Miracle-dz/UniFAR-FTUs huggingface dataset:
On the design of a two-way piezoelectric MEMS microspeaker based on a multi-shape cantilever array for high-frequency applications

This study presents the design and realization of a piezoelectric MEMS microspeaker for high-frequency enhancement. Based on piezoelectric thin film actuation, designs of cantilever diaphragms are conducted by modal analysis. Under a die size of 2.5 mm (w) × 5 mm (l) × 0.4 mm (t), the diaphragms are designed to include mid-range and tweeter units with regard to the balance of radiation area and sound pressure contribution. Furthermore, the out-of-phase driving of the proposed device can ensure that the superposition of the sound pressure level (SPL) is within the target frequency range (8–13 kHz) while reducing the SPL outside the target range. In pressure-field measurements, the proposed multi-shape cantilever array can produce high average SPL (91.6 dB) in the target frequency range from 8 kHz to 13 kHz and has a low total harmonic distortion (THD) of <1.4% under a 0.707 Vrms input signal. The performance can be further improved by biasing the input signal. With a 9 V bias, the average SPL of the proposed microspeaker in the target frequency range is enhanced to 99.4 dB, and the average THD is reduced to <0.7%. In addition, the THD from 7.7 kHz to 18 kHz is below 2.5%. This study shows the great potential of piezoelectric MEMS microspeakers for in-ear applications.
Factors associated with unfavorable outcome after anterior circulation stroke despite successful reperfusion and early neurological improvement

Background and Purpose: Successful reperfusion during endovascular therapy (EVT) usually leads to early neurological improvement (ENI), yet some patients do not achieve good longterm outcome. The aim of this study was to investigate factors associated with unfavorable clinical outcome (UCO) despite ENI. Methods: This was a retrospective singlecenter analysis of consecutive patients treated for anterior circulation large vessel occlusion who achieved successful reperfusion and ENI (at least 20% lower followup NIHSS compared to NIHSS on admission) between 01/2014 and 04/2019. The primary endpoint was unfavorable outcome (90d mRS > 2 or mRS > baseline mRS). Patients with favorable clinical outcome (FCO) and UCO despite ENI were compared in univariable regression analysis. Results: Successful EVT (mTICI 2c or 3) and ENI occurred in 396/549 (72.1 %) patients and unfavorable outcome despite ENI in 168/396 (42.2 %) patients. Factors associated with UCO were baseline mRS (Odds ratio (OR) 3.13, p < 0.001), age (OR 1.09, p < 0.001), baseline NIHSs (OR 1.09, p < 0.001), female sex (OR 1.92, p = 0.002), hypertension (OR 2.32, p = 0.002), smoking (OR 0.48, p = 0.019), history of previous stroke (OR 2.7, p < 0.001), atrial fibrillation (OR 1.73, p = 0.007), neutrophil-lymphocyte ratio (OR 1.05, p = 0.014), as well as ASPECTS after EVT (OR 0.77, p < 0.001), TAN score (OR 0.60, p < 0.001) and Swieten score (OR 2.55, p < 0.001). Several ASPECTS regions were associated with UCO despite ENI (insula, M1-M3 and M5). Conclusions: Relevant factors associated with UCO despite successful EVT and ENI were patient age, sex, baseline mRS, hypertension, history of smoking, previous stroke, atrial fibrillation, neutrophil-lymphocyte ratio, TAN and Swieten Score as well as ASPECTS after EVT. The involvement of certain brain regions by ASPECTS segments were associated with UCO despite ENI after EVT.
Plasma neurofilament light chain predicts Alzheimer’s disease in patients with subjective cognitive decline and mild cognitive impairment: a longitudinal study

Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) represent a target population for early detection of Alzheimer’s Disease (AD). Nevertheless, both MCI and SCD are common and heterogeneous conditions. We aim to evaluate the accuracy of plasma neurofilament light chain (NfL) in predicting AD and the progression of cognitive decline in patients with SCD and MCI.
Complications following surgeries for endometriosis: A systematic review protocol

Background Endometriosis is a common gynecological condition with a wide range of symptoms, including infertility, dyspareunia, intestinal disorders, and pelvic pain. Laparoscopy and laparotomy are used widely for diagnosing and managing endometriosis. We will conduct a systematic review and meta-analysis with the aims of reporting complications rates following each type of surgeries for endometriosis and determinants of complications. Method We will search Medline (via PubMed), Embase, the Cochrane Library, Web of Science, and Google Scholar for both retrospective and prospective cohorts or trials of at least 30 participants reporting perioperative and postoperative complications for endometriosis surgeries. We will restrict the studies to those conducted after 2011, to be representative of current practices, and will exclude studies of surgeries for gynecological cancer, or other concomitant benign gynecologic surgeries such as myomectomy. Two reviewers will independently screen references and select eligible studies. A standardized form will be used to collect data related to the baseline characteristics, potential determinants of complications, types of interventions, and outcomes. Cumulative incidences of complications will be pooled using DerSimonian and Laird random-effects method. The relation between potential determinants and complications will be reported with risk ratios and their 95% of confidence intervals. Subgroup analysis of surgical approach, surgical procedure, superficial and deep infiltrating endometriosis, and the indication of surgery will be conducted. Sensitivity analyses restricted to studies with low risk of bias will be performed. Discussion This systematic review will provide information on the rates of complications for different surgical approaches and procedures for the treatment of endometriosis. It will contribute to inform patients when making decisions regarding their care. Identifying potential determinants of complications will also help to improve care by identifying women being at higher risk of complications. Trial registration Systematic review registration: CRD42021293865.
Self-efficacy and resilience as predictors of students’ academic motivation in online education

Motivation as a catalyst for human conduct has been associated with lots of variables. However, self-efficacy and resilience as two important components of the individuals’ psychological capital have not received enough scientific attention. This gets more significance considering the global COVID-19 pandemic with noticeable psychological consequences for the learners receiving online education. Hence, the current study proceeded to investigate the relationship between students’ self-efficacy, resilience, and academic motivation in online education. To this aim, a convenience sample of 120 university students coming from two state universities in south of Iran participated in an online survey. The questionnaires used in the survey included the self-efficacy questionnaire, resilience questionnaire, and academic motivation questionnaire. Pearson correlation and multiple regression statistical methods were applied to analyze the obtained data. The results pointed to a positive relationship between self-efficacy and academic motivation. In addition, those with a higher degree of resilience were found to experience higher academic motivation. Moreover, the results of multiple regression test revealed that self-efficacy and resilience can significantly predict the academic motivation of the students involved in an online mode of education. The research proposes a number of recommendations for developing the learners’ level of self-efficacy and resilience through enacting various pedagogical interventions. In this way, a heightened level of academic motivation would enhance EFL learners’ learning rate.
Patho-epigenetics: histone deacetylases as targets of pathogens and therapeutics

ABSTRACT In recent years, the interplay of epigenetics and infection moved into the limelight. Epigenetic regulation describes modifications in gene expression without alterations of the DNA sequence. In eukaryotes, this mechanism is central for fundamental cellular processes such as cell development and differentiation, but it is also involved in more specific tasks such as the response to infection by a pathogen. One of the most common types of epigenetic changes is the modification of histones. Histones, the small protein building blocks that are wrapped with DNA are the fundamental packaging unit of chromatin. Histones can be modified by linking different moieties to them—one of the most abundant ones is acetylation. Histone acetylation is regulated by two main classes of enzymes, histone acetyl transferases (HAT) and their counterparts, histone deacetylases (HDAC). Given the high abundance and importance in regulating gene expression, histone acetylation is an excellent target for pathogens to manipulate the host cell to their advantage. Targeting HDACs gained particular interest in recent years, due to the increased use of HDAC inhibitors in clinical practice. Recently, the possibility to fight an infection with HDAC inhibitors was suggested as an alternative to overcome the ever-growing problem of antibiotic resistance. In this review, we focus on the regulation of HDACs and their involvement in immune cell function. We then highlight different mechanisms employed by pathogens to manipulate histone deacetylases and we discuss the possibility of HDAC inhibitors as therapeutics to fight infections.
Laughter as medicine: A systematic review and meta-analysis of interventional studies evaluating the impact of spontaneous laughter on cortisol levels

Objectives Laughter as an expression of humor has been recognized as good medicine for centuries. The health benefits of humor-induced well-being remain unclear and thus we conducted a systematic review and meta-analysis of interventional studies to evaluate the impact of spontaneous laughter on stress response as measured by cortisol levels. Design Systematic review and meta-analysis. Data sources MEDLINE/PubMed, EMBASE, PsycINFO, Scopus, and Clinicaltrials.gov. Eligibility criteria Interventional studies, which could be either randomized placebo-controlled trials (RCTs) or quasi-experimental studies, conducted in adults that compared any spontaneous laughter intervention to a controlled setting and reported changes in cortisol levels were selected. Data extraction and synthesis We examined the impact of laughter on percentage change in cortisol levels by calculating pooled estimates of the absolute differences between arithmetic means before and after interventions as compared to control using random-effects model. Results Eight studies (315 participants; mean age 38.6) met our inclusion criteria; four were RCTs and four were quasi-experiment studies. Five studies evaluated the impact of watching a humor/comedy video, two studies evaluating laughter sessions administered by a trained laughter therapist, and one study evaluating a self-administered laughter program. Pooling these data showed a significant reduction in cortisol levels by 31.9% (95%CI -47.7% to -16.3%) induced by laughter intervention compared to control group with no evidence of publication bias (P = 0.66). Sensitivity analyses demonstrated that even a single laughter session induced a significant reduction of 36.7% in cortisol (95%CI -52.5% to -20.8%). In addition, analyses including the four RCTs reinforced these results by demonstrating a significant reduction in cortisol levels promoted by laughter as compared to the placebo arm [-37.2% (95%CI -56.3% to -18.1%)]. Conclusions Current evidence demonstrates that spontaneous laughter is associated with greater reduction in cortisol levels as compared with usual activities, suggesting laughter as a potential adjunctive medical therapy to improve well-being. Trial registration Registration number: CRD42021267972.
Service user and stakeholder engagement in maternal and newborn health research in low- and middle-income countries: A systematic review protocol

Background Service user and stakeholder engagement have been widely considered as key aspects in translating knowledge into realistic policies and practices. However, there is a paucity of accumulative evidence about service user and stakeholder engagements in maternal and newborn health (MNH) research in low- and middle-income countries (LMICs). Therefore, we aim to systematically review the existing literature that includes service user and stakeholder engagement in maternal and newborn health research in low- and middle–income countries. Materials and methods The design of this protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA-P) checklist. We will systematically run the search in PubMed/MEDLINE, PsycINFO, Scopus, Science Direct, and CINAHL to obtain relevant peer-reviewed literature published between January 1990 and March 2023. The list of extracted references will be screened by applying the study inclusion criteria, and eligible studies will be processed for further evaluation before being included in the review. The quality of the selected study will be assessed using the critical appraisal skills program (CASP) checklists and the Mixed Method Appraisal Tool (MMAT) checklist. A narrative synthesis will be used to synthesised results from all the included studies. Discussion and conclusion To the best of our knowledge, this systematic review will be the first synthesised evidence on service user and stakeholder engagement in maternal and newborn health research in low- and middle-income countries. The study highlights the importance of service user and stakeholder roles in designing, implementing, and evaluating maternal and newborn health interventions in resource-poor settings. The evidence from this review is expected to be useful for national and international researchers/stakeholders for practising meaningful and effective ways of engaging users and stakeholders in maternal and newborn health research and related activities. The PROSPERO registration number is CRD42022314613.
Short-separation regression incorporated diffuse optical tomography image reconstruction modeling for high-density functional near-infrared spectroscopy

Abstract. Significance Short-separation (SS) regression and diffuse optical tomography (DOT) image reconstruction, two widely adopted methods in functional near-infrared spectroscopy (fNIRS), were demonstrated to individually facilitate the separation of brain activation and physiological signals, with further improvement using both sequentially. We hypothesized that doing both simultaneously would further improve the performance. Aim Motivated by the success of these two approaches, we propose a method, SS-DOT, which applies SS and DOT simultaneously. Approach The method, which employs spatial and temporal basis functions to represent the hemoglobin concentration changes, enables us to incorporate SS regressors into the time series DOT model. To benchmark the performance of the SS-DOT model against conventional sequential models, we use fNIRS resting state data augmented with synthetic brain response as well as data acquired during a ball squeezing task. The conventional sequential models comprise performing SS regression and DOT. Results The results show that the SS-DOT model improves the image quality by increasing the contrast-to-background ratio by a threefold improvement. The benefits are marginal at small brain activation. Conclusions The SS-DOT model improves the fNIRS image reconstruction quality.
Mechanism of elastic energy storage of honey bee abdominal muscles under stress relaxation

Abstract Energy storage of passive muscles plays an important part in frequent activities of honey bee abdomens due to the muscle distribution and open circulatory system. However, the elastic energy and mechanical properties of structure in passive muscles remain unclear. In this article, stress relaxation tests on passive muscles from the terga of the honey bee abdomens were performed under different concentrations of blebbistatin and motion parameters. In stress relaxation, the load drop with the rapid and slow stages depending on stretching velocity and stretching length reflects the features of myosin–titin series structure and cross-bridge–actin cyclic connections in muscles. Then a model with 2 parallel modules based on the 2 feature structures in muscles was thus developed. The model described the stress relaxation and stretching of passive muscles from honey bee abdomen well for a good fitting in stress relaxation and verification in loading process. In addition, the stiffness change of cross-bridge under different concentrations of blebbistatin is obtained from the model. We derived the elastic deformation of cross-bridge and the partial derivatives of energy expressions on motion parameters from this model, which accorded the experimental results. This model reveals the mechanism of passive muscles from honey bee abdomens suggesting that the temporary energy storage of cross-bridge in terga muscles under abdomen bending provides potential energy for springback during the periodic abdomen bending of honey bee or other arthropod insects. The finding also provides an experimental and theoretical basis for the novel microstructure and material design of bionic muscle.
Molecular phylogeny of Psychodopygina (Diptera, Psychodidae) supporting morphological systematics of this group of vectors of New World tegumentary leishmaniasis

New World sandflies are vectors of leishmaniasis, bartonellosis, and some arboviruses. A classification based on 88 morphological characters was proposed 27 years ago when the New World phlebotomines were organized into two tribes Hertigiini and Phlebotomini. The latter was structured into four subtribes (Brumptomyiina, Sergentomyiina, Lutzomyiina, and Psychodopygina) and 20 genera. The subtribe Psychodopygina, including most of the American vectors of tegumentary Leishmania comprises seven genera from which no molecular work has been produced to support this classification. Here, we carried out a molecular phylogeny based on combined sequences (1,334 bp) of two genes: partial 28S rDNA and mtDNA cytochrome b from 47 taxa belonging to the Psychodopygina. The Bayesian phylogenetic reconstruction agreed with the classification based on morphological characters, supporting the monophyly of the genera Psychodopygus and Psathyromyia, whereas Nyssomyia and Trichophoromyia seemed to be paraphyletic. The paraphylies of the two latter groups were exclusively caused by the doubtful position of the species Ny. richardwardi. Our molecular analysis provides additional support to adopt the morphologic classification of Psychodopygina.
Benchmarking halcyon ring delivery system for hypofractionated breast radiotherapy: Validation and clinical implementation of the fast‐forward trial

Abstract Purpose The aim of this study was to demonstrate the feasibility and efficacy of an iterative CBCT‐guided breast radiotherapy with Fast‐Forward trial of 26 Gy in five fractions on a Halcyon Linac. This study quantifies Halcyon plan quality, treatment delivery accuracy and efficacy by comparison with those of clinical TrueBeam plans. Materials and Methods Ten accelerated partial breast irradiation (APBI) patients (four right, six left) who underwent Fast‐Forward trial at our institute on TrueBeam (6MV beam) were re‐planned on Halcyon (6MV‐FFF). Three site‐specific partial coplanar VMAT arcs and an Acuros‐based dose engine were used. For benchmarking, PTV coverage, organs‐at‐risk (OAR) doses, beam‐on time, and quality assurance (QA) results were compared for both plans. Results The average PTV was 806 cc. Compared to TrueBeam plans, Halcyon provided highly conformal and homogeneous plans with similar mean PTVD95 (25.72 vs. 25.73 Gy), both global maximum hotspot < 110% (p = 0.954) and similar mean GTV dose (27.04 vs. 26.80 Gy, p = 0.093). Halcyon provided lower volume of ipsilateral lung receiving 8 Gy (6.34% vs. 8.18%, p = 0.021), similar heart V1.5 Gy (16.75% vs. 16.92%, p = 0.872), V7Gy (0% vs. 0%), mean heart dose (0.96 vs. 0.9 Gy, p = 0.228), lower maximum dose to contralateral breast (3.2 vs. 3.6 Gy, p = 0.174), and nipple (19.6 vs. 20.1 Gy, p = 0.363). Compared to TrueBeam, Halcyon plans provided similar patient‐specific QA pass rates and independent in‐house Monte Carlo second check results of 99.6% vs. 97.9% (3%/2 mm gamma criteria) and 98.6% versus 99.2%, respectively, suggesting similar treatment delivery accuracy. Halcyon provided shorter beam‐on time (1.49 vs. 1.68 min, p = 0.036). Conclusion Compared to the SBRT‐dedicated TrueBeam, Halcyon VMAT plans provided similar plan quality and treatment delivery accuracy, yet potentially faster treatment via one‐step patient setup and verification with no patient collision issues. Rapid delivery of daily APBI on Fast‐Forward trial on Halcyon with door‐to‐door patient time < 10 min, could reduce intrafraction motion errors, and improve patient comfort and compliance. We have started treating APBI on Halcyon. Clinical follow‐up results are warranted. We recommend Halcyon users consider implementing the protocol to remote and underserved APBI patients in Halcyon‐only clinics.
Testosterone Restores Body Composition, Bone Mass, and Bone Strength Following Early Puberty Suppression in a Mouse Model Mimicking the Clinical Strategy in Trans Boys

Transgender youth increasingly present at pediatric gender services. Some of them receive long‐term puberty suppression with gonadotropin‐releasing hormone analogues (GnRHa) before starting gender‐affirming hormones (GAH). The impact of GnRHa use started in early puberty on bone composition and bone mass accrual is unexplored. It is furthermore unclear whether subsequent GAH fully restore GnRHa effects and whether the timing of GAH introduction matters. To answer these questions, we developed a mouse model mimicking the clinical strategy applied in trans boys. Prepubertal 4‐week‐old female mice were treated with GnRHa alone or with GnRHa supplemented with testosterone (T) from 6 weeks (early puberty) or 8 weeks (late puberty) onward. Outcomes were analyzed at 16 weeks and compared with untreated mice of both sexes. GnRHa markedly increased total body fat mass, decreased lean body mass, and had a modest negative impact on grip strength. Both early and late T administration shaped body composition to adult male levels, whereas grip strength was restored to female values. GnRHa‐treated animals showed lower trabecular bone volume and reduced cortical bone mass and strength. These changes were reversed by T to female levels (cortical bone mass and strength) irrespective of the time of administration or even fully up to adult male control values (trabecular parameters) in case of earlier T start. The lower bone mass in GnRHa‐treated mice was associated with increased bone marrow adiposity, also reversed by T. In conclusion, prolonged GnRHa use started in prepubertal female mice modifies body composition toward more fat and less lean mass and impairs bone mass acquisition and strength. Subsequent T administration counteracts GnRHa impact on these parameters, shaping body composition and trabecular parameters to male values while restoring cortical bone architecture and strength up to female but not male control levels. These findings could help guide clinical strategies in transgender care. © 2023 American Society for Bone and Mineral Research (ASBMR).
Advances in the mTOR signaling pathway and its inhibitor rapamycin in epilepsy

Epilepsy is one of the most common and serious brain syndromes and has adverse consequences on a patient's neurobiological, cognitive, psychological, and social wellbeing, thereby threatening their quality of life. Some patients with epilepsy experience poor treatment effects due to the unclear pathophysiological mechanisms of the syndrome. Dysregulation of the mammalian target of the rapamycin (mTOR) pathway is thought to play an important role in the onset and progression of some epilepsies.