A deep learning experiment for semantic segmentation of overlapping characters in palimpsests

Palimpsests refer to historical manuscripts where erased writings have been partially covered by the superimposition of a second writing. By employing imaging techniques, e.g., multispectral imaging, it becomes possible to identify features that are imperceptible to the naked eye, including faded and erased inks. When dealing with overlapping inks, Artificial Intelligence techniques can be utilized to disentangle complex nodes of overlapping letters. In this work, we propose deep learning-based semantic segmentation as a method for identifying and segmenting individual letters in overlapping characters. The experiment was conceived as a proof of concept, focusing on the palimpsests of the Ars Grammatica by Prisciano as a case study. Furthermore, caveats and prospects of our approach combined with multispectral imaging are also discussed

Characterization and digital restauration of XIV-XV centuries written parchments by means of non-destructive techniques. Three case studies

Parchment is the primary writing medium of the majority of documents with cultural importance. Unfortunately, this material suffers of several mechanisms of degradation that affect its chemical-physical structure and the readability of text. Due to the unique and delicate character of these objects, the use of nondestructive techniques is mandatory. In this work, three partially degraded handwritten parchments dating back to the XIV-XV centuries were analyzed by means of X-ray fluorescence spectroscopy, µ-ATR Fourier transform infrared spectroscopy, and reflectance and UV-induced fluorescence spectroscopy. 'e elemental and molecular results provided the identification of the inks, pigments, and superficial treatments. In particular, all manuscripts have been written with iron gall inks, while the capital letters have been realized with cinnabar and azurite. Furthermore, multispectral UV fluorescence imaging and multispectral VIS-NIR imaging proved to be a good approach for the digital restoration of manuscripts that suffer from the loss of inked areas or from the presence of brown spotting. Indeed, using ultraviolet radiation and collecting the images at different spectral ranges is possible to enhance the readability of the text, while by illuminating with visible light and by collecting the images at longer wavelengths, the hiding effect of brown spots can be attenuated

Characterization and digital restauration of XIV-XV centuries written parchments by means of non-destructive techniques. Three case studies

Parchment is the primary writing medium of the majority of documents with cultural importance. Unfortunately, this material suffers of several mechanisms of degradation that affect its chemical-physical structure and the readability of text. Due to the unique and delicate character of these objects, the use of nondestructive techniques is mandatory. In this work, three partially degraded handwritten parchments dating back to the XIV-XV centuries were analyzed by means of X-ray fluorescence spectroscopy, µ-ATR Fourier transform infrared spectroscopy, and reflectance and UV-induced fluorescence spectroscopy. 'e elemental and molecular results provided the identification of the inks, pigments, and superficial treatments. In particular, all manuscripts have been written with iron gall inks, while the capital letters have been realized with cinnabar and azurite. Furthermore, multispectral UV fluorescence imaging and multispectral VIS-NIR imaging proved to be a good approach for the digital restoration of manuscripts that suffer from the loss of inked areas or from the presence of brown spotting. Indeed, using ultraviolet radiation and collecting the images at different spectral ranges is possible to enhance the readability of the text, while by illuminating with visible light and by collecting the images at longer wavelengths, the hiding effect of brown spots can be attenuated

Heel lance in newborn during breastfeeding: an evaluation of analgesic effect of this procedure

<p>Abstract</p> <p>Objectives</p> <p>The reduction of pain due to routine invasive procedures (capillary heel stick blood sampling for neonatal metabolic screening) in the newborn is an important objective for the so-called "Hospital with no pain". Practices such as skin to skin contact, or breastfeeding, in healthy newborn, may represent an alternative to the use of analgesic drugs. The aim of our work is to evaluate the analgesic effect of breastfeeding during heel puncture in full term healthy newborn.</p> <p>Methods</p> <p>We studied 200 healthy full term newborns (100 cases and 100 controls), proposing the puncture to mothers during breastfeeding, and explaining to them all the advantages of this practice. Pain assessment was evaluated by DAN scale (Douleur Aigue Nouveau ne scale).</p> <p>Results</p> <p>The difference in score of pain according to the DAN scale was significant in the two groups of patients (p = 0.000); the medium score was 5.15 for controls and 2.65 for cases (newborns sampled during breastfeeding).</p> <p>Conclusion</p> <p>Our results confirmed the evidence of analgesic effect of breastfeeding during heel puncture. This procedure could easily be adopted routinely in maternity wards.</p

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

New Frontiers in the Digital Restoration of Hidden Texts in Manuscripts: A Review of the Technical Approaches

The digital restoration of historical manuscripts centers on deciphering hidden writings, made imperceptible to the naked eye due to factors such as erasure, fading, carbonization, and aging effects. Recent advancements in modern technologies have significantly improved our ability to unveil and interpret such written cultural heritage that, for centuries, had remained inaccessible to contemporary understanding. This paper aims to present a critical overview of state-of-the-art technologies, engaging in discussions about perspectives and limitations, and anticipating future applications. Serving as a practical guide, this work seeks to assist in the selection of techniques for digitally restoring ancient writings. Additionally, potential and challenges associated with integrating these techniques with advanced machine-learning approaches are also outlined

Terahertz imaging and spectroscopy of papyrus phantoms

Terahertz (THz) radiation is known to penetrate layers of materials opaque to the visible light, discriminating among materials with similar elemental composition and low atomic number such as organic molecules. THz imaging is useful to investigate layered structures such as medieval manuscripts (e.g., pages stuck to each other and materials re-used in bookbinding structures), painting layers, or multi-layered papyrus fragments. The Herculaneum papyri are a collection of more than 1,800 manuscripts that were charred during the 79 AD Vesuvius eruption. Some of these papyri are rolled and others are unrolled. A portion of the latter is written on both sides but permanently sticked to kraft paper, so the “verso” side is unreadable. Any attempt to open the rolled scrolls or to remove the extremely fragile papyrus fragments from their kraft paper, results in irreparable damage. Therefore, an imaging technique with high penetration through papyrus is needed. X-ray phase-contrast tomography (XPCT) technique revealed many portions of text hidden inside scrolls without opening them. However, THz offers advantages such as using non-ionising radiation and portable instruments. We employed THz frequency domain spectroscopy and imaging to analyse carbonised papyrus phantom sample, written using a black-carbon based ink. We observed different values of transmittance and reflectance in the 0.1 - 0.4 THz range, according to the degree of carbonisation of the papyrus fiber. We also verified, by imaging a handwritten letter on a carbonised papyrus phantom, that carbon-based ink has a measurable contrast at 0.1 THz