Miracle-dz/UniFAR-FTUs huggingface dataset:
Changes in French family medicine residents’ perspectives about patient partners’ participation in teaching: A qualitative study in co-facilitated practice exchange groups

Abstract Purpose The patient partner in teaching method is progressively developing for clinical training in France. Practice exchange groups (PEG) co-facilitated by patient partners in teaching are used during the training of family medicine (FM) residents. This study explored the FM residents’ perspectives about patient partner in teaching’s participation in co-facilitated PEGs and how they changed over time. Students and methods In 2020, qualitative focus groups were carried out with 26 FM residents before and after a 5-month intervention based on monthly PEGs co-facilitated by patient partners in teaching. A reflective thematic analysis of the focus group interviews was performed according to Braun and Clarke’s approach. Results FM residents supported patient partners in teaching’s facilitation role and had high expectations concerning their contribution to the development of their skills and competencies. They expected patient partners in teaching to bring their individual experience and also a collective knowledge. Some limitations mentioned by FM residents disappeared over time, such as the loss of the medical group feeling among physicians, while others persisted and required pedagogical support targeted to FM residents before PEG initiation. Conclusion This study shows the good acceptance of patient partners in teaching by FM residents in the context of PEGs. Attention should be paid to make FM residents aware of patient partners in teaching’s missions before their introduction.
Impact of Intraoperative Hypothermia on Incidence of Infection in Implant-Based Breast Reconstruction

Background: Infection following implant-based breast reconstruction can lead to devastating complications. Risk factors for infection include smoking, diabetes, and obesity. Intraoperative hypothermia may represent another modifiable risk factor. This study analyzed the effect of hypothermia in postmastectomy immediate implant-based reconstruction on postoperative surgical-site infection (SSI). Methods: This was a retrospective review of 122 patients with intraoperative hypothermia, defined as less than 35.5°C, and 106 normothermic patients who underwent postmastectomy implant-based reconstruction between 2015 and 2021. Demographics, comorbidities, smoking status, hypothermia (and its duration), and length of surgery were collected. The primary outcome was SSI. Secondary outcomes included reoperation and delayed wound healing. Results: A total of 185 patients (81%) underwent staged reconstruction with tissue expander placement and 43 patients (18.9%) had a direct-to-implant procedure. Over half (53%) of the patients experienced intraoperative hypothermia. In the hypothermic group, a higher proportion of patients had SSIs (34.4% versus 17% of normothermic patients; P < 0.05) and wound healing complications (27.9% versus 16%; P < 0.05). Intraoperative hypothermia predicted SSI (OR, 2.567; 95% CI, 1.367 to 4.818; P < 0.05) and delayed wound healing (OR, 2.023; 95% CI, 1.053 to 3.884; P < 0.05). Longer duration of hypothermia significantly correlated with SSI, with an average 103 minutes versus 77 minutes (P < 0.05). Conclusions: This study demonstrates that intraoperative hypothermia is a significant risk factor for postoperative infection in postmastectomy implant-based breast reconstruction. Maintaining strict normothermia during implant-based breast reconstruction procedures may improve patient outcomes by reducing the risk of postoperative infection and delayed wound healing. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
Platform development and gliding optimization of a robotic flying fish with morphing pectoral fins

The aquatic-aerial robot with the free interface crossing can enhance adaptability in complex aquatic environments. However, its design is extremely challenging for the striking discrepancies in propulsion principles. The flying fish in nature exhibits remarkable multi-modal cross-domain locomotion capability, such as high-maneuvers swimming, agile water-air crossing, and long-distance gliding, providing extensive inspiration. In this paper, we present a unique aquatic-aerial robotic flying fish with powerful propulsion and a pair of morphing wing-like pectoral fins to realize cross-domain motion. Furthermore, to explore the gliding mechanism of flying fish, a dynamic model with a morphing structure of pectoral fins is established, and a double deep Q-network-based control strategy is proposed to optimize the gliding distance. Finally, experiments were conducted to analyze the locomotion of the robotic flying fish. The results suggest that the robotic flying fish can successfully perform the ‘fish leaping and wing spreading’ cross-domain locomotion with an exiting speed of 1.55 m s−1 (5.9 body lengths per second, BL/s) and a crossing time of 0.233 s indicating its great potential in cross-domain. Simulation results have validated the effectiveness of the proposed control strategy and indicated that the dynamical adjustment of morphing pectoral fins contributes to improving the gliding distance. The maximum gliding distance has increased by 7.2%. This study will offer some significant insights into the system design and performance optimization of aquatic-aerial robots.
Advances in the Treatment of Rare Epidermal Growth Factor Receptor Mutations in Advanced Nonsmall-Cell Lung Cancer

Epidermal growth factor receptor (EGFR) mutations are common driver genes in nonsmall-cell lung cancer and have different sensitivities to EGFR-tyrosine kinase inhibitors (EGFR-TKIs). EGFR is divided into classic mutations and rare mutations. Classic mutations are well known, but the understanding of rare mutations is not sufficient. In this article, we summarize the clinical research and treatment progress of rare mutations for different EGFR-TKIs and provide a basis for clinical treatment decisions.
A Study on Flight Altitude Discrepancy Base on the Fisher Ordinal Samples Cluster Method

There now exists a discrepancy between the practical flight altitude and the one calculated by CFP(Computerized Flight Plan),which is unfavorable to security as well as cost-saving of flights.Along air route,flight altitude discrepancy is variable between segments.According to this character,this paper studies the flight altitude discrepancy based on air route segmentation.The study applies the weighted Fisher ordinal samples cluster method to cluster around those air route points with similar discrepancy level,meanwhile keeping their original order in air route,consequently carrying out air route segmentation.The outcome can tell on which air route segments the discrepancy is striking and needs to be given special attention,which is of benefit to improve the rationality of flight plan(takeoff fuel) and helps pilots support takeoff preparation.
Incidence of Hyponatremia Among Critically Ill Patients With and Without COVID-19 Infection at a Community Teaching Hospital

Background: Various studies have demonstrated the incidence of hyponatremia in patients with Coronavirus Disease 2019 (COVID-19); however, to our knowledge, no study has assessed the difference in the incidence of hyponatremia in patients with and without COVID-19. Purpose: To compare the incidence of hyponatremia in patients requiring intensive care unit (ICU) admission with and without COVID-19 infection. Methods: This was a single-center, retrospective cohort study of patients with a diagnosis of pneumonia from February 2019 to January 2020, or a diagnosis of COVID-19 from June 2020 to May 2021. Included patients were matched on age and sex. The primary outcome was the incidence of hyponatremia within 72 h of admission. Secondary endpoints collected included severity of hyponatremia, symptomatic hyponatremia, and lowest serum sodium. Results: There were 99 and 104 patients included in pneumonia and COVID-19 arms, respectively. Twenty-nine patients in the pneumonia group and 56 patients in the COVID-19 group had a sodium level <134 mEq/L (29% vs 56%, RR 1.84, P < .01). The mean lowest serum sodium within 72 h of admission was 136.9 mEq/L in the pneumonia group and 134.5 mEq/L in the COVID-19 group (P < .01). Other notable findings included days of mechanical ventilation (3 days vs 8 days, respectively; P < .01), downgrade from the ICU (74.8% vs 59.6%, P = .02), ICU length of stay (4 days vs 10 days, P < .01), hospital length of stay (6 days vs 14 days, P < .01), and mortality (16.2% vs 39.4%, P < .01). Conclusion: Among critically ill patients with COVID-19, the risk of hyponatremia was significantly greater than the risk in critically ill patients with pneumonia.
Spectroscopy of six highly evolved Abell planetary nebulae

We have undertaken visual spectroscopy of the highly evolved planetary nebulae (PNe) A8, A13, A62, A72, A78 and A83 over a wavelength range 4330 < λ < 6830 A. This permits us to specify relative line intensities in various sectors of the nebular shells, and to investigate the variation of emission as a function of radius. We determine that the spectrum of the central star of A78 has varied appreciably over a period of 25 yr. There is now evidence for strong P Cygni absorption in the λ4589 and λ5412 transitions of He II, implying terminal velocities of the order of V∞ 3.83 x 10 3 km s -1 . We also note that the emission-line profiles of the sources can be used to investigate their intrinsic emission structures. We find that most PNe show appreciable levels of emission throughout their volumes; only one source (A13) possesses a thin-shell structure. Such results are in conformity with evolutionary theory, and probably reflect the consequences of adiabatic cooling in highly evolved outflows.
Current management of uveal melanoma: A review

Uveal melanoma is the most frequent primary intraocular cancer in adulthood and is mostly localised to the choroid. It can be treated using radiation therapy, laser therapy, local resection and enucleation, with the best results achieved by combining these procedures. However, up to half of patients develop metastatic disease. There are no efficacious treatment methods for patients in advanced stage or with metastasis. In recent years, several novel treatment modalities aimed at improving tumour control and reducing adverse events have emerged. This review summarises current clinical treatment methods and new therapeutic perspectives for uveal melanoma.
Speech2EEG: Leveraging Pretrained Speech Model for EEG Signal Recognition

Identifying meaningful brain activities is critical in brain-computer interface (BCI) applications. Recently, an increasing number of neural network approaches have been proposed to recognize EEG signals. However, these approaches depend heavily on using complex network structures to improve the performance of EEG recognition and suffer from the deficit of training data. Inspired by the waveform characteristics and processing methods shared between EEG and speech signals, we propose Speech2EEG, a novel EEG recognition method that leverages pretrained speech features to improve the accuracy of EEG recognition. Specifically, a pretrained speech processing model is adapted to the EEG domain to extract multichannel temporal embeddings. Then, several aggregation methods, including the weighted average, channelwise aggregation, and channel-and-depthwise aggregation, are implemented to exploit and integrate the multichannel temporal embeddings. Finally, a classification network is used to predict EEG categories based on the integrated features. Our work is the first to explore the use of pretrained speech models for EEG signal analysis as well as the effective ways to integrate the multichannel temporal embeddings from the EEG signal. Extensive experimental results suggest that the proposed Speech2EEG method achieves state-of-the-art performance on two challenging motor imagery (MI) datasets, the BCI IV-2a and BCI IV-2b datasets, with accuracies of ${89}. {5}\%$ and ${84}. {07}\%$ , respectively. Visualization analysis of the multichannel temporal embeddings show that the Speech2EEG architecture can capture useful patterns related to MI categories, which can provide a novel solution for subsequent research under the constraints of a limited dataset scale.
Plasticity between type 2 innate lymphoid cell subsets and amphiregulin expression regulates epithelial repair in biliary atresia

Background and Aims: Although a dysregulated type 1 immune response is integral to the pathogenesis of biliary atresia, studies in both humans and mice have uncovered a type 2 response, primarily driven by type 2 innate lymphoid cells. In nonhepatic tissues, natural type 2 innate lymphoid cell (nILC2s) regulate epithelial proliferation and tissue repair, whereas inflammatory ILC2s (iIlC2s) drive tissue inflammation and injury. The aim of this study is to determine the mechanisms used by type 2 innate lymphoid cell (ILC2) subpopulations to regulate biliary epithelial response to an injury. Approach and Results: Using Spearman correlation analysis, nILC2 transcripts, but not those of iILC2s, are positively associated with cholangiocyte abundance in biliary atresia patients at the time of diagnosis. nILC2s are identified in the mouse liver through flow cytometry. They undergo expansion and increase amphiregulin production after IL-33 administration. This drives epithelial proliferation dependent on the IL-13/IL-4Rα/STAT6 pathway as determined by decreased nILC2s and reduced epithelial proliferation in knockout strains. The addition of IL-2 promotes inter-lineage plasticity towards a nILC2 phenotype. In experimental biliary atresia induced by rotavirus, this pathway promotes epithelial repair and tissue regeneration. The genetic loss or molecular inhibition of any part of this circuit switches nILC2s to inflammatory type 2 innate lymphoid cell-like, resulting in decreased amphiregulin production, decreased epithelial proliferation, and the full phenotype of experimental biliary atresia. Conclusions: These findings identify a key function of the IL-13/IL-4Rα/STAT6 pathway in ILC2 plasticity and an alternate circuit driven by IL-2 to promote nILC2 stability and amphiregulin expression. This pathway induces epithelial homeostasis and repair in experimental biliary atresia.
Using Deadlifts as a Postactivation Performance Enhancement Strategy in Warm-ups in Football

Abstract Abade, E, Brito, J, Gonçalves, B, Saura, L, Coutinho, D, and Sampaio, J. Using deadlifts as a postactivation performance enhancement strategy in warm-ups in football. J Strength Cond Res 37(9): 1821–1827, 2023—Postactivation performance enhancement activities may be relevant warm-up strategies aiming to improve subsequent physical performance. The purpose of the current study was to investigate the effects of adding barbell deadlift or hex-bar deadlift exercises to current warm-up routines on running and jumping performances in football players. Ten highly trained male football players participated in the study during the competitive phase of the season. All players performed 3 protocols in the same week: a standard warm-up that included players' regular routines and 2 other protocols with the addition of barbell or hex-bar deadlift, after the end of the warm-up (3 sets of 3 reps, progressing set by set from 60% to 85% repetition maximum). All protocols had the same time interval between pretest (immediately after the warm-up) and posttest (15 minutes after the warm-up). Vertical jumping (countermovement jump [CMJ]; Abalakov jump [AJ]) and running performances (505 test) were impaired 15 minutes after the standard warm-up (CMJ: −6.7 ± 4.2%; AJ: −8.1 ± 8.4%; and 505 time: 1.4 ± 2.5%). For warm-up with the addition of barbell deadlift, vertical jump increased by 4.3 ± 5.6% (Cohen's dunb: 0.23 [0.02–0.47]) and 505 time decreased by −5.9 ± 3.6% (Cohen's dunb: 0.97 [−1.68 to −0.43]). The warm-up with hex-bar deadlift led to trivial changes for CMJ and AJ, but 505 time decrease by −2.7 ± 2.6% (Cohen's dunb: −0.53 [−1.01 to −0.13]). The deadlift exercise can be added to warm-up routines to maintain or even enhance acute physical performance. However, coaches and practitioners should be aware that performance enhancements resultant from deadlift may vary according to individual physical profiles.
Fast Generalized Motion Estimation and

We propose a new superresolution algorithm based on a fast motion estimation technique. Two stages of this algo- rithm, namely, motion estimation and high-resolution reconstruc- tion, rely on an area-based interpolation scheme that involves in- tersecting two pixel grids in arbitrary orientation, displacement, and scaling. We develop a fast approximate solution of the above problem, whose exact solution is prohibitively expensive. Also, gradient descent algorithm is used for fast convergence of the motion estimation algorithm. Experimental results demonstrate the good performance of the proposed superresolution algorithm as well its robustness against noise. In this paper a fast image registration and reconstruction algorithm is proposed which obtains a high-resolution (HR) frame using a number of adjacent low-resolution (LR) frames. It is assumed that there is only a global motion between the current frame and the reference frames. Although such an assumption is simplistic for real videos, algorithms similar to ours provide an important building block for the more generalized superresolution problem with local motions and occlusion (7). Furthermore, in its current form the algorithm can be applied to any part of video frames for which motion can be described by a single model. Accurate estimation of generalized motion is critical for superresolution (2) and many other applications. Our main contribution is a fast generalized motion estimation algorithm. Unlike available motion estimators (7), (9), which are based on optical flow, the proposed algorithm directly minimizes the dif- ference between the current frame pixels and the interpolated pixels of the motion-compensated reference frame. Gradient based iterations of the algorithm ensures fast convergence and accuracy. The algorithm is also robust against high noise level in video frames. In this paper we also introduce a fast HR reconstruction algorithm. Both motion estimation and HR reconstruction rely on area-based interpolation, which is approximated to speed-up the algorithms. Interested readers are directed to (1), (2), (3), (10) for detailed surveys on image registration and superresolution.
Association of Stages of Objective Memory Impairment With Incident Symptomatic Cognitive Impairment in Cognitively Normal Individuals

Background and Objectives Increasing evidence indicates that a subset of cognitively normal individuals has subtle cognitive impairment at baseline. We sought to identify them using the Stages of Objective Memory Impairment (SOMI) system. Symptomatic cognitive impairment was operationalized by a Clinical Dementia Rating (CDR) ≥0.5. We hypothesized that incident impairment would be higher for participants with subtle retrieval impairment (SOMI-1), higher still for those with moderate retrieval impairment (SOMI-2), and highest for those with storage impairment (SOMI-3/4) after adjusting for demographics and APOE ε4 status. A secondary objective was to determine whether including biomarkers of β-amyloid, tau pathology, and neurodegeneration in the models affect prediction. We hypothesized that even after adjusting for in vivo biomarkers, SOMI would remain a significant predictor of time to incident symptomatic cognitive impairment. Methods Among 969 cognitively normal participants, defined by a CDR = 0, from the Knight Alzheimer Disease Research Center, SOMI stage was determined from their baseline Free and Cued Selective Reminding Test scores, 555 had CSF and structural MRI measures and comprised the biomarker subgroup, and 144 of them were amyloid positive. Cox proportional hazards models tested associations of SOMI stages at baseline and biomarkers with time to incident cognitive impairment defined as the transition to CDR ≥0.5. Results Among all participants, the mean age was 69.35 years, 59.6% were female, and mean follow-up was 6.36 years. Participants in SOMI-1–4 had elevated hazard ratios for the transition from normal to impaired cognition in comparison with those who were SOMI-0 (no memory impairment). Individuals in SOMI-1 (mildly impaired retrieval) and SOMI-2 (moderately impaired retrieval) were at nearly double the risk of clinical progression compared with persons with no memory problems. When memory storage impairment emerges (SOMI-3/4), the hazard ratio for clinical progression increased approximately 3 times. SOMI stage remained an independent predictor of incident cognitive impairment after adjusting for all biomarkers. Discussion SOMI predicts the transition from normal cognition to incident symptomatic cognitive impairment (CDR ≥0.5). The results support the use of SOMI to identify those cognitively normal participants most likely to develop incident cognitive impairment who can then be referred for biomarker screening.
Correlation between flat foot and patellar instability in adolescents and analysis of related risk factors

Introduction Flatfoot and patellar instability are both developmental limb deformities that occur frequently in adolescents. A high number of patients with both diseases can be seen in clinic, and there are no studies showing a correlation between the two. The goal of this study is to investigate the association between developmental patellar instability and flat feet in adolescents and its associated risk factors. Methods This experiment uses a cross-sectional study to select 74 adolescent patients with flat foot from a randomly selected middle school in this city since December 2021 and obtain relevant data. SPSS26.0 statistical software was used for data analysis. Quantitative data were expressed as mean ± standard deviation, and Pearson correlation coefficient was used for analysis. p < 0.05 indicates a statistically significant difference. Results A total of 74 people (40 men and 34 women) were included in this study. The correlation coefficients between Meary angle, Pitch angle, calcaneal valgus angle, CSI, BMI, and Beighton scores and knee joint Q angle are 0.358 (p < 0.01), −0.312 (p < 0.01), 0.403 (p < 0.01), 0.596 (p < 0.01), 0.427 (p < 0.01), and 0.293 (p < 0.05), respectively, indicating that flat foot, overweight, and Beighton scores are all correlated with Q angle. The correlation coefficients between Meary angle, Pitch angle, calcaneal valgus angle, CSI, and BMI were 0.431 (p < 0.01), −0.399 (p < 0.01), 0.319 (p < 0.01), and 0.563 (p < 0.01), respectively, indicating a correlation between flat foot and BMI. The correlation coefficients between Meary’s angle, Pitch’s angle, calcaneal valgus angle, CSI, and Beighton’s score were 0.207 (p > 0.05), −0.240 (p < 0.05), 0.204 (p > 0.05), and 0.413 (p < 0.01), respectively, indicating a correlation between flat foot and Beighton’s score. Conclusion We believe that there is a significant correlation between adolescent flatfoot and patellar instability. Excessive weight and ligamental laxity during adolescent development are among the risk factors for flatfoot and patellar instability.