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A Semi-automatic Approach for Minimizing Expert Annotations in Medical Image Segmentation
No full textDeep learning excels in medical imaging segmentation but requires extensive annotated data. To reduce reliance on expert labeling, we propose a semi-automatic method, where a small subset of the available data is annotated to train a model. The model then generates pseudo-annotations for the remaining data, refining the model iteratively until no further improvement is observed. We demonstrate the method’s effectiveness by training models on the Kvasir-Seg and Breast Ultrasound Images Dataset using SegFormer and U-Net architectures. With only 30% of the annotated data, our method achieves at least 90% of the accuracy of models trained on the full dataset. We also propose a method to estimate optimal data annotation using the model’s entropy measure
2025 Advances in Brain Health: Brain Health as Capital for Vascular and Cognitive Resilience
No full textDeep Convection‐Driven Downward Transport of Trace Gases and Aerosols From the Free Troposphere to the Boundary Layer
No full textDeep convective clouds regulate Earth's energy and moisture budgets, yet their impact on the atmospheric boundary layer (BL) composition remains underexplored. Using long‐term observations from three mid‐latitude sites, we show that deep convection (DC) consistently enhances nighttime surface ozone and is often accompanied by modest increases in ultrafine particle concentrations. Within the BL, the condensational growth of these transported ultrafine particles may contribute up to 60% of total cloud condensation nuclei (CCN). Mass flux calculations suggest that short‐lived convective cores (∼30 min) account for ∼2% of total vertical air mass transport relative to steady entrainment, increasing to ∼13% when the trailing stratiform regions are included. These results show that DC provides an episodic but efficient pathway linking the free troposphere and BL, influencing oxidant budgets, CCN variability, and climate forcing. Accurately representing this process in climate models may help reduce uncertainties in climate projections, under both preindustrial and present‐day conditions. Plain Language Summary Thunderstorms can move air quickly between the upper and lower parts of the atmosphere. Using long‐term data from three different locations, we found that these storms can bring ozone and tiny airborne particles from high up in the sky down to the ground in just a few minutes. Even though such storms do not occur very often, when they do, they move air downward much faster than other mixing processes. Including this kind of storm‐related mixing in climate models can help us better understand how ozone and small particles are distributed near the ground and how these conditions change over time. Key Points Deep convection can enhance near‐surface ozone and ultrafine particle concentrations via rapid downward transport from the free troposphere Convective cores and the trailing stratiform can contribute to the vertical air mass transport from the free troposphere to the boundary layer Condensational growth of transported ultrafine particles may contribute to over 60% of cloud condensation nuclei under clean condition
Real-World Comparison of Overall Survival Among Patients With and Without Inherited Retinal Diseases
No full textThis study compared real-world overall survival and the risk of physical comorbidities and mental health conditions among patients aged <65 years with versus without inherited retinal diseases (IRDs) in the United States (US). Optum® Electronic Health Record data (January 2014–January 2023) were evaluated for IRD (patients with ≥2 medical visits with an IRD diagnosis; index date: second such medical visit) and non-IRD (patients without an IRD diagnosis; index date: random medical visit) cohorts. Baseline demographics were balanced between cohorts using propensity score matching (2:1). Outcome measures were overall survival (date of death due to any cause) and presence of physical comorbidities and mental health conditions (medical visit with a corresponding diagnosis code). In total, 4594 patients with IRD were matched to 9188 patients without IRD (mean age: 38.7 vs. 38.2 years, 53.9% vs. 55.1% female, mean follow-up: 53.1 vs. 52.8 months). Over 84 months, patients with versus without IRD had a 24% higher risk of death (overall survival: 95.8% vs. 96.7%; hazard ratio: 1.24; 95% confidence interval: 1.00–1.53; p = 0.046) and were at significantly higher risk for each evaluated physical comorbidity and mental health condition (all p < 0.05). The development of novel therapies is thus needed to address the clinical burden of IRD
Behind the Curtain: Consensus Recommendations to Support University-Level Performing Arts Students' Return to the Stage After Concussion
No full textPerforming artists are at risk of head injuries, such as falling from an elevated surface, partner stunting, collisions with other performers or equipment, and/or tripping because of low ambient lighting. However, contemporary clinical guidelines have not addressed the demands of university-level performing arts students. Furthermore, current return-to-learn strategies do not take into consideration the physical aspects of performance-specific skillsets. The purpose of this study was to develop consensus on appropriate postconcussion recommendations to support university-level performing arts students returning to dance, music, and theater performance.
Prospective panelists were recruited using targeted emails from May to June 2024, to participate in a study using the modified Delphi technique. During round 1 of the Delphi process, panelists responded to open-ended questions on how to adapt the International Concussion in Sport Group's 2022 return-to-sport strategy to address the needs of university performing arts students. The research team conducted constant comparative qualitative analysis to generate statements to be voted on during the subsequent rounds. In round 2, panelists anonymously rated each statement using a 9-point scale (1 = not at all important, 9 = very important). During round 3, panelists received the aggregate group scores with their individual scores from round 2 with the option to modify their responses if desired. Consensus was established if statements achieved average scores ≥7 after the final round.
Twenty-one panelists (mean age = 41.9 ± 11.6 years; 71.4% female) enrolled in a 3-part Delphi study from May to December 2024. They included university-affiliated clinicians (n = 5), concussion researchers (n = 5), performing arts faculty/staff (n = 7), and students/alumni with concussion history during their university performing arts training (n = 4). Following the Delphi process, the panel agreed on 101 of the initial 189 statements (53.4%) resulting in the Progressive Return-to-Performance Protocol (PRTPP), a stepwise approach supporting safe return to dance (n = 26), music (n = 36), and theater performance (n = 39) after concussion.
The recommendations generated herein include considerations for participating with other performers, using stage equipment/props, increasing performance endurance, and reintroducing environmental stimuli (e.g., costumes, lighting, amplifiers, or instruments). The proposed PRTPP serves as a framework to guide university-based medical and academic teams when developing individualized postconcussion management plans for performing arts students
Optimal maternal feeding isotopic niche: influence of breeder trophic behaviour on larval growth and survival in bluefin tuna species
No full textMaternal effects play a fundamental role in shaping early larval growth and survival in marine fishes. This study explores the relationship between maternal trophic ecology and larval growth in bluefin tunas, with a focus on Southern Bluefin Tuna (SBT) and an expanded dataset from multiple Atlantic Bluefin Tuna (ABT) populations incorporated into the General Bluefin Model (GBM). Daily growth and stable isotopes (δ15N and δ13C) were obtained from 80 pre-flexion SBT larvae and 355 pre-flexion larvae from the GBM dataset. Results revealed a significant negative linear trend between larval age and δ15N values, consistent with the gradual attenuation of maternally inherited isotopic signatures during development. Faster growing larvae showed significantly lower δ15N and δ13C values, indicating that maternal trophic behaviour and prey sources critically influence larval growth potential. Maternal isotopic niche breadth, inferred from larval isotope data, was markedly narrower in groups with optimal larval growth, suggesting that specialized (stenophagous) maternal feeding strategies promote enhanced offspring performance. These patterns were observed consistently in two bluefin species across seven different populations, despite geographic and temporal variability, highlighting a robust ecological link between maternal foraging behaviour and larval development. From these findings, we introduce the hypothesis of an Optimal Maternal Feeding Isotopic Niche, representing a constrained isotopic range associated with increased larval growth and survival. This framework advances our understanding of the influence of maternal trophic ecology on offspring fitness and offers valuable insights for the conservation and management of highly migratory pelagic species with complex reproductive strategies
Long‐Term Graft Survival and Visual Outcomes in Deep Anterior Lamellar Keratoplasty (DALK): A Narrative Review
No full textDeep anterior lamellar keratoplasty (DALK) selectively replaces the scarred or diseased corneal stroma, while preserving healthy endothelium, thus providing an alternative to penetrating keratoplasty (PK) for patients with stromal disorders. Despite its recognized advantages, DALK has not become as widely adopted as anticipated over the past decades. The satisfactory visual outcomes of PK, the lack of standardized DALK techniques, as well as the limited long‐term data on visual and refractive outcomes for both DALK and PK are commonly cited as barriers to its broader implementation. Evidence from long‐term studies indicates that DALK offers superior graft survival and provides a safer intraoperative profile with fewer complications and lower endothelial cell loss, making it the preferred option for stromal diseases with healthy endothelium
Improving guitar strumming mechanics in Parkinson’s disease: A case series using a forearm stabilization device
No full textImaging of Ocular Surface Lesions Using Anterior Segment Optical Coherence Tomography
No full textOcular surface lesions encompass a wide spectrum of entities ranging from benign degenerative lesions to non-invasive and invasive malignant tumours. Accurate clinical differentiation is essential to ensure timely management. In this manuscript, we describe a series of benign and malignant ocular surface lesions and their clinical and specific imaging findings on anterior segment optical coherence tomography (AS-OCT), highlighting the diagnostic utility of this non-invasive imaging modality. We characterise ocular surface squamous neoplasia, pterygia, Salzmann's nodular degeneration, conjunctival melanoma, primary acquired melanosis, conjunctival nevus, conjunctival lymphoma, benign reactive lymphoid hyperplasia and conjunctival amyloidosis. This series underscores the growing role of AS-OCT in supporting clinical assessment, guiding biopsy decisions and monitoring response to therapy in patients with ocular surface lesions. Its integration into routine practice offers a valuable, non-invasive supplement to slit-lamp biomicroscopy and histopathology
Cultivating Calm: Enhancing Resilience in Nursing Students Through Guided Meditation
No full textDoctoral nursing students experience high stress levels and mental health challenges, impacting resilience and professional readiness. Teaching wellness practices is essential to support student well-being and retention. High rates of stress and attrition among new nurses highlight the need for wellness-focused education, yet traditional teaching methods may not effectively promote self-care and stress reduction. Guided by Kolb's Experiential Learning Theory and the American Association of Colleges of Nursing Essentials Domain 10, this practice improvement project involved evaluation of a 40-minute guided meditation for Doctor of Nursing Practice students. The intervention included breath work, emotional grounding, and cognitive recentering. Using a pre-posttest design, 39 participants reported significantly reduced stress (P < .001) and increased relaxation (P < .001). Nearly all endorsed benefits to personal well-being and recommended future integration. Findings suggest experiential meditation fostered resilience and self-care, offering nurse educators a practical strategy to enhance student wellness, professional development, and workforce sustainability.Doctoral nursing students experience high stress levels and mental health challenges, impacting resilience and professional readiness. Teaching wellness practices is essential to support student well-being and retention. High rates of stress and attrition among new nurses highlight the need for wellness-focused education, yet traditional teaching methods may not effectively promote self-care and stress reduction. Guided by Kolb's Experiential Learning Theory and the American Association of Colleges of Nursing Essentials Domain 10, this practice improvement project involved evaluation of a 40-minute guided meditation for Doctor of Nursing Practice students. The intervention included breath work, emotional grounding, and cognitive recentering. Using a pre-posttest design, 39 participants reported significantly reduced stress (P < .001) and increased relaxation (P < .001). Nearly all endorsed benefits to personal well-being and recommended future integration. Findings suggest experiential meditation fostered resilience and self-care, offering nurse educators a practical strategy to enhance student wellness, professional development, and workforce sustainability