Search Results (1,258)

Background: Leishmaniasis is a zoonotic vector-borne disease and a significant global public health concern worldwide and in Algeria. In this study, we investigated the potential role of ticks and fleas as carriers of Leishmania in endemic regions of Algeria. Methods: Adult ectoparasites were collected from reservoir dogs and cohabiting animals across three provinces: Tizi-Ouzou (northeast), M’Sila (southeast), and Tébessa (extreme east). A subset of 247 ectoparasites was randomly selected for Leishmania DNA screening using ITS1-PCR. Results: Morphological identification revealed two tick species, Rhipicephalus turanicus (378 specimens) and Rhipicephalus sanguineus s.l (127 specimens), and one flea species, Ctenocephalides felis (94 specimens). Dogs were the most heavily infested hosts (74.12%), followed by sheep (9.51%) and cats (9.34%). Leishmania DNA was detected in 36.43% (90/247) of the tested specimens, with higher positivity in ticks (41.32%) compared to fleas (17.64%). Infection rates varied by host species, with dogs harboring the majority of positive ectoparasites (62/90), primarily R. sanguineus s.l (19/30) and R. turanicus (40/115). Leishmania DNA was also detected in ectoparasites collected from cats and sheep, whereas goats and rabbits were free from Leishmania DNA. Conclusions: This investigation highlights the high detection rate of Leishmania DNA in ticks and fleas from animals in Algerian endemic regions, indicating exposure to infected hosts. Together with previous reports, these findings support the view that ticks and fleas may act as incidental hosts or mechanical carriers of the parasite. However, their role in parasite transmission remains unconfirmed and warrant further investigation, particularly through studies assessing vector competence. These results emphasize the need for additional research to clarify the contribution of these ectoparasites to Leishmania transmission and multi-host dynamics. Full article

Objectives: To identify factors correlated with post-surgery residue in cases of breast cancer incidentally found via vacuum-assisted excision (VAE). Methods: A total of 6083 patients were enrolled in a retrospective study. Ultrasound evaluation and ultrasound-guided VAE were performed on these patients. According to the pathology of VAE, 53 patients with incidentally found breast cancer were included in the final analysis. Either breast-conserving surgery or mastectomy was performed. The maximal diameter, depth, location, BIRADS category, and Adler’s grade of all lesions before VAE was reviewed and recorded. VAE and post-surgery pathologies were used as gold standards. Either Pearson’s chi-square test or Fisher’s exact test was used for comparison of categorical variables. Results: The mean age of the enrolled patients was 49 years (IQR: 43–55 years). The mean maximal diameter of the lesions was 11.3 mm (IQR: 7–15 mm). There were twenty-eight ductal carcinomas in situ, twelve invasive ductal carcinomas, five lobular carcinomas in situ, two invasive lobular carcinomas, four intraductal papillary carcinomas, and two mucinous carcinomas. Post-surgery pathology showed 15 cases with residual cancer and 38 cases with no residual cancer. The maximal diameter, depth, and pathology derived via VAE were statistically correlated with post-surgery residue (p < 0.05). Conclusions: Small incidentally found noninvasive carcinomas located comparatively deep in the breast could be totally excised by ultrasound-guided vacuum-assisted excision. Both large and superficially invasive carcinomas were more likely to be associated with residue. Full article

Background/Objectives: Open thoracoabdominal aortic aneurysm (TAAA) repair remains essential despite expanded endovascular options, yet the contemporary open-surgery case-mix has shifted as minimally invasive therapies became widespread. The objective was to evaluate temporal changes in patient demographics, pathology, and perioperative outcomes of open TAAA repair across two decades. Methods: Retrospective, cross border cohort of all open TAAA repairs performed at two high-volume tertiary centers (Aachen, Germany; Maastricht, Netherlands) from 2000–2024. Patients were stratified into Early Era (2004–2013) and Late Era (2014–2024). Primary endpoints were shifts in demographics and perioperative mortality/morbidity; secondary endpoints included major complications (spinal cord ischemia, acute kidney injury, pulmonary and cardiac events). Results: Among 577 open repairs, 376 (65.2%) occurred in the Early Era and 201 (34.8%) in the Late Era, with annual volumes declining to <12 cases/year after 2020. Late Era patients were younger (median 55.9 vs. 63.0 years, $p<0.001$) and had more genetic aortopathy (Marfan 26.9% vs. 11.7%, $p<0.01$) and post-dissection pathology (64.7% vs. 43.1%, $p<0.01$), alongside more prior aortic surgery (59.2% vs. 43.4%, $p<0.01$). Massive transfusion and incidental splenectomy decreased (37.8% vs. 54.5%, $p<0.01$; 5.0% vs. 14.9%, $p<0.01$). In-hospital mortality was similar (18.4% Late vs. 21.8% Early, $p=0.34$); spinal cord ischemia showed a non-significant reduction (5.5% vs. 8.0%, $p=0.26$); myocardial infarction decreased (1.0% vs. 4.3%, $p=0.03$); and ARDS increased (15.9% vs. 5.1%, $p<0.01)$. Conclusions: Despite the shift towards endovascular repair and the changing demographics of patients selected for open TAAA repair, specialized centers can maintain stable outcomes through standardized protocols and concentrated expertise. The preservation of open surgical capabilities remains crucial for specific patient populations, emphasizing the need for a balanced approach that integrates both open and endovascular techniques to provide optimal, individualized care. Full article

In recent years, research in sequential recommendation has primarily refined user intent by constructing sequence-level contrastive learning tasks through data augmentation or by extracting preference information from the latent space of user behavior sequences. However, existing methods suffer from two critical limitations. Firstly, they fail to account for how random data augmentation may introduce unreasonable item associations in contrastive learning samples, thereby perturbing sequential semantic relationships. Secondly, the neglect of temporal dependencies may prevent models from effectively distinguishing between incidental behaviors and stable intentions, ultimately impairing the learning of user intent representations. To address these limitations, we propose TCLRec, a novel temporal-aware and intent contrastive learning framework for sequential recommendation, incorporating symmetry into its architecture. During the data augmentation phase, the model employs a symmetrical contrastive learning architecture and incorporates semantic enhancement operators to integrate user preferences. By introducing user rating information into both branches of the contrastive learning framework, this approach effectively enhances the semantic relevance between positive sample pairs. Furthermore, in the intent contrastive learning phase, TCLRec adaptively attenuates noise information in the frequency domain through learnable filters, while in the pre-training phase of sequence-level contrastive learning, it introduces a temporal-aware network that utilizes additional self-supervised signals to assist the model in capturing both long-term dependencies and short-term interests from user behavior sequences. The model employs a multi-task training strategy that alternately performs intent contrastive learning and sequential recommendation tasks to jointly optimize user intent representations. Comprehensive experiments conducted on the Beauty, Sports, and LastFM datasets demonstrate the soundness and effectiveness of TCLRec, where the incorporation of symmetry enhances the model’s capability to represent user intentions. Full article

In this paper, we investigate the Hyers–Ulam–Rassias stability of reciprocal functional equations in non-Archimedean fuzzy normed spaces by using both the direct method and the fixed point alternative. In addition, we study a modified reciprocal type functional equation within the same framework using Brzdȩk’s fixed point method. A brief remark is provided on the incidental role of symmetry in the structure of such functional equations. Finally, a comparative analysis highlights the distinctive features, strengths, and limitations of each approach. Full article

Background and Objectives: To identify clinical, ultrasound (US) and real-time elastography (RTE) characteristics indicative of malignancy in small thyroid lesions. Materials and Methods: 141 consecutive patients with incidentally discovered solid thyroid nodules (diameter ≤ 10 mm) by neck US were assessed, and RTE was performed. The nodules were classified per American (ACR-TIRADS) and European (EU-TIRADS) criteria; US-guided FNA was conducted on EU-TIRADS 5 nodules. The US and RTE features of nodules classified as benign (Bethesda II) or malignant (Bethesda V and VI) were compared. Results: 41 nodules were classified as EU-TIRADS 5. Their Fine Needle Aspiration (FNA) cytology was Bethesda II (n = 11), III-IV (n = 3), V (n = 10) or VI (n = 17). Bethesda V–VI patients had a higher rate of autoimmune thyroiditis (p = 0.015) and higher ACR-scoring points (p < 0.001) compared with Bethesda II. The elastography ratio was equal between the groups (p = 0.584). In logistic regression analysis, ACR-scoring points predicted FNA results, with an area under the curve (AUC) of 0.993 (sensitivity 92.6% and specificity of 100%). The clinical model (age, body mass index, sex, autoimmunity, L-thyroxine treatment, nodule diameter, elastography ratio) achieved an AUC of 0.744. A “mixed” model, combining clinical characteristics with the ACR scoring points, achieved perfect performance (AUC = 1.000), predicting FNA results with 100% sensitivity and specificity. Conclusions: The proposed “mixed model” can predict Bethesda V–VI in thyroid nodules <10 mm, allowing for the selection of those needing further evaluation. Full article

The global transition to a circular bioeconomy is accelerating the demand for sustainable, high-performance materials. Filamentous fungi represent a promising solution, as they function as living foundries that transform low-value biomass into advanced, self-assembling materials. While mycelium-based composites have proven potential, progress has been predominantly driven by empirical screening of fungal species and substrates. To unlock their full potential, a paradigm shift from empirical screening to rational design is required. This review introduces a conceptual framework centered on the biochemical programming of the fungal cell wall. Viewed through a materials science lens, the cell wall is a dynamic, hierarchical nanocomposite whose properties can be deliberately tuned. We analyze the contributions of its principal components—the chitin–glucan structural scaffold, the glycoprotein functional matrix, and surface-active hydrophobins—to the bulk characteristics of mycelium-derived materials. We then identify biochemical levers for controlling these properties. External factors such as substrate composition and environmental cues (e.g., pH) modulate cell wall architecture through conserved signaling pathways. Complementing these, an internal synthetic biology toolkit enables direct genetic and chemical intervention. Strategies include targeted engineering of biosynthetic and regulatory genes (e.g., CHS, AGS, GCN5), chemical genetics to dynamically adjust synthesis during growth, and modification of surface chemistry for specialized applications like tissue engineering. By integrating fungal cell wall biochemistry, materials science, and synthetic biology, this framework moves the field from incidental discovery toward the intentional creation of smart, functional, and sustainable mycelium-based materials—aligning material innovation with the imperatives of the circular bioeconomy. Full article

This article presents an analysis of wastewater inflow to a treatment plant and the impact of incidental (stormwater) inflow on the variability of its volume and quality. The study was conducted over a four-year period and showed that the average daily inflow of wastewater was 1133.2 m³ per day, which accounted for 56.7% of the plant’s design capacity. The variability of wastewater inflow was found to be significant, with stormwater having a considerable effect on increasing the volume of wastewater, especially during days with intense rainfall. Depending on precipitation levels, incidental water contributed between 12.2% and 46.2% of the total wastewater inflow. The analysis of the influent wastewater quality indicated a high variability in the concentrations of key pollution indicators. Despite this, the treatment processes in the membrane bioreactors (MBR) proved effective, consistently maintaining pollutant concentrations in the effluent below permissible limits. The conclusions highlight the necessity of considering stormwater in the design and operation of wastewater treatment plants to ensure their effective performance. Full article

Background: Parathyromatosis, an exceptional clinical and pathological entity, involves multiple small nodules of hyper-functional parathyroid tissue scattered throughout the neck and/or mediastinum, in relationship with a prior parathyroidectomy (mostly) or embryologic remnant. Since its first identification in 1975, many aspects of this condition have remained a matter of debate. Objective: We introduce an updated perspective on parathyromatosis covering the main clinical points for everyday practice, from diagnosis to management, as well as the current level of pathogenic understanding. Methods: A narrative review. Results: A total of 22 patients were identified, with the following characteristics: an age range of 33–68 (mean 46.18) years; 4/22 subjects <40 years; female-to-male ratio = 14:8. Of the 22 subjects, 21 had undergone previous parathyroidectomy for primary (n = 14) or secondary (n = 7) hyperparathyroidism. One case was a surgically naïve patient. Analysis of the surgical procedures (seeding circumstances) revealed the following: parathyroid cyst removal, left/right parathyroidectomy; removal of 3.5 parathyroids ± self-transplantation, VATS for mediastinal parathyroid tumours. Parathyroidectomy was accompanied by thyroid surgery (n = 3 patients), specifically hemi-thyroidectomy, partial left-thyroid lobectomy, and partial thyroidectomy. The shortest timeframe from parathyroidectomy to parathyromatosis-related hyperparathyroidism recognition was 1 year, and the longest was 17 years. The highest number of previous surgeries was four. The recognition of parathyromatosis was due to the clinical picture of associated hyperparathyroidism, except for in 2/21 cases with incidental detection. The implant sites coincided with the prior surgical area, but also with unusual locations (clavicle, pleura, mediastinum, sternocleidomastoid muscle and forearm, thyroid). The imaging evaluation included ultrasound plus CT plus 99m-Tc sestamibi scintigraphy, as well as (variable rates) neck MRI, SPECT/CT, 11-Choline PET-CT, Gallium-68 DOTATATE, and 4D CT. Surgery implied serial procedures in some cases (e.g., up to seven). The surgery spectrum largely varied, including not only cervicotomy, but also thoracoscopy, VATS, pericardial adipose tissue excision and thymectomy, etc. Conclusions: Awareness remains a key factor when approaching such an unusual ailment underlying little-understood pathogenic loops, which, if left unrecognized and untreated, might impair patients’ quality of life and the overall parathyroid disease burden. Full article

Hepatic actinomycosis (HA) and IgG4-related inflammatory pseudotumors are rare and often overlooked causes of liver mass, which can easily be misdiagnosed as primary liver cancer or metastasis. Diagnosis is arduous due to unspecified clinical and radiological features and the fact that histology is not always conclusive. In cases of actinomycosis, the use of molecular diagnostic techniques—such as polymerase chain reaction (PCR) for bacterial DNA—can aid in establishing a definitive diagnosis, especially when conventional cultures are non-diagnostic. We present a case report of one of our patients who was incidentally diagnosed with a hepatic lesion presenting aspecific radiological features. Since radiological imaging was inconclusive, a biopsy was performed, and a diagnosis of IgG4 related hepatic inflammatory pseudotumor was then made. Because of the disease progression, during immunosuppressive therapy, our diagnosis was questioned and a new liver biopsy was carried out. At the end, it took three consequent biopsies to finally find out the presence of an actinomyces infection. Full article

Background: Polypoid endometriosis is a rare variant of endometriosis that presents as a tumorous mass, making it difficult to differentiate it from a malignant tumor. It usually occurs in perimenopausal women or those undergoing hormone therapy, and its presence in a young pregnant woman is extremely uncommon. Case Presentation: This article describes a rare instance of polypoid ovarian endometriosis in a pregnant woman, a condition with few documented cases in the medical literature. An adnexal mass was discovered incidentally during a routine prenatal ultrasound, with imaging features that raised the suspicion of a neoplastic process and prompted surgery to exclude malignancy. However, histopathological examination of the excised lesion confirmed features compatible with polypoid endometriosis, without revealing evidence of cancer. This case highlights the diagnostic challenges of differentiating polypoid endometriosis from ovarian neoplasms, especially during gestation, where imaging findings can be ambiguous. In addition, the hormonal environment inherent in pregnancy may exacerbate the proliferative behavior of endometriotic lesions, thus complicating clinical evaluations. The presence of an adnexal mass in such a setting often requires careful evaluation to balance the risks of surgery with the potential consequences of delayed diagnosis. The data presented emphasize the importance of an accurate diagnosis. In conclusion, a well-coordinated approach ensures the protection of maternal and fetal health. Conclusions: By prioritizing accurate diagnosis and personalized treatment plans, physicians can minimize complications and improve outcomes for both mother and child. Full article

Background: Hepatic splenosis (HS) is a rare para-physiological condition resulting from the ectopic implantation of splenic tissue, most commonly following traumatic or surgical splenectomy. Its radiological features can mimic those of hepatocellular carcinoma (HCC), potentially leading to misdiagnosis and unnecessary invasive procedures, such as biopsies or liver resection. Methods: A literature review was conducted using the PubMed database to identify all reported cases of HS. Case Presentation: We report the case of a 52-year-old male with an incidental finding of a liver lesion in segment V, initially suspected to be HCC, and a history of post-traumatic splenectomy. The patient had no history of underlying liver disease. Due to the lesion’s superficial location, a biopsy was not performed because of the risk of tumor rupture with subsequent bleeding or peritoneal seeding. Consequently, the patient underwent upfront laparoscopic anatomic segmentectomy of segment V. Final pathology revealed a diagnosis of intrahepatic splenosis. Conclusions: HS should be considered in the differential diagnosis of liver lesions in patients with a history of splenectomy but no underlying liver disease, particularly when imaging shows features suggestive of HCC, such as arterial phase hyperenhancement and portal venous washout. Awareness of this entity may prevent unnecessary invasive interventions and guide appropriate patient management. Full article

Intraosseous hibernoma (IOH) is a rare benign tumor composed of brown adipose tissue within the bone, frequently mimicking metastatic lesions and leading to diagnostic challenges. This systematic review aimed to consolidate and analyze all published IOH cases to improve recognition and inform management. A comprehensive literature search was conducted in PubMed, Web of Science, Scopus, Google Scholar, and the Cochrane Library from database inception to March 2025. Studies were eligible for inclusion if they reported histopathologically confirmed cases of intraosseous hibernoma (IOH) in human patients. A total of 62 cases from 30 studies were included. The mean age was 59.2 years, with a female predominance. Lesions were most frequently located in the pelvis and spine and were typically identified incidentally during cancer staging or imaging performed for unrelated indications. Imaging often revealed sclerotic patterns on computed tomography (CT), hyperintense signals on magnetic resonance imaging (MRI) T2-weighted and short tau inversion recovery (STIR) sequences, and mild to moderate uptake on ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT). Immunohistochemistry consistently showed S100 protein positivity. Most patients underwent biopsy and were managed conservatively, with no cases of malignant transformation reported. IOH is a benign entity with distinctive radiologic and immunohistochemical features that may mimic malignancy. Awareness of its presentation can reduce misdiagnosis and unnecessary interventions, supporting biopsy-based confirmation and conservative management in most cases. Full article

Maxillary sinus abnormalities, including retention cysts and mucosal thickening, are often incidental findings and may be present in up to 35.6%, depending on imaging modality and population characteristics. To date, few studies have explored the appearance of maxillary sinus retention cysts using MRI. Aim: This study provides the first large-scale MRI-based assessment of these lesions, with the aim of evaluating the prevalence and characteristics of maxillary sinus abnormalities detected incidentally on head MRI scans, particularly focusing on retention cysts and mucosal changes. Materials and Methods: A retrospective analysis of 3092 head MRI scans obtained between 2023 and 2024 was conducted to assess the prevalence and characteristics of maxillary sinus abnormalities. The mean patient age was 54.5 ± 18.6 years (median 56; range 18–99 years), with 1,825 women (59%). Statistical power exceeded 83% to detect differences of at least 10% in the prevalence of cysts between age groups (α = 0.05). A simplified MRI-based sinus assessment scale was used to categorize findings. Results: Out of 3092 scans, 1995 (64.5%) showed normal sinuses, 817 (26.4%) had mucosal thickening < 5 mm, 116 (3.8%) presented with retention cysts without other pathology, 100 (3.2%) exhibited moderate changes, and 64 (2.1%) had severe changes. Cysts were significantly more frequent in men (7.5%) than in women (4.4%) (p < 0.001). Additionally, maxillary sinus involvement differed significantly between sexes, with a higher prevalence in men. Conclusions: Incidental maxillary sinus findings are common and often benign. A comprehensive diagnostic approach is essential, especially for unilateral lesions near tooth roots. Conservative management remains appropriate for asymptomatic patients, but ongoing monitoring and patient education are key to preventing complications. Full article

The European spruce bark beetle, Ips typographus (Linnaeus, 1758), poses a significant threat to Picea abies (Linnaeus) Karsten, 1881 forests, with outbreaks often exacerbated by abiotic disturbances like the 2018 Vaia windstorm in the Italian Alps. Pheromone-baited traps are widely used for control, yet their overall efficacy and potential side effects, particularly the incidental capture of non-target insects, remain debated. This study aimed to comprehensively assess the presence and composition of non-target insects in I. typographus pheromone traps, used for both mass-trapping and monitoring, in the affected Alpine regions. We took into account single monitoring traps (dry collection) and three-trap cross configurations for mass-trapping (with preservative liquid), collecting and morphologically identifying insect by-catch. Our results revealed a non-target proportion (excluding bark beetles) significantly higher in mass-trapping (4.15%) compared to monitoring (1.00%), with approximately half being natural enemies of bark beetles. Crucially, we report that bark beetle parasitoids were repeatedly caught, with Tomicobia seitneri (Ruschka, 1924) (the third most abundant non-target species) particularly well represented, and Ropalophorus clavicornis (Wesmaël, 1835) also detected, which is noteworthy given its ecological role despite its lower numbers. Our findings underscore the significant, previously underreported, capture of beneficial parasitoids and highlight the need for careful consideration of non-target catches in I. typographus pest management strategies. Full article