Search Results (3,374)

(1) Background: Monomorphic intestinal epitheliotropic T-cell lymphoma (MEITL) is a very rare subtype of lymphoma, being involved in less than 5% of lymphomas of the digestive tract. Accurate diagnosis is extremely challenging due to the lack of specific clinical symptoms and the low specificity of the diagnostic approaches. (2) Methods: We present the case of a patient admitted to the Neurology Clinic of the Emergency Clinical Hospital of Galati, Romania, with progressive cranial nerve impairment. (3) Results: Analyzing clinical and paraclinical data and corroborating the previous known diagnosis of MEITL, the positive diagnosis was that of meningitis with atypical lymphocytes with MEITL as starting point. The cytology of CSF was the basis for the diagnostic confirmation. (4) Conclusions: The present case is a rare situation of secondary dissemination of MEITL. We were not able to identify a similar report in the available literature that associated urothelial carcinoma with leptomeningeal MEITL-sourced neoplastic lesions. Full article

Introduction: Primary hyperparathyroidism (pHPT) is an endocrine disorder characterized by excessive parathyroid hormone production, typically due to adenomas, hyperplasia, or carcinoma. Preoperative imaging plays a critical role in guiding surgical planning, particularly in selecting patients for minimally invasive procedures. While first-line imaging techniques, such as ultrasound and 99mTc-sestamibi scintigraphy, are standard, advanced second-line imaging modalities like 18F-fluorocholine PET/CT (FCH-PET) and four-dimensional computed tomography (4D-CT) have emerged as valuable tools when initial diagnostics are inconclusive. Methods: This article provides an updated review and recommendations of the role of these advanced imaging techniques in localizing parathyroid adenomas. Results: FCH-PET has shown exceptional sensitivity (94% per patient, 96% per lesion) and is particularly useful in detecting small or ectopic adenomas. Despite its higher sensitivity, it can yield false positives, particularly in the presence of thyroid disease. On the other hand, 4D-CT offers detailed anatomical imaging, aiding in the identification of parathyroids in challenging cases, including recurrent disease and ectopic glands. Studies suggest that FCH-PET and 4D-CT exhibit similar diagnostic performance and could be complementary in preoperative planning of most difficult situations. Conclusions: This article also emphasizes a multimodal approach, where initial imaging is followed by advanced techniques only in cases of uncertainty. Although 18F-fluorocholine PET/CT is favored as a second-line option, 4D-CT remains invaluable for its high spatial resolution and ability to guide surgery in complex cases. Despite limitations in evidence, these imaging modalities significantly enhance the accuracy of parathyroid localization, contributing to more targeted and minimally invasive surgery. Full article

The continuous advancement of fire protection technologies has necessitated the development of comprehensive safety standards, leading to an increasingly diversified and specialized regulatory landscape. This has made it difficult for fire protection professionals to quickly and accurately locate the required fire safety standard information. In addition, the lack of effective integration and knowledge organization concerning fire safety standard entities has led to the severe fragmentation of fire safety standard information and the absence of a comprehensive “one map”. To address this challenge, we introduce FT-FLAT, an innovative CNN–Transformer fusion architecture designed specifically for fire safety standard entity extraction. Unlike traditional methods that rely on rules or single-modality deep learning, our approach integrates TextCNN for local feature extraction and combines it with the Flat-Lattice Transformer for global dependency modeling. The key innovations include the following. (1) Relative Position Embedding (RPE) dynamically encodes the positional relationships between spans in fire safety texts, addressing the limitations of absolute positional encoding in hierarchical structures. (2) The Multi-Branch Prediction Head (MBPH) aggregates the outputs of TextCNN and the Transformer using Einstein summation, enhancing the feature learning capabilities and improving the robustness for domain-specific terminology. (3) Experiments conducted on the newly annotated Fire Safety Standard Entity Recognition Dataset (FSSERD) demonstrate state-of-the-art performance (94.24% accuracy, 83.20% precision). This work provides a scalable solution for constructing fire safety knowledge graphs and supports intelligent information retrieval in emergency situations. Full article

Background: Lung cancer remains one of the leading causes of cancer-related mortality worldwide. While most diagnoses occur in outpatient settings, a subset of cases are incidentally identified during emergency department (ED) visits. The clinical characteristics and treatment decisions of these patients, particularly in relation to social background factors such as living situation and access to primary care, remain poorly understood. Methods: We conducted a retrospective study of patients diagnosed with malignancies in the ED of a single institution between April 2018 and December 2021. Patients diagnosed with lung cancer within 60 days of an ED visit were included. Data on demographics, disease status, treatment decisions, and background factors—including whether patients lived alone or had a primary care physician (PCP)—were extracted and analyzed. Results: Among 32,108 patients who visited the ED, 148 were diagnosed with malignancy within 60 days; 23 had lung cancer. Of these, 69.6% had metastatic disease at diagnosis, and 60.9% received active treatment (surgery or chemotherapy). No significant associations were observed between the extent of disease and either living arrangement or PCP status. However, the presence of a PCP was significantly associated with the selection of best supportive care (p = 0.023). No significant difference in treatment decisions was observed based on age (cutoff: 75 years). Conclusions: Although social background factors such as living alone were not significantly associated with cancer stage or treatment choice, the presence of a primary care physician was associated with a higher likelihood of best supportive care being selected. This may indicate that patients with an established PCP have more clearly defined care goals at the end of life. These findings suggest that primary care access may play a role in shaping end-of-life care preferences, highlighting the importance of personalized approaches in acute oncology care. Full article

In 1961, Los Angeles experienced the disastrous Bel Air fire, which swept through an affluent neighborhood situated in a hilly, WUI (wildland–urban interface) location. In January 2025, the city was devastated again by a nearly-simultaneous series of wildfires, the most severe of which took place close to the 1961 fire location. Disastrous WUI fires are, unfortunately, an anticipatable occurrence in many U.S. cities. A number of issues identified earlier remained the same. Some were largely solved, while other new ones have emerged. The paper examines the Palisades Fire of January, 2025 in this context. In the intervening decades, the population of the city grew substantially. But firefighting resources did not keep pace. Very likely, the single-most-important factor in causing the 2025 disasters is that the Los Angeles Fire Department operational vehicle count shrank to 1/5 of what it was in 1961 (per capita). This is likely why critical delays were experienced in the initial attack on the Palisades Fire, leading to a runaway conflagration. Two other crucial issues were the management of vegetation and the adequacy of water supplies. On both these issues, the Palisades Fire revealed serious problems. A problem which arose after 1961 involves the unintended consequences of environmental legislation. Communities will continue to be devastated by wildfires unless adequate vegetation management is accomplished. Yet, environmental regulations are focused on maintaining the status quo, often making vegetation management difficult or ineffective. House survival during a wildfire is strongly affected by whether good vegetation management practices and good building practices (“ignition-resistant” construction features) have been implemented. The latter have not been mandatory for housing built prior to 2008, and the vast majority of houses in the area predated such building code requirements. California has also suffered from a highly counterproductive stance on insurance regulation. This has resulted in some residents not having property insurance, due to the inhospitable operating conditions for insurance firms in the state. Because of the historical precedent, the details in this paper focus on the Palisades Fire; however, many of the lessons learned apply to managing fires in all WUI areas. Policy recommendations are offered, which could help to reduce the potential for future conflagrations. Full article

The manuscript examines the cause-and-effect relationships of fires in the Republic of Serbia over a fifteen-year period, primarily from the aspect of human safety. For this purpose, numerical variables describing the number of injuries and deaths in fires were introduced, on which various analysis and modeling techniques were implemented, which can be viewed in the context of data mining (DM). First, for both observed variables, stochastic modeling of their temporal dynamics was analyzed, and subsequently, cluster analysis of the values of these variables was performed using two different methods. Finally, by interpreting these variables as outputs (objectives) for the classification problem, several decision trees were formed that describe the influence and relationship of different fire causes on situations in which injuries or human casualties occur or not. In that way, several different types of fires have been identified, including rare but deadly incidents that require urgent preventive measures. Key risk factors such as fire cause, location, season, etc., have been found to significantly influence human casualties. These findings provide practical insights for improving fire protection policies and emergency response. Through such a comprehensive analysis, it is believed that some important results have been obtained that precisely describe the specific relationships between the causes and consequences of fires occurring in the Republic of Serbia. Full article

Teleoperation emerged as a promising fallback for situations beyond the capabilities of automated vehicles. Nevertheless, teleoperation still faces challenges, such as reduced situational awareness. Since situational awareness is primarily built through the remote operator’s visual perception, the graphical user interface (GUI) design is critical. In addition to video feed, supplemental informational elements are crucial—not only for the predominantly studied remote driving, but also for emerging desk-based remote assistance concepts. This work develops a GUI for different teleoperation concepts by identifying key informational elements during the teleoperation process through expert interviews (N = 9). Following this, a static and dynamic GUI prototype was developed and evaluated in a click dummy study (N = 36). Thereby, the dynamic GUI adapts the number of displayed elements according to the teleoperation phase. Results show that both GUIs achieve good system usability scale (SUS) ratings, with the dynamic GUI significantly outperforming the static version in both usability and task completion time. However, the results might be attributable to a learning effect due to the lack of randomization. The user experience questionnaire (UEQ) score shows potential for improvement. To enhance the user experience, the GUI should be evaluated in a follow-up study that includes interaction with a real vehicle. Full article

Background/Objectives: Emotional intelligence has emerged as a key factor in shaping nursing performance and care quality, yet its specific mechanisms and impact within the Greek public healthcare context remain underexplored. This study aimed to investigate the role of emotional intelligence in ethical behavior, crisis management, and the perceived quality of care among nurses working in Greek public hospitals. Methods: A cross-sectional survey was conducted among practicing nurses using validated instruments to assess emotional intelligence, ethical compliance, crisis management skills, and care quality. Data were analyzed using covariance-based structural equation modeling (CB SEM) to examine both direct and indirect relationships among variables. Results: The results indicated that emotional intelligence training had a strong and significant effect on nurses’ ethical behavior and their ability to manage critical situations. However, the direct effect of emotional intelligence on the perceived quality of care was not significant; instead, its influence was mediated through improvements in ethics and crisis management. Conclusions: These findings suggest that the benefits of emotional intelligence in nursing are most evident when integrated with supportive organizational practices and ongoing professional development. Overall, this study highlights the need for comprehensive emotional intelligence training and a supportive workplace culture to enhance ethical standards, resilience, and patient care quality in Greek healthcare settings. Full article

Background/Objectives: Effective teamwork is crucial for minimizing human error in healthcare settings. Medical teams, typically composed of physicians and nurses, supported by auxiliary professionals, achieve better outcomes when they possess strong collaborative competencies. High-quality teamwork is associated with fewer adverse events and complications and lower mortality rates. Based on this background, the objective of this study is to analyze the perception of non-technical skills and immediate learning outcomes in interprofessional simulation settings based on E-CRM items. Methods: A cross-sectional observational study was conducted involving participants from the official postgraduate Medicine and Nursing programs at the Catholic University of Murcia (UCAM) during the 2024–2025 academic year. Four interprofessional E-CRM simulation sessions were planned, involving randomly assigned groups with proportional representation of medical and nursing students. Teams worked consistently throughout the training and participated in clinical scenarios observed via video transmission by their peers. Post-scenario debriefings followed INACSL guidelines and employed the PEARLS method. Results: Findings indicate that 48.3% of participants had no difficulty identifying the team leader, while 51.7% reported minor difficulty. Role assignment posed moderate-to-high difficulty for 24.1% of respondents. Communication, situation awareness, and early help-seeking were generally managed with ease, though mobilizing resources remained a challenge for 27.5% of participants. Conclusions: This study supports the value of interprofessional education in developing essential competencies for handling urgent, emergency, and high-complexity clinical situations. Strengthening interdisciplinary collaboration contributes to safer, more effective patient care. Full article

Rapid and comprehensive assessment of building damage caused by earthquakes is essential for effective emergency response and rescue efforts in the immediate aftermath. Advanced technologies, including real-time simulations, remote sensing, and multi-sensor systems, can effectively enhance situational awareness and structural damage evaluations. However, most existing methods rely on isolated time snapshots, and few studies have systematically explored the continuous, time-scaled integration and update of building damage estimates from multiple data sources. This study proposes a stepwise framework that continuously updates time-scaled, single-damage estimation outputs using the best available multi-sensor data for estimating earthquake-induced building damage. We demonstrated the framework using the 2024 Noto Peninsula Earthquake as a case study and incorporated official damage reports from the Ishikawa Prefectural Government, real-time earthquake building damage estimation (REBDE) data, and satellite-based damage estimation data (ALOS-2-building damage estimation (BDE)). By integrating the REBDE and ALOS-2-BDE datasets, we created a composite damage estimation product (integrated-BDE). These datasets were statistically validated against official damage records. Our framework showed significant improvements in accuracy, as demonstrated by the mean absolute percentage error, when the datasets were integrated and updated over time: 177.2% for REBDE, 58.1% for ALOS-2-BDE, and 25.0% for integrated-BDE. Finally, for stepwise damage estimation, we proposed a methodological framework that incorporates social media content to further confirm the accuracy of damage assessments. Potential supplementary datasets, including data from Internet of Things-enabled home appliances, real-time traffic data, very-high-resolution optical imagery, and structural health monitoring systems, can also be integrated to improve accuracy. The proposed framework is expected to improve the timeliness and accuracy of building damage assessments, foster shared understanding of disaster impacts across stakeholders, and support more effective emergency response planning, resource allocation, and decision-making in the early stages of disaster management in the future, particularly when comprehensive official damage reports are unavailable. Full article

The Inner Mongolia Plateau (IMP), situated in the arid and semi-arid ecological transition zone of northern China, is particularly vulnerable to both climate change and human activities. Understanding the spatiotemporal vegetation dynamics and their driving forces is essential for regional ecological management. This study employs Sen’s slope estimation, BFAST analysis, residual trend method and Geodetector to analyze the spatial patterns of Normalized Difference Vegetation Index (NDVI) variability and distinguish between climatic and anthropogenic influences. Key findings include the following: (1) From 1982 to 2022, vegetation cover across the IMP exhibited a significant greening trend. Zonal analysis showed that this spatial heterogeneity was strongly regulated by regional hydrothermal conditions, with varied responses across land cover types and pronounced recovery observed in high-altitude areas. (2) In the western arid regions, vegetation trends were unstable, often marked by interruptions and reversals, contrasting with the sustained greening observed in the eastern zones. (3) Vegetation growth was primarily temperature-driven in the eastern forested areas, precipitation-driven in the central grasslands, and severely limited in the western deserts due to warming-induced drought. (4) Human activities exerted dual effects: significant positive residual trends were observed in the Hetao Plain and southern Horqin Sandy Land, while widespread negative residuals emerged across the southern deserts and central grasslands. (5) Vegetation change was driven by climate and human factors, with recovery mainly due to climate improvement and degradation linked to their combined impact. These findings highlight the interactive mechanisms of climate change and human disturbance in regulating terrestrial vegetation dynamics, offering insights for sustainable development and ecosystem education in climate-sensitive systems. Full article

Background: Nemaline myopathy is a rare congenital neuromuscular disease associated with progressive weakness and frequent respiratory complications. In emergency situations, families often serve as the first and only responders. The aim of this study is to explore how parents in Spain care for children with nemaline myopathy during emergency situations, focusing on the clinical responses performed at home and the organizational challenges encountered when interacting with healthcare systems. Methods: A qualitative phenomenological study was conducted with 17 parents from 10 families belonging to the Asociación Yo Nemalínica. Semi-structured interviews were performed via video calls, transcribed verbatim, and analyzed using Giorgi’s descriptive method and ATLAS.ti software (version 24). Methodological rigor was ensured through triangulation, reflexivity, and member validation. Results: Four themes were identified. First, families were described as acting under extreme pressure and in isolation during acute home emergencies, often providing cardiopulmonary resuscitation and respiratory support without professional backup. Second, families managed ambiguous signs of deterioration using clinical judgment and home monitoring tools, often preventing fatal outcomes. Third, parents frequently assumed guiding roles in emergency departments due to a lack of clinician familiarity with the disease, leading to delays or errors. Finally, the transition to the Pediatric Intensive Care Unit was marked by emotional distress and rapid decision-making, with families often participating in critical choices about invasive procedures. These findings underscore the complex, multidisciplinary nature of caregiving. Conclusions: Parents play an active clinical role during emergencies and episodes of deterioration. Their lived experience should be formally integrated into emergency protocols and the continuity of care strategies to improve safety and outcomes. Full article

As autonomous driving technologies advance, the need for human-in-the-loop systems becomes increasingly critical to ensure safety, adaptability, and public confidence. This paper presents the design and evaluation of a context-aware immersive teleoperation interface that integrates real-time simulation, virtual reality, and multimodal feedback to support remote interventions in emergency scenarios. Built on a modular ROS2 architecture, the system allows seamless transition between simulated and physical platforms, enabling safe and reproducible testing. The experimental results show a high task success rate and user satisfaction, highlighting the importance of intuitive controls, gesture recognition accuracy, and low-latency feedback. Our findings contribute to the understanding of human-robot interaction (HRI) in immersive teleoperation contexts and provide insights into the role of multisensory feedback and control modalities in building trust and situational awareness for remote operators. Ultimately, this approach is intended to support the broader acceptability of autonomous driving technologies by enhancing human supervision, control, and confidence. Full article

Augustine of Hippo (354–430), one of the most influential theologians of Late Antiquity, spent nearly a decade in the Manichaean sect before becoming a central figure in the shaping of Western “orthodox” Christianity. While his major works such as the Confessiones and De civitate Dei have been extensively studied for their treatment of Manichaeism, the vast collection of his ca. 300 preserved letters (Epistulae) remains an understudied source for understanding this aspect of his intellectual and theological development. This article addresses that gap by proposing a methodology to identify both anti- and crypto-Manichaean themes in his letters. Drawing on phenomenological openness, hermeneutical perspective, and close reading, the study also incorporates genuine Manichaean sources and anti-Manichaean polemics to contextualise Augustine’s rhetorical strategies. The Epistulae, unpolished and situated in specific communicative contexts, offer a unique view of Augustine’s doctrinal positioning after his conversion. Traces of his Manichaean past re-emerge in vocabulary, argumentation, and theological emphasis. This is exemplified in Epistula 137 to Volusianus (411–412), which, without naming the sect, covertly critiques key Manichaean doctrines such as Docetism and materialism. These critiques align with extant Manichaean sources and may reflect Augustine’s awareness of latent Manichaean influence in Christian communities. By bringing the Epistulae into the broader discussion of Augustine’s anti-Manichaean engagement, this study highlights their value as a window into his theological evolution and pastoral strategy in a religiously contested environment. Full article

Forest fire detection is an essential application in environmental surveillance since wildfires cause devastating damage to ecosystems, human life, and property every year. The effective and accurate detection of fire is necessary to allow for timely response and efficient management of disasters. Traditional techniques for fire detection often experience false alarms and delayed responses in various environmental situations. Therefore, developing robust, intelligent, and real-time detection systems has emerged as a central challenge in remote sensing and computer vision research communities. Despite recent achievements in deep learning, current forest fire detection models still face issues with generalizability, lightweight deployment, and accuracy trade-offs. In order to overcome these limitations, we introduce a novel technique (FireNet-KD) that makes use of knowledge distillation, a method that maps the learning of hard models (teachers) to a light and efficient model (student). We specifically utilize two opposing teacher networks: a Vision Transformer (ViT), which is popular for its global attention and contextual learning ability, and a Convolutional Neural Network (CNN), which is esteemed for its spatial locality and inductive biases. These teacher models instruct the learning of a Swin Transformer-based student model that provides hierarchical feature extraction and computational efficiency through shifted window self-attention, and is thus particularly well suited for scalable forest fire detection. By combining the strengths of ViT and CNN with distillation into the Swin Transformer, the FireNet-KD model outperforms state-of-the-art methods with significant improvements. Experimental results show that the FireNet-KD model obtains a precision of 95.16%, recall of 99.61%, F1-score of 97.34%, and mAP@50 of 97.31%, outperforming the existing models. These results prove the effectiveness of FireNet-KD in improving both detection accuracy and model efficiency for forest fire detection. Full article