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Background: Russo-Ukrainian war is associated with severe traumas, including injuries to the major vessels. Penetrating aortic injury remains one of the most difficult injuries; the mortality rate is 90–100% in case of gunshot wounds, associated with frequent lethal outcomes due to uncontrolled bleeding. Of the three main abdominal veins, the inferior vena cava (IVC) is the most frequently damaged, which is required quick and appropriate surgical decisions to be made. Little is known about the management of gunshot injuries to such major vessels as the aorta and IVC. It is also worth mentioning about the importance to share our practical experience from the ongoing war for better understanding and future considerations by war surgeons of the vascular trauma management. The aim of the study was to demonstrate the specific features of the diagnosis and management of a gunshot shrapnel blind penetrating wound to the abdomen with injury to the aortic bifurcation level and the infrarenal section of the inferior vena cava. Case presentation: A 44-year-old male soldier of the Armed Forces of Ukraine received a gunshot injury to the abdomen from a mortars' explosive shelling. The patient was evacuated to the Forward Surgical Team (Role 1) and received primary surgical treatment within one hour after the injury according to the "golden hour" principle. Then, evacuated was performed to the Role 3 hospital in Kharkiv. At the Role 3 hospital, the patient underwent second-look surgery as well as damage control surgery. At revision, no active bleeding was observed, and the surgical pads (packed previously by the Forward Surgical Team) were removed. Further revision showed a metal projectile within the aortic wall at the level of aortic bifurcation and wall defects were also detected for inferior vena cava. This metal projectile was removed by using the multifunctional surgical magnetic tool followed by suturing of the aortic wall defect as well as defects of the inferior vena cava. Conclusions: Application of Damage Control Surgery is a useful approach in the management of severe vascular injury as well as useful to stop abdominal contamination by intestinal contents. The application of a surgical magnetic tool for the searching and removal of ferromagnetic foreign bodies reduces operative trauma and reduces the time for identification of foreign bodies. [ABSTRACT FROM AUTHOR]

Study Objective Design Setting Participants Main Outcome Measures Results Conclusions To investigate the aetiology of vaginal bleeding and discharge in prepubescent girls, and the utility of vaginoscopy for making a diagnosis.Retrospective observational study over 14 years.Two major tertiary referral paediatric hospitals in Sydney, Australia.All prepubescent girls (n = 104) who presented with vaginal bleeding and/or discharge and subsequently underwent a vaginoscopy. A total of 120 procedures were performed.Surgical findings at vaginoscopy; number needed to investigate (NNI) to establish a diagnosis and to exclude malignancy.There were 52/120 (43.3%) vaginoscopies which provided a positive diagnosis, including 36/86 (41.8%) performed for bleeding and 16/34 (47.0%) for vaginal discharge. In the vaginal bleeding group, the causes found were a foreign body in 11/86 (12.7%), vulvovaginitis in 6/86 (6.9%), benign Mullerian papilloma in 5/86 (5.8%), trauma in 4/86 (4.6%), and malignant tumours in 2/86 (2.3%). To establish a diagnosis in girls presenting with vaginal bleeding, the NNI was 2.4; to detect a malignancy the NNI was 43.0. In girls presenting with vaginal discharge, vulvovaginitis was noted intraoperatively in 7/34 (20.6%) and a foreign body was found in 7/34 (20.6%). No malignant tumours were identified in the vaginal discharge group. To establish a diagnosis in girls presenting with vaginal discharge, the NNI was 2.1.Vaginoscopy is an important diagnostic tool in the setting of vaginal bleeding in prepubescent girls, allowing the ability to confirm a diagnosis, and importantly, to exclude malignancy. [ABSTRACT FROM AUTHOR]

Polymeric elastomers are extensively employed to fabricate implantable medical devices. However, implantation of the elastomers can induce a strong immune rejection known as the foreign body response (FBR), diminishing their efficacy. Herein, we present a group of immunocompatible elastomers, termed easy-to-synthesize vinyl-based anti-FBR dense elastomers (EVADE). EVADE materials effectively suppress the inflammation and capsule formation in subcutaneous models of rodents and non-human primates for at least one year and two months, respectively. Implantation of EVADE materials significantly reduces the expression of inflammation-related proteins S100A8/A9 in adjacent tissues compared to polydimethylsiloxane. We also show that inhibition or knockout of S100A8/A9 leads to substantial attenuation of fibrosis in mice, suggesting a target for fibrosis inhibition. Continuous subcutaneous insulin infusion (CSII) catheters constructed from EVADE elastomers demonstrate significantly improved longevity and performance compared to commercial catheters. The EVADE materials reported here may enhance and extend function in various medical devices by resisting the local immune responses. Fibrous capsule formation limits the lifetime of implanted devices. Here, the authors report on an elastomer designed to reduce the immune response which shows enhanced device utility in both mice and non-human primate models, including in an insulin infusion catheter model. [ABSTRACT FROM AUTHOR]

Purpose: Fibroblast activation protein (FAP)-inhibitor (FAPI)-PET tracers allow imaging of the FAP-expressing cancer associated fibroblasts (CAF) and also the normal activated fibroblasts (NAF) involved in inflammation/fibrosis that may be present after invasive medical interventions. We evaluated [68Ga]Ga-FAPI-46 uptake patterns post-medical/invasive non-systemic interventions. Methods: This single-center retrospective analysis was conducted in 79 consecutive patients who underwent [68Ga]Ga-FAPI-46 PET/CT. Investigators reviewed prior patient medical/invasive interventions (surgery, endoscopy, biopsy, radiotherapy, foreign body placement (FBP) defined as implanted medical/surgical material present at time of scan) and characterized the anatomically corresponding FAPI uptake intensity both visually (positive if above surrounding background) and quantitatively (SUVmax). Interventions with missing data/images or confounders of [68Ga]Ga-FAPI-46 uptake (partial volume effect, other cause of increased uptake) were excluded. Available correlative FDG, DOTATATE and PSMA PET/CTs were analyzed when available. Results: 163 medical/invasive interventions (mostly surgeries (49%), endoscopies (18%) and non-surgical biopsies (10%)) in 60 subjects were included for analysis. 43/163 (26%) involved FBP. FAPI uptake occurred in 24/163 (15%) of interventions (average SUVmax 3.2 (mild), range 1.5–5.1). The median time-interval post-intervention to FAPI-PET was 47.5 months and was shorter when FAPI uptake was present (median 9.5 months) than when absent (median 60.1 months; p = 0.001). Cut-off time beyond which no FAPI uptake would be present post-intervention without FBP was 8.2 months, with a sensitivity, specificity, positive predictive value and negative predictive value of 82, 90, 99 and 31% respectively. No optimal cutoff point could be determined when considering interventions with FBP. No significant difference was detected between frequency of [68Ga]Ga-FAPI-46 and [18F]FDG uptake in intervention sites. Compared to [68Ga]Ga-PSMA-11, [68Ga]Ga-FAPI-46 revealed more frequent and intense post-interventional tracer uptake. Conclusion: [68Ga]Ga-FAPI-46 uptake from medical/invasive interventions without FBP appears to be time dependent, nearly always absent beyond 8 months post-intervention, but frequently present for years with FBP. [ABSTRACT FROM AUTHOR]

The Federal Aviation Administration (FAA) is developing new design procedures to extend airport pavement life beyond 20 years based on the concept of serviceability: the measure of how well a pavement fulfills user expectations. A key element is a new distress megaindex called serviceability level (SL) whose components represent independent aspects of airport pavement serviceability: low foreign object damage (FOD) potential, low skid potential, and smoothness. This research validates the assumption of independence previously used to develop a probability-based form for SL. Independence greatly simplifies the mathematics of the new form, in particular, the ability to decompose a pavement condition model into multiple relatively simple submodels. Friction is shown to not correlate to the other two components. FOD and roughness are conditionally independent with a latent variable of crack and spall density. Conditional independence means the proposed SL formulation is generally valid but requires that FOD and roughness measurements or predictions be made at the same time using the same assumptions. [ABSTRACT FROM AUTHOR]

The presence of facial jewelry and medical devices within a radiographic field of view may promote the formation of artifacts that challenge diagnostic interpretation. The objective of this article is to describe a previously unreported radiographic anomaly produced by an oral piercing site below the lower lip. This unusual artifact masqueraded as a severe resorptive defect, dental caries, or cervical abfraction and occurred following removal of an extremely large labret below the lower lip and subsequent acquisition of a radiographic image. The radiolucency was ultimately attributed to an extensive aperture below the lower lip created by a series of sequentially larger soft tissue expanders. Clinicians should seek correlation of atypical radiographic presentations with soft tissue defects secondary to injury or intentional oral piercing. [ABSTRACT FROM AUTHOR]

Polymeric elastomers are widely utilized in implantable biomedical devices. Nevertheless, the implantation of these elastomers can provoke a robust foreign body response (FBR), leading to the rejection of foreign implants and consequently reducing their effectiveness in vivo. Building effective anti-FBR coatings on those implants remains challenging. Herein, we introduce a coating-free elastomer with superior immunocompatibility. A super-hydrophilic anti-fouling zwitterionic layer can be generated in situ on the surface of the elastomer through a simple chemical trigger. This elastomer can repel the adsorption of proteins, as well as the adhesion of cells, platelets, and diverse microbes. The elastomer elicited negligible inflammatory responses after subcutaneous implantation in rodents for 2 weeks. No apparent fibrotic capsule formation was observed surrounding the elastomer after 6 months in rodents. Continuous subcutaneous insulin infusion (CSII) catheters constructed from the elastomer demonstrated prolonged longevity and performance compared to commercial catheters, indicating its great potential for enhancing and extending the performance of various implantable biomedical devices by effectively attenuating local immune responses. The foreign body response remains a significant challenge for implants. Complicated coating procedures are usually needed to construct anti-fibrotic coatings on implantable elastomers. Herein, a coating-free elastomer with superior immunocompatibility was achieved using a zwitterionic monomer derivative. A pure zwitterionic layer can be generated on the elastomer surface through a simple chemical trigger. This elastomer significantly reduces protein adsorption, cell and bacterial adhesion, and platelet activation, leading to minimal fibrotic capsule formation even after six months of subcutaneous implantation in rodents. CSII catheters constructed from the PQCBE-H elastomer demonstrated prolonged longevity and performance compared to commercial catheters, highlighting the significant potential of PQCBE-H elastomers for enhancing and extending the performance of various implantable biomedical devices. [Display omitted] [ABSTRACT FROM AUTHOR]

Upper airway obstruction can occur suddenly and result in a patient's rapid deterioration. In this article we provide a structured approach to identifying those patients with acute airway compromise and stratifying them according to clinical urgency. This includes ways of distinguishing both the level of obstruction and its severity, based on the clinical signs and symptoms, and the role and timing of investigations. We describe the key aspects of emergency management, including temporizing measures and airway adjuncts. Management of rare, but important, situations are discussed such as post-thyroidectomy haematoma, occlusion of tracheostomy and laryngectomy stomas, and post-obstruction pulmonary oedema (POPE) is discussed. We describe the situation when an emergency surgical airway should be considered, along with our technique of performing one. [ABSTRACT FROM AUTHOR]

Purpose: Button battery nasal impactions pose serious risks due to complications and the need for prompt removal, yet research on interventions remains limited due to its rare occurrence. To delineate the clinical manifestations of nasal foreign bodies associated with button batteries and to explore treatment approaches focused on minimizing the reliance on general anesthesia and surgical interventions. Methods: This study focuses on 176 cases of children who received treatment for nasal cavity button battery impactions. It encompasses various factors including age, gender, battery location, impaction duration, methods of extraction, and associated complications. Results: The incidence of nasal button battery cases among nasal foreign body instances was 1.16%, with a majority being males (60.23%) aged 1–5 years (98.29%). Utilizing a specially designed nasal foreign body hook and following established treatment protocols enabled the successful outpatient management of the majority of cases. Only 12 cases (6.82%) necessitated removal under general anesthesia due to management challenges in an outpatient setting. Furthermore, our findings indicated no linear correlation between the duration of battery retention and the risk of nasal septal perforation, which was observed in 31 cases (17.61%). Conclusion: Nasal foreign bodies caused by button batteries in children demand urgent attention due to their potentially grave outcomes. Our research is directed towards enhancing diagnostic and therapeutic strategies to bolster the success rates of outpatient removal, curtail the duration of foreign body retention, and diminish the reliance on general anesthesia. [ABSTRACT FROM AUTHOR]

Although paediatric patients with gastrointestinal (GI) foreign bodies require multiple resources, they often present with few or no discernible symptoms and are typically assigned a low acuity level during triage. We compared the predictive accuracy of the revised Korean Triage and Acuity Scale (rKTAS), which elevates acuity by one step in relation to anticipated resource utilization, with that of the conventional KTAS for clinical outcomes. This was a retrospective study of National Emergency Department Information System data. Data on patient and ED characteristics, resources used, and clinical outcomes were collected from January 2018 to December 2021 for patients with GI foreign bodies aged under 19. The primary outcome was rKTAS accuracy in predicting hospitalization, ICU admission, operating room (OR) use, and ED length of stay (EDLOS). The AUROC was used to evaluate the performance via of the KTAS and rKTAS. In total, 25,324 paediatric patients visited the ED for GI tract foreign bodies. The mean age was 3.8 years, and 51% (12,923) were between 1 and 4 year old. Although most (23,658; 93.4%) were discharged, 4.9% required hospitalization. Two or more resources were utilized in 2514 (9.9%) cases, and 3,514 individuals had their triage levels increased by one step. Compared with those of the KTAS, the AUROCs of the rKTAS for predicting overall hospitalization (p < 0.05), admission to general wards (p < 0.05), ICU admission (p = 0.01), and admission via the OR (p < 0.05)were higher than KTAS. Compared with that with the KTAS, the EDLOS with the rKTAS was longer at levels 1, 2, and 3. The adjusted rKTAS is a better predictor of clinical outcomes for paediatric patients with GI tract foreign bodies than the KTAS. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to assess the effectiveness of capsule endoscopy in detecting gastric foreign bodies in normal dogs, considering variations in the number of foreign bodies and the gastric environment. Methods: Five healthy male beagles were administered virtual, non-harmful foreign objects that maintained their shape in the stomach. Capsule endoscopy was performed and the images were evaluated by veterinarians and nonveterinarians. Results: The overall sensitivity and specificity of capsule endoscopy were 99.1 and 90.4%, respectively. Sensitivity and specificity were comparable between veterinarians and non-veterinarians. Sensitivity and specificity in the veterinarian group were 98.7 and 91.2%, respectively, whereas those in the non-veterinarian group were 100 and 88.5%, respectively. Discussion: Capsule endoscopy is a valuable alternative diagnostic tool for identifying foreign bodies in the stomach, particularly in challenging cases in which conventional imaging or invasive approaches have limitations. [ABSTRACT FROM AUTHOR]

Background: Ingestion of foreign bodies may be seen unconsciously or intentionally in patients with mental health problems. Most cases pass through the esophagus slowly; however, in some cases, the tumor may be located in narrower areas of the digestive tract that require endoscopic or surgical intervention. This study describes a rare case of successful removal of more than 450 pieces of metal objects from the stomach of a 36-year-old man via ingestion of foreign bodies at Imam Khomeini Hospital in Ahvaz. Case presentation: A 36-year-old male patient (Aryan race) presented with complaints of chronic abdominal pain, frequent vomiting, and intolerance to liquids and food. The patient's companions mentioned a history of gradual ingestion of small metal objects 3 months prior. The patient was conscious and had stable vital signs. In the patient's X-ray and endoscopy, multiple metal objects inside the patient's stomach were observed, causing gastric outlet obstruction. The patient underwent gastrostomy surgery, and 452 screws, nuts, keys, stones, and other metal parts weighing 2900 g were removed from the stomach. Five days after the operation, the patient was transferred to the psychiatric service in good general condition and was diagnosed with psychosis, and her condition returned to normal at follow-up. Conclusion: Successful removal of this foreign body is rare. In chronic abdominal pain, especially in the context of psychiatric disorders, attention should be given to the ingestion of foreign bodies. In swallowing large amounts of sharp and metallic foreign objects, surgical intervention is necessary, especially in cases of obstruction, and saves the patient's life. [ABSTRACT FROM AUTHOR]

Introduction: This case report reports an unusual occurrence of gossypiboma, which refers to the accidental retention of surgical materials like sponges in the peritoneal cavity. The term is derived from "gossypium" (cotton) and "boma" (place of concealment). Its incidence varies with surgical type, posing diagnostic challenges due to nonspecific symptoms and equivocal imaging. Despite its rarity, gossypiboma poses significant risks, including intestinal obstruction and abscess formation. Case presentation: A 37-year-old woman with ten previous pregnancies and an emergent caesarean section presented with abdominal pain. Examination and ultrasound suggested an ovarian cyst. During surgery, a 10 × 10 cm gauze-filled mass adherent to the ovary and jejunum was found. Postoperatively, she recovered well with no complications. The patient was treated with intravenous fluids and antibiotics for five days post-surgery and recovered without any complications. She was discharged from the hospital five days after the procedure. Conclusion: To the best of our knowledge, this is the first reported case of gossypiboma in Sudan in 2024, highlighting diagnostic challenges and the need for preventive protocols. Root cause analysis of accidents, enhanced training, application of advanced technologies and a collaborative culture in the operating room can prevent the occurrence of such incidents. This case underscores the importance of meticulous surgical protocols and continuous improvement in safety measures to prevent retained surgical items, ensuring patient safety and optimal outcomes. [ABSTRACT FROM AUTHOR]

Foreign objects in coal flow easily cause damage to conveyor belts, and most foreign objects are often occluded, making them difficult to detect. Aiming at solving the problems of low accuracy and efficiency in the detection of occluded targets in a low-illumination and dust fog environment, an image detection method for foreign objects is proposed. Firstly, YOLOv5s back-end processing is optimized by soft non-maximum suppression to reduce the influence of dense objects. Secondly, SimOTA label allocation is used to reduce the influence of ambiguous samples under dense occlusion. Then, Slide Loss is used to excavate difficult samples, and Inner–SIoU is used to optimize the bounding box regression loss. Finally, Group–Taylor pruning is used to compress the model. The experimental results show that the proposed method has only 4.20 × 105 parameters, a computational amount of 1.00 × 109, a model size of 1.20 MB, and an mAP0.5 of up to 91.30% on the self-built dataset. The detection speed on the different computing devices is as high as 66.31, 41.90, and 33.03 FPS. This proves that the proposed method achieves fast and high-accuracy detection of multi-layer occluded coal flow foreign objects. [ABSTRACT FROM AUTHOR]

Angiogenesis, or the development of blood vessels by growing from already-formed vessels, is observed in embryonic development, physiological cyclical processes such as wound healing, the encapsulation of foreign bodies, tumor growth, and some other situations. In this review, we analyze the cellular mechanisms of angiogenesis, namely, angiogenesis by sprouting, ansiform (by loop formation) angiogenesis, coalescent angiogenesis, and angiogenesis by intussusception (splitting the capillary into two channels). The analysis of data revealed a lot of unanswered questions and contradictions. Here, we propose several new models of angiogenesis explaining these contradictions. [ABSTRACT FROM AUTHOR]

During the drying and processing of raisins, the presence of foreign matter such as fruit stems, branches, stones, and plastics is a common issue. To address this, we propose an enhanced real-time detection approach leveraging an improved YOLOv8 model. This novel method integrates the multi-head self-attention mechanism (MHSA) from BoTNet into YOLOv8's backbone. In the model's neck layer, selected C2f modules have been strategically replaced with RFAConv modules. The model also adopts an EIoU loss function in place of the original CIoU. Our experiments reveal that the refined YOLOv8 boasts a precision of 94.5%, a recall rate of 89.9%, and an F1-score of 0.921, with a mAP reaching 96.2% at the 0.5 IoU threshold and 81.5% across the 0.5–0.95 IoU range. For this model, comprising 13,177,692 parameters, the average time required for detecting each image on a GPU is 7.8 milliseconds. In contrast to several prevalent models of today, our enhanced model excels in mAP0.5 and demonstrates superiority in F1-score, parameter economy, computational efficiency, and speed. This study conclusively validates the capability of our improved YOLOv8 model to execute real-time foreign object detection on raisin production lines with high efficacy. [ABSTRACT FROM AUTHOR]

During the molybdenite mining process, conveyor belts stretching for miles are used to transport ore between the blasting sites, crushing stations, and the concentrator plant. In order to ensure the safety and stability of the industrial production process, this paper introduces a foreign matter detection method based on deep learning for the belt conveyor. Aiming at the problems of insufficient feature extraction capabilities in existing machine vision-based foreign body detection methods and poor detection accuracy due to imbalanced positive and negative samples, an improved foreign body detection method for anchorless frame-type metal mine belt conveyors is proposed. This method introduces atrous convolution in the pooling layer to increase the receptive field of feature extraction and improve the ability of extracting feature details of foreign objects. By optimizing the ratio of positive and negative samples in the training process, the overall loss function value of the algorithm is reduced to ensure the accuracy of foreign body recognition. Finally, the improved model is trained after enhancing and labeling the sample dataset. The experimental results show that the average mean accuracy of foreign body detection (MAP) is 90.9%, better than existing methods. It can be used as an effective new method for detecting foreign objects on molybdenum mine belt conveyors. [ABSTRACT FROM AUTHOR]

Objective: Unusual clinical course Background: Foreign body aspiration (FBA) is a common and serious problem in childhood that requires early recognition and treatment. Common complications include asphyxia, hemorrhage, infection, and pneumothorax. In severe cases of foreign body obstruction, death can result from asphyxia. We report an interesting case in which a forgotten cotton ball was inhaled into the lungs. Case Report: A 5-year-old boy presented to the local hospital with coughing for 6 days and fever for 4 days, without any information of foreign body aspiration upon admission. Laboratory findings indicated an elevated white blood cell; therefore, cefprozil was given as anti-infective treatment. However, the child’s condition did not improve. A computed tomography scan showed left pulmonary atelectasis. Considering that the child’s condition was serious, he was referred to our hospital for diagnosis and treatment. After referral, auscultation revealed decreased breath sounds over the left lung. After multidisciplinary discussion, combined with the results of auxiliary examination, the possibility of a foreign body was considered. He underwent rigid bronchoscopy, which confirmed a yellow-white foreign body in the left main bronchus that was later verified as a cotton ball. The operation was very successful. Eventually, his condition improved and he was discharged, without additional complications. Conclusions: For children with unclear history of foreign body aspiration, bronchoscopy is recommended if there is recurrent pulmonary infection, low auscultation breath sounds, or abnormal imaging. The choice of surgical method depends on the location and type of foreign body and the experience of the surgeon, which is also very important. [ABSTRACT FROM AUTHOR]

Purpose: Ocular emergencies require immediate intervention to prevent rapid vision loss or functional impairment. The aim of this study was to determine the proportion of true ocular emergencies among patients who presented to the general emergency department with ocular complaints and were referred to the Eye Clinic. Methods: In a retrospective cross-sectional study in a tertiary hospital in Istanbul, patients aged 0–100 years who presented to the general emergency department with ocular complaints between January and December 2022 were included. Inconclusive diagnoses and incomplete records were excluded. Patients were divided into three groups: top eye emergencies (TE), relative eye emergencies (REE), and non-emergency eyes (NEE). Results: Among the 652,224 individuals seeking care, 9,982 (1.5%) were referred to the Eye Emergency Clinic. Of these, 2,788 (27.9%) were female, and 7,194 (72.1%) were male, with ages ranging from 0 to 98 years. TopEye Emergencies (TEE), Relative Eye Emergencies (REE), and Non-Eye Emergencies (NEE) accounted for 13%, 60%, and 27% of the cases, respectively. Common top-eye emergencies (TEE) include chemical injuries, orbital-preseptal cellulitis, and orbital fractures. Relative eye emergencies (REEs) commonly feature corneal foreign bodies, corneal erosion, and conjunctivitis. Nonemulsion eye (NEE) methods involve simple eye redness, trauma without eye involvement, and subconjunctival haemorrhage. Conclusions: Consistent with the literature, 1.5% of patients presenting to the general emergency department had eye complaints.However, 27% of those referred to the ophthalmological clinic did not have an urgent eye condition. This is partly due to the high proportion of patients presenting to the emergency department with ocular complaints and the lack of knowledge of ophthalmological diseases by emergency physicians, leading to unnecessary referrals to the ophthalmology clinic, resulting in a loss of the workforce and reduced time allocated to patients with true ocular emergencies. [ABSTRACT FROM AUTHOR]

Subcutaneous nodular lesions in a patient with significantly elevated inflammatory markers always raise the possibility of infectious diagnoses such as atypical infection, pyogenic abscess, mycobacterial infection, and malignancy. Definitive diagnosis requires tissue biopsy and histopathologic examination. The atypical presentation of a foreign body granuloma with concurrent intraoperative findings supports the diagnosis of gouty arthritis. We report a case of a 67-year-old man who presented with an inflammatory nodular lesion on the left elbow that was initially suspected to have an infectious cause. Histopathologic examination of the nodular tissue later revealed that the patient had a foreign body granuloma due to urate crystal deposition. The atypical appearance of the gouty arthritis, the low serum urate level, the negative crystal identification in the synovial fluid, and the markedly elevated inflammatory markers, which did not respond to the previous antibiotic and steroid therapy, raised the suspicion of atypical infection in this case. [ABSTRACT FROM AUTHOR]

Foreign bodies are a rare cause of obstructive jaundice. In this case report, we present the case of a 59-year-old male who presented with abdominal pain and obstructive jaundice, which was later found out to be caused by an impacted shrapnel splinter in the common bile duct 7 years after a combat injury. To our knowledge, this is the first documented case from Syria. This case report is a reminder that impacted foreign bodies should be considered as a potential cause of obstructive jaundice in patients with previous combat injury. [ABSTRACT FROM AUTHOR]

Purpose: There is currently no ideal radiotracer for imaging bacterial infections. Radiolabelled d-amino acids are promising candidates because they are actively incorporated into the peptidoglycan of the bacterial cell wall, a structural feature which is absent in human cells. This work describes fluorine-18 labelled analogues of d-tyrosine and d-methionine, O-(2-[18F]fluoroethyl)-d-tyrosine (d-[18F]FET) and S-(3-[18F]fluoropropyl)-d-homocysteine (d-[18F]FPHCys), and their pilot evaluation studies as potential radiotracers for imaging bacterial infection. Procedures: d-[18F]FET and d-[18F]FPHCys were prepared in classical fluorination-deprotection reactions, and their uptake in Staphylococcus aureus and Pseudomonas aeruginosa was evaluated over 2 h. Heat killed bacteria were used as controls. A clinically-relevant foreign body model of S. aureus infection was established in Balb/c mice, as well as a sterile foreign body to mimic inflammation. The ex vivo biodistribution of d-[18F]FPHCys in the infected and inflamed mice was evaluated after 1 h, by dissection and gamma counting. The uptake was compared to that of [18F]FDG. Results: In vitro uptake of both d-[18F]FET and d-[18F]FPHCys was specific to live bacteria. Uptake was higher in S. aureus than in P. aeruginosa for both radiotracers, and of the two, higher for d-[18F]FPHCys than d-[18F]FET. Blocking experiments with non-radioactive d-[19F]FPHCys confirmed specificity of uptake. In vivo, d-[18F]FPHCys had greater accumulation in S. aureus infection compared with sterile inflammation, which was statistically significant. As anticipated, [18F]FDG showed no significant difference in uptake between infection and inflammation. Conclusions: d-[18F]FPHCys uptake was higher in infected tissues than inflammation, and represents a fluorine-18 labelled d-AA with potential to detect a S. aureus reference strain (Xen29) in vivo. Additional studies are needed to evaluate uptake of this radiotracer in clinical isolates. [ABSTRACT FROM AUTHOR]

Retrograde movement of gastric contents into the pharynx is termed Laryngopharyngeal Reflux (LPR). It represents an extraesophageal manifestation associated with gastroesophageal reflux disease (GERD). The objective of the study is to investigate the clinical profile of LPR and its response to treatment. Three hundred consecutive patients who presented to the ENT outpatient department with a clinical profile of LPR were selected. The patients' symptoms were assessed using the Reflux Symptom Index (RSI), followed by an endoscopic examination of the larynx and scoring using the Reflux Finding Score (RFS). Patients were started on LPR treatment if they had an RSI score of 13 and an RFS of more than 7. The patients were then started on medication and monitored for three months. The most common symptom in our research sample (52%) was a foreign body sensation in the throat. On endoscopic examination of the larynx, the most common sign was hyperemia/erythema of laryngeal tissue, especially bilateral arytenoids. Most of our patients responded favorably to a combination of pantoprazole (40 mg) and domperidone (30 mg) for 4 weeks. This was measured by the reduction in RSI and RFS scores. LPR is a frequently encountered clinical entity, and otorhinolaryngologists should consider it when treating patients with chronic symptoms such as throat pain and voice changes. Appropriate LPR diagnosis and care can help prevent unnecessary prescriptions for antibiotics and surgical interventions in these patients. [ABSTRACT FROM AUTHOR]

Ingested fish bone is a common otorhinolaryngology emergency in Malaysia. Fish bone is commonly impacted in the oropharynx for young patients and oesophagus for elderly patients. Rarely, a fish bone migrated extraluminal and require surgical exploration. We report a five cases of fish bone which involved extraluminal migration, and needed repeat CT scans and various types of surgical exploration. [ABSTRACT FROM AUTHOR]

The Canadian Association of Radiologists (CAR) Gastrointestinal Expert Panel consists of radiologists, a gastroenterologist, a general surgeon, a family physician, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 20 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 58 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 85 recommendation statements specific to the adult population across the 20 scenarios. This guideline presents the methods of development and the referral recommendations for dysphagia/dyspepsia, acute nonlocalized abdominal pain, chronic abdominal pain, inflammatory bowel disease, acute gastrointestinal bleeding, chronic gastrointestinal bleeding/anemia, abnormal liver biopsy, pancreatitis, anorectal diseases, diarrhea, fecal incontinence, and foreign body ingestion. [ABSTRACT FROM AUTHOR]

Devices for the gastrointestinal tract are widely available and constantly advancing with less invasive techniques. They play a crucial role in diagnostic and therapeutic interventions and are commonly placed by interventional radiologists, gastroenterologists, and surgeons. These devices frequently appear in imaging studies, which verify their proper placement, identify any complications, or may be incidentally detected. Radiologists must be able to identify these devices at imaging and understand their intended purpose to assess their efficacy, detect complications such as incorrect positioning, and avoid misinterpreting them as abnormalities. Furthermore, many patients with these devices may require MRI, making assessing compatibility essential for safe patient care. This review seeks to provide a succinct and practical handbook for radiologists regarding both common and uncommon gastrointestinal devices. In addition to textual descriptions of clinical indications, imaging findings, complications, and MRI compatibility, the review incorporates a summary table as a quick reference point for key information and illustrative images for each device. [ABSTRACT FROM AUTHOR]

Introduction: Foreign body (FB) injuries constitute an important part of admission to emergency and orthopedic clinics in daily practice. The localization and removal of FBs can be difficult. Ultrasound (USG) plays an important role in the localization of FBs. In this study, we aimed to present the results of patients who underwent US-guided FB extraction. Methods: Fifty-seven patients who were admitted to the emergency service and orthopedic outpatient clinic due to FB trauma to soft tissue were retrospectively evaluated. USG-guided removal was performed under local anesthesia. The number, size, shape, structure, distance to the skin, and integrity of the FB were determined using USG guidance. Patient satisfaction was evaluated with Roles-Maudsley score. Results: The mean duration of surgery was 7 min (range; 5 to 20 minutes), and the mean incision size was 11 mm (range; 5 to 25 mm). Forty-seven of the patients underwent an outpatient procedure and were discharged on the same day. No postoperative complications were observed. Fifty one of 57 (89.5%) were very satisfied with the surgery. Conclusion: Consequently, USG-guided FB extraction is a safe, fast, and comfortable option for the patient and the physician. Orthopedic physicians should receive USG training starting from their assistantship, and its use in daily practice should be increased. [ABSTRACT FROM AUTHOR]

Intraorbital foreign bodies (IOrFBs) are a significant cause of ocular morbidity. Although plastic IOrFBs are rare, the increasing use of plastic and polymer composites in motor vehicles will increase their prevalence. Although challenging to identify, plastic IOrFBs have unique radiographic characteristics. The authors describe a case of an 18-year-old man with a history of a motor vehicle accident and a left upper eyelid laceration. In retrospect, imaging suggested a plastic IOrFB, which was initially overlooked. A follow-up examination demonstrated persistent left upper lid ptosis with an underlying mass. Further work-up revealed a retained IOrFB, which was removed via anterior orbitotomy. Scanning electron microscopy of the material was consistent with a plastic polymer. This case demonstrates the importance of maintaining a high suspicion for IOrFBs in the correct clinical context, the need for increased awareness of plastic and polymer composite IOrFBs, and the use of diagnostic imaging for identification. [ABSTRACT FROM AUTHOR]

A 75-year-old immunocompetent male presented with a right orbital cellulitis after a foreign body penetrating injury. He was taken for orbitotomy with foreign body removal and started on broad-spectrum antibiotics. Intra-operative cultures were positive for Cladophialophora bantiana, a mold known for causing brain abscesses with no prior reports of orbital invasion in the literature. Following culture results, the patient was managed with voriconazole and required multiple orbitotomies and washouts for infection control. [ABSTRACT FROM AUTHOR]

Composite fan blades made of CFRP have been developed and investigated to reduce the weight of aircraft engines. Aircraft fan blades are subjected to high-speed impact by foreign objects, such as bird strikes. Because CFRP has lower impact resistance than metal materials, it is necessary to focus on possible failure not only at the impact point but also at the tip and trailing edge of the fan blade. This paper developed a finite element analysis model of fan blade geometry and investigated the dynamic deformation that may induce peripheral fracture when a bird strike occurs on a composite fan blade. Natural vibration analysis and transient response analysis were performed to analyze the vibration behavior at the fan blade periphery. The natural vibration analysis showed that the vibration modes in the out-of-plane direction of the blade are of low order. In the transient response analysis, when a group of particles defined by the equation of state and the SPH method collided, a sudden deformation in the periphery, called a whipping motion, was observed immediately after the impact. The spanwise strain has a peak value at the trailing edge of the fan blade, while the chordwise strain has a peak value at the leading edge of the fan blade. Furthermore, the transient response analysis with the fan blades rotating showed an increase in the peak strain value. A comparison of the impact loads and displacements immediately below the impact indicated that the centrifugal force increased the geometric stiffness, which increased the reaction force due to the fan blade, increasing the peak value. [ABSTRACT FROM AUTHOR]

OBJECTIVE To retrospectively report the historical and clinical findings, diagnostics, treatment, and outcome of horses with penetrating wood foreign bodies (PWFBs) of the coronary band. ANIMALS 15 client-owned horses. CLINICAL PRESENTATION Horses had varying degrees of lameness and soft tissue swelling of the coronary band and pastern region. A defect in the coronary band was identified, but the actual wood foreign body was not always readily visualized. RESULTS Medical records of horses diagnosed with PWFBs of the coronary band between 2004 and 2023 were reviewed. Information retrieved from the medical records included history, signalment, diagnostics, treatment, and outcome. Thirteen of 15 horses that sustained a PWFB to the coronary band were participating in foxhunting. Penetrating wood foreign bodies occurred more frequently near the central axis or toe region (11/15) and more commonly in the forelimbs (11/15). Removal of PWFBs can be performed with the horse standing and sedated with regional anesthesia. Complete removal of the PWFB required partial removal of the adjacent hoof wall. CLINICAL RELEVANCE Penetrating wood foreign bodies occurred in the coronary band and lodged distally in the hoof wall of horses. Foxhunting may be a risk factor for this type of injury. Penetrating wood foreign bodies occurred most commonly in the front feet, near the central axis of the coronary band. Complete removal of the PWFB required removing a section of the adjacent hoof wall. The prognosis for return to the previous level of activity following treatment was favorable. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Accidental foreign body ingestion is the most common hidden cause of abdominal pain. A high index of suspicion should be implemented in patients with unresolved abdominal pain. Here we reported a 54‐year‐old patient with vague abdominal pain who had a successful laparoscopic removal of a toothpick. Toothpicks and fish bones are considered one of the most common accidentally ingested foreign bodies. Fortunately, most patients are asymptomatic. About 80%–90% of ingested foreign bodies pass through the gut spontaneously within a week. We present a case of a 54‐year‐old female with chronic epigastric pain and fever found to have a foreign body (toothpick) that penetrated the stomach and migrated to the liver causing liver abscess with portal vein thrombosis. The patient was managed with laparoscopic removal of the foreign body with an uneventful postoperative course. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Foreign bodies such as bone with a sharp end can penetrate the esophageal wall and lie extramurally. When a foreign body is not found on rigid oesophagoscopy, reassessing with imaging is important. The transcervical approach is a better alternative for such patients to remove the foreign bodies. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Foreign body aspiration is common in old age, sometimes lodged in unusual locations like the left upper lobe bronchus when aspiration happens in a recumbent position. Computed tomography is the preferred diagnostic tool, while flexible bronchoscopy is effective for removing the foreign body. Tracheo‐bronchial foreign body aspiration (FBA) is common in children and elderly, but often goes unnoticed due to vague symptoms and atypical imaging findings. We present a case of aspiration of pea in elderly presenting with acute symptoms. Computed tomography (CT) reveled an atypical site of foreign body (FB), that is left upper lobe bronchus and immediate removal of the FB was done using a flexible bronchoscope. The symptoms subsided after removal of the FB. Missed FBs can lead to chronic issues like pneumonia and airway obstruction. Advanced age, psychiatric illness, stroke, seizure disorder, and neuromuscular disease increase the risk of aspiration in older adults. Commonly, FBs get lodged in the right middle and lower lobes after aspiration due to vertical orientation of the airways. CT is a helpful tool for diagnosis of FBA and flexible bronchoscopy is effective in removal of the FB in elderly. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Perforation of Meckel's diverticulum (MD) is rare, particularly by foreign body. High index of suspicion and thorough intraoperative assessment is needed in patients undergoing surgery for acute appendicitis, specifically when appendix appears normal. Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. While often asymptomatic, it can present with several complications. Perforation due to foreign body ingestion is rare but can have severe consequences if late diagnosis occurs. A 13‐year‐old male, initially suspected of acute appendicitis, was eventually diagnosed with perforation of MD by a wood splinter‐like foreign body after intraoperative assessment. Histological analysis revealed ectopic colonic tissue within the MD, a finding whose implications are not well understood, in contrast with the well‐established complications associated with ectopic gastric and pancreatic tissues. This case highlights the diagnostic challenges of MD, which can mimic acute appendicitis, emphasizing the need for high suspicion when faced with atypical clinical presentation such as foreign body‐induced perforation. Although surgical resection of asymptomatic MD remains controversial, we recommend a case‐specific approach based on risk factors to guide decision‐making on surgical resection for asymptomatic MD. [ABSTRACT FROM AUTHOR]

Foreign bodies in soft tissue after trauma are common, and the smaller the wound, the easier it is to miss them. Moreover, undetected foreign bodies can lead to severe complications. A 60-year-old male patient presented to our emergency room with a 4-cm back laceration and a slightly decreased sensation in the left S1 dermatome after falling over a glass fish tank. A foreign body on the left side of the L5/S1 epidural space and S1 nerve root compression in the lateral recess were observed. Consequently, a midline longitudinal incision was made at the L5/S1 level, a paravertebral muscle subperiosteal dissection was performed, and the foreign body was carefully removed. Foreign bodies may exist even in simple, small wounds. Therefore, their presence should be confirmed or excluded through appropriate imaging and history-taking. [ABSTRACT FROM AUTHOR]

As English forces struggled to bring Ireland under Crown control during the early modern period, all aspects of Irish culture and identity were seen as potentially subversive. Irish culture posed a threat to both the regime, and to the very identity and sanctity of English bodies in a foreign and hostile land. This paper will examine the role that food played in the political discourse of sixteenth and seventeenth-century Ireland. It will investigate how aspects of food, from infant feeding, to diet, dairying and cookery became a cause of concern for English colonial commentators. It will show how descriptions of foodways were used to cast the Irish as "savages," but importantly, how they were also used to illustrate the "degeneration" of the Old English. Through the discussion of food commentators warned newcomers not to follow the fate of their predecessors; their bodies were not impenetrable, and through culinary contact, they too could be "undone." [ABSTRACT FROM AUTHOR]

Upon implantation into a patient, any biomaterial induces a cascade of immune responses that influences the outcome of that device. This cascade depends upon several factors, including the composition of the material itself and the location in which the material is implanted. There is still significant uncertainty around the role of different tissue microenvironments in the immune response to biomaterials and how that may alter downstream scaffold remodeling and integration. In this study, we present a study evaluating the immune response to decellularized extracellular matrix materials within the intraperitoneal cavity, the subcutaneous space, and in a traumatic skeletal muscle injury microenvironment. All different locations induced robust cellular recruitment, specifically of macrophages and eosinophils. The latter was most prominent in the subcutaneous space. Intraperitoneal implants uniquely recruited B cells that may alter downstream reactivity as adaptive immunity has been strongly implicated in the outcome of scaffold remodeling. These data suggest that the location of tissue implants should be taken together with the composition of the material itself when designing devices for downline therapeutics. Different tissue locations have unique immune microenvironments, which can influence the immune response to biomaterial implants. By considering the specific immune profiles of the target tissue, researchers can develop implant materials that promote better integration, reduce complications, and improve the overall outcome of the implantation process. [Display omitted] [ABSTRACT FROM AUTHOR]

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Foreign object debris (FOD) includes any unwanted and unintentional material lying on the charging lane or parking lots, posing a risk to the wireless charging system, the vehicle, or the people inside. FOD in an Electric Vehicle (EV) wireless charging system can cause problems, including decreased charging efficiency, safety risks, charging system damage, communication issues, and health risks. To address this problem, this paper proposes the deep learning object detection network approach of using YOLOv4 (You Only Look Once), which is a single-shot detector. Additionally, for real-time implementation, YOLOv4-Tiny is suggested, which is a compressed version of YOLOv4 designed for devices with low computational power. YOLOv4-Tiny enables faster inferences and facilitates the deployment of FOD detectors on edge devices. The algorithm is trained using the FOD dataset, consisting of images of common debris on runways or taxiways. Furthermore, utilizing the concept of transfer learning, the last few layers of the pre-trained YOLOv4 model are modified using the COCO (Common Objects in Context) dataset to transfer features to the new network and retrain the model on the FOD dataset. The results obtained using this YOLOv4 model yielded a precision rate of 99.05%, while the results from YOLOv4-Tiny achieved a precision rate of 97.74%, with an average inference time of 150 ms under the ambient light and weather conditions. [ABSTRACT FROM AUTHOR]

Key Points Penetrating orbital trauma from marine creatures, especially needlefish, should be considered after injuries sustained in open water. Advances in endoscopic sinus surgery have enabled surgeons to remove certain orbital foreign bodies through endoscopic endonasal approaches. 3D segmentation is a valuable pre‐operative tool in complex endoscopic orbital cases. [ABSTRACT FROM AUTHOR]

When a mass occurs at the staple line following lung resection, it can be difficult to distinguish between local cancer recurrence and granuloma. We present a case of a staple‐line granuloma with 18F‐fluorodeoxyglucose‐positron emission tomography uptake and elevated serum carbohydrate antigen 19–9 (CA19‐9) in a patient with ovarian cancer lung metastasis. After granuloma resection, serum CA19‐9 levels normalized, and CA19‐9 positive cells were identified in the resected tumor. Therefore, serum CA19‐9 elevation does not rule out a staple‐line granuloma. Whereas granulomas on computed tomography (CT) scans tend to show smooth shadows along the staple line unilaterally, detailed CT evaluation may help diagnostic differentiation. Differentiation based on imaging and tumor markers has limitations. However, core needle biopsy has the risk of misdiagnosis and tumor cell dissemination, therefore surgical resection should be considered when comprehensive findings indicate a potential recurrence. [ABSTRACT FROM AUTHOR]

During the foreign body response (FBR), macrophages fuse to form foreign body giant cells (FBGCs). Modulation of FBGC formation can prevent biomaterial degradation and loss of therapeutic efficacy. However, the microenvironmental cues that dictate FBGC formation are poorly understood with conflicting reports. Here, we identifiedmolecular and cellular factors involved indriving FBGCformation in vitro. Macrophages demonstrated distinct fusion competencies dependent on monocyte differentiation. The transition from a proinflammatory to a reparative microenvironment, characterised by specific cytokine and growth factor programmes, accompanied FBGC formation. Toll-like receptor signalling licensed the formation of FBGCs containing more than 10 nuclei but was not essential for cell-cell fusion to occur. Moreover, the fibroblast-macrophage crosstalk influenced FBGC development, with the fibroblast secretome inducingmacrophages to secrete more PDGF, which enhanced large FBGC formation. These findings advance our understanding as to how a specific and timely combination of cellular and microenvironmental factors is required for an effective FBR, with monocyte differentiation and fibroblasts being key players. [ABSTRACT FROM AUTHOR]

Background: This case mainly describes a relatively rare case of an old mineral-like corneal foreign body that existed for up to 20 years, and did not significantly affect the visual quality of the patient. Case presentation: A 56-year-old male miner complained of right eye vision loss for 3 years, swollen and painful for 4 months. Admission examination: Best corrected visual acuity was no light perception in the right eye and 20/20 in the left eye. Anterior segment examination: A large number of spot-like grayish-brown mineral foreign bodies in the conjunctiva of the nasal conjunctiva, emulsified silicone oil floating in the anterior chamber, Corneal foreign bodies in the right eye were widely distributed in the upper cortex and the proelastic layer. There were fewer foreign bodies in the left cornea. Previous medical history, 20 years ago due to forging and burning sulphur mine explosion, resulting in a large number of ore foreign bodies in the conjunctiva of both eyes. As these corneal foreign bodies did not affect the visual quality of the patient, we adopted a conservative treatment plan, did not remove these foreign bodies, and only carried out symptomatic treatment for the patient's secondary ocular hypertension. The patient was followed up normally in the outpatient department, and no cornea-related complications occurred up to now. Conclusions: First of all, it is necessary to understand the source and nature of the foreign body in patients with corneal and conjunctival foreign body injuries. In the second, for the old corneal metal foreign body, when the patient's visual acuity is stable and there are no symptoms of corneal irritation and inflammatory reaction, it can be Conservative treatment or outpatient follow-up observation. In the end, corneal Optical coherence tomography imaging should not be ignored, which is very important for determining the depth of embedding and the location of the corneal foreign body. [ABSTRACT FROM AUTHOR]

Introduction: The secure operation of electric power transmission lines is essential for the economy and society. However, external factors such as plastic film and kites can cause damage to the lines, potentially leading to power outages. Traditional detection methods are inefficient, and the accuracy of automated systems is limited in complex background environments. Methods: This paper introduces a Weighted Spatial Attention (WSA) network model to address the low accuracy in identifying extraneous materials within electrical transmission infrastructure due to background texture occlusion. Initially, in the model preprocessing stage, color space conversion, image enhancement, and improved Large Selective Kernel Network (LSKNet) technology are utilized to enhance the model's proficiency in detecting foreign objects in intricate surroundings. Subsequently, in the feature extraction stage, the model adopts the dynamic sparse BiLevel Spatial Attention Module (BSAM) structure proposed in this paper to accurately capture and identify the characteristic information of foreign objects in power lines. In the feature pyramid stage, by replacing the feature pyramid network structure and allocating reasonable weights to the Bidirectional Feature Pyramid Network (BiFPN), the feature fusion results are optimized, ensuring that the semantic information of foreign objects in the power line output by the network is effectively identified and processed. Results: The experimental outcomes reveal that the test recognition accuracy of the proposed WSA model on the PL (power line) dataset has improved by three percentage points compared to that of the YOLOv8 model, reaching 97.6%. This enhancement demonstrates the WSA model's superior capability in detecting foreign objects on power lines, even in complex environmental backgrounds. Discussion: The integration of advanced image preprocessing techniques, the dynamic sparse BSAM structure, and the BiFPN has proven effective in improving detection accuracy and has the potential to transform the approach to monitoring and maintaining power transmission infrastructure. [ABSTRACT FROM AUTHOR]