bluuebunny/crossref_metadata_2025 huggingface dataset:
Focal Liver Lesions
Authors: Schima Wolfgang , Koh Dow-Mu
Published: March 2023

Contrast-enhanced multi-phasic MDCT is the most important liver imaging technique in many institutions, when a focal lesion is suspected at ultrasound. Lesion characterization is based on size, shape, contour, and assessment of contrast enhancement pattern. If a lesion shows peripheral and nodular enhancement, with the density of enhancing portions similar to the vascular pool, a hemangioma can be confidently diagnosed. There are many different arterial-phase hypervascular lesions, include FNH, adenoma, HCC, and metastases from NET, melanoma, renal cell carcinoma, sarcoma, and breast cancer. Lesion characterization in general, HCC is considered in a setting of cirrhosis or chronic liver disease.

An MR examination of the liver routinely includes unenhanced T1-weighted GRE DIXON, T2-weighted TSE fatsat, and diffusion-weighted imaging (DWI) as well as dynamic contrast-enhanced pulse sequences. DWI’s main clinical benefit is the detection of focal liver lesions, which may be missed on conventional and contrast-enhanced imaging sequences. Liver-specific MR contrast agents have been shown to increase the detection of liver metastases, improve the characterization of FNH and adenoma, as well as the characterization of equivocal lesions in cirrhosis.
Die sozial-ökologische Transformation wird auch ein Demokratisierungsprozess sein oder scheitern. Eine Einleitung
Authors: Legrand Jupp , Linden Benedikt , Arlt Hans-Jürgen
Published: March 2023

Die Frage nach der Zukunft der gesellschaftlichen Arbeit stellt sich achtsamen Beobachter:innen in der multiplen Krisenkonstellation am Beginn des 21. Jahrhunderts so dringlich und grundsätzlich, dass es verwundert, wie groß die öffentliche Bereitschaft zu sein scheint, sie auf der Agenda nachrangig einzuordnen und sich mit Hoffnungen auf Künstliche Intelligenz, algorithmische Antworten und Ausflüge ins Universum zu beruhigen. Ins Auge zu fassen gilt es das „magische Dreieck“ aus Arbeit, Zivilgesellschaft und Politik, innerhalb dessen gesellschaftliche Evolution ihren Weg findet. Die Arbeit und die sozialen sowie ökonomischen Formen, in welchen sie organisiert wird, die Zivilgesellschaft und die Art und Weise, in der sie das Persönliche, das Familiäre und das Allgemeine zueinander in Beziehung setzt, die Politik und ihre Fähigkeit, über kollektive Verbindlichkeiten zu entscheiden – dass diese Drei über alle Divergenzen und Kontroversen hinaus eine demokratisch-emanzipatorische Grundrichtung eint, darauf käme es an.
Souveränitätsgewinne oder Freiheitsverluste – wohin treibt der Arbeitsmarkt?
Authors: Allmendinger Jutta , Schroeder Wolfgang
Published: March 2023

Die Arrangements der Plattformökonomie stehen für eine weitreichende Transformation, an deren Ende sich das rechtliche und soziale Band der Erwerbsarbeit auflöst. Solange die Plattformarbeit eher ein Randphänomen bleibt, wird die regulierte Arbeitsgesellschaft nicht grundlegend infrage gestellt. Entwickelt sich dieses Phänomen aber in der heutigen Form ungezügelt weiter, werden unsere Prinzipien des Sozialversicherungsstaats bedroht. Die neuen Konstellationen von Beschäftigung, Managementstrategien und Interessenvertretung führen dann zu Veränderungen, die das etablierte Akteurs- und Institutionengefüge sprengen und sich herkömmlichen sozialpartnerschaftlichen Aushandlungsformen und politischer Regulierung entziehen. Eine Arbeitspolitik der Souveränität braucht Antworten, die den Kontext der Akteure und Institutionen stärkt. Davon wird es abhängen, ob die Freiheitspotenziale erschlossen werden können. Dafür gibt es Ansätze, wie die bald weltweit verortete Initiative von Fairwork zeigt.
Leben, lieben, kämpfen – in einem anderen Land
Authors: Ayata Imran
Published: March 2023

Die Resilienz und die widerständigen Strategien der Migrantinnen und Migranten gegenüber institutionellem und alltäglichem Rassismus sowie ökonomischer und sozialer Ausgrenzung verdienen viel größere Anerkennung. Es ist erstaunlich, wie schwer Deutschland sich als Land tut, in Zeiten der Globalisierung und Digitalisierung zukunftsweisende Antworten auf Fragen zu finden, die bleiben werden. Es bedarf eines Perspektivwechsels, der darin besteht, Einwanderung und Migration als nichts Temporäres oder Vergängliches, sondern als gesellschaftliche Normalität zu begreifen. Denn das Jahrhundert der Migration hat für Almanya erst begonnen. Das Deutschland von morgen wird sehr viel stärker von Einwanderung geprägt sein, als es heute schon ist. Dabei ist es mitnichten die Aufgabe von Menschen mit Einwanderungsgeschichte, Almanya zu bereichern, weder ökonomisch noch kulturell. Ist es nicht merkwürdig, wenn in einer Demokratie dies von manchen eingefordert wird und anderen nicht? Warum müssen überhaupt Migrantinnen und Migranten produktiv und erfolgreich sein, um ohne Wenn und Aber dazuzugehören?
The η-secretase-derived APP fragment ηCTF is localized in Golgi, endosomes and extracellular vesicles and contributes to Aβ production
Authors: Afram Elissa , Lauritzen Inger , Bourgeois Alexandre , El Manaa Wejdane , Duplan Eric , Chami Mounia , Valverde Audrey , Charlotte Bauer , Pardossi-Piquard Raphaëlle , Checler Frederic
Published: March 2023

The processing of the amyloid precursor protein (APP) is one of the key events contributing to Alzheimer’s disease (AD) etiology. Canonical cleavages by β- and γ-secretases lead to Aβ production which accumulate in amyloid plaques. Recently, the matrix metalloprotease MT5-MMP, referred to as η-secretase, has been identified as a novel APP cleaving enzyme producing a transmembrane fragment, ηCTF that undergoes subsequent cleavages by α- and β-secretases yielding the Aηα and Aηβ peptides, respectively. The functions and contributions of ηCTF and its related fragments to AD pathology are poorly understood. In this study, we designed a novel immunological probe referred to as ηCTF-NTer antibody that specifically interacts with the N-terminal part of ηCTF targeting ηCTF, Aηα, Aηβ but not C99, C83 and Aβ. We examined the fate and localization of ηCTF fragment in various cell models and in mice. We found that overexpressed ηCTF undergoes degradation in the proteasomal and autophagic pathways and accumulates mainly in the Golgi and in endosomes. Moreover, we observed the presence of ηCTF in small extracellular vesicles purified from neuroblastoma cells or from mouse brains expressing ηCTF. Importantly, the expression of ηCTF in fibroblasts devoid on APP leads to Aβ production demonstrating its contribution to the amyloidogenic pathway. Finally, we observed an ηCTF-like immunoreactivity around amyloid plaques and an age-dependent accumulation of ηCTF in the triple-transgenic mouse AD model. Thus, our study suggests that the ηCTF fragment likely contributes to AD pathology by its exosomal spreading and involvement in Aβ production.
An Algebraic and Microlocal Approach to the Stochastic Nonlinear Schrödinger Equation
Authors: Bonicelli Alberto , Dappiaggi Claudio , Rinaldi Paolo
Published: March 2023

In a recent work Dappiaggi (Commun Contemp Math 24:2150075, 2022), a novel framework aimed at studying at a perturbative level a large class of nonlinear, scalar, real, stochastic PDEs has been developed and inspired by the algebraic approach to quantum field theory. The main advantage is the possibility of computing the expectation value and the correlation functions of the underlying solutions accounting for renormalization intrinsically and without resorting to any specific regularization scheme. In this work, we prove that it is possible to extend the range of applicability of this framework to cover also the stochastic nonlinear Schrödinger equation in which randomness is codified by an additive, Gaussian, complex white noise.
Toxicity of dose-escalated radiotherapy up to 84 Gy for prostate cancer
Authors: Rosenbrock Johannes , Baues Christian , Kreis Marius , Fouassi Redouane , Celik Eren , Paffenholz Pia , Pfister David , Heidenreich Axel , Marnitz Simone
Published: March 2023

Purpose

The outcome of radiotherapy (RT) for prostate cancer (PCA) depends on the delivered dose. While the evidence for dose-escalated RT up to 80 gray (Gy) is well established, there have been only few studies examining dose escalation above 80 Gy. We initiated the present study to assess the safety of dose escalation up to 84 Gy.

Methods

In our retrospective analysis, we included patients who received dose-escalated RT for PCA at our institution between 2016 and 2021. We evaluated acute genitourinary (GU) and gastrointestinal (GI) toxicity as well as late GU and GI toxicity.

Results

A total of 86 patients could be evaluated, of whom 24 patients had received 80 Gy and 62 patients 84 Gy (35 without pelvic and 27 with pelvic radiotherapy). Regarding acute toxicities, no > grade 2 adverse events occurred. Acute GU/GI toxicity of grade 2 occurred in 12.5%/12.5% of patients treated with 80 Gy, in 25.7%/14.3% of patients treated with 84 Gy to the prostate only, and in 51.9%/12.9% of patients treated with 84 Gy and the pelvis included. Late GU/GI toxicity of grade ≥ 2 occurred in 4.2%/8.3% of patients treated with 80 Gy, in 7.1%/3.6% of patients treated with 84 Gy prostate only, and in 18.2%/0% of patients treated with 84 Gy pelvis included (log-rank test p = 0.358).

Conclusion

We demonstrated that dose-escalated RT for PCA up to 84 Gy is feasible and safe without a significant increase in acute toxicity. Further follow-up is needed to assess late toxicity and survival.
The association between experience of COVID-19-related discrimination and psychological distress among healthcare workers for six national medical research centers in Japan
Authors: Shrestha Rachana Manandhar , Inoue Yosuke , Yamamoto Shohei , Fukunaga Ami , Sampei Makiko , Okubo Ryo , Morisaki Naho , Ohmagari Norio , Funaki Takanori , Ishizuka Kazue , Yamaguchi Koushi , Sasaki Yohei , Takeda Kazuyoshi , Miyama Takeshi , Kojima Masayo , Nakagawa Takeshi , Nishimura Kunihiro , Ogata Soshiro , Umezawa Jun , Tanaka Shiori , Inoue Manami , Konishi Maki , Miyo Kengo , Mizoue Tetsuya
Published: March 2023

Background

Discrimination is an important determinant of negative mental health outcomes. This study determined the association between the experience of COVID-19-related discrimination and psychological distress among healthcare workers (HCWs) in Japan.

Methods

This cross-sectional study conducted a health survey among 5703 HCWs of six national medical and research centers in Japan from October 2020 to March 2021. COVID-19-related discrimination was defined either when participants or their family members were badmouthed or when they felt discriminated against in some way. We used the Kessler Psychological Distress Scale (K6) to assess the presence of severe psychological distress (≥ 13 points). We used logistic regression models to examine the association between discrimination and psychological distress. We also identified factors associated with discrimination.

Results

Of the participants, 484 (8.4%) reported COVID-19-related discrimination and 486 (8.5%) had severe psychological distress. HCWs who were female vs. male (adjusted odds ratio [AOR] = 1.41, 95% confidence interval [CI] = 1.28–1.55), had high vs. low viral exposure (AOR = 2.31, 95% CI = 1.81–2.93), and worked for 11 or more hours/day vs. 8 or less hours/day (AOR = 1.42, 95% CI = 1.35–1.49) were more likely to have experienced COVID-19-related discrimination. The AOR (95% CI) of severe psychological distress was 1.83 (1.29–2.59) among those who experienced discrimination. In the stratified analysis by sociodemographic and job-related factors, all the interactions did not reach statistical significance (p for interaction > 0.20).

Conclusion

Experience of COVID-19-related discrimination was associated with severe psychological distress among HCWs. During the pandemic, effective measures should be taken to prevent the development of negative mental health outcomes in HCWs who experience discrimination.
Bogomolov–Sommese type vanishing theorem for holomorphic vector bundles equipped with positive singular Hermitian metrics
Authors: Watanabe Yuta
Published: March 2023

In this article, we obtain the Bogomolov–Sommese type vanishing theorem involving multiplier ideal sheaves for big line bundles. We define a dual Nakano semi-positivity of singular Hermitian metrics with$$L^2$$L2-estimates and prove a vanishing theorem which is a generalization of the Bogomolov–Sommese type vanishing theorem to holomorphic vector bundles.
Age at first exposure to antibiotics and neurodevelopmental outcomes in childhood
Authors: Slykerman Rebecca F. , Neumann Denise , Underwood Lisa , Hobbs Mark , Waldie Karen E.
Published: March 2023

Rationale

Viral illnesses in children are common and are frequently treated with antibiotic medication. Antibiotics reduce the diversity and composition of the gut microbiota, leading to poor developmental outcomes.

Objectives

To investigate the relationship between age at first exposure to antibiotics and cognitive and behavioural development at 4.5 years while controlling for multiple confounders, including otitis media.

Methods

Study participants were 5589 children enrolled in the broadly generalisable Growing Up in New Zealand cohort study, with antibiotic exposure data, maternal antenatal information, and age 4.5-year behaviour and cognitive outcome data. Children were categorised as first exposed to antibiotics according to the following mutually exclusive ages: 0–2 months; 3–5 months; 6–8 months; 9–11 months; 12–54 months or not exposed by 54 months. Developmental outcome measures included the Strengths and Difficulties Questionnaire, Luria hand clap task, and the Peabody Picture Vocabulary Test-III.

Results

In univariate analysis, there was an evident dose–response relationship where earlier exposure to antibiotics in the first year of life was associated with behavioural difficulties, lower executive function scores, and lower receptive language ability. After adjusting for confounders, pairwise comparisons showed that first antibiotic exposure between birth and 3 months or between 6 and 9 months was associated with lower receptive vocabulary. Antibiotic exposure at any age prior to 12 months was associated with increases in behavioural difficulties scores at 4.5 years.

Conclusions

Following adjustment for socioeconomic factors and otitis media, there is evidence that antibiotic exposure during potentially sensitive windows of development is associated with receptive language and behaviour later in childhood.
Synchronous motor imagery and visual feedback of finger movement elicit the moving rubber hand illusion, at least in illusion-susceptible individuals
Authors: Berger Christopher C. , Coppi Sara , Ehrsson H. Henrik
Published: March 2023

Recent evidence suggests that imagined auditory and visual sensory stimuli can be integrated with real sensory information from a different sensory modality to change the perception of external events via cross-modal multisensory integration mechanisms. Here, we explored whether imagined voluntary movements can integrate visual and proprioceptive cues to change how we perceive our own limbs in space. Participants viewed a robotic hand wearing a glove repetitively moving its right index finger up and down at a frequency of 1 Hz, while they imagined executing the corresponding movements synchronously or asynchronously (kinesthetic-motor imagery); electromyography (EMG) from the participants’ right index flexor muscle confirmed that the participants kept their hand relaxed while imagining the movements. The questionnaire results revealed that the synchronously imagined movements elicited illusory ownership and a sense of agency over the moving robotic hand—the moving rubber hand illusion—compared with asynchronously imagined movements; individuals who affirmed experiencing the illusion with real synchronous movement also did so with synchronous imagined movements. The results from a proprioceptive drift task further demonstrated a shift in the perceived location of the participants’ real hand toward the robotic hand in the synchronous versus the asynchronous motor imagery condition. These results suggest that kinesthetic motor imagery can be used to replace veridical congruent somatosensory feedback from a moving finger in the moving rubber hand illusion to trigger illusory body ownership and agency, but only if the temporal congruence rule of the illusion is obeyed. This observation extends previous studies on the integration of mental imagery and sensory perception to the case of multisensory bodily awareness, which has potentially important implications for research into embodiment of brain–computer interface controlled robotic prostheses and computer-generated limbs in virtual reality.
Dose length product to effective dose coefficients in children
Authors: Chu Philip W. , Kofler Cameron , Mahendra Malini , Wang Yifei , Chu Cameron A. , Stewart Carly , Delman Bradley N. , Haas Brian , Lee Choonsik , Bolch Wesley E. , Smith-Bindman Rebecca
Published: March 2023

Background

The most accurate method for estimating effective dose (the most widely understood metric for tracking patient radiation exposure) from computed tomography (CT) requires time-intensive Monte Carlo simulation. A simpler method multiplies a scalar coefficient by the widely available scanner-reported dose length product (DLP) to estimate effective dose.

Objective

Develop pediatric effective dose coefficients and assess their agreement with Monte Carlo simulation.

Materials and methods

Multicenter, population-based sample of 128,397 pediatric diagnostic CT scans prospectively assembled in 2015–2020 from the University of California San Francisco International CT Dose Registry and the University of Florida library of highly realistic hybrid computational phantoms. We generated effective dose coefficients for seven body regions, stratified by patient age, diameter, and scanner manufacturer. We applied the new coefficients to DLPs to calculate effective doses and assessed their correlations with Monte Carlo radiation transport-generated effective doses.

Results

The reported effective dose coefficients, generally higher than previous studies, varied by body region and decreased in magnitude with increasing age. Coefficients were approximately 4 to 13-fold higher (across body regions) for patients  <1 year old compared with patients 15–21 years old. For example, head CT (54% of scans) dose coefficients decreased from 0.039 to 0.003 mSv/mGy-cm in patients  <1 year old vs. 15–21 years old. There were minimal differences by manufacturer. Using age-based conversion coefficients to estimate effective dose produced moderate to strong correlations with Monte Carlo results (Pearson correlations 0.52–0.80 across body regions).

Conclusions

New pediatric effective dose coefficients update existing literature and can be used to easily estimate effective dose using scanner-reported DLP.
Doppler-ultrasound reference values after pediatric liver transplantation: a consecutive cohort study
Authors: Verhagen Martijn V. , de Kleine Ruben H. , Groen Henk , van der Doef Hubert P. J. , Kwee Thomas C. , de Haas Robbert J.
Published: March 2023

Objectives

Doppler ultrasound (DUS) is the main imaging modality to evaluate vascular complications of pediatric liver transplants (LT). The current study aimed to determine reference values and their change over time.

Methods

A consecutive cohort of pediatric patients undergoing an LT were retrospectively included between 2015 and 2020. Timepoints for standardized DUS were intra-operative and postoperative (day 0), days 1–7, months 1 and 3, and years 1 and 2. DUS measurements of the hepatic artery (HA), portal vein (PV), and hepatic vein(s) (HV) were included if there were no complications during 2 years follow-up. Measurements consisted of: peak systolic velocity (PSV) and resistive index (RI) for the HA, PSV for the PV, and venous pulsatility index (VPI) for the HV. Generalized estimating equations were used to analyze change over time.

Results

One hundred twelve pediatric patients with 123 LTs were included (median age 3.3 years, interquartile range 0.7–10.1). Ninety-five HAs, 100 PVs, and 115 HVs without complications were included. Reference values for HA PSV and RI, PV PSV, and HV VPI were obtained for all timepoints (4043 included data points in total) and presented using 5th–95th percentiles and threshold values. All reference values changed significantly over time (p = 0.032 to p < 0.001).

Conclusions

DUS reference values of hepatic vessels in children after LT are presented, reference values change over time with specific vessel-dependent patterns. Timepoint–specific reference values improve the interpretation of DUS values and may help to better weigh their clinical significance.

Key Points

• Doppler ultrasound reference values of pediatric liver transplantations are not static but change over time. Applying the correct reference values for the specific timepoint may further improve the interpretation of the measurements.

• The pattern of change over time of Doppler ultrasound measurements differs between the hepatic vessel and measurement; knowledge of these patterns may help radiologists to better understand normal postoperative hemodynamic changes.
The efficacy of retrograde intra-renal surgery (RIRS) for lower pole stones: results from 2946 patients
Authors: Giulioni Carlo , Castellani Daniele , Somani Bhaskar Kumar , Chew Ben Hall , Tailly Thomas , Keat William Ong Lay , Teoh Jeremy Yuen‑Chun , Emiliani Esteban , Chai Chu Ann , Galosi Andrea Benedetto , Ragoori Deepak , Tanidir Yiloren , Hamri Saeed Bin , Gadzhiev Nariman , Traxer Olivier , Gauhar Vineet
Published: March 2023

Purpose

To evaluate the perioperative outcomes of retrograde intra-renal surgery (RIRS) for lower pole stones (LPS) and factors affecting stone-free rate (SFR).

Methods

Data from 20 centers were retrospectively reviewed. Inclusion criteria were adult patients, normal renal anatomy, and LPS. Exclusion criteria were bilateral surgery, concomitant surgery for ureteral stones. SFR was defined as a single residual fragment (RF) ≤ 2 mm and evaluated 3-months after surgery. A multivariable logistic regression analysis was performed to assess factors associated with RF. Statistical significance was set at p value < 0.05.

Results

2946 patients were included. Mean age and stone size were 49.9 years 10.19 mm, with multiple LPS in 61.1% of cases. Total operation and laser time were 63.89 ± 37.65 and 17.34 ± 18.39 min, respectively. Mean hospital stay was 3.55 days. Hematuria requiring blood transfusion and fever/urinary infections requiring prolonged antibiotics occurred in 6.1% and 169 5.7% of cases, while sepsis with intensive-care admission in 1.1% of patients. On multivariate analysis, Multiple stones (OR 1.380), stone size (OR 1.865), and reusable ureteroscopes (OR 1.414) were significantly associated with RF, while Thulium fiber laser (TFL) (OR 0.341) and pre-stenting (OR 0.750) were less likely associated with RF.

Conclusions

RIRS showed safety and efficacy for LPS with a mean diameter of 10 mm. This procedure can achieve a satisfactory SFR in pre-stented patients with a single and smaller stone, particularly with TFL use.
Forensic age estimation: comparison and validation of the Iscan method in 3D reconstructions using a surface scanner in a Spanish population
Authors: Beltran-Aroca Cristina M. , Lopez-Alcaraz Manuel , Perez-Jorge Pablo , Velazquez-Gomez Jose L. , Font-Ugalde Pilar , Girela-Lopez Eloy
Published: March 2023

When investigating a death, post-mortem identification provides with results of great legal and humanitarian significance. The effectiveness of the methods used to estimate age depends on the reference population, considering variables such as sex and ancestry. The aim of this study was to validate the Iscan method to estimate age in a Spanish forensic population, comparing the estimates obtained in dry bones and 3D reconstructions created with a surface scanner. We carried out a cross-sectional study on 109 autopsied corpses (67% male), scanning the sternal end of the right fourth rib in a 3D mesh, using an EinScan-Pro® surface scanner (precision: 0.05 mm). Two observers estimated the phases in dry bones and 3D images according to the Iscan method and to the sex of the subject. The mean age was 57.73 years (SD = 19.12 years;18–93 years). The intra-observer agreement was almost perfect in bones (κ = 0.877–0.960) and 3D images (κ = 0.954), while the inter-observer agreement was almost perfect in bones (κ = 0.813) and substantial in 3D images (κ = 0.727). The correlation with the Iscan phases was very strong in bones (Rho = 0.794–0.820;p < 0.001) and strong in 3D images (Rho = 0.690–0.691;p < 0.001). Both sex-adjusted linear regression models were significant (dry bones:R2 = 0.65; SEE =  ± 11.264 years; 3D images:R2 = 0.50; SEE =  ± 13.537 years) from phase 4 onwards. An overestimation of age was observed in the first phases, and an underestimation in the later ones. Virtual analysis using a surface scanner in the fourth rib is a valid means of estimating age. However, the error values and confidence intervals were considerable, so the joint use of different methods and anatomical sites is recommended.
TEsoNet: knowledge transfer in surgical phase recognition from laparoscopic sleeve gastrectomy to the laparoscopic part of Ivor–Lewis esophagectomy
Authors: Eckhoff J. A. , Ban Y. , Rosman G. , Müller D. T. , Hashimoto D. A. , Witkowski E. , Babic B. , Rus D. , Bruns C. , Fuchs H. F. , Meireles O.
Published: March 2023

Background

Surgical phase recognition using computer vision presents an essential requirement for artificial intelligence-assisted analysis of surgical workflow. Its performance is heavily dependent on large amounts of annotated video data, which remain a limited resource, especially concerning highly specialized procedures. Knowledge transfer from common to more complex procedures can promote data efficiency. Phase recognition models trained on large, readily available datasets may be extrapolated and transferred to smaller datasets of different procedures to improve generalizability. The conditions under which transfer learning is appropriate and feasible remain to be established.

Methods

We defined ten operative phases for the laparoscopic part of Ivor-Lewis Esophagectomy through expert consensus. A dataset of 40 videos was annotated accordingly. The knowledge transfer capability of an established model architecture for phase recognition (CNN + LSTM) was adapted to generate a “Transferal Esophagectomy Network” (TEsoNet) for co-training and transfer learning from laparoscopic Sleeve Gastrectomy to the laparoscopic part of Ivor-Lewis Esophagectomy, exploring different training set compositions and training weights.

Results

The explored model architecture is capable of accurate phase detection in complex procedures, such as Esophagectomy, even with low quantities of training data. Knowledge transfer between two upper gastrointestinal procedures is feasible and achieves reasonable accuracy with respect to operative phases with high procedural overlap.

Conclusion

Robust phase recognition models can achieve reasonable yet phase-specific accuracy through transfer learning and co-training between two related procedures, even when exposed to small amounts of training data of the target procedure. Further exploration is required to determine appropriate data amounts, key characteristics of the training procedure and temporal annotation methods required for successful transferal phase recognition. Transfer learning across different procedures addressing small datasets may increase data efficiency. Finally, to enable the surgical application of AI for intraoperative risk mitigation, coverage of rare, specialized procedures needs to be explored.

Graphical abstract
Deceased donor kidney transplanted in childhood functioning well after 52 years
Authors: Spartà Giuseppina , Hadaya Karine , Paunier Luc , Girardin Eric , Leumann Ernst
Published: March 2023

Background

Kidney transplantation in children in 1970 was considered by many to be unethical, as long-term survival was minimal. It was therefore risky at the time to offer transplantation to a child.

Case diagnosis/treatment

A 6-year-old boy with kidney failure due to haemolytic uraemic syndrome received 4 months of intermittent peritoneal dialysis followed by 6 months of haemodialysis until at 6 years and 10 months, he underwent bilateral nephrectomy and received a kidney transplant from a deceased 18-year-old donor. Despite moderate long-term immunosuppression of prednisone (20 mg/48 h) and azathioprine (62.5 mg/day), at the last visit in September 2022, he was well, normotrophic, with a serum creatinine of 157 µmol/l (eGFR 41 ml/min/1.73 m2) and no haematuria, proteinuria or hypertension. Except for benign skin lesions due to azathioprine, and undergoing an aortic valve replacement and an aortic aneurysm repair in adulthood, the now 58-year-old man has had no major complications.

Conclusions

We speculate that stable and unmodified immunosuppressive therapy, started before the era of calcineurin inhibitors, the lack of significant rejection episodes, the absence of donor-specific antibodies, and the young donor age have contributed to maintaining exceptional long-term kidney transplant survival. Luck, a robust health system and an adherent patient are also important. To the best of our knowledge, this is the longest functioning kidney transplant from a deceased donor performed in a child worldwide. Despite its risky nature at the time, this transplant paved the way for others.
Prophylactic gabapentin during head and neck cancer therapy: a systematic review and meta-analysis
Authors: Smith Loren E. , Murphy Barbara A. , Smith Derek K.
Published: March 2023

Purpose

This review was designed to compile the currently available evidence on the prophylactic use of gabapentin in the head and neck cancer patient population.

Methods

A systematic search was conducted of PubMed, Web of Science, and Google Scholar to identify articles related to the use of prophylactic gabapentin in patients undergoing head and neck cancer therapy. Candidate studies were screened for inclusion and a subsequent bias assessment was conducted by multiple reviewers. Meta-analysis was conducted in cases in which the studies used compatible outcome measures.

Results

Ten studies were identified that met the inclusion criteria and were assessed for bias. Among the four small studies that examined pain prevention, 2 were positive and 2 were inconclusive. Three of the four studies examiniRDng opioid use noted less need for opioids in the treatment arm. Meta-analysis of the pertinent studies showed no difference in feeding tube placement (RD = 0.64%, 95%CI: (− 25.8%, 27.1%), p = 0.962) but substantially less weight loss among those in the treatment arm (p = 0.047).

Conclusion

Prophylactic gabapentin appears to be a promising treatment option for preventing pain, reducing opioids, and reducing weight loss in patients undergoing head and neck cancer therapy. However, the studies on the treatment to date are small and several have a substantial risk of bias.
Vertebropexy as a semi-rigid ligamentous alternative to lumbar spinal fusion
Authors: Farshad Mazda , Tsagkaris Christos , Widmer Jonas , Fasser Marie-Rosa , Cornaz Frédéric , Calek Anna-Katharina
Published: March 2023

Purpose

To develop ligamentous vertebral stabilization techniques (“vertebropexy”) that can be used after microsurgical decompression (intact posterior structures) and midline decompression (removed posterior structures) and to elaborate their biomechanical characteristics.

Methods

Fifteen spinal segments were biomechanically tested in a stepwise surgical decompression and ligamentous stabilization study. Stabilization was achieved with a gracilis or semitendinosus tendon allograft, which was attached to the spinous process (interspinous vertebropexy) or the laminae (interlaminar vertebropexy) in form of a loop. The specimens were tested (1) in the native state, after (2) microsurgical decompression, (3) interspinous vertebropexy, (4) midline decompression, and (5) interlaminar vertebropexy. In the intact state and after every surgical step, the segments were loaded in flexion–extension (FE), lateral shear (LS), lateral bending (LB), anterior shear (AS) and axial rotation (AR).

Results

Interspinous vertebropexy significantly reduced the range of motion (ROM) in all loading scenarios compared to microsurgical decompression: in FE by 70% (p < 0.001), in LS by 22% (p < 0.001), in LB by 8% (p < 0.001) in AS by 12% (p < 0.01) and in AR by 9% (p < 0.001). Interlaminar vertebropexy decreased ROM compared to midline decompression by 70% (p < 0.001) in FE, 18% (p < 0.001) in LS, 11% (p < 0.01) in LB, 7% (p < 0.01) in AS, and 4% (p < 0.01) in AR. Vertebral segment ROM was significantly smaller with the interspinous vertebropexy compared to the interlaminar vertebropexy for all loading scenarios except FE. Both techniques were able to reduce vertebral body segment ROM in FE, LS and LB beyond the native state.

Conclusion

Vertebropexy is a new concept of semi-rigid spinal stabilization based on ligamentous reinforcement of the spinal segment. It is able to reduce motion, especially in flexion–extension. Studies are needed to evaluate its clinical application.
An end-to-end pipeline for historical censuses processing
Authors: Petitpierre Rémi , Kramer Marion , Rappo Lucas
Published: March 2023

Censuses are structured documents of great value for social and demographic history, which became widespread from the nineteenth century on. However, the plurality of formats and the natural variability of historical data make their extraction arduous and often lead to ungeneric recognition algorithms. We propose an end-to-end processing pipeline, based on optimization, in an attempt to reduce the number of free parameters. The layout analysis is based on semantic segmentation using neural networks for a generic recognition of the explicit column structure. The implicit row structure is deduced directly from the position of the text segments. The handwritten text detection is complemented by an intelligent framing method which significantly improves the quality of the HTR. In the end, we propose to combine several post-correction approaches, neural networks, and language models, to further improve the performance. Ultimately, our flexible methods make it possible to accurately detect more than 98% of the columns and 88% of the rows, despite the lack of graphical separator and the diversity of formats. Thanks to various reframing and post-correction strategies, HTR results reach the excellent performance of 3.44% character error rate on these noisy nineteenth century data. In total, more than 18,831 pages were extracted in 72 censuses over a century. This large historical dataset, as well as training data, is made open-access and released along with this article.
Quantifying stream-loss recovery in a spring using dual-tracer injections in the Snake Creek drainage, Great Basin National Park, Nevada, USA
Authors: Humphrey C. Eric , Gardner Philip M. , Spangler Lawrence E. , Nelson Nora C. , Toran Laura , Solomon D. Kip
Published: March 2023

Simultaneous short-pulse injections of two tracers (sodium bromide [Br–] and fluorescein dye) were made in a losing reach of Snake Creek in Great Basin National Park, Nevada, USA, to evaluate the quantity of stream loss through permeable carbonates that resurfaces at a spring approximately 10 km down drainage. A revised hydrogeologic cross section for a possible flow path of the infiltrated Snake Creek water is presented, and the results may inform water management in the region. First arrival and peak concentration of the two tracers occurred at 9.5 and 12.7 days after injection, respectively. Fracture transport simulations indicate that Br– preferentially diffuses into immobile regions of the aquifer, and this diffusive flux is likely responsible for the major differences in the breakthrough curves. When considering the diffusive tracer flux, total apparent Br– and fluorescein dye recoveries were 16.9–22.1% and 21.7–24.3%, respectively. These findings imply that consideration of diffusive flux and long-term monitoring in fracture-dominated flow may support accurate quantification of tracer recovery. In addition, the apparent power law slopes of the breakthrough tails for both tracers were steeper at early times than have been attributed to heterogeneous advection or channeling in meter-scale tests, but the late-time Br– power law slope becomes less steep than has been attributed to diffusive exchange. These deviations may reflect fracture transport patterns that occur at larger scales.
Rockfall susceptibility analysis through 3D simulations in marine protected areas of the Portofino coastline: case studies of San Fruttuoso and Paraggi bays
Authors: Clemente Jon Ander , Spizzichino Daniele , Leoni Gabriele , Marchese Alessandra , Uriarte Jesus A. , Morales Tomás , Wilting Rolf , Vojinovic Zoran , Faccini Francesco
Published: March 2023

The research focuses on the assessment of the potential geomorphological hazards affecting the stability of the Promontory of Portofino (Regional Natural Park of Portofino, Northern Italy), mainly on the bays of San Fruttuoso and Paraggi. The study area constitutes one of the most representative and most populated environments, both by locals and tourists, of the entire Liguria area. For this reason, there is a growing need for investigation on the natural dynamics of these landscapes, based on detailed topographic information. The research starts from a regional geological and geomorphological analysis specific to the study area, combined with a multi-model comparison algorithm (M3C2), which allows comparing two LiDAR datasets acquired in 2008 and 2020, respectively, to assess the overall dynamics of the promontory development. Then, a detailed study of San Fruttuoso and Paraggi bays, two key points for visitors and therefore for management, is performed. Three-dimensional modeling of rockfalls is carried out, which allows the development of a specific management oriented to the use of nature-based solutions (NBSs) strategies, respecting the environment and increasing safety against instability processes in these areas.
Identification of predictors for neurological outcome after cardiac arrest in peripheral blood mononuclear cells through integrated bioinformatics analysis and machine learning
Authors: Li Zhonghao , Qin Ying , Liu Xiaoyu , Chen Jie , Tang Aling , Yan Shengtao , Zhang Guoqiang
Published: March 2023

Neurological prognostication after cardiac arrest (CA) is important to avoid pursuing futile treatments for poor outcome and inappropriate withdrawal of life-sustaining treatment for good outcome. To predict neurological outcome after CA through biomarkers in peripheral blood mononuclear cells, four datasets were downloaded from the Gene Expression Omnibus database. GSE29546 and GSE74198 were used as training datasets, while GSE92696 and GSE34643 were used as verification datasets. The intersection of differentially expressed genes and hub genes from multiscale embedded gene co-expression network analysis (MEGENA) was utilized in the machine learning screening. Key genes were identified using support vector machine recursive feature elimination (SVM-RFE), least absolute shrinkage and selection operator (LASSO) logistic regression, and random forests (RF). The results were validated using receiver operating characteristic curve analysis. An mRNA-miRNA network was constructed. The distribution of immune cells was evaluated using cell-type identification by estimating relative subsets of RNA transcripts (CIBERSORT). Five biomarkers were identified as predictors for neurological outcome after CA, with an area under the curve (AUC) greater than 0.7: CASP8 and FADD-like apoptosis regulator (CFLAR), human protein kinase X (PRKX), miR-483-5p, let-7a-5p, and let-7c-5p. Interestingly, the combination of CFLAR minus PRKX showed an even higher AUC of 0.814. The mRNA-miRNA network consisted of 30 nodes and 76 edges. Statistical differences were found in immune cell distribution, including neutrophils, NK cells active, NK cells resting, T cells CD4 memory activated, T cells CD4 memory resting, T cells CD8, B cells memory, and mast cells resting between individuals with good and poor neurological outcome after CA. In conclusion, our study identified novel predictors for neurological outcome after CA. Further clinical and laboratory studies are needed to validate our findings.
Auswirkungen körperlicher Aktivität auf Status epilepticus im Tiermodell
Authors: van den Bongard Franziska , Gowik Julia Kristin , Reinsberger Claus
Published: March 2023

Hintergrund

Die Evidenz zum Einfluss körperlicher Aktivität (kA) auf die Anfallsfrequenz in Humanstudien ist niedrig.

Ziel

Literaturbasierte narrative Darstellung des Einflusses von kA auf Status epilepticus (SE) im Tiermodell.

Material und Methode

Auf Basis einer systematischen Literaturrecherche wurden kontrollierte, sportliche Interventionsstudien im Tiermodell für alle Anfallsmodelle sowie Belastungsformen und Modalitäten eingeschlossen, die den Einfluss auf klinische Endpunkte wie Anfallsfrequenz, Latenz und Intensität von Anfällen oder epilepsietypische Aktivität im EEG untersuchten.

Ergebnisse

Es wurden 33 Studien mit 37 Interventionen (Ausdauer‑, Schwimm- oder Krafttrainings verschiedener Intensität, Dauer und Frequenz) eingeschlossen, im Rahmen derer eine Trainings- mit einer Kontrollgruppe verglichen wurde. Die untersuchten Endpunkte waren sehr heterogen und beinhalteten unter anderem epilepsietypische Aktivität im EEG, Latenz bis zum ersten Anfall, Stärke der Symptome oder Anfallsfrequenz. Insgesamt zeigte sich nach 20 Interventionen ein positiver Effekt, nach 9 Interventionen ein heterogener Effekt (positiv oder ausbleibend), nach 6 Interventionen ein ausbleibender Effekt und nach 1 Intervention ein positiver und ein negativer Effekt bezüglich der untersuchten klinischen Endpunkte.

Schlussfolgerung

Im Tiermodell scheint kA keinen relevanten negativen Einfluss auf anfallsassoziierte Endpunkte zu haben und wirkt sich tendenziell in den meisten Fällen, z. B. hinsichtlich der Anfallsfrequenz, positiv aus. Diese Ergebnisse sollten zur Untersuchung des Einflusses von kA auf die Anfallsfrequenz in Humanstudien motivieren.
Plasma chemistry and hematology reference values in wild nestlings of White-tailed Sea Eagles (Haliaeetus albicilla): effects of age, sex and hatching date
Authors: Ferrer Miguel , Evans Rhian , Hedley Joanna , Hollamby Simon , Meredith Anna , Morandini Virginia , Selly Owen , Smith Claire , Whitfield D. Philip
Published: March 2023

Studies on normal concentration of blood constituents of free-living birds are not very common. An adequate knowledge of blood chemistry is greatly recommended for those projects involving research and management of populations as far as they can be valuable for the assessment of the nutritional levels and health status of species. No previous published reports on these parameters from this species are available. The aim of this study was to obtain representative reference measures for hematologic and biochemical values in free-living clinically healthy wild White-tailed Sea Eagle nestlings (Haliaeetus albicilla). In addition, we investigated potential relationships between blood parameters, sex, age and hatching dates. Blood samples were obtained as part of routine monitoring and management when wild chicks were removed from their nest as part of a reintroduction program prerelease health check. A total of 83 nestlings, 43 males and 40 females, between 41 and 66 days of age (mean = 54.22, SD = 5.7), were sampled. Significant differences between sexes were found. Among hematological parameters, MCH, lymphocytes P and thrombocytes showed significant differences between males and females. In biochemical parameters, significant differences were found only in calcium, CK and LDH between sexes. No effect was found of age of the nestling when the sample was taken in any of the analyzed hematological parameters. No other significant relationships were found between biochemical parameters and other considered explanatory variables. Hatching date showed no relationship with blood parameters excepting urea. Urea was the only variable showing a strong relationship with hatching date, with those nestlings hatching later in the season showing higher urea concentration.
Tool-based renewable energy system planning using survey data: A case study in rural Vietnam
Authors: Hart Maria C. G. , Eckhoff Sarah , Breitner Michael H.
Published: March 2023

Renewable energies provide effective sustainable development by raising living standards, accelerating economic growth, and mitigating pollution. However, specifically in developing countries, the lack of information, data, and local expertise challenges the design process and long-term success of renewable energy systems. Following the call for inter-disciplinary, solution-oriented research, this work uses a design science research-approach to facilitate multi-energy planning. The decision support system NESSI4D is developed, which considers site-specific economic, environmental, technological, and social factors and is tuned for stakeholder needs in developing countries. Following a step-by-step process model manual, the artifact’s applicability is demonstrated in a use case for a rural community in Thua Thien-Hue, Vietnam. Missing load data are synthesized from the TVSEP with the software RAMP. The results show that the implementation of renewable energy technologies only enables affordable, low-emission electrification with governmental financial incentives. Several sensitivity tests illustrate the impact of changing assumptions and highlight the importance of detailed analyses with highly specialized tools. The demonstrating use case validates the method’s relevance for research and practice towards the goals of effective sustainable development.
Pre-school Skills and School-Age Reading Comprehension in Children on the Autism Spectrum: A Preliminary Investigation
Authors: Paynter Jessica , O’Leary Kate , Westerveld Marleen
Published: March 2023

We explored reading comprehension development in children on the spectrum from pre-school to the first (YOS1) and third year of schooling (YOS3). Children were first assessed on meaning-related skills in pre-school. Forty-one children completed follow-up assessments of reading comprehension, reading accuracy, and listening comprehension in YOS1. Nineteen returned for assessments of reading accuracy, reading comprehension, and listening comprehension in YOS3. Children showed poorer reading comprehension than reading accuracy at both timepoints. Reading comprehension, reading accuracy, and listening comprehension were significantly concurrently correlated. Pre-school receptive vocabulary was a significant predictor of YOS3 reading comprehension. Results from this preliminary investigation highlight the potential for early identification of children on the spectrum at risk for reading comprehension difficulties.