bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automatic classification and segmentation of blast cells using deep transfer learning and active contours
Authors: Ametefe Divine Senanu , Sarnin Suzi Seroja , Ali Darmawaty Mohd , Ametefe George Dzorgbenya , John Dah , Aliu Abdulmalik Adozuka , Zoreno Zadok 
Published: May 2024

AbstractIntroductionAcute lymphoblastic leukemia (ALL) presents a formidable challenge in hematological malignancies, necessitating swift and precise diagnostic techniques for effective intervention. The conventional manual microscopy of blood smears, although widely practiced, suffers from significant limitations including labor‐intensity and susceptibility to human error, particularly in distinguishing the subtle differences between normal and leukemic cells.MethodsTo overcome these limitations, our research introduces the ALLDet classifier, an innovative tool employing deep transfer learning for the automated analysis and categorization of ALL from White Blood Cell (WBC) nuclei images. Our investigation encompassed the evaluation of nine state‐of‐the‐art pre‐trained convolutional neural network (CNN) models, namely VGG16, VGG19, ResNet50, ResNet101, DenseNet121, DenseNet201, Xception, MobileNet, and EfficientNetB3. We augmented this approach by incorporating a sophisticated contour‐based segmentation technique, derived from the Chan‐Vese model, aimed at the meticulous segmentation of blast cell nuclei in blood smear images, thereby enhancing the accuracy of our analysis.ResultsThe empirical assessment of these methodologies underscored the superior performance of the EfficientNetB3 model, which demonstrated exceptional metrics: a recall specificity of 98.5%, precision of 95.86%, F1‐score of 97.16%, and an overall accuracy rate of 97.13%. The Chan‐Vese model's adaptability to the irregular shapes of blast cells and its noise‐resistant segmentation capability were key to capturing the complex morphological changes essential for accurate segmentation.ConclusionThe combined application of the ALLDet classifier, powered by EfficientNetB3, with our advanced segmentation approach, emerges as a formidable advancement in the early detection and accurate diagnosis of ALL. This breakthrough not only signifies a pivotal leap in leukemia diagnostic methodologies but also holds the promise of significantly elevating the standards of patient care through the provision of timely and precise diagnoses. The implications of this study extend beyond immediate clinical utility, paving the way for future research to further refine and enhance the capabilities of artificial intelligence in medical diagnostics.
Evaluating special representation of non‐resident citizens: Eligibility, constituency and proportionality
Authors: Umpierrez de Reguero Sebastián , Bauböck Rainer , Wegschaider Klaudia 
Published: May 2024

AbstractSo far, 21 countries have introduced—and some thereafter withdrawn—reserved legislative seats for their citizens living abroad. Existing literature on this form of special representation has studied this topic either empirically or normatively. We bring these two approaches together based on the main dimensions of institutional variation of special representation: (1) eligibility, (2) constituency structure and (3) electoral proportionality. We first discuss each dimension from a normative perspective. In the second step, we map the range of empirical variation and highlight the most common arrangements. We conclude that the normative justification for special representation is generally weak, but some institutional configurations pose fewer problems. Specifically, we see fewer issues with special representation when electoral inclusion is limited to the first generation of emigrants and when it is used to limit the electoral influence of non‐resident populations that make up a large share of the overall electorate. By grounding our normative discussion on an empirical mapping, we bridge two disconnected literatures on special representation of non‐resident citizens.
Impact of the COVID‐19 Pandemic on Influenza Circulation During the 2020/21 and 2021/22 Seasons, in Europe
Authors: Sinnathamby Mary A. , Meslé Margaux M. I. , Mook Piers , Stolyarov Kirill ,   The European Region Influenza Network Group Authorship, Pebody Richard 
Published: May 2024

ABSTRACTBackgroundThe emergence of SARS‐CoV‐2 in late 2019 saw the implementation of public health and social measures (PHSM) by countries across Europe to reduce its transmission and impact on populations. Consequently, countries reported changes in influenza circulation and extensive disruptions to routine surveillance systems.MethodsWe describe the epidemiology of influenza in Europe between Weeks 40/2020 and 39/2022 compared to the 2016/17 to 2019/20 seasons, to assess the impact of the COVID‐19 pandemic and PHSM on surveillance systems and influenza circulation.ResultsLow detections of influenza were observed through primary care sentinel sources during seasonal influenza periods (Week 40 to 20); 56 (of 39,457 specimens tested; < 1% positivity) in 2020/21 and 7261 (of 64,153 specimens tested; 11% positivity) detections in 2021/22 were observed, compared to an average of 18,383 (of 50,544 specimens tested; 36% positivity) detections in 2016/17 to 2019/20. Similarly, 11 (of 19,989 specimens tested; < 1% positivity) and 1488 (of 23,636 specimens tested; 6% positivity) detections were reported through SARI surveillance sources in 2020/21 and 2021/22, respectively, compared to an average of 2850 (of 10,389 specimens tested; 27% positivity) detections in 2016/17 to 2019/20. However, the 2021/22 interseasonal period saw unusual increases in influenza detections across surveillance site types when PHSM were easing.ConclusionIn conclusion, findings suggest that the restriction and easing of PHSM measures were associated with variations in influenza detections. Our observations of out‐of‐season influenza activity highlight the importance of an integrated respiratory surveillance strategy to monitor circulating respiratory viruses throughout the year to inform optimal prevention and control strategies.
Nursing/midwifery students' perceptions of caring pedagogy and online learning during the COVID‐19 pandemic
Authors: Jones Rikki , Jackson Debra , Rice Kylie , Fisher Murray , Calleja Pauline , Hopkins Martin , West Caryn , Irwin Pauletta , McGough Shirley , Luck Lauretta , Walker Felicity , Whiteing Nicola , Usher Kim 
Published: May 2024

AbstractAimThis study aimed to gain a better understanding of nursing/midwifery students' perspectives on a pedagogy of caring and online learning during the COVID‐19 pandemic. In addition, it aimed to determine if the COVID‐19 pandemic impacted students' perceptions and experience of online learning and students' desire to enter the nursing/midwifery workforce.DesignMixed methods.MethodsA multi‐centre cross‐sectional survey of Australian nursing and midwifery students was undertaken to explore students’ experience of learning during the COVID‐19 pandemic.ResultsThere are several key findings from this study that may be relevant for the future delivery of undergraduate health education, students transitioning to practice and healthcare workforce retention. The study found that although students were somewhat satisfied with online learning during COVID‐19, students reported significant issues with knowledge/skill acquisition and barriers to the learning process. The students reported feeling less prepared for practice and identified how clinical staff were unable to provide additional guidance and support due to increased workloads and stress. The textual responses of participants highlighted that connection/disconnection, empathy and engagement/disengagement had an impact on learning during COVID‐19.ConclusionConnection, engagement and isolation were key factors that impacted nursing students’ online learning experiences. In addition, graduates entering the workforce felt less prepared for entry into practice due to changes in education delivery during COVID‐19 that they perceived impacted their level of clinical skills, confidence and ability to practice as new graduate nurses/midwives.Patient or Public ContributionNot applicable.Impact

Attention must be given to the transition of new graduate nurses and midwives whose education was impacted by pandemic restrictions, to support their professional career development and to ensure retention of future healthcare workforce.
Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. Educators should consider how connection and engagement can be actively embedded in the online learning environment.
Species richness responds to buffer effectiveness and competitive priorities in simulations of alpine microrefugia
Authors: Malanson George P. , Dullinger Stefan , Pauli Harald , Winkler Manuela , Saccone Patrick , Jiménez‐Alfaro Borja 
Published: May 2024

AbstractAimMicrorefugia on alpine slopes may allow species to persist in a warming climate. How plant species richness could respond to of the effectiveness of climatic buffering, defined as the difference in climate change in a microrefugium in comparison to that of an open alpine slope as mediated by competitive priority effects, is explored.LocationAlpine habitat anywhere.TaxonVascular plants.MethodsA simple spatially explicit model of plant species with adaptations across a climatic gradient simulates reproduction, dispersal, and mortality through climatic change. The effectiveness of microrefugia in buffering climate change and levels of competitive priority effects are included as factors that alter demographic rates in an experimental framework. Spatial patterns of microrefugia and differences in dispersal are also simulated. Differences in mean species richness were analysed.ResultsThe number of species conserved, relative to an instantaneous equilibrium calculation with the same climatic change, decreases with inclusion of a period of change (transient vs. instantaneous, equilibrium change) and further with competitive priority effects. In these simulations, the number of species conserved does not simply increase with buffer effectiveness, as hypothesized, but instead is bimodal.Main ConclusionsThe dip in number of species conserved in the middle range of buffer effectiveness occurs because barriers develop. These are temporal ecological traps, wherein species adapted to the middle of a climatic gradient become extinct, because their colonization of microrefugia is blocked by an extinction debt of resident species. The inertia that allows these demographic consequences is increased by competitive priorities. The highest levels of buffering and resulting inertia will not be ubiquitous but the bimodal pattern indicates that assessments of the role of microrefugia need to recognize the temporal species‐environment and species‐species interactions that will change the number of species conserved versus extinctions.
Comparison of outcomes and required tools between transvenous extraction of pacemaker and implantable cardioverter defibrillator leads: Insight from single high‐volume center experience
Authors: Hayashi Katsuhide , Callahan Thomas , Rickard John , Baranowski Bryan , Martin David O. , Nakhla Shady , Tabaja Chadi , Paul Aritra , Wilkoff Bruce L. 
Published: May 2024

AbstractIntroductionReports of comparison with procedural outcomes for implantable cardioverter defibrillator (ICD) and pacemaker (PM) transvenous lead extraction (TLE) are old and limited. We sought to compare the safety, efficacy, and procedural properties of ICD and PM TLE and assess the impact of lead age.MethodsThe study cohort included all consecutive patients with ICD and PM TLE in the Cleveland Clinic Prospective TLE Registry between 2013 and 2022. Extraction success, complications, and failure employed the definitions described in the HRS 2017 TLE guidelines.ResultsA total of 885 ICD leads, a median implant duration of 8 (5−11) years in 810 patients, and 1352 PM leads of 7 (3−13) years in 807 patients were included. Procedural success rates in ICD patients were superior to those of PM in >20 years leads but similar in ≤20 years leads. In the PM group, the complete success rate of TLE decreased significantly according to the increase of lead age, but not in the ICD group. ICD TLE required more extraction tools compared with PM TLE but cases with older leads required non‐laser sheath extraction tools in both groups. The most common injury site in major complication cases differed between ICD and PM TLE, although major complication rates showed no difference in both groups (2.7% vs. 1.6%, p = .12).ConclusionThe procedural success rate by TLE is greater for ICD patients than PM patients with leads >20 years old but requires more extraction tools. Common vascular complication sites and the impact of lead age on procedural outcomes and required tools differed between ICD and PM TLE.
Contemporary educational methods in periodontology
Authors: Preshaw Philip M. , Ramseier Christoph A. , Loos Bruno G. , Balčiūnaitė Aušra , Crnić Tin , Davey Kevin , Dommisch Henrik , Ettmayer Johanna B. , Roberts Anthony , Verheijck E. Etienne , Walter Clemens , Zappalà Graziano 
Published: May 2024

AbstractAimThe 1st European Workshop on Periodontal Education in 2009 made recommendations regarding the scope of periodontal education at undergraduate (UG), postgraduate (PG) and continuing professional development (CPD) levels, defining competencies and learning outcomes that were instrumental at the time in helping to define periodontal teaching curricula. The 19th European Workshop on Periodontology and 2nd European Consensus Workshop on Education in Periodontology (Education in Periodontology in Europe) was held in 2023 to identify changes and future developments in periodontal education (including those informed by the COVID‐19 pandemic) and embracing methods and formats of periodontal teaching and training. The aim of this review was to assess current knowledge regarding education methods in periodontology, including traditional face‐to‐face (F2F) teaching and the move to student‐centred methods, virtual learning methods and use of digital technology, as well as blended teaching and learning (including teaching delivery and assessment) at UG, PG and CPD levels.Materials and MethodsSystematic searches were conducted to identify relevant studies from the literature. Data were extracted and descriptive summaries collated.ResultsThe pandemic was a major disruptor of traditional F2F teaching but provided opportunities for rapid implementation of alternative and supplementary teaching methods. Although online learning has become an integral part of periodontal education, teachers and learners alike favour some form of F2F teaching. Blended teaching and learning are feasible in many areas of periodontal education, both for knowledge and skills acquisition as well as in assessment. Student‐centred methods and blended approaches such as the flipped classroom seem highly effective, and online/virtual classrooms with both synchronous and asynchronous lectures are highly valued. Learning with haptic methods and virtual reality (VR) enhances the educational experience, especially when VR is integrated with traditional methods. The quality of the teacher continues to be decisive for the best knowledge transfer in all its forms.ConclusionsLive F2F teaching continues to be highly trusted; however, all types of student‐centred and interactive forms of knowledge transfer are embraced as enhancements. While digital methods offer innovation in education, blended approaches integrating both virtual and traditional methods appear optimal to maximize the achievement of learning outcomes. All areas of periodontal education (UG, PG and CPD) can benefit from such approaches; however, more research is needed to evaluate their benefits, both for knowledge transfer and skills development, as well as in assessment.
Circulating netrin‐1 levels are reduced and related to corneal nerve fiber loss in patients with diabetic neuropathy
Authors: Mondal Asif , Bose Chiranjit , Pramanik Subhasish , Dash Debasish , Mukherjee Bidisha , Malik Rayaz A , Mukhopadhyay Satinath 
Published: May 2024

AbstractAims/IntroductionDeficiency of neurotropic factors is implicated in diabetic neuropathy (DN). Netrin‐1 is a neurotropic factor, but its association with DN has not been explored. We have assessed the association between serum netrin‐1 levels and early diabetic neuropathy assessed by quantifying corneal nerve fiber loss using corneal confocal microscopy.Materials and MethodsA total of 72 participants with type 2 diabetes, without and with corneal nerve fiber loss (DN− n = 42, DN+ n = 30), and 45 healthy controls were studied. Serum netrin‐1 levels were measured by enzyme‐linked immunosorbent assay, and corneal nerve morphology was assessed using corneal confocal microscopy.ResultsCorneal nerve fiber density, branch density, fiber length and serum netrin‐1 levels were significantly lower in the DN− and DN+ groups compared with controls (P < 0.001). Netrin‐1 levels correlated with corneal nerve fiber length in the DN+ group (r = 0.51; P < 0.01). A receiver operating characteristic curve analysis showed that a netrin‐1 cut‐off value of 599.6 (pg/mL) had an area under the curve of 0.85, with a sensitivity of 76% and specificity of 74% (P < 0.001; 95% confidence interval 0.76–0.94) for differentiating patients with and without corneal nerve loss.ConclusionsSerum netrin‐1 levels show a progressive decline with increasing severity of small nerve fiber damage in patients with diabetes. Netrin‐1 could act as a biomarker for small nerve fiber damage in DN.
Criteria for melanocytic lesions in LC‐OCT
Authors: Perez‐Anker J. , Soglia S. , Lenoir C. , Albero R. , Alos L. , García A. , Alejo B. , Cinotti E. , Orte Cano C. , Habougit C. , Dorado Cortes Ch. , Pellegrino L. , Tognetti L. , Castillo P. , Rubegni P. , Suppa M. , Perrot J. L. , del Marmol V. , Puig S. , Malvehy J. 
Published: May 2024

AbstractBackgroundLine‐field confocal optical coherence tomography (LC‐OCT) is an emerging diagnostic tool with imaging depth reaching ~400 μm and a novel three‐dimensional (3D) cube providing cellular resolution. As far as we are aware, there are only a limited number of papers that have reported diagnostic criteria for melanocytic lesions using this technique, and none of them have been multicentric.ObjectivesOur aim was to establish the diagnostic criteria for melanocytic lesions using LC‐OCT and identify the most significant architectural and cytologic features associated with malignancy.MethodsA retrospective evaluation of 80 consecutive melanocytic lesions from a prospective multicentric data set spanning three European centres was conducted. We excluded facial, acral and mucosal lesions from the study. Dermoscopic and LC‐OCT images were evaluated by a consensus of four observers. Multivariate logistic regression with backward elimination was employed.ResultsThe main melanoma diagnostic criteria include detecting >10 pagetoid cells in 3D acquisition, irregular 3D epidermal architecture, disrupted dermoepidermal junction (DEJ) and clefting. Significant risk factors were irregular 3D epidermal architecture, >10 pagetoid cells, dendritic cells at DEJ without underlying inflammation. Novel malignancy criteria in vertical view were DEJ disruption and clefting around atypical melanocyte nests. Exclusive melanoma features were epidermal nests, epidermal consumption, dense dermal nests with atypia. Protective features in the absence of any malignancy indicators were DEJ ring pattern, cobblestone, elongated rete ridges (vertical), well‐defined DEJ and wave pattern (vertical).ConclusionsA series of diagnostic criteria for the identification of melanocytic lesions with LC‐OCT have been established. Validation of these criteria in clinical practice through future studies is essential to further establish their utility.
Association of HBeAg decline rate from mid‐pregnancy to delivery with HBeAg seroconversion after delivery in hepatitis B virus‐infected mothers
Authors: Zhong Wenting , Zheng Jie , Yao Naijuan , Feng Yali , Zhu Yage , Jiao Zhe , Yan Lanzhi , Shi Lei , He Yingli , Chen Tianyan 
Published: May 2024

AbstractThere is still controversy about whether to continue antiviral therapy (AVT) after delivery, especially for pregnant women in the immune tolerance (IT) phase. In this study, a retrospective cohort study was conducted to explore the relationship between hepatitis B e antigen (HBeAg) decline rate (%) from mid‐pregnancy to delivery and HBeAg seroconversion postpartum among patients using nucleos(t)ide analogs (NAs) to prevent mother‐to‐child transmission (MTCT), with the goal of identifying the ideal candidates for postpartum AVT continuation. This retrospective cohort study included 151 postpartum women. Univariate and multivariable logistic regression analyses were conducted to assess the association between the HBeAg decline rate (%) from mid‐pregnancy to delivery and HBeAg seroconversion postpartum. Receiver operating characteristic (ROC) analysis was utilized to evaluate the predictive capacity of the HBeAg decline rate (%) and determine the optimal cut‐off point. The univariate analysis revealed a significant association between the HBeAg decline rate (%) and HBeAg seroconversion postpartum (OR 1.068, 95% CI: 1.034–1.103, p < .001). In the multivariate regression analysis, adjusting for age, hepatitis B surface antigen (HBsAg) titre (log10 IU/mL) at mid‐pregnancy, HBeAg titre (log10 S/CO) at mid‐pregnancy, and hepatitis B virus (HBV) DNA load decline rate (%) from mid‐pregnancy to delivery, the HBeAg decline rate(%) remained significantly associated with HBeAg seroconversion postpartum (OR 1.050, 95% CI: 1.015–1.093, p = .009). Then HBeAg decline rate (%) was treated as a categorical variable (tertiles) for sensitivity analysis. In the three distinct models, taking Tertile1 as a reference, women in Tertile3 still had a 4.201‐fold (OR 4.201, 95% CI: 1.382–12.773, p = .011) higher risk of developing HBeAg seroconversion (p for trend <.05) after adjusting above covariates. The area under the curve (AUC) was 0.723 (95% CI: 0.627–0.819). The optimal cut‐off value was 5.43%, with a sensitivity of 0.561, specificity of 0.791, and Youden's index of 0.352.A higher HBeAg decline rate (%) from mid‐pregnancy to delivery independently correlated with an increased risk of HBeAg seroconversion postpartum. This decline rate can serve as a valuable clinical indicator for predicting HBeAg seroconversion.