Miracle-dz/UniFAR-FTUs huggingface dataset:
To stay or go? Unpacking the decision-making process and coping strategies of International Medical Graduates practising in rural, remote, and regional Queensland, Australia

Australia is one of many countries to rely on International Medical Graduates (IMGs) to fill general practitioner (GP) positions throughout its regional, rural, and remote (RRR) communities. Current government initiatives requiring IMGs to work for specified periods in RRR areas offer only short-term solutions. The need to improve the long-term retention of IMGs practising in RRR areas has motivated this research to improve our understanding of how IMGs make decisions about where to practise. Specifically, this study sought to: (a) identify the factors that influence an IMG’s decision to remain working in RRR areas, and (b) develop a theory, grounded in the data, to explain how these factors are prioritised, evaluated and used to inform a decision to remain working in RRR areas. This study adopted a qualitative approach and employed grounded theory methods. Data collection and analysis occurred concurrently, using constant, comparative analysis, guided by theoretical sampling and data saturation. Data sources were transcripts from semi-structured interviews with IMG registrars (n = 20) and supervisors (n = 5), interviewers’ notes and analytic memos. Interviewees were all currently working in RRR areas of Queensland, Australia. The analysis involved a three-phase coding process, progressing from specific, inductive coding to abstract, abductive coding. The analysis revealed that the IMG decision-making process involves a complex, dynamic, and iterative process of balancing life goals based on life stage. Many factors are considered when assessing the balance of three main life goals: satisfaction with work, family, and lifestyle. The prioritisation and balance of these life goals can vary as the IMG moves through varying work-, family-, and age-related life stages. It is hoped that having this understanding of the complexity of the IMG decision-making process, will better equip medical educators, policy makers and support service providers to tailor services to encourage IMGs to continue practising in these regions.
WIRE–GRID MODELING OF CASSINI SPACECRAFT FOR THE DETERMINATION OF EFFECTIVE ANTENNA LENGTH VECTORS OF THE RPWS ANTENNAS

The Cassini RPWS (Radio and Plasma Wave Science) antenna system consists of three non–coplanar 10 m long monopoles. With this configuration the RPWS experiment is capable to perform a direction finding of incoming radio waves and to determine the four Stokes parameters. For this procedure it is necessary to know the so–called effective antenna length vectors, which describe the reception properties of the antenna system. Several methods have been used to determine these vectors. Although numerical calculations with a wire–grid model have already been performed, it was the aim of this work to calculate a more realistic and detailed wire–grid to determine the influence of several parts of the Cassini spacecraft like the tanks, the RTGs (Radio Thermonuclear Generators) and their shades, the Experimental Platform, the CDA (Cosmic Dust Analyzer), the Huygens Probe (HP) mounting and the HP itself, and the magnetometer boom (MB). The results are in good agreement with those found by the method of rheometry and the recent in–flight calibration of the RPWS antennas.
Antibiotic prescription practices in primary care in low- and middle-income countries: A systematic review and meta-analysis

Background The widespread use of antibiotics plays a major role in the development and spread of antimicrobial resistance. However, important knowledge gaps still exist regarding the extent of their use in low- and middle-income countries (LMICs), particularly at the primary care level. We performed a systematic review and meta-analysis of studies conducted in primary care in LMICs to estimate the prevalence of antibiotic prescriptions as well as the proportion of such prescriptions that are inappropriate. Methods and findings We searched PubMed, Embase, Global Health, and CENTRAL for articles published between 1 January 2010 and 4 April 2019 without language restrictions. We subsequently updated our search on PubMed only to capture publications up to 11 March 2020. Studies conducted in LMICs (defined as per the World Bank criteria) reporting data on medicine use in primary care were included. Three reviewers independently screened citations by title and abstract, whereas the full-text evaluation of all selected records was performed by 2 reviewers, who also conducted data extraction and quality assessment. A modified version of a tool developed by Hoy and colleagues was utilized to evaluate the risk of bias of each included study. Meta-analyses using random-effects models were performed to identify the proportion of patients receiving antibiotics. The WHO Access, Watch, and Reserve (AWaRe) framework was used to classify prescribed antibiotics. We identified 48 studies from 27 LMICs, mostly conducted in the public sector and in urban areas, and predominantly based on medical records abstraction and/or drug prescription audits. The pooled prevalence proportion of antibiotic prescribing was 52% (95% CI: 51%–53%), with a prediction interval of 44%–60%. Individual studies’ estimates were consistent across settings. Only 9 studies assessed rationality, and the proportion of inappropriate prescription among patients with various conditions ranged from 8% to 100%. Among 16 studies in 15 countries that reported details on prescribed antibiotics, Access-group antibiotics accounted for more than 60% of the total in 12 countries. The interpretation of pooled estimates is limited by the considerable between-study heterogeneity. Also, most of the available studies suffer from methodological issues and report insufficient details to assess appropriateness of prescription. Conclusions Antibiotics are highly prescribed in primary care across LMICs. Although a subset of studies reported a high proportion of inappropriate use, the true extent could not be assessed due to methodological limitations. Yet, our findings highlight the need for urgent action to improve prescription practices, starting from the integration of WHO treatment recommendations and the AWaRe classification into national guidelines. Trial registration PROSPERO registration number: CRD42019123269.
Optimal Operation Modes of Virtual Power Plants Based on Typical Scenarios Considering Output Evaluation Criteria

Stimulated by the severe energy crisis and the increasing awareness about the need for environmental protection, the efficient use of renewable energy has become a hot topic. The virtual power plant (VPP) is an effective way of integrating distributed energy systems (DES) by effectively deploying them in power grid dispatching or electricity trading. In this paper, the operating mode of the VPP with penetration of wind power, solar power and energy storage is investigated. Firstly, the grid-connection requirements of VPP according to the current wind and solar photovoltaic (PV) grid-connection requirements, and analyzed its profitability are examined. Secondly, under several typical scenarios grouped by a self-organization map (SOM) clustering algorithm using the VPP’s output data, a profit optimization model is established as a guideline for the VPP’s optimal operation. Based on this model, case studies are performed and the results indicate that this model is both feasible and effective.
Histone methyltransferase MLL4 controls myofiber identity and muscle performance through MEF2 interaction.

Skeletal muscle depends on the precise orchestration of contractile and metabolic gene expression programs to direct fiber type specification and to ensure muscle performance. Exactly how such fiber type-specific patterns of gene expression are established and maintained remains unclear, however. Here, we demonstrate that histone mono-methyltransferase MLL4 (KMT2D), an enhancer regulator enriched in slow myofibers, plays a critical role in controlling muscle fiber identity as well as muscle performance. Skeletal muscle-specific ablation of MLL4 in mice resulted in downregulation of the slow-oxidative myofiber gene program, decreased number of type I myofibers, and diminished mitochondrial respiration, which caused reductions in muscle fat utilization and endurance capacity during exercise. Genome-wide ChIP-seq and mRNA-seq analyses revealed that MLL4 directly binds to enhancers and functions as a coactivator of the myocyte enhancer factor 2 (MEF2) to activate transcription of slow-oxidative myofiber genes. Importantly, we also found that the MLL4 regulatory circuit is associated with muscle fiber type remodeling in humans. Thus, our results uncover a pivotal role for MLL4 in specifying structural and metabolic identities of myofibers that govern muscle performance. These findings provide new therapeutic opportunities for enhancing muscle fitness to combat a variety of metabolic and muscular diseases.
Complications of appendectomy and cholecystectomy in acute care surgery: A systematic review and meta-analysis

Supplemental digital content is available in the text. INTRODUCTION Acute care surgery (ACS) was initiated two decades ago to address timeliness and quality in emergency general surgery. We hypothesized that ACS has improved the management of acute appendicitis and biliary disease. METHODS A comprehensive systematic review and meta-analysis of outcome studies for emergent appendectomy and cholecystectomy from 1966 to 2017, comparing studies prior to and following ACS implementation, were performed. RESULTS Of 1,704 studies, 27 were selected for analysis (appendicitis, 16; biliary pathology, 7; both, 4). Following ACS introduction, the complication rate was significantly reduced in both appendectomy and cholecystectomy (risk ratios, 0.70; 95% confidence interval [CI], 0.57–0.85; I2 = 9.2% and relative risk, 0.62; 95% CI, 0.41–0.94; I2 = 63.5%) respectively. There was a significant reduction in the time from arrival in emergency until admission and from admission to operation (−1.37 hours: 95% CI, −1.93 to −0.80; −2.51 hours: 95% CI, −4.44 to −0.58) in the appendectomy cohort. Time to operation was shorter in the cholecystectomy group (−6.46 hours; 95% CI, −9.54 to −3.4). Length of hospital stay was reduced in both groups (appendectomy, −0.9 day; cholecystectomy, −1.09 day). There was a reduction in overall cost in cholecystectomy group (−US $854.37; 95% CI, –1,554.1 to −154.05). No statistical significance was detected for wound infection, abscess, conversion of laparoscopy to open technique, rate of negative appendectomy, after hours, readmission, and cost. CONCLUSION The implementation of ACS models in general surgery emergency care has significantly improved system and patient outcomes for appendicitis and biliary pathology. LEVEL OF EVIDENCE Systematic review and meta-analysis of a retrospective study, level III.
Consequences of disease and treatment in ANCA-associated vasculitis

ANCA-geassocieerde vasculitis (AAV) zijn auto-immuunziekten die ontstekingen veroorzaken in de kleine tot middelgrote bloedvaten. Elk orgaan in het lichaam kan in het ziekteproces betrokken raken, wat aanleiding geeft tot een zeer gevarieerde klinische presentatie. AAV zijn chronische, recidiverende aandoeningen die in remissie kunnen worden gebracht met immuunsuppressiva, afweeronderdrukkende medicijnen. Zowel de ziekte zelf als de behandeling veroorzaakt schade op korte- en lange termijn. Deze schade draagt bij aan een verlaagde kwaliteit van leven en slechtere prognose op langere termijn. In het eerste deel van dit proefschrift worden de gevolgen van de ziekte en de behandeling voor vruchtbaarheid en zwangerschap bij vrouwen en kwaliteit van leven in relatie met testosteron bij mannen onderzocht. Met name behandeling met cyclophosphamide heeft een ongunstig effect op de vruchtbaarheid. wij laten zien dat dit risico tegenwoordig lager is bij de huidige behandelprotocollen met lagere cumulatieve doseringen. De uitkomsten van zwangerschap waren gunstig voor zowel moeder als kind. Remissie van de ziekte lijkt een belangrijke voorwaarde voor dergelijke goede uitkomst. Bij een gedeelte van de mannen blijkt androgeen deficientie een rol te spelen bij vermoeidheid en kwaliteit van leven. Meer onderzoek naar dit fenomeen zal uit moeten wijzen wat de rol voor substitutietherapie is in geval van androgeen deficientie in deze populatie. Deel twee richt zich met name op het vinden van beter afgestemde behandelingen. Geindividualiseerde prednisolon behandelingen bieden mogelijk een betere tolerantie en veiligheidsprofiel dan gestandaardiseerde behandeling door meer inzicht in de individuele gevoeligheid voor prednisolon. Het gebruik van trimethoprim/ sulfamethoxazole voor patienten met een gelimiteerde vorm van de ziekte en het gebruik van mycphenolate mofetil voor patienten met recidiverende ziekte bleken waardevolle toevoegingen aan de huidige behandelprotocollen. Concluderend geeft dit proefschrift meer inzicht in enkele gevolgen van AAV en biedt het enkele behandelingsopties ter vermindering van schade.
Physical therapy management of a patient with persistent groin pain after total hip arthroplasty and iliopsoas tenotomy: a case report

ABSTRACT Background: Hip impingement syndrome can occur after total hip arthroplasty (THA). Nonoperative treatment is inconsistently recommended, and surgical options include iliopsoas tenotomy. The current case report describes the unique case of a patient with persistent groin pain after THA and iliopsoas tenotomy. Case Description: The 72-year-old male had persistent groin pain after right THA and an unsuccessful iliopsoas tenotomy. He had pain and limited right hip range of motion during active and passive hip flexion, abduction, and external rotation. Treatment consisted of high-grade joint mobilization to improve the range of motion of the right hip and an exercise program. Outcomes: The patient was treated for six visits over 3 weeks. Clinically important improvements were noted in pain, function, and perceived level of improvement. Pain during hip flexion improved on the Numeric Pain Rating Scale, and function improved on the Lower Extremity Functional Scale. Improvements in the range of motion and strength were also observed. At 6-month follow-up, he reported maintenance of improvements. Discussion: Joint mobilization and exercise were effective for improving range of motion, groin pain, and function in a patient with a 4-year history of persistent groin pain after THA and subsequent iliopsoas tenotomy.
Reliability of Synthetic Brain MRI for Assessment of Ischemic Stroke with Phantom Validation of a Relaxation Time Determination Method

The reliability of relaxation time measures in synthetic magnetic resonance images (MRIs) of homemade phantoms were validated, and the diagnostic suitability of synthetic imaging was compared to that of conventional MRIs for detecting ischemic lesions. Phantoms filled with aqueous cupric-sulfate (CuSO4) were designed to mimic spin-lattice (T1) and spin-spin (T2) relaxation properties and were used to compare their accuracies and stabilities between synthetic and conventional scans of various brain tissues. To validate the accuracy of synthetic imaging in ischemic stroke diagnoses, the synthetic and clinical scans of 18 patients with ischemic stroke were compared, and the quantitative contrast-to-noise ratios (CNRs) were measured, using the Friedman test to determine significance in differences. Results using the phantoms showed no significant differences in the interday and intersession synthetic quantitative T1 and T2 values. However, between synthetic and referenced T1 and T2 values, differences were larger for longer relaxation times, showing that image intensities in synthetic scans are relatively inaccurate in the cerebrospinal fluid (CSF). Similarly, CNRs in CSF regions of stroke patients were significantly different on synthetic T2-weighted and T2-fluid-attenuated inversion recovery images. In contrast, differences in stroke lesions were insignificant between the two. Therefore, interday and intersession synthetic T1 and T2 values are highly reliable, and discrepancies in synthetic T1 and T2 relaxation times and image contrasts in CSF regions do not affect stroke lesion diagnoses. Additionally, quantitative relaxation times from synthetic images allow better estimations of ischemic stroke onset time, consequently increasing confidence in synthetic MRIs as diagnostic tools for ischemic stroke.
A “Global–Local” Visual Servo System for Picking Manipulators

During the process of automated crop picking, the two hand–eye coordination operation systems, namely “eye to hand” and “eye in hand” have their respective advantages and disadvantages. It is challenging to simultaneously consider both the operational accuracy and the speed of a manipulator. In response to this problem, this study constructs a “global–local” visual servo picking system based on a prototype of a picking robot to provide a global field of vision (through binocular vision) and carry out the picking operation using the monocular visual servo. Using tomato picking as an example, experiments were conducted to obtain the accuracies of judgment and range of fruit maturity, and the scenario of fruit-bearing was simulated over an area where the operation was ongoing to examine the rate of success of the system in terms of continuous fruit picking. The results show that the global–local visual servo picking system had an average accuracy of correctly judging fruit maturity of 92.8%, average error of fruit distance measurement in the range 0.485 cm, average time for continuous fruit picking of 20.06 s, and average success rate of picking of 92.45%.
1 System Overview Natural Language Understanding ASR Dialog Manager Context Intent Classifier Feedback Topic Dialog Modules Natural Language Generation Segmentation Noun Phrase

Gunrock is a social bot designed to engage users in open domain conversations. We improved our bot iteratively using large scale user interaction data to be more capable and human-like. Our system engaged in over 40, 000 conversations during the semi-finals period of the 2018 Alexa Prize. We developed a context-aware hierarchical dialog manager to handle a wide variety of user behaviors, such as topic switching and question answering. In addition, we designed a robust threestep natural language understanding module, which includes techniques such as sentence segmentation and automatic speech recognition (ASR) error correction. Furthermore, we improve the human-likeness of the system by adding prosodic speech synthesis. As a result of our many contributions and large scale user interactions analysis, we achieved an average score of 3.62 on a 1− 5 Likert scale on Oct 14th. Additionally, we achieved an average of 22.14 number of turns and a 5.22 minutes conversation duration.
Context-Aware Multimodal FIDO Authenticator for Sustainable IT Services

Existing sustainable IT services have several problems related to user authentication such as the inefficiency of managing the system security, low security, and low usability. In this paper, we propose a Fast IDentity Online (FIDO) authenticator that performs continuous authentication with implicit authentication based on user context and multimodal authentication. The proposed FIDO authenticator, a context-aware multimodal FIDO authentication (CAMFA) method, combines information such as the user context, state of the mobile device, and user biometrics, then applies implicit and explicit authentication methods to meet the level of authentication required by the service provider. This reduces the user’s explicit authentication burden and continually authenticates users at risk during the session. Moreover, it is able to respond to attacks such as the theft of the authentication method or session hijacking. To study the effectiveness of CAMFA, we ran a user study by collecting data from 22 participants over 42 days of activity on a practical Android platform. The result of the user study demonstrates that the number of explicit authentication requests could be reduced by half. Based on the results of this study, an advanced user authentication that provides multimodal and continuous authentication could be applied to sustainable IT services.
Genotype, Temperature, and Sampling Date Affect Embryogenesis in Asparagus Anther Culture

Asparagus (Asparagus officinalis L.) anthers from flowers of field-grown plants were cultured for five genotypes, four incubation temperatures, and three sampling dates. Treatments were evaluated for total and embryogenic callus production. Incubating anthers at 35C was optimal for initiating embryogenic callus for three genotypes. Another line performed best and equally well at 29 and 32C, while one was recalcitrant to embryogenic callus formation at the temperatures evaluated. For all genotypes, almost half of the anthers produced callus for at least one temperature treatment, hut the percentage of these calli that was embryogenic ranged from 0% to 50%. Sampling date affected response only for specific genotype-temperature combinations. Embryo recovery ranged from six to 14 per callus. For the four responsive genotypes, 77% to 100% of plantlets was haploid. Culturing anthers at several temperatures ranging from 29 to 35C, with repeated samplings of flowers from the field, likely will allow recovery of haploid embryos from many selections. This result will expand the germplasm base to develop all-male asparagus hybrids.
Proteomic Profiling of Retinoblastoma-Derived Exosomes Reveals Potential Biomarkers of Vitreous Seeding

Retinoblastoma (RB) is the most common tumor of the eye in early childhood. Although recent advances in conservative treatment have greatly improved the visual outcome, local tumor control remains difficult in the presence of massive vitreous seeding. Traditional biopsy has long been considered unsafe in RB, due to the risk of extraocular spread. Thus, the identification of new biomarkers is crucial to design safer diagnostic and more effective therapeutic approaches. Exosomes, membrane-derived nanovesicles that are secreted abundantly by aggressive tumor cells and that can be isolated from several biological fluids, represent an interesting alternative for the detection of tumor-associated biomarkers. In this study, we defined the protein signature of exosomes released by RB tumors (RBT) and vitreous seeding (RBVS) primary cell lines by high resolution mass spectrometry. A total of 5666 proteins were identified. Among these, 5223 and 3637 were expressed in exosomes RBT and one RBVS group, respectively. Gene enrichment analysis of exclusively and differentially expressed proteins and network analysis identified in RBVS exosomes upregulated proteins specifically related to invasion and metastasis, such as proteins involved in extracellular matrix (ECM) remodeling and interaction, resistance to anoikis and the metabolism/catabolism of glucose and amino acids.