bluuebunny/crossref_metadata_2025 huggingface dataset:
Music-enhanced Immersive Virtual Reality in the Rehabilitation of Memoryrelated Cognitive Processes and Functional Abilities: A Case Report
Authors: Optale Gabriele , Capodieci Salvatore , Pinelli Pietro , Zara Daniela , Gamberini Luciano , Riva Giuseppe
Published: July 2002

The use of virtual reality (VR) applications in the rehabilitation of memory-related cognitive processes and functional abilities, is supported by different studies showing that, in persons with neurologically-based memory impairment, procedural memory often remain relatively intact. VR, by way of its interactive and immersive features, could be used to exploit the patient's preserved procedural abilities. In particular, cognitive processes could be restored via procedures practiced repetitively within an environment which contains functional real-world demands.

Starting from the above rationale, the paper presents the music-enhanced VRbased treatment of C., a 65-year old woman, experiencing an impairment in memory-related cognitive processes. At the end of treatment the subject experienced a 12-week booster section. The results presented showed that, after the treatment, the patient experienced an improved clinical condition confirmed by the results of different neuropsychological tests. These results were maintained even during a 3-month follow-up.
4 + 4 Fingers Manipulating Virtual Objects in Mixed-Reality Environment
Authors: Walairacht Somsak , Yamada Keita , Hasegawa Shoichi , Koike Yasuharu , Sato Makoto
Published: July 2002

This paper describes the construction of a prototype system that allows the user to manipulate virtual objects in a mixed-reality environment. The user can perceive haptic sensations at his or her fingertips and see a virtual world with a live image of his or her hands manipulating the virtual objects. The difficulty of constructing such a visual presentation is the problem of merging the real image with correct geometrical occlusion with images of virtual objects in the simulated virtual world. In this paper, a method of solving registration of real and virtual images to produce mixedreality scenes is proposed. We have combined this method with our haptic interface device, SPIDAR-8, to construct a system that integrates these realities by using the sense of touch and vision of real images in the virtual world that can be realized during the manipulation of virtual objects. The implemented results are shown and remaining problems are discussed.
Share-Z: Client/Server Depth Sensing for See-Through Head-Mounted Displays
Authors: Ohta Yuichi , Sugaya Yasuyuki , Igarashi Hiroki , Ohtsuki Toshikazu , Taguchi Kaito
Published: July 2002

In mixed reality, occlusions and shadows are important to realize a natural fusion between the real and virtual worlds. In order to achieve this, it is necessary to acquire dense depth information of the real world from the observer's viewing position. The depth sensor must be attached to the see-through HMD of the observer because he/she moves around. The sensor should be small and light enough to be attached to the HMD and should be able to produce a reliable dense depth map at video rate. Unfortunately, however, no such depth sensors are available. We propose a client/server depth-sensing scheme to solve this problem. A server sensor located at a fixed position in the real world acquires the 3-D information of the world, and a client sensor attached to each observer produces the depth map from his/her viewing position using the 3-D information supplied from the server. Multiple clients can share the 3-D information of the server; we call it Share-Z. In this paper, the concept and merits of Share-Z are discussed. An experimental system developed to demonstrate the feasibility of Share-Z is also described.
Group Properties of Crossover and Mutation
Authors: Rowe Jonathan E. , Vose Michael D. , Wright Alden H.
Published: July 2002

It is supposed that the finite search space Ω has certain symmetries that can be described in terms of a group of permutations acting upon it. If crossover and mutation respect these symmetries, then these operators can be described in terms of a mixing matrix and a group of permutation matrices. Conditions under which certain subsets of Ω are invariant under crossover are investigated, leading to a generalization of the term schema. Finally, it is sometimes possible for the group acting on Ω to induce a group structure on Ω itself.
What the Pollution Havens Debate Overlooks
Authors: Clapp Jennifer
Published: July 2002

Whether or not pollution havens exist in poor countries has been the subject of a great deal of debate in recent decades. This concern is warranted, as the intensity of dirty industry is rising in the developing world just as it is falling in the industrialized world. But identifying pollution havens is extremely difficult in practice. Part of the reason for this is that there are important flaws with the methods and measures used in the pollution havens literature which results in an overly narrow debate. It may be time to abandon the narrowly constructed pollution havens debate in favor of a more open-ended analysis of the linkages between global trade and investment and environmental regulation.
THE KING'S MEN IN UGARIT AND SOCIETY IN LATE BRONZE AGE SYRIA
Authors: Rowe Ignacio Márquez
Published: July 2002

This paper examines the sector of society generally known as the "palace dependents" in Late Bronze Age Syria. The discussion, however, is not centred on the notion itself (and the whole model of two economically divided sectors of society), but rather on the empirical evidence found in the cuneiform archives of Ugarit, Alalakh and Emar. Therefore, the social designations "king's man" in Ugarit (Ugaritic bunušu malki), and (Hurrian) eǵelli in Alalakh are revaluated, with the result of a new interpretation which seems to find confirmation in the terminology used in Emar. Rather than a designation based on modern economic notions, the dependent nature of these social categories seems to reveal a juridical ground, namely antichretic debt service. Cet article examine le secteur de la société connu généralement comme les "dépendants du palais" en Syrie à l'âge du Bronze récent. L'étude, cependant, n'est pas centrée autour de cette notion-ci (ou de l'idée plus générale qui met en cause une division bipartite de la société selon des critères d'ordre économique), mais vise plutôt à analyser l'évidence empirique des textes cunéiformes d'Ougarit, Alalakh et Emar. Il s'agit, donc, d'un réexamen de la terminologie sociale: d'une part les "hommes du roi" à Ougarit (en Ougaritique, bunušu malki), et, d'autre part, la désignation hourrite eǵelli à Alalakh. Le résultat c'est une nouvelle interprétation qui semble trouver une certaine confirmation dans la propre terminologie attestée à Emar. Plutôt qu'une terminologie basée sur des notions économiques modernes, la nature dépendante de ces catégories sociales semblent révéler une base d'ordre juridique, notamment le service antichrétique pour dettes.
The Other Criminalities of Animal Freeze-Killers: Support for a Generality of Deviance
Authors: Green Gary
Published: July 2002

This research analyzes the overall arrest histories of persons aged 18-34 convicted for weapon-related deer spotlighting in Virginia during 1997 and 1998. Deer spotlighting, or "freeze-killing," is a specific form of deer poaching involving shining a deer with a spotlight for an easier kill. Defined as unsporting, freeze-killing constitutes animal abuse. This study isolated and compared arrest rates of white males - 90% of the sample in the present research - with estimated rates of a cross-sectional national sample of the same race-sex-age combinations. Results showed that about two in five freeze killers had been arrested, more than one in five for a crime of violence. Freeze-killers had almost twice the rate for violent crime and almost three times the rate for property crime as the control group - after accounting for age and for the time at risk of arrest. The findings' direction is consistent with the recent literature and a "generality of deviance" approach, and support an earlier call to expand hypotheses about animal abuse to include other criminal correlates in addition to violence.
Animal Problems/People Skills: Emotional and Interactional Strategies in Humane Education
Authors: Irvine Leslie
Published: July 2002

Recent changes in the organizational culture of nonhuman animal sheltering, coupled with attitudes that are more progressive toward companion animals, have made shelters into resources rather than last resorts. Consequently, shelter workers need the "people skills" to communicate to a public that urgently needs accurate information about animal behavior and training. This poses a difficulty for workers drawn to working with animals but who find themselves working with people. Based on participant observation and informed by social psychology and the sociology of emotions, this study articulates three primary dimensions of shelter workers' interactions with clients: (a) Narrative Knowing, (b) Emotion Management, and (c) Deference. From the analysis of these dimensions, the paper then draws conclusions about the individual costs of shelter work and suggests practical steps that workers and animal care organizations could take to recognize and reduce these costs.
Heidegger's Hole: The Space of Thinking. Nihilism in the Text (Of Philosophy)
Authors: Schufreider Gregory
Published: July 2002

Through a free reading of Heidegger's Zur Seinsfrage, we propose - with the help of the reader - to scribe into being the space of an opening; in fact, to transcribe it with the drawing of an ×. The point of this writing and thinking "Over the Line" is neither to draft a new structure nor to mark a new center but, as a sign of nothing, to inscribe a hole in the text of philosophy. In view of a topological sketch of the original opening of Western ontology, the unfolding of a complete nihilism may finally be described, in a thinking that marks its own vanishing point.
Meditations on the Philosophy of History
Authors: Baracchi Claudia
Published: July 2002

In spite (or because) of the infinity of (the) voice, of the boundless mystery it carries and exhales, of its disembodied traversing and joining, sayings follow barely traced courses. They travel along fragile lines of memory, often discontinuous bridges, transpositions into notational forms. They travel alone, exposed to corruption, consuming friction, repetition - their beginning and final destination often lost to those who listen to them and send them past. In spite of the power of memory and its arts, there are sayings and stories handed down to us in fragments, like decapitated Níke and disfigured Diónysos. There are poems reaching us, race of diggers and preservers, through somebody else's reminiscence, recovery, or loving quotation. In turn, our receiving and sending (stretching) forth, our being thus traversed, shares something with the destiny of these sayings and sculpted deities - being sent, crossing and (un)covering distances, in the fragmented continuity of dialogues, or what remains of them. The present essay is devoted to a meditation on the question of temporality and history in its epistemologico-metaphysical implications. It is developed mainly by reference to Aristotle, after Heidegger.
Socioeconomic Characteristics of Communities With Primary Care Practices With Nurse Practitioners
Authors: O’Reilly-Jacob Monica , Featherston Kyle G. , Barnes Hilary , Xue Ying , Poghosyan Lusine
Published: February 2025

Importance

Given the disparities in access to primary care and the growing nurse practitioner (NP) workforce, it is important to understand the distribution of primary care practices with NPs across communities of varying socioeconomic characteristics.

Objective

To compare the socioeconomic characteristics of communities that have primary care practices with or without NPs.

Design, Setting, and Participants

This secondary, cross-sectional analysis of 79 743 primary care practices used 4 merged data sources: the IQVIA 2023 OneKey database, the 2020 US biennial Census, the 2017-2022 American Community Survey, and the 2021 Area Deprivation Index (ADI). US Census Tracts and Divisions from 2023 were used to examine differences in socioeconomic characteristics across communities.

Exposure

Primary care practices with NPs vs without NPs.

Main Outcomes and Measures

Socioeconomic characteristics of Census Tracts and Block Groups, including racial and ethnic composition, median household income, percentage below the federal poverty level, educational attainment, and the ADI (an ordinal percentile ranking of Census Block Groups from 1 to 100, with 1 being least disadvantaged and 100 being most disadvantaged).

Results

Of 79 743 primary care practices, 42 601 (53.4%) employed NPs in 2023. Practices with NPs, compared with those without, were significantly more likely to be in communities classified as low income (23.3% vs 17.0%; P < .001) and rural (11.9% vs 5.5%; P < .001). On average, these communities had a higher proportion of the population living below the federal poverty level (14.4% [95% CI, 14.3%-14.5%] vs 12.8% [95% CI, 12.7%-12.9%]; P < .001) and without a high school diploma (19.8% [95% CI, 19.7%-19.9%] vs 18.5% [95% CI, 18.4%-18.6%]; P < .001). Communities with practices with NPs also had significantly higher mean ADI percentiles than communities with practices without NPs (53.3% [95% CI, 53.1%-53.6%] vs 42.5% [95% CI, 42.2%-42.7%]; P < .001). As the number of primary care practices decreased in disadvantaged areas, the proportion of practices with NPs increased. In most US Census Divisions, there were more primary care practices with NPs than without, a difference that was marked in low-income communities.

Conclusions and Relevance

This cross-sectional study of primary care practices in the US found that primary care practices with NPs, compared with those without NPs, were more likely to be located in communities with lower income and educational attainment and greater levels of overall socioeconomic disadvantage. This finding suggests that NPs are key to ensuring access to primary care in communities with socioeconomic disadvantage.
Unsupervised ML with Language Data
Authors: Wulff Peter , Kubsch Marcus , Krist Christina
Published: February 2025

This chapter introduces a case study of how to apply unsupervised ML to science education-related language data. We will start with dimensionality reduction and hierarchical-agglomerative clustering. Later on, we will extend these analyses using LLMs and more involved clustering techniques.
Data in Science Education Research
Authors: Wulff Peter , Kubsch Marcus , Krist Christina
Published: February 2025

In this chapter, we explain why ML can be valuable for analyzing complex data in science (education) and show what types of data you might encounter in your research project. We single out important characteristics of these types of data that can become particularly important for the performance of ML algorithms.
Prefiguring Afro-Centric and Inclusive AI Digital Commons: A Normative African Perspective to AI Development, Deployment, and Governance
Authors: Munetsi Dennis
Published: February 2025

This chapter critically explores the nexus of technology, society, and power, emphasising Africa’s integral role in global technological innovation and challenging the notion of technology as a neutral entity, instead framing it as a tool that can perpetuate existing power imbalances. It argues that technology serves as a political tool for dominant groups and is shaped by historical factors that have kept the continent under domination and oppression. Hence, the chapter proposes a prefigurative Afro-centric approach to the development of AI imbued with African epistemologies as a tool for expressing African politics and power in global socio-technological constellations—an argument for technology that can represent African interests on the world stage. The chapter contrasts incremental innovation with the need for radical change in Africa as a traditional technological periphery, underscoring the urgency for significant change within Africa’s technology sector. The development of African AI must navigate the complexities of evolving state governance, where traditional power is challenged by globalisation and regional integration, leading to hybrid governance arrangements of shared sovereignty. A three-tiered governance model is then proposed, advocating for scalable AI solutions that are inclusive and adaptable to the continent’s specificities, with a participatory approach that extends beyond elite circles to encompass a broader range of stakeholders. This model envisions a unified African AI strategy that leverages local, national, and regional diversities for collective advancement and equitable distribution of technological benefits.
Wasserstoffumstieg
Authors: Präger Fabian
Published: February 2025

Dieses Kapitel betrachtet die techno-ökonomischen Merkmale, Einsatzbereiche, Produktionswege, Infrastruktur und Planungsansätze für den Wasserstoffumstieg. Dabei werden Chancen und Risiken des Wasserstoffsystems sowie der politischen Gestaltung aufgezeigt. Ergebnisse betonen die Priorisierung einer nachhaltigen Wasserstoffproduktion aus 100% Erneuerbaren Energien, die Notwendigkeit einer gezielten Nutzung und die Risiken fossiler und importabhängiger Wasserstoffquellen. Eine übergreifende Energieinfrastrukturplanung, ausgerichtet am 1,5°-Ziel, ist essenziell, um die sozial-ökologische Transformation voranzutreiben und Fehlentwicklungen zu vermeiden.
Epidemiology of myocardial injury in trauma patients: proposed phenotypes for future research
Authors: Karolewski Jett , Williams Jodie-Kate , Weaver Natasha , Meakes Simone , Gane Karen , Balogh Zsolt J.
Published: February 2025

Purpose

To describe the epidemiology of myocardial injury in trauma patients, in doing so informing design for future multicentre prospective studies.

Method

A one-year retrospective study ending on 31/08/2023 was conducted at a Level-1 Trauma Centre. All adult trauma resuscitation patients with elevated Troponin serum concentration were included. Patient demographics, medical history, mechanism, injury severity, laboratory data, cardiac investigations, LOS, ICU admission and mortality were collected. Patients were categorised into three pragmatic groups based on the timing of their Troponin peak (Group1:<12 h; Group2:12–24 h; Group3:>24 h).

Results

From 1408 admissions, 97(7%) patients [Age:57(35,80); Male:71%; ISS:18(9–33); LOS:9(4,16.5); ICU:66%; Mortality:16.5%] had elevated Troponin. Group 1 [n = 37; Age:47(24,70); Male:76%; ISS:9(4,22); LOS:7(3,14); ICU:51%; Mortaliy:5.4%]; Group 2 [n = 32; Age:53.5(26,74); Male:78%; ISS:27(12.5,53.5); LOS:10(5,17); ICU:84%; Mortaliy:25%] and Group 3 [n = 28; Age:78(62,84); Male:57%; ISS:19(9.5,47.5); LOS:12.5(6,19.5); ICU:64%; Mortaliy:21%]. 64% of patients had thoracic injuries, which was consistent among the three groups. Group 3 had most frequent ECG (61%) and echocardiography (25%) findings.

Conclusion

Troponin elevation occurs in 7% of all trauma admissions and it identifies the seriously injured high-risk cohort. The timing of the maximum Troponin concentration seems to describe three distinct phenotypes. “Hyperacute” with most favourable outcomes, “Subacute” with severe trauma and tissue injury requiring major resource utilisation and associated with the highest mortality rate, and “Late” characterised by ECG and ECHO changes suggesting primary ischaemic cardiac pathology.
Tailoring Escherichia coli BL21 (DE3) for preferential xylose utilization via metabolic and regulatory engineering
Authors: Molina-Vázquez Eliseo R. , Caspeta Luis , Gosset Guillermo , Martínez Alfredo
Published: February 2025

Xylose is the most abundant pentose in nature. However, it is usually obtained in mixtures with glucose, leading to carbon catabolite repression in many microorganisms. Among E. coli lineages, significant metabolic and regulatory differences exist, requiring distinct metabolic engineering strategies to develop a xylose-selective phenotype in the strains W, K-12, and C. In this study, strain ES02 was engineered from Escherichia coli BL21 (DE3) as a xylose-selective strain by deleting the glk, ptsG, and manZ genes. However, when grown in a mixture of xylose and glucose, this strain’s specific growth rate and xylose consumption rate decreased by about 50% compared to cultures with only xylose. A modified version of the xylose-responsive transcriptional activator XylRQ31K was utilized to overcome this issue. The resulting strain ES04 (BL21 (DE3) Δglk, ΔmanZ, ΔptsG, xylR::Km

r
, lacZ::xylR

C91A

-Gm

r
) efficiently used xylose as carbon source either alone or in a mixture with glucose, with a specific xylose consumption rate 75% higher than that of the wild-type strain BL21(DE3). Unexpectedly, strain ES04 partially recovers the ability to grow and consume glucose at a low rate, preferentially consuming xylose over glucose in sugar mixtures, revealing an altered carbon catabolite repression phenotype. Transcriptomics analysis suggested that glucose assimilation in this strain was related to the overexpression of the galactitol operon gatDCBAZY. Further inactivation of this operon confirmed its participation in glucose assimilation.

Key points

• XylR

Q31K

alleviates carbon catabolite repression in the xylose-selective strain ES04.

• Galactitol operon overexpression in ES04 links to partial glucose utilization.

• ES04 strain preferentially uses xylose over glucose, revealing altered CCR.
Exploring the landscape of current in vitro and in vivo models and their relevance for targeted radionuclide theranostics
Authors: Bokhout Lisa , Campeiro Joana D. , Dalm Simone U.
Published: February 2025

Cancer remains a leading cause of mortality globally, driving ongoing research into innovative treatment strategies. Preclinical research forms the base for developing these novel treatments, using both in vitro and in vivo model systems that are, ideally, as clinically representative as possible. Emerging as a promising approach for cancer management, targeted radionuclide theranostics (TRT) uses radiotracers to deliver (cytotoxic) radionuclides specifically to cancer cells. Since the field is relatively new, more advanced preclinical models are not yet regularly applied in TRT research. This narrative review examines the currently applied in vitro, ex vivo and in vivo models for oncological research, discusses if and how these models are now applied for TRT studies, and whether not yet applied models can be of benefit for the field. A selection of different models is discussed, ranging from in vitro two-dimensional (2D) and three-dimensional (3D) cell models, including spheroids, organoids and tissue slice cultures, to in vivo mouse cancer models, such as cellline-derived models, patient-derived xenograft models and humanized models. Each of the models has advantages and limitations for studying human cancer biology, radiopharmaceutical assessment and treatment efficacy. Overall, there is a need to apply more advanced models in TRT research that better address specific TRT phenomena, such as crossfire and abscopal effects, to enhance the clinical relevance and effectiveness of preclinical TRT evaluations.
Deep learning image enhancement algorithms in PET/CT imaging: a phantom and sarcoma patient radiomic evaluation
Authors: Bonney L. M. , Kalisvaart G. M. , van Velden F. H. P. , Bradley K. M. , Hassan A. B. , Grootjans W. , McGowan D. R.
Published: February 2025

Purpose

PET/CT imaging data contains a wealth of quantitative information that can provide valuable contributions to characterising tumours. A growing body of work focuses on the use of deep-learning (DL) techniques for denoising PET data. These models are clinically evaluated prior to use, however, quantitative image assessment provides potential for further evaluation. This work uses radiomic features to compare two manufacturer deep-learning (DL) image enhancement algorithms, one of which has been commercialised, against ‘gold-standard’ image reconstruction techniques in phantom data and a sarcoma patient data set (N=20).

Methods

All studies in the retrospective sarcoma clinical [

$$^{18}$$

18

F]FDG dataset were acquired on either a GE Discovery 690 or 710 PET/CT scanner with volumes segmented by an experienced nuclear medicine radiologist. The modular heterogeneous imaging phantom used in this work was filled with [

$$^{18}$$

18

F]FDG, and five repeat acquisitions of the phantom were acquired on a GE Discovery 710 PET/CT scanner. The DL-enhanced images were compared to ‘gold-standard’ images the algorithms were trained to emulate and input images. The difference between image sets was tested for significance in 93 international biomarker standardisation initiative (IBSI) standardised radiomic features.

Results

Comparing DL-enhanced images to the ‘gold-standard’, 4.0% and 9.7% radiomic features measured significantly different (pcritical < 0.0005) in the phantom and patient data respectively (averaged over the two DL algorithms). Larger differences were observed comparing DL-enhanced images to algorithm input images with 29.8% and 43.0% of radiomic features measuring significantly different in the phantom and patient data respectively (averaged over the two DL algorithms).

Conclusion

DL-enhanced images were found to be similar to images generated using the ‘gold-standard’ target image reconstruction method with more than 80% of radiomic features not significantly different in all comparisons across unseen phantom and sarcoma patient data. This result offers insight into the performance of the DL algorithms, and demonstrate potential applications for DL algorithms in harmonisation for radiomics and for radiomic features in quantitative evaluation of DL algorithms.
Comparison of ATG-thymoglobulin with atg-fresenius in patients with hematological malignancies who undergo allogeneic hematopoietic stem cell transplantation: a propensity score-matched analysis
Authors: Zhang Hanyue , Zhou Yuhang , Zhao Kui , Cui Jiaqi , Zhang Xiangzhong , Wen Ruijuan , Sun Yanling , Li Xudong , Long Bing
Published: February 2025

We retrospectively compared the outcomes of 166 patients with hematological malignancies who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) using ATG-Thymoglobulin (ATG-T) at 10 mg/kg or ATG-Fresenius (ATG-F) at 20 mg/kg. Propensity score matching (PSM) analysis was applied, with 44 patients assigned to each group. The ATG-T group showed a trend toward a higher incidence of bacterial infections (72.7% vs. 65.9%, P = 0.064). Additionally, the ATG-T group had a significantly higher incidence of other viral infections, including BK virus and herpes zoster virus (40.9% vs. 15.9%, P = 0.003), compared to the ATG-F group. Furthermore, the ATG-F group experienced a lower incidence of high fever (4.5% vs. 50.0%, P < 0.001) and reduced ATG treatment costs [¥ 45100 (28700–82000) vs. ¥ 56250 (38000–85000), P < 0.001] compared to ATG-T. The incidences of acute GVHD, grade III-IV aGVHD, grades of aGVHD, chronic GVHD, 3-year overall survival (OS), transplantation-related mortality (TRM), non-relapse mortality (NRM), disease-free survival (DFS), and GVHD-free and relapse-free survival (GRFS) were similar between the ATG-T and ATG-F groups. In conclusion, our study suggests that ATG-F is superior to ATG-T in terms of viral infections, fever rate, and treatment cost.
Management of patients with mesh perforation into viscus following pelvic mesh surgery
Authors: Tan Yu Hwee , Thayalan Krishanthy , Krause Hannah , Wong Vivien , Goh Judith
Published: February 2025

Purpose

Pelvic mesh has been used for the treatment of pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Between 3 and 20% suffer complications with debilitating long-term outcomes. Uncommon complications include mesh perforation into viscus however there is minimal published data regarding outcomes following surgical management.

Methods

A retrospective observational study of patients with diagnosis of mesh in viscus at three tertiary urogynaecology units was performed to report on clinical outcomes following surgical management.

Results

Fifty-eight patients were diagnosed with mesh in viscus following cystourethroscopy and thorough examination of vagina/rectum. Mesh involved included mid-urethral slings—retropubic (36.9%), transobturator (18.5%), single incision slings (10.8%); transvaginal POP mesh (15.4%); sacrocolpopexy (13.8%); uncertain type (4.6%). Viscus involved included bladder (39.7%), urethra (50%), bladder and urethra (3.4%), and rectum (6.9%). Main presenting symptoms included mixed urinary incontinence (UI) (75.9%), recurrent urinary tract infections (rUTIs) (48.3%) and rectal/pelvic pain (56.9%). Fifty-one patients underwent mesh excision and viscus repair, with successful repair in all (100%). 48% had complete mesh excision. Mean follow up was 9.5 months (range 0.5–96 months). Post-operatively, there was a statistically significant reduction in rUTIs (p = 0.0004) as well as pain (p = 0.000005). None had recurrent mesh erosion, lower genitourinary tract fistula or wound breakdown.

Conclusions

All patients required thorough examination and cystourethroscopy for diagnosis. Surgical management of mesh in viscus appears to have low morbidity and is shown to reduce symptoms of rUTIs and pain as well as risk of recurrent mesh erosion and fistulae.
Criteria for the authorisation of specialty training for competence in internal medicine and rheumatology—a position paper of the German Society for Rheumatology and Clinical Immunology
Authors: Pfeil Alexander , Fleck Martin , Aringer Martin , Baraliakos Xenofon , Ernst Diana , Haase Isabell , Hillebrecht Christiana , Hoyer Bimba Franziska , Keyßer Gernot , Kötter Ina , Krause Andreas , Krusche Martin , Lorenz Hanns-Martin , Proft Fabian , Schuch Florian , Vossen Diana , Voormann Anna , Wagner Ulf , Wollenhaupt Jürgen , Specker Christof ,   the board of the German Society for Rheumatology and Clinical Immunology,   Commission for Continuing Education and Training of the German Society for Rheumatology and Clinical Immunology
Published: February 2025

The model advanced training regulations define the content of advanced training to achieve the qualification of medical specialist in all specialties and sub-specialties of medicine. As rheumatology is one of the ten specialties for internal medicine in Germany, regulations cover basic competencies of general and all other specialties in internal medicine as well as special skills in rheumatology. There are currently no criteria for issuing the authorization in advanced training. This position paper describes the criteria proposed by the German Society for Rheumatology and Clinical Immunology (DGRh), which should be the foundation for the issuance of authorization for advanced training in the field of internal medicine and rheumatology and for the assessment of the duration. The model advanced training regulations 2018 and the advanced training plan recommended by experts function as the basis for this. Based on the criteria, the authorization for advanced training to advanced specialist training in internal medicine and rheumatology can be allocated in a standardized, graded and transparent manner throughout Germany. This enables an optimal quality of advanced training in rheumatology, which can be adapted to the future developments in the discipline.
Hidradenitis suppurativa, from basic science to surgery and a new era of tailored targeted therapy: An expert opinion paper
Authors: Marzano Angelo Valerio , Bartoletti Michele , Bettoli Vincenzo , Bianchi Luca , Chiricozzi Andrea , Clerici Mario , Dapavo Paolo , Dini Valentina , Foti Caterina , Magnoni Cristina , Megna Matteo , Micali Giuseppe , Molinelli Elisa , Prignano Francesca
Published: February 2025

Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterised by an aberrant activation of innate immunity and increased production of pro-inflammatory mediators such as interleukin 17 (IL-17). IL-17 has been shown to play a key role in the pathogenesis of HS and evidence highlights the potential of IL-17-targeted therapies. The fully human IgG/κ monoclonal antibody secukinumab, which specifically targets IL-17A and inhibits interaction with its receptor, has recently been approved for the treatment of moderate-to-severe HS. Secukinumab offers patients an efficacious and well-tolerated treatment option in terms of sustained response by rapidly improving signs and symptoms, and preventing disease progression in the absence of loss of response. Being a challenging disease, HS is associated with a delay to diagnosis of 3–10 years and, consequently, late implementation of appropriate treatment, leading to disease progression. Misdiagnosis due to flawed understanding and lack of awareness among medical providers and patients is considered an important factor contributing to the delayed diagnosis. Thus, serious efforts must be made on a large scale to urgently reduce the delay in HS diagnosis and reduce the disease burden in patients, including raising awareness, implementation of education programmes at medical and specialisation schools, as well as continuous education of healthcare providers at different levels for the early detection of HS and initiation of appropriate treatment. Here, we present the main critical unmet needs in the diagnosis and treatment of patients affected by HS, address how disease awareness and comprehensive multidisciplinary management (offering both medical and surgical care) can benefit patients, and suggest therapeutic options, based on clinical characterisation and early identification and intervention (window of opportunity), to be adopted for a timely and better management of disease progression and to fill current gaps.
Objectifying persistent subjective cognitive impairment following COVID-19 infection: cross-sectional data from an outpatient memory-clinic in Germany
Authors: Tarantini Luca , Möller Corina , Schiestl Victoria , Sordon Sabrina , Noll-Hussong Michael , Wittemann Miriam , Menzie Nicole , Riemenschneider Matthias
Published: February 2025

Objective

Subjective cognitive impairment is frequently reported by patients experiencing Post-COVID symptoms. This study aims to assess objective impairment in attention, memory, and executive functions among these patients. Further, we investigated potential determinants of objective cognitive impairment.

Methods

In this cross-sectional study, standardized neuropsychological testing (Vienna Testing System), assessment of cognitive symptom aggravation, psychiatric anamnesis, and psychometrics (BDI-II, Fatigue Severity Scale) were conducted in 229 patients who voluntarily presented to our outpatient memory-clinic due to subjective cognitive impairment following COVID-19. Blood-samples were collected to assess peripheral immune markers (IL-6, CRP) and APOE-ε4 genotype.

Results

Objective cognitive impairment in at least one domain was present in 39% of the patients and 47% showed symptoms of moderate or severe depression. The APOE-ε4 allele was present in 32% of the patients. Higher rates of depressive symptoms (OR = 1.41, 95%-CI = 1.02–1.95) and higher burden of the APOE-ε4 allele (OR = 3.29, 95%-CI = 1.51–7.40) predicted objective cognitive impairment, regardless of age, sex, years of formal education, time since infection, and medication for diabetes or hypertension. Fatigue severity, acute COVID-19 severity or inflammation markers had no impact.

Conclusions

In our study, subjective cognitive impairment following COVID-19 was more likely associated with high rates of depression rather than relatively low rates of objective cognitive performance. Thus, the study emphasizes the necessity for extensive neuropsychological testing and evaluation of depression when examining Post-COVID patients in clinical practice. Further, the link between objective cognitive impairment, depression and APOE-ε4 does not appear to be specific to Post-COVID symptoms. Therefore, depression- and APOE-ε4-mediated neurodegenerative pathomechanisms might be a promising therapeutical target.
Psychiatric antecedents in young patients with first episode psychosis: what relevance for clinical outcomes?
Authors: Pelizza Lorenzo , Catalano Fabio , Leuci Emanuela , Quattrone Emanuela , Palmisano Derna , Pupo Simona , Paulillo Giuseppina , Pellegrini Clara , Pellegrini Pietro , Menchetti Marco
Published: February 2025

Examining psychiatric antecedents and help-seeking behavior for people with First Episode Psychosis (FEP) could help understand determinants for timely care pathways, decrease the “Duration of Untreated Psychosis” (DUP), and consequently improve their prognosis. The aims of this study were: (1) to calculate the proportion of FEP participants with previous contact with mental healthcare services recruited within a specialized “Early Intervention in Psychosis” service, and (2) to longitudinally compare sociodemographic, clinical, and treatment parameters between FEP patients with and without psychiatric antecedents across a 2-year follow-up period. All participants (aged 12–35 years) were enrolled within the “Parma Early Psychosis” (Pr-EP) program. At baseline, they completed the Health of the Nation Outcome Scale (HoNOS). A mixed-design ANOVA and a Kaplan–Meier survival analysis were used. Of the 489 FEP participants, 204 (41.7%) patients had prior contact with mental health services. In 83% of cases, a care discontinuity was observed. Main psychiatric antecedents at entry were personality disorders (32.8%), anxious-depressive disorder (28.9%), conduct disorder (16.2%), and learning disorder (9.8%). FEP subjects with antecedents were more likely to receive a diagnosis of schizophrenia at baseline. Having previous contact with psychiatric services resulted to be a predictor of poorer clinical and functional outcome. It is very important to carefully monitor mental health suffering and related help-seeking-behavior in young patients typically manifested in their early 20s, especially in terms of psychosis prevention. Particular attention should also be given to service engagement as care continuity within adolescent-adult transition.
The optimal cut-off value of postoperative day three C-reactive protein to predict for major complications in colorectal cancer patients
Authors: Smit Coco , Janssen-Heijnen Maryska L. , van Osch Frits , Rops Jonas , Gielen Anke H. C. , van Heinsbergen Maarten , Melenhorst Jarno , Konsten Joop L. M.
Published: February 2025

Purpose

To identify an optimal postoperative day 3 (POD3) C-reactive protein (CRP) cut-off for predicting major complications in colorectal cancer (CRC) patients. Secondary objectives included identifying patient and surgical factors associated with POD3 CRP levels and assessing the accuracy of the cut-off across subgroups.

Methods

A retrospective cohort study of 1536 CRC patients who underwent an oncological resection was conducted. The predictive accuracy of POD3 CRP for major complications was tested using Receiver Operating Characteristics curves. The CRP cut-off was tested across subgroups. Multivariable logistic regression analyses was performed to evaluate the predictive value of the POD3 CRP cut-off, while also determining whether patient and surgical characteristics independently predicted major complications.

Results

An optimal cut-off of 114 mg/L was identified, with a sensitivity of 0.80 and specificity of 0.59 and an Area Under the Curve for POD3 CRP of 0.78. Sensitivity remained consistently high across all subgroups, whereas specificity exhibited variability, with a notable decrease observed in the subgroups; aged 66–69, obese, ASA III and open surgery. After adjusting for patient and surgery characteristics, a POD3 CRP level above 114 mg/L was associated with a significant 5.29-fold increase in the odds for developing major complications.

Conclusions

A POD3 CRP cut-off of 114 mg/L is an effective predictor of major complications following CRC surgery, supporting safe early discharge. The cut-off remains a reliable predictor, even after adjusting for patient and surgery factors.
Genetic variants and phenotypic data curated for the CAGI6 intellectual disability panel challenge
Authors: Aspromonte Maria Cristina , Del Conte Alessio , Polli Roberta , Baldo Demetrio , Benedicenti Francesco , Bettella Elisa , Bigoni Stefania , Boni Stefania , Ciaccio Claudia , D’Arrigo Stefano , Donati Ilaria , Granocchio Elisa , Mammi Isabella , Milani Donatella , Negrin Susanna , Nosadini Margherita , Soli Fiorenza , Stanzial Franco , Turolla Licia , Piovesan Damiano , Tosatto Silvio C. E. , Murgia Alessandra , Leonardi Emanuela
Published: February 2025

Neurodevelopmental disorders (NDDs) are common conditions including clinically diverse and genetically heterogeneous diseases, such as intellectual disability, autism spectrum disorders, and epilepsy. The intricate genetic underpinnings of NDDs pose a formidable challenge, given their multifaceted genetic architecture and heterogeneous clinical presentations. This work delves into the intricate interplay between genetic variants and phenotypic manifestations in neurodevelopmental disorders, presenting a dataset curated for the Critical Assessment of Genome Interpretation (CAGI6) ID Panel Challenge. The CAGI6 competition serves as a platform for evaluating the efficacy of computational methods in predicting phenotypic outcomes from genetic data. In this study, a targeted gene panel sequencing has been used to investigate the genetic causes of NDDs in a cohort of 415 paediatric patients. We identified 60 pathogenic and 49 likely pathogenic variants in 102 individuals that accounted for 25% of NDD cases in the cohort. The most mutated genes were ANKRD11, MECP2, ARID1B, ASH1L, CHD8, KDM5C, MED12 and PTCHD1 The majority of pathogenic variants were de novo, with some inherited from mildly affected parents. Loss-of-function variants were the most common type of pathogenic variant. In silico analysis tools were used to assess the potential impact of variants on splicing and structural/functional effects of missense variants. The study highlights the challenges in variant interpretation especially in cases with atypical phenotypic manifestations. Overall, this study provides valuable insights into the genetic causes of NDDs and emphasises the importance of understanding the underlying genetic factors for accurate diagnosis, and intervention development in neurodevelopmental conditions.
Quantification of indocyanine green fluorescence angiography in colorectal surgery: a systematic review of the literature
Authors: McEntee Philip D. , Singaravelu Ashokkumar , McCarrick Cathleen A. , Murphy Edward , Boland Patrick A. , Cahill Ronan A.
Published: February 2025

Background

Indocyanine green fluorescence angiography (ICGFA) during colorectal surgery associates with reduced post-operative anastomotic complication rates. Because its interpretation is subjective, quantification has been proposed to address inter-user variability. This study reviews the published literature regarding ICGFA quantification during colorectal surgery with a focus on impactful clinical deployment.

Methods

A systematic review was performed of English language publications regarding clinical studies of ICGFA quantification in colorectal surgery in PubMed, Scopus, Web of Science and Cochrane Library on 29th August 2024, updated to 18th November 2024, following PRISMA guidelines. Newcastle Ottawa scale (NOS) was used to assess quality.

Results

A total of 1428 studies were screened with 22 studies (1469 patients) selected. There was significant heterogeneity of ICGFA methodology, quantification methods and parameter selection and only three studies were NOS “high” quality. Extracorporeal application was most common. Four studies (154 patients) conducted real-time ICGFA analyses (others were post hoc) and four utilised artificial intelligence methods. Eleven studies only included patients undergoing left-sided resection (six focusing specifically on rectal resections). Only one study employed the quantification method to guide intra-operative decision-making regarding colonic transection. Twenty-six different perfusion parameters were assessed, with time from injection to visible fluorescence and maximum intensity the most commonly (but not only) correlated parameters regarding anastomotic complication (n = 18). Other grounding correlates were tissue oxygenation (n = 3, two with hyperspectral imagery), metabolites (n = 2) and surgeon interpretation (n = 5).

Conclusion

Quantification of the ICGFA signal for colorectal surgery is feasible but has so far seen limited academic advancement beyond feasibility.
A lightweight CNN model for UAV-based image classification
Authors: Deng Xinjie , Shi Michael , Khan Burhan , Choo Yit Hong , Ghaffar Fazal , Lim Chee Peng
Published: February 2025

For many unmanned aerial vehicle (UAV)-based applications, especially those that need to operate with resource-limited edge networked devices in real-time, it is crucial to have a lightweight computing model for data processing and analysis. In this study, we focus on UAV-based forest fire imagery detection using a lightweight convolution neural network (CNN). The task is challenging owing to complex image backgrounds and insufficient training samples. Specifically, we enhance the MobileNetV2 model with an attention mechanism for UAV-based image classification. The proposed model first employs a transfer learning strategy that leverages the pre-trained weights from ImageNet to expedite learning. Then, the model incorporates randomly initialised weights and dropout mechanisms to mitigate over-fitting during training. In addition, an ensemble framework with a majority voting scheme is adopted to improve the classification performance. A case study on forest fire scenes classification with benchmark and real-world images is demonstrated. The results on a publicly available UAV-based image data set reveal the competitiveness of our proposed model as compared with those from existing methods. In addition, based on a set of self-collected images with complex backgrounds, the proposed model illustrates its generalisation capability to undertake forest fire classification tasks with aerial images.
How vulnerable are the nesting sites of loggerhead turtles in Cabo Verde?
Authors: Sousa-Guedes Diana , Marco Adolfo , Neves Elton , Medina Maria , Taxonera Albert , Fairweather Kirsten , Queiruga Alberto , Veiga Jairson , Patino-Martinez Juan , Alírio João , Bessa Filipa , Sillero Neftalí
Published: February 2025

Marine turtles’ nesting grounds face imminent threats from urbanisation, climate change, and pollution. In this study, we estimated the vulnerability of loggerhead turtles (Caretta caretta) nesting beaches in Cabo Verde, one of the largest rookeries globally. We surveyed 61 sandy beach segments (~ 100 m) with a drone and modelled nest density by incorporating topographical and oceanographic variables. Then, we digitised all beaches across the islands, divided them into smaller sections (digitised segments), and projected the model onto this layer. Each digitised beach segment was evaluated considering their exposure to five risk factors: (a) marine litter density, (b) inundation trends, (c) land surface temperature trends, (d) light pollution trends, and (e) tourism pressure. Our analysis revealed that 48% of digitised segments are exposed to at least one threat. São Vicente, Santiago, and Sal are the most affected islands, mainly from marine debris and light pollution, while Santo Antão and Maio are the least impacted. Sal showed the highest overlap between vulnerable areas and high-density sites, highlighting its priority for conservation, though less affected islands should also be protected. We found that marine debris correlates positively with nest density, while light pollution negatively affects it. Our study emphasises the need for conservation efforts to ensure the sustainability of nesting sites amid escalating global changes.