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Endoscopic papillectomy for laterally spreading lesions of the papilla : a propensity score-matched analysis
No full textBackground Endoscopic papillectomy is a standard treatment for ampullary lesions, which are typically small and confined to the papillary mound. Laterally spreading lesions (LSLs) of the papilla of Vater are a rare ampullary lesion subtype involving extensive duodenal mucosa. Data on endoscopic papillectomy outcomes for LSLs are limited. This study compared endoscopic papillectomy for ampullary LSLs and non-LSLs in matched cohorts. Methods The ESAP study (Endoscopic papillectomy vs. Surgical Ampullectomy vs. Pancreaticoduodenectomy for ampullary neoplasm) encompassed 1422 endoscopic papillectomies. Propensity score matching used the nearest-neighbor method for age, sex, co-morbidity, and histologic subtype as cofactors. The main outcomes were complete resection (R0), technical success, complications, and recurrences. Results Propensity score-based matching identified 232 patients with ampullary lesions (116 non-LSL, 116 LSL) with comparable baseline characteristics. After first intervention, the R0 resection rate, the primary outcome measure, was significantly lower in the LSL group (54.3% [95%CI 45.3%–63.1%]) vs. 69.0% [95%CI 60.4%–76.6%]). Following repeated endoscopic interventions, technical success was similar in both groups (82.8%). After a 22-month median follow-up, the LSL group had significantly more recurrences (41.3% vs. 15.0%) and lower 1- and 3-year disease-free survival rates (61.1% and 44.0% vs. 86.1% and 81.6%, respectively). Complication rates did not differ significantly between the two groups (LSL 32.8% vs. non-LSL 26.7%). Conclusion LSLs can be safely resected by endoscopic papillectomy, although repeated interventions are necessary to achieve complete resection. The higher risk of recurrence in LSLs necessitates a vigilant surveillance strategy
Challenges in managing driving licence legislation when using B-Phosphatidylethanol to identify high levels of alcohol use in primary care patients : A qualitative study
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Probabilistic parameter estimation and uncertainty quantification of mode I fracture in wood
No full textThe characterisation of wood’s fracture behaviour is a challenging task due to its inherently complex microstructure and natural variability. Consequently, to accurately model wood for engineering applications, deterministic input parameters are rarely sufficient in, for example, finite element models; the stochastic nature of the material must be considered. In the present work, we aim to quantify the variability in the fracture behaviour of two wood species: Norway spruce, which is commonly used for structural purposes in Europe, and birch, which could be an advantageous complement to Norway spruce, mainly thanks to its stiffer and stronger mechanical properties. The fracture behaviour is characterised through the three parameters that govern a material’s brittleness: the stiffness, the strength and the specific fracture energy. By formulating a parameter estimation problem based in probability theory, we use Bayesian optimisation to estimate statistical distributions of the fracture parameters of interest. These distributions are multi-variate distributions and thus contain information about the mean values, variability and dependence among the parameters. It is shown that by using random samples from the acquired distributions as input parameters to finite element models, variability observed in experimental testing is recovered well
A distinct lineage pathway drives parvalbumin chandelier cell fate in human interneuron reprogramming
No full textDirect lineage reprogramming of glial cells to induced neurons has the potential for restoring brain circuits and function in neuronal disorders and states. We introduce three-dimensional (3D) human glia reprogramming into neurons with a GABAergic interneuron phenotype using stem cell-derived human glia. Single-nucleus RNA sequencing of the converted cells demonstrates distinct neuronal clusters within 2 weeks, including a parvalbumin (PV) cluster with high neuronal maturity and features of chandelier interneurons. A lineage trajectory analysis of the glia-to-neuron conversion reveals a distinct lineage pathway to PV chandelier fate, including various neuronal developmental stages and the establishment of synaptic machinery. This analysis reveals PV fate-important genes that are previously unknown to neural reprogramming with promising functional importance for future derivations. Our data demonstrate successful human glia conversion into interneurons with features of bona fide PV subtype and highlight the reprogramming trajectory with key transitional genes. This advancement holds promise for future human brain cell engineering and repair
Artificial intelligence and corporate ideation systems
No full textMany companies leverage the creativity of their employees to gather ideas for innovations. These ideas are collected, saved, and evaluated via platforms known as corporate ideation systems. Moderated ideation systems (ideation 2.0) emerged as a solution to address the limitations of traditional, rather passive ideation systems (ideation 1.0). In this study, we apply a qualitative mixed-method approach (literature review, company case studies, expert interviews, and focus group workshops) to examine how artificial intelligence (AI) technology may relieve the remaining pains of stakeholders in collaborative, moderated ideation systems. This leads to a new framework of corporate ideation systems, termed AI-based ideation systems (ideation 3.0). We identify five major pains suffered by stakeholders in today's moderated ideation systems: creativity pain, content formulation pain, search pain, analytical pain, and administration pain. We find that AI agents act as pain relievers when serving five supporting functions: inspirer, stylist, matchmaker, analyst, and organizer. The interconnected nature of pains means that employing AI agents in certain functions within corporate ideation systems can create positive externalities across the entire system. Practical insights into AI agent implementation and application in corporate ideation systems are provided by six mini-case studies, which lead to the proposition of two organizational principles: the contextualization of AI usage and the generalization of AI implementation as the requirements for successful ideation 3.0
Improving evapotranspiration estimation by integrating process-based biophysical variables into a deep learning approach
No full textStudy Region 103 FLUXNET2015 flux towers distributed across diverse climatic and ecological regions. Study Focus Accurate estimation of evapotranspiration (ET) is critical for understanding regional ecohydrological processes. Physically based models such as the Penman-Monteith-Leuning (PML) model are robust but often constrained by fixed parameterization schemes, while data-driven approaches such as Long Short-Term Memory (LSTM) networks can capture nonlinearities but depend heavily on training data. To address these limitations, this study developed a hybrid model (PML-LSTM) by integrating biophysical variables from PML simulation into LSTM network. Model performance was systematically evaluated against standalone PML and LSTM across three modelling levels: local (site), type (vegetation type), and group (forest and non-forest). New Hydrological Insights for the Region The PML-LSTM model achieved superior performance, with median NSE values of 0.851, 0.913, and 0.933 during validation, surpassing both the PML model (0.843, 0.788, 0.766) and the LSTM model (0.818, 0.879, 0.873). Integrating biophysical information in the PML-LSTM model improved ET estimation accuracy and model generalization, leading to more robust spatiotemporal performance under leave-one-out cross-validation and extreme weather extrapolation experiments. Distinct model behaviors emerged under varying sample conditions: the PML model exhibited greater robustness under data-scarce conditions at the local level, while the LSTM and PML-LSTM models benefited from larger training datasets. This study highlights the potential of combining process-based and data-driven approaches to improve ET estimation and provides insights for regional ecohydrological modelling
Exploration of Flow-Cytometric Methods for the Study of Dyserythropoiesis. A book of Science, Fiction, and Greek Philosophy.
No full textFact-checkers Perception on Social Media Governance Models to Combat Disinformation : Insights from a European Qualitative Study
No full textDisinformation is growing rapidly on social media, driven by evolving tactics. Meanwhile, the shift towards community-based fact-checking has raised concerns among fact-checking organizations. This study aims to explore fact-checkers’ perceptions of changes in social media governance models to counter disinformation. Based on qualitative interviews with European fact-checkers, the study reveals that, while community-based fact-checking is seen as a valuable complement to third-party models, it is not viewed as a standalone solution. Fact-checkers value concise labelling formats like contextual notes, but express concerns around transparency—especially from platforms—and growing distrust in their institutions. This paper contributes by (1) providing empirical insights into how European fact-checkers perceive the emergence of community-based fact-checking, (2) describing legitimacy and transparency challenges in an era of growing distrust of fact-checking, and (3) offering future directions for social media governance models. European fact-checkers call for an adaptive, multi-level governance to counter disinformation in the evolving landscape
Symptoms and Diagnoses Prior to Suicide in Children and Young Adults—A Swedish Medical Record Review
No full textSuicide in children and young adults is a leading cause of premature mortality, and there is a need to develop a more profound understanding of the factors that contribute to these deaths. This study is part of the nationwide Retrospective Investigation of Health Care Utilization in Individuals who died by Suicide in Sweden 2015, conducted at Lund University, Sweden. The aim was to examine symptoms and diagnoses in children and young adults who died by suicide, as documented in their medical records at their last visits for primary care, somatic specialist care, or psychiatric care 24 months prior to suicide, and to apply contemporary psychological research in youth suicidality to the findings to formulate clinical implications. The proportions of symptoms and diagnoses in children (0–17 years), young adults (18–24 years), males, and females are described. The main symptoms noted in the cohort were depressive symptoms (28%), anxiety symptoms (26%), and pain (25%). The diagnoses predominately covered mental and behavioural disorders, and the most frequent of the mental and behavioural diagnoses were neurotic, stress-related, and somatoform disorders (32%) and mood (affective) disorders (29%). The diagnoses and symptoms were not sufficient to uncover suicidality in children and young adults. The clinical implications for alternative assessments and preventive interventions are discussed