A systematic and bibliometric review, combined with a meta-analysis, was used to adjust an equation for estimating the physiological responses of Santa Inês sheep subjected to different thermal challenges. The systematic review compiled data on physiological responses and the thermal environment, which were then used in the meta-analysis to adjust regression models. The bibliometric analysis mapped the relationships among studies, highlighting their usefulness in interpreting research findings and biases. Addressing prior methodological critiques, the core of this study involves replacing the linear approach with a non-linear segmented regression model to accurately define the Thermal Neutral Zone (TNZ). The Segmented Regression Model was crucial, establishing the upper limit of the Thermal Neutral Zone (TNZ) at an air temperature (tair) of 34.64 °C, where trectal begins to increase abruptly. The model, while identifying a biologically significant breakpoint, exhibited a moderate Multiple R-squared of 0.3529, highlighting the high heterogeneity and methodological variability in the current Santa Inês literature. This non-linear approach offers a biologically superior tool for identifying the onset of thermal distress.

A 6-year-old, neutered male domestic shorthair cat was referred for evaluation of a recurrent subcutaneous mass on the right caudodorsolateral hip, 4 months after excision of a presumed feline injection site sarcoma (FISS). Advanced imaging revealed a bilobed soft tissue mass closely associated with the sciatic nerve and rectum. Surgical excision was limited by adjacent structures, and histopathology confirmed a sarcoma with incomplete margins. Definitive-intent radiation therapy was administered postoperatively. Follow-up imaging initially demonstrated no evidence of local recurrence. Approximately 9 months after completion of radiation therapy, the cat developed progressive pelvic limb paraparesis, fecal incontinence and urinary retention. MRI identified a large contrast-enhancing extradural spinal lesion extending from L5 to the sacrum, with suspected intramedullary invasion and marked thickening of the lumbosacral nerve roots. Surgical exploration with hemilaminectomy and spinal cord biopsy revealed a poorly differentiated sarcoma histologically similar to the original tumor. Progressive disease was confirmed on follow-up imaging, and palliative radiation therapy was administered. Despite treatment, the cat developed severe neurologic deterioration and was humanely euthanized.

Feasibility dose-volume histogram (FDVH) can provide patient-specific information on the anatomically achievable dose range for organs at risk (OARs) and may complement knowledge-based planning using RapidPlan. This study evaluated whether FDVH-guided re-optimization can improve RapidPlan-generated prostate volumetric-modulated arc therapy (VMAT) plans. A total of 50 patients with prostate cancer treated with VMAT were included. Thirty cases were used to construct a RapidPlan model from manually generated clinical plans created with reference to FDVH, and the remaining 20 independent cases were used for evaluation. Plans generated by automatic optimization using RapidPlan were defined as KBP, whereas those re-optimized with reference to FDVH were defined as KBP+FDVH. During re-optimization, mean dose and upper generalized equivalent uniform dose were used as auxiliary DVH-based parameters. Dosimetric parameters for the planning target volume excluding the rectum (PTV-R), rectum, and bladder were compared between KBP and KBP+FDVH using the Wilcoxon signed-rank test. For PTV-R, D2% was significantly reduced with KBP+FDVH compared with KBP (63.69 Gy vs 62.35 Gy, p < 0.001), and D98% was significantly increased (59.02 Gy vs 59.24 Gy, p = 0.009). Rectal V31 Gy was significantly lower with KBP+FDVH (35.51% vs 32.03%, p = 0.010). No clear improvement was observed in bladder dose. FDVH-guided re-optimization improved PTV-R dose homogeneity and reduced the low-dose region of the rectum, suggesting that this approach may serve as an auxiliary workflow for selected RapidPlan-generated prostate VMAT plans.

Objective Surgical necrotizing enterocolitis (NEC, Bell stage 3B) complicating neonatal supraventricular tachycardia (SVT) is exceedingly rare. We describe a novel per-rectal propranolol strategy to maintain antiarrhythmic prophylaxis during mandatory nil per oral (NPO) status imposed by NEC. Study Design This study includes a single case report at a tertiary neonatal unit in Western India. Results A 35-week neonate with antenatal fetal tachyarrhythmia (>300 beats per minute [bpm]) developed postnatal SVT at 6 h of life (280-300 bpm), requiring adenosine cardioversion and oral propranolol. On day of life (DOL) 4, hematochezia, abdominal distension, and portal venous gas indicated Bell stage 3A NEC, mandating NPO status. With enteral routes contraindicated, propranolol was continued per rectum, to our knowledge the first reported neonatal antiarrhythmic use of this route. Deterioration to pneumoperitoneum by DOL 8 necessitated laparotomy with jejuno-jejunal and ileo-caecal resection and anastomosis. No SVT recurred during NPO. The infant was discharged on DOL 25 on oral propranolol. Conclusion This first Indian report of SVT-associated surgical NEC highlights two novelties: Bell stage 3B NEC requiring surgery and per-rectal propranolol as a novel antiarrhythmic bridge during NPO. Clinicians should maintain vigilance for NEC in neonates with SVT regardless of hemodynamic stability, and consider the rectal route for propranolol when NPO.

Rectal tonsil is an uncommon reactive lymphoid proliferation that may mimic a rectal neuroendocrine tumor endoscopically and a low-grade lymphoid neoplasm histologically. A 43-year-old woman underwent colonoscopy for abdominal pain, which revealed a smooth, hemispheric subepithelial lesion measuring approximately 22 mm in the lower rectum, 8 cm from the anal verge. Endoscopic ultrasonography demonstrated a well-demarcated hypoechoic lesion predominantly confined to the submucosal layer, with preservation of the muscularis propria. Because a rectal neuroendocrine tumor was the leading preoperative diagnosis and superficial biopsy might not preserve the required submucosal architecture, en bloc endoscopic submucosal dissection was performed. Histology demonstrated reactive lymphoid hyperplasia with tonsil-like architecture. Immunohistochemistry showed preserved B- and T-cell compartmentalization, BCL6-positive reactive germinal centers, relative absence of BCL2 expression within germinal centers, and germinal-center-predominant Ki-67 activity. No morphological or immunophenotypic evidence of lymphoma was identified; molecular clonality testing was not performed. The findings were compatible with rectal tonsil.

Sacrococcygeal pilonidal disease (SPD) is an acquired inflammatory condition predominantly affecting young adults and adolescents, with a rising incidence and substantial clinical burden. Despite increasing research activity, the global scientific landscape of SPD, including research output, co-authorship patterns, knowledge diffusion pathways, thematic evolution, and emerging research frontiers, has not been systematically analyzed in the peer-reviewed literature. This study aimed to address this gap using a multitool bibliometric analysis. Bibliometric tools (VOSviewer, CiteSpace, and Pajek) were used to summarize the key features and generate visualizations. Articles and reviews on SPD published between 2000 and 2025 were retrieved from the Web of Science Core Collection. A total of 1,014 papers from 72 countries and 1,387 institutions were included. Research output steadily increased, with a marked acceleration after 2018. Turkey led in publication productivity and citation impact, whereas Germany, England, and the USA were key hubs for international collaboration. The University of Naples Federico II published the most articles, while the Technical University of Munich received the most citations. Dietrich Doll emerged as the most prominent and productive researcher in this field. Diseases of the Colon & Rectum was the most influential journal. Increasing research attention toward minimally invasive techniques, alongside continued interest in conventional surgical approaches, was identified. Current research interests emphasize less invasive strategies, etiological prevention, and evidence synthesis. This study provides valuable information for clinicians and researchers to better understand the current global status of SPD, recognize emerging research themes, and identify potential areas for future investigation and collaboration.

Solitary rectal ulcer syndrome (SRUS) is a rare benign disorder of the rectum strongly associated with chronic straining and rectal mucosal prolapse, which may be overt or occult. Its endoscopic appearance is highly variable, and atypical presentations can create significant diagnostic challenges, particularly in immunocompromised patients in whom infectious etiologies must be systematically excluded. We report a case of SRUS presenting as simultaneous contralateral kissing rectal ulcers in an HIV positive patient. Histopathology demonstrated the characteristic triad of fibromuscular obliteration of the lamina propria, smooth muscle extension between distorted crypts, and muscularis mucosae hypertrophy, establishing occult internal mucosal prolapse as the underlying mechanism. Comprehensive infectious evaluation including targeted testing for cytomegalovirus, herpes simplex virus, Neisseria gonorrhoeae, and Chlamydia trachomatis including lymphogranuloma venereum serovars was entirely negative. The patient achieved complete symptomatic resolution on conservative therapy with psyllium fiber supplementation at 2-month follow-up. This case illustrates an uncommon endoscopic presentation of SRUS, the diagnostic importance of histopathology in the absence of visible mucosal prolapse, and a systematic infectious exclusion approach in an HIV positive patient that may serve as a clinical reference for similar presentations.

Background and Study Aims Argon plasma coagulation (APC) is an established ablation technique, but limited by tangential probe orientation. ArgoCap was developed to allow precise, safe, and reproducible APC through visualizing the argon beam, shielding the probe, maintaining a defined distance, and enabling hybrid APC procedures. This study aimed to evaluate the clinical feasibility and safety of ArgoCap across multiple indications. Patients and Methods Between January 2022 and May 2025, 54 APC procedures using the ArgoCap were performed at three expert centers. Indications included Barrett's mucosa, ectopic gastric mucosa, gastric angioectasia, gastric antral vascular ectasia, radiation proctitis, and other indications. Primary endpoint was technical success, defined as access to the lesions and macroscopically complete ablation. Secondary endpoints included technical complications, adverse events, and procedural time. Results The majority of lesions were located in the esophagus (70%), followed by stomach (19%) and rectum (11%). Median lesion size was 13 mm (range 2-240 mm). Median ablation and procedure times were 8 min (2-15 min) and 25 min (8-75 min), respectively. Technical success was achieved in 47 cases (87%); subtotal ablation (>90% of the lesion) was possible in 52 cases (96%). Technical difficulties occurred in 1 case (2%); primary complication (ulceration with subsequent bleeding) was observed in 1 case (2%). Conclusions The ArgoCap enables easy and precise APC in the upper and lower gastrointestinal tract across multiple indications. It facilitates lesion access and visualization, reduces unintended mucosal contact, and allows hybrid APC procedures.