bluuebunny/crossref_metadata_2025 huggingface dataset:
Holistic Wisdom Education: Towards Transformational Creativity
Authors: Kallio Eeva K. , Mononen Laura , Ek Terhi
Published: March 2024

We suggest that holistic education and pedagogy, which are grounded in a philosophical holistic view of human nature, would be important in the current era for the development of transformative creativity at all levels of education. We base our holistic view of human nature on the model of the philosopher Lauri Rauhala. Holistic pedagogy refers here to an approach where multimodal perspectives that include emotional, volitional, cognitive, ethical, and physical education, are brought together. It is furthermore theorized that wisdom and creativity are closely related phenomena, and as part of holistic pedagogy, they may create possibilities for innovations and new understandings. Wisdom is understood here as progress toward an ethical common good of action and creativity is defined as the ability to produce something novel that is also applied in practice. When holistic pedagogies include also integrative thinking, which enables synthesizing inner and outer realities, different logical systems and mental modes, they have the possibility to support transformative creativity, which is the ability to benefit both self and the environment (social, cultural and physical) in a purposeful way. For supporting our theocratization, we present examples of two kinds of holistic education practices in formal and informal education, as well as in children and adults that could provide a sustainable approach to support growth. Firstly, we give an initial example of a qualitative empirical study of practical wisdom of pre-schoolers in the forest environment. The study found that when asked about children’s ability to learn wisdom, the teachers reported contents of creative thinking and acting. Secondly, we suggest that in adults’ self-education such as in the model of Positive Disintegration by Kazimierz Dąbrowski well as others could be possible fruitful way to enhance wise, and creative competencies. We conclude that different forms of holistic education can be planted, and they have the ability to support transformative creativity, which is essential for countering the challenges of socio-emotional sphere, as well as in ethical decision-making and acting for common human well-being.
On the Availability and Quality of Data in Spain for the Development of Indicators to Measure Building Renovation Policies Effectiveness and the Decarbonization of the Building Stock
Authors: Gómez-Gil Marta , Arbulu Markel , Hernández-Minguillón Rufino J. , López-Mesa Belinda
Published: March 2024

It is crucial to achieve long-term decarbonization goals in the building sector by relying building renovation policies on well-founded evidence based on indicators regarding the current state of the building stock, decarbonization requirements and potential, feasibility of solutions, possible failures, risks, and other relevant factors. To develop such indicators, it is necessary to have data of good quality. This chapter analyzes the availability of data in Spain and its quality to develop indicators to assess the effectiveness of building renovation policies and the progress of decarbonization. With this objective, the developability of a set of indicators was analyzed regarding their availability, processing method and data processability, and the data source quality was assessed regarding data processability, georeferencing, and data update frequency. The results show pronounced challenges related to data availability in indicators concerning deep renovation of buildings and policies for mobilizing investments into building renovation. The diversity in data processing methods, with 42% indicators directly processable and 58% requiring indirect methods, underscores the complexity in obtaining and manipulating data. Additionally, the limited georeferencing (9%) and insufficient update frequencies (54% with update frequencies of more than five years) highlight areas for improvement.
Indicators and Data in Spain for an Overview of the General Characteristics of the National Building Stock
Authors: Gómez-Gil Marta , Etxebarria-Mallea Matxalen , Arbulu Markel , Oregi Xabat , Espinosa-Fernández Almudena , Monzón-Chavarrías Marta
Published: March 2024

A country or a city is largely characterized by its architecture and urbanism. A robust understanding of the characteristics of the existing building stock provides a more solid basis for the development of European or national policies. In this chapter, we propose indicators to measure the general characteristics of the buildings at the national and regional levels, using as case studies Spain and two of its regions, Aragon and the Basque Country. Given there is no official definition of what the general characteristics of a building are, in this chapter we propose the general characteristics of a building whose knowledge can allow to lay the foundations for its improvement. We also studied the sources of information available in Spain and in the two mentioned regions for the development of these indicators and developed them when there were available data. Out of the fourteen proposed indicators, five could be fully developed, eight were partially developed, and one could not be developed due to lack of data.
Indicators and Data in Spain for an Overview of the Energy Characteristics of the National Building Stock
Authors: Gómez-Gil Marta , Espinosa-Fernández Almudena , López-Mesa Belinda , Monzón-Chavarrías Marta
Published: March 2024

The decarbonization objectives outlined by Europe, coupled with the aging of existing buildings, underscore the importance of evaluating the evolution of energy characteristics of the building stock at both national and regional levels. To facilitate this evaluation in Spain, along with its regions Aragon and the Basque Country, a set of indicators is suggested in this chapter. These indicators aim to offer insights into the evolution of annual final energy consumption by building type and per end use. Additionally, the Energy Performance Certificates (EPCs) are put forth as valuable indicators, with a focus on the number and energy class derived from these certificates. In the case of the former indicators, Spain benefits from both national and regional data sources, although enhancements are possible through improved data processing techniques and the extraction of information based on building characteristics. As for EPCs, it is recommended that the information provided by regions undergo a standardization process to ensure a more comprehensive development of the indicators. Furthermore, an additional proposed indicator involves the measurement of the quantity and surface area of nearly zero-energy buildings (nZEB). Unfortunately, the current lack of national or regional sources hampers the development of this particular indicator.
Relations Between Democracy and Parties
Authors: Fink-Hafner Danica
Published: March 2024

A variety of relationships between parties and democracy is summarized on the basis of political philosophy and political science literature. It is found that parties: (1) are not explicitly mentioned in relation to democracy, (2) are positioned at various points in time in relation to democracy (with a lack of clarity as to which comes first); (3) play positive roles in relation to democracy; (4) play negative roles in relation to democracy; (5) play ambiguous roles in relation to democracy; and (6) are redundant (that is, democracy exists without parties). Many factors affecting democracy, besides political parties, are presented.
Party System Characteristics and Challenges to Democracy
Authors: Fink-Hafner Danica
Published: March 2024

In the literature, several theses can be found on the relationship between the characteristics of party systems and democracy. Particular attention is paid to those party system characteristics that are believed to have negative impacts on democracy. These are the deinstitutionalization and the polarization of the party system; the findings on the impact of party system fragmentation are inconclusive. Since the characteristics of parties may influence the characteristics of party systems, these are also taken into account. Brief overviews of the indicators of fragmentation, institutionalization and polarization are presented. The chapter concludes with a section on the role of a broader set of actors, particularly party supporters, citizens and civil society, in relation to democracy.
Tracing Changes in Parties, Party Systems, Context and Democracy
Authors: Fink-Hafner Danica
Published: March 2024

Parties, party systems, context and democracy are all dynamic phenomena. This is why, in research into their mutual relationships, it is important to create a methodology that includes the relevant variables, their indicators and the time factor. This chapter contains an overview in several sections of how to trace changes in democracy, context, parties and party systems. Case studies, which offer an opportunity for a longitudinal study of these changes in a stable institutional setting, may be valuable contributions to theoretical developments in the understanding of the relationships between parties and democracy. Slovenia is such a case and is also theoretically interesting as the trajectory of democracy in Slovenia is different from that in the rest of the post-socialist region.
Fluidity of Slovenia’s Democracy in a Changing Context
Authors: Fink-Hafner Danica
Published: March 2024

The V-Dem data for Slovenia reveal three main periods with distinct evaluations of democracy: (1) a transitional low evaluation, (2) a rather high and constant evaluation of democracy in the period just after the adoption of the new constitution (1991) and before the COVID-19 crisis and (3) a radical decline in democracy (2020–2021). The analysis of the contextual factors points to the circumstances that produced major dissatisfaction among the citizens with parties and party government. The most visible factors were: a radical worsening of the economy, a rise in social inequalities (considered by the citizens as unjust), external factors enhancing these economic and socio-economic trends (the EU’s neoliberal orientation since 2004, and the international financial crisis and its management within the Eurozone), an international trend towards autocracy, multiplying international crises and an international trend towards managing the COVID-19 crisis by limiting the usual democratic functioning.
Celestial self-dual Yang-Mills theory: a new formula and the OPE limit
Authors: Chattopadhyay Pratik , Tao Yi-Xiao
Published: March 2024

Abstract

Celestial holography is a new way to understand flat-space amplitudes. Self-dual theories, due to their nice properties, are good subjects to study celestial holography. In this paper, we developed a new formula to calculate the celestial color-ordered self-dual Yang-Mills amplitudes based on celestial Berends-Giele currents, which makes the leading OPE limit manifest. In addition, we explore some higher-order terms of OPE in the celestial self-dual Yang-Mills theory.
Null Hamiltonian Yang–Mills theory: Soft Symmetries and Memory as Superselection
Authors: Riello A. , Schiavina M.
Published: March 2024

Soft symmetries for Yang–Mills theory are shown to correspond to the residual Hamiltonian action of the gauge group on the Ashtekar–Streubel phase space, which is the result of a partial symplectic reduction. The associated momentum map is the electromagnetic memory in the Abelian theory, or a nonlinear, gauge-equivariant, generalisation thereof in the non-Abelian case. This result follows from an application of Hamiltonian reduction by stages, enabled by the existence of a natural normal subgroup of the gauge group on a null codimension-1 submanifold with boundaries. The first stage is coisotropic reduction of the Gauss constraint, and it yields a symplectic extension of the Ashtekar–Streubel phase space (up to a covering). Hamiltonian reduction of the residual gauge action leads to the fully reduced phase space of the theory. This is a Poisson manifold, whose symplectic leaves, called superselection sectors, are labelled by the (gauge classes of the generalised) electric flux across the boundary. In this framework, the Ashtekar–Streubel phase space arises as an intermediate reduction stage that enforces the superselection of the electric flux at only one of the two boundary components. These results provide a natural, purely Hamiltonian, explanation of the existence of soft symmetries as a byproduct of partial symplectic reduction, as well as a motivation for the expected decomposition of the quantum Hilbert space of states into irreducible representations labelled by the Casimirs of the Poisson structure on the reduced phase space.
Instability of Electroweak Homogeneous Vacua in Strong Magnetic Fields
Authors: Gardner Adam , Sigal Israel Michael
Published: March 2024

We consider the classical vacua of the Weinberg–Salam (WS) model of electroweak forces. These are no-particle, static solutions to the WS equations minimizing the WS energy locally. We study the WS vacuum solutions exhibiting a non-vanishing average magnetic field of strength b and prove that (i) there is a magnetic field threshold $$b_*$$

b

∗

such that for $$b<b_*$$

b
<

b

∗

, the vacua are translationally invariant (and the magnetic field is constant), while, for $$b>b_*$$

b
>

b

∗

, they are not, (ii) for $$b>b_*$$

b
>

b

∗

, there are non-translationally invariant solutions with lower energy per unit volume and with the discrete translational symmetry of a 2D lattice in the plane transversal to b, and (iii) the lattice minimizing the energy per unit volume approaches the hexagonal one as the magnetic field strength approaches the threshold $$b_*$$

b

∗

. In the absence of particles, the Weinberg–Salam model reduces to the Yang–Mills–Higgs (YMH) equations for the gauge group U(2). Thus, our results can be rephrased as the corresponding statements about the U(2)-YMH equations.
Unveiling synergistic QTLs associated with slow wilting in soybean (Glycine max [L.] Merr.)
Authors: Kwon Hakyung , Kim Moon Young , Yang Xuefei , Lee Suk-Ha
Published: March 2024

Key message

A stable QTL qSW_Gm10 works with a novel locus, qSW_Gm01, in a synergistic manner for controlling slow-wilting traits at the early vegetative stage under drought stress in soybean.

Drought is one of the major environmental factors which limits soybean yield. Slow wilting is a promising trait that can enhance drought resilience in soybean without additional production costs. Recently, a Korean soybean cultivar SS2-2 was reported to exhibit slow wilting at the early vegetative stages. To find genetic loci responsible for slow wilting, in this study, quantitative trait loci (QTL) analysis was conducted using a recombinant inbred line (RIL) population derived from crossing between Taekwangkong (fast-wilting) and SS2-2 (slow-wilting). Wilting score and leaf moisture content were evaluated at the early vegetative stages for three years. Using the ICIM-MET module, a novel QTL on Chr01, qSW_Gm01 was identified, together with a previously known QTL, qSW_Gm10. These two QTLs were found to work synergistically for slow wilting of the RILs under the water-restricted condition. Furthermore, the SNP markers from the SoySNP50K dataset, located within these QTLs, were associated with the wilting phenotype in 30 diverse soybean accessions. Two genes encoding protein kinase 1b and multidrug resistance-associated protein 4 were proposed as candidate genes for qSW_Gm01 and qSW_Gm10, respectively, based on a comprehensive examination of sequence variation and gene expression differences in the parental lines under drought conditions. These genes may play a role in slow wilting by optimally regulating stomatal aperture. Our findings provide promising genetic resources for improving drought resilience in soybean and give valuable insights into the genetic mechanisms governing slow wilting.
The revised Psychosis Attachment Measure: further psychometric evidence
Authors: Justo-Nunez Miranda , Morris Lydia , Berry Katherine
Published: March 2024

Purpose

Disorganised attachment is a key concept in understanding the development of psychosis. However, existing questionnaires of adult attachment do not adequately measure this construct hindering future research into the psychosocial causes of psychosis. The most widely measure of adult attachment in people experiencing psychosis is the Psychosis Attachment Measure (PAM). The measure has recently been revised to include disorganised attachment items. This study develops previous research by providing a rigorous examination the psychometric properties of the revised questionnaire (PAM-R).

Methods

A total of 407 participants with self-reported experiences of psychosis completed a battery of questionnaires which included the PAM-R and other measures which were conceptually related to the concept of disorganised attachment.

Results

Confirmatory factor analysis (CFA) indicated a three-factor solution with factors corresponding to anxious, avoidant, and disorganised attachment. The majority of the fit statistics were acceptable with the exception of the RMSEA statistic. Internal consistency and test–retest reliability were good for all subscales. The disorganised subscale correlated in expected directions with other measures of attachment, dissociation, trauma, and psychotic experiences.

Conclusion

The PAM-R is a valid and reliable measure of adult attachment. It is a practical assessment tool for clinicians and researchers to measure insecure and disorganised attachment patterns that is acceptable to people experiencing psychosis.
Point cloud registration with quantile assignment
Authors: Oğuz Ecenur , Doğan Yalım , Güdükbay Uğur , Karaşan Oya , Pınar Mustafa
Published: March 2024

Point cloud registration is a fundamental problem in computer vision. The problem encompasses critical tasks such as feature estimation, correspondence matching, and transformation estimation. The point cloud registration problem can be cast as a quantile matching problem. We refined the quantile assignment algorithm by integrating prevalent feature descriptors and transformation estimation methods to enhance the correspondence between the source and target point clouds. We evaluated the performances of these descriptors and methods with our approach through controlled experiments on a dataset we constructed using well-known 3D models. This systematic investigation led us to identify the most suitable methods for complementing our approach. Subsequently, we devised a new end-to-end, coarse-to-fine pairwise point cloud registration framework. Finally, we tested our framework on indoor and outdoor benchmark datasets and compared our results with state-of-the-art point cloud registration methods.
Optimization of critical process control parameters in MEX additive manufacturing of high-performance polyethylenimine: energy expenditure, mechanical expectations, and productivity aspects
Authors: Vidakis Nectarios , Petousis Markos , Spiridaki Mariza , Mountakis Nikolaos , Moutsopoulou Amalia , Kymakis Emmanuel
Published: March 2024

The demand for 3D-printed high-performance polymers (HPPs) is on the rise across sectors such as the defense, aerospace, and automotive industries. Polyethyleneimine (PEI) exhibits exceptional mechanical performance, thermal stability, and wear resistance. Herein, six generic and device-independent control parameters, that is, the infill percentage, deposition angle, layer height, travel speed, nozzle temperature, and bed temperature, were quantitatively evaluated for their impact on multiple response metrics related to energy consumption and mechanical strength. The balance between energy consumption and mechanical strength was investigated for the first time, contributing to the sustainability of the PEI material in 3D printing. This is critical considering that HPPs require high temperatures to be built using the 3D printing method. PEI filaments were fabricated and utilized in material extrusion 3D printing of 125 specimens for 25 different experimental runs (five replicates per run). The divergent impacts of the control parameters on the response metrics throughout the experimental course have been reported. The real weight of the samples varies from 1.06 to 1.82 g (71%), the real printing time from 214 to 2841 s (~ 1300%), the ultimate tensile strength from 15.17 up to 80.73 MPa (530%), and the consumed energy from 0.094 to 1.44 MJ (1500%). The regression and reduced quadratic equations were validated through confirmation runs (10 additional specimens). These outcomes have excessive engineering and industrial merit in determining the optimum control parameters, ensuring the sustainability of the process, and the desired functionality of the products.

Graphical Abstract
Global Hyperbolicity through the Eyes of the Null Distance
Authors: Burtscher Annegret , García-Heveling Leonardo
Published: March 2024

No Hopf–Rinow Theorem is possible in Lorentzian Geometry. Nonetheless, we prove that a spacetime is globally hyperbolic if and only if it is metrically complete with respect to the null distance of a time function. Our approach is based on the observation that null distances behave particularly well for weak temporal functions in terms of regularity and causality. Specifically, we also show that the null distances of Cauchy temporal functions and regular cosmological time functions encode causality globally.
Gaussian Fluctuations for the Stochastic Burgers Equation in Dimension $$d\ge 2$$
Authors: Cannizzaro Giuseppe , Gubinelli Massimiliano , Toninelli Fabio
Published: March 2024

The goal of the present paper is to establish a framework which allows to rigorously determine the large-scale Gaussian fluctuations for a class of singular SPDEs at and above criticality, and therefore beyond the range of applicability of pathwise techniques, such as the theory of Regularity Structures. To this purpose, we focus on a d-dimensional generalization of the Stochastic Burgers equation (SBE) introduced in van Beijeren et al. (Phys Rev Lett 54(18):2026–2029, 1985. https://doi.org/10.1103/PhysRevLett.54.2026). In both the critical $$d=2$$

d
=
2

and super-critical $$d\ge 3$$

d
≥
3

cases, we show that the scaling limit of (the regularised) SBE is given by a stochastic heat equation with non-trivially renormalised coefficient, introducing a set of tools that we expect to be applicable more widely. For $$d\ge 3$$

d
≥
3

the scaling adopted is the classical diffusive one, while in $$d=2$$

d
=
2

it is the so-called weak coupling scaling which corresponds to tuning down the strength of the interaction in a scale-dependent way.
Geriatric chronic recurrent multifocal osteomyelitis (CRMO) mimicking multifocal multiple myeloma: a first in an octogenarian
Authors: Sgaglione Jonathan , Muran Andrew , Rhode Matthew , Goodman Howard J. , Edelman Morris C. , Shah Suhail Ahmed , Greenberg Andrew S. , Kenan Shachar
Published: March 2024

Chronic recurrent multifocal osteomyelitis (CRMO), an autoinflammatory bone disorder characterized by non-bacterial osteomyelitis causing recurrent multifocal bone lesions, is a well-known, yet uncommon pediatric condition that rarely affects adults; to date, it has never been diagnosed over the age of 75. The following report will discuss the first octogenarian diagnosed with CRMO and therefore represents an exceptionally rare presentation of a rare disease. An 83-year-old woman presented with progressive right shoulder, forearm, and hip pain, with associated weight loss and global weakness, requiring a wheelchair for mobility. Imaging revealed a pathologic right ulna fracture in addition to lytic lesions of the right proximal humerus and proximal femur. The clinical picture was thus that of a patient with probable multiple myeloma versus metastatic disease. After an extensive workup, however, the lesions were not malignant; histologic findings were instead suggestive of chronic osteomyelitis with negative cultures. Given the multifocal nature of this condition, combined with a lack of clinical symptoms of infection, a diagnosis of CRMO was rendered. The patient underwent intramedullary nailing of the right femur and splinting of the ulna, with a subsequent remarkable recovery to painless ambulation, complete union of the right ulna fracture, and resolution of the lytic lesions without receiving any targeted medical treatment. This case highlights the importance of maintaining CRMO on the differential for multifocal skeletal lesions, regardless of age. Performing a thorough workup with necessary imaging, biopsy, and culture are critical to establishing this diagnosis, which can only made as a diagnosis of exclusion.
The prevalence of neutropenia and association with infections in patients with systemic lupus erythematosus: a Swedish single-center study conducted over 14 years
Authors: Saleh Muna , Sjöwall Johanna , Bendtsen Marcus , Sjöwall Christopher
Published: March 2024

Hematologic abnormalities are common manifestations of SLE, although neutropenia is observed less frequently and is not included in the classification criteria. Nonetheless, neutropenia is a risk factor for infections, especially those caused by bacteria or fungi. We aimed to evaluate the impact of neutropenia in SLE through a systematic investigation of all infections in a large cohort of well-characterized patients, focusing on neutropenia, lymphopenia, and hypocomplementemia. Longitudinal clinical and laboratory parameters obtained at visits to the Rheumatology Unit, Linköping University Hospital, and linked data on all forms of healthcare utilization for all the subjects included in our regional SLE register during 2008–2022 were assessed. Data regarding confirmed infections were retrieved from the medical records. Overall, 333 patients were included and monitored during 3,088 visits to a rheumatologist during the study period. In total, 918 infections were identified, and 94 occasions of neutropenia (ANC < 1.5 × 109/L) were detected in 40 subjects (12%). Thirty neutropenic episodes in 15 patients occurred in association with infections, of which 13 (43%) required in-hospital care, 4 (13%) needed intensive care, and 1 (3%) resulted in death. Bayesian analysis showed that patients with ≥ 1 occasion of neutropenia were more likely to experience one or more infections (OR = 2.05; probability of association [POA] = 96%). Both invasiveness (OR = 7.08; POA = 98%) and severity (OR = 2.85; POA = 96%) of the infections were significantly associated with the present neutropenia. Infections are common among Swedish SLE patients, 12% of whom show neutropenia over time. Importantly, neutropenia is linked to both the invasiveness and severity of infections. Awareness of the risks of severe infections in neutropenic patients is crucial to tailor therapies to prevent severe illness and death.
SINGV-RCM: the convection-permitting regional climate model for Singapore
Authors: Prasanna Venkatraman , Dipankar Anurag , Liu Jianyu , Lim Gerald , Moise Aurel , Chua Xin Rong , Sanchez Claudio , Chen Chen , Yu Jianjun , Raavi Harika Pavan , Luo Fei , Hassim Muhammad Eeqmal , Sahany Sandeep , Webster Stuart
Published: March 2024

The development of the Singapore regional climate model (SINGV-RCM) is documented in this study. The model’s skill in predicting mean and extreme rainfall over the Maritime Continent at 8 km and 2 km grid resolution is assessed using observed rainfall. The model’s sensitivity to vertical grid and convection parametrization is also evaluated. Results demonstrate the added value of downscaling to 8 and 2 km. The spatial and temporal characteristic of the diurnal rainfall is shown to be in good agreement with the observation. The model also demonstrates skill in capturing extreme rainfall. In general, the rainfall in the 8 km and 2 km simulations are quite similar, when regrided to a coarser resolution. Even then, the convection-permitting simulation at 2 km is found to add value over the 8 km simulation, particularly in capturing the higher rainfall thresholds. Mean biases over the ocean is found to be larger than that over the land, which suggests the need to further tune SINGV-RCM for long climate simulations.
Intravascular papillary endothelial hyperplasia of the maxillary sinus extending into the contralateral nasal cavity
Authors: Nakamura Masahiro , Anzai Takashi , Ishimizu Erina , Ashikawa Karin , Inoshita Ayako , Takata Yusuke , Matsumoto Fumihiko
Published: March 2024

Introduction

Intravascular papillary endothelial hyperplasia (IPEH) predominantly occurs in the subcutaneous and dermal regions and rarely originates from the sinonasal mucosa.

Case presentation

We report on the case of a 58-year-old male patient who presented with progressive bilateral nasal obstruction, left-sided epiphora, and intermittent epistaxis. Computed tomography revealed a soft tissue opacity in the left maxillary sinus with intersinusoidal nasal wall demineralization, extending into the surrounding ethmoid cells and the right nasal cavity through a contralateral deviation of the nasal septum. Contrast-enhanced T1-weighted magnetic resonance imaging further confirmed these findings. The IPEH originating from the maxillary sinus extended into the contralateral nasal cavity, and it was successfully removed using an endoscopic endonasal approach, avoiding overly aggressive treatment.

Conclusion

This case report highlights the diagnostic challenges of IPEH in the sinonasal region and the importance of considering IPEH as a differential diagnosis in patients presenting with nasal obstruction, epiphora, and intermittent epistaxis.
Genetics of ischemic stroke functional outcome
Authors: Carnwath Troy P. , Demel Stacie L. , Prestigiacomo Charles J.
Published: March 2024

Ischemic stroke, which accounts for 87% of cerebrovascular accidents, is responsible for massive global burden both in terms of economic cost and personal hardship. Many stroke survivors face long-term disability—a phenotype associated with an increasing number of genetic variants. While clinical variables such as stroke severity greatly impact recovery, genetic polymorphisms linked to functional outcome may offer physicians a unique opportunity to deliver personalized care based on their patient’s genetic makeup, leading to improved outcomes. A comprehensive catalogue of the variants at play is required for such an approach. In this review, we compile and describe the polymorphisms associated with outcome scores such as modified Rankin Scale and Barthel Index. Our search identified 74 known genetic polymorphisms spread across 48 features associated with various poststroke disability metrics. The known variants span diverse biological systems and are related to inflammation, vascular homeostasis, growth factors, metabolism, the p53 regulatory pathway, and mitochondrial variation. Understanding how these variants influence functional outcome may be helpful in maximizing poststroke recovery.
Gross-total resection in optic nerve sheath meningiomas: minimally invasive and cosmetic pleasing
Authors: Dai Qin , Li Xinyu , Fang Yenan , Shen Bingyan , Wei Jinfei , Xie Qiqi , Wu Wencan , Wang Min
Published: March 2024

Purpose

The optic nerve sheath meningioma (ONSM) is one of the most challenging tumors in orbital surgery. From the perspective of mental health and patient needs, we analyzed the necessity and importance of the endoscopic transnasal approach (ETA) combined with optic nerve transection (ONT) in gross-total resection (GTR) in ONSM patients with residual vision and aim to broaden the use of ONT for specific people.

Methods

The authors included patients with ONSMs who were treated between 2014 and 2022. We divided those cases into two groups named ETA group and lateral orbitotomy approach (LOA) group. We present the application of ETA and analyze the preoperative indication of the ONT and compared the advantages and disadvantages between ETA and LOA. The degree of tumor resection was based on imaging and surgical evaluation.

Results

A total of 23 patients with ONSM were included. Sixteen patients underwent ETA, and seven underwent LOA. Among ETA cases, GTR was achieved in 14 patients with ONT and most patients maintained normal eye movement function (75%) and morphology (93.75%). In the ETA group, 14 patients experienced vision loss, while two other patients saw improvements in vision. And proptosis was alleviated (5.20 ± 2.34 vs 0.27 ± 0.46, p < 0.0001). Six patients with blindness and proptosis of the LOA group resulted in GTR with ONT and ophthalmectomy. Although intracranial extension and recurrence included no cases in the two groups, a significant psychological gap was presented due to cosmetic problems.

Conclusions

Under the premise of reducing damage and improving aesthetics, the selection of ETA combined with ONT to gross-total resect ONSMs successfully provides a minimally invasive access with acceptable complications. As an important adjunct to GTR in the surgical treatment of ONSM, the scope of ONT application should be expanded to relieve the patient’s psychological burden.
Large language models as decision aids in neuro-oncology: a review of shared decision-making applications
Authors: Lawson McLean Aaron , Wu Yonghui , Lawson McLean Anna C. , Hristidis Vagelis
Published: March 2024

Shared decision-making (SDM) is crucial in neuro-oncology, fostering collaborations between patients and healthcare professionals to navigate treatment options. However, the complexity of neuro-oncological conditions and the cognitive and emotional burdens on patients present significant barriers to achieving effective SDM. This discussion explores the potential of large language models (LLMs) such as OpenAI's ChatGPT and Google's Bard to overcome these barriers, offering a means to enhance patient understanding and engagement in their care. LLMs, by providing accessible, personalized information, could support but not supplant the critical insights of healthcare professionals. The hypothesis suggests that patients, better informed through LLMs, may participate more actively in their treatment choices. Integrating LLMs into neuro-oncology requires navigating ethical considerations, including safeguarding patient data and ensuring informed consent, alongside the judicious use of AI technologies. Future efforts should focus on establishing ethical guidelines, adapting healthcare workflows, promoting patient-oriented research, and developing training programs for clinicians on the use of LLMs. Continuous evaluation of LLM applications will be vital to maintain their effectiveness and alignment with patient needs. Ultimately, this exploration contends that the thoughtful integration of LLMs into SDM processes could significantly enhance patient involvement and strengthen the patient-physician relationship in neuro-oncology care.
Upregulation of the histone γ-H2AX correlates with worse patient survival and basal-like subtype in pancreatic ductal adenocarcinoma
Authors: Knipper Karl , Hussein Yussra , Simon Adrian Georg , Fretter Caroline , Damanakis Alexander I. , Zhao Yue , Bruns Christiane J. , Schmidt Thomas , Popp Felix C. , Quaas Alexander , Lyu Su Ir ,   The PANCALYZE Study Group, Heise Michael , Marusch Frank , Siech Marco , Mosa Tawfik , Schniewind Bodo , Tepel Jürgen , Hartwig Werner , Prinz Christoph , Rau Bettina M. , Niedergethmann Marco , Kube Rainer , Saada George , Hiller Wolfgang , Settmacher Utz
Published: March 2024

Purpose

Patients with pancreatic ductal adenocarcinoma (PDAC) have yet to experience significant benefits from targeted therapy. Olaparib is currently the only active substance in BRCA-mutated PDACs that successfully influences the DNA repair of carcinoma cells. H2AX belongs to the histone family and is known as a part of the DNA repair system. The inhibition of γ-H2AX could lead to the inhibition of mitotically active tumor cells. Therefore, we aimed to evaluate the predictive value of the γ-H2AX in patients with PDAC.

Methods

All included patients (n = 311) received a pancreatic resection with curative intention in one of our PANCALYZE study centers. Subsequently, they were enrolled in a standardized follow-up protocol. Immunohistochemical stainings for γ-H2AX were conducted on tissue microarrays.

Results

Patients exhibiting high levels of γ-H2AX expression experience more frequent R1 resections, indicating advanced tumor stages in this subgroup. Additionally, patients with high γ-H2AX expression demonstrated significantly poorer survival compared to those with low expression (median OS: 15 vs. 25 months, p < 0.001). In multivariate analyses, high γ-H2AX expression could be identified as an independent risk factor for worse patient survival. Moreover, high γ-H2AX expression could be more frequently observed in the more aggressive basal-like subtype.

Conclusion

γ-H2AX can be characterized as a predictive biomarker for poorer patient survival. Consequently, upcoming clinical trials focused on the efficacy of targeted therapies influencing the DNA repair system and radiotherapy should evaluate γ-H2AX as a potential biomarker for therapy response. Furthermore, γ-H2AX may serve as a viable target for treatment in the future.
Index admission cholecystectomy for biliary acute pancreatitis or choledocholithiasis reduces 30-day readmission rates in children
Authors: Pathak Sagar J. , Avila Patrick , Dai Sun-Chuan , Arain Mustafa A. , Perito Emily R. , Kouanda Abdul
Published: March 2024

Background

Adult patients with biliary acute pancreatitis (BAP) or choledocholithiasis who do not undergo cholecystectomy on index admission have worse outcomes. Given the paucity of data on the impact of cholecystectomy during index hospitalization in children, we examined readmission rates among pediatric patients with BAP or choledocholithiasis who underwent index cholecystectomy versus those who did not.

Methods

Retrospective study of children (< 18 years old) admitted with BAP, without infection or necrosis (ICD-10 K85.10), or choledocholithiasis (K80.3x–K80.7x) using the 2018 National Readmission Database (NRD). Exclusion criteria were necrotizing pancreatitis with or without infected necrosis and death during index admission. Multivariable logistic regression was performed to identify factors associated with 30-day readmission.

Results

In 2018, 1122 children were admitted for index BAP (n = 377, 33.6%) or choledocholithiasis (n = 745, 66.4%). Mean age at admission was 13 (SD 4.2) years; most patients were female (n = 792, 70.6%). Index cholecystectomy was performed in 663 (59.1%) of cases. Thirty-day readmission rate was 10.9% in patients who underwent cholecystectomy during that index admission and 48.8% in those who did not (p < 0.001). In multivariable analysis, patients who underwent index cholecystectomy had lower odds of 30-day readmission than those who did not (OR 0.16, 95% CI 0.11–0.24, p < 0.001).

Conclusions

Index cholecystectomy was performed in only 59% of pediatric patients admitted with BAP or choledocholithiasis but was associated with 84% decreased odds of readmission within 30 days. Current guidelines should be updated to reflect these findings, and future studies should evaluate barriers to index cholecystectomy.
Therapeutic apheresis: is it safe in children with kidney disease?
Authors: Kalenderoğlu Muhammed Doğukan , Çomak Elif , Aksoy Gülşah Kaya , Bilge Uğur , Küpesiz Osman Alphan , Koyun Mustafa , Akman Sema
Published: March 2024

Background

Therapeutic apheresis (TA) is already used to treat various diseases in the field of nephrology. The aim of this study was to evaluate the frequency and types of complications that occur during TA in children with kidney disease.

Methods

Records of children (≤ 18 years) who underwent TA between 2007 and 2022 were retrospectively reviewed. Children with missing data and those with a diagnosis of nonnephrological disease were excluded.

Results

A total of 1214 TA sessions, including 1147 therapeutic plasma exchange (TPE) sessions and 67 immunoadsorption (IA) sessions, were performed on the 108 patients enrolled in the study. Forty-seven percent of the patients were male, and the mean age was 12.22 ± 4.47 years. Posttransplant antibody-mediated rejection (64.8%) and hemolytic uremic syndrome (14.8%) were the most common diagnoses indicating TA. Overall, 17 different complications occurred in 58 sessions (4.8%), and 53 sessions (4.6%) were not completed because of these complications. The distribution of complications among the patients was as follows: 41.4% had technical complications, 25.9% had allergic complications, and 32.7% had others. The most common technical complication was insufficient flow (37.5%). The incidence of complications was greater in patients aged 3–6 years than in patients in the other age groups (p = 0.031). The primary disease, type of vascular access, and rate of fresh frozen plasma/albumin use were similar between patients with and without complications (p values of 0.359 and 0.125 and 0.118, respectively).

Conclusions

Our study showed that complications occurred in only 4.8% of TA sessions. The most common complication was technical problems.

Graphical Abstract
Fusion-s2igan: an efficient and effective single-stage framework for speech-to-image generation
Authors: Zhang Zhenxing , Schomaker Lambert
Published: March 2024

The goal of a speech-to-image transform is to produce a photo-realistic picture directly from a speech signal. Current approaches are based on a stacked modular framework that suffers from three vital issues: (1) Training separate networks is time-consuming, inefficient and the convergence of the final generative model depends on the previous generators; (2) The quality of precursor images is ignored; (3) Multiple discriminator networks need to be trained. We propose an efficient and effective single-stage framework called Fusion-S2iGan to yield perceptually plausible and semantically consistent image samples on the basis of spoken descriptions. Fusion-S2iGan introduces a visual+speech fusion module (VSFM), with a pixel-attention module (PAM), a speech-modulation module (SMM) and a weighted-fusion module (WFM), to inject the speech embedding from a speech encoder into the generator while improving the quality of synthesized pictures. The PAM module models the semantic affinities between pixel regions and by assigning larger weights to significant locations. The VSFM module adopts SMM to modulate visual feature maps using fine-grained linguistic cues present in the speech vector. Subsequently, the weighted-fusion model (WFM) captures the semantic importance of the image-attention mask and the speech-modulation module at the level of the channels, in an adaptive manner. Fusion-S2iGan spreads the bimodal information over all layers of the generator network to reinforce the visual feature maps at various hierarchical levels in the architecture. A series of experiments is conducted on four benchmark data sets: CUB birds, Oxford-102, Flickr8k and Places-subset. Results demonstrate the superiority of Fusion-S2iGan compared to the state-of-the-art models with a multi-stage architecture and a performance level that is close to traditional text-to-image approaches.
Rock Mass Structure Characterization Considering Finite and Folded Discontinuities: A Parametric Study
Authors: Erharter Georg H.
Published: March 2024

The quantification of a rock mass’s internal structure and description of discontinuity properties is imperative for modern rock mass characterization. This study builds on decades of rock engineering development by reviewing and revising different parameters such as the rock quality designation ($${\text{RQD}}$$
RQD
), volumetric joint count ($${J}_{v}$$

J
v

), the Pij system and others. Analyses of these parameters are done by means of a Monte Carlo simulation that generated 5000 samples of discrete discontinuity networks including finite, folded and very low to very high discontinuity densities ($${J}_{v}$$

J
v

range: 0.5–117 discontinuities/m3), thus representing a wide range of possible geological scenarios. $$P10$$

P
10

, $$P20$$

P
20

, $$P21$$

P
21

, $$P30$$

P
30

, $$P32$$

P
32

, $$RQD$$

RQD

and the fractal dimension of the rock mass are virtually measured on these samples and a range of higher level parameters that are used in practical rock engineering computed and their relationships investigated. It is concluded that parameters which are based on subjective estimations of discontinuity spacing, the number of discontinuity sets or $$RQD$$

RQD

are not suited to describe the rock mass structure in cases of demanding geological scenarios featuring many discontinuities, weak and anisotropic rock masses, metamorphic rock masses, folded rock masses, etc. By revising classical parameters and their relationships, this study contributes to basic rock mass characterization and furthermore paves the way for future developments by making the developed discrete discontinuity network dataset and all included codes openly accessible to the rock mechanics community.
Ideological ambiguity and political spectrum
Authors: Galindo-Silva Hector
Published: March 2024

This study examines the relationship between ambiguity and the ideological positioning of political parties across the political spectrum. We identify a strong non-monotonic (inverted U-shaped) relationship between party ideology and ambiguity within a sample of 202 European political parties. This pattern is observed across all ideological dimensions covered in the data. To explain this pattern, we argue that centrist parties are perceived as less risky by voters compared to extremist parties, giving them an advantage in employing ambiguity to attract more voters at a lower cost. We support our explanation with additional evidence from electoral outcomes and economic indicators in the respective party countries.
Implementing climate change adaptation through mainstreaming at the local level—a comparative case study of two municipalities in the Netherlands
Authors: Baack Franziska , Özerol Gül , Vinke-de Kruijf Joanne , Halman Johannes , Kuks Stefan
Published: March 2024

Governments face increasing urgency to adapt to climate change. However, there is a persistent gap between needed and implemented adaptation. The implementation of adaptation often takes place at the local level, making municipalities crucial actors, particularly regarding mainstreaming adaptation into various sectors. While mainstreaming has the potential to bring many benefits, it does not necessarily result in the implementation of adaptation. Its contribution to the adaptation process over time and the resulting implementation at the local level remain poorly understood, exacerbating the adaptation implementation gap. To advance the understanding of mainstreaming for implementation, we synthesize the emerging debates on adaptation mainstreaming with the literature on environmental policy integration and offer a framework towards a nuanced conceptualization of mainstreaming. Our results from a case study of two Dutch municipalities show that managerial actions precede the acceleration of implementation in the built environment and point to a learning curve. Furthermore, mainstreaming focuses on the water sector, built environment and green infrastructure, with little attention paid to the intersection of heat stress and drought with other sectors, while differences in the implementation of adaptation in the two cases hint at the influence of the local context. We conclude that there is no blueprint to implement adaptation, and while local preferences determine the sectors where integration and implementation occur, consideration of long-term future climate change is lacking in both cities’ mainstreaming of adaptation implementation. Our framework allowed identifying the potential and pitfalls of mainstreaming adaptation towards implementation at the local level.