Miracle-dz/UniFAR-FTUs huggingface dataset:
Cone Beam CT (CBCT) Based Synthetic CT Generation Using Deep Learning Methods for Dose Calculation of Nasopharyngeal Carcinoma Radiotherapy

Objective: To generate synthetic CT (sCT) images with high quality from CBCT and planning CT (pCT) for dose calculation by using deep learning methods. Methods: 169 NPC patients with a total of 20926 slices of CBCT and pCT images were included. In this study the CycleGAN, Pix2pix and U-Net models were used to generate the sCT images. The Mean Absolute Error (MAE), Root Mean Squared Error (RMSE), Peak Signal to Noise Ratio (PSNR), and Structural Similarity Index (SSIM) were used to quantify the accuracy of the proposed models in a testing cohort of 34 patients. Radiation dose were calculated on pCT and sCT following the same protocol. Dose distributions were evaluated for 4 patients by comparing the dose-volume-histogram (DVH) and 2D gamma index analysis. Results: The average MAE and RMSE values between sCT by three models and pCT reduced by 15.4 HU and 26.8 HU at least, while the mean PSNR and SSIM metrics between sCT by different models and pCT added by 10.6 and 0.05 at most, respectively. There were only slight differences for DVH of selected contours between different plans. The passing rates of 2D gamma index analysis under 3 mm/3% 3 mm/2%, 2 mm/3%and 2 mm/2% criteria were all higher than 95%. Conclusions: All the sCT had achieved better evaluation metrics than those of original CBCT, while the performance of CycleGAN model was proved to be best among three methods. The dosimetric agreement confirmed the HU accuracy and consistent anatomical structures of sCT by deep learning methods.
Surgical turndowns are not no option patients

• Patients with extensive, high-risk coronary artery disease (CAD) deemed surgically ineligible who undergo elective percutaneous coronary intervention (PCI) have better than predicted surgical 30-day outcomes. • Risk factors predicting 1-year PCI outcomes include frailty and STS score. • Future trials are needed to best assess acceptable risk profiles for PCI in surgical turndowns as well as the impact of procedural characteristics such as completeness of revascularization, hemodynamic support, and image-guided stenting on late outcomes.
Blended learning model via small private online course improves active learning and academic performance of embryology

While blended learning has been growing in popularity in recent years, the effectiveness of this procedure remains controversial. In this report, we assess the effectiveness of blended learning of embryology within international medical students. The participants were international medical students taking embryology in the Bachelor of Medicine and Bachelor of Surgery program. The blended learning group (BLG) consisted of students (n = 43) in the 2018–2019 academic year, taught with blended learning model via a customized small private online course (SPOC). The control traditional teaching group (TTG) consisted students (n = 48) in the 2017–2018 academic year, taught with traditional teaching model. Academic performance, including mean scores and passing ratios on the final exam of two groups were compared and analyzed with a t‐test. In addition, a questionnaire directed toward evaluating student's perceptions with the blended learning was administered to students in BLG. The majority of students in BLG actively participated in online self‐study activities and discussion in face‐to‐face class sessions. The mean score and passing ratio were significantly greater than those of students in TTG (p < 0.01). Results from the questionnaire revealed that the majority of BLG students felt that this method was beneficial for their learning of human embryology. The blended learning model, that integrates SPOC with face‐to‐face class lectures proved a more effective means for the teaching of embryology than the traditional lecture‐based teaching model. This blended learning method may serve as a feasible model that can be readily applied for use in other medical courses.
The effect of a high-pressure protocol on penalty shooting performance, psychological, and psychophysiological response in professional football: A mixed methods study

ABSTRACT The penalty kick in soccer is arguably one of the most highly visible and high-pressured sporting situations in the world. This study examined the effect of a high-pressure protocol on penalty shooting performance, and the associated psychological and psychophysiological responses to, and perceptions of that protocol. A sequential mixed-method research design was employed wherein the experimental condition consisted of a repeated-measures design with pressure as the within-participants factor (low-pressure, high-pressure). Quantitative data collection was complemented with a semi-structured interview. Twenty professional footballers took part. The Immediate Anxiety Measurement Scale (IAMS) and Pressure Likert-type scale were administered prior to both conditions. The NeXus-10 biofeedback system recorded players’ heart rate and respiration rate. Outfield players took five penalty kicks to four targets to the goal, under low and high-pressure. Pressure, cognitive anxiety, and respiration rate significantly increased in the high-pressure condition. After controlling for the level of pressure experienced in the high-pressure condition, bivariate variable error performance significantly increased (i.e., players were more variable in their grouping of shots under stress). Qualitative data indicated the 6-step high-pressure protocol predominantly evoked the distraction mechanism. This research provided first insight into the experiences of professional footballers to a simulated high-pressure penalty protocol.
The Intergenerational Transmission of Family Conflict on Children’s Aggression: The Compensatory Effect of Positive Parenting

Department of Health Behavior and Health Education, University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI, USA Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan School of Social Work, University of Michigan, Ann Arbor, Michigan, USA Deepwater Counseling, Ypsilanti, MI, USA Department of Health Promotion and Behavioral Sciences, University of Texas, Houston, TX, USA
Towards a New Paradigm: Design Strategies for Architecture, Energy and Climate Change using Danish Office Buildings as a Case Study

This paper argues that the understanding of architecture again needs to be widened if the architectural profession is to play an active role in combating climate change. The paper therefore examines past, present and future challenges for building energy consumption in Denmark as the basis for developing a new paradigm for zero-energy architecture. There has been a radical transformation in building energy consumption over the last 30 years, with an absolute reduction in heat consumption and a rapid growth in electricity consumption, reflecting wider technological and social transformations in the movement from an industrial to a knowledge-based society. In new offices it is shown that electricity consumption now dominates the total primary energy consumption, whilst at the same time, climate change means that rising temperatures will result in falling heat demand and increasing cooling demand in the future. With this background, a new paradigm for zeroenergy architecture is developed that reflects the architectural design process. In this way, the architectural focus early in the design process on functional disposition, spatial quality and built form can act as the driving force in the movement towards zero-energy architecture that has good daylighting and indoor comfort, and is adapted to future climate change.
Analysis of bacterial communities of three cassava‐based traditionally fermented Nigerian foods (abacha, fufu and garri)

Globally, cassava is an important food crop that contributes significantly to food security. In Nigeria, cassava can be traditionally processed into abacha (fermented strips), fufu (submerged‐fermented porridge) and garri (solid‐state fermented farinated granules) for human consumption. Despite the widespread consumption of these foods, there is a major knowledge gap in understanding their core bacterial diversity. This study, therefore, applied next‐generation sequencing of 16S rRNA gene to delineate the bacterial diversity in abacha, fufu and garri. Amplicon sequence variants belonging to nine phyla were present in the three foods. Firmicutes dominated the bacterial community of abacha and fufu, whereas, Proteobacteria was the dominant phylum in garri. At genus level taxa, Lactococcus, Lysinibacillus and Pseudomonas dominated the bacterial community in abacha, fufu and garri, respectively. Other dominant phylotypes reported in the foods belonged to Bacillus, Clostridium sensu stricto (cluster 1), Cupriavidus, Enterobacter, Sphingomonas and Staphylococcus. To the best of our knowledge, Clostridium sensu stricto cluster 1 and Lysinibacillus in fufu, and Brevundimonas, Cupriavidus, Sphingomonas and Strenotrophomomas in garri are reported for the first time. Although some potential pathogenic genera were recorded, the foods contained potentially functional species that could be explored to improve artisanal food production, food security and safeguard consumer health.
Pharmacokinetics, Pharmacodynamics, and Safety of Etrolizumab in Children With Moderately to Severely Active Ulcerative Colitis or Crohn’s Disease: Results from a Phase 1 Randomized Trial

Abstract Background Etrolizumab, a humanized anti-β7 antibody, has not been studied in children. Here, we evaluate the pharmacokinetics, pharmacodynamics, and safety of etrolizumab in children with inflammatory bowel disease. Methods Patients age 4 to 17 years with moderately to severely active ulcerative colitis or Crohn’s disease were randomized 1:1 to receive 1.5mg/kg of etrolizumab subcutaneously every 4 weeks (q4w) or 3.0mg/kg every 8 weeks (q8w) for 16 weeks in this open-label phase 1 trial. Pharmacokinetics, pharmacodynamics, safety, and efficacy were assessed. Results Of the 24 patients treated, 21 completed the study. In the groups of 1.5mg/kg q4w and 3.0mg/kg q8w, respectively, mean (SD) maximum concentration (Cmax) was 9.8 (4.86) µg/mL and 18.1 (6.25) µg/mL; and mean (SD) area under the curve within a dosing interval (AUCtau) was 167 (86.9) and 521 (306) μg·day/mL after the last dose. The Cmax increased dose proportionally. The AUC over an 8-week period was slightly higher in the 3.0mg/kg q8w dose group. Median half-life was similar for both dosing regimens. Median numbers of free β7high gut-homing T and B cell subsets declined below 10% of baseline, confirming β7 target engagement and complete/near-complete receptor occupancy. Adverse events were consistent with the safety profile in adults. Approximately 60% of patients achieved a clinical response. Conclusions Etrolizumab showed a dose-proportional increase in Cmax and a slightly greater than dose-proportional increase in AUCtau. Both regimens achieved complete/near-complete β7 receptor occupancy, with a similar relationship to concentration as adults. Etrolizumab was well tolerated and demonstrated clinical activity in children.
Finite difference time domain simulation of earth electrodes soil ionisation under lightning surge condition

The non linear effects of soil ionisation on the behaviour of earth electrodes are investigated by a finite difference time domain numerical scheme. A time variable soil resistivity is used in order to simulate the soil breakdown; step by step the resistivity value is controlled by the local instantaneous value of the electric field compared with the electrical strength, fixed for the soil. No a priori hypothesis about the geometrical shape of the ionised zone around the electrodes has to be enforced. Simulation results related to complex earth electrodes of limited extension are reported. The model has been validated by comparing the computed results with data available in technical literature. A discussion about dangerous earth voltages is reported, by underlining the role of soil ionisation. Electrodes of larger extension can be straightforwardly simulated by means of larger computational resources.
Gradient coil and radiofrequency induced heating of orthopaedic implants in MRI: influencing factors

Patients with implanted orthopaedic devices represent a growing number of subjects undergoing magnetic resonance imaging (MRI) scans each year. MRI safety labelling is required for all implants under the EU Medical Device Regulations to ensure regulatory compliance, with each device assessed through standardised testing procedures. In this paper, we employ parametric studies to assess a range of clinically relevant factors that cause tissue heating, performing simulations with both radiofrequency (RF) and gradient coil (GC) switching fields, the latter of which is often overlooked in the literature. A series of ‘worst-case’ scenarios for both types of excitation field is discussed. In the case of GC fields, large volume implants and large plate areas with the field orientated perpendicular to the plane cause the highest heating levels, along with sequences with high rates of field switching. Implant heating from RF fields is driven primarily from the ‘antenna effect’, with thin, linear implants of resonant length resulting in the highest temperature rises. In this work, we show that simplifications may be made to the field sequence and in some cases the device geometry without significantly compromising the accuracy of the simulation results, enabling the possibility for generic estimates of the implant heating for orthopaedic device manufacturers and opportunities to simplify the safety compliance process.
Revision Stapes Surgery: Hearing Symptoms and Associations With Intraoperative Findings and Outcomes

Objective Stapes surgery for otosclerosis occasionally requires revision due to recurrent or persistent conductive hearing loss (CHL). This study examines outcomes after revision stapes surgery. Study Design Retrospective review. Setting Single tertiary neurotology center. Methods Patients undergoing revision stapes surgery for otosclerosis from 2008 to 2017 were reviewed. Postoperative air-bone gaps (ABGs) were the primary outcome measure. Results During the study period, 150 patients underwent revision stapes surgery. One hundred patients (67%) had gradually progressive recurrent CHL; 16 (11%), sudden recurrent CHL; 13 (9%), persistent CHL; and 21 (14%), no CHL. For 129 patients with CHL, the mean ABG improved from 23.7 to 9.3 dB (P < .0005). The most common intraoperative findings for these patients were prosthesis displacement with incus necrosis (38%) or without it (43%), normal anatomy with seemingly good prosthesis placement (6%), and abundant scar tissue (6%). Patients with recurrent hearing loss achieved lower mean ABGs than patients with persistent hearing loss (8.8 vs 13.2 dB, P = .02). There were no associations between onset pattern of CHL or intraoperative findings and hearing outcomes (P > .05). Four patients (2.7%) developed sensorineural hearing loss after revision, defined as an increase in bone conduction pure tone average ≥15 dB, all of whom had previous replacement of a malpositioned prosthesis. Conclusions Revision stapes surgery confers significant improvement in hearing for patients with persistent and recurrent CHL, although patients with persistent CHL after initial surgery see less improvement with revision.
Safety in Multi-Assembly via Paths Appearing in All Path Covers of a DAG

A multi-assembly problem asks to reconstruct multiple genomic sequences from mixed reads sequenced from all of them. Standard formulations of such problems model a solution as a path cover in a directed acyclic graph, namely a set of paths that together cover all vertices of the graph. Since multi-assembly problems admit multiple solutions in practice, we consider an approach commonly used in standard genome assembly: output only partial solutions (contigs, or safe paths), that appear in all path cover solutions. We study constrained path covers, a restriction on the path cover solution that incorporate practical constraints arising in multi-assembly problems. We give efficient algorithms finding all maximal safe paths for constrained path covers. We compute the safe paths of splicing graphs constructed from transcript annotations of different species. Our algorithms run in less than 15 seconds per species and report RNA contigs that are over 99% precise and are up to 8 times longer than unitigs. Moreover, RNA contigs cover over 70% of the transcripts and their coding sequences in most cases. With their increased length to unitigs, high precision, and fast construction time, maximal safe paths can provide a better base set of sequences for transcript assembly programs.
Sex differences in muscle excitation and oxygenation, but not in force fluctuations or active hyperemia resulting from a fatiguing, bilateral isometric task

It remains to be fully elucidated if there are sex-specific physiological adjustments within the human neuromuscular and vascular systems that contribute to symptoms of fatigue during a sustained bilateral task. This, in part, is likely due to various limitations in experimental design such as an inability to independently record force fluctuations from each limb. Objective. Therefore, the purpose of the current study was to examine the fatigue-induced changes in muscle excitation, force fluctuations, skeletal muscle tissue saturation (StO2), and muscle blood flow resulting from a sustained, bilateral task. Approach. Thirty healthy, college-aged adults (15 males, 15 females) performed a bilateral leg task at 25% of maximum voluntary isometric (MVIC). Before and after the task, MVICs were completed. Resting and post-task femoral artery blood flow (FABF) were determined. Muscle excitation was quantified as electromyographic amplitude (EMG AMP) from the right and left vastus lateralis. During the task, force fluctuations were determined independently from each leg. The StO2 signal was collected with a near-infrared spectroscopy device attached to the right vastus lateralis. The rate of change in these variables was calculated via simple linear regression. The exercise-induced magnitude of change in MVIC (i.e. performance fatigability) and FABF (i.e. active hyperemia) was determined. Main Results. There was no sex difference in the percent decline in MVIC (20.5 ± 20.1% versus 16.4 ± 3.5%; p > 0.05). There were no inter-leg differences in EMG AMP or force fluctuations. The males exhibited a faster rate of increase in EMG AMP (b = 0.13 versus b = 0.08; p < 0.001), whereas the females exhibited a slower rate of decline in StO2 (b = −0.049 versus b = −0.080). There was no sex difference in force fluctuations or change in FABF. Significance. Males and females likely have different neuromuscular strategies and muscle characteristics, but these did not elicit a sex difference in performance fatigability.
Psychological Distress in Primary Healthcare Workers during the COVID-19 Pandemic in Greece.

OBJECTIVE The present study aims to evaluate the symptoms of psychological distress during the COVID-19 pandemic, in Greek primary healthcare workers, correlating them with their individual characteristics. MATERIALS AND METHODS The research is based on a self-report questionnaire distributed to primary HCWs of Thessaloniki's public health care units. A sample of 143 respondents was gathered. The questionnaire consists of 21 items: 6 demographic questions, 9 on personal distress, 5 on work-related distress and 1 on one dominant feeling of the participants. These items were based on existing validated measures, such as the "Depression Anxiety Stress Scale-21", the "Kessler Psychological Distress Scale-10", "General Health Questionnaire- 28" and "Hospital Anxiety and Depression Scale". The associations between participants' gender, education, specialty and parenthood were determined with Pearson's chi-squared (χ2) test. RESULTS Overall, 70.4% of HCWs were generally affected by the pandemic. The personal distress factors revealed that the majority (67%) experienced distress due to routine changes. The effects on health behavior (sleep, eating behavior and substance use) were not high. Psychological/psychiatric needs were relatively low, while negative emotions and need of social support were high. 31.4% displayed intense emotional instability. All work-related distress factors were rated high. Worry about contracting COVID-19 in the workplace scored the highest (82.6%). Almost half of the participants felt exposed to COVID-19 infection (47.0%). Anxiety (47.2%) and burn-out (78.4%) symptoms were also revealed. Female participants appeared to be more anxious (P<0.01) and upset (P=0.013). CONCLUSION The exposure to a constant risk could potentially lead to an increase in HCWs' psychological distress. Designing the right tools and organizing the right plans are of paramount importance to prevent the deterioration of their wellness and quality of life.
Governments’ Late Payments and Firms’ Survival: Evidence from the European Union

Outstanding payments in commercial transactions, if delayed beyond the agreed period of time, can engender a range of negative externalities and expose firms to severe liquidity risks. In this study we examine to what extent stricter regulations addressing payment backlogs, brought about by the EU directive on late payments, have affected firms’ performance. We focus on government-to-business activities and on the firms’ responses to the introduction of these regulations. Our evidence suggests that firms’ exit rates fall relatively more in sectors that sell a larger fraction of their output to the government. We document more pronounced effects in sectors with a large share of small firms, for countries characterized by longer payment delays, and for countries with high levels of perceived corruption. Taken together, our findings indicate that more discipline in governments’ payment terms can have considerable effects on economic activity.