bluuebunny/crossref_metadata_2025 huggingface dataset:
Effective and Successful Control of Symptomatic Vertebral Hemangiomas With Epidural Extension Using Stereotactic Spine Radiosurgery
Authors: Patel Arpan A. , Lilly Daniel , Chao Samuel T. , Benzel Edward , Subramaniam Gandhivarma , Krishnaney Ajit , Suh John H. , Angelov Lilyana
Published: April 2024

BACKGROUND AND OBJECTIVES:

We present our experience in the management of symptomatic vertebral hemangiomas with epidural extension (SVHEE) using spine stereotactic radiosurgery (SSRS).

METHODS:

An Institutional Review Board approved retrospective review of all SVHEE patients treated with SSRS at our institution (2007-2022) was performed. Baseline patient demographics, clinical presentation, lesion volume, and Bilsky grade (to directly evaluate the epidural component) were determined. Clinical and radiographic response and treatment outcomes were subsequently evaluated at first (∼6 months) and final follow-up.

RESULTS:

Fourteen patients with SVHEE underwent SSRS (16-18 Gy/1-fraction); the mean follow-up was 24 months. The median lesion volume (cc) was 36.9 (range: 7.02-94.1), 31.5 (range: 6.53-69.7), and 25.15 (range: 6.01-52.5) at pre-SSRS, first, and final follow-up, respectively. Overall volume reduction was seen in the last follow-up in all 14 patients, median 29.01% (range: 6.58%-71.58%). Bilsky score was stable or improved in all patients at the last follow-up when compared with pre-SSRS score. Patients who underwent both surgical decompression and SSRS (n = 9): 8 had improved myelopathic symptoms and pain and 1 had stable radiculopathy postintervention. In the 5 patients treated with SSRS monotherapy, 2 had stable radicular pain and the other 3 improved pain and numbness. No patients experienced adverse outcomes.

CONCLUSION:

To our knowledge, this represents the largest series of SVHEE patients treated with SSRS, either as monotherapy or part of a multimodal/separation surgery treatment approach. We demonstrate that SSRS represents a potentially safe and effective treatment option in these patients. However, larger prospective studies and longer follow-ups are necessary to further assess the role, durability, and toxicity of SSRS in the management of these patients.
“The Only Disability in Life is a Bad Attitude”
Authors: Burt Anna , Lite Randi
Published: April 2024

Apply It!

After reading this article, the reader should be able to:

• Define “inspiration porn” and give an example

• Articulate both negative consequences and positive effects of inspirational images of disabled people in social media

• Use guidelines to differentiate positive versus negative posts of disabled people

• Understand the important role that exercise professionals can play in improving access and inclusion for disabled people in fitness and wellness spaces

Authors’ note: We have chosen to use identity-first language (disabled person) rather than person-first language (person with a disability) in this paper. We have chosen identity-first language as we believe it better reflects disability as an important piece of an individual’s identity that one can claim in pride.
Micro(nano)plastics: invisible compounds with a visible impact
Authors: Sharma Prabhakar , Sharma Prateek
Published: April 2024

The plastic related research has been an epicentre in recent times. The presence and spread of micro (nano) plastics (MNPs) are well-known in the terrestrial and aquatic environment. However, the focus on the fate and remediation of MNP in soil and groundwater is limited. The fate and bioaccumulation of ingested MNPs remain unknown within the digestive tract of animals. There is also a significant knowledge gap in understanding the ubiquitous organic environmental pollutants with MNPs in biological systems. Reducing plastic consumption, improving waste management practices, and developing environmentally friendly alternatives are some of the key steps needed to address MNP pollution. For better handling and to protect the environment from these invisible substances, policymakers and researchers urgently need to monitor and map MNP contamination in soil and groundwater.
Proposal of a domain model for 3D representation of buildings in Ecuador.
Authors: Velastegui Cáceres Luis Alejandro , Velastegui Cáceres Julia Desirée , Carretero Poblete Pedro A , Moyón Gusqui Manuel Fabian , Cevallos Díaz María Alejandra
Published: April 2024

The accelerated urban sprawl of cities around the world presents major challenges for urban planning and land resource management. In this context, it is crucial to have a detailed 3D representation of buildings enriched with accurate alphanumeric information. A distinctive aspect of this proposal is its specific focus on the spatial unit corresponding to buildings. In order to propose a domain model for the 3D representation of buildings, the national standard of Ecuador and the international standard (ISO 19152:2012 LADM) were considered. The proposal includes a detailed specification of attributes, both for the general subclass of buildings and for their infrastructure. The application of the domain model proposal was crucial in a study area located in the Riobamba canton, due to the characteristics of the buildings in that area. For this purpose, a geodatabase was created in pgAdmin4 with official information, taking into account the structure of the proposed model and linking it with geospatial data for an adequate management and 3D representation of the buildings in an open-source Geographic Information System. This application improves cadastral management in the study region and has wider implications. This model is intended to serve as a benchmark for other countries facing similar challenges in cadastral management and 3D representation of buildings, promote efficient urban development and contribute to global sustainable development.
Understanding the Challenges of Hashimoto's Thyroiditis: Perspectives on Diagnosis, Treatment, and Associated Conditions
Authors: Kułak Klaudia Brygida , Palacz Karolina Alicja , Gadżała Katarzyna , Janik Izabela , Pliszka Marzena , Chamera-Cyrek Katarzyna , Koman Anna Maria
Published: April 2024

Introduction: Hashimoto's thyroiditis is a prevalent autoimmune disease among the population. With the progress in diagnostic and research techniques, it has come to light that Hashimoto's thyroiditis is linked to a higher likelihood of developing other disorders that impact multiple organs and systems. Throughout the course of this disease, individuals may experience an array of complications such as sexual dysfunctions, fertility problems, specific mental disorders, cardiovascular diseases and other autoimmune diseases.
Aim of the Study: The primary aim of this study is to explore the potential association between Hashimoto’s thyroiditis and its consequential effects on other physiological systems and organs.
Description of the State of Knowledge: Hashimoto's thyroiditis is a complex autoimmune disease characterized by chronic inflammation of the thyroid gland. The pathogenesis of the disease is not yet completely understood. Hashimoto's thyroiditis has been associated with a range of health issues, including sexual dysfunction, fertility problems, psychiatric disorders, cardiovascular diseases, and other autoimmune disorders.
Materials and methods: An unsystematic scientific literature review was conducted using specific keywords such as Hashimoto's thyroiditis, fertility problems, thyroid tumor, cardiovascular diseases, and autoimmune diseases. The review was carried out on PubMed, analyzing a total of 53 sources published until 2023.
Conclusions: HT's association with psychiatric disorders, fertility issues, thyroid tumors, cardiovascular dysfunction, and comorbid autoimmune conditions underscores its broad clinical impact, necessitating integrated management approaches. Effective management of HT requires collaboration among specialists to ensure early detection, proactive intervention, and patient education, ultimately improving therapeutic outcomes and quality of life.
Ashwagandha (Withania somnifera) - Its Antibacterial and Anticancer Activity
Authors: Mazurkiewicz Aleksandra , Mądry Wojciech , Kołodziej Magdalena , Męczyńska Joanna , Saiuk Nazarii , Kozicz Michał Andrzej , Seredyński Tomasz , Wojciechowska Adriana , Marcicka Justyna , Salasa Weronika
Published: April 2024

Introduction

Ashwagandha, a traditional Indian plant, is gaining increasive attention from scientists worldwide due to its potential health benefits, especially in the context of its antibacterial and anticancer properties.

Aim of the study

The aim of this review was to discuss recent findings regarding the impact of Withania Somnifera on antibacterial effect and its potential applications in anticancer therapy.

Materials and methods:

The paper was created based on the Pubmed and Google Scholar database. The literature was reviewed using the keywards: ,,Ashwagandha”, ,,Withania Somnifera”, ,,antibacterial ”, ,,anticancer”, ,,side effects”, ,,breats cancer”.

Results

Studies have confirmed Withania Somnifera, exhibits significant anticacterial and anticancer effects. It inhibits the growth of both Gram-negative and Gram-positive bacteria. Futhermore, it demonstrates anticancer activity, especially in breast cancer, by stimulating apoptosis, induction of cytotoxic effects on cancerous cells and increasing cell sensitivity to radiation.

Conclusion

Despite promising results, futher research on the benefits of Ashwagandha, particulary in the long term, is essential. There is growing need of more research of the potencial benefits of Ashwagandha in the treatment of various disorders including cancer and bacterial infections and to develop more effective therapeutic strategies. The need for large randomized studies comparing long term clinical effectiveness is emphasized
Thermal Injuries in Children: A Literature-Based Overview
Authors: Wierzejska Natalia , Michalczewska Aneta , Fugas Agnieszka , Pach Magdalena , Nowak Agnieszka , Chmielowiec Zuzanna , Partyka Alicja , Dziedzic Mariola , Smykiewicz Karolina , Dobrzańska Justyna
Published: April 2024

Burns are a significant cause of morbidity and mortality in children. While the majority of pediatric burns are not life-threatening, they can have a significant impact on a child's physical and psychological health. They pose a major social and financial burden, particularly in developing countries. The management of pediatric patients with thermal injuries requires a complex and multifaceted approach.

Pediatric burns constitute approximately 40-50% of all reported cases of severe burns. The most common etiologies of pediatric burns include scalds, contact burns, flames, and chemicals. From 80% to 90% of burns occurred at home and were accidental. Despite advancements in treatment, severe burns can lead to life-threatening complications, such as sepsis, multisystem organ failure, and hypermetabolic response or even death.

This article aims to provide a literature-based overview of pediatric burn trauma, outlining its unique characteristics, etiology, epidemiology, classification, and initial management.
Segregación residencial en Cali
Authors: Bahos Diana Marcela , Castillo-Valencia María , Vivas Pacheco Harvy
Published: April 2024

Este capítulo está compuesto por ocho secciones. En la primera se reseña la literatura asociada con las nociones, los determinantes y la cuantificación de la segregación espacial y se revisan los estudios realizados en América Latina nacionales y locales. En la segunda se especifica el procedimiento utilizado para la obtención de los datos y se incluye la metodología desarrollada con las dimensiones y los índices asociados. En la tercera se hace un análisis descriptivo de las tres variables de estudio y se presenta mediante mapas dequintiles su distribución espacial en cada una de las escalas. En la cuarta se calculan los índices y se hace un análisis exploratorio de datos espaciales. En la quinta se desarrolla una discusión que compara los resultados obtenidos en esta investigación con estudios previos. En la sexta y séptima se realizan los análisis de segregación residencial para las manzanas del oriente y la comuna 18, respectivamente. Por último, en la octava se presentan las conclusiones, se sintetizan los resultados y se responden a las preguntas de investigación.
A qualitative study of clinicians’ experience of a clinical trial for displaced distal radius fractures
Authors: Phelps Emma E. , Tutton Elizabeth , Costa Matthew L. , Achten Juul , Gibson Phoebe , Perry Daniel C.
Published: April 2024

Aims

The aim of this study was to explore clinicians’ experience of a paediatric randomized controlled trial (RCT) comparing surgical reduction with non-surgical casting for displaced distal radius fractures.

Methods

Overall, 22 staff from 15 hospitals who participated in the RCT took part in an interview. Interviews were informed by phenomenology and analyzed using thematic analysis.

Results

Analysis of the findings identified the overarching theme of “overcoming obstacles”, which described the challenge of alleviating staff concerns about the use of non-surgical casting and recruiting families where there was treatment uncertainty. In order to embed and recruit to the Children’s Radius Acute Fracture Fixation Trial (CRAFFT), staff needed to fit the study within clinical practice, work together, negotiate treatment decisions, and support families.

Conclusion

Recruiting families to this RCT was challenging because staff were uncertain about longer-term patient outcomes, and the difficulties were exacerbated by interdisciplinary tensions. Strong family and clinician beliefs, coupled with the complex nature of emergency departments and patient pathways that differed site-by-site, served as barriers to recruitment. Cementing a strong research culture, and exploring families’ treatment preferences, helped to overcome recruitment obstacles.

Cite this article: Bone Jt Open 2024;5(4):324–334.
Enhancing Orthopedic Rehabilitation: The Emergence and Impact of Virtual Reality Technology
Authors:   Department of Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Chennai, Tamil Nadu, India,, Jeyaraman Madhan , Jeyaraman Naveen ,   Department of Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Chennai, Tamil Nadu, India,, Ramasubramanian Swaminathan ,   Department of Orthopaedics, Government Medical College, Omandurar Government Estate, Chennai, Tamil Nadu, India,, Shyam Ashok ,   Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra. India.
Published: April 2024

Virtual Reality (VR) is progressively transforming the landscape of orthopedic rehabilitation. Initially conceptualized for entertainment, VR now plays a pivotal role in the medical field, particularly in orthopedics. Traditional rehabilitation methods in orthopedics often encounter limitations in patient engagement and the personalization of therapy. VR counters these limitations by offering immersive environments that can be specifically tailored to meet individual rehabilitation needs. The ascent of this technology from a groundbreaking concept to a practical therapeutic tool represents a notable advancement in rehabilitation techniques. The capability of VR to simulate real-life scenarios significantly enhances its applicability and efficacy in orthopedic care. This adaptability allows for a more engaged and personalized treatment experience for patients, marking a departure from traditional, more generic therapy methods. However, incorporating VR into orthopedic rehabilitation is accompanied by certain challenges. These include the high costs associated with the technology, potential technological barriers, and issues related to accessibility. These factors can hinder the widespread adoption of VR in clinical settings. Despite these challenges, the integration of VR into orthopedic rehabilitation practices signals a shift toward more innovative and effective patient care. This technology not only promises to heighten patient involvement but also steers therapy toward a more individualized approach. By addressing the issues of patient engagement and customization in therapy, VR stands out as a compelling solution in the realm of orthopedic rehabilitation. Its potential to reshape patient experiences and outcomes in orthopedic recovery is substantial, indicating promising prospects for its role in the medical field [1, 2].
Case Report: Total Knee Arthroplasty in Ipsilateral Below-Knee Amputee
Authors:   Department of Orthopaedic Surgery, LSUHSC, New Orleans, Louisiana., Marrero Christopher E , Willard Jonathan ,   Department of Orthopaedic Surgery, LSUHSC, New Orleans, Louisiana.
Published: April 2024

Introduction: Total knee arthroplasty (TKA) has the highest annual incidence among all joint replacement surgeries. Below-knee amputation (BKA) is another common procedure to treat lower-limb-threatening pathologies. These two procedures are commonly performed individually, but an ipsilateral TKA performed on a BKA patient is rare. While ipsilateral amputation is not a contraindication for TKA, it presents orthopaedic surgeons with a unique case and necessitates thoughtful pre-operative planning regarding proper positioning, alignment determination, surgical technique, and rehabilitation for the best outcome. Objectives: We present a case of a patient with a BKA who underwent ipsilateral TKA. Case Report: This patient has a history of osteoarthritis (OA) of the right knee and diabetic neuropathy and underwent a right BKA after sustaining second-degree thermal burns to the bilateral forefeet. The patient was scheduled to undergo elective TKA prior to these injuries but was forced to postpone due to their severity. Following the BKA, the patient regained his ability to ambulate independently with prosthesis but continued to suffer from OA symptoms. The patient was then scheduled for surgery, and a TKA was performed. Results: The patient underwent a TKA and tolerated the surgery well without complications. Appropriate positioning was achieved using a popliteal post. Alignment and tibial cut were checked using fluoroscopy. All components were cemented into position, and the patella was resurfaced. The patient did well postoperatively and was using his prosthesis and ambulating independently at the final follow-up. Keywords: Below-knee amputation, total knee arthroplasty, osteoarthritis.
Breaking Free from Knee Pain: A Surgical Triumph in Managing Pellegrini–Stieda Syndrome with Massive Lesion: A Case Report
Authors:   Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India., Bhavani Prashant , Dwidmuthe Samir ,   Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India., Math Suhas Aradhya Bhikshavarthi ,   Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India., Das Deepanjan ,   Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India., Roy Mainak ,   Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India., Reddy M Harsha Vardhan ,   Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India.
Published: April 2024

Introduction: Pellegrini–Stieda syndrome, characterized by medial collateral ligament (MCL) calcification or ossification, often follows a history of trauma. While rare, its distinct radiographic features pose diagnostic challenges. Conservative treatments are effective for many, but surgical intervention is necessary when they fail. Case Report: A 31-year-old male with knee pain and stiffness, an inability to extend his knee, and a fixed flexion deformity. Radiological examinations confirmed heterotopic ossification along the MCL, indicating post-traumatic Pellegrini–Stieda syndrome. Despite 3 months of conservative treatment, the patient’s pain persisted, leading to surgical excision. The surgical approach involved diagnostic arthroscopy, revealing arthritic changes and adhesions. Arthroscopic adhesiolysis and open excision of the ossified mass significantly improved the patient’s range of motion. Histopathological examination confirmed heterotopic bone formation. Follow-up appointments at 1, 3, and 6 months showed a pain-free and mobile knee joint, with the Pellegrini–Stieda lesion disappearing from radiographs. Conclusion: This case underscores the effectiveness of surgical intervention for refractory Pellegrini–Stieda syndrome, offering hope for improved patient outcomes and highlighting the importance of early diagnosis and tailored treatment in managing this rare condition. Keywords: Pellegrini–stieda syndrome, massive lesion, heterotopic ossification, arthroscopic adhesiolysis, medial collateral ligament.
Multiple Joint Replacements for Progressive Pseudorheumatoid Dysplasia: A Case Report
Authors:   Department of Orthopedic and Trauma, Cliniques Universitaires Saint-Luc UCL, UCLouvain, Bruxelles, Belgium., Outrequin Antoine , Manon Julie ,   Department of Orthopedic and Trauma, Cliniques Universitaires Saint-Luc UCL, UCLouvain, Bruxelles, Belgium., Paulmier Amaury ,   Department of Orthopedic and Trauma, Cliniques Universitaires Saint-Luc UCL, UCLouvain, Bruxelles, Belgium., Putineanu Dan ,   Department of Orthopedic and Trauma, Cliniques Universitaires Saint-Luc UCL, UCLouvain, Bruxelles, Belgium., Docquier Pierre-Louis ,   Department of Orthopedic and Trauma, Cliniques Universitaires Saint-Luc UCL, UCLouvain, Bruxelles, Belgium., Cornu Olivier ,   Department of Orthopedic and Trauma, Cliniques Universitaires Saint-Luc UCL, UCLouvain, Bruxelles, Belgium.
Published: April 2024

Introduction: Progressive pseudorheumatoid dysplasia is a rare autosomal recessive disorder caused by a mutation in the Wnt1-inducible signaling protein 3 gene, with few cases reported. Case Report: We discuss the case of a 19-year-old Caucasian male patient with polyarticular involvement, including shoulders, elbows, wrists, hands, spine, hips, knees, and notably the ankles. Despite a well-conducted medical treatment, due to the rapid progression of his condition, the patient underwent bilateral total hip and knee arthroplasties, as well as left ankle replacement. Conclusion: This case report highlights the importance of conducting the diagnosis of these rare diseases and the important place of joint replacements in the recovery of joint functions, even in young patients. Keywords: Progressive pseudorheumatoid dysplasia, total arthroplasty, WISP3, mutation.
Hemorrhagic Ligamentum Flavum Cyst in the Adjacent Level of Lytic Spondylolisthesis – A Case of Diagnostic and Therapeutic Dilemma
Authors:   Spine Services, Indian Spinal Injuries Centre, New Delhi - 110070, India,, Mohapatra Bibhudendu , Jagadeesh Nirdesh Hiremagalur ,   Spine Services, Indian Spinal Injuries Centre, New Delhi - 110070, India,, Guha Mayukh ,   Spine Services, Indian Spinal Injuries Centre, New Delhi - 110070, India,, Agarwal Anita ,   Department of Radiology, Indian Spinal Injuries Centre, New Delhi - 110070, India., George Jomin ,   Spine Services, Indian Spinal Injuries Centre, New Delhi - 110070, India,, Rehman T Fazal ,   Spine Services, Indian Spinal Injuries Centre, New Delhi - 110070, India,
Published: April 2024

Introduction: Occurrence of hemorrhagic cyst inside ligamentum flavum is a very rare phenomenon and presents with back pain, radiculopathy, or neurogenic claudication. Various causes reported in the literature are trauma, anticoagulant therapy, and increased micromotion in the setting of unstable and degenerated motion segment. Case Report: We report a case of 41-year-old male patient who presented with claudication pain in both lower limbs for the past 6 months associated with bilateral calf atrophy. Plain radiograph with dynamic films showed lytic spondylolisthesis at L4-L5 level. Magnetic resonance imaging revealed a hemorrhagic cyst inside ligamentum flavum at the L3-L4 level occupying the posterior epidural space severely compressing the thecal sac. After a thorough diagnostic and therapeutic work up, we did a midline sparing decompression of L3-L4 level under microscope without fixing the listhetic segment. The patient had significant pain relief after surgery and doing well till now. Conclusion: In general, hemorrhagic cyst of ligamentum flavum is seen in a degenerated lumbar spine at the areas of increased micromotion and instability. Our case has shown that it can also occur in an adjacent segment of spondylolisthesis or instability. The obvious finding like listhesis in the adjacent segment may hinder a spine surgeon from diagnosing the cyst component and may guide to a erroneous treatment outline. Hence, it should not be missed in the imaging. Keywords: Ligamentum flavum cyst, hemorrhagic flavum cyst, lytic spondylolisthesis.
Heterotopic Ossification Secondary to Motor Vehicle Collision Trauma Leading to Femoroacetabular Impingement Syndrome: A Case Report
Authors:   Department of Biology, Florida Atlantic University, Boca Raton, Florida,, Sancilio Christopher , Mastroianni Michael ,   Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, United State, Mousad Albert ,   Department of Biology,Tufts University School of Medicine, Boston, Massachusetts,, De Jesus Nicholas ,   Department of Biology, Florida Atlantic University, Boca Raton, Florida,, McCormick Frank ,   Beth Israel Deaconess Medical Center at Signature Healthcare, Brockton, Massachusetts.
Published: April 2024

Introduction: A patient presented for recalcitrant right hip pain secondary to femoroacetabular impingement (FAI) after blunt motor vehicle trauma and following the development of a 12 cm heterotopic ossification (HO). FAI is an increasingly recognized diagnosis where the hip joint is exposed to repeated femoral microtrauma from high-level physical activity or trauma, often causing labral ossification, and perhaps underlying a similar biological mechanism to HO. Case Report: In this case report, we have an otherwise healthy 49-year-old male who was involved in a high-speed motor vehicle collision who was diagnosed with right hip FAI secondary to HO (Brooker’s Class IV) and indicated for surgical excision of the HO anterior to the right proximal femur. The care team and patient initially trialed non-operative conservative treatment with non-steroidal anti-inflammatories drugs (NSAIDs) and hypothesized therapeutic success using a non-surgical approach. Surgical resection was pursued with the patient after a failure of conservative measures. The patient reported a zero out of ten on a ten-point numerical rating scale for pain, he also stated improved quality of life, satisfaction with the procedure, and subsequent rehabilitation at 1-month post-operative follow-up. Conclusion: HO with near complete ankylosis of the hip joint may be causative of FAI when untreated. Although this case demonstrates a rarely studied traumatic etiology of impingement secondary to HO, initial standard conservative anti-inflammatory treatment can still be pursued. By analyzing the periarticular impact of HO secondary to non-surgical trauma, we can utilize and make inferential correlations from the literature, studying HO and impingement in the setting of prior hip surgery to guide treatment and prognosis in those presenting with FAI symptoms secondary to blunt force trauma. Key words: Heterotopic ossification, femoroacetabular impingement, blunt trauma.
Governing Hegemonic Spaces in Carl Schmitt: Colonialism, Anti-Imperialism and the Großraum Theory
Authors: von Bernstoff Jochen
Published: April 2024

Abstract: With both China and Russia currently claiming a hegemonic position within a regionally defined and allegedly state-border transcending space, Carl Schmitt's theory of international law has gained new prominence in feuilletons and academic writings. Observers have diagnosed a "Schmitt fever" in Chinese literature on international relations and international law. The article argues that Schmitt's advocacy of hegemonically dominated and state-border transcending spaces (Großräume) is not a principled contradiction to his then ground-breaking critique of US imperialism in the first half of the 20th century. The sharp criticism of US imperialism and Schmitt's apologetic or permissive attitude towards hegemonic and colonial rule over foreign peoples are not contradictory, they belong together. Both these tension-filled tenets of his international legal theory are based on his rather coherent conception of international law, represented by Schmitt's highly idealized reconstruction of the old ius publicum europaeum.
A New Data-Mining Method for the Digital Great Wall Exemplified by Statistical Evaluation and Analysis of the Ming Great Wall Archery Windows
Authors: Li Zhe , Zhang Mengdi , Tuo Xiaolong , Zhang Yukun , Li Yan
Published: April 2024

Abstract: The authors reveal the functions of the Ming Great Wall's archery windows as well as the wisdom behind their construction. They developed a cross-regional, quantitative research method that identifies heritage values, beginning with data collection by drones, proceeding through data processing using artificial intelligence, and concluding with data analysis via landscape archaeology. The data collection method respects the morphology of the Great Wall and the rugged terrain around it. The authors improved an existing neural network by introducing automatic labeling and processing of image data. The method performs automatic statistical analyses of basic features such as the size, proportion, and morphology of archery windows along the Great Wall. The functions of the windows become apparent, as do the strategical importance to garrisons of watchtowers with windows and the principles of defensive zone planning that considers the surrounding terrain. The method breathes new life into heritage places and adds value to heritage interpretations. The images that the authors acquired and processed render heritage value analysis more efficient. Their method aids value mining and conservation of large cultural heritage sites.
FRD-Net: a full-resolution dilated convolution network for retinal vessel segmentation
Authors: Huang Hua , Shang Zhenhong , Yu Chunhui
Published: April 2024

Accurate and automated retinal vessel segmentation is essential for performing diagnosis and surgical planning of retinal diseases. However, conventional U-shaped networks often suffer from segmentation errors when dealing with fine and low-contrast blood vessels due to the loss of continuous resolution in the encoding stage and the inability to recover the lost information in the decoding stage. To address this issue, this paper introduces an effective full-resolution retinal vessel segmentation network, namely FRD-Net, which consists of two core components: the backbone network and the multi-scale feature fusion module (MFFM). The backbone network achieves horizontal and vertical expansion through the interaction mechanism of multi-resolution dilated convolutions while preserving the complete image resolution. In the backbone network, the effective application of dilated convolutions with varying dilation rates, coupled with the utilization of dilated residual modules for integrating multi-scale feature maps from adjacent stages, facilitates continuous learning of multi-scale features to enhance high-level contextual information. Moreover, MFFM further enhances segmentation by fusing deeper multi-scale features with the original image, facilitating edge detail recovery for accurate vessel segmentation. In tests on multiple classical datasets,compared to state-of-the-art segmentation algorithms, FRD-Net achieves superior performance and generalization with fewer model parameters.
Multi-objective optimization for vector quantization via genetic algorithm
Authors: Abedi Firas , Al-Baghdadi Ahmed Fahim
Published: April 2024

The issue of image compression continues to be a subject of ongoing research within the domain of image processing, particularly in the context of medical applications. The quality of the decompressed image can vary depending on the accuracy of the compression technique, resulting in either fine or distorted details. Therefore, the diagnostic procedure performed by medical professionals is contingent upon the precision of the compression and decompression process. In addition, the compression of medical images serves to decrease the amount of storage required, thereby enabling faster transmission over computer networks through the reduction of their bit size. This paper proposes a hybrid mix of the discrete wavelet transform (DWT) technique and vector quantization (VQ) to improve the compression technique of medical images. The aim of the proposed compression technique is to preserve diagnostic image information while achieving a high compression ratio. First, noise in medical images is caused by salt pepper noise. At the same time, the edges of the images are maintained in sharpness and context. Then, a lossless compression method is applied to the wavelet coefficients of the subband with the lowest frequency, while the thresholding method was used to efficiently construct coefficients for high-frequency sub-bands. This process will produce a traditional VQ, which is estimated via the Genetic Algorithm (GA) with fuzzy clustering. While Arithmetic encoded theory was being utilized to quantize coefficients, the proposed compression technique was evaluated by dividing the image into two levels and three levels of sub-bands, respectively, in two different scenarios. Comparing the decompressed image to the filtered image by means of different evaluation metrics, the proposed method can enhance compression performance and strike a balance between compression ratio and image visual quality.
Access of older people to primary health care in low and middle-income countries: A systematic scoping review
Authors: Dableh Saydeh , Frazer Kate , Stokes Diarmuid , Kroll Thilo
Published: April 2024

Introduction

Ensuring access for older people to Primary Health Care (PHC) is vital to achieve universal health coverage, improve health outcomes, and health-system performance. However, older people living in Low-and Middle-Income Countries (LMICs) face barriers constraining their timely access to appropriate care. This review aims to summarize the nature and breadth of literature examining older people’s experiences with access to PHC in LMICs, and access barriers and enablers.

Methods

Guided by Arksey and O’Malley’s framework, four databases [CINAHL, Cochrane, PubMed, and Embase] were systematically searched for all types of peer-reviewed articles published between 2002 and 2023, in any language but with English or French abstract. Gray literature presenting empirical data was also included by searching the United Nations, World Health Organization, and HelpAge websites. Data were independently screened and extracted.

Results

Of 1165 identified records, 30 are included. Data were generated mostly in Brazil (50%) and through studies adopting quantitative designs (80%). Older people’s experiences varied across countries and were shaped by several access barriers and enablers classified according to the Patient-Centered Access to Healthcare framework, featuring the characteristics of the care delivery system at the supply side and older people’s attributes from the demand side. The review identifies that most access barriers and enablers pertain to the availability and accommodation dimension, followed by the appropriateness, affordability, acceptability, and approachability of services. Socio-economic level and need perception were the most reported characteristics that affected older people’s access to PHC.

Conclusions

Older people’s experiences with PHC access varied according to local contexts, socioeconomic variables, and the provision of public or private health services. Results inform policymakers and PHC practitioners to generate policies and services that are evidence-based and responsive to older people’s needs. Identified knowledge gaps highlight the need for research to further understand older people’s access to PHC in different LMICs.
Strategic choices of migrants and smugglers in the Central Mediterranean sea
Authors: Hoffmann Pham Katherine , Komiyama Junpei
Published: April 2024

The sea crossing from Libya to Italy is one of the world’s most dangerous and politically contentious migration routes, and yet over half a million people have attempted the crossing since 2014. Leveraging data on aggregate migration flows and individual migration incidents, we estimate how migrants and smugglers have reacted to changes in the border enforcement regime, namely the rise in interceptions by the Libyan Coast Guard starting in 2017 and the corresponding decrease in the probability of rescue to Europe. We find support for a deterrence effect in which attempted crossings along the Central Mediterranean route declined, and a diversion effect in which some migrants substituted to the Western Mediterranean route. At the same time, smugglers adapted their tactics. Using a strategic model of the smuggler’s choice of boat size, we estimate how smugglers trade off between the short-run payoffs to launching overcrowded boats and the long-run costs of making less successful crossing attempts under different levels of enforcement. Taken together, these analyses shed light on how the integration of incident- and flow-level datasets can inform ongoing migration policy debates and identify potential consequences of changing enforcement regimes.
Knowledge, attitudes, and practices about HIV and other sexually transmitted infections among High School students in Southern Italy: A cross-sectional survey
Authors: Di Gennaro Francesco , Segala Francesco Vladimiro , Guido Giacomo , Poliseno Mariacristina , De Santis Laura , Belati Alessandra , Santoro Carmen Rita , Bottalico Irene Francesca , Pellegrino Carmen , Novara Roberta , Frallonardo Luisa , Cormio Mariangela , Camporeale Michele , Cotugno Sergio , Giliberti Vincenzo , Di Gregorio Stefano , Totaro Valentina , Catucci Nicola , De Giosa Anna , Giusto Roberta , Lanera Ilaria Viviana , Angarano Gioacchino , Lo Caputo Sergio , Saracino Annalisa
Published: April 2024

High School students, recognized as a high-risk group for sexually transmitted infections (STIs), were the focal point of an educational campaign in Southern Italy to share information and good practices about STIs and HIV/AIDS. A baseline survey comprising 76 items was conducted via the REDCap platform to assess students’ initial knowledge, attitudes, and practices (KAP) related to STIs and HIV/AIDS. Sociodemographic variables were also investigated. The association between variables and KAP score was assessed by Kruskal-Wallis’ or Spearman’s test, as appropriate. An ordinal regression model was built to estimate the effect size, reported as odds ratio (OR) with a 95% confidence interval (CI), for achieving higher KAP scores among students features. On a scale of 0 to 29, 1702 participants achieved a median KAP score of 14 points. Higher scores were predominantly reported by students from classical High Schools (OR 3.19, 95% C.I. 1.60–6.33, p<0.001). Additionally, elevated scores were associated with sexually active students (OR 1.48, 95% C.I. 1.12–1.96, p = 0.01), those vaccinated against Human Papilloma Virus (OR 2.47, 95% C.I. 1.89–3.24, p<0.001), those who had used emergency contraception (OR 1.56, 95% C.I. 1.09–2.24, p = 0.02, Table 2) and those obtaining information from TikTok (OR 1.62, 95% C.I. 1.14–2.30, p = 0.01). Conversely, being heterosexual was associated with an overall lower score (OR 0.48, 95% C.I. 0.32–0.73, p<0.001). High School students, often due to early sexual debut, seek information about HIV and STIs independently using social channels. However, the overall level of knowledge, attitudes, and practices remains low. Urgent school-based interventions are needed for this age group.
Test-retest reliability of Latin American Group for Maturity (GDLAM) protocol in older women
Authors: Huerta Ojeda Álvaro , Jofré-Saldía Emilio , Arriagada Molina Jimena , Rojas Quinchavil Patricia , Parada Toledo María Paz , Galdames Maliqueo Sergio , Yeomans-Cabrera María-Mercedes , Jorquera-Aguilera Carlos , Giakoni-Ramirez Frano , Bravo Maximiliano
Published: April 2024

Functional autonomy (FA) is a critical factor in determining the quality of life of older adults (OA), especially in the case of older women (OW), as they face a decline in FA in their later years of life. FA should be assessed early, using valid, reliable, and low-cost tests. This study evaluated the test-retest reliability of GDLAM and GDLAM autonomy index (GI) in OW. Thirty-nine OW (71.2 ± 6.50 years) participated in the study. A repeated measures design was used to compare the interday test-retest reliability of the five GDLAM tests (seconds) and the GI (points). The five tests represent activities of daily living, such as dressing or wandering around the house, while the GI provides a weighting of the results of the five tests. The analysis consisted of the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and coefficient of variation (CV). A CV ≤ 10% and an ICC ≥ 0.80 were considered acceptable reliability, whereas a CV ≤ 5% and an ICC ≥ 0.90 were considered high reliability. The outcome of the five tests, represented by the GI, showed high interday test-retest reliability (CV = 6.00% and ICC = 0.91). The results of this study demonstrate that the five tests of the GDLAM protocol and the GI have high interday test-retest reliability and good interday reproducibility. From a practical point of view, the GDLAM protocol allows the assessment of FA of community-dwelling OW, providing background for early diagnosis and, with it, the possibility of developing an individualized physical exercise prescription.
VIX constant maturity futures trading strategy: A walk-forward machine learning study
Authors: Wang Sangyuan , Li Keran , Liu Yaling , Chen Yijun , Tang Xianbo
Published: April 2024

This study employs seven advanced machine learning approaches to conduct numerical predictions of the next-day returns of VIX constant-maturity futures (VIX CMFs) using the term structure information derived from VIX CMFs. Based on precise numerical predictions, this study proposes a new Constrained-Mean-Variance Portfolio Optimization (C-MVO) trading strategy and tests it against a benchmark long-short trading strategy to evaluate the profitability of the machine learning numerical predictions. This study applies three unique feature sets, each incrementally incorporating the VIX CMFs’ term structure features, to individually examine the predictive ability of the seven machine learning models and their backtesting performance. Over a comprehensive 11-year period, the experiment adheres to a strict walk-forward expanding-window methodology for both training and backtesting. The predictive and backtesting results show that four of the seven machine learning models attain a prediction information ratio greater than 0.02, with an average prediction information ratio of 0.037. This result suggests that the VIX CMFs term structure features have predictive power for the next-day returns of VIX CMFs. Moreover, the average C-MVO information ratio is 0.623, and the long-short strategy information ratio is 0.404. This increase in the information ratio under the C-MVO strategy validates the effectiveness of the machine learning models and the C-MVO strategy.
A novel and ubiquitous miRNA-involved regulatory module ensures precise phosphorylation of RNA polymerase II and proper transcription
Authors: Wang Zhiwen , Zhong Shan , Zhang Sicong , Zhang Borui , Zheng Yang , Sun Ye , Zhang Qinghua , Liu Xili
Published: April 2024

Proper transcription orchestrated by RNA polymerase II (RNPII) is crucial for cellular development, which is rely on the phosphorylation state of RNPII’s carboxyl-terminal domain (CTD). Sporangia, developed from mycelia, are essential for the destructive oomycetes Phytophthora, remarkable transcriptional changes are observed during the morphological transition. However, how these changes are rapidly triggered and their relationship with the versatile RNPII-CTD phosphorylation remain enigmatic. Herein, we found that Phytophthora capsici undergone an elevation of Ser5-phosphorylation in its uncanonical heptapeptide repeats of RNPII-CTD during sporangia development, which subsequently changed the chromosomal occupation of RNPII and primarily activated transcription of certain genes. A cyclin-dependent kinase, PcCDK7, was highly induced and phosphorylated RNPII-CTD during this morphological transition. Mechanistically, a novel DCL1-dependent microRNA, pcamiR1, was found to be a feedback modulator for the precise phosphorylation of RNPII-CTD by complexing with PcAGO1 and regulating the accumulation of PcCDK7. Moreover, this study revealed that the pcamiR1-CDK7-RNPII regulatory module is evolutionarily conserved and the impairment of the balance between pcamiR1 and PcCDK7 could efficiently reduce growth and virulence of P. capsici. Collectively, this study uncovers a novel and evolutionary conserved mechanism of transcription regulation which could facilitate correct development and identifies pcamiR1 as a promising target for disease control.
Sensitive detection of pathological seeds of α-synuclein, tau and prion protein on solid surfaces
Authors: Orrú Christina D. , Groveman Bradley R. , Hughson Andrew G. , Barrio Tomás , Isiofia Kachi , Race Brent , Ferreira Natalia C. , Gambetti Pierluigi , Schneider David A. , Masujin Kentaro , Miyazawa Kohtaro , Ghetti Bernardino , Zanusso Gianluigi , Caughey Byron
Published: April 2024

Prions or prion-like aggregates such as those composed of PrP, α-synuclein, and tau are key features of proteinopathies such as prion, Parkinson’s and Alzheimer’s diseases, respectively. Their presence on solid surfaces may be biohazardous under some circumstances. PrP prions bound to solids are detectable by ultrasensitive real-time quaking-induced conversion (RT-QuIC) assays if the solids can be immersed in assay wells or the prions transferred to pads. Here we show that prion-like seeds can remain detectable on steel wires for at least a year, or even after enzymatic cleaning and sterilization. We also show that contamination of larger objects with pathological seeds of α-synuclein, tau, and PrP can be detected by simply assaying a sampling medium that has been transiently applied to the surface. Human α-synuclein seeds in dementia with Lewy bodies brain tissue were detected by α-synuclein RT-QuIC after drying of tissue dilutions with concentrations as low as 10−6 onto stainless steel. Tau RT-QuIC detected tau seeding activity on steel exposed to Alzheimer’s disease brain tissue diluted as much as a billion fold. Prion RT-QuIC assays detected seeding activity on plates exposed to brain dilutions as extreme as 10−5–10−8 from prion-affected humans, sheep, cattle and cervids. Sampling medium collected from surgical instruments used in necropsies of sporadic Creutzfeldt-Jakob disease-infected transgenic mice was positive down to 10−6 dilution. Sensitivity for prion detection was not sacrificed by omitting the recombinant PrP substrate from the sampling medium during its application to a surface and subsequent storage as long as the substrate was added prior to performing the assay reaction. Our findings demonstrate practical prototypic surface RT-QuIC protocols for the highly sensitive detection of pathologic seeds of α-synuclein, tau, and PrP on solid objects.