Miracle-dz/UniFAR-FTUs huggingface dataset:
Accuracy of ultrasound for the diagnosis of acute appendicitis in the emergency department: A systematic review

Background: Point-of-Care Ultrasound (POCUS) is a quick, useful, noninvasive, and inexpensive diagnostic tool used for the diagnosis of trauma, abdominal pain, dyspnea, and chest pain in the emergency department (ED). However, the diagnostic accuracy of ultrasound in the ED may be different from those reported in previous studies owing to the setting and time constraints in ED. Methods: We conducted our study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A literature search was conducted using databases on US National Library of Medicine’s database of biomedical literature, Ovid MEDLINE, online database of biomedical articles, and the collection of databases of systematic reviews and other evidence. The inclusion criteria were the use of bedside ultrasound as a diagnostic tool for acute appendicitis in the ED and the available data on diagnostic parameters such as sensitivity, specificity, and positive and negative predictive values (NPV). We constructed forest plots and summary receiver operating characteristic curves to evaluate the diagnostic accuracy of bedside ultrasound for acute appendicitis in the ED. Results: A total of 21 studies that met the inclusion criteria of this study were included for analysis. The overall pooled sensitivity was 0.81 (95% CI, 0.78–0.83), whereas the pooled specificity was 0.87 (95% CI, 0.85–0.88). However, the I2 test showed 91.7% and 90.9% heterogeneity in the sensitivity and specificity values, respectively. The summary receiver operating characteristic curves showed high levels of accuracy, as evidenced by an area under the curve of 0.9249 (standard error: 0.0180). Conclusions: The use of ultrasound for the diagnosis of acute appendicitis in the ED showed that ultrasound has high overall sensitivity and specificity for the diagnosis of acute appendicitis. however, high heterogeneity among the included studies was observed.
The Detection of Clusters in Rare Diseases

SUMMARY Tests for clustering of rare diseases investigate whether an observed pattern of cases in one or more geographical regions could reasonably have arisen by chance alone, bearing in mind the variation in background population density. In contrast, tests for the detection of clusters are concerned with screening a large region for evidence of individual 'hot spots' of disease but without any preconception about their likely locations; the results of such tests may form the basis for subsequent small area investigations, statistical or non-statistical, but will rarely be an end in themselves. The main intention of the paper is to describe and illustrate a new technique for the identification of small clusters of disease. A secondary purpose is to discuss some common pitfalls in the application of tests of clustering to epidemiological data.
Neutrophilic inflammation promotes SARS-CoV-2 infectivity and augments the inflammatory responses in airway epithelial cells

Introduction In response to viral infection, neutrophils release inflammatory mediators as part of the innate immune response, contributing to pathogen clearance through virus internalization and killing. Pre- existing co-morbidities correlating to incidence to severe COVID-19 are associated with chronic airway neutrophilia. Furthermore, examination of COVID-19 explanted lung tissue revealed a series of epithelial pathologies associated with the infiltration and activation of neutrophils, indicating neutrophil activity in response to SARS-CoV-2 infection. Methods To determine the impact of neutrophil-epithelial interactions on the infectivity and inflammatory responses to SARS-CoV-2 infection, we developed a co-culture model of airway neutrophilia. This model was infected with live SARS-CoV-2 virus the epithelial response to infection was evaluated. Results SARS-CoV-2 infection of airway epithelium alone does not result in a notable pro-inflammatory response from the epithelium. The addition of neutrophils induces the release of proinflammatory cytokines and stimulates a significantly augmented proinflammatory response subsequent SARS-CoV-2 infection. The resulting inflammatory responses are polarized with differential release from the apical and basolateral side of the epithelium. Additionally, the integrity of the \epithelial barrier is impaired with notable epithelial damage and infection of basal stem cells. Conclusions This study reveals a key role for neutrophil-epithelial interactions in determining inflammation and infectivity. Graphical Abstract
A new multiplex SARS-CoV-2 antigen microarray showed correlation of IgG, IgA, and IgM antibodies from patients with COVID-19 disease severity and maintenance of relative IgA and IgM antigen binding over time

Zoonotic spillover of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to humans in December 2019 caused the coronavirus disease 2019 (COVID-19) pandemic. Serological monitoring is critical for detailed understanding of individual immune responses to infection and protection to guide clinical therapeutic and vaccine strategies. We developed a high throughput multiplexed SARS-CoV-2 antigen microarray incorporating spike (S) and nucleocapsid protein (NP) and fragments expressed in various hosts which allowed simultaneous assessment of serum IgG, IgA, and IgM responses. Antigen glycosylation influenced antibody binding, with S glycosylation generally increasing and NP glycosylation decreasing binding. Purified antibody isotypes demonstrated a binding pattern and intensity different from the same isotype in whole serum, probably due to competition from the other isotypes present. Using purified antibody isotypes from naïve Irish COVID-19 patients, we correlated antibody isotype binding to different panels of antigens with disease severity, with binding to the S region S1 expressed in insect cells (S1 Sf21) significant for IgG, IgA, and IgM. Assessing longitudinal response for constant concentrations of purified antibody isotypes for a patient subset demonstrated that the relative proportion of antigen-specific IgGs decreased over time for severe disease, but the relative proportion of antigen-specific IgA binding remained at the same magnitude at 5 and 9 months post-first symptom onset. Further, the relative proportion of IgM binding decreased for S antigens but remained the same for NP antigens. This may support antigen-specific serum IgA and IgM playing a role in maintaining longer-term protection, important for developing and assessing vaccine strategies. Overall, these data demonstrate the multiplexed platform as a sensitive and useful platform for expanded humoral immunity studies, allowing detailed elucidation of antibody isotypes response against multiple antigens. This approach will be useful for monoclonal antibody therapeutic studies and screening of donor polyclonal antibodies for patient infusions.
Does aerobic scope influence geographical distribution of teleost fishes?

Fishes with a large geographical distribution are expected to also have a large aerobic scope (AS). Our study of the literature found, however, a negative correlation between maximum AS and distribution range fishes living in temperate climates. However, no link was found between thermal range AS and latitudinal range in 32 species.
Vortical structures behind a sphere at subcritical Reynolds numbers

Large eddy simulations of turbulent flow over a sphere are conducted at subcritical Reynolds numbers (Re=3700 and 104) based on the freestream velocity and sphere diameter. At Re=3700, the separating shear layer persists downstream to form a cylindrical vortex sheet and its instability becomes manifest at x≈2d. The flow right behind the sphere contains only a few vortices. On the other hand, at Re=104, the shear-layer instability occurs right behind the sphere in a form of vortex rings, and the flow becomes turbulent in the near wake. Therefore, at Re=104, the size of the recirculation region is smaller and the wake recovers more quickly than at Re=3700. At both Reynolds numbers, large-scale waviness of vortical structures is observed in the wake and the plane containing the large-scale waviness changes quasirandomly in time. This waviness is more pronounced at Re=104 than at Re=3700. The mechanism responsible for this large-scale waviness of vortical structures is shown to be closely associated with the .
The efficacy and safety of cupping as complementary and alternative therapy for metabolic syndrome: A systematic review and meta-analysis

Introduction: This systematic review and meta-analysis aimed to assess the efficacy and safety of cupping therapy in patients with metabolic syndrome (MetS). Methods: This systematic review focused on patients with MetS and included randomized controlled trials (RCTs) that compared the effects of cupping therapy with control groups. A total of 12 electronic databases were searched from inception until February 03, 2023. The main outcome after the meta-analysis was waist circumference; the others included anthropometric variables, blood pressure, lipid profile, fasting blood glucose level, and high-sensitivity C-reactive protein level. The incidence of adverse events and the follow-up courses were also evaluated. Risk of bias (ROB) was evaluated using ROB 2.0 from the Cochrane Handbook. Results: This systematic review included five studies involving 489 patients. Some risks of bias were also identified. The meta-analysis revealed a statistically significance in waist circumference (MD = −6.07, 95% CI: −8.44 to −3.71, P < .001, I2 = 61%, τ2 = 3.4), body weight (MD = −2.46, 95% CI: −4.25 to −0.68, P = .007, I2 = 0%, τ2 = 0) and body mass index (MD = −1.26, 95% CI: −2.11 to −0.40, P = .004, I2 = 0%, τ2 = 0) between the cupping therapy and control groups. However, there were no significant results in total fat percentage and blood pressure values. Regarding biochemical markers, cupping significantly lowered the concentration of low-density lipoprotein cholesterol (MD = −3.98, 95% CI: −6.99 to −0.96, P = .010, I2 = 0%, τ2 = 0) but had no significant effect on total cholesterol, triglyceride, high-density lipoprotein cholesterol, fasting blood glucose, and high-sensitivity C-reactive protein. 3 RCTs reported no adverse events. Conclusions: Despite some ROB and low to substantial heterogeneity of the included studies, cupping therapy can be considered a safe and effective complementary intervention for reducing waist circumference, body weight, body mass index, and low-density lipoprotein cholesterol in patients with MetS. In the future, well-designed, high-quality, rigorous methodology, and long-term RCTs in this population are required to assess the efficacy and safety of cupping therapy.
Incidence and characteristics of early elevation of cardiac troponin I after intrathoracic surgery: A single-center retrospective observational study

The early elevation of cardiac troponins within 24 hours after noncardiac surgery is reportedly associated with increased postoperative morbidities. Several predisposing factors, including the frequent occurrence of hypoxia and increased pulmonary arterial pressure, may likely contribute to this elevation, especially after intrathoracic surgery. Therefore, this retrospective study aimed to elucidate the incidence and characteristics of the early elevation of cardiac troponin I after intrathoracic surgery. This study included 320 patients who underwent intrathoracic surgery between January 1, 2018, and June 30, 2021. Specific perioperative variables were retrospectively collected from their electrical clinical records. The serum concentration of high-sensitivity cardiac troponin I (hs cTnI) was measured twice immediately after the intensive care unit arrival and on the following day. We grouped these patients into two: the early elevation of hs cTnI (EECT) group (hs cTnI value > 26.2 ng/L by at least 1 measurement) and the non-early elevation (non-EECT) group. Patient characteristics were then compared between these groups. The hs cTnI level elevated within 24 hours postoperatively in 103 patients (32.2%). In univariate analysis, intraoperative variables, including the duration of unilateral ventilation (199.2 minutes, P = .0025) and surgery (210.6 minutes, P = .0012), estimated blood loss volume (406.7 mL, P = .0022), percentage of stored red blood cell (RBC) transfusion (10.7%, P = .0059), and percentage of lobectomy or combination of other lung resection types (88.3%, P = .00188), were significantly higher in the EECT group than in the non-EECT group. In the log-rank test, prolonged hospitalization was more prevalent in the EECT group (P = .0485). Furthermore, multivariate analysis revealed 3 independent risk factors for the early elevation of hs cTnI: coexisting chronic renal failure (odds ratio [OR], 3.25), lobectomy or combined resections (OR, 2.65), and stored RBC transfusion (OR, 3.41). The early elevation of hs cTnI commonly occurs after intrathoracic surgery, with an incidence of 32.2%. Its 3 independent risk factors are coexisting chronic renal failure, lung resection type, and stored RBC transfusion.
Auricular therapy for primary dysmenorrhea: A protocol for systematic review and meta-analysis of randomized controlled trials

Background: Primary dysmenorrhea (PD) is a common problem among women. It is defined as any degree of perceived cramping pain during menstruation without any evident pathology. Auricular therapy (AT), a widely used alternative medical treatment method as part of traditional Chinese acupuncture, lacks reliable evidence to support its safety and effectiveness for PD. We aimed to conduct a meta-analysis to investigate the efficacy and safety of AT in PD and to investigate possible factors impacting the particular efficacy of AT in PD by meta-regression. Methods: This protocol followed the PRISMA guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. The following 9 sources will be searched for randomized control trials of AT for PD: the Cochrane Central Register of Controlled Trials, PubMed, Medline, Embase, Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure, Chinese Science and Technology Periodicals (VIP) database and WanFang Database from inception to January 1, 2023. Primary outcomes include visual rating scales and clinical efficacy rates, while secondary outcomes include endocrine hormone indicators related to PD and adverse events. Two reviewers will work independently on study selection, data extraction, and coding, including the risk of bias assessment in the included studies. While conducting a meta-analysis, Review Manager version 5.3 will be employed. Otherwise, a descriptive analysis will be performed. The results will be displayed as a risk ratio with 95% confidence intervals for dichotomous data as well as weight mean difference or standardized mean difference with 95% confidence intervals for continuous data. Results: This study’s protocol will investigate the efficacy and safety of AT in the treatment of PD in a systematic way. Conclusion: This systematic evaluation will objectively and systematically assess the efficacy and safety of AT in PD based on the available evidence, as well as provides clinicians with evidence to support the treatment of the disease.
Successful treatment of a gravida with acute type A aortic dissection in the third trimester: A case report

Rationale: Acute type A aortic dissection is a rare and catastrophic complication of pregnancy with a very high mortality rate for both the mother and the fetus. Patient concerns: A 40-year-old female who was 31 weeks pregnant was transferred to our hospital due to “chest and back pain for 7 hours. ” Enhanced computed tomography (CT) of the aorta revealed a Standford A dissection, involving 3 branches of the aortic arch and the opening of the right coronary artery. The aortic root and ascending aorta were significantly widened. Diagnoses: Acute type A aortic dissection. Interventions: After multidisciplinary discussions, we decided to perform cesarean section first and then cardiac surgery. A live male infant was delivered successfully by Obstetrician and Gynecologist. And then, we performed the Betalls procedure with the use of a mechanical 23# aortic-valve vessel for the patient. The innominate artery openings were reinforced with felt pads. Outcomes: The procedure was successful. CT examination at 2 months after operation showed that the true lumen of the aorta was enlarged, and no dissection was found in the 3 branches of the aortic arch. Lessons: Type A aortic dissection during pregnancy is a rare event that carries a high risk of death for both mother and fetus. An optimal outcome can be achieved through early and accurate diagnosis, safe imaging techniques, timely and effective multidisciplinary discussion, and precise and individualized treatment.
The RoboCOS Study: Development of an international core outcome set for the comprehensive evaluation of patient, surgeon, organisational and population level impacts of robotic assisted surgery

Background The introduction of robot-assisted surgery is costly and requires whole system transformation, which makes the assessment of benefits (or drawbacks) complex. To date, there has been little agreement on which outcomes should be used in this regard. The aim of the RoboCOS study was to develop a core outcome set for the evaluation of robot-assisted surgery that would account for its impact on the whole system. Methods Identification of a long-list of potentially relevant outcomes through systematic review of trials and health technology assessments; interviews with individuals from a range of stakeholder groups (surgeons, service managers, policy makers and evaluators) and a focus group with patients and public; prioritisation of outcomes via a 2-round online international Delphi survey; consensus meeting. Results 721 outcomes were extracted from the systematic reviews, interviews and focus group which were conceptualised into 83 different outcome domains across four distinct levels (patient, surgeon, organisation and population) for inclusion in the international Delphi prioritisation survey (128 completed both rounds). The consensus meeting led to the agreement of a 10-item core outcome set including outcomes at: patient level (treatment effectiveness; overall quality of life; disease-specific quality of life; complications (including mortality); surgeon level (precision/accuracy; visualisation); organisation (equipment failure; standardisation of operative quality; cost-effectiveness); and population (equity of access). Conclusion The RoboCOS core outcome set, which includes the outcomes of importance to all stakeholders, is recommended for use in all future evaluations of robot-assisted surgery to ensure relevant and comparable reporting of outcomes.
Linearly implicit time discretization of non-linear parabolic equations

We give a stability and error analysis of linearly implicit one-step methods for time discretization of non-linear parabolic equations. We derive precise error bounds for Rosenbrock and W-methods, and we explain the error reduction by Richardson extrapolation of the linearly implicit Euler method which occurs in spite of the breakdown of asymptotic expansions. The parabolic equations are studied in a Hilbert space framework that includes semilinear and quasilinear parabolic equations, and also stiff reaction-diffusion equations with reactions at different time scales.
Analysis of KROTOS Steam Explosion Experiments Using the Improved Fuel-Coolant–Interaction Code TEXAS-VI

Abstract In the present study, we propose a new fragmentation criterion for the explosion phase to take account of the effect of partial fuel melt solidification on the rapid fragmentation process. This new criterion judges whether or not the explosive fragmentation can occur by comparing the impact stress induced by vapor film collapse and water jet impingement with the fracture toughness of the corium crust layer. The fragmentation criterion was incorporated into the revised Thermal EXplosion Analysis Simulation (TEXAS) fuel-coolant-interaction (FCI) model TEXAS-VI and combined with the previously proposed fuel particle solidification model and the fragmentation criterion for the mixing phase. TEXAS-VI was compared to KROTOS alumina test K-44 and corium tests K-52 and K-53, and good agreement was obtained. The simulation results indicate that TEXAS-VI has the capability to consider the effect of partial solidification for both the mixing and the explosion phases of the FCI process and can capture the effect of fuel solidification, which reduces corium-water explosion energetics. Experiments K-52 and K-53 also demonstrate the ability of TEXAS-VI to model the effects of ambient pressure on energetics.
Prediction of conditional survival in esophageal cancer in a population-based cohort study

Background: The authors aimed to produce a prediction model for survival at any given date after surgery for esophageal cancer (conditional survival), which has not been done previously. Materials and Methods: Using joint density functions, the authors developed and validated a prediction model for all-cause and disease-specific mortality after surgery with esophagectomy, for esophageal cancer, conditional on postsurgery survival time. The model performance was assessed by the area under the receiver operating characteristic curve (AUC) and risk calibration, with internal cross-validation. The derivation cohort was a nationwide Swedish population-based cohort of 1027 patients treated in 1987–2010, with follow-up throughout 2016. This validation cohort was another Swedish population-based cohort of 558 patients treated in 2011–2013, with follow-up throughout 2018. Results: The model predictors were age, sex, education, tumor histology, chemo(radio)therapy, tumor stage, resection margin status, and reoperation. The medians of AUC after internal cross-validation in the derivation cohort were 0.74 (95% CI: 0.69–0.78) for 3-year all-cause mortality, 0.76 (95% CI: 0.72–0.79) for 5-year all-cause mortality, 0.74 (95% CI: 0.70–0.78) for 3-year disease-specific mortality, and 0.75 (95% CI: 0.72–0.79) for 5-year disease-specific mortality. The corresponding AUC values in the validation cohort ranged from 0.71 to 0.73. The model showed good agreement between observed and predicted risks. Complete results for conditional survival any given date between 1 and 5 years of surgery are available from an interactive web-tool: https://sites.google. com/view/pcsec/home. Conclusion: This novel prediction model provided accurate estimates of conditional survival any time after esophageal cancer surgery. The web-tool may help guide postoperative treatment and follow-up.
Supernovae and the spectra of high-redshift galaxies

The effect of supernova remnants (SNR) on the UV continuum of galaxies is estimated. It is shown that the radiation from the remnants may lead to a very small rest frame Lyman break. The appearance of such galaxies at high redshift is calculated, and we conclude that even galaxies with negligible rest frame Lyman break will have large observed breaks because of absorption by intervening Lyα clouds.