Miracle-dz/UniFAR-FTUs huggingface dataset:
A Novel Hybrid Autoregressive Integrated Moving Average and Artificial Neural Network Model for Cassava Export Forecasting

This paper proposes a novel hybrid forecasting model combining autoregressive integrated moving average (ARIMA) and artificial neural network (ANN) with incorporating moving average and the annual seasonal index for Thailand’s cassava export (i.e., native starch, modified starch, and sago). The comprehensive experiments are conducted to investigate the appropriate parameters of the proposed model as well as other forecasting models compared. In particular, the proposed model is experimentally compared to the ARIMA, the ANN and the other hybrid models according to three popular prediction accuracy measures, namely mean square error (MSE), mean absolute error (MAE) and mean absolute percentage error (MAPE). The empirical results show that the proposed model gives the lowest error in all three measures for the native starch and the modified starch which are major cassava exported products (98% of the total export volume). However, the Khashei and Bijari’s model is the best model for the sago (2% of the total export volume). Therefore, the proposed model can be used as an alternative forecasting method for stakeholders making a decision in cassava international trading to obtain better accuracy in predicting future export of native starch and modified starch which are the majority of the total export.
Automated productivity assessment of earthmoving operations

This paper presents an automated system for actual productivity assessment of earthmoving operations in near real-time. Several research attempts had been made to calculate productivity, but a number limitations had been found in literature such as, assuming the hauling unit is loaded to its full capacity and the need for manual user entry of efficiency factors (For example: bucket fill factor). The proposed system addresses some of the limitations found in previous research. The system consists of hardware and software developments. The hardware consists of three main units: (1) Truck mounted unit, (2) Loader mounted unit and (3) Fixed unit at the construction site. The software development consists of three main algorithms: (1) Data processing algorithm, (2) Productivity calculation algorithm and (3) Operating conditions analysis. Using sensor-aided GPS, site data is collected, organized and saved in the system’s database, which is housed on a central server. Equipment location is tracked using the GPS, while the hauling unit load weight is measured using strain gauges mounted on its suspension and wired to a micro-controller. The loading and dumping activities are monitored by a number of sensors mounted on both the loader and trucks. The site weather condition is recorded and correlated with measured productivity in each recorded interval for later use in future estimates. A simulated case study is presented to demonstrate the usage and capabilities of the system. The case study demonstrated how the proposed system can assist project managers in measuring actual projects.
Circulating miRNA expression analysis reveals new potential biomarkers for human cutaneous melanoma staging

Malignant melanoma accounts for around 80% of all skin cancer-related deaths and its incidence continues to increase worldwide1 . Identification of patients at high risk of tumor progression is currently critical for melanoma management. Intratumoral miRNAs are involved in melanoma tumor progression and are able to predict melanoma survival2 . Recently, circulating cell-free miRNAs (cfmiRNAs) have shown to have utility as non-invasive biomarkers in cancer, including melanoma3-5 .
Rescue endoscopic therapy after malfunctioning choledochoduodenostomy in patient with malignant distal biliary obstruction

Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CD) using a lumen-apposing metal stent (LAMS) has recently been reported as an alternative approach after failure of endoscopic retrograde cholangiopancreatography (ERCP) in patients with malignant obstructive jaundice [1]. Here, we report the case of an 83-yearold man affected by obstructive jaundice (total bilirubin 25mg/dL, predominantly direct) due to advanced pancreatic head cancer with gallbladder in situ. He underwent ERCP; however, it was not possible to cannulate the common bile duct (CBD) because of serrated stenosis, and therefore EUS-CD was performed. From the duodenal bulb view, the CBD had a diameter of about 20mm above the pancreatic mass, and no interposing vessels on Doppler flow were present. An 8×8mm LAMS (Hot Axios; Boston Scientific, Marlborough, Massachusetts, USA) was directly deployed, creating an EUS-CD with initial good biliary drainage into the duodenum. A computed tomography scan confirmed the correct positioning of the stent, which, together with subsequent decompression of the CBD, resulted in improvement in cholestasis parameters. Nevertheless, 2 days later, obstructive jaundice worsened. Cholangiography with sphincterotome through the LAMS revealed CBD decompression and the LAMS distal flange located close to the contralateral CBD wall, hampering biliary drainage. A 10× 40mm uncovered self-expandable metal stent (SEMS; Wallflex; Boston Scientific) was placed inside the LAMS with its proximal edge in the common hepatic duct, restoring a functional axis, and allowing biliary drainage (▶Fig. 1, ▶Video 1). The patient remained in a satisfactory clinical condition with progressive resolution of obstructive jaundice and was referred for outpatient oncologic treatment. After 4 weeks of follow-up, laboratory tests revealed that total bilirubin levels had returned to normal (1.2mg/dL). In conclusion, the “SEMS in LAMS technique” can be considered as rescue therapy after malfunctioning EUS-CD. Placement of the uncovered SEMS within the LAMS restored the functional axis, thus avoiding both risk of stent misplacement and cholecystitis.
Radiation Pattern Reconfigurable mm-Wave Bow-Tie Array Integrated with PIFA Antenna

In this paper, a millimeter-wave (mm-wave) bow-tie antenna array is proposed to be integrated with a low-frequency Planar Inverted F-Antenna (PIFA) at the top edge of a handset. A layer of grating strips with pin diodes is added between the low and high-frequency antennas to provide reconfigurable radiation patterns. The proposed 5G array is matched from 24-30 GHz and can steer the beam in both configurations with a realized gain higher than 8 dBi in the broadside case, and more than 6 dBi when the radiation pattern is endfire.
Frailty syndrome: implications and challenges for health care policy

Older adults are a highly heterogeneous group with variable health and functional life courses. Frailty has received increasing scientific attention as a potential explanation of the health diversity of older adults. The frailty phenotype and the Frailty Index are the most frequently used frailty definitions, but recently new frailty definitions that are more practical have been advocated. Prevalence of frailty among the community-dwelling population aged 65 years and older is ~10% but varies depending on which frailty definitions are used. The mean prevalence of frailty gradually increases with age, but the individual’s frailty level can be improved. Older adults, especially frail older adults, form the main users of medical and social care services. However, current health care systems are not well prepared to deal with the chronic and complex medical needs of frail older patients. In this context, frailty is potentially a perfect fit as a risk stratification paradigm. The evidence from frailty studies has not yet been fully translated into clinical practice and health care policy making. Successful implementation would improve quality of care and promote healthy aging as well as diminish the impact of aging on health care systems and strengthen their sustainability. At present, however, there is no effective treatment for frailty and the most effective intervention is not yet known. Based on currently available evidence, multi-domain intervention trials, including exercise component, especially multicomponent exercise, which includes resistance training, seem to be promising. The current challenges in frailty research include the lack of an international standard definition of frailty, further understanding of interventions to reverse frailty, the best timing for intervention, and education/training of health care professionals. The hazards of stigmatization should also be considered. If these concerns are properly addressed, widespread application of public health approaches will be possible, including screening, identification, and treatment of frailty, resulting in better care and healthier aging for older people.
The Nellix endovascular aneurysm sealing system: current perspectives

Background The Nellix endovascular aneurysm sealing (EVAS) system is a novel approach for the treatment of abdominal aortic aneurysm (AAA). We aimed to evaluate the efficacy of EVAS in the management of patients with AAA. Materials and methods We searched PubMed/MEDLINE, CINAHL, and bibliographic reference lists to identify studies reporting clinical outcomes in patients with asymptomatic, non-ruptured AAA treated with EVAS with the Nellix device. We pooled dichotomous outcome data using random-effects models. Results We identified 14 single-arm observational studies, reporting a total of 1,510 patients. The pooled estimate of technical success was 99% (95% CI =98–100; heterogeneity: P=0.869, I2=0%). Adjunctive procedures were carried out in 39% (95% CI =19–63; heterogeneity: P<0.0001, I2=88%). Two cases of aneurysm rupture were reported within 30 days of treatment (0.7%, 95% CI =0.3–1.6; heterogeneity: P=0.923, I2=0%) and another five cases of rupture occurred during follow-up (0.8%, 95% CI =0.4–1.6; heterogeneity: P=0.958, I2=0%). The pooled estimates of early (within 30 days) and late (during follow-up) type I endoleak were 2.8 % (95% CI =1.8–4.2; heterogeneity: P=0.254, I2=18%) and 1.9% (95% CI =1.3–2.8; heterogeneity: P=0.887, I2=0%), respectively. Sac enlargement was noted in 3.1% (95% CI =1.8–5.4; heterogeneity: P=0.419, I2=0%) and device migration in 2.1% (95% CI =0.8–5.3; heterogeneity: P=0.004, I2=65%). The early and late reintervention rates were 2.7% (95% CI =1.7–4.2; heterogeneity: P=0.183, I2=27%) and 3.5% (95% CI =2.3–5.5; heterogeneity: P=0.061, I2=42%), respectively. The pooled estimate of 30-day mortality was 1.5% (95% CI =0.9–2.6; heterogeneity: P=0.559, I2=0%) and the pooled estimate of aneurysm-related death during follow-up was 1.0% (95% CI =0.6–1.9; heterogeneity: P=0.872, I2=0%). Conclusion Reported outcomes of EVAS are acceptable. Type I endoleak, sac enlargement, device migration, and aneurysm rupture are recognized complications. High-level research is required to investigate potential advantages of EVAS over conventional treatments.
Allergic Airway-Induced Hypersensitivity Is Attenuated by Bergapten in Murine Models of Inflammation

Bergapten (5-methoxypsoralen, 5-MOP) is a plant-derived furocoumarin with demonstrated anti-inflammatory action. The present study investigated its effects on allergic inflammation in two related pathways of mast cell degranulation. Compound 48/80 and lipopolysaccharide (LPS) were used to activate the IgE-independent pathway while bovine serum albumin (BSA) was used as allergen for the IgE-dependent pathway. The modulatory effect of bergapten on mast cell degranulation, neutrophil extravasation, protein concentration, lung histopathology, and oxidative stress was assessed. Bergapten at 10, 30, and 100 μg/ml for 15 min stabilized mast cells in rat mesenteric tissue from disruption in vitro and when administered in vivo at 3, 10, and 30 mg kg−1 for 1 h protected mice from fatal anaphylaxis induced by compound 48/80. Similarly, treatment of LPS-challenged mice with bergapten (3, 10, and 30 mg kg−1) for 24 h significantly decreased neutrophil infiltration into bronchoalveolar lavage fluid, mean protein concentration, and inflammatory cell infiltration of pulmonary tissues when compared to the saline-treated LPS-challenged control. In addition, lung histology of the bergapten-treated LPS-challenged mice showed significantly less oedema, congestion, and alveolar septa thickening when compared to the saline-treated LPS-challenged disease control. LPS-induced oxidative stress was significantly reduced through increased tissue activities of catalase and superoxide dismutase and reduced malondialdehyde levels on treatment with bergapten. In the triple antigen-induced active anaphylaxis, daily administration of bergapten at 3, 10, and 30 mg kg−1 for 10 days, respectively, protected previously sensitized and challenged mice against anaphylactic shock. Overall, our study demonstrates the ability of bergapten to attenuate allergic airway-induced hypersensitivity in murine models of inflammation, suggesting its possible therapeutic benefit in this condition.
The Relationship between Prematurity, Method of Delivery, and Functional Gastrointestinal Disorders in Children.

BACKGROUND The pathogenesis of functional gastrointestinal disorders (FGIDs) remains unknown. Early life events including method of delivery and length of gestation may be risk factors for FGIDs. Data from studies on early life events and the development of FGIDs are scarce and contradictory. OBJECTIVE To assess the association between mode of delivery, length of gestation, and FGIDs in children. We hypothesized that delivery via Cesarean section and prematurity would be associated with an increased prevalence of FGIDs. METHODS Questionnaires were mailed to families from 3 cities in Colombia. Parents provided information on mode of delivery, demographics, and medical history. School-children completed the Spanish version of the Questionnaire of Pediatric Gastrointestinal Symptoms Rome IV. Categorical data was analyzed using Fisher exact tests. Calculation of OR with 95% CI was performed. RESULTS 1497 children (535 preadolescents 10-12 years, 962 adolescents 13-18 years) participated. For participants born via Cesarean delivery, there was no significant increase in prevalence of any of the Rome IV FGIDs compared with vaginal delivery. There was a significant association between prematurity and FGIDs for those born between 28 and 32 weeks [CI 0.99-3.37] (P = 0.03). In this group, functional nausea was the only category of FGID to reach significance [0.16-112.23] (P = 0.02). However, statistical significance was lost when gestational ages were grouped together with multivariate analysis. CONCLUSIONS Our findings provide evidence that Cesarean delivery and prematurity are not risk factors for the development of FGIDs. Future studies are indicated to further evaluate the relationship between early life events and FGIDs.
MicroRNAs as Potential Biomarkers in Atherosclerosis

Atherosclerosis is a complex multifactorial disease that, despite advances in lifestyle management and drug therapy, remains to be the major cause of high morbidity and mortality rates from cardiovascular diseases (CVDs) in industrialized countries. Therefore, there is a great need in reliable diagnostic/prognostic biomarkers and effective treatment alternatives to reduce its burden. It was established that microRNAs (miRNAs/miRs), a class of non-coding single-stranded RNA molecules, can regulate the expression of genes at the post-transcriptional level and, accordingly, coordinate the cellular protein expression. Thus, they are involved not only in cell-specific physiological functions but also in the cellular and molecular mechanisms of human pathologies, including atherosclerosis. MiRNAs may be significant in the dysregulation that affects endothelial integrity, the function of vascular smooth muscle and inflammatory cells, and cellular cholesterol homeostasis that drives the initiation and growth of an atherosclerotic plaque. Besides, distinct expression patterns of several miRNAs are attributed to atherosclerotic and cardiovascular patients. In this article, the evidence indicating the multiple critical roles of miRNAs and their relevant molecular mechanisms related to atherosclerosis development and progression was reviewed. Moreover, the effects of miRNAs on atherosclerosis enabled to exploit them as novel diagnostic biomarkers and therapeutic targets that may lead to better management of atherosclerosis and CVDs.
Prolonged ventilation and postnatal growth of preterm infants

Abstract Background Extremely premature infants often need invasive respiratory support from birth, but have low nutritional reserves and high metabolic demands. Our aim was to determine if there was a relationship between prolonged ventilation and reduced postnatal growth in such infants. Methods A retrospective, observational study was undertaken. Data from infants born at less than 28 weeks of gestational age and ventilated for 7 days or more were collected and analysed including gestational age, gender, birth and discharge weight, birth and discharge head circumference, days of invasive mechanical ventilation and use of postnatal corticosteroids. The duration of invasive mechanical ventilation and the differences in weight (ΔWz) and head circumference (ΔHz) z-score from birth to discharge were calculated. Results Fifty-five infants were studied with a median [interquartile range (IQR)] gestational age at birth of 25.3 (24.3–26.7) weeks and birth weight of 0.73 (0.65–0.87) kg. The median duration of mechanical ventilation was 45 (33–68) days. Both ΔWz and ΔHz were significantly negatively correlated to the number of invasive mechanical ventilation days (P = 0.01 and P = 0.03, respectively), but not to the use of postnatal corticosteroids. Conclusion Poor postnatal growth is significantly negatively associated with a longer duration of mechanical ventilation in extremely prematurely born infants.
Artificial intelligence in breast ultrasound

Artificial intelligence (AI) is gaining extensive attention for its excellent performance in image-recognition tasks and increasingly applied in breast ultrasound. AI can conduct a quantitative assessment by recognizing imaging information automatically and make more accurate and reproductive imaging diagnosis. Breast cancer is the most commonly diagnosed cancer in women, severely threatening women’s health, the early screening of which is closely related to the prognosis of patients. Therefore, utilization of AI in breast cancer screening and detection is of great significance, which can not only save time for radiologists, but also make up for experience and skill deficiency on some beginners. This article illustrates the basic technical knowledge regarding AI in breast ultrasound, including early machine learning algorithms and deep learning algorithms, and their application in the differential diagnosis of benign and malignant masses. At last, we talk about the future perspectives of AI in breast ultrasound.
Comparison of smartphone ophthalmoscopy vs conventional direct ophthalmoscopy as a teaching tool for medical students: the COSMOS study

Purpose To investigate the utility of smartphone ophthalmology for medical students for learning fundoscopy compared with direct ophthalmoscopy. Methods After 1 hour of didactic instruction on ophthalmoscopy, second-year medical students in a small group setting were randomized to start training with the direct ophthalmoscope vs smartphone ophthalmoscope and crossed over to the other instrument through the session. Main outcome measures Ability to visualize the optic nerve and retinal blood vessels in an undilated pupil as well as a survey evaluating ease of use, confidence, and ability to visualize the optic nerve with the two instruments. Results One hundred and one medical students participated. Significantly more medical students were able to visualize the optic nerve with the smartphone ophthalmoscope vs the direct ophthalmoscope in an undilated pupil (82.3% vs 48.5%, P<0.0001). Students reported a more positive experience with the smartphone ophthalmoscope, specifically regarding ease of use (median of 4 vs 3; P<0.0001), their confidence in performing ophthalmoscopy (median of 4 vs 3; P<0.0001), and their ability to visualize features of the optic nerve (median 4 vs 3; P<0.0001). A significant number of participants preferred the smartphone ophthalmoscope over the traditional direct ophthalmoscope for learning how to identify the optic disc and for evaluating patients (78.2% and 77.2%, respectively; P<0.0001). Conclusion Smartphone ophthalmoscopy may serve as a useful adjunctive tool to teach direct ophthalmoscopy as well as being an alternative for examining the fundus for noneye care physicians.
Clostridium difficile Enteritis after Total Abdominal Colectomy for Ulcerative Colitis

Introduction Isolated Clostridium difficile small bowel enteritis is a rare condition with significant morbidity and mortality. Presentation of Case An 83-year-old female with refractory ulcerative colitis underwent a total proctocolectomy and end ileostomy. Her postoperative course was complicated with return to the operating room for repair of an incarcerated port site hernia. Subsequently, she developed septic shock and multiorgan failure requiring intubation and mechanical ventilation, renal replacement therapy, and high dose vasopressors. Diagnostic workup revealed diffuse small bowel wall thickening on computed tomography scan as well as positive nucleic acid amplification test for C. difficile toxin B gene. Despite treatment with antibiotics and maximum attempts at resuscitation, the patient expired. Discussion. C. difficile infection most commonly affects the colon but rarely can involve the small bowel. The pathogenesis of C. difficile enteritis is unclear but is believed to mirror that of colitis. Surgical patients are susceptible for C. difficile infection, as they tend to be relatively immunosuppressed in the postoperative period. Radiologic findings of enteritis may mimic those of colitis and this includes small bowel dilation and thickening. Treatment for this condition has not been well established but it is approached similar to colitis. Conclusion Despite an increase in the number of case reports of C. difficile enteritis, it continues to be a rare but potentially fatal infection. Clinicians should maintain a high index of suspicion especially in patients with inflammatory bowel disease who undergo colon resections.
Benign biliary strictures: prevalence, impact, and management strategies

Benign biliary strictures (BBSs) may form from chronic inflammatory pancreaticobiliary pathologies, postoperative bile-duct injury, or at biliary anastomoses following liver transplantation. Treatment aims to relieve symptoms of biliary obstruction, maintain long-term drainage, and preserve liver function. Endoscopic therapy, including stricture dilatation and stenting, is effective in most cases and the first-line treatment of BBS. Radiological and surgical therapies are reserved for patients whose strictures are refractory to endoscopic interventions. Response to treatment is dependent upon the technique and accessories used, as well as stricture etiology. In this review, we discuss the various BBS etiologies and their management strategies.