Miracle-dz/UniFAR-FTUs huggingface dataset:
To Compare the Efficacy of Dexmedetomidine Versus Labetalol in Providing Controlled Hypotension in Functional Endoscopic Sinus Surgery

Background Functional endoscopic sinus surgery (FESS) is a surgical intervention for sinus diseases. Bleeding is a common concern during FESS. Hemodynamic stability and quality surgical field visibility help to achieve the best outcomes. Objectives The present study primarily intended to compare the effectiveness of dexmedetomidine versus labetalol in providing controlled hypotension during FESS and then to assess the quality of the surgical field. Methods The current research was conducted as a prospective randomized double-blinded clinical study. Sixty patients of the American Society of Anesthesiologists grade I or II status undergoing FESS under general anesthesia were divided into two groups, each with 30 members. Patients receiving dexmedetomidine and labetalol were named as group D and L, respectively. The study intended to manage mean arterial pressure (MAP) between 65 - 75 mmHg. The visibility of the operative field was evaluated using Fromme and Boezaart scoring system. Total intraoperative fentanyl consumption and postoperative first analgesic request time were recorded. Results The MAP target was achieved in both groups. Intergroup differences concerning MAP were observed in both D (75.0 ± 2.0) and L (82.4 ± 5.2) groups (P-value < 0.05). Scores for blood loss were significantly lower in the D group (1.3 ± 0.3) compared to the L group (2.1 ± 0.3) (P-value < 0.05). There was no intergroup difference concerning the mean heart rate (group D; 70.8 ± 4.2, and group L; 73.4 ± 4.4). The total dose of fentanyl consumed was found to be significantly lower in the group D (41.9 ± 5.8) compared to group L (59.9 ± 5.3) (P-value < 0.05). The first analgesic request time was significantly longer in the group D (50.2 ± 9.1) compared to group L (24.8 ± 5.1) (P-value < 0.05). Conclusions Dexmedetomidine provided better hemodynamic stability and operative field visibility as compared to labetalol during FESS.
Clinical Applications of In Vivo and Ex Vivo Confocal Microscopy

Confocal laser scanning microscopy (CLSM) has been introduced in clinical settings as a tool enabling a quasi-histologic view of a given tissue, without performing a biopsy. It has been applied to many fields of medicine mainly to the skin and to the analysis of skin cancers for both in vivo and ex vivo CLSM. In vivo CLSM involves reflectance mode, which is based on refractive index of cell structures serving as endogenous chromophores, reaching a depth of exploration of 200 μm. It has been proven to increase the diagnostic accuracy of skin cancers, both melanoma and non-melanoma. While histopathologic examination is the gold standard for diagnosis, in vivo CLSM alone and in addition to dermoscopy, contributes to the reduction of the number of excised lesions to exclude a melanoma, and to improve margin recognition in lentigo maligna, enabling tissue sparing for excisions. Ex vivo CLSM can be performed in reflectance and fluorescent mode. Fluorescence confocal microscopy is applied for “real-time” pathological examination of freshly excised specimens for diagnostic purposes and for the evaluation of margin clearance after excision in Mohs surgery. Further prospective interventional studies using CLSM might contribute to increase the knowledge about its application, reproducing real-life settings.
Supportive Care Needs Survey Short Form-34(SCNS-SF-34) Nepali Version: Psychometric Assessment Among Cervical Cancer Patients in Nepal

PurposePsychometrically valid and reliable supportive care need survey(SCNS) instrument explores perceived supportive care needs of cervical cancer patients in comprehensively. No Nepali validated version so we decided to test the psychometric properties of the translated Nepali version of SCNS-SF 34-N(Nepali) among cervical cancer patients.Methods334 participants were recruited purposively from 5 cancers specific hospital. Factor structure was assessed by using Exploratory factor analysis (EFA). Structure validity, Internal consistency convergent validity, and discriminant validity of the resulting factor structure were calculated and confirmed. ResultsUsing EFA a five-factor structure was developed considering higher loading factor for multiple loaded items which was similar with the dimensions of the original version of the SCNS-SF34 (psychological, health system and information, physical and daily living, patient care and support, and sexuality), accounting for 65.48% of the total variance. Internal consistency was achieved at an acceptable level, with Cronbach's alpha coefficients ranging from 0.789 to 0.929for all five domains and 0.887 for the whole scale. Convergent validity was confirmed by significant inter item correlations with all corresponding items. Independent 't' test between known subgroups on age, marital status, stage of disease and treatment modalities confirmed discriminant validity.ConclusionsIt was confirmed that the SCNS-SF 34 N(Nepali) is a valid and reliable instrument for the assessment of the supportive care needs of cervical cancer patients in Nepal
Compensating Online Content Producers: A Theoretical Analysis

The digital content industry is rapidly growing, and many platforms host a vast amount of content that is produced by independent producers. A major source of revenue for these platforms is advertising. However, advertising revenue depends on the number of active customers who visit the platform and enjoy content created by content producers. Therefore, major platforms provide incentives for content producers to encourage high-quality content creation. A commonly used incentive is ad revenue sharing. In this paper, we study how such sharing incentives are affected by the nature of competition among various producers, the size of customer base, and the type of customers. We also examine the implications for profits and welfare and extend the analysis to consider the case when the platform allows consumers to directly donate to the producers. Our results show that increased producer competition can lead to higher compensation for the producers, higher content quality, and higher producers’ profits. We also show that allowing consumers to donate to producers can lead to a higher commission rate and better-quality content. However, increased consumer generosity may lead to lower profits for content producers. In addition, we find that asymmetry among producers can sometimes benefit the platform.This paper was accepted by Matthew Shum, marketing.
Two-Phase Flow Simulations Using 1D Centerline-Based C- and U-Shaped Pipe Meshes

This study aims to investigate the pressure changes, bubble dynamics, and flow physics inside the U- and C-shaped pipes with four different gravitational directions. The simulation is performed using a 1D centerline-based mesh generation technique along with a two-fluid model in the open-source software, OpenFOAM v.6. The continuity and momentum equations of the two-fluid model are discretized using the pressure-implicit method for the pressure-linked equation algorithm. The static and hydrostatic pressures in the two-phase flow were consistent with those of single-phase flow. The dynamic pressure in the two-phase flow was strongly influenced by the effect of the buoyancy force. In particular, if the direction of buoyancy force is the same as the flow direction, the dynamic pressure of the air phase increases, and that of the water phase decreases to satisfy the law of conservation of mass. Dean flows are observed on the transverse plane of the curve regions in both C-shaped and U-shaped pipes. The turbulent kinetic energy is stronger in a two-phase flow than in a single-phase flow. Using the 1D centerline-based mesh generation technique, we demonstrate the changes in pressure and the turbulent kinetic energy of the single- and two-phase flows, which could be observed in curve pipes.
Interplay Between Class II HLA Genotypes and the Microbiome and Immune Phenotypes in Individuals With PTEN Hamartoma Tumor Syndrome

PURPOSE We evaluate potential contributors to the development of autoimmunity and other phenotypes consistent with immune dysregulation in individuals with germline mutations in the tumor suppressor gene PTEN in this observational report. MATERIALS AND METHODS Illumina sequencing of bacterial and fungal microbes was carried out on patient-donated fecal samples in a cohort of 67 patients with pathogenic germline PTEN mutations, including 41 individuals with autoimmunity and/or phenotypes consistent with immune dysregulation (cases) and 26 individuals without (controls). From these data, we measured differences in alpha and beta diversity between cases and controls and identified differentially abundant bacterial and fungal taxa using phyloseq and MicrobiomeSeq packages in R. We analyzed correlations between these taxa and specific HLA genotypes, along with correlations between HLA diversity and microbial diversity, by conducting high-resolution HLA genotyping at four class II loci (DRB1, DRB345, DQA1, and DQB1). RESULTS We found that alpha diversity distributions for both bacterial and fungal genera were statistically different between cases and controls. We identified differentially abundant bacterial and fungal taxa between cases and controls. Network analysis of differentially abundant bacterial taxa revealed some co-varying bacterial genera. We additionally found significant correlations between certain HLA genotypes and certain taxa and significant correlations between HLA diversity and alpha diversity. CONCLUSION PTEN-associated immune phenotypes might be influenced by the gut microbiome, and class II HLA molecules, in part, crosstalk with the gut microbiome. These preliminary observations should lay the groundwork for future studies to ultimately derive clinical measures, which could use gut microbiome and HLA molecule biomarkers to predict, and perhaps prevent, immunity and inflammation in patients predisposed to cancer because of germline PTEN mutations.
The Prevalence Of Binge Eating Disorder And Associated Psychiatric And Substance Use Disorders In A Student Population In Kenya – Towards A Public Health Approach

Background: Changing lifestyles in Kenya can lead to eating related behaviors and problems. The more severe problems are likely to manifest in clinical settings, but the majority and less severe forms will remain unrecognized. There is therefore the need to take a public health awareness approach to identify cases at community level and initiate appropriate intervention. This requires characterization of Eating Disorders (ED) and its associations in the local context. Our focus will be on the more common Binge Eating Disorder (BED). The overarching objective of this study is to generate Kenyan data on BED and fill a gap that exists not only in Kenya but Africa in general. The specific aims are: (1) To document the patterns and prevalence of different symptoms of BED in a student population whose age range represents a significant proportion of the population. (2) To determine associated psychiatric and substance use disorders (3) To determine independent predictors of BED. Method: We administered to a total of 9742 participants following tools: A researcher designed socio-demographic and economic indicators questionnaire; an instrument on DSM-IV diagnosis of BED and its various symptoms; instruments to determine DSM-IV psychiatric disorders, substance abuse, affectivity, psychosis and stress indicators. The participants were high school, college and university students in four out of the 47 counties in Kenya. We used descriptive and inferential analysis to determine prevalence and association of the different variables. The independent predictors of BED were generated from the generalized linear model (p<0.05). Results: We found a prevalence of 3.2% of BED and a wide range of BED symptoms varying from 8.1% to 19.0%. There were significant (p<0.05) associations between BED with various socio-demographic variables and psychiatric and substance use disorders. However, only some of these disorders were independent predictors of BED. Conclusion: Our findings on prevalence of BED and significant associations with various psychiatric disorders and substance use disorders are similar to those obtained in HICs using similar large scale samples in non-clinical populations. Economic status is not a predictor of BED. Our findings suggest a public health approach to awareness and management.
Clinical Characteristics of Severe COVID-19 in China: A Case Series and Meta-analysis

Background: There have been inconsistent reports regarding the unique manifestations of severe coronavirus disease 2019 (COVID-19) occurring in China. This study analyzed the clinical manifestation of 13 severe COVID-19 cases at a single institution and compared the data to previously reported characteristics of severe COVID-19 in China. Methods: This retrospective case study included patients with severe COVID-19 who were admitted to the isolation ward of the Shandong Chest Hospital from January 2020 to February 2020. The clinical signs and symptoms, laboratory examination results, imaging features, treatment strategies, and patient prognoses were summarized. A database search was then conducted for studies published through December 2020 documenting characteristics of severe COVID-19 cases in China. The pooled results for severe COVID-19 patients in China were calculated by using the random-effects model.Results: A total of 4 severe and 9 critical patients were included from Shandong Chest Hospital. The average patient age was 55.3 (range 23-88) years, and 61.5% of patients were male. Chest computed tomography for all patients showed multiple lesions as ground-glass shadows in both lungs. All patients presented bacterial infection and various degrees of liver and myocardial injury. The treatment strategies for patients included antibiotics, immunoglobulin, and glucocorticoids, and mechanical ventilation was used in all patients for respiratory failure. Two patients died, and 11 recovered. In the pooled data for severe COVID-19 patients, the most common comorbidities were hypertension, diabetes mellitus, and coronary heart disease. The common signs in these patients were fever, cough, fatigue, chest tightness, and a leukocyte count > 10. Conclusions: Older males with hypertension, diabetes mellitus, and coronary heart disease may be at higher risk of developing severe COVID-19. Patients should be assessed for concomitant bacterial infections. Cardiac and liver enzymes, fever, cough, fatigue, chest tightness, and leukocytosis should be monitored for signs of disease progression.
Impact of Green Entrepreneurship Orientation on Environmental Performance: The Natural Resource-Based View Perspective

Environmental sustainability is the primary task of environmental entrepreneurship by critically handling increased institutional, customer, and environmental pressures. Green entrepreneurship orientation (GEO) seeks to harmonize their relationships with the external environment to foster the impact of green innovation performance (GIP) on environmental performance (EP). Drawing upon the natural resource-based view, the study examines the effect of green entrepreneurship orientation on GIP and EP. Additionally, the moderating effect of managerial environmental concerns (MEC) on this relationship is also inspected. The results revealed that green absorptive capacity (GAC), environmental cooperation (EC), and MEC significantly affect GEO. Furthermore, GEO positively influenced GIP and EP. Indeed, GEO partially mediates GAC, EC, and managerial concern’s relationship on green innovation and EP. Additionally, MEC significantly moderates the relationship between GEO and EP. Firms GEO should adequately enhance green practices performance and environmental performance to accommodate their external environment relationships. Theoretical and practical implications were also presented.
Genomic Characterization of the Three Balkan Livestock Guardian Dogs

Balkan Livestock Guardian Dogs (LGD) were bred to help protect sheep flocks in sparsely populated, remote mountainous areas in the Balkans. The aim of this study was genomic characterization (107,403 autosomal SNPs) of the three LGD breeds from the Balkans (Karst Shepherd, Sharplanina Dog, and Tornjak). Our analyses were performed on 44 dogs representing three Balkan LGD breeds, as well as on 79 publicly available genotypes representing eight other LGD breeds, 70 individuals representing seven popular breeds, and 18 gray wolves. The results of multivariate, phylogenetic, clustering (STRUCTURE), and FST differentiation analyses showed that the three Balkan LGD breeds are genetically distinct populations. While the Sharplanina Dog and Tornjak are closely related to other LGD breeds, the Karst Shepherd is a slightly genetically distinct population with estimated influence from German Shepard (Treemix analysis). Estimated genomic diversity was high with low inbreeding in Sharplanina Dog (Ho = 0.315, He = 0.315, and FROH>2Mb = 0.020) and Tornjak (Ho = 0.301, He = 0.301, and FROH>2Mb = 0.033) breeds. Low diversity and high inbreeding were estimated in Karst Shepherds (Ho = 0.241, He = 0.222, and FROH>2Mb = 0.087), indicating the need for proper diversity management. The obtained results will help in the conservation management of Balkan LGD dogs as an essential part of the specific grazing biocultural system and its sustainable maintenance.
Smart City Design Differences: Insights from Decision-Makers in Germany and the Middle East/North-Africa Region

Smart cities offer solutions to environmental, economic, and societal problems in urban agglomerations. We investigate the potential for mutual learning in smart city implementation by comparing German approaches (smaller, local projects) to projects implemented in the MENA region (bigger, national designs). We contrast the outside view on these projects with an inside perspective, surveying key decision-makers in five German and seven MENA smart cities. We assess motivation, technology options, and factors that drive or impede smart city implementation. We find strong similarities in the motives to engage in smart cities, offering common ground for mutual good practice exchange. Energy efficiency solutions and—to a lesser extent—renewable energies are of strong interest to policymakers in all countries. In contrast, the appraisal of mobility solutions strongly diverges, showing that technology deployment is far from being a simple “plug and play” solution. Considering these insights can facilitate the overall deployment of smart cities, not only in the surveyed countries but also in global manner.
Effect of Calcium, Magnesium and Sulphur Fertilizer on Wine Grape in Eastern Foot of Helan Mountain

To solve the problems of single chemical fertilizer, few kinds of fertilizer and low utilization in wine grape cultivation in eastern foot of Helan Mountain, 4 kinds of treatment including no fertilizer(control), conventional fertilization, conventional fertilization with calcium-magnesia phosphate fertilizer, conventional fertilization with calcium, magnesium and sulphur fertilizer, and humic acid fertilizer was set. The growth, production, quality, and soil physicochemical property of wine grape under each treatment was measured. Results showed that CaMgS plus humic acid fertilizer played a significant role in improving pH of wine grape in arid sandy soil vineyards. On the basis of conventional fertilization, increasing CaMgS plus humic acid fertilizer can effectively improve the chlorophyll content of leaves, promote the accumulation of petiole potassium pigment and increase the production growth. CaMgS treatment significantly increased the Vitamin C content and soluble solids of wine grape, but significantly reduced the total acidity. When the humic acid fertilizer treatment was increased, the sugaracid ratio reached up to 31.94 and the wine grape quality was improved compared with conventional fertilization.
Analyzing China’s provincial pollution and its influencing factors: A spatial analysis

In-depth analyses of the spatial heterogeneity in pollution, and the causes of differences are of great importance for contributing to provide reference for reduction policies. However, a spatial analysis of the existence and mechanism of China’s pollution is still ignored. Using the province-level data of thirty provinces in China over 2005–2017, this paper constructs a spatial Durbin model (SDM) to empirically address the existence and spatial transmission mechanism of pollution. The main results are as follows: first, China’s pollution shows significant characteristics of spatial dependence and clustering from global and local perspectives, indicating that the existence of spatial autocorrelation in pollution across regions. Second, both per capita GDP and urbanization have positive impacts on pollution, but the impacts of environmental regulation and FDI are insignificant. Third, urbanization not only directly influences pollution, but also indirectly influences pollution. Our analysis provides valuable information for developing policies to effectively alleviate pollution.
Seasonal Variation of Vertical Heat and Energy Fluxes due to Dissipating Gravity Waves in the Mesopause Region Over the Andes

Vertical energy transports due to dissipating gravity waves in the mesopause region (85–100 km) are analyzed using over 400 h of observational data obtained from a narrow‐band sodium wind‐temperature lidar located at Andes Lidar Observatory (ALO), Cerro Pachón (30.25°S, 70.73°W), Chile. Sensible heat flux is directly estimated using measured temperature and vertical wind; energy flux is estimated from the vertical wavenumber and frequency spectra of temperature perturbations; and enthalpy flux is derived based on its relationship with sensible heat and energy fluxes. Sensible heat flux is mostly downward throughout the region. Enthalpy flux exhibits an annual oscillation with maximum downward transport in July above 90 km. The dominant feature of energy flux is the exponential decrease from 10−2 to 10−4 W m−2 with the altitude increases from 85 to 100 km and is larger during austral winter. The annual mean thermal diffusivity inferred from enthalpy flux decreases from 303 m2 s−1 at 85 km to minimum 221 m2 s−1 at 90 km then increases to 350 m2 s−1 at 99 km. Results also show that shorter period gravity waves tend to dissipate at higher altitudes and generate more heat transport. The averaged vertical group velocities for high, medium, and low frequency waves are 4.15 m s−1, 1.15 m s−1, and 0.70 m s−1, respectively. Gravity wave heat transport brings significant cooling in the mesopause region at an average cooling rate of 6.7 ± 1.1 K per day.
Preoperative detection of the TERT promoter mutations in papillary thyroid carcinomas

Telomerase reverse transcriptase promoter (TERT‐p) mutations are strongly associated with tumour aggressiveness and worse prognosis in papillary thyroid carcinomas (PTCs). Since the TERT‐p mutations have been reported to be subclonal, it is unclear how accurately they can be detected by preoperative fine‐needle aspiration (FNA). The objective of this study was to analyse the concordance rate of the TERT‐p mutations between preoperative FNA and corresponding postoperative surgical specimens.