Uterine Embolization as a New Treatment Option in Adenomyosis Uteri

Adenomyosis is characterized by the development of endometrial ectopic glands and tissue in the myometrium layer in depth greater than 2.5 mm from the endometrial surface of the separative area by -myomas well as by hypertrophy and hyperplasia of the smooth muscles of the myometrium. This is filtration, not mere displacement, of the myometrium, from the endometrium. Clinical symptoms include dysmenorrhea and menorrhagia. It is diffuse (adenomyosis) or focal (adenomyoma), asymmetrically affects the uterine wall of premenopausal women (usually the posterior) and often coexists with myomas. The pathogenesis of adenomyosis remains unknown. The treatment options are: drug therapy, invasive treatment of fibroids: myomectomy (open—intra-abdominal, laparoscopic, hysteroscopic), hysterectomy, myolysis—cryocatalysis, microwave or radiofrequency thermal catalysis (RF-ablation), ultrasound focus catalysis (FUS), laser photocatalysis and percutaneous selective uterine artery embolization (UAE). Embolization remains an alternative and not a substitute of hysterectomy. The medical indication is made on a case-by-case basis, depending on age, desire for pregnancy and the clinical symptoms of adenomyosis

Federated learning enables big data for rare cancer boundary detection.

Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing

Author Correction: Federated learning enables big data for rare cancer boundary detection.

10.1038/s41467-023-36188-7NATURE COMMUNICATIONS14

Federated Learning Enables Big Data for Rare Cancer Boundary Detection

Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing

Enlightenment and History: the 18th century greek-language historiography

The object of this PhD thesis is the discourse about history that emerged in the 18th century Greek-language book-publishing and its ideological consequences in the Greek-Orthodox community in a period that has been characterized as the age of educational and scientific reborn; the so called “Neo-Hellenic Enlightenment”. The main aim is to comprehend the way that the historical discourse unfolded between the new social strata that rose among the Greek-speaking communities, mainly those that had been in touch with the cultural and ideological developments of western Europe, where the Enlightenment were in progress. The main thesis of this study is that the historical way of thinking and writing about the past had its own way of evolving in the Greek-language historiography, which had no much to do with the western, the “enlightened way”, where the political needs were different and the cultural tradition have had embraced the processes of the Renaissance and the Reformation. This is shown by examining two characteristic paradigms of historical works; the ecclesiastic historiography and the contemporary political historiography of the Greek 18th century. It seems that historiography is a kind of a political action that is tied up to the context in which is being produced and tries to answer the problems and meet the demands of the locality. The whole project seeks to underline the significance of the processes of appropriation in European periphery of the scientific ideas and practices that had been emerged in the so called enlightened “centre” of the scientific activity that is Western Europe. The production of historical knowledge is the result of the work of an active local intelligentsia and not just a merely process of transmission from the European centre.Αντικείμενο της διατριβής είναι ο ιστορικός λόγος που παράγεται από τις ελληνόγλωσσες εκδόσεις του 18ου αιώνα και οι ενδεχομενικές ιδεολογικές και κοινωνικές του επιπτώσεις στον ελληνορθόδοξο κοινωνικό σχηματισμό την περίοδο της «πνευματικής του αναγέννησης» («Νεοελληνικός Διαφωτισμός»). Το πλαίσιο μελέτης το συγκροτεί η τοπικότητα με την πνευματική της παράδοση και τις αξιακές της παραδοχές, ενώ η ιστορική πρακτική ερμηνεύεται με βάση το συγκεκριμένο κοινωνικοπολιτικό πλαίσιο και την ιδιαίτερη συγκυρία της βαλκανικής και της ΝΑ Μεσογείου. Η μεθοδολογία που ακολουθείται αντικρούει τη θεωρία της διάκρισης μεταξύ ενός κέντρου παραγωγής καινοτόμων φιλοσοφικών και επιστημονικών ιδεών (Ευρωπαϊκός Διαφωτισμός) και μίας λόγιας κοινότητας (ελληνόγλωσσοι λόγιοι) που κινείται στην περιφέρεια αυτού του κόσμου και προσπαθεί να τον αφομοιώσει. Η ιστοριογραφία του ελληνικού 18ου αιώνα συγκροτήθηκε κυρίως γύρω από την αφήγηση με βάση την κριτική επεξεργασία των πηγών με τη συνοδεία τεκμηρίων και την προβληματική για τις σύγχρονες εξελίξεις. Σκοπός της υπήρξε η διατύπωση ενός «ωφέλιμου λόγου» για το Γένος και η κατοχύρωση της κοινωνικής κινητικότητας που έφερνε η ανάδυση των νέων κοινωνικών στρωμάτων. Η πολυμορφία του ιστορικού εντύπου, τονίζει την αντίσταση της τοπικής παράδοσης στα διεθνή κελεύσματα και την προσήλωσή του στην έκφραση των ιδεολογικών ζυμώσεων μιας κοινωνίας σε φάση μετασχηματισμού. Παραδειγματικά εξετάζεται α) η εκκλησιαστική ιστοριογραφία που εμφανίζεται στα τέλη του 17ου και τις αρχές του 18ου αιώνα, η οποία αποτελεί μία προσπάθεια παρέμβασης στα πολιτικά δρώμενα της εποχής, προκειμένου να κατοχυρωθεί η πολύχρονη και βαρύνουσα σημασία της ελληνικής ορθόδοξης παρουσίας στην Εγγύς Ανατολή σε αντιδιαστολή προς το καθολικό στοιχείο· β) η σύγχρονη πολιτική ιστορία που εκδίδεται από τα τέλη της τέταρτης δεκαετίας και μετά και παρακολουθεί τις πολιτικές εξελίξεις στη Ρωσία και τις ευρύτερες διπλωματικές και πολεμικές συγκρούσεις στη ΝΑ. Μεσόγειο και τη Β. Βαλκανική

An updated brief overview on post-traumatic headache and a systematic review of the non-pharmacological interventions for its management

Post-traumatic headache (PTH), a common type of headache secondary to traumatic brain injury (TBI) or whiplash, carries a relevant burden to patients. PTH is still an undertreated condition, because of limited pharmacological treatment options. Therefore, multimodal non-pharmacologic approaches, which account for comorbidities and biopsychosocial factors, are often used in PTH patients

Suction thrombectomy using a microcatheter as a salvage method for acute distal occlusion during cerebral aneurysm embolization: A case report

The aneurysm coiling process presents a risk of thromboembolic complications, mostly in patients with ruptured aneurysms, given the fact that they cannot receive antiplatelet therapy. Management strategies include medical anticoagulation or antiplatelet therapy, intra-arterial thrombolysis, and mechanical thrombectomy using direct aspiration first-pass technique or stent retrievers. We report our own experience of using an Excelsior SL-10 Microcatheter (Stryker, Fremont, California, USA) with an internal diameter of 0.0165”, originally designed for coil delivery, for contact aspiration of a thrombotic occlusion of a distal anterior cerebral artery during coiling of a broad-based trilobar anterior communicating artery aneurysm. The clot was removed under continuous manual aspiration, and complete recanalization has been accomplished. Mechanical thrombectomy through microcatheter aspiration may be a safe and feasible treatment option for acute distal artery occlusions, especially in the case of tortuous distal vessels during embolization of cerebral aneurysms