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Protein kinase A signaling regulates immune evasion by shaving and concealing fungal β-1,3-glucan
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320770.pdf (Publisher’s version ) (Open Access
How Can Labor Migration Policies Help Tackle Europe’s Looming Skills Crisis?
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320808.pdf (Publisher’s version ) (Open Access)34 p
Co-delivery of antigen and adjuvant by site-specific conjugation to dendritic cell-targeted Fab fragments potentiates T cell responses
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320841.pdf (Publisher’s version ) (Open Access
Automated detection and classification of osteolytic lesions in panoramic radiographs using CNNs and vision transformers.
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320282.pdf (Publisher’s version ) (Open Access)BACKGROUND: Diseases underlying osteolytic lesions in jaws are characterized by the absorption of bone tissue and are often asymptomatic, delaying their diagnosis. Well-defined lesions (benign cyst-like lesions) and ill-defined lesions (osteomyelitis or malignancy) can be detected early in a panoramic radiograph (PR) by an experienced examiner, but most dentists lack appropriate training. To support dentists, this study aimed to develop and evaluate deep learning models for the detection of osteolytic lesions in PRs. METHODS: A dataset of 676 PRs (165 well-defined, 181 ill-defined, 330 control) was collected from the Department of Oral and Maxillofacial Surgery at Charité Berlin, Germany. The osteolytic lesions were pixel-wise segmented and labeled as well-defined or ill-defined. Four model architectures for instance segmentation (Mask R-CNN with a Swin-Tiny or ResNet-50 backbone, Mask DINO, and YOLOv5) were employed with five-fold cross-validation. Their effectiveness was evaluated with sensitivity, specificity, F1-score, and AUC and failure cases were shown. RESULTS: Mask R-CNN with a Swin-Tiny backbone was most effective (well-defined F1 = 0.784, AUC = 0.881; ill-defined F1 = 0.904, AUC = 0.971) and the model architectures including vision transformer components were more effective than those without. Model mistakes were observed around the maxillary sinus, at tooth extraction sites, and for radiolucent bands. CONCLUSIONS: Promising deep learning models were developed for the detection of osteolytic lesions in PRs, particularly those with vision transformer components (Mask R-CNN with Swin-Tiny and Mask DINO). These results underline the potential of vision transformers for enhancing the automated detection of osteolytic lesions, offering a significant improvement over traditional deep learning models
Behavioral Analysis of a Digital Twin using Logging and Model Learning
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321062.pdf (Publisher’s version ) (Open Access)14 p
How do undergraduate medical students use the annotation option of a video feedback system when recording consultations with real patients; a qualitative document analysis.
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320052.pdf (Publisher’s version ) (Open Access)BACKGROUND: Observation during clerkships is challenging for clinical supervisors. Using a video feedback system (VFS) to record consultations with a patient, facilitates asynchronous feedback. Within this system it is also possible to add annotations, linked to a timeline. Learners are facilitated to share both recordings and annotations with others, who can provide feedback at a self-selected moment. METHODS: A qualitative document analysis on the content of annotations from 23 medical students has been conducted to explore how they use the annotation option in a VFS during their first clerkship. Thematic analysis was chosen as an inductive strategy. RESULTS: Thirteen students opted to share their videos for feedback, while ten chose not to. The main themes were "content", "labeling video fragments" and "responses to shared annotations". Subthemes within the theme "Content" were 'Typing', 'Empathy', 'Directing' and 'Communication and communications skills'. Students were critical of themselves, but tempered their feedback by mitigating language. Many students made concise notes to their recordings, without adding questions or interpretations. The provided feedback was carefully phrased and alternatives were formulated. CONCLUSION: Students apply "feedback principles" as they have learned from prior training. Alternatives were carefully constructed. It seems they also assess themselves using short notes similar to items of assessments scales. Their tendency to temper their feedback and not always share the videos with others, may indicate the need for a safe learning environment, as a prerequisite for using a VFS. Considering the diligence in feedback provision and varied topics addressed, the use of a VFS seems to be a good way to provide asynchronous feedback on communication skills during clerkships, offering instructors increased observation opportunities and the chance to facilitate peer feedback
Safety and Feasibility of Pulsed Electric Field Ablation for Early-Stage Non-Small Cell Lung Cancer Prior to Surgical Resection.
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320709.pdf (Publisher’s version ) (Open Access)BACKGROUND AND METHODS: Surgery remains the standard of care for non-small cell lung cancer (NSCLC) but is applicable to ≤ 30% of patients. Pulsed Electric Fields (PEF) ablation uses short-duration, high-voltage electrical pulses to induce cell death without relying on thermal mechanisms. Safety findings are reported from a two-arm, non-randomized, study evaluating the use of PEF in patients with early-stage NSCLC. METHODS: PEF energy was delivered bronchoscopically or percutaneously to 36 patients with suspected or confirmed early-stage NSCLC approximately 20 days before resection; 8 control patients had biopsy only. The primary safety analysis was the device and/or procedure related serious adverse events (AEs) rate from PEF procedure through resection. Immunohistochemical evaluation of resected tissue was also assessed. RESULTS: PEF was delivered to all patients in the treatment group after biopsy of targeted tumor. No device or procedure-related AE were observed. Histopathological assessment of resected tumors demonstrated a cellular depletion zone characterized by decrease or absence of tumor cellularity and a variable degree of inflammation. Tertiary lymphoid structures were observed within PEF-treated tumors. CONCLUSIONS: These clinical observations and histopathologic tissue alterations, indicate that PEF energy delivery is feasible and safe in NSCLC, with potential signals of immune system activation.01 juni 202
Effects of the after deployment adaptive parenting tools intervention on social functioning in veterans and their partners: A pilot study
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320414.pdf (Publisher’s version ) (Open Access)Deployment-related PTSD can negatively impact social functioning in veteran families. Individualized PTSD-focused therapy does not consistently lead to improved social functioning. Addressing social difficulties more directly in these families is thus important. The goal of this study was to conduct an observational pilot of the clinical effectiveness of after deployment adaptive parenting tools (ADAPT), a parenting intervention for veterans and their partners. Participants were recruited at Psychotrauma Center South Netherlands of Reinier van Arkel, an institute of psychiatric care in The Netherlands. Social functioning (family functioning, parent reported child functioning, parental attachment) was assessed at baseline, 4-month post-baseline (end-of-treatment), and 10-month post-baseline. Veteran outcomes in ADAPT were compared with outcomes for veterans undergoing treatment as usual (TAU) consisting of individualized PTSD treatment. Emotion regulation and mentalization were tested as possible mediators of effect. Results showed a direct and sustained reduction in perceived posttreatment family dysfunction in veterans, and preliminary evidence of a decrease in perceived family dysfunction in partners at 10-month post-baseline. Although veterans in both ADAPT and TAU groups received PTSD therapy and reported a reduction in PTSD symptoms, only the ADAPT group showed enhanced family functioning. No significant effects were found on child functioning and parental attachment. No mediation effects were found for emotion regulation and mentalization. Low statistical power may explain the lack of significant findings. This study provides initial evidence of ADAPT's clinical effectiveness in improving family functioning, yet future research should examine the mediating processes, preferably using longer time frames with more follow-up measurements.10 p
Instrument design and performance of the first seven stations of RNO-G
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318593.pdf (Publisher’s version ) (Open Access