Occluded person Re-identification (Re-ID) is to identify a particular person when the person’s body parts are occluded. However, challenges remain in enhancing effective information representation and suppressing background clutter when considering occlusion scenes. In this paper, we propose a novel Attention Map-Driven Network (AMD-Net) for occluded person Re-ID. In AMD-Net, human parsing labels are introduced to supervise the generation of partial attention maps, while we suggest a Spatial-frequency Interaction Module (SIM) to complement the higher-order semantic information from the frequency domain. Furthermore, we propose a Taylor-inspired Feature Filter (TFF) for mitigating background disturbance and extracting fine-grained features. Moreover, we also design a part-soft triplet loss, which is robust to non-discriminative body partial features. Experimental results on Occluded-Duke, Occluded-Reid, Market-1501, and Duke-MTMC datasets show that our method outperforms existing state-of-the-art methods. The code is available at: https://github.com/ISCLab-Bistu/SA-ReID.

This study investigates the influence of immersive virtual reality environments and gamification on the classification of imaginary motor (MI) signals and the associated increase in energy in the motor cortex region for neurorehabilitation purposes. Two immersive virtual environments, indoor and outdoor, were selected, each with gamified and non-gamified scenarios. Event-Related Desynchronization (ERD) data underwent analyses to determine if there were significant differences in ERD levels between distinct age groups and whether Fully Immersive Virtual Reality (FIVR) environments induced notable energy increases. The initial analysis found no significant energy changes between age groups under constant environmental conditions. In the second analysis, FIVR environments did not lead to a statistically significant increase in cortical energy for the 21–24 age group (Group I). However, a notable difference in cortical energy increase was identified between gamified and non-gamified environments within the 32–43 age group (Group II). The study also explored the impact of environmental factors on MI signal classification using four deep learning algorithms. The Recurrent Neural Network (RNN) classifier exhibited the highest performance, with an average accuracy of 86.83%. Signals recorded indoors showed higher average classification performance, with a significant difference observed among age groups. Group I participants performed better in non-gamified environments (88.8%), while Group II achieved high performance indoors, especially in the gamified scenario (93.6%). Overall, the research underscores the potential of immersive virtual environments and gamification in enhancing MI signal classification and cortical energy increase, with age and environmental factors influencing the outcomes.

Adenovirus, a common respiratory pathogen, has witnessed a notable rise in incidence rates across various regions in Pakistan. Utilizing epidemiological data and climate records, this research discerns a potential linkage between the burgeoning adenovirus cases and alterations in regional climate patterns. Through statistical analysis and modeling techniques, the study aims to elucidate the relationship between climatic variables such as temperature, humidity, and precipitation, and the prevalence of adenovirus infections. Understanding these dynamics is crucial for developing effective public health interventions and preparedness strategies to mitigate the impact of adenovirus outbreaks in Pakistan. Furthermore, this research contributes to the broader discourse on the intersection of infectious diseases and climate change, highlighting the need for comprehensive adaptive measures to address emerging health challenges in a changing environment.

Patients with DICER1 syndrome typically harbor a germline truncating variant in the coding region. Here, we report a case of DICER1 syndrome caused by an intronic germline variant. The patient was diagnosed with pleuropulmonary blastoma at the 3 years of age, and a somatic p.D1810Y, but not a germline variant in DICER1 was detected by whole-exome sequencing. After 13 years, he developed urogenital embryonal rhabdomyosarcoma with a somatic p.E1813D in DICER1. Further analysis using complementary DNA DICER1 confirmed that a germline p.I813Ffs*24 and c.2437-15T>G caused the alteration. This report highlights the importance of a germline-dedicated analysis covering introns.

Using a common protocol across seven countries in the European Union/European Economic Area, we estimated XBB.1.5 monovalent vaccine effectiveness (VE) against COVID-19 hospitalisation and death in ≥65-year-olds, during October-November 2023. We linked electronic records to construct retrospective cohorts and used Cox models to estimate adjusted Hazard Ratios and derive VE. VE for COVID-10 hospitalisation and death was, respectively, 67% (95%CI: 60-72) and 68% (95%CI: 44-82) in 65–79-year-olds, and 64% (95%CI: 49-75) and 74% (95%CI: 56-85) in ≥80-year-olds. Results indicate that periodic vaccination of individuals ≥65 years has an ongoing benefit, and support the current vaccination strategies in the EU/EEA.

A case of müllerianchoristoma in rectovaginal septum：Developmental Endocervicosis and Developmental Endometriosis –MüllerianosisYaqi Fang1#,Jun Li2#,Fang Zhang1,Yunqian Chen1,Zhongfeng Liu1*1Department of Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China.2Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China.#These authors contributed equally to this study.*Corresponding author: Zhongfeng Liu, No. 717, Jinbu Street, Department of Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China. Email: liuyichaoxy@163.comCASE reportThe presence of Müllerian choristoma in the rectovaginal septum, which containing developmental endocervicosis and developmental endometriosis (müllerianosis), has not been documented in any literature.In this case, we present a patient with heterotopic endocervical tissue and endometrium in the rectovaginal septum. Ultrasound and MRI revealed a lesion within the rectovaginal septum. The final microscopic diagnosis and immunohistochemistry confirmed müllerianosis: developmental endocervicosis and developmental endometriosis. We conclude that our patient has a benign müllerianchoristoma (müllerianosis) with a lesion similar to those previously described by Marwan Habiba[1] and Ronald E.Batt et al[2], except for its location. To our knowledge,this is the first documented case of müllerianchoristoma inrectovaginal septum.Müllerianosis may be defined as an organoid structure of embryonic origin that incorporated within other normal organs during organogenesis[3]. A 36-year-old patient, gravida 1 para 1, has been experiencing bloody stool and constipation for the past two years.A transvaginal scan was performed using a head scanning probe. The ultrasound examination revealed an echo reflection in the intrauterine cavity that resembled an endometrial polyp, as well as endometriosis-like echoes in the right ovary. Furthermore, the scan detected a pelvic effusion and an uneven high echo clump in the rectovaginal septum.The transvaginal biplane ultrasound transducer was used to scan the lesions in the rectovaginal septum. A hyperechoic structure resembling ’Pleurotus eryngii’ was detected in the rectovaginal septum (Fig.1). This structure measured approximately 4.98cm in length and consisted of a ’pileus’ and a ’stipe’. The ’pileus’ was positioned leaning forward and in close proximity to the middle part of the posterior vaginal wall (about 0.27cm away from the posterior vaginal wall), while its hollow ’stipe’ tilted backward and downward, opening between the anocutaneous line and the rear of the perineum. The ’pileus’ is surrounded by a hyperechoic cyst wall, which is about 0.1cm thick. The interior of the ’pileus’ contains multiple polyp-like structures with slightly hyperechoic reflections.The area between the ’pileus’ and the hyperecho cyst wall is filled with an anechoic zone with poor sound transmission. Multiple thin-walled anechoic areas with distinct boundariesare scattered in the ’pileus’.The polypoid echo and the muscle fascicle-like ’stipe’ echo extend towards the front of the external opening of the anal canal. CDFI reveals that both the polypoid echo and the ’stipe’ echo exhibit rich blood flow signals(Fig.2). One of these vessels is connectedto thevessels surrounding the anal canal.After injecting sterile ultrasound gel, an increase in the presence of small bubble anechoic areas can be observed between the ’pileus’ and the polyp-like echo.A double-lumen urethral catheter was inserted through the end opening of the ’stipe’,while simultaneously inserting a catheter into the anal canal. The opening of the lesion was found to be approximately 0.2cm away from the front of the external opening of the anal canal (Fig.3).MRI revealedabnormal signals in the rectum,consistent with pelvic endometriosis. Electronic colonoscopy detected a 2cm submucosal bulge in the rectum, located approximately 4cm away from the anus.The bulge was palpable and could be moved upon touch. After administering general anesthesia, it was observed that the polypoid mass had prolapsed between the rear of the perineal body and the anal skin line. The lesion was able to recover to its original position.During laparoscopic exploration of the pelvic cavity, multiple scattered endometriosis lesions were observed within the pelvic cavity.A sinus was detected between the rectum and vagina during the digital rectal examination. The sinus was located 1cm away from the anal verge. Based on these findings, the patient was diagnosed with pelvic endometriosis.Histological sections (Fig.4) of the specimen revealed two types of epithelial components in the examined polypoid tissue: squamous epithelium and glandular epithelium, consistent with the characteristics of Mullerian epithelium. Immunohistochemical examinations found that the epithelial cells exhibited diffuse expression of PAX-8, and both their histomorphology and immunomarkers were consistent with those of cervical glandular epithelium. Immunohistochemistry analysis also revealed SMA expression. The glandular cells in the cyst wall exhibited a higher proportion of cell nucleus, which were pen-shaped and located at the bottom of the cells, resembling Mullerian epithelium.The positive expression of CD10 in immunohistochemistry supported that these glands and the interstitium shared similar characteristics with the endometrium.The histological analysis and immunohistochemical examinations revealed the presence of ectopic endocervixand endometrium within the soft tissues.Based on this,we concluded that this case was müllerianosiscontaining developmental endocervicosis and developmental endometriosis.DISCUSSIONEndometriosis is a prevalent benign illness defined by the presence of endometrial glands and stroma outside of the uterine cavity, primarilyon the ovary, pelvic peritoneum, and rectovaginal septum[4].This case strongly supports the theory ofFour DevelopmentalMüllerian Diseases proposed by Ronald E. Batt et al[2].According to this theory, developmental adenomyosis, endometriosis, endosalpingiosis, and endocervicosis are referred to as the 4 developmentalmüllerian diseases[2]. In this case, the lesion was found in the rectovaginal septum, with no direct communications with the endocervix, endometrium, or endosalpinx.Immunohistochemistry analysis also revealed SMAexpression. Bundles of differentiated smooth muscle tissue were observed surrounding the cervical stromal cells and cyst wall-like structures,suggesting that epithelial cells induce the simultaneous development of surrounding smooth muscle during the formation of ectopic tissue. Additionally, epithelial cells contribute to the development of smooth muscle tissue during embryonic development.These findings support that this is a developmental (embryonic origin) müllerian disease rather than an acquired müllerian disease.Our hypothesis is that the hyperechoic cyst wall surrounding the ’pileus’ is comparable to the concept of ’peritoneal pocket’described by Batt R E in 1990[5] and 2007[3] . The term ’peritoneal pocket’ was proposed to represent an organoid structure, where the floor of this structure could be grasped and turned inside out for excision. In this case, a similar eversion state was observed.The cells in the cyst wall surrounding the ’pileus’ exhibit characteristics of Mullerian epithelium. The presence of bloody stool and constipation can be attributed to the developmental endometriosis of the cyst wall. This condition is influenced by hormones and undergoes periodic shedding and bleeding. The blood passes through the tube that opens between the anocutaneous line and the perineal body, leading to the presence of bloody stool. Additionally, constipation can be caused by straining to defecate and the presence of everted multiple polyps that block the external anal opening.In this case, müllerianosis lesion is located in the lower-middle part of the rectovaginal septum at the end of the midline of the human body, which is consistent with the distribution of lesions described by Batt RE[2, 6],Hattori H[7], Andronik IshkhanKalayjyan[8], Pansera[9],Buerger[10],Xueyan Chen[11],and others.Based on Ludwig’s theory[12], Batt R.E predicted that no cases of endocervicoticchoristomas will be found above the diaphragm[6]. Conversely, it is predicted that no cases of endosalpingiosischoristomas will be found below the pelvic diaphragm.Whether this prediction can be established requires the discovery of new cases for verification.

Background 98% of neonatal deaths worldwide occur in low- and middle-income countries (LMICs), yet there is little bereavement care guidance available for these settings. Objectives To explore parents’, families’ and healthcare professionals’ experiences of care after neonatal death in healthcare facilities in LMICs. Search Strategy and Selection Criteria Four databases were searched for peer-reviewed literature meeting the inclusion criteria of qualitative studies exploring the experiences of people who provided or received bereavement care following neonatal death in a LMIC healthcare setting. Data Collection and Analysis Data were collected by two independent reviewers, collated through line-by-line coding then reciprocal and refutational translation, and analysed through Noblit and Hare’s seven-step meta-ethnography approach to create first, second and third order themes. Main Results Seven first order themes extracted from the literature included emotional responses, social relationships, staff and systems, religion, connecting with the baby, coping strategies, and economic concerns. From these data, three third order themes arose; the individual, the healthcare setting, and the community/ context. Conclusions Over-arching themes in bereavement care shape grief responses and are often similar across geographical locations. Analysing these similarities allows a deeper understanding of the important elements of bereavement care and may be helpful to inform the creation of high quality, bereavement care guidelines suitable for use in LMIC settings.

Black carbon emitted in the aircraft exhaust plume has the potential to seed cirrus clouds, as well as modify optical properties of existing clouds. Optical differences between natural- and aviation-induced cirrus are not well characterized or understood. This study combines datasets containing advected aircraft locations with two sources of LIDAR observations. We find that ice clouds that correspond to the locations of aircraft exhaust plumes show higher depolarization ratios (mean increase of 3.36% [95% CI: 3.19% to 3.54%]). This increase in depolarization occurs without a proportional increase in backscatter, but with a large increase in extinction (mean increase from 5.58e-5 [95% CI: 3.70e-5 to 7.50e-5] to 1.78e-4 [95% CI: 1.38e-4 to 2.17e-4]). Using linear optical scattering theory, we show that these changes are well explained by the inclusion of black carbon within the ice crystals. No suitable explanation has previously been offered to explain this measured increase in depolarization.

In order to solve the problem of partial loss of data information and structure of 3D point cloud model due to subjective and objective factors such as occlusion and noise, a partial deletion reconstruction method of 3D point cloud model based on PF-Net was proposed, and a model deletion reconstruction system was developed. Based on the deep learning PF-Net network architecture, the Batch Normal layer and the Dropout layer are introduced to normalize the original datasets in batches, which further improves the reconstruction efficiency and accuracy of some missing point cloud models. In this paper, 11 point cloud models are selected to carry out reconstruction experiments with some missing data information and structural features, and the experiments show that the proposed method has higher reconstruction efficiency than the L-Gan and PCN methods when the same dataset is used for training and testing. In the eleven test categories, the average improvement of the refactoring method in this paper is 12%-27%. The proposed method has a significant effect in dealing with the partial deletion reconstruction of small-scale models, and at the same time improves the efficiency and accuracy of reconstruction, which has good application value.

Herein, we develop a novel dual network hydrogel system for the treatment of infected full-thickness skin wounds, leveraging the synergistic effects of TA-modified MXene and bacterial cellulose within a polyvinyl alcohol-borax/GelMA hydrogel matrix. The incorporation of bacterial cellulose, a natural biopolymer produced by certain bacteria, enhances the mechanical properties and biocompatibility of the hydrogel while providing a scaffold for cell adhesion and proliferation. The addition of TA-modified MXene further enhances the antibacterial efficacy of the hydrogel and enables photothermal therapy through NIR light absorption. Moreover, the fabricated hydrogel demonstrated excellent biocompatibility. Furthermore, the in vivo study confirmed that hydrogel can accelerate infectious wound healing under NIR irradiation. The resulting hydrogel system offers a multifunctional platform for combating infection, promoting wound healing, and facilitating tissue regeneration in infected skin wounds.

AbstractHatcheries nationwide suffer from unexplained acute production failures, termed crashes. The microbiota of oysters relates to larval health with previous studies showing that some bacterial species have positive and others negative effects on oyster health. To investigate microbial correlates of crashes, we collected samples from every batch of oyster larvae produced by the Horn Point Laboratory Oyster Hatchery since 2021 and analyzed the microbiota of 15 of those batches over their duration in the hatchery, from age of 3 to 5 days until either harvest or complete die off of the batch. Across events, die-offs generally became evident at or after six days of age. We found that the microbiota of oyster larvae appears to respond to die-off events with crashed batches having fundamentally different microbiota than good batches at age 7 to 9 and 9 to 12 days. Crashed batches were often taken over by microeukaryotes and bacterial taxa from the Protobacteria and Bacteroidetes phyla. However, this presumably opportunistic community differed between batches. Observed Vibrio species level groups did not appear to be oyster pathogens and appeared to respond to, rather than precede, crashes. The microbiota of 3 to 5 day old larvae were statistically related to whether a die-off occured later in the larval batches’ life, only when the taxa were first agglomerated to family level. The detection of two microbial species not previously known to associate with oysters, along with an increased presence of Dinophyceae, predominantly the toxin-producing Gyrodinium jinhaense, in 3 to 5 day old oyster larvae was statistically linked with subsequent batch crashes.This study suggests that the health of larval oysters shapes their microbiome. Conversely, it provides hints that the microbiome of larvae, and perhaps harmful algae, may drive hatchery crashes.IntroductionPrivate and government run shellfish hatcheries support oyster aquaculture and restoration efforts by providing farmers and managers with broodstock oyster larvae and spat on shell (Wallace et al., 2008). Although hatchery production has improved immensely over the past several decades (Helm and Millican, 1977; Elston et al., 1981; Urban and Langdon, 1984; Lewis et al., 1988; Robert and Gérard, 1999), hatcheries regularly experience massive unexplained die-off of stock (termed “crashes”) without clear causative factors (Walker, 2017; Gray et al., 2022). The Horn Point Laboratory Oyster Hatchery (HPLOH) is the largest producer of oyster seed (Crassostrea virginica ) on the Atlantic Coast of the United States, and experiences slowdowns and halts to its production every year (Gray et al. 2022). Crashes at HPLOH have common characteristics, with most to all of the larvae in a feeding tank ceasing to feed and then dying at the age of 6 to 21 days. Preliminary observations associate low salinity in the oysters’ overwintering location with lower spat yield (Gray et al., 2022). However, a causal relationship is not established. Changes to precipitation patterns driven by a warming climate may drive both changes in salinity and concurrent changes in chemistry and microbial community structure (Gibson and Najjar, 2000; Wang et al., 2021).Microbial communities are known to modulate the health of a range of animal hosts (Peixoto et al., 2021), including many aquaculture species (Infante-Villamil et al., 2021), and both adult and larval oysters (Yeh et al., 2020). Some bacteria are pathogenic, such as many species of the bacterial genusVibrio, which have been shown to sicken oyster larvae (Elston and Leibovitz, 1980; Richards et al., 2015). Contrastingly, other bacteria can help their hosts. Additions of probiotic species, includingBacillus pumilus RI06-95, and Phaobacter inhibens S4 have been shown to protect their hosts from Vibrio coralliilyticusinfection, by shaping the host’s innate immune response (Stevick et al., 2019; Modak and Gomez-Chiarri, 2020). Furthermore, bacteria can serve as indicators of changes in the host’s environment and health. For instance, oysters fed compromised microalgae showed both decreased health and a concurrent change in their microbiome (Vignier et al., 2021). Specifically, many species from the Rhodobacteraceae family positively associated with multiple measures of host fitness, while two species of Flavobacteriaceae associated with low fitness (Vignier et al., 2021). Preliminary investigation of larval crashes suggests that microbial communities differed between one crashed and one non-crashed larval brood at HPLOH (Cram et al., 2022; Gray et al., 2022). However, identifying a pattern requires surveying more than two batches of samples.Microbial communities, both in the waters of the Chesapeake Bay that feed the HPLOH hatchery (Arora‐Williams et al., 2022), and in other animal and environmental systems are in a state of constant change (Fauci and Dick, 1994; Fuhrman et al., 2015; Bashan et al., 2016). Time-series observations offer an advantage over those taken at a single point in time by identifying statistical associations in which one factor changes before the other factor, because leading indicators are valuable for prediction and can provide clues about causality (Fuhrman et al., 2015). Specifically, if one variable leads to another, the lagging variable cannot predict the leading variable. In hatchery crashes, this is important because crashes and microbes both shape each other – microbial changes that happen before crash events are unlikely to be caused by the crash itself and are therefore more likely to shape crashes, or else are associated with another variable that leads to crashes.While some studies have explored the community composition in oyster hatcheries (Le Deuff et al., 1996; Ramachandran et al., 2018; Arfken et al., 2021; Gray et al., 2022) and dynamics of those communities (Stevick et al., 2019), none to our knowledge have explored the microbial dynamics of normal production hatcheries over multiple crash and non-crash events. Therefore, we have been collecting samples of larvae and their microbiota from every water change of the HPLOH since the beginning of the 2021 growing season. In this study, we performed amplicon sequencing of the microbiota from every time point of selected batches from the 2021 season, including some that were healthy and some that experienced die-offs. Our goal was to explore whether microbiota from the first time-point were predictive of crashes, and whether the microbiota over the life of healthy and underperforming batches changed in predictable ways over the development or die-off of the larvae batches.

Alpha oscillations are associated with various cognitive functions. However, the determinants of alpha power variation remain ambiguous, primarily due to its inconsistent associations with autonomic responses and subjective states under different experimental conditions. To thoroughly examine the correlations between alpha power variation and these factors, we implemented a range of experimental conditions, encompassing attentional and emotional tasks, as well as a resting state. In addition to the electroencephalogram data, we gathered a suite of autonomic response measurements and subjective ratings. We employed multivariate linear regression analysis, utilizing autonomic responses and subjective reports as predictors of alpha power. We also subtracted the aperiodic components for better estimation of the power of periodic alpha oscillations. Our results demonstrated that the combined use of autonomic response measurements and subjective ratings effectively predicted the periodic alpha power variation across a range of conditions. These predictions were supported by leave-one-participant-out cross-validation, confirming that multivariate linear relationships can be generalized to new participants. This study demonstrates the links of alpha power variations with autonomic responses and subjective states, suggesting that during investigations of the cognitive functions of alpha oscillations, it is important to consider the potential influences of autonomic responses and subjective states on alpha oscillations.

A document by Chris Soulsby. Click on the document to view its contents.

Nailfold capillaroscopy is an important means of monitoring human health. Panoramic nailfold images improve the efficiency and accuracy of examinations. However, the acquisition of panoramic nailfold images is seldom studied and the problem manifests of few matching feature points when image stitching is used for such images. Therefore, this paper presents a method for panoramic nailfold image stitching based on vascular contour enhancement, which first solves the problem of few matching feature points by pre-processing the image with contrast-constrained adaptive histogram equalization (CLAHE), bilateral filtering (BF), and sharpening algorithms. The panoramic images of the nailfold blood vessels are then successfully stitched using the fast robust feature (SURF), fast library of approximate nearest neighbors (FLANN) and random sample agreement (RANSAC) algorithms. The experimental results show that the panoramic image stitched by this paper’s algorithm has a field of view width of 7.43 mm, which improves the efficiency and accuracy of diagnosis.

Vascular diseases are a leading cause of death and disability worldwide. Despite having precursor conditions like peripheral arterial disease (PAD), they are often only diagnosed after the onset of strokes or heart attacks. Low-cost, portable, non-invasive, point-of-care (POC) assessment of deep vascular function benefits PAD diagnosis, especially in low-and-middle-income countries. Doppler ultrasound-based blood flow measurements can diagnose PAD, albeit, with limited sensitivity and specificity. To overcome this, here, we propose the first-of-its-kind photoacoustic-and-ultrasound (PAUS) imaging system that integrates a multiwavelength pulsed laser diode (PLD) with a compact ultrasound data acquisition system. The portable PLD-PAUS system was validated for deep tissue imaging using tissue phantoms, and for multispectral photoacoustic imaging using an atherosclerosis mimicking phantom. Further, we demonstrated high-contrast volumetric in-vivo photoacoustic imaging of rodent abdominal vasculature and quantified vessel reactivity due to hypercapnia stimulation. The multiparametric functional and molecular imaging capabilities of the PLD-PAUS system holds promise for POC applications.

Clinical pharmacology is a recent medical specialty that deals with everyday aspects of the relationship between drugs and humans, promoting safe and effective use of medicines while maintaining the sustainability of healthcare systems through pharmacoeconomics considerations. Since its creation in 2019, our Clinical Pharmacology Unit (UFC) has cooperated with the Pharmacy and Therapeutics Committee (CFT), creating, at request, technical and scientific reports that support decision processes of this local regulatory entity. As all clinical protocols need to be approved by CFT before institutional implementation, UFC acts as an expert and independent organ that evaluates clinical and pharmacological evidence, providing, ultimately, better healthcare access to patients. Our paper describes our cumulative experience and systematic approach in clinical protocol evaluation, over 4 years, with the use of a self-made checklist. We divided protocol evaluation into three sections: 1) introduction; 2) critical appraisal; and 3) final remarks and considerations. Since the most important part is critical appraisal, we further divided this section into two parts; the first one addresses formal aspects and the second discusses regulatory matters, pharmacology aspects, evidence-based prescription, safety concerns, and pharmacoeconomics considerations. We also describe key and fundamental aspects that, from our experience, should be included to grant protocol quality. Our experience, which derived from the evaluation of 63 protocols, showed that the suggestions emerging from the evaluation processes were well accepted by the proponent services and that the overall quality of the protocols was improved, resulting in better health services.

Thrombolysis and thrombectomy in an extensive Portal Vein Thrombosis without underlying liver disease – A case report.Dr. Mohammadshah Isam Gula, Dr. Waseem Umera, Ahmed Daniyal Nawazc, Dr. Mohammad J H Elhissib, Dr. Muhammad Zahida,c,dInternal Medicine Department, Hamad Medical Corporation, Doha, QatarRadiology Department, Hamad Medical Corporation, Doha, QatarQatar University, Doha, QatarWeill Cornell Medicine, Doha, Qatar

Background: Peanut allergy is among the most severe and common food allergies. The diagnosis has a significant impact on the quality of life for patients and their families. An effective management approach depends on accurate, safe, and easily implementable diagnostic methods. We previously developed a cell-based assay using Hoxb8 mast cells (Hoxb8 MCs) aimed at improving clinical allergy diagnosis. In this study we assessed its diagnostic performance by measuring blinded sera from a prospectively enrolled and pre-validated peanut allergy cohort. Methods: Hoxb8 MCs were passively sensitized with sera from peanut-allergic and peanut tolerant children and adolescents (n=96). Degranulation of Hoxb8 MCs was quantified upon stimulation with dose-titrated peanut extract by means of flow cytometry, using CD107a as activation marker. The results from the Hoxb8 mast cell activation test (Hoxb8 MAT) were compared to established diagnostic assays such as the skin prick test (SPT), specific IgE (sIgE) levels, and the basophil activation test (BAT). Additionally, serum samples from BAT non-responders were assessed with the Hoxb8 MAT. Results: Hoxb8 MAT displayed a robust dose-dependent activation to peanut extract, with a cut-off value of ≤5.2% CD107a positive cells. The diagnostic accuracy was highest at allergen concentrations ≥100 ng/ml, with an area under the receiver operating characteristic curve (AUROC) of 0.97, 93% sensitivity, and 96% specificity, outperforming traditional SPT and sIgE tests. When compared to BAT, Hoxb8 MAT exhibited comparable diagnostic efficacy. However, sera from BAT non-responders were accurately classified into allergics and non-allergics by the Hoxb8 MAT. Conclusions: The Hoxb8 MAT demonstrated a very good diagnostic precision in patients prospectively assessed for peanut allergy comparable to the fresh blood based BAT. It also demonstrated its value for accurate classification of BAT non-responders into allergic and non-allergic individuals. Further investigations into its utility in the routine clinical setting are warranted.

A document by Mohammed Najdat Seijari. Click on the document to view its contents.

Handover is the process of transferring a cellular call or data session from one base station (BS) to another. This process aims to establish reliable and uninterrupted connection, thereby providing satisfactory Quality of Service (QoS) and Quality of Experience (QoE) for users. 5G networks will use millimetre wave (mmWave) frequencies in addition to sub-6 GHz bands, which will make handover (HO) more challenging. This paper focuses on the problem of partially blind HOs which is a novel HO type. In this sense, we modify an extant algorithm used for the partially blind HOs [1] which the algorithm is based on machine learning (ML). In our modified algorithm, we use the extant algorithm with a powerful boosting method that is Categorical Boosting (CatBoost). We compare our modified algorithm with a baseline algorithm, the originally proposed algorithm, Support Vector Machine integrated original algorithm. Different settings of simulation time and number of users are considered in comparing the algorithms, and our modified algorithm outperforms the rest of the algorithms in majority of the settings with higher HO prediction rates as per obtained results. The obtained results clearly indicate that the integration of ML with partially blind HOs enables accurate predictions whether HO execution will be successful in collocated cells in a network in the real-world case. A noteworthy takeaway from the obtained results is that ML deployment with partially blind HOs will likely contribute to self-organizing networks (SONs) in 5G communication systems.

Covid-19 had a devastating impact on every part of the world. Cities were the epi-centers of coronavirus transmission and fatality. This has raised questions on the ‘survival of the city’ and the role of ‘density’ in catalyzing economic growth, social capital formation, and human development. The questions are misleading for developing countries that are destined to go a long way to complete the development transition with rural-urban transformation. They conceal the failure of urban policymakers and administrators to prepare for and effectively manage pandemics. In fact, cities in the past have tackled pandemics far worse than Covid-19 and bounced back. This paper delves into the history of pandemics and how disease-ravaged cities shaped urban morphology, developing a strong public health foundation, undertaking spatial planning innovation, facilitating housing for the poor, building institutions, and investing in science, including epidemiology, disease control, and management methods. The objective of the paper is to learn lessons for cities in the developing world to become pandemic-resilient and sustainable so that they act as engines of growth as did cities in developed countries. We suggest broad directions for urban policy reforms, covering public health, spatial planning, infrastructure development, governance, and disaster management.

This study is novel in that it quantitatively exams the impact of human brucellosis, an endemic zoonotic disease in Malta from 1919 until 1954, and the impact on reproductive loss through stillbirths. Based on regression analysis, brucellosis had a statistically significant effect (t = 2.8986, p = 0.0039) on stillbirth rate for males, but the effect of brucellosis on stillbirths is not statistically significant for females (p = 0.9103). This paper points to the importance of brucellosis, one of the most common zoonotic diseases, as having implications for health burden in women and fetuses in the contemporary context; this relationship has been largely ignored in the literature.

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Background and aims Patients affected by metastatic germ cell tumors may occasionally experience enlargement of metastatic lesions with concurrent normalization of tumor markers after chemotherapy. This phenomenon is described as Growing Teratoma Syndrome (GTS). The aim of the present study is to assess the prevalence of GTS in the pediatric population and its implications in terms of surgical outcome. Methods The clinical notes of patients diagnosed with stage III and IV malignant germ cell tumors from January 2010 until December 2020 at our Institution were retrospectively reviewed. Patients with residual disease after chemotherapy were studied; the occurrence of GTS, treatment strategies, survival and outcome were analyzed. Results Thirty-three patients with high stage malignant germ cell tumors were diagnosed in our Institution in the analyzed period. Eleven patients (34%) had radiologic evidence of enlargement of metastases after chemotherapy; nine of them (28%) had normal markers after chemotherapy and were classified as GTS patients. All nine patients underwent resection of metastatic lymph nodes and six had surgery on visceral metastases. In six patients, radical excision of all metastatic sites was achieved; five patients are alive and in complete remission while one died for peri-operative complications. Out of the three patients who could not achieve radical excision of the metastases, two died for progressive disease and one is alive with progressive disease. Conclusions Patients affected by GTS have a risk of progression of chemotherapy-resistant disease and death. Radical surgical excision is essential to achieve disease control and long-term survival.