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Genetics of Thrombotic Thrombocytopenic Purpura (TTP): Systematic Review in Immune and Congenital TTP
No full textThrombotic Thrombocytopenic Purpura (TTP) is a thrombotic microangiopathy, caused by severe deficiency of the metalloprotease ADAMTS13. TTP has two subtypes: immune (iTTP) and congenital (cTTP). Autoimmune mechanisms underlie iTTP, however the genetic factors influencing disease risk, relapse risk and response to treatment are incompletely understood. In cTTP, although variants are described throughout the ADAMTS13 gene, the effect of many of these variants is uncertain. We conducted a comprehensive literature review of both iTTP and cTTP, incorporating findings from genome-wide association studies (GWAS), case-control studies, registry publications and population-level databases. In iTTP, nine studies have investigated the effect of HLA alleles, with HLA-DRB1*11 most consistently associated with an increased risk, and HLA DRB1*04 with protection. However, effect sizes varied across ancestral populations, as we highlight in a meta-analysis of available studies. Beyond the HLA locus, a GWAS in iTTP patients with European ancestry identified a locus on chromosome 3 (rs9884090) associated with a reduced iTTP risk. In cTTP, we identified 364 variants within the literature, the majority (199, 54.7%) being missense variants within coding regions. Although variants are located across the gene, the highest density of variants was observed within exon 7 (32 variants, 8.8% of the total), corresponding to the metalloprotease domain. Finally, analysis of population-level constraint data from gnomAD offered additional insight into the tolerance of ADAMTS13 to variation. Together, these findings highlight the complexity of the genetic factors influencing TTP, and the value of combining clinical information and population data to increase understanding of the disease
EndoSfM3D: Learning to 3D Reconstruct Any Endoscopic Surgery Scene using Self-supervised Foundation Model
No full text3D reconstruction of endoscopic surgery scenes plays a vital role in enhancing scene perception, enabling AR visualization, and supporting context-aware decision-making in image-guided surgery. A critical yet challenging step in this process is the accurate estimation of the endoscope’s intrinsic parameters. In real surgical settings, intrinsic calibration is hindered by sterility constraints and the use of specialized endoscopes with continuous zoom and telescope rotation. Most existing methods for endoscopic 3D reconstruction do not estimate intrinsic parameters, limiting their effectiveness for accurate and reliable reconstruction. In this paper, we integrate intrinsic parameter estimation into a self-supervised monocular depth estimation framework by adapting the Depth Anything V2 (DA2) model for joint depth, pose, and intrinsics prediction. We introduce an attention-based pose network and a Weight-Decomposed Low-Rank Adaptation strategy for efficient fine-tuning of DA2. Our method is validated on the SCARED and C3VD public datasets, demonstrating superior performance compared to recent state-of-the-art approaches in self-supervised monocular depth estimation and 3D reconstruction. Code and model weights can be found in project repository: https://github.com/MOYF-beta/EndoSfM3D
Multidimensional Assessment of Recovery After Total Knee Arthroplasty in Clinical Practice: Critical Narrative Review
No full textBackground:
Total knee arthroplasty (TKA) is the primary treatment for advanced knee osteoarthritis. Despite its clinical success and favorable patient-reported outcome measures (PROMs), approximately 20% to 30% of patients continue to experience persistent functional limitations and muscle weakness. This highlights the need for a comprehensive evaluation of recovery parameters beyond pain and range of motion. Given the wide range of methods available for assessing TKA outcomes, clinicians often select tools based on personal preference and understanding, which may affect accuracy and consistency; for example, the Knee Injury and Osteoarthritis Outcome Score may overestimate function compared to gait analysis studies.
Objective:
The aim of this study was to conduct a narrative review focusing on the use, strengths, and limitations of different outcome measures used in routine orthopedic practice to optimize post-TKA evaluation.
Methods:
A literature search was conducted in February 2025 across 2 databases (PubMed and Web of Science). Eligible studies included original research articles, systematic reviews, and meta-analyses that focused on validated measures used to evaluate TKA. Case reports, conference abstracts, and studies focused exclusively on surgical techniques were excluded. Themes were identified across studies to structure the results according to types of assessments and clinical applicability.
Results:
A total of 6831 studies were retrieved and screened in this review, with 4 themes emerging around muscle mass, strength, performance, and PROMs. The Oxford Knee Score is favored for its ease of use and minimal ceiling effects. Broader tools like the Knee Injury and Osteoarthritis Outcome Score and Western Ontario and McMaster Universities Osteoarthritis Index provide detailed insights but are less practical clinically. For muscle strength, the portable fixed dynamometer showed high reliability and comparability to isokinetic dynamometry. Dual-energy X-ray absorptiometry remains the gold standard for assessing muscle mass, while bioelectrical impedance analysis offers a practical alternative. The 5-Repetition Sit-to-Stand test effectively evaluates lower limb power and speed.
Conclusions:
Clinicians should integrate both objective (muscle mass, strength, and performance) and subjective (PROMs) measures to improve TKA recovery assessment. This multidimensional approach has the potential to enhance the accuracy of patient evaluation and supports the development of tailored rehabilitation strategies that address individual deficits and optimize functional outcomes
Minoritised-language music as a demarginalising space: the case of Meänkieli song lyrics in Sweden
No full textA novel framework for realistic modelling of 3D mesostructure and fracture behaviour of recycled aggregate concrete
Get PDFRecycled aggregate concrete (RAC) offers a sustainable alternative to natural aggregate concrete, while its meso-scale modelling is often limited by overly simplified geometries. This study presents a novel 3D computational framework using Voronoi tessellation and hierarchical clustering to realistically generate 3D mesostructure of RAC. The model equips six distinct phases including old aggregate, old mortar, new mortar, two interfacial transition zones (ITZs) and voids, and employs splining and scaling techniques to control morphology. It produces irregular recycled aggregates with realistic size distribution, volume fraction, old mortar content, and shape descriptors in terms of sphericity, roundness and convexity. Validation indicates consistence with experimental findings in terms of geometry and composition. 3D meso-scale modelling of fracture processes in RAC under uniaxial compression can accurately capture the crack initiation at old ITZs and shear-dominated failure. The proposed modelling framework offers a robust tool for understanding the mesostructure-mechanical property relationships in RAC and optimising material design of RAC
The Politics of Copossession of the World
Get PDFThis article critiques Pierre Crétois’ theory of copossession of the world which rethinks
property as a relative right, regulated by the principle of social equity. It argues that despite
aiming to deconstruct proprietary absolutism, his theory inverts rather than challenges its
logic: copossession replaces private property as the foundation of a fair and rational society.
As the only system to realise distributive justice, its politics forecloses legitimate opposition
and restricts the democratic agency it claims to promote. Like the proponents of private
ownership, Crétois presumes his model’s inherent respectability to the extent that any
inequality copossession would cause would register as personal rather than systemic failure.
Crétois’s citizens would therefore have to accept that system rather than question, and take
responsibility for, its fairness. To repoliticise copossession, the article draws on Pierre
Dardot’s and Christian Laval’s cosmopolitics of the commons: copossession gets reconceived
as one situated praxis of commoning among others rather than the politics of the world.
Relativising it reintroduces antagonism, plurality, and contingency as conditions for fostering
collective responsibility for justice and for enacting and defending a world that many worlds
can share. Only then could Crétois’ politics remain responsive to the issue of how equally the
world is copossessed
Commentary on Lim et al.: Real-world e-cigarette use under prescription-only regulation
No full text"Prescription-only access to e-cigarettes has been proposed as a regulatory compromise that could restrict youth uptake while enabling access for smoking cessation. Evidence from Australia’s experience suggests that this model neither prevented experimentation among never-smokers nor facilitated the widespread use of regulated products for cessation, instead shifting use toward unregulated supply channels.
Private Finance for Nature-based Solutions in Developing Countries: A Study of Kenya with Perspectives from Costa Rica
No full textThe global climate finance gap is substantial. Despite the recognized potential of nature-based solutions (NbS) for climate action, they remain critically underfunded, with more than 80% of the estimated funding coming from public sources. This contrasts sharply with broader climate finance figures, where the majority comes from private sources. Although policymakers advocate for an increased role of the private sector in addressing policy challenges, the topic of private climate finance remains underexplored, especially in developing nations.
This thesis examines the dynamics of private climate finance deployment for NbS in three empirical cases in Kenya, drawing on insights from Costa Rica’s Payment for Ecosystem Services programme and other NbS initiatives in the country. How are private climate finance and NbS conceptualised within the UNFCCC, and how are they, in turn, translated at the national level in Kenya and Costa Rica? How is private climate finance currently deployed for NbS? How do the roles and drivers of private climate finance shape NbS implementation? What are the barriers to and enablers of private climate finance for NbS? To what extent does private climate finance for NbS support the achievement of the Paris Agreement Goals and the broader transition toward sustainability?
The empirical cases highlight the emergence of voluntary carbon markets as a dominant financing instrument for NbS. The study reveals the need for a more nuanced understanding of private climate finance flows, especially in terms of financing sources. The analysis suggests that examining the beneficiaries of the ecosystem services provided by the NbS helps clarify the roles and motivations of private actors, as well as their potential financial contributions. Costa Rica’s state-centred approach demonstrates that public climate finance can be effective in supporting NbS, but also highlights potential limitations in attracting private investment. At a broader level, the study reveals the various ways in which private actors engage with NbS