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Objective: Congenital defects/diseases Background: The rarity of ischiopagus tripus conjoined twins complicates the surgical separation, owing to the lack of cases and high complexity. We aim to report our experience in performing orthopedic correction for ischiopagus tripus twins. Case Report: A pair of 3-year-old conjoined boys presented with a fused body at the pelvis region and only 1 umbilicus. There were 2 legs separated by shared genitalia and an anus at the midline, and 1 fused leg, which could be felt and moved by both of the patients. The twins also shared internal organs of the bladder, intestine, and rectum, as visualized through angiography computerized tomography scan. After several team discussions with the institutional review board, the hospital ethics committee, and both parents, it was agreed to perform disarticulation of the fused third limb, followed by correction of the trunk alignment by pelvic closed wedge osteotomy and internal fixation. We successfully reconstructed the pelvis using locking plates and additional 3.5-mm cortical screws and 1.2-mm stainless steel wire. Conclusions: This report describes the presentation and surgical management of a case of ischiopagus tripus conjoined twins. It highlights the challenges involved in surgery and the importance of investigating these infants for other congenital abnormalities. Although surgical approaches for different sets of twins should be individually tailored, interventions aimed to provide optimal outcomes should consider ethical issues and parental/patient expectations. Even in situations in which the twins are inseparable, there is still room for surgical correction to be performed. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To increase your awareness of craniopagus, a rare condition in which identical twins are joined at the head • To identify the multidisciplinary skills and expertise required for successful separation of craniopagus twins • To explore the pivotal role of nurses in the management and care of craniopagus twins in hospital. Craniopagus is a rare condition in which the skulls of conjoined twins, and the neurovascular structures in their skulls, are incompletely separated. Separation surgery is complex and requires a range of skills and expertise, including from all the nursing teams involved. A multidisciplinary group of professionals in a tertiary paediatric care setting in Italy developed a comprehensive protocol for the nursing care of craniopagus twins in hospital, informed by the findings of a literature review and the expertise of its members. The protocol was applied to the management of a pair of craniopagus twins who successfully underwent separation surgery at the authors’ hospital. The protocol describes the crucial role of nurses in the care of craniopagus twins and their families before, during and after separation surgery. [ABSTRACT FROM AUTHOR]

In robotics, finding new structures of parallel robots to achieve higher kinematic and dynamic performance is a great matter. This article describes the introduction, design, and modeling of a novel parallel spatial robot. The name "conjoined twins 3RPRS" (CT-3RPRS) is chosen for the introduced robot as its structure is based on an innovative combination of two 3RPRS robots. Initially, the actuators of the 3RPRS robot were shifted from the base plane to the middle plane of the robot, and then three new links were added to balance the robot. Therefore, CT-3RPRS has six links, three on each side of the middle plane (actuator plane) that are connected to the prismatic actuators with revolute joints. The complete kinematic equations of the robot are extracted. Afterward, the singularity analysis is performed. The results of the simulations showed that CT-3RPRS provides a better reachable workspace feature than 3RPRS. The mentioned advantage is achieved while the size of the two robots is the same and the movement range of CT-3RPRS actuators is less. [ABSTRACT FROM AUTHOR]

A review of an unusual twin type—twins born to women with two uteri (uterus didelphys)—is presented. This review is followed by summaries of recent research and perspectives concerning prenatal aneuploidy screening for twin pregnancies, twin conceptions by same-sex male couples, legal personality of conjoined twins, and a twin study of cannabis use. Interesting information about twins that has appeared in the media is also presented, namely how being taken for twins saved a pair of sisters; twin children of a jailed Nobel Prize winner, British 'biracial' twins, triplets born at the start of Russia's attack on Ukraine, and twins born in different years. [ABSTRACT FROM AUTHOR]

Deza digraphs were introduced in 2003 by Zhang and Wang as directed graph version of Deza graphs, that also generalize the notion of directed strongly regular graphs. In this paper, we give several new constructions of Deza digraphs. Further, we introduce twin and Siamese twin (directed) Deza graphs and construct several examples. Finally, we study a variation of directed Deza graphs and provide a construction from finite fields. [ABSTRACT FROM AUTHOR]

Conjoined twins (CTs), popularly referred to as Siamese twins, are a rare anomaly due to monochorionic and monoamniotic twin pregnancies. Dicephalus dibrachius dipus, a type of parapagus conjoined twin which is characterized by possessing two arms, two legs, a single trunk and two heads, epidemiologically, is an even rarer occurrence of CTs. In this article, a rare, well-preserved anatomical specimen of a dicephalus dibrachius dipus conjoined twin is presented. This study was conducted in a specimen which is part of the collection of the Embryology Museum of the institution by donation and approved by the Research Ethics Committee (REC). The female conjoined twins were born at full-term by cesarean section in the 1970s and died hours after birth. A thorough anatomical description was made through observational analysis, computed tomography and 3D reconstructed images. Major abnormalities were observed in the cardiovascular, respiratory and digestive systems. The internal anatomy exhibited a heart with three atria, two ventricles, two aortic arches, two pulmonary arteries, one innominate venous trunk and a respiratory system with two tracheas and four lungs. No other report was similar to our three atria heart description. This article provides a thorough anatomical description of all systems, which is valuable information for further studies on CTs. [ABSTRACT FROM AUTHOR]

Conjoined twins are identical twins joined in utero and are a rare phenomenon. This report discusses a case of female thoraco-omphalo-ischiopagus tripus conjoined twins. The twins were separated at age two, and once medically stable, spent one month in inpatient rehabilitation to improve their sitting balance and gross motor skills. This was followed by outpatient physical therapy. The twins initially had customized ZipZac seats, which they were able to wheel independently. After six months of therapy, the girls began walking with posterior walkers and prostheses. The hemipelvectomy prosthesis included a customized thoracolumbosacral orthosis component and was directly attached to a non-articulated pylon. A manual-locking hip joint was added to accommodate sitting. An articulated ankle-foot orthosis was used for the intact leg. Care of formerly conjoined twins requires comprehensive care from a multidisciplinary team involving, but not limited to, a physiatrist, orthopaedic surgeon, physical therapist, and orthotist/prosthetist. Complex congenital limb deficiencies are often a major undertaking for the rehabilitation team as continuous treatment and management are needed throughout the patient’s lifetime due to growth, development, and evolving physical demands. Anatomic variations must be examined on a case-by-case basis but often include limb deficiencies, orthopedic abnormalities, and organ comorbidities. [ABSTRACT FROM AUTHOR]

There are sex-dependent differences in hematological and biochemical variables in adulthood attributed to the predominant effects of testosterone in males and estrogen in females. The Twin Testosterone Transfer (TTT) hypothesis proposes that opposite-sex females may develop male-typical traits due to exposure to relatively higher levels of prenatal testosterone than same-sex females. Additionally, prenatal testosterone exposure has been suggested as a correlate of current circulating testosterone levels. Consequently, opposite-sex females might exhibit male-typical patterns in their hematological and biochemical variables. Despite this hypothesis, routine laboratory investigations assign the same reference range to all females. Our cross-sectional study, conducted in Tamale from January to September 2022, included 40 twins, comprising 10 opposite-sex (OS) males (25%), 10 OS females (25%), and 20 same-sex (SS) females (50%), all aged between 18 and 27 years. Fasting venous blood samples were collected and analyzed using automated hematology and biochemistry laboratory analyzers. Results indicated that levels of hemoglobin, serum creatinine, gamma-glutamyl transferase, total protein, globulins, and total testosterone were significantly higher in OS males than OS females. Conversely, total cholesterol and low-density lipoprotein cholesterol were significantly higher in OS females than OS males. Unexpectedly, levels of low-density lipoprotein cholesterol and total testosterone were significantly higher in SS females than OS females. Contrary to expectations, opposite-sex females did not exhibit male-typical patterns in their hematological and biochemical variables. This suggests that the TTT effect may not occur or may not be strong enough to markedly affect hematological and biochemical variables in OS females. [ABSTRACT FROM AUTHOR]

Summary: Risk of sleep disturbances depends on individuals' personality, and a large body of evidence indicates that individuals prone to neuroticism, impulsivity, and (low) extraversion are more likely to experience them. Origins of these associations are unclear, but common genetic background may play an important role. Participants included 405 twin pairs (mean age of 54 years; 59% female) from the National Survey of Midlife Development in the United States (MIDUS) who reported on their personality traits (broad and specific), as well as sleep disturbances (problems with falling asleep, staying asleep, waking early, and feeling unrested). Uni‐ and bivariate biometric decompositions evaluated contributions of genetic and environmental factors to associations between personality and poor sleep, as well as unique contributions from individual traits. Neuroticism, extraversion, conscientiousness, and aggressiveness were the strongest phenotypic predictors of poor sleep. Genetic sources of covariance were about twice as large as non‐shared environmental sources, and only shared genetic background accounted for links between aggressiveness and poor sleep. Neuroticism and extraversion accounted for most of the genetic overlap between personality and sleep disturbances. The findings shed light on developmental antecedents of ties between personality and poor sleep, suggesting a larger role of common genetic background than idiosyncratic life experiences. The results also suggest that emotion‐related traits play the most important role for poor sleep, compared to other personality traits, and may partially account for genetic associations with other traits. [ABSTRACT FROM AUTHOR]

Animalism is the doctrine that you and I are animals. Like any substantive philosophical position, animalism faces objections. For example, imagine a case of conjoined twins, where there are two heads, but only one "body," and where each head seems to have its own typically human and fully discrete mental life. It would be natural to assume that each of the twins is a thing like you and me—each twin is one of us. But it appears that each twin cannot be a distinct human animal, since it appears in this case that there is only one animal. So it appears that animalism renders the wrong verdict in this case. I present two responses to this worry, drawing on Aristotelian claims about the centrality of sensation to animals, and on an account of organism-hood from Maureen and Samuel Condic. I close by considering craniopagus parasiticus and cephalopagus, and show the Aristotelian response is effective in such cases as well. [ABSTRACT FROM AUTHOR]

The circumstances and subsequent life events of the first twins to have been born in different countries are examined. Given that both twins were born in the United Kingdom, their common citizenship was never questioned. In contrast, twins born in Canada to a legally married gay transnational couple — composed of one American and one Israeli — were assigned as citizens of different nations and their parents were regarded as if unmarried. This essay is followed by reviews of research on the Hallermann-Streiff syndrome in monozygotic (MZ) twins, the effects of technology on conjoined twin separation, reciprocal deep inferior epigastric perforator (DIEP) transplantation in MZ twins and new guidelines for managing multifetal pregnancies. Finally, media reports on a book by the world's oldest Auschwitz-Birkenau twin survivor, the passing of Dr Ian Wilmut, the identical twinship of Zhores Medvedev, another case of gay fathers with twin sons, twins and siblings admitted to medical school, and the first and fourth records for major league baseball twins are presented. [ABSTRACT FROM AUTHOR]

Human-robot collaboration (HRC) has been identified as a highly promising paradigm for human-centric smart manufacturing in the context of Industry 5.0. In order to enhance both human well-being and robotic flexibility within HRC, numerous research efforts have been dedicated to the exploration of human body perception, but many of these studies have focused only on specific facets of human recognition, lacking a holistic perspective of the human operator. A novel approach to addressing this challenge is the construction of a human digital twin (HDT), which serves as a centralized digital representation of various human data for seamless integration into the cyber-physical production system. By leveraging HDT, performance and efficiency optimization can be further achieved in an HRC system. However, the implementation of visual perception-based HDT remains underreported, particularly within the HRC realm. To this end, this study proposes an exemplary vision-based HDT model for highly dynamic HRC applications. The model mainly consists of a convolutional neural network that can simultaneously model the hierarchical human status including 3D human posture, action intention, and ergonomic risk. Then, on the basis of the constructed HDT, a robotic motion planning strategy is further introduced with the aim of adaptively optimizing the robotic motion trajectory. Further experiments and case studies are conducted in an HRC scenario to demonstrate the effectiveness of our approach. [ABSTRACT FROM AUTHOR]

Various cases of conjoined twinning have been presented as problems for the animalist view that we are animals. In some actual and possible cases of human dicephalus that have been discussed in the literature, it is arguable that there are two persons but only one human animal. It is also tempting to believe that there are two persons and one animal in possible instances of craniopagus parasiticus that have been described. Here it is argued that the animalist can admit that these are cases in which human persons are not animals, without forfeiting the title "animalist." It is also shown that this is not only an option but also a well‐motivated and plausible option for the animalist. Seeing this requires getting clear on what the word "we" should be thought to include in the animalist's claim that we are animals. Here animalism is defended against twinning objections by figuring out how to view the scope of the animalist's identity claim. [ABSTRACT FROM AUTHOR]

A multitude of additional anomalies can be observed in virtually all types of symmetrical conjoined twins. These concomitant defects can be divided into different dysmorphological patterns. Some of these patterns reveal their etiological origin through their topographical location. The so-called shared anomalies are traceable to embryological adjustments and directly linked to the conjoined-twinning mechanism itself, inherently located within the boundaries of the coalescence area. In contrast, discordant patterns are anomalies present in only one of the twin members, intrinsically distant from the area of union. These dysmorphological entities are much more difficult to place in a developmental perspective, as it is presumed that conjoined twins share identical intra-uterine environments and intra-embryonic molecular and genetic footprints. However, their existence testifies that certain developmental fields and their respective developmental pathways take different routes in members of conjoined twins. This observation remains a poorly understood phenomenon. This article describes 69 cases of external discordant patterns within different types of otherwise symmetrical mono-umbilical conjoined twins and places them in a developmental perspective and a molecular framework. Gaining insights into the phenotypes and underlying (biochemical) mechanisms could potentially pave the way and generate novel etiological visions in the formation of conjoined twins itself. [ABSTRACT FROM AUTHOR]

Alzheimer's disorder (AD) causes permanent impairment in the brain's memory of the cellular system, leading to the initiation of dementia. Earlier detection of Alzheimer's disease in the initial stages is challenging for researchers. Deep learning and machine learning‐based techniques can help resolve many issues associated with brain imaging exploration. Brain MR Images (Brain‐MRI) are used to detect Alzheimer's in computable research work. To correctly categorize the stages of Alzheimer's disease, discriminative features need to be extracted from the MR images. Recently, many studies have used deep learning methods for the early detection of this disorder. However, overfitting degrades the deep learning method's performance because the dataset's selection images are smaller and imbalanced. Some studies could not reach more discriminative and effectual attention‐aware features for Alzheimer's stage classification to increase the model performance. In this paper, we develop a novel hierarchical residual attention learning‐inspired multistage conjoined twin network (HRAL‐CTNN) to classify the stages of Alzheimer's. We used augmentation approaches to scale insufficient and imbalanced data. The HRAL‐CTNN is efficiently overcoming the issues of not obtaining efficient attention‐aware and generative features for Alzheimer's stage classification. The proposed model solved the problem of redundant features by extracting attentive discriminant features, and scaling imbalance data by data augmentation, after that training and validation using HRAL‐CTNN. The execution of this proposed work has been performed on the ADNI MRI dataset. This work achieved outstanding accuracy of 99.97 ±$$ \pm $$ 0.01% and F1 score of 99.30 ±$$ \pm $$ 0.02% for Alzheimer's stage classification. This model proposed by our group outperformed the existing related studies in terms of the model's performance score. [ABSTRACT FROM AUTHOR]

Medical imaging plays a crucial role in the management of conjoined twins. The role of imaging is to explore the anatomy, outline the shared organs and determine whether surgery is feasible. It also serves as a roadmap for successful separation. Additionally, imaging helps with counseling parents about prognosis. This review aims to illustrate recent advances in different imaging modalities and their role in the management of the various types of conjoined twins with an emphasis on relevant tips for optimal imaging. [ABSTRACT FROM AUTHOR]

Marfan Syndrome (MFS) is an autosomal dominant disease caused in most cases by mutations in the FNB1 gene, which encodes for fibrillin 1. MFS does not alway shows typical phenotypic signs. Indeed, the occurrence of sudden death of unknown cause is increasingly seen in young adults without ante mortem preexisting pathology to explain the event. In many cases the diagnosis of Marfan Syndrome (MFS) is carried out post mortem, especially in cases where the disease’s external phenotype is absent. Here is reported a case of a young woman who died during a twin pregnancy investigated with medico-legal and forensic anthropological procedures. The autopsy showed the absence of a typical marfanoid habitus and the presence of a dissecting aneurysm of the aorta with histopathological degeneration of the aortic elastic fibers. The genetic investigation revealed two previously undetected de novo mutations of the FBN1 gene: c.T6181C: p.C2061R and c.G1415A: p.C472Y. This new mutations, together with a comprehensive analysis, demonstrates the existence of a causal relationship between these mutations and the dissecting aneurysm of the aorta. This also stresses the importance of a combined multidisciplinary approach to this condition which includes morphological and genetic studies. [ABSTRACT FROM AUTHOR]

The UK's family immigration regime involves the routine separation of partners from their families. Most obviously, it keeps apart those who are unable to meet the income and other requirements for family (re)unification, and those refused visas. But separation for at least several months, and sometimes much longer, is the norm even for those whose applications are eventually successful. This article draws on creative, co-produced accounts of immigration-related separation to reveal multi-faceted temporalities of crisis in the 'experiential migrantisation' of British citizens seeking to reunite bi-national families in the UK. The bureaucratic temporalities of immigration control impede aspirations for life-course progression and shared futures, while increasing the tempo of working and caring lives. In exploring the accounts of British citizens kept apart from partners by the immigration regime through a temporal lens, we chart this experiential migrantisation through the varied and intersecting temporalities of bureaucracy and immigration control, and of biography and (transnational) family life. These can become intertwined with and compound other temporalities of crisis at different levels, from the global Covid-19 pandemic and other international geo-political events, to the more intimate and familial, leading to 'times of crises'. Such crises are, moreover, often expressed through temporal tropes of key dates missed—birthdays, anniversaries, holidays—and phases of family life postponed. [ABSTRACT FROM AUTHOR]

A case of 6-week-old female twins is presented. Twin 1 was fully formed, whereas twin 2 was parasitic, adhered to the left flank, and had anencephaly and complete upper limbs. Depending on the twins' overall condition, the recommendation is to separate conjoined twins as soon as possible for a better outcome. [ABSTRACT FROM AUTHOR]

Introduction: Conjoined twin is an extremely rare condition and requires a thorough knowledge of anatomy, and a multidisciplinary approach is essential to successfully separate the twins. Thoracopagus twins lie face to face and are attached from chest to upper abdomen. They are the most common among all the varieties but have a poor survival rate. Materials and Methods: This study is a review of literature from 2019 to the oldest via PubMed and Google Scholar using keywords: Conjoined twins, Thoracopagus twins, Thoracoomphalopagus and Thoraco-omphalopagus twins. The articles were reviewed for the description of the anatomy of shared organs, management and outcome of these twins. Results: One hundred and fifty-eight sets of thoracopagus and thoraco-omphalopagus twins including our twins were included in this study. Out of 158 reported thoracopagus twin sets in literature, with M: F ratio of 1:2.3, 71 sets were found to be non-operable and all of them subsequently expired; 82 sets were operated upon, out of which 83 babies survived, suggesting an overall surgical success rate of about 50%. Conclusion: Thoracopagus twins have a dismal prognosis. The most important decisive parameter for successful separation is the extent of sharing of organs between twins. The role of a motivated multidisciplinary team is also indispensable and cannot be overemphasised. [ABSTRACT FROM AUTHOR]

Objective: In the present study, the morphological features of common tortoise (Testudo graeca Linnaeus, 1758) found in the Pamukkale ruins and determined to be two-headed Siamese twins, were investigated using computed tomography. Material and Methods: The size and weight of the twin tortoise were measured and placed under care in a terrarium similar to their natural habitat. The anatomical features of the two headed Siamese twins were evaluated by three-dimensional volumetric computed tomography. Results: The Siamese twins combined from the end of the shell have 4 anterior extremities and 2 posterior extremities. Even though tortoises were conjoined, they were reacting independently, but had to move together due to their abnormal shell structures. The Siamese twins weighed 13.2 grams when they were found. They survived 47 days in the terrarium. The tomography scanning showed that that one of the twins was fused from the 7th vertebrae and the other from the 8th vertebrae. Although the internal organ structure is not clear, it has been observed that they use a shared cloaca. Conclusion: The anomalies rarely seen in reptiles can be caused by many factors, including environmental and genetic factors. [ABSTRACT FROM AUTHOR]

Pygopagus twin is a rare congenital malformation with a worldwide incidence of 1in 200,000. Few literature reports are published regarding the matter. In some cases, neuromonitoring is essential for safe surgical separation. We believe it is important to share our challenges and nuances in order to minimize obstacles one might encounter. We utilized neuromonitoring during our separation of both twins, and we planned a multidisciplinary approach and efficient communication system with the other teams in order to plan a successful, safe, and timely separation of the twins. We seek to highlight not our success but rather the obstacles and challenges we encountered during the separation of pygopagus twins in our institute using neuromonitoring for future reference. [ABSTRACT FROM AUTHOR]

Are there any differences between conjoined twin fetuses at the molecular level? Skin tissues were collected from thoracopagus conjoined twins at 15+4 weeks of gestation. The skin tissues were collected from the thigh side of conjoined twins after the abortion procedure. All specimens were obtained after written informed patient consent and were fully anonymized. All relevant ethical regulations were followed. Every specimen underwent multiomics sequencing analysis to determine associations among the DNA methylome, transcriptome and mutations in the exon regions in the conjoined twins. The global methylation pattern was similar in the two fetuses of conjoined twins, while significant differences were seen in local regions such as CpG islands (P = 0.026), enhancers (P < 0.001) and various repetitive elements (P < 0.05), which showed significant differences. The conjoined twins also differed in genes related to growth and development, cellular component morphogenesis and cellular stress, both in terms of DNA methylation levels and gene expression levels. Exon data analysis revealed that the common mutations in conjoined twins mainly occurred in neural development, lipid metabolism and microtubule morphogenesis. Specific mutations were associated with cellular component biosynthesis, behaviour and germ cell development. Conjoined twins were similar to each other globally, but there were significant differences related to growth and development, cellular component morphogenesis and cellular stress. The current study reveals the molecular features of conjoined twins for the first time, laying the foundation for future exploration of the mechanism of conjoined twins. [ABSTRACT FROM AUTHOR]

Nancy L. Segal's book, "The Twin Children of the Holocaust: Stolen Childhood and the Will to Survive," features photographs taken by Segal during two events in 1985: a group of surviving twins returning to Auschwitz and a mock trial of Josef Mengele at Yad Vashem in Israel. The book primarily focuses on the photographs themselves, which are accompanied by short essays and captions. While the book does not contribute to the scholarly study of the Holocaust or offer new insights, it provides thought-provoking images of the surviving twins and highlights the passage of time since the events took place. The book serves as a reminder of the importance of remembering the Holocaust and its relevance in today's world. [Extracted from the article]

Twins' memoirs and autobiographies both enlighten and entertain. These works, often overlooked by researchers, may suggest new avenues for investigation, such as nonshared environmental events that propel twins in different directions. Of course, MZ twins' generally parallel experiences and DZ twins generally criss-crossing paths are the bases of fascinating life stories. The following sections examined recent research on fetal reduction in twin pregnancy, twins' personality and military service, growth restriction in twins, and advances in conjoined twin separation. This article closes with reports of a scientist who performed gene editing on twins, a twin conception from 33-year-old embryos, twins' physical outcomes from dietary differences, fraternal twins with the world's largest height difference and the Twin Home Experts who conquer rat infestation in New York. [ABSTRACT FROM AUTHOR]

The management of conjoined twins has several special aspects, mostly linked to the parents of the twins, such as communication, ethics and trust issues. A multidisciplinary team approach plus high level of vigilance at each perioperative stage is required. Conjoined omphalopagus twins, aged one year, were planned for separation surgery. They had fused liver, fused portal and hepatic veins, and partially fused intestines. Patient B appeared with complications of pentalogy of Fallot (PoF). The patient also had polycythemia (hemoglobin 14.7 g/dL, hematocrit 50%). Radiological features showed anterior abdominal wall with images of interconnected intestinal system between the two. In thoracoabdominopagus conjoined twins, the possibility of shared circulation becomes important especially associated with injection of intravenous drugs. The goal of anesthesia in PoF is to maintain cardiac output by maintaining heart rate, contractility and preload; and preventing right to left shunting via ventricular septal defect (VSD). Induction can cause vasodilation and the resultant decrease in systemic vascular resistance (SVR) can exacerbate right-to-left shunts. Monitoring end tidal CO2 (EtCO2) is needed. We present a report of anesthesia for such a case. Abbreviations: ASD: Atrial Septal Defect; PoF: Pentalogy of Fallot; VSD: Ventricular Septal Defect; SVR: Systemic Vascular Resistance [ABSTRACT FROM AUTHOR]

Automated classification of blood cells from microscopic images is an interesting research area owing to advancements of efficient neural network models. The existing deep learning methods rely on large data for network training and generating such large data could be time-consuming. Further, explainability is required via class activation mapping for better understanding of the model predictions. Therefore, we developed a Siamese twin network (STN) model based on contrastive learning that trains on relatively few images for the classification of healthy peripheral blood cells using EfficientNet-B3 as the base model. Hence, in this study, a total of 17,092 publicly accessible cell histology images were analyzed from which 6% were used for STN training, 6% for few-shot validation, and the rest 88% for few-shot testing. The proposed architecture demonstrates percent accuracies of 97.00, 98.78, 94.59, 95.70, 98.86, 97.09, 99.71, and 96.30 during 8-way 5-shot testing for the classification of basophils, eosinophils, immature granulocytes, erythroblasts, lymphocytes, monocytes, platelets, and neutrophils, respectively. Further, we propose a novel class activation mapping scheme that highlights the important regions in the test image for the STN model interpretability. Overall, the proposed framework could be used for a fully automated self-exploratory classification of healthy peripheral blood cells. The whole proposed framework demonstrates the Siamese twin network training and 8-way k-shot testing. The values indicate the amount of dissimilarity. [ABSTRACT FROM AUTHOR]

Surgical separation of conjoined twins remains one of the most unique and rewarding experiences in the field of pediatric surgery, bearing in mind that this decision is their best chance of survival. These are the first reported cases of successfully separating omphalopagus conjoined twins by the liver in Sudan. After an emergency cesarean section, 62-day-old term-conjoined twins were referred to our pediatric surgery center. Examination revealed well-appearing twins fused from the xiphoid to the umbilicus; imaging confirmed a fused liver with a separate portal and caval structures, necessitating surgical separation and closure, which was done successfully on subsequent hours with well tolerance and recovery discharged on day 21. The second case involved 21-day-old term-conjoined female twins who were fused from the xiphoid to the umbilicus and shared the same cord, as well as complete fusion of the liver with separate other vital organs. They were successfully separated and recovered well. [ABSTRACT FROM AUTHOR]

Reports on morphological malformations in amphibians have been extensively documented worldwide. However, in the Amazon Forest records are recent and still a horizon to be explored, considering that they are potential cues of serious environmental problems. Here, we report five individuals of different species with limb morphological malformations (Callimedusa tomopterna, Trachycephalus cunauaru, Dendropsophus marmoratus, Ceratophrys cornuta and Rhinella proboscidea), collected between February 2020 and April 2022 during fieldwork expeditions at localities of Brazilian Amazonia, and a rare case of Siamese twins in a specimen of Synapturanus ajuricaba previously deposited at the Herpetological Collection of Instituto Nacional de Pesquisas da Amazônia. We provide radiographs and discuss about the affected bone structures. These records provide the first malformation cases known for adult specimens in the abovementioned species, and also in the family Phyllomedusidae. [ABSTRACT FROM AUTHOR]

Introduction: Pygopagus comprises 17% of all conjoined twin cases. Survival rate is higher compared to other variations of conjoined twins, but separation is a great challenge due to multiorgan involvement. Intraoperative neuromonitoring (IONM) used aims to aid operator in preserving as much function as possible. Case presentations: The authors reported 2 pairs of pygopagus separation. Intraoperatively, motor-evoked potential (MEP) and sensory-evoked potential (SEP) were used in all patients. Three patients survived in which all had transient motor deficits. Urinary retention was reported in one patient. One patient died 2 weeks after separation as twins only had one kidney which was spared for the healthier twin. Discussion: IONM was used to guide operator in dissecting, identify the ownership of the neural structures, and determine the safest point to separate in pygopagus separation. Despite the normal MEP and SEP recordings, transient motor weakness may still occur transiently. The motor tract development of children is achieved in adolescence, making MEP less accurate. However, the reliability of MEP increases when it is combined with SEP. Autonomic function monitoring such as bulbocavernosus reflex (BCR) could not be assessed due to the unavailability of the probe. Conclusion: IONM can aid operator in pygopagus separation during determining the origins of the structure, dissecting, and cutting the neural structures. Normal MEP interpretations are still possible to correlate with transient deficits, but reliability can be improved with the use of SEP. In surgeries involving the lower spine level, BCR monitoring is recommended to avoid autonomic deficits. [ABSTRACT FROM AUTHOR]

In this article, we introduce a new approach to human movement by defining the movement as a static super object represented by a single two-dimensional image. The described method is applicable in remote healthcare applications, such as physiotherapeutic exercises. It allows researchers to label and describe the entire exercise as a standalone object, isolated from the reference video. This approach allows us to perform various tasks, including detecting similar movements in a video, measuring and comparing movements, generating new similar movements, and defining choreography by controlling specific parameters in the human body skeleton. As a result of the presented approach, we can eliminate the need to label images manually, disregard the problem of finding the start and the end of an exercise, overcome synchronization issues between movements, and perform any deep learning network-based operation that processes super objects in images in general. As part of this article, we will demonstrate two application use cases: one illustrates how to verify and score a fitness exercise. In contrast, the other illustrates how to generate similar movements in the human skeleton space by addressing the challenge of supplying sufficient training data for deep learning applications (DL). A variational auto encoder (VAE) simulator and an EfficientNet-B7 classifier architecture embedded within a Siamese twin neural network are presented in this paper in order to demonstrate the two use cases. These use cases demonstrate the versatility of our innovative concept in measuring, categorizing, inferring human behavior, and generating gestures for other researchers. [ABSTRACT FROM AUTHOR]

This article, titled "Conjoined," explores the author's visit to an exhibit on Eng and Chang, the original Siamese Twins, at the Andy Griffith Museum in North Carolina. The twins were famous entertainers who later became farmers. The article reflects on the twins' lives, their marriages to sisters, their routine of alternating between wives, and their fathering of twenty-two children. It also mentions their ownership of slaves and their sons' involvement in the Confederate Army. The author contemplates why the twins were not surgically separated and reflects on a previous encounter with a medical museum exhibit on conjoined twins. The article ends with the author and their wife leaving the cemetery and discussing the significance of the twins' legacy. [Extracted from the article]

Background: Diprosopus is a rare malformation of still unclear aetiology. It describes a laterally double faced monocephalic and single-trunk individual and has to be distinguished from the variant Janus type diprosopus. Results: We examined seven double-faced foetuses, five showing true diprosopus, and one each presenting as monocephalic Janiceps and parasitic conjoined twins. Four of the foetuses presented with (cranio)rachischisis, and two had secondary hydrocephaly. Three foetuses showed cerebral duplication with concordant holoprosencephaly, Dandy-Walker cyst and/or intracranial anterior encephalocele. In the Janiceps twins, cerebral duplication was accompanied by cerebral di-symmetry. In the parasitic twins the cyclopic facial aspects were suggestive of concordant holoprosencephaly. In one of the true diprosopus cases, pregnancy was achieved after intracytoplasmic sperm injection. Whole-exome sequencing, perfomed in one case, did not reveal any possible causative variants.The comparison of our double-faced foetuses to corresponding artistic representations from the Tlatilco culture allowed retrospective assignment of hairstyles to brain malformations. Conclusion: Brain malformations in patients with diprosopus may not be regarded as an independent event but rather as a sequel closely related to the duplication of the notochord and neural plate and as a consequence of the cerebral and associated craniospinal structural instabilities. [ABSTRACT FROM AUTHOR]

Notwithstanding their rarity, conjoined twins have often been remarked and represented throughout human history. The medieval visual record includes two depictions of historical twins, some exotic two-headed monsters, the ancient god Janus, and many instances of the zodiac Gemini as conjoined. Comparing the imagery with physiological fact, it is clear that artists were familiar with various forms of natural corporeal fusion, although they were also prone to misunderstandings. The representations reflect conflicting conceptions of the phenomenon debated among Western theologians and philosophers, that they were one person or two. Conjoined twins are found in both European and Islamic art. The conjoined Gemini, in particular, began to appear regularly in both cultures at roughly the same time toward the beginning of the thirteenth century, with possible earlier hints in the West. This parallel iconographical development raises difficult questions of genealogy and dissemination. [ABSTRACT FROM AUTHOR]

Conjoined twins (CT) is an extremely rare complication in a monoamniotic twin pregnancy, affecting approximately 1 in 80,000 births. In our case report, we present the occurrence of this complication in a patient with a triple dichorionic pregnancy. The complication was diagnosed in the 15th week of pregnancy. The degree of organ connection in CT did not predict the survival of the conjoined foetuses after delivery. The third foetus was morphologically normal and had a separate chorion. The patient did not decide to undergo selective CT foeto-reduction in the second trimester. The natural course resulted in spontaneous intrauterine death of the affected foetuses in the 30th week of pregnancy, followed by spontaneous preterm labour in the 36th week of pregnancy. The description of the case along with photographic documentation allows the diagnosis, procedure, and the spontaneous course of pregnancy with such a complication to be traced. The attached discussion deals with similar descriptions of such rare cases in the literature and proceedings. [ABSTRACT FROM AUTHOR]

Quadruplets are at elevated physical risks at prenatal, perinatal, and postnatal levels, relative to twins. A brief review of this area is followed by discussion of a female quadruplet with three co-quadruplet brothers. Next, several timely twin research reports are examined. The topics include antenatal corticosteroids and twins' neonatal outcomes, the meaning of fatherhood in families with twins, what doppelgängers (look-alikes) reveal about physical and behavioral similarity, and monozygotic (MZ) co-twin discordance for asymmetric pigmented paravenous chorioretinal atrophy. A lawsuit involving alleged cheating on a medical school examination by identical twins is also reviewed. General interest stories cover opposite-sex twin Holocaust survivors, twin models at a Gucci fashion show, twins with different fathers, reunited female twins who entered the same convent, the death of an MZ female twin soldier during training, and the surgical separation of conjoined twins in Brazil. [ABSTRACT FROM AUTHOR]

Taira finds that the term I religion i has traditionally been most important for scholars of religion but argues that they should start taking the term "religion" seriously or even more seriously than religion. At the same time, perhaps only scholars of religion are the ones interested in "religion" and perhaps knowing something about religion may help a scholar study "religion.". [Extracted from the article]

5 Louis Tompkins Wright, "I Remember ...", in Louis T. Wright Papers, box 130-31, folder 12 (Manuscript Division, Moorland Spingarn Research Center, Howard University), 17, 48. 6 "William Augustus Hinton" (n. 4). 7 Hinton to Wright, December 1, 1937; Wright to Hinton, December 18, 1937; and Wright to Hinton, May 20, 1938 in Louis Tompkins Wright papers, 1879, 1898, 1909-1997. R. F. Buckley, "Winds of Change: Holmes Academic Society Renamed in Honor of Physician-Scientist William Augustus Hinton", I The Harvard Gazette i , September 23, 2020, and "William Augustus Hinton", I OnView: Digital Collections & Exhibits i , accessed November 8, 2022, https://collections.countway.harvard.edu/onview/items/show/18162. As a historian of race and medicine, my first visit to the National Museum of African American History and Culture was a peculiar experience. [Extracted from the article]

We describe new types of Lorenz-like attractors for three-dimensional flows and maps with symmetries. We give an example of a three-dimensional system of differential equations, which is centrally symmetric and mirror symmetric. We show that the system has a Lorenz-like attractor, which contains three saddle equilibrium states and consists of two mirror-symmetric components that are adjacent at the symmetry plane. We also found a discrete-time analog of this "conjoined-twins" attractor in a cubic three-dimensional Hénon map with a central symmetry. We show numerically that both attractors are pseudohyperbolic, which guarantees that each orbit of the attractor has a positive maximal Lyapunov exponent, and this property is preserved under small perturbations. We also describe bifurcation scenarios for the emergence of the attractors in one-parameter families of three-dimensional flows and maps possessing the symmetries. [ABSTRACT FROM AUTHOR]

Background: Parasitic conjoined twin is a rare but well-known entity with unclear embryopathogenesis. Abnormal conjoined twinning can result in an externally attached parasitic twin (PT), an enclosed foetus in foetu, or a mature teratoma. The treatment requires complete excision and reconstruction of local anatomy which is not always straightforward.Materials and Methods: PT cases presenting over 12 years were analysed. Patients with complete data, histopathological diagnosis and follow-up were included in the study. During follow-up, specific complications and related investigations were considered.Results: A total of five patients at four different sites were identified: two retroperitoneal foetus in foetu and three externally attached PTs which were located in the lumbar region, sacrococcygeal area and on the lower anterior abdominal wall. All patients underwent complete surgical excision. In foetus in foetu cases, the blood supply was directly from the aorta with a short stump while the three externally located ones required meticulous and careful dissection with the reconstruction of local anatomy.Conclusion: Parasitic conjoined twinning can present at different sites and surgical challenges vary accordingly. For surface lesions, reconstruction may be as complicated as excision. Prognosis can be affected by the excellence of anatomical restoration. Long-term follow-up is essential to address problems specific to the site of lesion and method of surgical reconstruction. [ABSTRACT FROM AUTHOR]

Simple Summary: Cases of newborn connected twins, so-called Siamese twins, are well known in humans, laboratory mammals, domestic and wild birds, reptiles, amphibians and fish. This report describes a unique case of newborn conjoined twins in guinea pigs (Cavia aperea f. porcellus). Connected twins in guinea pigs have been very rare, and there are only a few previous reported cases. This report is only the fourth described case of the birth of conjoined guinea pigs. They were born in breeding in the Czech Republic in 2020. The conjoined twins were males connected in the upper body by a cephalopagus-type connection, which has occurred in all three previous reports. The skeletons of both the bodies were connected by a broad shared skull and sternum. Both of the fused bodies had their own hearts and livers, but the lungs were mutual. The issue of this anomaly has not yet been clearly explained. The report describes a unique case of newborn conjoined twins in guinea pigs (Cavia aperea f. porcellus). Connected twins in guinea pigs have been very rare, and there are only a few previous reported cases. The newborns were stillborn in breeding in the Czech Republic in 2020 as two bodies conjoined into one. The external and internal structure of the body and the type of connection of both of the bodies are described. The weights of selected internal organs of the twins are compared with those of normally developed newborn guinea pigs. [ABSTRACT FROM AUTHOR]

Fetus in fetu is a rare phenomenon of infancy, separate from conjoined twins, teratomas, and acardiac twins. The pathogenesis is not well understood but has been theorized to originate from either the involution of a twin or the differentiation of a teratoma. While the majority of these are found in the retroperitoneum, the presence of a fetus in fetu within the scrotum is exceedingly rare. We present the diagnosis and management of a case of fetus in fetu in the scrotum of a newborn male including radiologic imaging and pathologic examination. [ABSTRACT FROM AUTHOR]

Purpose: Heteropagus twinning (HT) is a rare anomaly. Six new cases along with a systematic review are described.Methods: Six cases of HT managed at two tertiary care teaching hospitals over the last 26 years are described. A PubMed search with words: Heteropagus AND/ OR parasitic twins from 2001 to 2021 hit 183 articles. 36 were added from non-PubMed sources. Finally, 120 cases including 114 from 69 articles and 6 new cases were analysed.Results: Of the new cases, 2/6 had an antenatal diagnosis. Five were males. 4 autosites had omphaloceles. Split notochord and 2 parasites attached to a single autosite were encountered. 5/6 autosites survived. On systematic review, the most frequent variant seen was rachipagus (n = 50) followed by omphalopagus (n = 46). Limbs were reported in 75 cases. Congenital heart disease was seen in 17/120(14.2%) autosites. Omphalocele and meningomyelocele were the most common extracardiac anomalies in autosites. Weight along with the anatomy and position of heteropagus twins was a better determinant of the mode of delivery than weight alone. Mortality was reported in 12 cases.Conclusion: Autosites in HT generally carry a good prognosis, however, final outcome depends mainly on associated major cardiac anomalies. Meticulous antenatal assessment and preoperative planning are of paramount importance.Level Of Evidence: IV. [ABSTRACT FROM AUTHOR]

The school for the black deaf and blind stayed on in Raleigh under various names into the second half of the twentieth century, while the white blind moved back into the original building two blocks from the capitol.61 At the time that the white deaf school left Raleigh, Louisa and Zacharias had been married for twenty-one years and were still raising their family in Raleigh. The state General Assembly appropriated five thousand dollars toward a new school building for the Colored Department, now to be sited a mile and half from the old building near the Capitol.50 Principal Nichols, however, had a new complaint to lodge on another topic: it seems that some of the parents of the school's white pupils were exhibiting their children! Meanwhile, under a new principal, former teacher Willie J. Palmer, and with forty-two deaf pupils (and two blind in the still small blind program), the print shop was turning out Confederate paper money, and pupils were making the paper cartridges for Confederate Army rifles, which explains, perhaps, why the NCIDDB was the only deaf school in the Confederacy to remain open during the Civil War. Their father considered them so disabled that he left an extra five hundred dollars to each in his will, stating explicitly that this bonus bequest was "on account of their affliction."3 The North Carolina white Deaf community, then forming around the NCIDDB in Raleigh, would not have considered deaf children "feebly organized", pitiable, or afflicted, though the school wasn't above playing the pity card when asking the state for money for a new roof or water closets. [Extracted from the article]