Miracle-dz/UniFAR-FTUs huggingface dataset:
Artificial Intelligence-Driven Prediction Modeling and Decision Making in Spine Surgery Using Hybrid Machine Learning Models

Healthcare systems worldwide generate vast amounts of data from many different sources. Although of high complexity for a human being, it is essential to determine the patterns and minor variations in the genomic, radiological, laboratory, or clinical data that reliably differentiate phenotypes or allow high predictive accuracy in health-related tasks. Convolutional neural networks (CNN) are increasingly applied to image data for various tasks. Its use for non-imaging data becomes feasible through different modern machine learning techniques, converting non-imaging data into images before inputting them into the CNN model. Considering also that healthcare providers do not solely use one data modality for their decisions, this approach opens the door for multi-input/mixed data models which use a combination of patient information, such as genomic, radiological, and clinical data, to train a hybrid deep learning model. Thus, this reflects the main characteristic of artificial intelligence: simulating natural human behavior. The present review focuses on key advances in machine and deep learning, allowing for multi-perspective pattern recognition across the entire information set of patients in spine surgery. This is the first review of artificial intelligence focusing on hybrid models for deep learning applications in spine surgery, to the best of our knowledge. This is especially interesting as future tools are unlikely to use solely one data modality. The techniques discussed could become important in establishing a new approach to decision-making in spine surgery based on three fundamental pillars: (1) patient-specific, (2) artificial intelligence-driven, (3) integrating multimodal data. The findings reveal promising research that already took place to develop multi-input mixed-data hybrid decision-supporting models. Their implementation in spine surgery may hence be only a matter of time.
Determining Carina and Clavicular Distance-Dependent Positioning of Endotracheal Tube in Critically Ill Patients: An Artificial Intelligence-Based Approach

Simple Summary Endotracheal intubation (ETI) is employed for maintaining the airway patency of in critically ill patients during mechanical ventilation. Generally, ETI is conducted under anesthesia in the intensive care unit, during which the endotracheal tube (ETT) is inserted at a particular depth into the trachea, and a malpositioned ETT may result in hazardous consequences, such as a collapsed or hyperinflated lung. Therefore, we proposed a deep learning-based CNN approach, combined with four key point annotations on chest radiographs (tracheal tube end, carina, and left/right clavicular heads), which demonstrated significant sensitivity, specificity, and accuracy for recognizing and localizing the ETT tip on chest radiographs. These findings may assist in radiographic confirmation of precise ETT placement and help in ruling out other etiologies of respiratory failure. Abstract Early and accurate prediction of endotracheal tube (ETT) location is pivotal for critically ill patients. Automatic and timely detection of faulty ETT locations from chest X-ray images may avert patients’ morbidity and mortality. Therefore, we designed convolutional neural network (CNN)-based algorithms to evaluate ETT position appropriateness relative to four detected key points, including tracheal tube end, carina, and left/right clavicular heads on chest radiographs. We estimated distances from the tube end to tracheal carina and the midpoint of clavicular heads. A DenseNet121 encoder transformed images into embedding features, and a CNN-based decoder generated the probability distributions. Based on four sets of tube-to-carina distance-dependent parameters (i.e., (i) 30–70 mm, (ii) 30–60 mm, (iii) 20–60 mm, and (iv) 20–55 mm), corresponding models were generated, and their accuracy was evaluated through the predicted L1 distance to ground-truth coordinates. Based on tube-to-carina and tube-to-clavicle distances, the highest sensitivity, and specificity of 92.85% and 84.62% respectively, were revealed for 20–55 mm. This implies that tube-to-carina distance between 20 and 55 mm is optimal for an AI-based key point appropriateness detection system and is empirically comparable to physicians’ consensus.
Toward a better understanding of phylogenetic relationships within Conringieae (Brassicaceae)

One new tribe (Plagiolobeae), one new species (Plagioloba derakii) together with two new combinations (P. persica and P. clavata) are established within Brassicaceae based on a decisive consideration of molecular phylogenetic dataset, morphological characters, fruit septum nature, as well as seed microsculpturing features. Results distinctly justified Arabis ottonis-schulzii as a synonym of Conringia persica and further molecular analyses proved its placement as a member of genus Plagioloba. It is also placed in a new tribe Plagiolobeae as close relatives of Conringieae and Coluteocarpeae. Finally, the diagnostic morphological characters separating the new tribe from the previously assigned tribe (Conringieae) are also discussed.
External Match Load in Amateur Soccer: The Influence of Match Location and Championship Phase

Assessment of the physical dimension implicit in the soccer match is crucial for the improvement and individualization of training load management. This study aims to: (a) describe the external match load at the amateur level, (b) analyze the differences between playing positions, (c) verify whether the home/away matches and if (d) the phase (first or second) of the championship influence the external load. Twenty amateur soccer players (21.5 ± 1.9 years) were monitored using the global positioning system. The external load was assessed in 23 matches, where 13 were part of the first phase of the competition (seven home and six away matches) and the other 10 matches belonged to the second (and final) phase of the championship (five home and five away matches). A total of 173 individual match observations were analyzed. The results showed significant differences between playing positions for all the external load measures (p < 0.001). There were higher values observed in the total distance covered for central defenders (p = 0.037; ES = 0.70) and in high-intensity decelerations for forwards (p = 0.022; ES = 1.77) in home matches than in away matches. There were higher values observed in the total distance (p = 0.026; ES = 0.76), relative distance (p = 0.016; ES = 0.85), and moderate-intensity accelerations (p = 0.008; ES = 0.93) for central defenders, in very high-speed running distance for forwards (p = 0.011; ES = 1.97), and in high-intensity accelerations (p = 0.036; ES = 0.89) and moderate-intensity decelerations (p = 0.006; ES = 1.11) for wide midfielders in the first phase than in the second phase of the championship. Match location and championship phase do not appear to be major contributing factors to influence the external load while the playing position should be used as the major reference for planning the external training load.
Effects of exercise on serum ischemia-modified albumin, brain natriuretic peptide and copeptin levels in boxers and kick boxers

Introduction boxing and kick boxing are combat sports that can cause severe head, neck, face and hand injuries during fighting. Then, traumatic brain injury (TBI) incidence is high in these sports. Ischemia-modified albumin (IMA), brain natriuretic peptide (BNP) and copeptin have diagnostic and prognostic value for cardiac and non-cardiac ischemic events. The purpose of this study is to evaluate exercise-induced variations of serum IMA, BNP and copeptin. Methods twenty male boxers, twenty-three male kick boxers and twenty-three age-matched male were enrolled in the study. Health assessment data were analysed. Boxers and kick boxers underwent an exercise program including training plus fighting matches. Serum samples were collected in the pre- and post-exercise periods. Serum IMA, BNP and copeptin concentrations were measured in these specimens using ELISA reagents. Results comparative analysis of analytes before and after exercise showed that exercise significantly increased serum IMA, BNP and copeptin levels both in boxers and kick boxers. Conclusion in conclusion, IMA, BNP and copeptin levels may be candidate biomarkers for exercise-related traumatic brain injuries. The identification of new biomarkers in patients with acute and chronic neurological disorders is of considerable interest to clinicians. Then, further studies should be conducted to evaluate the possible role of IMA, BNP and copeptin in TBI pathophysiology.
Evaluation the Relationship between Mandibular Molar Root Apices and Mandibular Canal among Residents of the Moscow Population using Cone-Beam Computed Tomography Technique

Background: The relationship between the inferior alveolar nerve and the root apices of the mandibular molars and premolars is of clinical importance. The aim of this study was to determine the relationship between the mandibular canal (MC) and the mandibular molar root apices using cone-beam computed tomography (CBCT) scanning among residents of the Moscow population. Materials and Methods: Three hundred CBCT scans for patients aged 20–70 years were analyzed. Patients were divided into three age groups: young group (20–44 years), middle-age group (45–59 years), and elderly group (60–70). The distance from the MC and the mandibular molar root apices was measured in each group in the coronal view of CBCT scans. Statistical analysis was set on P < 0.05. Results: The mean distance from the mesial root apices of the first, second, and third molars to the MC was 4.92, 2.85, and 2.24 mm, respectively. The distal root showed to be the closest root to the MC in multirooted teeth. The young age group showed smaller distances to MC than other age groups (P < 0.05). Females showed smaller distances to MC in mandibular molars than males (P < 0.05). Conclusions: The distance between the root apices and the MC has to be taken into consideration when performing surgical or endodontic procedures.
Design and Analysis of Buildings with Fluidic Self-Centering Systems

AbstractDesign and analysis procedures for buildings with fluidic self-centering systems are presented and evaluated. The design procedures parallel those for buildings with damping systems in Chapter 18 of the ASCE 7 Standard. The evaluation of the procedures is based on the design and nonlinear response history analysis of 3- and 6- story steel moment frame example buildings. The study establishes the validity of simplified methods of analysis and determines their range of accuracy. Specifically, the simplified methods of analysis provide good and most often conservative estimates of drift and good predictions of self-centering device forces. The results demonstrated that buildings equipped with fluidic self-centering devices and designed per the presented procedures offer benefits of substantial reduction in residual story drift but also reduced peak story drift, peak floor acceleration, peak story shear and base shear forces, and reduced floor acceleration response spectra by comparison to the code-co.
Fluocinolone Acetonide Microemulsion in Combination with a Fractional Laser for the Treatment of Scalp Psoriasis

This study introduces fluocinolone acetonide (FA) microemulsion in combination with ablative fractional lasering as a new effective treatment for scalp psoriasis. A pseudo-ternary phase diagram was constructed using the aqueous titration method. The suitable ratio of surfactant mixture (Smix):oil mixture (Omix):water was chosen from the microemulsion region of the diagram. FA was loaded into the selected ratio to prepare FA microemulsion. Exvivo skin permeation study of the FA microemulsion with fractional laser assistance was performed to determine a proper ablative depth. A pilot clinical study was conducted to evaluate the efficacy of FA microemulsion and FA microemulsion combination with lasering at the optimum ablation depth. The selected microemulsion base contained (in wt%) 77% water, 20% Smix (Tween 80:ethanol, 2:1), 3% Omix (10% benzyl benzoate and 1% benzyl alcohol in bergamot oil), and 0.2% sodium carboxymethylcellulose. FA was loaded into this base at a concentration of 0.1%. The skin lasered at an ablation depth of 50 µm was conducted in the pilot clinical study. Scalp psoriasis responded well to the FA microemulsion. Psoriasis scalp severity index (PSSI) scores indicated that the FA microemulsion plus laser treatment provides higher efficacy than the FA microemulsion alone without any topical and systemic side effects. The efficacy of the treatments could be maintained for at least 1 week after treatment discontinuation. FA microemulsion was properly formulated and evaluated. The microemulsion demonstrating the greatest benefits was used in combination with ablative fractional lasering to treat scalp psoriasis.
Factors Associated With COVID-19 Behavioral Intentions: Findings From an Online Survey

Purpose The COVID-19 pandemic provides a novel context through which to evaluate salient factors for promoting behavioral change. We examined how attitudes, perceived community behaviors, and prior related behaviors predict intentions to (1) receive COVID-19 vaccination and (2) practice social distancing. Design Cross-sectional online survey administered through Amazon’s Mechanical Turk in September 2020. Subjects A convenience sample of US adults (N = 1804). Measures COVID-19 vaccination and social distancing intentions were measured on a 7-point Likert scale. Predictor variables included general vaccination and social distancing attitudes, perceived community mask-wearing, prior influenza vaccination, prior social distancing, and socio-demographics. Analysis Descriptive statistics and linear regressions. Results Thirty percent of respondents reported a strong willingness to receive COVID-19 vaccination, while 67% strongly intended to engage in social distancing. In regression analyses, vaccination intention was predicted by positive vaccine attitudes (b = .84; 95%CI: .78, .90; P < .001), prior influenza vaccination (b = −.47; 95%CI: −.63, −.32; P < .001), and perceived community mask-wearing (b = −.28; 95%CI: −.56, −.01; P=.049). Intention to practice social distancing was predicted by positive attitudes (b = .65; 95%CI: .61, .69; P < .001), prior social distancing (b = −.49; 95%CI: −.59, −.39; P < .001), and perceived community mask-wearing (b = −.28; 95%CI: −.46, −.09; P = .003). Conclusion Findings have implications for health promotion efforts. Messages that are targeted and tailored on pre-existing attitudes may be more effective. Additionally, leveraging prior behaviors and perceived community behavior may improve communication strategies.
Performance of the frailty index in predicting complete remission, intensive care unit admission, and overall mortality in older and younger patients with acute myeloid leukemia receiving intensive chemotherapy

Abstract The frailty index (FI) predicts clinical outcomes in oncology. However, in the acute myeloid leukemia (AML) setting, its predictive ability is poorly understood. We assessed whether the FI predicts complete remission (CR), intensive care unit (ICU) admission, and 1-year all-cause mortality in younger and older adults with AML receiving intensity chemotherapy. This was a secondary analysis of a prospective study. In total, 237 patients (n = 140 younger and n = 97 older adults) were classified as non-frail, prefrail, or frail. Frail younger adults were less likely to achieve CR compared with non-frail younger adults. Pre-frail and frail younger adults were more likely to be admitted to the ICU compared with their non-frail counterparts. The FI was not predictive of 1-year all-cause mortality. The FI predicts CR and ICU admission in younger but not older adults. Disease biology may be more important than frailty in predicting 1-year overall mortality in patients with AML undergoing chemotherapy.
Effect of Local Versus General Anesthesia in Breast-Conserving Surgery on Cancer Recurrence and Cost

Background The association between the type of anesthesia used and the recurrence of cancer remains controversial. This study aimed to compare the effects of local vs general anesthesia on recurrence-free survival and cost after breast-conserving surgery. Materials and Methods We reviewed the data of 2778 patients who underwent breast-conserving surgery followed by radiation at our center between 1999 and 2014. We analyzed the data of 994 patients with hormone receptor-positive and Her2-negative tumors who underwent breast-conserving surgery without axillary lymph node dissection under local or general anesthesia. Patients were grouped according to whether local or general anesthesia was used for the surgery. Results Of the 994 patients enrolled in this study, 367 received local anesthesia and 627 patients received general anesthesia. The median follow-up duration for all patients was 93 months. The Kaplan–Meier survival curves did not reveal significant differences between the recurrence-free survival of the two groups, with 5-year recurrence-free survival rates of 96.3% (95% CI, 94.3–98.3%) in the local anesthesia group and 97.3% (95% CI, 95.9–98.7%) in the general anesthesia group. The total cost of hospitalization in the local anesthesia group was significantly lower than that in the general anesthesia group (P <.001). The difference in the cost between the two groups remained significant, irrespective of the type of hospitalization, after excluding 165 patients receiving chemotherapy during their hospitalization. Conclusions Our analysis indicated no association between the type of anesthesia used during breast-conserving surgery and the long-term prognosis of breast cancer. However, breast-conserving surgery under local anesthesia may be a less expensive option than that under general anesthesia.
Sexual Assault, Psychological Distress, and Protective Factors in a Community Sample of Black, Latinx, and White Lesbian and Bisexual Women

Intersectionality and minority stress frameworks were used to guide examination and comparisons of psychological distress (depression, anxiety, posttraumatic stress disorder symptoms) and protective factors (religiosity, spirituality, social support) among 673 Black, Latinx, and White lesbian and bisexual women with and without histories of sexual assault. Participants were from Wave 3 of the 21-year longitudinal Chicago Health and Life Experiences of Women (CHLEW) study. More than one-third (38%) of participants reported having experienced adolescent or adult sexual assault (i.e., rape or another form of sexual assault) since age 14. Confirmatory factor analysis, structural equation modeling, and multivariate analyses of covariance were used to analyze the data. Results revealed that levels of religiosity/spirituality and psychological distress varied by race/ethnicity and by sexual identity (i.e., Black lesbian, Black bisexual, Latinx lesbian, Latinx bisexual, White lesbian, White bisexual). Black lesbian women reported the highest level of religiosity/spirituality whereas White lesbian women reported the lowest level. White bisexual women reported the highest level of psychological distress whereas White lesbian women reported the lowest level. We found no significant differences in reports of sexual assault or in social support (i.e., significant other, family, friend, and total social support). However, White lesbian women had higher friend, significant other, and total social support relative to the other five groups of women with minoritized/marginalized sexual identities. Future work should examine whether religiosity, spirituality, and social support serve as protective factors that can be incorporated into mental health treatment for lesbian and bisexual who have experienced sexual assault to reduce psychological distress.
Effect of an ongoing pharmacist service to reduce medicine-induced deterioration and adverse reactions in aged-care facilities (nursing homes): a multicentre, randomised controlled trial (the ReMInDAR trial)

Abstract Objective To assess the effectiveness of a pharmacist-led intervention using validated tools to reduce medicine-induced deterioration and adverse reactions. Design and setting Multicenter, open-label parallel randomised controlled trial involving 39 Australian aged-care facilities. Participants Residents on ≥4 medicines or ≥1 anticholinergic or sedative medicine. Intervention Pharmacist-led intervention using validated tools to detect signs and symptoms of medicine-induced deterioration which occurred every 8 weeks over 12 months. Comparator Usual care (Residential Medication Management Review) provided by accredited pharmacists. Outcomes Primary outcome was change in Frailty Index at 12 months. Secondary outcomes included changes in cognition, 24-hour movement behaviour by accelerometry, grip strength, weight, adverse events and quality of life. Results 248 persons (median age 87 years) completed the study; 120 in the interventionand, 128 in control arms. In total 575 pharmacist, sessions were undertaken in the intervention arm. There was no statistically significant difference for change in frailty between groups (mean difference: 0.009, 95% CI: −0.028, 0.009, P = 0.320). A significant difference for cognition was observed, with a mean difference of 1.36 point change at 12 months (95% CI: 0.01, 2.72, P = 0.048). Changes in 24-hour movement behaviour, grip strength, adverse events and quality of life were not significantly different between groups. Point estimates favoured the intervention arm at 12 months for frailty, 24-hour movement behaviour and grip strength. Conclusions The use of validated tools by pharmacists to detect signs of medicine-induced deterioration is a model of practice that requires further research, with promising results from this trial, particularly with regards to improved cognition.
The Opioid Epidemic and the State of Stigma: A Pennsylvania Statewide Survey

Abstract Background: The opioid epidemic is a public health crisis. Among initiatives surrounding treatment and prevention, opioid use disorder (OUD) stigma has emerged as a subject for intervention. Objectives: This study examines overall results and demographic differences of three subscales of a public stigma survey instrument: general attitudes, social distance, and treatment availability and effectiveness. Methods: A statewide sample of Pennsylvanian adults (N = 1033) completed an online survey about the opioid epidemic. Weighted percentage level of agreement was reported for each item. To determine significant differences in responding across demographic groups (gender, race, and urban/rural status), multiple one-way ANOVAs were analyzed. Significant differences in the level of agreement and disagreement (p < .05) were reported. Results: The majority of respondents agreed that the opioid epidemic is a problem and that anyone can become addicted to opioids; however, many Pennsylvanians still disagree that OUD is a medical disorder and continue to endorse social distance beliefs of people with OUD. Most participants agreed that there are effective treatments available, and that recovery was possible; however, a large portion of participants were unsure whether specific treatments are effective. Subscale mean differences were significant for gender and age. Conclusions/Importance: Findings highlight that stigmatized attitudes, behaviors, and beliefs about individuals who use opioids are still prevalent and that uncertainty remains about the effectiveness of OUD treatment. OUD interventions should use targeted messaging in order to impact the ongoing opioid crisis.