Miracle-dz/UniFAR-FTUs huggingface dataset:
Cognitive error in an academic emergency department

Abstract Background Medical error is a leading cause of death nationwide. While systems issues have been closely investigated as a contributor to error, little is known about the cognitive factors that contribute to diagnostic error in an emergency department (ED) environment. Methods Eight months of patient revisits within 72 h where patients were admitted on their second visit were examined. Fifty-two cases of confirmed error were identified and classified using a modified version of the Australian Patient Safety Foundation classification system for medical errors by a group of trained physicians. Results Faulty information processing was the most frequently identified category of error (45% of cases), followed by faulty verification (31%). Faulty knowledge (6%) and faulty information gathering (18%) occurred relatively infrequently. “Misjudging the salience of a finding” and “premature closure” were the individual errors that occurred most frequently (13%). Conclusions Despite the complex nature of diagnostic reasoning, cognitive errors of information processing appear to occur at higher rates than other errors, and in a similar pattern to an internal medicine service despite a different clinical environment. Further research is needed to elucidate why these errors occur and how to mitigate them.
Translational regulation in response to stress in Saccharomyces cerevisiae

The budding yeast Saccharomyces cerevisiae must dynamically alter the composition of its proteome in order to respond to diverse stresses. The reprogramming of gene expression during stress typically involves initial global repression of protein synthesis, accompanied by the activation of stress‐responsive mRNAs through both translational and transcriptional responses. The ability of specific mRNAs to counter the global translational repression is therefore crucial to the overall response to stress. Here we summarize the major repressive mechanisms and discuss mechanisms of translational activation in response to different stresses in S. cerevisiae. Taken together, a wide range of studies indicate that multiple elements act in concert to bring about appropriate translational responses. These include regulatory elements within mRNAs, altered mRNA interactions with RNA‐binding proteins and the specialization of ribosomes that each contribute towards regulating protein expression to suit the changing environmental conditions.
Primary and metastatic brain tumours in adults: summary of NICE guidance

### What you need to know Although primary malignant brain tumours represent only 3% of all cancers, they result in the most life-years lost of any cancer.1 Survival with malignant brain tumours has remained poor despite improvements in diagnosis and management (table 1), and it was believed that survival and quality of life could be improved by standardising care across the country with a guideline. Over 60% of people with primary brain tumours present at and are diagnosed by accident and emergency services rather than by general practitioners or in specialist settings.2 Brain metastases are the most common brain tumour to present in primary care, but other forms of brain cancer are seen. View this table: Table 1 Care requirements for brain tumours by approximate median survival Although brain tumours are usually managed by specialist teams, primary care and non-specialist teams have an important role in patients’ long term care, particularly when it comes to considering the longer term cognitive, physical, and mental health effects of the tumour and its treatment (table 1). This article summarises the most recent …
Comparison of Pediatric Intercalary Allograft Reconstructions with and without a Free Vascularized Fibula

Background: Lower extremity intercalary allograft reconstruction has traditionally been used to facilitate limb salvage. Combining the allograft with a free vascularized fibula graft has been described; however, there is a paucity of data comparing the outcome of these reconstructions. Methods: Twenty-nine pediatric patients (15 boys and 14 girls) underwent lower extremity limb salvage with the use of intercalary cadaveric allograft at a mean age of 12 years. The most common diagnosis was osteosarcoma (n = 18). Patients underwent reconstruction with an allograft alone (n = 11) or supplemented with a free vascularized fibula graft (n = 18). Results: The mean time to union of the allograft was 11 months, with 10 patients requiring additional bone grafting. There was no difference in the need for an additional bone graft (OR, 0.87; p = 1.0) between patients with a free vascularized fibula graft and those without. The allograft was revised in three patients because of fracture (n = 2) and fracture and infection (n = 1). In all of these patients, the allograft was not supplemented with a free vascularized fibula graft (p < 0.001). Five patients underwent an amputation, most commonly for disease recurrence. At last follow-up, the mean Mankin and Musculoskeletal Tumor Society rating was 90 percent, with 19 patients (66 percent) who achieved a “good” or “excellent” outcome according to the Mankin score. Conclusion: Use of an intercalary allograft to reconstruct a lower extremity provides a durable means of reconstruction; however, supplementation with a free vascularized fibula graft reduces the risk of allograft revision. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
Ultrastructure of the colon of Locusta migratoria

The ultrastructure of the colon of Locusta migratoria is described. The colon is lined by a thick cuticle that, for the most part, adheres to the underlying epithelium. The cuboid epithelial cells are characterized by moderate invaginations of the apical and, to a lesser extent, basal plasma membranes; the lateral plasma membranes are relatively flat. The bulk of the mitochondria are located in the apical region of the cell and are not particularly associated with any of the plasma membranes. The basal region of the cells contains much rough endoplasmic reticulum, glycogenlike granules, and a predominance of spherical, electron‐dense bodies of various sizes. Where muscle fibers make contact with the epithelium, the cells are much reduced; the cytoplasm is usually less electron‐dense, and, typically, the nucleus has a thick layer of granular material associated with the inner nuclear membrane. The apical and basal plasma membranes of the reduced epithelial cells contain numerous hemidesmosomes. The apical hemidesmosomes occur in pairs around an extracellular space that contains electron‐opaque material. The latter forms tonofibrillae that extend into the endocuticle. Bundles of microtubules are associated with the hemidesmosomes. The tubules traverse the cell from the apical to the basal region. The possible significance of these findings is discussed.
Smoking attitudes of the patients with allergic rhinitis: a comparison with asthma and chronic obstructive pulmonary disease. Are there differences when only upper airways are involved?

Introduction Despite the well documented relationship between lower airway diseases and smoking, there are limited data about smoking and allergic rhinitis (AR). In this study, we aimed to document the smoking behaviour and environmental tobacco smoke (ETS) exposure of the patients with AR in comparison with patients with asthma, chronic obstructive pulmonary diseases (COPD) and healthy controls (HC). Materials and Methods Demographics and disease characteristics were recorded from case files whereas smoking history, childhood and current exposures to ETS, as well as the smoking behaviors were investigated by a self reported questionnaire. Result A total of 937 subjects comprising patients with AR (n= 252), asthma (n= 249), COPD (n= 188) and HCs (n= 248) were enrolled in the study. The rates of active smokers were 35% (HCs), 26% (COPD), 21% (AR), and 11% (asthma). Exposure to ETS while with friends was significantly higher among HCs and AR groups (p< 0.0001). The rate of willingness to quit smoking is high in AR patients (73%) but they did not determined about date of quiting. Conclusions Our results showed that a significant number of patients with AR actively smoke and neither the patients with AR nor the people in their surroundings were sufficiently aware of the health hazards of smoking with AR. It seems necessary to inform patients with about the health effects of smoking on all respiratory tract diseases.
Atherosclerosis on CT Angiogram Predicts Acute Kidney Injury After Transcatheter Aortic Valve Replacement.

OBJECTIVE The purpose of this study is to determine the association of vascular calcification and renal artery stenosis on CT angiogram (CTA) obtained before transcatheter aortic valve replacement (TAVR) with postprocedure acute kidney injury (AKI). MATERIALS AND METHODS In this single-center retrospective cohort study, 106 pre-TAVR CTAs were evaluated by two independent blinded readers. Renal artery stenosis was visually graded as less than 50% or greater than or equal to 50% luminal narrowing. Calcification of the aorta and iliac arteries was scored from 0 (no calcification) to 3 (severe calcification) and was summed to develop a calcification score. Univariate comparisons between patients who did and did not develop AKI were made for radiologic measurements. Multivariable logistic regression was used to assess association of renal artery stenosis and atherosclerotic calcification with post-TAVR AKI. RESULTS Post-TAVR AKI occurred in 20 of 106 patients. Subjects with bilateral main renal artery stenosis greater than or equal to 50% had significantly greater odds (odds ratio, 4.84; 95% CI, 1.41-16.54; p = 0.01) of developing post-TAVR AKI than did subjects with unilateral or no stenosis greater than or equal to 50% in the main renal arteries. Subjects who developed post-TAVR AKI had significantly higher aortic and iliac arterial calcification scores compared with subjects who did not develop post-TAVR AKI (mean ± SD, 21.4 ± 5.6 vs 17.9 ± 6.7; p = 0.04). CONCLUSION AKI as a complication of TAVR is more likely to develop in patients with bilateral renal artery stenosis greater than or equal to 50% or severe atherosclerotic calcification of the aorta and iliac arteries.
Mitigation of soil loss from turfgrass cultivation by utilizing poultry abattoir sludge compost and biochar on low-organic matter soil

ABSTRACT Commercial turfgrass cultivation is one of the main ornamental industries world-wide; however, successive turfgrass sod cutting from the same site removes surface soil, leading to a decline in soil organic matter, impairment of soil fertility and degradation of environment. The present study was aimed to investigate the applicability of poultry abattoir sludge compost (PASC) and biochar (BC) on the establishment of turfgrass by evaluating plant growth performance and mitigation of soil loss by organic waste amendments. The experimental study was designed on the soil which had originally low-organic matter content and previously used as a turfgrass sod harvested site in a sandy loam soil. Incorporation of PASC to soil improved the physicochemical properties in terms of bulk density (BD), water holding capacity (WHC), cation exchange capacity (CEC), pH, total nitrogen, total organic carbon (TOC), and organic matter (OM) by 37 (±2)%, 45 (±3)%, 55 (±3)%, 21 (±2)%, 48 (±2)%, 90 (±10)%, and 96 (±4)%, respectively. PASC-amended treatments enhanced the turfgrass growth rate more than the BC due to its increased nutrient availability. Incorporation of 100 Mg ha–1 (mega gram per hectare) PASC in surface soil with or without BC decreased the mineral soil removal rate by half of the respective soil (control) treatments. The results of the present study confirmed the utilization of PASC and BC as promising agro-industrial-based fertilizers in turfgrass sod production for sustainable soil and nutrient management. GRAPHICAL ABSTRACT
Hallux Interphalangeal Arthrodesis Following First Metatarsophalangeal Arthrodesis

Background: Hallux interphalangeal (IP) arthritis can occur after first metatarsophalangeal (MTP) arthrodesis. IP arthrodesis is a standard treatment, but in the setting of prior MTP surgery there will be increased stress on the IP joint. This may result in diminished potential for bone healing. This investigation assessed the outcomes of hallux IP arthrodesis after first MTP arthrodesis. Methods: Charts were retrospectively reviewed for patients who underwent interphalangeal arthrodesis between January 1, 2007, and April 3, 2017, and who had a minimum of 12 weeks of follow-up. We compared patients with and without prior ipsilateral first MTP arthrodesis. There were 42 patients whose median follow-up was 9 (range, 3-135) months. Results: Median time from previous first MTP arthrodesis until IP arthrodesis was 54 months. Six nonunions (35.3%) occurred in 17 patients with prior first MTP arthrodesis. Only 2 nonunions (8.0%) occurred in 25 patients with isolated IP arthrodesis. The multivariable risk difference of nonunion was 53.3% (P = .001). Prior first MTP arthrodesis also was more likely to have complications (52.9% vs 24.0%, respectively). The multivariable risk difference of complications was 35.7% (P = .082). The speed of bone healing was significantly different, with a multivariable rate ratio of 0.21 (P = .012). Conclusion Prior first MTP arthrodesis resulted in 4.8 times slower bone healing for IP arthrodesis. It increased the risks of nonunion and any other complications. Level of Evidence: Level III, retrospective comparative study.
Invasive rat eradication strongly impacts plant recruitment on a tropical atoll

Rat eradication has become a common conservation intervention in island ecosystems and its effectiveness in protecting native vertebrates is increasingly well documented. Yet, the impacts of rat eradication on plant communities remain poorly understood. Here we compare native and non-native tree and palm seedling abundance before and after eradication of invasive rats (Rattus rattus) from Palmyra Atoll, Line Islands, Central Pacific Ocean. Overall, seedling recruitment increased for five of the six native trees species examined. While pre-eradication monitoring found no seedlings of Pisonia grandis, a dominant tree species that is important throughout the Pacific region, post-eradication monitoring documented a notable recruitment event immediately following eradication, with up to 688 individual P. grandis seedlings per 100m2 recorded one month post-eradication. Two other locally rare native trees with no observed recruitment in pre-eradication surveys had recruitment post-rat eradication. However, we also found, by five years post-eradication, a 13-fold increase in recruitment of the naturalized and range-expanding coconut palm Cocos nucifera. Our results emphasize the strong effects that a rat eradication can have on tree recruitment with expected long-term effects on canopy composition. Rat eradication released non-native C. nucifera, likely with long-term implications for community composition, potentially necessitating future management interventions. Eradication, nevertheless, greatly benefitted recruitment of native tree species. If this pattern persists over time, we expect long-term benefits for flora and fauna dependent on these native species.
Development of Wheel Pressure Control Algorithm for Electronic Stability Control (ESC) System of Commercial Trucks

This paper presents a wheel cylinder pressure control algorithm for application to the vehicle electronic stability control (ESC) systems for commercial trucks. An ESC system is an active system that improves the driving stability by distributing the appropriate braking pressure to each wheel, which is an essential system for safe driving. It is important that the ESC system, through proper braking pressure supply, delivers the correct pressure under control. However, to reduce the cost involved, commercial trucks use a solenoid valve of the on/off-type, rather than a proportional valve that has good pressure control capability. The performance of a proposed wheel pressure control system based on an on/off solenoid valve control was verified by means of experiments conducted using the wheel pressure control algorithm presented in this paper.
The effect of alkali-soluble lignin on purified core cellulase and hemicellulase activities during hydrolysis of extractive ammonia-pretreated lignocellulosic biomass

Removing alkali-soluble lignin using extractive ammonia (EA) pretreatment of corn stover (CS) is known to improve biomass conversion efficiency during enzymatic hydrolysis. In this study, we investigated the effect of alkali-soluble lignin on six purified core glycosyl hydrolases and their enzyme synergies, adopting 31 enzyme combinations derived by a five-component simplex centroid model, during EA-CS hydrolysis. Hydrolysis experiment was carried out using EA-CS(−) (approx. 40% lignin removed during EA pretreatment) and EA-CS(+) (where no lignin was extracted). Enzymatic hydrolysis experiments were done at three different enzyme mass loadings (7.5, 15 and 30 mg protein g−1 glucan), using a previously developed high-throughput microplate-based protocol, and the sugar yields of glucose and xylose were detected. The optimal enzyme combinations (based on % protein mass loading) of six core glycosyl hydrolases for EA-CS(−) and EA-CS(+) were determined that gave high sugar conversion. The inhibition of lignin on optimal enzyme ratios was studied, by adding fixed amount of alkali-soluble lignin fractions to EA-CS(−), and pure Avicel, beechwood xylan and evaluating their sugar conversion. The optimal enzyme ratios that gave higher sugar conversion for EA-CS(−) were CBH I: 27.2–28.2%, CBH II: 18.2–22.2%, EG I: 29.2–34.3%, EX: 9.0–14.1%, βX: 7.2–10.2%, βG: 1.0–5.0% (at 7.5–30 mg g−1 protein mass loading). Endoglucanase was inhibited to a greater extent than other core cellulases and xylanases by lignin during enzyme hydrolysis. We also found that alkali-soluble lignin inhibits cellulase more strongly than hemicellulase during the course of enzyme hydrolysis.
Kinds of individuals defined by patterns of variables

Abstract This paper argues that investigators should consider replacing the popular practice of comparing individuals varying in gender, social class, and/or ethnicity on one or more continuous measures with a search for kinds of individuals defined by patterns of properties that include not only their values on outcome measures but also their gender, social class, and ethnicity. Investigators who believe that a particular predictor contributes to an outcome independent of the gender, class, or ethnicity of the participants often implement statistical procedures that promise to remove the contributions of the above categories. These analyses lead to misleading conclusions when the controlled category is correlated with the dependent measures. The final sections summarize the properties of genders, classes, and ethnic groups that make distinctive contributions to many psychological outcomes. The paper ends by noting that a society's ethical beliefs constitute a defensible basis for ignoring the biological properties associated with these categories in order to allow members of these groups access to whatever educational or occupational goals they desire.
Clinical and Pathological Aspects of Silent Pituitary Adenomas

Abstract Context Silent pituitary adenomas are anterior pituitary tumors with hormone synthesis but without signs or symptoms of hormone hypersecretion. They have been increasingly recognized and represent challenging diagnostic issues. Evidence Acquisition A comprehensive literature search was performed using MEDLINE and EMBASE databases from January 2000 to March 2018 with the following key words: (i) pituitary adenoma/tumor and nonfunctioning; or (ii) pituitary adenoma/tumor and silent. All titles and abstracts of the retrieved articles were reviewed, and recent advances in the field of silent pituitary adenomas were summarized. Evidence Synthesis The clinical and biochemical picture of pituitary adenomas reflects a continuum between functional and silent adenomas. Although some adenomas are truly silent, others will show some evidence of biochemical hypersecretion or could have subtle clinical signs and, therefore, can be referred to as clinically silent or “whispering” adenomas. Silent tumors seem to be more aggressive than their secreting counterparts, with a greater recurrence rate. Transcription factors for pituitary cell lineages have been introduced into the 2017 World Health Organization guidelines: steroidogenic factor 1 staining for gonadotroph lineage; PIT1 (pituitary-specific positive transcription factor 1) for growth hormone, prolactin, and TSH lineage, and TPIT for the corticotroph lineage. Prospective studies applying these criteria will establish the value of the new classification. Conclusions A concise review of the clinical and pathological aspects of silent pituitary adenomas was conducted in view of the new World Health Organization classification of pituitary adenomas. New classifications, novel prognostics markers, and emerging imaging and therapeutic approaches need to be evaluated to better serve this unique group of patients.
Multi-Scale Stress Wave Simulation for Aggregates Segregation Detection of Concrete Core in Circular CFST Coupled with PZT Patches

In this study, the numerical investigation of the detectability of concrete aggregate segregation in circular concrete-filled steel tubulars (CCFST) based on piezoelectric lead zirconate titanate (PZT) measurement is performed. The stress wave propagation in the concrete core of circular CCFST excited with a surface-mounted PZT actuator is studied with multi-scale and multi-physical field coupling analysis. The piezoelectric effect of PZT patches and its coupling effect with CFSTs are considered. Numerical concrete modeling technology is employed to construct the concrete core composed of randomly distributed aggregates with and without aggregate segregation at different levels, mortar, and an interfacial transition zone (ITZ). The effects of the random distribution of elliptical aggregates, aggregate segregation, and the existence of ITZ in the concrete core on the wave fields in the cross-section and the corresponding voltage response of the embedded PZT sensor are discussed. An evaluation index based on wavelet packet analysis on the output voltage response is defined, and its sensitivity to concrete aggregate segregation is systematically investigated. The multi-scale and multi-physics coupling simulation results indicate that concrete aggregate segregation in the concrete core of CFST members can be efficiently detected based on the stress wave measurement with a PZT sensor.