Miracle-dz/UniFAR-FTUs huggingface dataset:
Predictability of preoperative carotid artery-corrected flow time for hypotension after spinal anaesthesia in patients undergoing caesarean section: A prospective observational study.

BACKGROUND Spinal anaesthesia-induced hypotension is frequently reported in patients undergoing caesarean section. Mechanistically, sympathetic blockade reduces the systemic vascular resistance and the left ventricular preload, causing hypotension, which is augmented by aortocaval compression. The corrected blood flow time (FTc) is affected by the preload and is inversely related to the afterload. OBJECTIVE We hypothesised that the preanaesthetic carotid artery FTc could predict hypotension after induction in patients undergoing a caesarean section with spinal anaesthesia. DESIGN A prospective observational study. SETTING A tertiary referral centre in South Korea from September 2018 to November 2019. PARTICIPANTS Thirty-eight parturients scheduled for elective caesarean section under spinal anaesthesia. INTERVENTIONS Using carotid ultrasonography, FTc was measured twice prior to inducing spinal anaesthesia. FTc was calculated using both Bazett's (B) and Wodey's (W) formulae. Hypotension was defined as an SBP decrease to less than 80 mmHg, or less than 75% of baseline, or if symptoms consistent with hypotension occurred from the time of injection of the spinal anaesthetic until delivery. MAIN OUTCOME MEASURES The primary endpoint was to determine the predictive value of preanaesthetic FTc for postspinal hypotension during caesarean delivery. RESULTS Among the 35 patients who completed this study, hypotension occurred in 21 (60%). The areas under the receiver-operating characteristic curves for FTc (B) and FTc (W) were 0.905 [95% confidence interval (CI), 0.757 to 0.978, P < 0.001] and 0.922 (95% CI, 0.779 to 0.985, P < 0.001), respectively. The optimal cut-off values for predicting hypotension were 346.4 and 326.9 ms, respectively. The grey zone for FTc (B) and FTc (W) included 40 and 14% of the patients, respectively. CONCLUSION Preanaesthetic carotid artery FTc was a reliable indicator of postspinal hypotension in parturients. Considering the grey zone, Wodey's formula is better than Bazett's formula. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03631329.
A scoping review of clinical decision support tools that generate new knowledge to support decision making in real time

OBJECTIVE A growing body of observational data enabled its secondary use to facilitate clinical care for complex cases not covered by the existing evidence. We conducted a scoping review to characterize clinical decision support systems (CDSSs) that generate new knowledge to provide guidance for such cases in real time. MATERIALS AND METHODS PubMed, Embase, ProQuest, and IEEE Xplore were searched up to May 2020. The abstracts were screened by 2 reviewers. Full texts of the relevant articles were reviewed by the first author and approved by the second reviewer, accompanied by the screening of articles' references. The details of design, implementation and evaluation of included CDSSs were extracted. RESULTS Our search returned 3427 articles, 53 of which describing 25 CDSSs were selected. We identified 8 expert-based and 17 data-driven tools. Sixteen (64%) tools were developed in the United States, with the others mostly in Europe. Most of the tools (n = 16, 64%) were implemented in 1 site, with only 5 being actively used in clinical practice. Patient or quality outcomes were assessed for 3 (18%) CDSSs, 4 (16%) underwent user acceptance or usage testing and 7 (28%) functional testing. CONCLUSIONS We found a number of CDSSs that generate new knowledge, although only 1 addressed confounding and bias. Overall, the tools lacked demonstration of their utility. Improvement in clinical and quality outcomes were shown only for a few CDSSs, while the benefits of the others remain unclear. This review suggests a need for a further testing of such CDSSs and, if appropriate, their dissemination.
Application of xylitol on nitrogen removal from saline wastewater through “Candidatus Brocadia sinica”‐dominated anammox process under low temperature

Xylitol was first applied to enhance nitrogen removal from saline wastewater through “Candidatus Brocadia sinica”‐dominated anammox process under low temperature. The reactor was maintained at 15°C, and the salinity of wastewater was 35 g/L. Ammonium removal rate (ARR) and nitrite removal rate (NRR) were stable at around 0.27 kg/(m3 d) without xylitol addition. As an osmotic pressure regulator and cryoprotective agent, optimal ARR and NRR were 0.51 kg/(m3 d) and 0.63 kg/(m3 d) at 0.3 mM xylitol. At the addition of 1 mM high‐dosage xylitol, there existed dissimilatory reduction in nitrate to ammonium nitrogen and heterotrophic denitrification in the reactor. Remodified logistic model was suitable to simulate NH4+-N removal process with xylitol addition. As a result, xylitol dose should be controlled within 0.3 mM, which greatly promoted the nitrogen removal from saline wastewater under low temperature.
Volunteering.

■ Abstract Volunteering is any activity in which time is given freely to benefit another person, group or cause. Volunteering is part of a cluster of helping behaviors, entailing more commitment than spontaneous assistance but narrower in scope than the care provided to family and friends. Although developed somewhat independently, the study of volunteerism and of social activism have much in common. Since data gathering on volunteering from national samples began about a quarter of a century ago, the rate for the United States has been stable or, according to some studies, rising slightly. Theories that explain volunteering by pointing to individual attributes can be grouped into those that emphasize motives or self-understandings on the one hand and those that emphasize rational action and cost-benefit analysis on the other. Other theories seek to complement this focus on individual level factors by pointing to the role of social resources, specifically social ties and organizational activity, as explanations for volunteering. Support is found for all theories, although many issues remained unresolved. Age, gender and race differences in volunteering can be accounted for, in large part, by pointing to differences in self-understandings, human capital, and social resources. Less attention has been paid to contextual effects on volunteering and, while evidence is mixed, the impact of organizational, community, and regional characteristics on individual decisions to volunteer remains a fruitful field for exploration. Studies of the experience of volunteering have only just begun to plot and explain spells of volunteering over the life course and to examine the causes of volunteer turnover. Examining the premise that volunteering is beneficial for the helper as well as the helped, a number of studies have looked at the impact of volunteering on subjective and objective well-being. Positive effects are found for life-satisfaction, self-esteem, self-rated health, and for educational and occupational achievement, functional ability, and mortality. Studies of youth also suggest that volunteering reduces the likelihood of engaging in problem behaviors such as school truancy and drug abuse.
Deep Learning Based Assessment of Synthetic Speech Naturalness

In this paper, we present a new objective prediction model for synthetic speech naturalness. It can be used to evaluate Text-To-Speech or Voice Conversion systems and works language independently. The model is trained end-to-end and based on a CNN-LSTM network that previously showed to give good results for speech quality estimation. We trained and tested the model on 16 different datasets, such as from the Blizzard Challenge and the Voice Conversion Challenge. Further, we show that the reliability of deep learning-based naturalness prediction can be improved by transfer learning from speech quality prediction models that are trained on objective POLQA scores. The proposed model is made publicly available and can, for example, be used to evaluate different TTS system configurations.
Universal Speech Transformer

Transformer model has made great progress in speech recognition. However, compared with models with iterative computation, transformer model has ﬁxed encoder and decoder depth, thus losing the recurrent inductive bias. Besides, ﬁnding the optimal number of layers involves trial-and-error attempts. In this paper, the universal speech transformer is proposed, which to the best of our knowledge, is the ﬁrst work to use universal transformer for speech recognition. It generalizes the speech transformer with dynamic numbers of encoder/decoder layers, which can relieve the burden of tuning depth related hyperpa-rameters. Universal transformer adds the depth and positional embeddings repeatedly for each layer, which dilutes the acoustic information carried by hidden representation, and it also performs a partial update of hidden vectors between layers, which is less efﬁcient especially on the very deep models. For better use of universal transformer, we modify its processing framework by removing the depth embedding and only adding the positional embedding once at transformer encoder frontend. Furthermore, to update the hidden vectors efﬁciently, especially on the very deep models, we adopt a full update. Experiments on LibriSpeech, Switchboard and AISHELL-1 datasets show that our model outperforms a baseline by 3.88%-13.7%, and surpasses other model with less computation cost.
How does a partner’s motor variability affect joint action?

Motor learning studies demonstrate that an individual’s natural motor variability predicts the rate at which she learns a motor task. Individuals exhibiting higher variability learn motor tasks faster, presumably because variability fosters exploration of a wider space of motor parameters. However, it is unclear how individuals regulate variability while learning a motor task together with a partner who perturbs their movements. In the current study, we investigated whether and how variability affects performance and learning in such joint actions. Participants learned to jointly perform a sequence of movements with a confederate who was either highly variable or less variable in her movements. A haptic coupling between the actors led to translation of partner’s movement variability into a force perturbation. We tested how the variability and predictability of force perturbations coming from a partner foster or hamper individual and joint performance. In experiment 1, the confederate produced more or less variable range of force perturbations that occurred in an unpredictable order. In experiment 2, the confederate produced more or less variable force perturbations in a predictable order. In experiment 3, the confederate produced more or less variable force perturbations in which the magnitude of force delivered was predictable whereas the direction of the force was unpredictable. We analysed individual performance, measured as movement accuracy and joint performance, measured as interpersonal asynchrony. Results indicated that in all three experiments, participants successfully regulated the variability of their own movements. However, individual performance was worse when partner produced highly variable force perturbations in an unpredictable order. Interestingly, predictability of force perturbations offset the detrimental effects of variability on individual performance. Furthermore, participants in the high variability condition achieved higher flexibility and resilience for a wide range of force perturbations, when the partner produced predictable movements. Participants improved their joint performance with a highly variable partner only when the partner produced partially predictable movements. Our results indicate that individuals involved in a joint action selectively rely on either their own or their partner’s variability (or both) for benefitting individual and joint action performance, depending on the predictability of the partner’ movements.
Voice Conversion Based Data Augmentation to Improve Children's Speech Recognition in Limited Data Scenario

Automatic recognition of children’s speech is a challenging research problem due to several reasons. One among those is un-availability of large amounts of speech data from child speakers to develop automatic speech recognition (ASR) systems employing deep learning architectures.Using a limited amount of training data limits the power of the learned system. To overcome this issue, we have explored means to effectively make use of adults’ speech data for training an ASR system. For that purpose, generative adversarial network (GAN) based voice conversion (VC) is exploited to modify the acoustic attributes of adults’ speech making it perceptually similar to that of children’s speech. The original and converted speech samples from adult speakers are then pooled together to learn the statistical model parameters. Signiﬁcantly improved recognition rate for children’s speech is noted due to VC-based data augmentation. To further enhance the recognition rate, a limited amount of children’s speech data is also pooled into training. Large reduction in error rate is observed in this case as well. It is worth mentioning that GAN-based VC does not change the speaking-rate. To demonstrate the need to deal with speaking-rate differences we report the results of time-scale modiﬁcation of chil-drens speech test data.
Infantile toxic epidermal necrolysis: Successful treatment of an 8‐week‐old with intravenous immunoglobulin and amniotic membrane transplant

Stevens‐Johnson syndrome and toxic epidermal necrolysis comprise a spectrum of severe mucocutaneous hypersensitivity reactions. A paucity of data limits current understanding of the etiology, treatment options, and prognosis of this entity in the infantile population compared to that in the adult and pediatric literature. We describe the case of an 8‐week‐old male with toxic epidermal necrolysis treated successfully with intravenous immunoglobulin and amniotic membrane transplant. This patient is the youngest surviving infant with toxic epidermal necrolysis to be reported.
A Simulated Graphical Interface for Integrating Patient-Generated Health Data From Smartwatches With Electronic Health Records: Usability Study

Background Wearable technology, such as smartwatches, can capture valuable patient-generated data and help inform patient care. Electronic health records provide logical and practical platforms for including such data, but it is necessary to evaluate the way the data are presented and visualized. Objective The aim of this study is to evaluate a graphical interface that displays patients’ health data from smartwatches, mimicking the integration within the environment of electronic health records. Methods A total of 12 health care professionals evaluated a simulated interface using a usability scale questionnaire, testing the clarity of the interface, colors, usefulness of information, navigation, and readability of text. Results The interface was positively received, with 14 out of the 16 questions generating a score of 5 or greater among at least 75% of participants (9/12). On an 8-point Likert scale, the highest rated features of the interface were quick turnaround times (mean score 7.1), readability of the text (mean score 6.8), and use of terminology/abbreviations (mean score 6.75). Conclusions Collaborating with health care professionals to develop and refine a graphical interface for visualizing patients’ health data from smartwatches revealed that the key elements of the interface were acceptable. The implementation of such data from smartwatches and other mobile devices within electronic health records should consider the opinions of key stakeholders as the development of this platform progresses.
Extensive trimming of short single-stranded DNA oligonucleotides during replication-coupled gene editing in mammalian cells

Through transfection of short single-stranded oligodeoxyribonucleotides (ssODNs) small genomic alterations can be introduced into mammalian cells with high precision. ssODNs integrate into the genome during DNA replication, but the resulting heteroduplex is prone to detection by DNA mismatch repair (MMR), which prevents effective gene modification. We have previously demonstrated that the suppressive action of MMR can be avoided when the mismatching nucleotide in the ssODN is a locked nucleic acid (LNA). Here, we reveal that LNA-modified ssODNs (LMOs) are not integrated as intact entities in mammalian cells, but are severely truncated before and after target hybridization. We found that single additional (non-LNA-modified) mutations in the 5’-arm of LMOs influenced targeting efficiencies negatively and activated the MMR pathway. In contrast, additional mutations in the 3’-arm did not affect targeting efficiencies and were not subject to MMR. Even more strikingly, homology in the 3’-arm was largely dispensable for effective targeting, suggestive for extensive 3’-end trimming. We propose a refined model for LMO-directed gene modification in mammalian cells that includes LMO degradation.
A Review of Key Features and Their Implementation in Unstructured, Structured, and Agent‐Based Population Models for Ecological Risk Assessment

Population models can provide valuable tools for ecological risk assessment (ERA). A growing amount of work on model development and documentation is now available to guide modelers and risk assessors to address different ERA questions. However, there remain misconceptions about population models for ERA, and communication between regulators and modelers can still be hindered by a lack of clarity in the underlying formalism, implementation, and complexity of different model types. In particular, there is confusion about differences among types of models and the implications of including or ignoring interactions of organisms with each other and their environment. In this review, we provide an overview of the key features represented in population models of relevance for ERA, which include density dependence, spatial heterogeneity, external drivers, stochasticity, life‐history traits, behavior, energetics, and how exposure and effects are integrated in the models. We differentiate 3 broadly defined population model types (unstructured, structured, and agent‐based) and explain how they can represent these key features. Depending on the ERA context, some model features will be more important than others, and this can inform model type choice, how features are implemented, and possibly the collection of additional data. We show that nearly all features can be included irrespective of formalization, but some features are more or less easily incorporated in certain model types. We also analyze how the key features have been used in published population models implemented as unstructured, structured, and agent‐based models. The overall aim of this review is to increase confidence and understanding by model users and evaluators when considering the potential and adequacy of population models for use in ERA. Integr Environ Assess Manag 2021;17:521–540. © 2020 SETAC
Effects of Fluid Resuscitation on the Occurrence of Organ Failure and Mortality in Patients With Acute Pancreatitis.

OBJECTIVES Acute pancreatitis (AP) is a serious gastroenterological condition requiring urgent fluid resuscitation and emergent intensive care. However, the benefit of fluid resuscitation is inconsistent. Therefore, this study aimed to examine the effects of fluid resuscitation on the occurrence of organ failure and mortality in patients with AP. METHODS The data were retrospectively extracted from the Medical Information Mart for Intensive Care III 2002-2012 database. The fluid resuscitation and fluid balance were calculated at 12, 24, 36, and 48 hours after intensive care unit admission. Multivariate analysis models were used. RESULTS A total of 317 patients with AP were included. Odds of organ failure increased significantly with increased fluid input at 0 to 12 hours [adjusted odds ratio (aOR), 1.124; 95% confidence interval (CI), 1.015-1.244] and with increased fluid balance at 36 to 48 hours (aOR, 1.184; 95% CI, 1.009-1.389). Odds of in-hospital mortality increased significantly with increased fluid balance at 24 to 36 hours (aOR, 1.201; 95% CI, 1.052-1.371). Odds of 30-day mortality increased significantly with increased fluid balance at 24 to 36 hours (aOR, 1.189; 95% CI, 1.039-1.361). CONCLUSIONS Increased fluid balance was associated with increased risk of organ failure and mortality. Increased fluid output may decrease mortality.
Regulation of plasma volume in male lowlanders during 4 days of exposure to hypobaric hypoxia equivalent to 3500 m altitude

Acclimatization to hypoxia leads to a reduction in plasma volume (PV) that restores arterial O2 content. Findings from studies investigating the mechanisms underlying this PV contraction have been controversial, possibly as experimental conditions were inadequately controlled. We examined the mechanisms underlying the PV contraction evoked by 4 days of exposure to hypobaric hypoxia (HH) in 11 healthy lowlanders, while strictly controlling water intake, diet, temperature and physical activity. Exposure to HH‐induced an ∼10% PV contraction that was accompanied by a reduction in total circulating protein mass, whereas diuretic fluid loss and total body water remained unchanged. Our data support an oncotically driven fluid redistribution from the intra‐ to the extravascular space, rather than fluid loss, as the mechanism underlying HH‐induced PV contraction.
Ecology and breeding biology of a tropical bird, the Lovely Fairy-Wren (Malurus amabilis)

ABSTRACT The Lovely Fairy-Wren (Malurus amabilis) is endemic to the wet tropics of Australia and is one of 11 species in the genus Malurus. Despite the large number of studies on fairy-wrens, little is known about the Lovely Fairy-Wren. This study provides the first detailed description of its ecology, behaviour, and breeding biology. Lovely Fairy-Wrens displayed breeding behaviour characteristic of tropical birds, with groups maintaining territories and breeding year-round, small clutch size (two to three eggs), long juvenile dependence (2 months) and high adult breeder survival (86%). They breed cooperatively, and groups formed when male (but not female) offspring delayed dispersal and remained in their natal group as subordinates. Groups were typically small (2.5 ± 0.8 individuals), possibly because productivity was low: 29% of the monitored groups produced at least one fledgling per year. Males provided high levels of parental care and this, together with low extra-pair courtship and petal displays, suggests that this species may not be as promiscuous as other fairy-wrens. Unlike other Australian fairy-wrens, males maintained their brightly coloured adult plumage year-round after initial acquisition. This lack of seasonal moult into dull plumage, coupled with the unusually colourful plumage of females in this species, suggests that the impact of natural selection on the plumage colour of both sexes may be lower in this species than in their congeners. We discuss similarities and differences in life-history and morphological traits between the Lovely Fairy-Wren and other Malurus species.