.2%), bilateral optic nerve involvement (66/78 patients; 84.6%) and multisutural involvement (37/52; 71.2%). Other upper cranial nerve involvement (III, IV, VI) was more frequently reported in the management of craniosynostosis children. Some cranial nerves were part of specific syndromes (e.g., I or V) or were involved during surgery. Finally, very scarce literature reports inferior cranial nerve involvement even though posterior cranial fossa neural impingement is a common complication in syndromic forms. Cranial nerve involvement is common; it presents differences among syndromes and specific suture involvement but is still under-investigated in craniosynostosis. Guidelines for the assessment and the proper treatment of cranial nerve-related deficits are warranted, and a joint effort of referral centers is needed for overcoming the rarity of craniosynostosis forms.