Early Descriptions Research Articles

Selective Sentinel Node Dissection in Melanoma with Trends and Future Directions

Starting with its earliest descriptions, melanoma has been recognized as a tumor with a predilection for metastasis to regional lymph nodes. This tendency led to initial recommendations for very aggressive early surgical management of the regional nodal basin. However, those recommendations were the source of much controversy over nearly a century, until the minimally invasive surgical technique of sentinel lymph node (SLN) biopsy was developed by Morton, Cochran and colleagues. This technique has been evaluated in a series of prospective clinical trials, which have clarified its role and the management of lymph nodes in this disease. Current controversies relating to SLN biopsy include optimal selection of patients for the procedure, the role of gene expression profiling in initial melanoma management, and the potential therapeutic effects of SLN biopsy-based management. In addition, the SLN appears to be a rich source of data relating to the host–tumor interface and the immune microenvironment, which may advance our understanding of the biology of melanoma. Finally, although the surgical technique is well developed at this point, there may be additional technical improvements that are possible as well.

Lithium-ion battery future degradation trajectory early description amid data-driven end-of-life point and knee point co-prediction

This study develops a novel lithium-ion battery future degradation trajectory early description method amid data-driven end-of-life (EOL) point and knee point (KP) co-prediction. Inspired by the concept of KP, the proposed method firstly employs two-stage curve fitting to offline locate KP with minimization total absolute error between the original trajectory and fitted secants as object. Secondly, from partial multi-step fast-charging curves lying in high state-of-charge (SOC) level with only approximately 0.09 SOC interval, our method mines three new aging-dependent features for EOL and knee cycle co-prediction via two optimized Gaussian process regression models. Afterwards, considering the highly linear characteristics of slow degradation stage, knee capacity is further calculated by the linear function fitted via early capacity degradation sequence. Finally, with early capacity degradation sequence, predicted KP and predicted EOL point, the developed method adopts piece-wise cubic Hermite interpolating polynomial to directly generate future degradation trajectory. The verification results using a 140-cell aging dataset demonstrate that the proposed method is powerful for future degradation trajectory early prediction with high accuracy and extremely low real-time computational cost, where most root-mean-square-error and mean-absolute-percentage-error of trajectory prediction results are below 0.03 Ah and 3%, respectively. Our work, for the first time, reveals the possibility of feature extraction from partial multi-step fast-charging curves, and also provides a low-complexity universal framework for accurate future degradation trajectory early prediction.

Risk of thromboembolism after intraosseous implantation of metallic devices with extracellular vesicles derived from multipotent stromal cells: preliminary results

Background. New implantation methods are of great importance due to the development of endoprostheses in traumatology and orthopedics, restorative medicine and dentistry. Equally important is the early detection and description of the implant-associated complications. The aim of the study is to find and describe thrombi and emboli in the heart and lungs formed after experimental implantation of metallic devices in the peripheral part of limb using extracellular vesicles of mesenchymal stromal cells. Methods. Outbred rabbits of both genders at the age from 4 to 6 months and of weight from 3 to 4 kg underwent experimental implantation. The study enrolled 57 species in total. They were divided into two groups: 30 animals underwent implantation of metallic devices using extracellular vesicles of mesenchymal stromal cells (EV MSCs), 27 — without their use. The rabbits’ hearts and lungs were studied by light microscopy methods at different stages after integration of screw titanium implants into the proximal condyle of the tibia using EV MSCs. Results. After implantation of metallic devices into the proximal condyle of the tibia, we detected fibrin, detritus and even the red bone marrow structures (various blast forms of hematopoietic cells: megakaryocytes, cells of the erythroid and myeloid lineages) in the right cavities of the heart. In the pulmonary arteries, we also found thrombi and emboli, which either led to the obliteration of the involved vessel or to gradual lysis, not disappearing completely within 10 days of follow-up. Conclusions. After intraosseous implantation of the metallic devices, there is an embolism risk in the right atria and ventricle of the heart and the pulmonary arteries and veins due to the debris migration with the bloodstream from the surgery site. At the same time, one cannot exclude a thrombotic risk in the heart and pulmonary arteries as a reaction to the presence of detritus. It is advisable to take measures aimed at preventing both debris releasing into the bloodstream and pulmonary embolism during any implantations into the bone tissues, even of relatively small devices. Using EV MSCs to affect the implant engraftment processes has no significant effect on the severity and frequency of thromboembolic complications.

Family Medicine Clerkship Directors' Perspectives on USMLE Pass/Fail Scoring: A CERA Study.

Reports on the effects of changing the United States Medical Licensing Exam (USMLE) Step 1 examination scoring to pass/fail are evolving in the medical literature. This Council of Academic Family Medicine Educational Research Alliance family medicine clerkship directors' study seeks to describe family medicine clerkship directors' perceptions on the impact of incorporation of Step 1 pass/fail score reporting on students' family medicine clerkship performance. Ninety-six clerkship directors responded (56.8% response rate). After exclusion of Canadian schools, we analyzed 88 clerkship directors' responses from US schools. We used descriptive statistics for demographics and responses to survey questions. We used ꭓ2 analysis to determine statistically significant associations between survey items. Clerkship directors did not observe changes in students' overall clinical performance after Step 1 pass/fail scoring (60.8%). Fifty percent of clerkship directors reported changes in Step 1 timing recommendations in the past 3 years. Reasons included curriculum redesign (30.5%), COVID (4.5%), change in Step 1 to pass/fail (11.0%), and other reasons (3.7%). Forty-five percent of these clerkship directors did not observe a change in students' clinical medical knowledge after Step 1 went to pass/fail. Eighty-four percent of these clerkship directors did not compare student performance on clerkship standardized exams before and after Step 1 score changes. We found no significant relationship between Step 1 timing and student performance. This study represents an early description of family medicine clerkship directors' perceived observations of the impact of Step 1 scoring changes on student performance. Continued investigation of the effects of USMLE Step 1 pass/fail scoring should occur.

Understanding the Concept of Being in general: From Being and Time back to Young Heidegger

This paper exhibits a way of understanding Heidegger’s concept of being in general [Sein überhaupt] – the central aim of Being and Time’s questioning – by getting insight into his early years. I argue that the term “being” [Sein] as Heidegger understands it in the early 1920s describes the meaningful relation between humans and the things of their surrounding world which is given to us as a fact. I maintain that Sein überhaupt refers to this fact, i.e., the fact that every particular being is always with a certain meaning for us. I come to this conclusion by exploring (1) Heidegger’s early analysis of Umwelterlebnis, (2) his early description of medieval transcendentia, (3) his critique of formalization and the introduction of formal indication. Lastly, (4) I observe the way Heidegger introduces the concepts of Sein and Sein überhaupt pointing to the simple fact of beings’ being in meaningful relation to us.

Statistical Scaling in Localization-Induced Failures

Abstract The investigation of statistical scaling in localization-induced failures dates back to da Vinci's speculation on the length effect on rope strength in 1500 s. The early mathematical description of statistical scaling emerged with the birth of the extreme value statistics. The most commonly known mathematical model for statistical scaling is the Weibull size effect, which is a direct consequence of the infinite weakest-link model. However, abundant experimental observations on various localization-induced failures have shown that the Weibull size effect is inadequate. Over the last two decades, two mathematical models were developed to describe the statistical size effect in localization-induced failures. One is the finite weakest-link model, in which the random structural resistance is expressed as the minimum of a set of independent discrete random variables. The other is the level excursion model, a continuum description of the finite weakest-link model, in which the structural failure probability is calculated as the probability of the upcrossing of a random field over a barrier. This paper reviews the mathematical formulation of these two models and their applications to various engineering problems including the strength distributions of quasi-brittle structures, failure statistics of micro-electromechanical systems (MEMS) devices, breakdown statistics of high– k gate dielectrics, and probability distribution of buckling pressure of spherical shells containing random geometric imperfections. In addition, the implications of statistical scaling for the stochastic finite element simulations and the reliability-based structural design are discussed. In particular, the recent development of the size-dependent safety factors is reviewed.

Historical Perspectives of Parkinson's Disease: Early Clinical Descriptions and Neurological Therapies

Historical Perspectives of Parkinson's Disease: Early Clinical Descriptions and Neurological Therapies

The nucleosome reference frame and standard geometries for octasomes.

There are over 533 nucleosome structures in the Research Collaboratory for Structural Bioinformatics (RCSB). Collectively, numerous variants and species are present, as are sub-nucleosomal and super-nucleosomal assemblies within the nucleosome family. The organization of the histones and DNA is highly conserved in all standard octasomes containing 145, 146, or 147 base pairs. This observation is used to establish a nucleosome reference frame that enables us to describe and compare the gross structure and organization of all nucleosomes. We observe that cumulative sums of Rise, Twist, and DNA arc length are linear functions of the base pair index with values exceeding 0.999 for almost all octasome structures. These relationships enable us to readily compare the location and orientation of DNA director frames extracted from the crystal structures to ideal superhelix values. Such comparisons reveal that the DNA superhelix extracted from X-ray structures exhibits a sinusoidal variation with an amplitude of approximately 5Å about a constant superhelix radius of Å, in agreement with early descriptions of nucleosome organization as tripartite. There is also a distinct straightening of the nucleosomal DNA over the outermost turn of DNA's double helix. The straightening of the DNA superhelix marks the transition to linker DNA and is easily recognized as a rapid increase in superhelix radius and is concomitant with a change in pitch. This provides a rigorous means of separating nucleosomal DNA from linker DNA. For all X-ray structures, we find that near the dyad, there exists a set of DNA director frames for which the spatial location and orientation are highly conserved. Away from the dyad, the DNA superhelix exhibits "singletrack" and "multipath" regions. In the singletrack region, all structures exhibit a single highly conserved pathway along which all base pairs must track, but at varying rates. In the multipath regions, the base pairs are allowed to map out a limited number of different pathways along the surface of the histone octamer. To demonstrate the utility of the proposed reference geometries, standard and distorted octasome structures, super-nucleosomal structures, nucleosomes with linker DNA, and nucleosomes in closed circular DNA are analyzed. The online version contains supplementary material available at 10.1007/s12551-024-01206-5.

François Rabelais and his dystonic giants.

Spasmodic torticollis was an early designation used for cervical dystonia. The origin of this name is attributed to French physician and writer François Rabelais in the mid-sixteenth century. This early description of torticollis in the book Pantagruel was an inspiration for the understanding of cervical dystonia. The art expressed in Rabelais' literature ‒ which was immortalized by the drawings of Gustave Doré ‒ influenced poetry, art, and photography, and led to the adoption of the term torticollis in the neurological sciences.

SHARIA MICROFINANCE MODELS: A GRAMEEN BANK APPROACH FOR SUSTAINABLE CONSTRUCTION AND WELFARE ENHANCEMENT

This research aims to build a model for strengthening Sharia microfinance through an adapted Grameen Bank replica based on the pillars of leadership, collaboration, spirituality, and women's freedom. This research used a quantitative method to analyze a Grameen Bank replica or build a model for strengthening Sharia microfinance. It provides an early description of the model's independent and dependent variables using Path Investigation and Structural Equation Modeling (SEM). Data were gathered through participatory observation methods, interview techniques, and the distribution of SEM questionnaires to MFI managers and beneficiary customers. The findings indicate a link between the influence of the Grameen Bank-based Islamic Microfinance Institution system on partners in terms of leadership, cooperation, economy, community, and spirituality, as well as alternative strategies for strengthening Grameen Bank-based MFIs in improving the welfare of women's microbusiness groups. This research encourages more attention and implementation of Islamic microfinance models in an effort to improve social and economic welfare, especially among vulnerable groups such as women micro-entrepreneurs.

Local Action, Global Impact: Acute Appendicitis as a Metric for Surgical Care Quality

Throughout history, renowned clinicians, anatomists, and researchers have endeavoured to understand acute appendicitis over the course of two millennia. Galen referred to the condition as "colic passion," while the eminent anatomists Vesalius and Fallopius both made early descriptions of the human appendix. In the absence of effective operative techniques, treatment methods were limited, with Boerhaave advocating heated bowel washouts, compression, and bloodletting. It wasn't until the early eighteenth century that English and French surgeons described the operative removal of the human appendix.

A ‘sea monster’ depicted in the 1585 map of Iceland may exemplify spy-hopping behaviour in cetaceans

While there is a long history of misidentifying whales as sea monsters, historical maps and anecdotes can provide early depictions and descriptions of cetacean biology. For example, the map of ‘Islandia’ [Iceland] reproduced by Abraham Ortelius (1527–1598) in numerous printings of his atlas Theatrum orbis terrarum has an array of sea monsters, including the ‘Staukul’, that was said to stand upright out of the water for extended periods. This may be the earliest portrayal of spy-hopping, a common behaviour in which whales elevate themselves above the water to observe their surroundings.

Analyzing recent trends in deep-learning approaches: a review on urban environmental hazards and disaster studies for monitoring, management, and mitigation toward sustainability

Abstract Deep learning has changed the approach of urban environmental risk assessment and management. These methods enable solid models for large data sets, enabling early identification, prediction, and description of environmental risks. The current work analyses the advances in deep learning for urban environmental hazard assessments and disaster studies to provide monitoring, management, and mitigation measures. It reports the improvement in self-supervised learning, transformer architectures, persistent learning, attention mechanisms, adversarial robustness, associated learning, meta-learning, and multimodal learning within the domain of urban environmental hazard analysis. These approaches allow the creation of robust models for handling vast data volumes, facilitating early detection, prediction, and characterisation of diverse environmental threats. This trends analysis for urban applications will bring insights for connecting deep-learning models for effective and proactive approaches to tackle urban environmental hazards and disasters.

The Beginnings of Attention Deficit in a Dutch 18th Century Medical Treatise

Objective: An early description, possibly the earliest, of attention deficit disorder in a 1753 Dutch medical book by Cornelius Kloekhof is presented. Method: The author of this text is briefly introduced and contextualized. The text is translated from Latin and afterwards, its impact on later scientific literature is discussed. Results and Conclusions: Kloekhofs description of attention deficit was one of the first and thoroughly inspired the subsequent literature, such as Adam Weikard, making this text an important moment in the rich history of ADHD.

The inseparability of context and clinical reasoning.

Early descriptions of clinical reasoning have described a dual process model that relies on analytical or nonanalytical approaches to develop a working diagnosis. In this classic research, clinical reasoning is portrayed as an individual-driven cognitive process based on gathering information from the patient encounter, forming mental representations that rely on previous experienceand engaging developed patterns to drive working diagnoses and management plans. Indeed, approaches to patient safety, as well as teaching and assessing clinical reasoning focus on the individual clinician, often ignoring the complexity of the system surrounding the diagnostic process. More recent theories and evidence portray clinical reasoning as a dynamic collection of processes that takes place among and between persons across clinical settings. Yet, clinical reasoning, taken as both an individual and a system process, is insufficiently supported by theories of cognition based on individual clinicals and lacks the specificity needed to describe the phenomenology of clinical reasoning. In this review, we reinforce that the modern healthcare ecosystem - with its people, processesand technology - is the context in which health care encounters and clinical reasoning take place.

Pathogen perception and signaling in plant immunity.

Plant diseases are a constant and serious threat to agriculture and ecological biodiversity. Plants possess a sophisticated innate immunity system capable of detecting and responding to pathogen infection to prevent disease. Our understanding of this system has grown enormously over the past century. Early genetic descriptions of plant disease resistance and pathogen virulence were embodied in the gene-for-gene hypothesis, while physiological studies identified pathogen-derived elicitors that could trigger defense responses in plant cells and tissues. Molecular studies of these phenomena have now coalesced into an integrated model of plant immunity involving cell surface and intracellular detection of specific pathogen-derived molecules and proteins culminating in the induction of various cellular responses. Extracellular and intracellular receptors engage distinct signaling processes but converge on many similar outputs with substantial evidence now for integration of these pathways into interdependent networks controlling disease outcomes. Many of the molecular details of pathogen recognition and signaling processes are now known, providing opportunities for bioengineering to enhance plant protection from disease. Here we provide an overview of the current understanding of the main principles of plant immunity, with an emphasis on the key scientific milestones leading to these insights.

Inflammatory breast cancer: Epidemiologic data and therapeutic results.

Since the early description more than a century ago, inflammatory breast cancer (IBC) remains an aggressive disease, with a different geographic repartition, with the highest ones incidence reported in the North of Africa (Tunisia, Algeria, Morocco, and Egypt), and the lowest incidence in Western countries (USA, Europe…). In this study, we reviewed the literature using the Surveillance, Epidemiology, and End Results (SEER) database compared to other published series. We observed that in the high incidence areas (North of Africa) when compared to "classical" breast cancer, IBC was associated to younger age (less than 50 years) with rapid evolution of signs and symptoms (in less than 3 up to 6 months), and more aggressive clinical and histopathological-molecular parameters, due to the predominance of triple-negative and HER2+ subtypes in around 60% of cases. An epidemiologic trend was observed in both high and low incidence areas since the eighties are towards reduction of IBC prevalence. Concerning Tunisia, in comparison with the historical series of the 1980s, the incidence decreased in part by applying more stringent diagnostic criteria but also probably due to a slight improvement of the socio-economic level (SEL). This trend was also observed in the US, due to the efforts of collaborative IBC groups from MD Anderson Cancer Center (MDACC), Duke and IBC patient advocacy groups. Therapeutic results are slightly better due to the standardization of a multidisciplinary approach and the use of combined primary chemotherapy and/or targeted therapies (especially in HER2 positive patients), followed by mastectomy plus radiotherapy. The 5-year overall and disease-free survival is at more than 60%, related to an IBC mortality decrease observed in the cohorts of patients treated in the last decade.

Equiano's African Methodist Appetite: Feasting and Purification Rituals as Community and Resistance

Abstract: This article draws on food studies, religious history, and research on Equiano's religious orientation to argue that Equiano's Interesting Narrative describes a creolized African and Methodist asceticism in relation to food and ritual practice. His introduction to the Moravian-Methodist love feast before his conversion resonates with his earlier textual recollections of commensality and feasting practices in his eastern Nigerian homeland. Equiano's early textual descriptions of feasting rituals suggest that he was attracted to Methodism because of his experiences through the Middle Passage and his memories of feasting practices, purification rites, and sacrifices and offerings from his childhood in Igboland. Equiano's experiences of sacrifice and his portrayals of hunger and hunger strikes as a form of resistance on the slave ships mark his choice of religious and ascetic orientation. His reclamation of the ocean as a free Black sailor, an Atlantic Creole, contributes to his interest to a temperate Methodist orientation and inner-worldly asceticism.

A history of home mechanical ventilation: The past, present and future.

This state-of-the-art review provides an overview of the history of home mechanical ventilation (HMV), including early descriptions of mechanical ventilation from ancient and Renaissance perspectives and the mass development of ventilators designed for long-term use during the poliomyelitis epidemic. Seminal data from key clinical trials supports the application of HMV in certain patients with chronic obstructive pulmonary disease, neuromuscular disease and obesity-related respiratory failure. Innovative engineering coupled with refined physiological understanding now permits widespread delivery of home mechanical ventilation to a global population, using portable devices with advanced ventilatory modes and telemonitoring capabilities. Exponential growth in digital technology continues, and ongoing research is needed to understand how to harness clinical and physiological data to benefit patients and healthcare services in a clinically- and cost-effective manner.

Early Description of Common Embryonic Origin of Skin and Nervous System by Avicenna.

Early Description of Common Embryonic Origin of Skin and Nervous System by Avicenna.