Ovarian cancer is a leading cause of cancer-related death in women. Cytoreductive surgery is the cornerstone of treatment, but frequently requires extensive surgical procedures.1 Frozen section analysis remains the reference for intraoperative differentiation between malignant and normal tissues; however, complementary real-time optical imaging technologies are being developed to support surgical decision-making through rapid tissue characterization directly at the surgical field.2-5 Probe-based confocal laser endomicroscopy (pCLE) is a novel real-time imaging technique that may help achieve this goal.6-8 PATIENTS AND METHODS: This video demonstrates the pCLE procedure step by step through two surgical cases: a 57-year-old woman affected by recurrent FIGO stage IIIB epithelial ovarian cancer (EOC) and a 40-year-old woman with a confirmed pathogenic BRCA2 mutation underwent laparoscopic bilateral adnexectomy as a prophylactic procedure. The real-time microscopic images were acquired using the GastroFlex™ UHD Confocal Miniprobe™ connected to the Cellvizio® system (Mauna Kea Technologies, France), which provided illumination at a wavelength of 488 nm. In vivo pCLE images and subsequent biopsies were acquired from various anatomical sites after injection of fluorescein. Each endomicroscopic sequence was analyzed by dedicated investigators highly experienced in pCLE imaging and compared with the histology of the corresponding specimen. Normal tissues exhibited uniform stromal fibers, consistent cellular architecture, and regular vascularization. In contrast, malignant nodules were identified by fluorescein leakage, reflecting abnormal vessel permeability and highlighting clusters of neoplastic cells. Preliminary data from our observations indicate a substantial concordance between pCLE findings and histology. pCLE is a promising intraoperative tool for real-time cellular analysis.

While the clinical focus on the sentinel lymph node biopsy (SLNB) is the presence of intra- or extra-nodal metastases, preclinical studies suggest that tumor-draining SLNB-associated vascular architecture and adhesion properties are altered regardless of SLNB positivity. Human intravital microscopy (HIVM) has defined blood vessel abnormalities that may impact lymphocyte adhesion and systemic drug delivery at primary melanoma sites. In this pilot study of HIVM during melanoma SLNB, we sought to determine the feasibility of obtaining HIVM observations of SLNB-associated vessels. We successfully performed HIVM in all 20 SLNB patients, and 7 were found to have nodal micrometastases by standard pathology. HIVM was capable of identifying both functional and non-functional SLNB-associated vessels based on the presence or absence of fluorescent dye uptake, respectively. Comparing vessel characteristics as a secondary exploratory objective, no statistically significant differences were noted in the diameter, flow rate, functionality, or shear stress of SLNB-associated blood vessels between positive and negative SLNBs, which may likely have been a reflection of the minimal disease burden. Nonetheless, these initial observations provide the framework to optimize future trials of HIVM in cancer patients.

Female genital schistosomiasis (FGS) is a neglected but highly prevalent disease in sub-Saharan Africa, caused by Schistosoma haematobium egg-induced inflammation in the pelvic region. FGS is characterized by four mucosal lesion types in the lower female genital tract: grainy sandy patches (GSP), homogeneous yellow sandy patches, abnormal blood vessels, and rubbery papules. This study focuses on the segmentation of cervical GSP lesions using a deep-learning convolutional neural network. A total of 583 cervical images from women in a S. haematobium endemic region of Madagascar, all exhibiting FGS-associated lesions, particularly GSP lesions, were used for this study. Weak annotations (non-pixel-wise) were generated using QubiFier software. A U-Net model with a focal loss function, and an Adam optimizer was trained to segment GSP lesions. A 5-fold cross validation was performed, thus resulting in 5 models. The models were evaluated on a dedicated test set, where model predictions were compared to the annotations. The average results of the models after cross validation were a DICE score of 0.61, accuracy of 0.81, sensitivity of 0.84, and specificity of 0.81. While the models performed well, the performance was affected by factors such as weak annotations, limited number of images, and image quality issues in the form of artifacts like specular reflections. These findings highlight the potential of U-Net-based models for automated lesion segmentation of FGS. Integration of such models into smartphone-based diagnostic tools could enable real-time detection and possible diagnosis of FGS in regions lacking specialized medical equipment or expertise. This approach may enhance access to early diagnosis, particularly in rural and underserved areas of sub-Saharan Africa, where FGS remains a significant public health burden. Future work should focus on enhancing model performance, validating using external datasets, and exploring feasibility for mobile integration, offering a cost-effective solution for point-of-care FGS detection.

Non-neuronal cell microenvironment control retinal vascular remodeling by CST3 in the oxygen-induced retinopathy in mice.

Fluorinated ROS-responsive polycation enables noninvasive siRNA Delivery for the treatment of corneal neovascularization.

Congenital pulmonary vein atresia (PVA) is a rare condition often associated with vascular anomalies and complex pulmonary hemodynamics. A 54-year-old woman was referred for evaluation of a nodular shadow in the right upper lobe, initially suspected to represent a pulmonary arteriovenous malformation (PAVM). Four-dimensional enhanced computed tomography (4D-CT) revealed no abnormal vessels, suggesting a PAVM in the pulmonary arterial phase. However, in the venous phase, the pulmonary vein of the right upper lobe was occluded at the trunk, with reflux via a pulmonary vein varix and an abnormal vein draining into the pulmonary vein of the right middle lobe. Due to the risk of pulmonary hypertension, thromboembolism, or varix rupture, the patient underwent right upper lobectomy. 4D-CT effectively delineates the vascular morphology by separating the pulmonary arterial and venous phases. Congenital PVA may involve pulmonary vein varices and abnormal vascular formation; 4D-CT may be valuable for diagnosis and treatment planning.

Repairing abnormal vessels in the complex fluidic and biological environment of blood remains challenging. Current approaches, such as non-adhesive polymeric sealants or vessel coiling, have unsatisfactory outcomes. Here, we present an injectable magnetoactive adhesive hydrogel (iMAH) for vascular repair in the challenging blood environment. Designed with biocompatible functional components, including the superparamagnetic component, a bio-inspired tissue adhesive, and quick-crosslinking agents, the catheter-deployable iMAH can be magnetically guided to a targeted site, quickly crosslink within approximately 2s, and strongly adhere to the vessel surface in dynamic conditions with circulating and pressurized blood. Moreover, magnetic actuation enables targeted gel deployment and can drive the iMAH into a narrow and confined space, squeezing out interfacial fluid to facilitate high-strength tissue adhesion, as systematically investigated in vitro. Magnetically controlled delivery of iMAH for vascular repair has been demonstrated in a large-animal beagle dog model; branching lumbar arteries from the abdominal aorta, mimicking the opening of a ruptured artery, were successfully embolized under magnetic guidance using a 5-axis magnetic vascular robot. With these demonstrated features, magnetically controlled delivery of injectable magnetoactive adhesive hydrogel provides a promising solution for vascular repair such as sealing ruptured vessels or embolizing abnormal arteries in the challenging blood environment.

Lymphatic dysfunction can manifest through a spectrum of clinical features, including lower limb lymphoedema and pulmonary complications such as recurrent pleural effusions. Diagnosing underlying lymphatic abnormalities remains challenging due to nonspecific symptoms and limited imaging options. This case study describes a man hospitalised for a left-sided pneumothorax followed by recurrent pleural effusions and peripheral oedema. Using non-contrast MR lymphangiography and near-infrared fluorescence imaging, lymphatic vessel abnormalities were visualised in the extremities. Imaging also revealed thoracic lymphangiectasia and dilated lymphatic vessels, resembling abnormalities observed in patients with a Fontan circulation who experience pleural effusions. This combined imaging approach shows promise for evaluating complex lymphatic phenotypes and may enable more personalised treatment strategies for patients with these symptoms.

The maritime industry is undergoing a rapid digital transformation, driven by the adoption of technologies such as the Automatic Identification System (AIS), advanced navigation software, and onboard Internet of Things (IoT) sensors. These innovations have significantly improved operational efficiency, safety, and situational awareness. However, this increasing reliance on interconnected digital systems also expands the sector’s exposure to cyber threats. Traditional rule-based monitoring and siloed intrusion detection systems often fail to identify coordinated multi-modal attacks, leaving vessels vulnerable to sophisticated, stealthy intrusions. The dual nature of this transformation underscores the urgent need for more sophisticated and adaptive cybersecurity strategies. This study introduces VessiGuard, an AI-driven anomaly detection system designed to detect and mitigate abnormal vessel behaviour as an early indicator of potential cyber intrusions, system failures, or operational anomalies. The approach leverages two complementary artificial intelligence techniques: Long Short-Term Memory (LSTM) neural networks, which model temporal dependencies in vessel movement, and Isolation Forest algorithms, which excel at detecting rare and unusual behaviour patterns. By fusing navigational telemetry with operational technology (OT) sensor readings, specifically engine temperature and fuel consumption, the model creates a unified, cross-domain anomaly score that is robust against single-variable manipulation. A prototype anomaly detection system was implemented and evaluated using controlled simulation and publicly available maritime datasets that reflect real-world operational scenarios. Results demonstrate that VessiGuard effectively detects anomalies, including GPS spoofing, sensor drift, and structured interference. Experimental validation indicates a detection accuracy of approximately 94.2% for trajectory anomalies and 92.8% for sensor deviations. Furthermore, the system demonstrates modality-specific responsiveness, identifying operational sensor faults in under four minutes while accurately accumulating evidence for trajectory deviations within five to eight minutes. This work presents a practical pathway towards adaptive, data-driven cybersecurity solutions by situating anomaly detection within the broader maritime operational ecosystem. The findings highlight how AI-based anomaly detection can complement existing maritime defence mechanisms, support decision-making under dynamic threat conditions, and improve incident response readiness. Furthermore, the results lay the groundwork for future research into autonomous and semi-autonomous detection architectures, ultimately contributing to a more resilient, secure, and intelligence-driven digital maritime domain.

Purpose Retinopathy of prematurity (ROP), a leading cause of visual impairment and blindness in preterm infants, is characterized by abnormal retinal vascular development, including tortuous arterioles and abnormally dense capillaries. Dysregulated production of vascular endothelial growth factor (VEGF) and disrupted interactions between glial and vascular cells contribute to its pathogenesis. This study investigated the effects of aflibercept, a clinically used anti-VEGF drug, and KRN633, a VEGF receptor tyrosine kinase inhibitor, on abnormal retinal vasculature and astrocyte distribution in a rat model of ROP. Methods ROP was induced in neonatal rats by subcutaneous injections of KRN633 on postnatal day (P) 7 and P8. Arteriolar tortuosity, capillary density, mammalian target of rapamycin complex 1 (mTORC1) activity (as indicated by phosphorylation of S6 protein [pS6]), and the distribution of glial fibrillary acidic protein (GFAP)-positive astrocytes were evaluated. Results In ROP model rats, tortuous arterioles and dense capillary plexuses were observed. At the vascular front, many vascular endothelial cells lacked GFAP-positive astrocyte coverage and exhibited strong pS6 immunoreactivity. Treatment with aflibercept or KRN633 significantly reduced capillary density and pS6-positive blood vessels at the vascular front. Following treatment, most vascular endothelial cells were covered by GFAP-positive astrocytes. However, neither aflibercept nor KRN633 ameliorated arteriolar tortuosity. Conclusion These findings suggest that pathological angiogenesis in ROP is mediated through VEGF- and mTORC1-dependent mechanisms. Anti-VEGF therapies may help restore glial–vascular interactions by reducing abnormal blood vessels in the ROP retina.

Aberrant tumor vasculature is a major barrier limiting the efficacy of immunotherapy, including chimeric antigen receptor T-cell (CAR-T) therapy in solid tumors, by restricting T cell infiltration and impairing their functional activity. Glioblastoma (GBM), one of the most vascularized and immunotherapy-refractory cancers, exemplifies these challenges with its highly abnormal vessels and profoundly immune-cold microenvironment. Single-cell transcriptomic analysis of GBM samples suggests that endothelial-to-mesenchymal transformation (Endo-MT) is a key mechanism contributing to vascular abnormalities. Here, we conduct functional screening using a curated chemical library and identify erianin, a natural small-molecule compound, as a potent inhibitor of Endo-MT, thereby normalizing tumor vasculature and subsequently enhancing T cell infiltration in GBM mouse models. Importantly, erianin sensitizes GBM to Egfrviii CAR-T cell therapy and improves chemotherapy efficacy in preclinical models. Chemoproteomic and biophysical analyses reveal that erianin targets P4HA1 at the Arg379 site within the α-ketoglutarate (α-KG) binding pocket, leading to downregulation of the HIF1α/SNAIL/SLUG pathway, thereby restoring endothelial integrity by stabilizing VE-cadherin-mediated junctions and upregulating ICAM1 to enhance T-cell adhesion. These findings highlight erianin's potential to overcome vascular barriers and reprogram the tumor microenvironment, providing a novel therapeutic strategy to enhance immunotherapy in GBM and other solid tumors.

Moyamoya disease (MMD) is characterized by chronic progressive stenosis of intracranial vessels and subsequent formation of abnormal collateral vessel networks. Indirect revascularization techniques, such as encephalo-duro-arterio-synangiosis (EDAS), promote angiogenesis to restore perfusion but have variable success rates. This study aimed to identify clinical and radiographic predictors of successful collateral vessel ingrowth after EDAS, emphasizing the role of contralateral interhemispheric collaterals. We conducted a single-center retrospective analysis of cerebral hemispheres from adult MMD patients who underwent EDAS. We assessed demographic characteristics, clinical presentation, procedural details, clinical and radiographic outcomes. Angiographic outcomes were assessed using the Orbital Grading System. Univariate analysis was performed to identify factors associated with favorable postoperative collateral development. Consequently, preoperative contralateral interhemispheric collateralization was quantitatively evaluated through pixel density analysis on digital subtraction angiography (DSA), comparing the moyamoya-affected hemisphere to the contralateral hemisphere. 61 MMD hemispheres of 43 adult patients were included in the study. Median times to last clinical and angiographic follow up were 29.9 months and 13.6 months, respectively. Higher Suzuki-stages (V and VI; p=<0.01), occlusions of the anterior cerebral artery (ACA; p=0.03) and internal carotid artery (ICA; p=0.048) were associated with superior postoperative collateralization. The presence of robust contralateral collaterals on preoperative angiography significantly predicted poor postoperative neovascularization (p=0.01). Pixel density analysis showed that increased pixel density ratios of moyamoya-affected hemisphere to contralateral hemisphere significantly correlated with reduced postoperative collateral vessel formation (Orbital Grading System, OR=130.94, p=0.008; Matsushima grading system, OR=52.09, p=0.018). Higher Suzuki-stages, ACA and ICA occlusion predict successful neovascularization after EDAS. The presence of robust preoperative contralateral interhemispheric collaterals is an important predictor of poor collateral vessel ingrowth following EDAS. This finding suggests that such collateralization might reduce the local ischemic stimulus required for effective indirect revascularization. These findings could refine surgical decision-making by identifying patients who may be less likely to benefit from EDAS.

Intraoperative free flap failure necessitates prompt intraoperative decision-making on alternative reconstructive strategies. In this study, we investigate the etiology and management of intraoperative flap loss. Retrospective review between 2010 and 2024 at 6 institutions. There were 7423 free flaps performed with 46 instances of intraoperative flap failure (0.62%). The most common recipient subsite was oral cavity (27/46, 57%). Anterolateral thigh (ALT) was the most common flap type to fail (18/46, 39%), followed by the fibula (15/46, 32%). The most common reasons for total failure were clotting without observable vessel abnormality (12/35, 34.3%), poor quality perforator (11/35, 31.4%), and vessel spasm or intimal abnormality leading to clotting (8/35, 22.9%). The most common acute management was converting to an additional free flap intraoperatively (28/46, 60.9%). Flap failure intraoperatively is rare. The majority of cases were acutely managed with an additional flap to provide defect coverage.

Metabolic and functional aspects of high-density lipoproteins (HDL) in familial hypercholesterolemia with or without subclinical coronary atherosclerosis.

Large-caliber choroidal arteriovenous shunt in macular neovascularization: A brief report of a novel morphological finding.

Placental vascular remodeling in preeclampsia: A three-dimensional analysis of microvascular alterations across disease severity.

Each myocardial function parameter has limitations. The myocardial performance index (MPI) relies solely on cardiac time intervals and appears optimal. However, its accuracy may be compromised in fetuses with prolonged atrioventricular (AV) conduction time and variable fetal heart rate (FHR). We evaluated whether ejection fraction (EF) and fractional area change (FAC), assessed by two-dimensional speckle-tracking echocardiography (2D-STE), are less influenced by AV conduction time and FHR than MPI. We studied 468 fetuses without structural, hemodynamic, or major vessel abnormalities. Fetuses with AV time >90th percentile for the corresponding trimester comprised the study group. MPI and its components, AV time, and FHR were measured using simultaneous left ventricular (LV) inflow and outflow pulsed-wave Doppler (PWD) recordings. LV EF and FAC were assessed via 2D-STE. AV time correlated strongly with isovolumic contraction time (ICT) in both the second (r = 0.73, p < 0.001, after Bonferroni correction) and third trimesters (r = 0.63, p < 0.001). AV time showed moderate correlation with MPI in both trimesters (second: r = 0.41; third: r = 0.34; p < 0.001). MPI increased significantly with prolonged AV time. EF and FAC remained robust and independent regardless of AV time or FHR changes. A significant negative correlation between FHR and ejection time (ET) was observed in both trimesters (second: r = -0.56; third: r = -0.60; both p < 0.001). Logistic regression identified MPI as the sole parameter discriminating between groups (AUC >0.7), whereas EF and FAC showed no discrimination (AUC ≈0.5). This study demonstrated that the LV MPI showed a significant dependence on AV conduction time. In contrast, LV EF and FAC, calculated using 2D-STE, remained robust and independent of variations in AV conduction time and FHR in healthy fetuses.

Background: The liver is the largest gland of the body, can be considered a chemical factory that manufactures, stores, alters, and excretes a large number of substances involved in metabolism. The location of liver is essential in this function because it receives nutrients–rich blood directly from the gastrointestinal (GI) tract and then either stores or transforms these nutrients into chemicals that are used elsewhere in the body for metabolic needs. Cirrhosis is a chronic progressive disease of the liver characterized by extensive degeneration and destruction of the liver parenchymal cells. The liver cells attempt to regenerate, but the regenerative process is disorganized, resulting in abnormal blood vessel and bile duct architecture. Aims: (1) To assess the existing knowledge regarding of alcoholic cirrhosis among diploma students. (2) To determine the effectiveness of structure teaching programme regarding alcoholic cirrhosis among diploma students. (3) To find out the association between post-test knowledge level regarding alcoholic cirrhosis among diploma students. With their selected socio- demographic variables. Materials and Methods: Study approach this was a qualitative study and follow the ìexamination plan as pre-exploratory, for example one gathering pre –test and post –test without control group. The population associated with this investigation was diploma students studying at bvvs institute of poly technic college at Bagalkot. Test size is 50 (Total) diploma students were redeemed for the investigation. Further information was gathered by organized shut finished information poll. Results: The knowledge level of the students regarding alcoholic cirrhosis showed that in pretest scores, majority (6%) of the sample had average knowledge, (44%) had poor knowledge and (0%) had good knowledge on alcoholic cirrhosis where as in post test score all of them had very good knowledge and (92%) had average knowledge on alcoholic cirrhosis. Interpretations and

Female genital schistosomiasis (FGS) remains an important neglected tropical disease with significant reproductive health consequences for women in endemic regions of sub-Saharan Africa. A cross-sectional survey was conducted among 529 females aged 15–50 years across six local government areas. Participants underwent structured interviews and colposcopic examinations to document gynaecological symptoms and characteristic lesions, including sandy patches, grainy sandy patches, rubbery papules, contact bleeding, and abnormal blood vessels. Logistic regression models were applied to identify independent predictors of FGS. The most frequent colposcopic findings were contact bleeding (10.8%) and grainy sandy patches (9.3%), while the predominant self-reported symptoms included vaginal itching (66.2%), vaginal discharge (60.0%), dysuria (47.2%), and lower abdominal pain (44.7%). Multivariate analysis revealed that vaginal bleeding (adjusted odds ratio [aOR] = 2.33, p &lt; 0.001) and postcoital bleeding (aOR = 1.77, p = 0.005) were independently associated with FGS.

To investigate the clinicopathological characteristics of neuroendocrine(NE) cell dysplasia in gastric oxyntic gland mucosa. The clinical data of the patients with gastric mucosal NE cell dysplasia who underwent endoscopic submucosal dissection or endoscopic mucosal resection treatment at Xiangcheng County People's Hospital and the 989th Hospital of the Joint Logistics Support Force from January 2011 to October 2024 were retrospectively included. The clinical and endoscopic manifestations of the patients were analyzed, and their pathological morphological characteristics were observed in combination with immunohistochemical staining. A total of 15 patients were included, aged 54 years (32-69 years), including 6 males and 9 females. There were a total of 25 lesions (4 and 3 patients with 2 and 3 lesions, respectively) lincluding 21 lesions in the gastric body (84.0%) and 4 lesions in the gastric fundus (16.0%). Paris classification: 24 cases (96.0%) were classified as 0-Ⅱa type, 1 case (4.0%) as 0-Ⅱc type, with a median lesion diameter of 11.0 mm (2.0-36.0 mm). Narrowband imaging under endoscopy showed glandular duct disorder and abnormal blood vessels, and the mucosal features were consistent with autoimmune gastritis changes. Histological examination showed intrinsic glandular atrophy accompanied by intestinal metaplasia, and NE cells in mucosal hyperplasia presented as solid micro nodules (≤150 μm), arranged in a beam or glandular pattern. Enlarged micro nodules (>150 μm), fusion, sprout, and micro infiltration foci or single-cell infiltration can be seen, as well as nodules with newly formed stroma. It can be seen that the nodules are located within the mucosal muscle or above the lamina propria. Immunohistochemistry showed positive synaptic and chromaffin in NE cells, with nodules smaller than 0.5 mm in diameter and no submucosal infiltration. Sixteen (64.0%) cases of dysplasia lesions were accompanied by G1 grade neuroendocrine tumors, with continuous cell shape and unclear boundaries between the two. Gastric NE cell dysplasia is a precursor lesion of neuroendocrine tumors, and the key to diagnosis lies in identifying interstitial infiltration.