Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation and Optimisation of Incremental Processors

Incremental spoken dialogue systems, which process user input as it unfolds, pose additional engineering challenges compared to more standard non-incremental systems: Their processing components must be able to accept partial, and possibly subsequently revised input, and must produce output that is at the same time as accurate as possible and delivered with as little delay as possible. In this article, we define metrics that measure how well a given processor meets these challenges, and we identify types of gold standards for evaluation. We exemplify these metrics in the evaluation of several incremental processors that we have developed. We also present generic means to optimise some of the measures, if certain trade-offs are accepted. We believe that this work will help enable principled comparison of components for incremental dialogue systems and portability of results.
Mass Switch From Intravenous to Subcutaneous Tocilizumab in Rheumatic Diseases During the SARS-COV-2 Pandemic

Background With the arrival of the SARS-CoV-2 pandemic in 2020, it was proposed to make the change from intravenous (IV) tocilizumab (TCZ) to its subcutaneous formulation, in order to avoid rheumatological patients having to go to the day hospital and guarantee enough IV TCZ for those critical patients with COVID who needed it. The aim of this study was to describe the rate and reasons for switching back to IV TCZ from subcutaneous TCZ. Methods We included patients from the rheumatology service that were on treatment with IV TCZ in February 2020 and were followed up until March 2021. Patients that remained on subcutaneous TCZ were compared with those who switched back to IV TCZ (switch-back group). A subgroup analysis according to rheumatic disease was performed. Results Fifty-five patients switched to subcutaneous TCZ: 28 rheumatoid arthritis, 19 giant cell arteritis, 4 polymyalgia rheumatica, 2 juvenile idiopathic arthritis, and 2 systemic sclerosis. Seventeen patients switched back to IV TCZ due to ineffectiveness (n = 8), patient preference (n = 4), adverse events (n = 4), and difficulty with the SC administration route (n = 1). In the analysis by disease, 4 of 23 patients switched back to IV TCZ in giant cell arteritis/polymyalgia rheumatica group due to ineffectiveness (n = 2), injection site reaction (n = 1), or patient preference (n = 1). In rheumatoid arthritis group, 11 of 28 patients switched back to IV TCZ: ineffectiveness (n = 5), patient preference (n = 3), headache (n = 1), injection site reaction (n = 1), and due to difficulty with the SC administration route (n = 1). Conclusions Mass switch from IV to subcutaneous TCZ during the SARS-CoV-2 pandemic has been safe, effective, and well tolerated after 1 year of follow-up.
HIDDEN IN THE RISK SEGMENT OF AESTHETIC AND BEAUTY: AN ASSESSMENT OF THE KNOWLEDGE OF PROFESSIONAL AND PRACTICES IN SALONS BIOSAFETY 1

The risk of microbial transmission potentially increases when manicurists and pedicurists are unaware of or do not use biosecurity procedures. This study aimed to evaluate the knowledge and adherence to biosecurity procedures for manicurists/pedicurists who work in beauty salons. This was a cross-sectional survey with manicurists in beauty salons and in a technical school of podiatry, which evaluated the adherence to and knowledge of biosecurity procedures, with 75% of correct answers taken as the minimum for adequate adherence and knowledge. A total of 84 manicurists/pedicurists were interviewed, all female. There was poor adherence to the use of personal protection equipment (45%) and to methods of reprocessing equipment. The oven was the most widely used method of sterilizing, insufficient for cleaning and decontamination of material. A significant portion did not use an apron/uniform or closed shoes at work. The intervening factor most cited for non-adherence to the measures was the lack of information. The results reinforce the need for increased assistance regarding biosecurity procedures for professionals in this sector. DESCRIPTORS: Beauty and aesthetic centers. Podiatry. Exposure to biological agents. Universal precautions.
Takotsubo Syndrome and Sudden Cardiac Death

Takotsubo syndrome (TTS), triggered by intense emotional or physical stress, occurring most commonly in post-menopausal women, presents as an ST-elevation myocardial infarction (MI). Cardiovascular complications occur in almost half the patients with TTS, and the inpatient mortality is comparable to MI (4–5%) owing to cardiogenic shock, myocardial rupture, or life-threatening arrhythmias. Thus, its prognosis is not as benign as previously thought, as it may cause mechanical complications (cardiac rupture) and potentially lethal arrhythmias and sudden cardiac death (SCD). Similar to MI, some patients may perish before reaching the hospital due to out-of-hospital cardiac arrest; this may lead to underestimation of the actual SCD risk. Furthermore, after discharge, some patients may develop late SCD and/or TTS recurrence that may result in SCD. There are risk factors for SCD in TTS patients, such as severe/persistent QT-interval prolongation inciting torsade-de-pointes, other ECG abnormalities (diffuse giant negative T-waves, widened QRS-complex), bradyarrhythmias, comorbidities, concurrent obstructive coronary artery disease or vasospasm, male gender, older age, severe left ventricular dysfunction, and use of sympathomimetic drugs. All these issues are herein reviewed, case reports/series and data from large cohort studies and meta-analyses are analyzed, risk factors are tabulated, and proarrhythmic effects and management strategies are discussed and pictorially illustrated.
Amelioration of glucose intolerance through directly acting antiviral agents in chronic hepatitis C cirrhotic patients without overt diabetes

Hepatitis C virus (HCV) eradication through antivirals ameliorates metabolic profiles. The changes in 2‐h plasma glucose (2HPG) levels by oral glucose tolerance test (OGTT), in chronic hepatitis C (CHC) patients who receive directly acting antivirals (DAAs) was elusive. Five hundred and thirty‐three CHC patients who achieved sustained virological response (SVR, undetectable HCV RNA throughout 3 months after the end‐of‐treatment) by DAAs were consecutively enrolled. Pre‐ and posttreatment 2HPG levels and glucose status were compared. The proportion of patients with improved, worsened, and stable 2HPG was 14.4% (n = 77), 18.6% (n = 99), and 67.0% (n = 357), respectively. Compared with patients with worsening 2HPG, those with improved 2HPG had a higher proportion of cirrhosis (45.5% vs. 24.2%, p = 0.004) and higher pretreatment 2HPG levels (175.3 vs. 129.5 mg/dl, p < 0.001). High baseline 2HPG was independently associated with improved 2HPG in multivariate analysis (odds ratio [OR]/CI: 1.05/1.03–1.06, p < 0.001). When baseline 2HPG was not taken into account, cirrhosis was the only factor independently associated with improved 2HPG status (OR/CI: 2.58/1.29–5.15, p = 0.007). Linear regression analysis revealed that factors independently correlated to changes in 2HPG levels were female sex (β: 8.78; 95% CI:2.34, 15.22; p = 0.01), diabetes (β: −27.72; 95% CI: −50.16, −5.28; p = 0.02), liver cirrhosis (β: −8.91; 95% CI: −16.75, −2.20; p = 0.01), and genotype 1 of HCV (β: −0.12; 95% CI: −15.19, −2.43; p = 0.01). 2HPG improved after HCV eradication by DAAs, particularly in cirrhotic patients.
Primary care experiences among Brazilian adults: Cross-sectional evidence from the 2019 National Health Survey

Objectives The Brazilian Family Health Strategy (FHS) is strongly associated with better health system performance, but there are no nationally-representative data examining individual-level primary care experiences in the country. Here, we examine reports of primary care experiences among adults with different forms of healthcare coverage (FHS, “traditional” public health posts, and private health plans). Methods Data are from the 2019 National Health Survey that included a shortened version of the Primary Care Assessment Tool (PCAT). PCAT questions were administered to a subsample of randomly-selected adults who had a doctor visit within the past 6 months and sought care in a primary care setting (9677 respondents). We used linear regression to examine the association between type of healthcare coverage and PCAT scores adjusted for sex, age, socioeconomic status, health status, geographic region and state of residence. Results Primary care experiences in the sample of Brazilians who had a doctor visit 6 months prior to the survey averaged a modest PCAT score of 57 out of 100. Regression models show that users of the FHS had superior primary care experiences, but with large variations across Brazilian regions and states. Individuals selected to respond to the PCAT questions were more likely to be female, older, and poorer, and to be in worse health than the general population. Conclusions Brazil’s FHS is associated with modest, but higher-reported primary care experiences than both traditional public health posts and those who have a private health plan. Future iterations of the PCAT module could enhance generalizability by including individuals who had a doctor visit in the past 12 (instead of 6) months.
Free flap reconstruction of distal extremity necrosis after COVID‐19‐related multisystem inflammatory syndrome in a pediatric patient

Dear Editor, Multisystem inflammatory syndrome in children (MIS-C) is a recently recognized spectrum of disease symptoms and signs associated with COVID-19 infection. As defined by the Centers for Disease Control and Prevention (CDC), MIS-C is diagnosed in individuals aged <21 years presenting with fever; laboratory evidence of inflammation; clinically severe illness requiring hospitalization; multisystem (≥2) organ involvement (dermatologic, cardiac, renal, respiratory, hematologic, gastrointestinal, or neurological); a positive test for current or recent SARS-CoV-2 infection, and no plausible alternative diagnoses. (Centers for Disease Control and Prevention (CDC), 2019) Among the clinical scenarios of multisystem compromise, vascular manifestations at the foot level (including edema, exanthems, chilblains, ischemia, and distal necrosis) are occasional signs that have been described in various reports. (Jimenez-Cebrian et al., 2021) We present a 7-year-old female patient with COVID-19 disease and acral necrotic lesions of the lower limbs that underwent microvascular tissue transfer. The patient was admitted with a diagnosis of COVID-19 pneumonia (SARS-CoV-2 detected at RT-PCR testing). Twelve days later, ischemic/livedoid lesions associated with severe pain, rapidly progressing to necrosis, appeared in the patient's feet. The patient's initial investigations revealed hemoglobin (Hb) of
Association of Dietary Phytosterols Intake and Survival of Esophageal Squamous Cell Carcinoma: A Prospective Cohort Study

Abstract Background The association of dietary phytosterols intake with survival of esophageal squamous cell carcinoma (ESCC) remains unclear. This study was to examine the effect of dietary phytosterols intake on ESCC survival in a Chinese rural population. Methods A total of 942 incident ESCC patients diagnosed between 2011 and 2013 in Yanting area were followed up until March 1st, 2020. Dietary intake five years before ESCC diagnosis was collected using a food frequency questionnaire. The outcome of interest was all-cause mortality. Cox proportional hazards regression model was used to estimate hazard ratio (HR) and 95% confidence intervals (CI). Results When comparing the highest with lowest intake quartiles, intake of five specific and total phytosterols was not significantly associated with risk of death after adjustment for covariates, the adjusted HR (95% CI) for β-sitosterol, campesterol, stigmasterol, β-sitostanol, campestanol and total phytosterols was 0.90 (95% CI: 0.70-1.16), 0.92 (95% CI: 0.71-1.19), 0.86 (95% CI: 0.66-1.12), 0.93 (95% CI: 0.73-1.20), 0.94 (95% CI: 0.72-1.21), 0.89 (95% CI: 0.69-1.15), respectively. Conclusion This study does not find any association between pre-diagnostic phytosterols intake and risk of all-cause mortality among ESCC patients. Further research is required to determine the effect of post-diagnostic phytosterols intake on ESCC survival.
Adapting Brief Behavioral Treatment for Insomnia for Former National Football League Players: A Pilot Study

ABSTRACT Objectives Insomnia is highly prevalent among persons with chronic pain. Although cognitive behavioral therapy for insomnia is recommended as first-line treatment for insomnia, it is underutilized. We tested the feasibility of a potentially scalable alternative – Brief Behavioral Therapy for Insomnia (BBTI) for former National Football League (NFL) players, a group with a high prevalence of chronic pain. We assessed changes in sleep, pain, and psychological health. Methods Single-arm clinical trial of an adapted telephone-delivered BBTI intervention in 40 former NFL players with insomnia. We collected data on changes in sleep, pain, and psychological health outcomes. Results Among former players (30% racial/ethnic minorities), BBTI was both acceptable and feasible. BBTI was associated with improvements in sleep disturbance (primary exploratory sleep outcome, mean T-score change −6.2, 95% CI: −7.6, −4.8), sleep-related impairment (mean T-score change −5.7, 95% CI: −7.9, −3.5) and insomnia severity (mean change −5.3, 95% CI: −6.8, −3.5) post-intervention. Improvements were maintained at 2-months. BBTI was also associated with improvements in pain interference and intensity, but not psychological health. Conclusion An adapted telephone-delivered BBTI is acceptable and feasible among retired players with a range of insomnia symptoms and shows promise for improving sleep and pain. These data support the need for future trials assessing BBTI’s effect on both sleep and pain outcomes.
Fear of COVID‐19, stress and depression: A meta‐analytic test of the mediating role of anxiety

Abstract Objectives The COVID‐19 pandemic has negatively affected the lives of millions of individuals physiologically, behaviorally, socially, and/or psychologically. Moreover, there is now much empirical evidence that mental health problems have increased during the pandemic period and these problems have various consequences. The changes in the mood states of individuals due to the pandemic underpins the rationale of the present study. The aim of the study was to identify the cross‐sectional associations between fear of COVID‐19, stress, anxiety, and depression by using two stage‐meta‐analytic structural equation modeling (TS‐MASEM). Design This is a meta‐analytic structural equation modelling study. Method A systematic literature review initially identified 4840 studies. As a result of applying inclusion and exclusion criteria, 25 studies comprising 28 samples (reporting 120 effect sizes) were eligible for inclusion in the current TS‐MASEM (N = 16,452). Results The results showed significant associations between fear of COVID‐19, stress, anxiety, and depression. Additionally, the mediation role of anxiety in the association between depression and fear of COVID‐19 and stress was explored. Conclusions Although the results did not allow for causal inferences regarding depression, they provide insight into the possible consequences of fear of COVID‐19 and comorbid problems for clinicians and researchers.
Relação entre queixas apresentadas por pacientes na urgência e o desfecho final

Objetivo:relacionar queixas apresentadas pelos pacientes classificados pelo Sistema de Triagem de Manchester em um pronto-socorro com o desfecho final (alta/obito/transferencia). Metodos:estudo de coorte prospectivo, realizado com 509 pacientes que deram entrada no pronto-socorro e que nele permaneceram por mais de 24 horas apos a admissao, sendo acompanhados ate o desfecho final. Os dados foram digitados e analisados com estatistica descritiva e analitica em um pacote estatistico.Resultados:entre os pacientes, 59,3% eram do sexo masculino, com idade media de 59,1 anos. As queixas principais eram de mal-estar no adulto (130-22,5%), dispneia em adulto (81-14,0%), dor abdominal em adulto (58-10,0%), alteracoes de comportamento (34-5,9%), sendo que, desses, 87% recebeu alta. Foram encontrados mais obitos nos pacientes classificados nas cores mais graves, sendo 42,8% classificados como vermelho, 17,0% laranja e 8,9% como amarelo. Entre os pacientes classificados como verde, 9,6% evoluiu para obito.Conclusao:nas diversas cores do Sistema de Triagem Manchester, o obito prevaleceu nos pacientes que apresentaram a queixa de mal-estar no adulto, dispneia, sofreram trauma craniano, trauma maior, diarreia e vomito. Quanto maior a prioridade clinica maior a prevalencia de obito.
The efficacy of probiotics supplementation for the treatment of atopic dermatitis in adults: a systematic review and meta-analysis

Abstract Background There is a lack of certain evidence for the therapeutic efficacy of probiotics for adult atopic dermatitis (AD). Methods PubMed, EMBASE, and the Cochrane Database were searched for relevant studies, and randomized controlled trials of AD describing treatment with single/mixed probiotic therapy were included. Changes in outcomes were calculated by standard mean difference (SMD) and 95% confidence interval (CI). Relative efficacies of the probiotics were ranked by the surface under the cumulative ranking (SUCRA). Results Nine studies with a total of 402 participants, including 208 AD patients who received probiotic treatments and 194 controls, were considered during the current analysis. A reduction in disease severity for probiotic supplementation compared to controls in both the short term (SMD: 0.63; 95% CI: 0.02–1.25) and the long term (SMD: 1.57; 95% CI: 0.66–2.49). There was a significant improvement in long-term quality of life after probiotic supplementation compared with controls (SMD: 0.74; 95% CI: 0.39–1.09). A mixture of L. salivarius (LS01) and Bifidobacterium (BR03) was found the highest probability of the best supplementation. Conclusions Probiotic supplementation decreases clinical severity and improves the quality of life among adult AD patients. The mixture of LS01 and BR03 appeared optimal.
Prospects of cell chemotactic factors in bone and cartilage tissue engineering

ABSTRACT Introduction Tissue engineering has brought hope for the repair of bone and cartilage injury. As potential therapeutic molecules for use in tissue engineering, chemokines promote the development of cell-free tissue engineering, avoiding dilemmas faced by cell-based tissue engineering. The main role of chemokines in tissue engineering is to recruit progenitor/stem cells to the site of damaged tissue in vivo and induce differentiation into the corresponding tissue, thus remodeling tissue function. In recent years, many studies have demonstrated the great potential of chemokines in the regeneration and repair of various tissues, such as heart, bone and cartilage tissue. Areas covered The classification, structure, and function of chemokines and the application of several common chemokines in diseases, especially in bone/cartilage tissue regeneration are discussed. Expert opinion Many studies have demonstrated that the combinatory use of cell chemotactic factors (CCFs) and growth factors can exert synergistic effects on chondrogenesis and osteogenesis. With further understanding of biomaterials and the development of powerful bio-fabrication techniques, intelligent biomaterials will be created to meet the requirements for controlled bioactive factor release and biomimetic architecture. Also, a better understanding of the biological cascade reactions and pathways of CCFs is beneficial to guide the design of innovative biomaterials.
The Spruce Budworm Genome: Reconstructing the Evolutionary History of Antifreeze Proteins

Abstract Insects have developed various adaptations to survive harsh winter conditions. Among freeze-intolerant species, some produce “antifreeze proteins” (AFPs) that bind to nascent ice crystals and inhibit further ice growth. Such is the case of the spruce budworm, Choristoneura fumiferana (Lepidoptera: Tortricidae), a destructive North American conifer pest that can withstand temperatures below −30°C. Despite the potential importance of AFPs in the adaptive diversification of Choristoneura, genomic tools to explore their origins have until now been limited. Here, we present a chromosome-scale genome assembly for C. fumiferana, which we used to conduct comparative genomic analyses aimed at reconstructing the evolutionary history of tortricid AFPs. The budworm genome features 16 genes homologous to previously reported C. fumiferana AFPs (CfAFPs), 15 of which map to a single region on chromosome 18. Fourteen of these were also detected in five congeneric species, indicating Choristoneura AFP diversification occurred before the speciation event that led to C. fumiferana. Although budworm AFPs were previously considered unique to the genus Choristoneura, a search for homologs targeting recently sequenced tortricid genomes identified seven CfAFP-like genes in the distantly related Notocelia uddmanniana. High structural similarity between Notocelia and Choristoneura AFPs suggests a common origin, despite the absence of homologs in three related tortricids. Interestingly, one Notocelia AFP formed the C-terminus of a “zonadhesin-like” protein, possibly representing the ancestral condition from which tortricid AFPs evolved. Future work should clarify the evolutionary path of AFPs between Notocelia and Choristoneura and assess the role of the “zonadhesin-like” protein as precursor of tortricid AFPs.
Monitoring of analgesia level during general anesthesia in children

Purpose of review Monitoring of intraoperative nociception has made substantial progress in adult anesthesia during the last 10 years. Several monitors have been validated and their use has been associated with intraoperative or postoperative benefits in the adult population. In pediatric anesthesia, less data are available. However, several recent publications have assessed the performance of nociception monitors in children, and investigated their potential benefits in this context. This review will describe the main validated intraoperative nociception monitors, summarize adult findings and describe the available pediatric data. Recent findings Six intraoperative nociception indices were included in this review. Among them, four have shown promising results in children: Surgical Pleth Index (GE-Healthcare, Helsinki, Finland), Analgesia-Nociception Index (Mdoloris Medical Systems, Loos, France), Newborn-Infant Parasympathetic Evaluation (Mdoloris Medical Systems), and Pupillometry (IDMED, Marseille, France). The relevance of Skin Conductance (MedStorm innovations, AS, Oslo, Norway) under general anesthesia could not be established. Finally, the Nociception Level (Medasense, Ramat Gan, Israel) still requires to be investigated in children. Summary To date, four monitors may provide a relevant assessment of intraoperative nociception in children. However, the potential clinical benefits associated with their use to guide analgesia remain to be demonstrated.
The current landscape of Acute Care for Elders units in the United States

The clinical benefits of Acute Care for Elders (ACE) units have been established for over 25 years. However, how widely disseminated ACE units are in the United States and the degree of fidelity to the key elements of this model of care are unknown. Our objective was to identify all existing ACE units in the United States and to obtain detailed information about variations in implementation.