bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical management of umbilical endometrioma within an umbilical hernia
Authors: Cumbo Nicole , Leung Stephen , Aikman Noelle , ElSahwi Karim
Published: January 2025

A nulliparous woman in her 40s is referred to gynaecological oncology secondary to umbilical pain and bleeding with menses. Examination revealed a blood-filled cystic mass within an umbilical hernia consistent with umbilical endometrioma. The patient exhausted medical management options, then pursued surgical management via umbilectomy, excision of umbilical endometriosis, lysis of adhesions and umbilical hernia repair. Surgical pathology revealed cystic endometriosis within a hernia sac. Postoperative course was complicated by a surgical site infection, which resolved with antibiotic treatment and ultrasound-guided percutaneous drainage. Few theories attempt to explain the pathogenesis of umbilical endometriosis. Medical management has not been well studied but may prove to be an effective first-line adjuvant strategy. Surgical management is reported to have a low-recurrence rate. Many techniques have been described for umbilical reconstruction, but a superior surgical technique has yet to be identified. The case presented discusses the management of a secondary endometrioma in an umbilical hernia.
The feasibility and effectiveness of telecare consultations in a nurse-led post-acute stroke clinic
Authors: Wong Arkers Kwan Ching , Wang Robbie Mian , Wong Frances Kam Yuet , Yuen Bernard Man Kam , Fong Ching Sing , Chan Shun Tim , Kwok Vivian Wai Yan
Published: January 2025

Background

Telecare may provide an alternative to maintaining post-acute stroke care services in making benefit to both the providers and the stroke survivors, although study is needed to investigate its feasibility and effectiveness in integrating this innovative delivery mode into a routine.

Objectives

The objectives of this study are to assess the feasibility and effectiveness of telecare consultations in a nurse-led post-acute stroke clinic.

Methods

A pre- and post-test one group quasi-experimental design was adopted. Subjects were recruited in the clinic and received three secondary stroke care consultations in 3 months via telecare from stroke nurses. Data were collected at pre- and post-intervention. A Wilcoxon signed-rank test was used to compare the two time-points for differences in effectiveness.

Results

Ninety-two stroke survivors participated. The drop-out rate was 27%. The majority perceived the programme as time-friendly and cost-saving and as alleviating their health-related worries. At the 3-month follow-up, notable improvements were observed in the activities of daily living and the strength domain of stroke-specific quality of life.

Conclusions

Integrating telecare consultations within nurse-led stroke clinics is a feasible and acceptable strategy for monitoring the health and fostering the self-care abilities of individuals following their discharge from hospital after an acute stroke episode.
Comparing apples and oranges in youth depression treatments? A quantitative critique of the evidence base and guidelines
Authors: Stringaris Argyris , Burman Charlotte , Delpech Raphaelle , Uher Rudolph , Bhudia Dayna , Miliou Despoina , Rokas Ioannis-Marios , Kyriakopoulos Marinos , Foulkes Lucy , Moreno Carmen , Cortese Samuele , Lewis Glyn , Krebs Georgina
Published: January 2025

Objectives

Should a young person receive psychotherapy or medication for their depression and on what evidence do we base this decision? In this paper, we test the factors across modalities that may influence comparability between medication and psychotherapy trials.

Methods

We included 92 randomised controlled trials (RCTs) of psychotherapy and medication for child and adolescent depression (mean age 4–18 years). Using meta-analyses, we compared (a) participant characteristics and (b) trial characteristics in medication and psychotherapy trials. Lastly, we examined whether psychotherapy controls are well-matched to active conditions.

Results

Participants in medication RCTs had higher depression severity and were more frequently male compared with psychotherapy RCTs. There was a dramatic difference in the within-subject improvement due to placebo (SMD=−1.9 (95% CI: −2.1 to −1.7)) vs. psychotherapy controls (SMD=−0.6 (95% CI: −0.9 to −0.3)). Within psychotherapy RCTs, control conditions were less intensive on average than active conditions.

Conclusions

Medication and psychotherapy RCTs differ on fundamental participant and methodological characteristics, thereby raising questions about their comparability. Psychotherapy controls often involve little therapist contact and are easy-to-beat comparators. These findings cast doubt on the confidence with which psychotherapy is recommended for youth depression and highlight the pressing need to improve the evidence base.
Evaluation of the implementation of personalised outcomes forecasts to optimise supervised exercise therapy in patients with intermittent claudication: a multimethods process evaluation
Authors: Marcellis Laura H M , Sinnige Anneroos , van Bergen Anne G E , Spruijt Steffie , Kittelson Andrew , Teijink Joep A W , van der Wees Philip J , Hoogeboom Thomas J
Published: January 2025

Background

Personalised outcomes forecasts (POFs) were introduced among physical and exercise therapists in the Netherlands to optimise supervised exercise therapy for patients with intermittent claudication. Yet, therapists’ initial adoption and sustainable implementation of POFs can be influenced by various factors.

Objectives

The purpose of this study was to examine therapists’ adoption of the POFs, their fidelity to the measurement protocol for supervised exercise therapy, and their perceived barriers and facilitators for using POFs in practice.

Methods

A multimethod process evaluation was conducted, including quantitative descriptive and pre–post approaches, as well as a qualitative framework approach. To examine adoption, we evaluated the proportion of therapists who expressed interest in POFs by completing one of three provided e-learnings and the proportion of therapists who started using POFs in practice. To examine fidelity to the measurement protocol, we compared the per-episode proportion of follow-up measurements documented by therapists preimplementation and postimplementation. Qualitative data on barriers and facilitators were identified through semistructured interviews with therapists.

Results

One year after the implementation, 89% of therapists eligible to use POFs (n=1727) completed at least one e-learning and 51% of therapists started using POFs. The per-episode proportion of documented follow-up measurements per therapist increased, from a mean rate of 37% (3 months) and 22% (6 months) during the preimplementation period to a mean rate of 53% (3 months) and 32% (6 months) during the postimplementation period (p<0.001). Among interviewed therapists (n=12), identified barriers included competing demands and a lack of skills or confidence. Identified facilitators included the potential to improve the quality of care and a positive user attitude.

Conclusions

Our findings suggest that although there is initial interest in and adoption of POFs, addressing barriers and leveraging facilitators through tailored implementation strategies could further increase their utilisation in practice.
Challenges with achieving and maintaining oral cholera vaccine coverage: insights from serial cross-sectional representative surveys in a cholera-endemic community in the Democratic Republic of the Congo
Authors: Koyuncu Aybüke , Bugeme Patrick Musole , Dent Juan , Hutchins Chloe , Xu Hanmeng , Gallandat Karin , Cumming Oliver , Matundanya Joseph , Cikomola Aimé , Rukakiza Delphin , Nkombo Merveille , Mufitini Jaime Saidi , Bashige Rumedeka Baron , Akilimali Laurent , Lee Elizabeth C , Welo Placide Okitayemba , Knee Jackie , Azman Andrew S , Malembaka Espoir Bwenge
Published: January 2025

Background

We conducted three serial cross-sectional representative surveys after a mass cholera vaccination campaign in Uvira, Democratic Republic of the Congo to (1) estimate the vaccination coverage and explore heterogeneity by geographic and demographic factors; (2) examine barriers and facilitators of vaccine uptake and (3) describe the changes in coverage over time and predict future coverage.

Methods

We collected data on sociodemographics, self-reported vaccination status, population movement and knowledge, attitudes and behaviours related to killed oral cholera vaccines (kOCVs) in August 2021, April 2022 and April 2023, approximately 11, 19 and 30 months postvaccination. We compared the characteristics of participants by vaccination status and explored the potential role of population movement as a cause for low coverage. We used an exponential decay model to predict the proportion of the population vaccinated with ≥1 dose of kOCV over time based on age-specific coverage.

Results

We enrolled 8735 participants from 1433 households across all surveys. Coverage in survey 1 (August 2021) was 55% for ≥1 dose of kOCV (95% CI 51 to 60) and 23% for ≥2 doses (95% CI 20 to 27). Vaccine refusal was associated with a lack of confidence in the vaccine’s safety, and 29% of unvaccinated adults reported it was unlikely they would accept kOCVs if an additional mass vaccination campaign was conducted in their area. Coverage of ≥1 one dose of kOCV declined on average by 18% per year (95% credible interval 14 to 23) and was 39% (95% CI 36 to 43) by survey 3 (approx. 30 months after second dose campaign).

Conclusions

Our findings suggest that in settings like Uvira, efforts to strengthen vaccine confidence are needed to achieve higher campaign coverage, and vaccine coverage dilution may be reduced by more frequent and coordinated geographic vaccination efforts.
A retrospective study to understand the differences in maternal mortality among women admitted in critical and stable conditions in Malawi
Authors: Munthali Laura , Chirombo James , Makhaza Lumbani , Riches Jennifer , Mbewe Malangizo , Bilesi Rosemary , Tagiyeva-Milne Nara , Lissauer David
Published: January 2025

Introduction

Addressing the burden of preventable maternal deaths remains a critical focus of global health efforts in countries like Malawi which still has a high maternal mortality ratio of 381 deaths per 100 000 live births. We investigated the differences in case characteristics, survival and causes of death between pregnant and recently pregnant women who died, following their admission in stable or critical conditions to healthcare facilities in Malawi.

Methods

We conducted a retrospective analysis of maternal deaths of women from all district and central hospitals of Malawi between August 2020 and August 2022. Data were sourced from the national maternal and newborn health surveillance platform. We performed descriptive analyses, stratified by condition on admission, to identify differences in case characteristics between the two groups, and an exploratory survival analysis, to understand the differences in time to death since admission. Lastly, we performed a principal component analysis to reduce dimensionality to identify the main factors leading to deaths.

Results

Obstetric haemorrhage was the predominant cause of death among women admitted in stable condition, while those admitted in critical condition primarily died of hypertensive disorders. Most deaths in both categories occurred on the day of admission, corresponding to their primary causes of death. The key factors leading to deaths were mostly healthcare worker factors followed by administrative factors.

Conclusion

Understanding and responding to the different underlying causes of maternal mortality and contributing factors in the stable and critical cohorts are vital to designing well-targeted and impactful interventions to prevent maternal deaths.
Role of IPF genetic risk loci in post-COVID-19 lung abnormalities: a cohort study
Authors: Marinescu Daniel-Costin , Wong Alyson W , Shah Aditi , Hague Cameron J , Murphy Darra , Yang Julia , Johnston James , Leung Janice , Carlsten Christopher , Ryerson Christopher J
Published: January 2025

Introduction

Persistent lung abnormalities following COVID-19 infection are common. Similar parenchymal changes are observed in idiopathic pulmonary fibrosis (IPF). We investigated whether common genetic risk factors in IPF are associated with developing lung parenchymal abnormalities following severe COVID-19 disease.

Methods

Consecutive adults hospitalised for laboratory-confirmed COVID-19 infection were prospectively recruited from March to May 2020. Three single-nucleotide polymorphisms (SNPs) conferring risk for IPF were genotyped (MUC5Brs35705950, ATP11Ars1278769 andDPP9rs12610495). High-resolution CT and pulmonary function tests were performed at 3 months postdischarge from hospital. Ground glass opacities and reticulation on imaging were visually quantified by two expert thoracic radiologists. Linear regression was used to evaluate the association between risk alleles at each of the three SNPs and (a) lung parenchymal abnormalities as well as (b) pulmonary function, adjusted for age, sex, smoking history and days spent on supplemental oxygen during acute illness.

Results

71 patients were included. Mean age was 63±16 years, 62% were male, 31% were ever-smokers and median hospital length of stay was 9±11 days, with 23% requiring mechanical ventilation. TheMUC5Brisk allele was associated with a significant decrease in ground glass (β=−0.8, 95% CI −1.5 to –0.1, p=0.02) at 3 months, and this finding was paralleled by a concurrent but non-significant trend towards increased diffusion capacity for carbon monoxide (DLCO) (β=8.8, 95% CI −1.2 to 18.8, p=0.08) compared with patients without this risk allele. None of the risk alleles were significantly associated with reticulation at 3 months.

Conclusion

In an adjusted analysis controlling for severity of infection,MUC5Bwas associated with reduced ground glass and a trend towards concordant higher DLCO at 3 months after severe COVID-19 illness. This hypothesis-generating result suggests a possible protective effect ofMUC5Bin postinfectious lung abnormalities as compared with fibrosis in IPF, highlighting a plausible trade-off between its role in immune defence and epithelial cell function.
Unlocking novel T cell-based immunotherapy for hepatocellular carcinoma through neoantigen-driven T cell receptor isolation
Authors: Maravelia Panagiota , Yao Haidong , Cai Curtis , Nascimento Silva Daniela , Fransson Jennifer , Nilsson Ola B , Lu Yong-Chen William , Micke Patrick , Botling Johan , Gatto Francesca , Rovesti Giulia , Carlsten Mattias , Sallberg Matti , Stål Per , Jorns Carl , Buggert Marcus , Pasetto Anna
Published: January 2025

Background

Tumour-infiltrating T cells can mediate both antitumour immunity and promote tumour progression by creating an immunosuppressive environment. This dual role is especially relevant in hepatocellular carcinoma (HCC), characterised by a unique microenvironment and limited success with current immunotherapy.

Objective

We evaluated T cell responses in patients with advanced HCC by analysing tumours, liver flushes and liver-draining lymph nodes, to understand whether reactive T cell populations could be identified despite the immunosuppressive environment.

Design

T cells isolated from clinical samples were tested for reactivity against predicted neoantigens. Single-cell RNA sequencing was employed to evaluate the transcriptomic and proteomic profiles of antigen-experienced T cells. Neoantigen-reactive T cells expressing 4-1BB were isolated and characterised through T-cell receptor (TCR)-sequencing.

Results

Bioinformatic analysis identified 542 candidate neoantigens from seven patients. Of these, 78 neoantigens, along with 11 hotspot targets from HCC driver oncogenes, were selected for ex vivo T cell stimulation. Reactivity was confirmed in co-culture assays for 14 targets, with most reactive T cells derived from liver flushes and lymph nodes. Liver flush-derived T cells exhibited central memory and effector memory CD4+ with cytotoxic effector profiles. In contrast, tissue-resident memory CD4+ and CD8+ T cells with an exhausted profile were primarily identified in the draining lymph nodes.

Conclusion

These findings offer valuable insights into the functional profiles of neoantigen-reactive T cells within and surrounding the HCC microenvironment. T cells isolated from liver flushes and tumour-draining lymph nodes may serve as a promising source of reactive T cells and TCRs for further use in immunotherapy for HCC.
Can a novel computer vision-based framework detect head-on-head impacts during a rugby league tackle?
Authors: Mohan Manish , Weaving Dan , Gardner Andrew J , Hendricks Sharief , Stokes Keith A , Phillips Gemma , Cross Matt , Owen Cameron , Jones Ben
Published: January 2025

Background

Head-on-head impacts are a risk factor for concussion, which is a concern for sports. Computer vision frameworks may provide an automated process to identify head-on-head impacts, although this has not been applied or evaluated in rugby.

Methods

This study developed and evaluated a novel computer vision framework to automatically classify head-on-head and non-head-on-head impacts. Tackle events from professional rugby league matches were coded as either head-on-head or non-head-on-head impacts. These included non-televised standard-definition and televised high-definition video clips to train (n=341) and test (n=670) the framework. A computer vision framework consisting of two deep learning networks, an object detection algorithm and three-dimensional Convolutional Neural Networks, was employed and compared with the analyst-coded criterion. Sensitivity, specificity and positive predictive value were reported.

Results

The overall performance evaluation of the framework to classify head-on-head impacts against manual coding had a sensitivity, specificity and positive predictive value (95% CIs) of 68% (58% to 78%), 84% (78% to 88%) and 0.61 (0.54 to 0.69) in standard-definition clips, and 65% (55% to 75%), 84% (79% to 89%) and 0.61 (0.53 to 0.68) in high-definition clips.

Conclusion

The study introduces a novel computer vision framework for head-on-head impact detection. Governing bodies may also use the framework in real time, or for retrospective analysis of historical videos, to establish head-on-head rates and evaluate prevention strategies. Future work should explore the application of the framework to other head-contact mechanisms and also the utility in real time to identify potential events for clinical assessment.
Genetic features and pharmacological rescue of novel Kv7.2 variants in patients with epilepsy
Authors: Song Yue , Xia Yang , Peng Ziyue , Meng Yuhuan , Jing Wenwen , Xie Li , Cao Tianhua , Zhang Jiahui , Song Huilin , Meng Lingdi , Zhang Yi , Sui Shengbin , Mao Di , Jia Ying , Qiao Shupei , Yu Shihui , Zhang Xue
Published: January 2025

Background

Increasing evidence indicates a robust correlation between epilepsy and variants of the Kv7.2 (KCNQ2) channel, which is critically involved in directing M-currents and regulating neuronal excitability within the nervous system. With the advancement of next-generation sequencing, the identification ofKCNQ2variants has surged. Nonetheless, their functional impacts are still being determined, introducing uncertainty into the diagnostic process for affected families and potentially hindering their ability to participate in targeted precision medicine trials. This study aims to elucidate the pathogenicity of these novel variants and explore potential therapeutic interventions.

Methods

Whole-cell patch-clamp recordings, western blotting, and immunofluorescent staining were performed to elucidate the functional consequences of the identified variants. Moreover, coimmunoprecipitation techniques were conducted to explore protein interactions, thus facilitating a deeper understanding of the underlying pathogenetic mechanisms contributing to the disease. Ultimately, the effects of pharmacological interventions were evaluated in vitro using the patch-clamp technique.

Results

Herein, we identified 12 novelKCNQ2variants, further expanding the mutational spectrum ofKCNQ2. Our investigation revealed that one gain-of-function variant (p.L102V (c.304C>G)) and three loss-of-function variants (p.H328Q (c.984C>G), p.A336V (c.1007C>T) and p.D563Efs*22 (c.1688_1689insACTT)) had different impacts on the binding of calmodulin and phosphati-dylinositol-4,5-bisphosphate, potentially altering their localisation and protein stability. Furthermore, the application of ML213, unlike Retigabine and ICA-069673, led to a significant increase in the current of p.H328Q.

Conclusion

This study expanded the mutational spectrum ofKCNQ2and analysed the genetic and functional consequences, as well as the pharmacological rescue, of fourde novo KCNQ2variants. These findings offer valuable insights into the precise medicine ofKCNQ2-related epilepsy.
Cross-sectional and longitudinal association of sleep patterns and aneurysmal vulnerability biomarkers on high-resolution magnetic resonance vessel wall imaging
Authors: Duan Chuan-Zhi , Huang Chi , Wen Zhuohua , Li Yu-Xin , Huang Mengshi , Ma Gengwu , Li Cai-Hong , Yuan Hao , Xu Anqi , Shi HongYu , Lin Jiancheng , Li Can , Huang Jiwan , Ge Runze , Bi Yiming , Qian Yi , Su Shixing , Zhang Xin , Li Xifeng , Wen Zhibo , Feng Xin
Published: January 2025

Background

Aneurysm wall enhancement (AWE) on vessel wall imaging (VWI) scans is a robust biomarker for aneurysmal vulnerability. This study aimed to explore the association of different sleep patterns with AWE and other vulnerability features.

Methods

Patients with unruptured intracranial aneurysms were prospectively recruited. Sleep characteristics were collected through a standard questionnaire. Poor sleep quality was defined using the Pittsburgh Sleep Quality Index (PSQI)>5. Cross-sectional multistate predictive models were used to identify various sleep patterns related to aneurysmal vulnerability. In longitudinal observation, core covariates were adjusted with each sleep characteristic to verify cross-sectional results.

Results

A total of 344 aneurysms were enrolled for cross-sectional analyses, while 74 cases (21.5%) that did not receive preventive treatment participated in longitudinal follow-up. In cross-sectional analysis, U-shaped relationships were evident between AWE and nocturnal sleep duration and siesta habit. Improper nocturnal sleep duration, inappropriate siesta habits, insomnia, and snoring were significantly associated with multiple VWI markers of aneurysmal vulnerability (all P<0.05). Notably, all vulnerability indicators were related to poor sleep quality. In longitudinal analysis, short nocturnal sleep duration, snoring, and poor sleep quality were independently associated with aneurysmal progression (all P<0.05).

Conclusions

Unhealthy sleep patterns were significantly associated with multiple features related to aneurysmal vulnerability. Interventional studies are needed to evaluate the role of improving sleep burden and individual sleep symptoms as potential targets for reducing the risk of aneurysm rupture.
Residual sleepiness and impaired alertness in treated obstructive sleep apnoea: role of hypoxic burden and sleep fragmentation
Authors: Tankéré Pierre , Taillard Jacques , PetitJean Thierry , Le-Cam Pierre , Ricordeau François , Blanchard Margaux , Vanbuis Jade , Nofal Anice , Tamisier Renaud , Peter-Derex Laure , Stauffer Emeric
Published: January 2025

The pathophysiology of residual sleepiness in treated obstructive sleep apnoea (OSA) remains poorly understood. Animal models suggest that it may involve neuronal damage due to intermittent hypoxia and sleep fragmentation. In a cohort of 122 continuous positive airway pressure (CPAP) treated OSA patients referred for maintenance of wakefulness test, we explored the determinants of (objective) alertness and those of (subjective) sleepiness assessed by Epworth Sleepiness Scale.

We found that in logistic models, residual hypoxic burden was significatively associated with objective impaired alertness (OR=1.005, 95% CI 1.002 to 1.008), p=0.003), whereas arousal index >25/h was significatively associated with subjective residual sleepiness (OR=1.23, 95% CI 1.05to 1.43, p=0.02). This suggests that hypoxia and sleep fragmentation may be involved in different dimensions of residual hypersomnolence in treated OSA.
Stressors contributing to burnout among acute care and trauma surgery care teams: a systems-analysis approach
Authors: Kwong Elizabeth , Adapa Karthik , Goodacre Viola , Vizer Lisa , Ra Jin , Greenberg Caprice , Ivester Thomas , Charguia Nadia , Marks Lawrence B , Mazur Lukasz
Published: January 2025

Background

Burnout negatively impacts healthcare professionals’ well-being, leading to an increased risk of human errors and patient harm. There are limited assessments of burnout and associated stressors among acute care and trauma surgery teams.

Methods

Acute care and trauma surgery team members at a US academic medical center were administered a survey that included a 2-item Maslach Burnout Inventory and 21 workplace stressors based on the National Academy of Medicine’s systems model of clinician burnout and professional well-being. Stressors were summarized and presented to participants in focus groups. Contextual inquiries (CIs) were conducted to gather additional information about key stressors. Qualitative data were used to generate an affinity model, which participants then validated and used to prioritize top stressors. Participants rated stressors by level of impact and level of effort, and improvement recommendations were made based on these results.

Results

74% (n=14/19) acute care and trauma surgery team members reported high burnout. Key stressors included inadequate staffing, organizational culture, excessive workload, and inefficient workflows. Attending faculty (surgeons) classified the following key priorities for improvement: (i) improve throughput and patient flow, (ii) provide better information technology support, and (iii) improve rewards and support. Non-faculty (advanced practice providers (APPs), nurses, staff) classified the following for improvement: (i) align APP job responsibilities, (ii) improve lack of recognition from leadership, and (iii) robust and consistent APP training.

Conclusions

A contextual design approach to studying burnout using surveys, focus groups, CIs, modeling, and validation and prioritization is a feasible method for identifying key stressors and improvements that may enable more impactful and appropriately targeted interventions. Results indicate high levels of burnout among acute care and trauma surgery team members, requiring prioritized attention to operational and relationship issues necessary to care for patients. Efforts to improve surgery teams’ workflows, auxiliary support, compensation, and relationships with leadership may address burnout.

Level of evidence

Level V.
Air-Stable PnictogenIII Dications Supported by Terpyridine
Authors: Howlett William P. , Land Michael A. , Robertson Katherine N. , Chitnis Saurabh , Macdonald Charles L. B.
Published: January 2025

A homologous series of pnictogen(III) dications supported by the terpyridine ligand has been prepared. The compounds contain Ph−PnIII (Pn = P, As, Sb, Bi) moieties and have been fully characterized using spectroscopic methods including single-crystal X-ray crystallography. The solid-state structure of the bismuth analogue revealed it to be a rare nine-coordinate bismuth dication, arising from the formation of several interionic interactions with the triflate anions. The Lewis acidities of these compounds have also been measured using experimental and computational methods and the results suggest they are moderate Lewis acids. The Sb and Bi compounds are air and moisture stable over extended periods of time, suggesting that they may be suitable Lewis acids for bench-top catalytic transformations.
Investigating Research Software Engineering: Toward RSE Research
Authors: Felderer Michael , Goedicke Michael , Grunske Lars , Hasselbring Wilhelm , Lamprecht Anna-Lena , Rumpe Bernhard
Published: January 2025

Research software engineering research aims at understanding and improving how software is developed for research.
Learning from Orthogonal Space with Multimodal Large Models for Generalized Few-shot Segmentation
Authors: Zhou Xiaojie , Yu Hang , Yang Shengjie , Huo Jing , Tian Pinzhuo
Published: January 2025

Generalized Few-Shot Segmentation (GFSS) aims to segment both base and novel classes in a query image, conditioning on richly annotated data of base classes and limited exemplars from novel classes. The learning of novel classes undoubtedly faces a disadvantage in this competition due to the highly unbalanced data, which skews the learned feature space towards the base classes. In this paper, we present an innovative idea termed as “learning from orthogonal space” to avoid the conflict in the process of learning novel classes. Specifically, we first utilize textual modal information from labels to provide more distinguishable initial prototypes for different categories, ensuring that the prototypes for base and novel classes have distinct initial separations. Then, a simple but effective Feature Separating Module (FSM) is introduced to enhance the model’s ability to differentiate between base and novel classes through learning the novel features from orthogonal space. In addition, we propose a Trigger-Promoting Framework (TPF) during the testing stage to further boost performance. The prediction results from the FSM serve as a multimodal prompt to leverage information residing in large models, such as CLIP and SAM, to enhance performance. Comprehensive experiments on two benchmarks demonstrate that our method achieves superior performance on novel classes without sacrificing accuracy on base classes. Notably, our Feature Separating with Trigger-Promopting Network (FS-TPNet) outperforms the current state-of-the-art method by

\(12.8\%\)

overall IoU on novel classes on PASCAL-

\(5^{i}\)

under the 1-shot scenario. Our codes will be available at
https://github.com/returnZXJ/FS-TPNet
.
Improving Glycemic Control via Heat Therapy in older adults at risk for Alzheimer’s Disease (FIGHT-AD): a pilot study
Authors: Blankenship Anneka E. , Kemna Riley , Kueck Paul J. , John Casey , Vitztum Michelle , Yoksh Lauren , Mahnken Jonathan D. , Vidoni Eric D. , Morris Jill K. , Geiger Paige C.
Published: January 2025

Impaired glycemic control increases the risk for type 2 diabetes (T2D) and Alzheimer’s Disease (AD). Heat therapy (HT), via hot water immersion (HWI), has shown promise in improving shared mechanisms implicated in both T2D and AD, like blood glucose regulation, insulin sensitivity, and inflammation. The potential for HT to improve brain health in individuals at risk for AD has not been examined. This pilot study aimed to assess the feasibility and adherence of utilizing HT in cognitively healthy older individuals at risk for AD due to existing metabolic risk factors. Participants underwent four weeks of HT (three sessions/week) via HWI, alongside cognitive screening, self-reported sleep characterization, glucose tolerance tests, and MRI scans pre- and post-intervention. A total of 18 participants (9 male, 9 female; mean age: 71.1 ± 3.9 years), demonstrating metabolic risk, completed the intervention. Participant adherence for the study was 96% (8 missed sessions out of 216 total sessions), with one study related mild adverse event (mild dizziness/nausea). Overall, the research participants responded to a post-intervention survey saying they enjoyed participating in the study and it was not a burden on their schedules. Secondary outcomes of the HT intervention demonstrated significant changes in mean arterial pressure, diastolic blood pressure, and cerebral blood flow p<0.05), with a trend toward improved body mass index (p=0.06). Future studies, including longer durations and a thermoneutral control group, are needed to fully understand heat therapy’s impact on glucose homeostasis and potential to improve brain health.
Changes in thoracic erector spinae regional activation during postural adjustments and functional reaching tasks after spinal cord injury
Authors: van Helden Joeri F. L. , Cabral Hélio V. , Alexander Emma , Strutton Paul H. , Martinez-Valdes Eduardo , Falla Deborah , Chowdhury Joy Roy , Chiou Shin-Yi
Published: January 2025

We demonstrate that individuals with chronic incomplete spinal cord injury (SCI) recruit lower part of the thoracic erector spinae (ES) for postural control of the trunk. We also show that activation was restricted in a smaller part of the ES, and the discrete control of the ES was lost during functional reaching movements in individuals with SCI. Our study provides evidence of alterations in neural control between vertebral levels in individuals with SCI.
Spatial Soil Erosion Modeling for Improved Land Management in Gumara Watershed, Ethiopia
Authors: Tiruneh Gizachew Ayalew , Ayalew Mersha , Ayalew Mamaru , Mequanent T. D. , M. Chandrakala , Tibebe Dessie , Reichert José Miguel
Published: January 2025

Agriculture output and environmental sustainability are threatened by land degradation, which deteriorates soil resources. In response, soil and water conservation (SWC) initiatives were implemented in Ethiopia. However, soil erosion remains a main challenge to soil productiveness and sedimentation in the country. To determine erosion‐prone areas and assess the impact of SWC activities on soil erosion in the country, a revised version of the universal soil loss equation (RUSLE) was implemented. Gumara catchment is an erosion‐prone area in Ethiopia. Spatial estimation of soil erosion is essential to conserve, manage, and use soil and water resources. Therefore, research was conducted to evaluate the soil erosion of the catchment using the RUSLE with ArcGIS environment. The results indicated that the soil erosion extent was classified into four categories as per the erosion rate, and 5.45% of the catchment explained very high erosion (> 200 ton ha−1 yr−1) followed by 17.24% classified as high (50–200 ton ha−1 yr−1). And, 24.21% and 53.11% of the catchment had a moderate and slight class, respectively. The spatial distribution of soil erosion in the Gumara watershed could be used to better use soil resources, increase agricultural production, and ensure environmental sustainability. The country’s soil erosion is characterized by various estimates, indicating spatiotemporal dynamics. This is primarily due to the heterogeneity of the different sites, which is primarily linked to varying cover values and management factors. With this information, conservation decisions can be made with greater knowledge by concentrating on important hotspots. Therefore, RUSLE applied with ArcGIS across various land management practices and climate zones is a potential tool for SWC demanding site identification. This continues to be beneficial in the pursuit of sustainable land management techniques for the local people’s long‐term well‐being.
Pediatric Red Ear Syndrome Misdiagnosed as Relapsing Polychondritis: A Case Report and Review of Literature
Authors: Sandakly Nicolas , El Koubayati Georgio , Sarkis Jeannette , Haddad Fady
Published: January 2025

Red ear syndrome (RES) is a rare clinical entity presenting with paroxysmal erythema of one or both ears associated with a burning sensation or earache. The onset of symptoms could be either spontaneous or triggered by touch, stress, coughing, sneezing, neck movements, chewing, and combing hair. While most cases are usually described in adults, it can rarely present in children. This article reports a case of pediatric RES, first misdiagnosed as relapsing polychondritis. The patient’s condition improved after introduction of ibuprofen, isoptin, and amitriptyline, with no new attacks reported after a 1 year follow up.
The Role of Key Molecules of Pyroptosis in Liver Damage of Rats With Exertional Heat Stroke
Authors: Lin Lifang , Zheng Jiaolong , Lin Qingqing , Cai Fangze , Li Dongliang
Published: January 2025

Purpose: This study is aimed at investigating the role of key molecular elements involved in pyroptosis in liver injury caused by exertional heat stroke (EHS).

Methods: We established a model of EHS‐induced liver injury in Sprague–Dawley rats, with a control group (receiving no treatment) for comparison and 12 rats in each group. Alanine transaminase (ALT) and aspartate transaminase (AST) levels in the blood were detected. Interleukin‐1 beta (IL‐1β) and interleukin‐18 (IL‐18) levels were assessed using enzyme‐linked immunosorbent assays (ELISA). Pathological changes in liver tissue were examined by hematoxylin and eosin (H&E) staining. Quantitative real‐time polymerase chain reaction (qRT‐PCR) and Western blotting were used to detect mRNA and protein expression levels of Caspase‐1 and Gasdermin D.

Results: Compared to the control group, the liver tissue of the EHS group showed congestion in hepatic sinusoids, hepatocyte edema, eosinophilic changes, necrosis, and infiltration of inflammatory cells. ALT and AST levels in the EHS group were significantly higher than those in the control group (p < 0.05). The mRNA expressions of Caspase‐1, Gasdermin D, IL‐1β, and IL‐18 were significantly increased in the EHS group compared to the control group (p < 0.001). The protein expressions of Caspase‐1, cleaved Caspase‐1, Gasdermin D, and cleaved Gasdermin D were significantly increased in the EHS group.

Conclusion: These findings indicated that hepatic pyroptosis plays an important role in EHS‐induced liver injury.
Design and Evaluation of Hybrid Drivetrain Damper Considering the Influence of Engine Misfire on Torsional Shock
Authors: Zhang Guogeng , Liu Tao , Xie Lingran , Huang Pengcheng , Zhang Weilin , Yu Xiaoxiang , Song Xiaowen
Published: January 2025

Engine misfire is an accidental failure mode in internal combustion vehicles that can lead to the malfunction of power transmission system components. However, previous studies on engine misfire have generally focused on the engine rather than the drivetrain. In this study, we established a simulation model of a hybrid drive system with multiple degrees of freedom to investigate the torsional shock characteristics of the engine under normal and engine misfire conditions. Factors such as the torsional stiffness, gear‐pair meshing stiffness, and moments of inertia for the damper, generator, and drive motor were considered. The dual‐mass flywheel (DMF) was subsequently applied in the drivetrain model, and its stiffness parameters were varied to optimize their effects on the torsional shock experienced by the power transmission system. According to the results, the first‐ and second‐stage stiffnesses of the DMF were set as 5.1 and 15.0 Nm/deg, respectively. Finally, the performance of the designed DMF damper was evaluated through simulations and physical tests of the drivetrain. The engine at full load under normal and engine misfire conditions as well as under a steady‐state load when generating power at the engine output was investigated. The simulation results indicated that the torsional shock on the power transmission system satisfied the design limit of 500 Nm with an angular acceleration below 500 rad/s2. The errors between the simulated and measured peak impact torques and resonance speeds under the misfire condition were approximately 15% and 5%, respectively.
Prospective Evaluation of Remote Software Based Surveillance Supplementing Clinical Monitoring For Hemodialysis Vascular Access
Authors: Eltahan Alshymaa Rafiek , Pondor Zulfikar , Donne Rosemary L. , Lewis David , Raman Maharajan , Cowperthwaite Jan , Resiga Marinela Liliana , Hinchliffe Paul , Lim Jazzle , Gleave Paula , Allsopp Jonathan , Poulikakos Dimitrios
Published: January 2025

Background and Hypothesis: Efficient arteriovenous access (VA) surveillance is vital for early identification of dysfunctional access, allowing timely intervention to prevent thrombosis. This study compares the efficacy of adding remote software surveillance to standard clinical care across our units.
Methods: We conducted a 12-month prospective study on maintenance hemodialysis (HD) patients using Vasc-Alert software technology to assist clinical decision-making in 2 satellite HD units (Group 1) and standard care in the remaining 3 HD units (Group 2) . Patients with Vasc-alert derived high Access Risk Score (ARS) (≥7) underwent clinical assessment and were referred for fistulogram based on relevant Kidney Disease Outcome Quality Initiative (KDOQI) criteria. Data on referrals for fistulogram, subsequent VA events, access abandonment, and complication-free days- extended (CFD-extended) were collected.. VA survival analysis of post-intervention primary patency rate at 3 and 6 months was conducted.
Results: There were 23 (28.1%) preemptive correction of stenosis and 6 (7.3%) thrombosis episodes in Group 1, compared to 40 (19.5%)and 21 (10.2%) in Group 2 (p value 0.155, 0.587),respectively). Amongst the thrombotic episodes, 83% of cases in Group 1 had been detected during surveillance and referred for diagnostic fistulogram +/- angioplasty but developed thrombosis whilst awaiting elective intervention compared to 19% in Group 2 (P value = 0.004). Median time from fistulogram request to thrombosed VA was 26 days (IQR 21-42 days).Group 1 exhibited better post-intervention primary patency rates and longer CFD compared to Group 2 (p value < 0.001, 0.002, respectively).
Conclusion: Incorporating Vasc-Alert technology into VA clinical surveillance pathway was associated with improved early detection of high-risk VA, higher primary patency rates, and longer CFD-extended compared to standard of care. Improving elective interventional radiology (IR) capacity for timely intervention (< 3 weeks from referral) is crucial to materialise the benefits of enhanced surveillance in preventing acute thrombosis.
Unfolding University Instructors’ Perspectives on Translanguaging Practices in English Medium Instruction at a Polish University: A Qualitative Analysis
Authors: Romanowski Piotr
Published: January 2025

Imparting content through the medium of a foreign language is a phenomenon that has grown exponentially in tertiary education all over the world. English, which has an established status of a lingua franca worldwide, stimulates academic internationalisation of universities. Consequently, educational institutions with English medium of instruction are more favoured by students. As a result, English competes with Polish as the medium of instruction in Poland. The choice to use English exclusively in English-medium instruction courses results from methodological assumptions underscoring the exclusive use of English; therefore, it might seem unnatural to notice the translanguaging pedagogy being employed. On the other hand, bilingual and multilingual speakers may draw upon all their languages (e.g., Polish and English) to express their thoughts, make meaning in their situated social context and achieve specific goals. This study explores lecturers’ perceptions of translanguaging in a Polish higher education institution offering English-medium instruction programmes. Adopting a qualitative case study approach, this research revealed that instructors supported the use of various translanguaging strategies to create a ‘translanguaging space’ for content learning. The use of many of the students’ linguistic repertoires implied that several questions on terminology and content arose, leading to reflections, discussions and ultimately greater, deeper understanding of the content. Through the application of focus group discussions, the lecturers unfolded their perspectives on translanguaging in English-medium instruction courses, which revealed a collective and metalinguistic reflection, facilitating a co-construction of knowledge, meaning and understanding.
Personalized Persuasion for Visitors’ Data-Sharing Activities in Amusement Parks: Matching Visitors’ Social Value Orientation
Authors: Au Wai Ching Wilson , Petrick James F.
Published: January 2025

Tourist’s unwillingness to share personal data has been detrimental to smart tourism development. Drawing on social value orientation theory and the unification model of framing, this study examined how person–situation interaction affects theme park visitors’ willingness to share three types of personal travel data in hopes of better understanding crowd management. A between–group method was applied in a micro-longitudinal single factor (message framing: individualistic vs. competitive vs. cooperative) scenario-based experimental design. An analysis of 532 survey responses revealed that a competitive message was the only type of message framing to stimulate people’s data-sharing behavior (i.e., among individualists, competitors, and cooperators). The alignment between message framing techniques and personalities strengthened the intervention effects of personality-relevant messages. These results enrich the theoretical understanding of visitors’ responses toward data collection and suggest amusement park management should consider encouraging visitors to share their personal travel data using competitive messaging.
Tripping in the Happiest Country of the World – Use Values of Psychedelics According to Finnish Users
Authors: Tsupari Mika , Hellman Matilda , Tammi Tuukka
Published: January 2025

Background

The use of psychedelics is on the rise worldwide as more people are experimenting, self-medicating or seeking benefits from these substances.

Aims

This study explores the use values ascribed to classic psychedelics by 40 users in Finland – a country that scores high in welfare and happiness but has faced an increase in mental health problems and has adapted austerity policies in the public service sector.

Methods

The data consists of thematical interviews with individuals who use or have used psychedelics. We analysed the data focusing on the sense-making regarding use practices and use values.

Results

The analysis identified three main functions and benefits: (a) psychedelics as a catalyst for change, (b) psychedelics as a self-medication practice and (c) psychedelics as a device for self-improvement. Positive experiences included feelings of beauty, calmness, awe, connecting with others and mystical experiences. Psychedelics had helped the participants with depression, anxiety, difficult experiences and traumas.

Conclusions

Psychedelics appear to offer users experiences that are unattainable in their everyday lives. Their use can be seen as part of a contemporary biopolitical project of self-care and individualistic solutions for contemporary need for better mental health, living a carefree and meaningful life. When certain harm and risk reduction practices are considered, psychedelic use still seems likely to provide more benefits than harm for some individuals.