Miracle-dz/UniFAR-FTUs huggingface dataset:
Performance of ACR TI-RADS and the Bethesda System in Predicting Risk of Malignancy in Thyroid Nodules at a Large Children’s Hospital and a Comprehensive Review of the Pediatric Literature

Simple Summary Children are not little adults, when it comes to many things, especially in medicine. Sometimes, a new radiology or pathology test is developed for use in adults, and only later are pediatric applications considered—perhaps the disease being tested for is more common in adults. In this study, we aim to understand differences between adults and children when it comes to how we test for thyroid cancer. Thyroid nodules are much more common in adults, but they are much more likely to be malignant in children. Ultrasound is typically the first test when a patient has a thyroid nodule, and radiologists have developed risk stratification systems to try and determine who can be safely followed clinically and with repeat ultrasound, versus those who need to proceed to a second test, fine-needle aspiration biopsy, in which cells are removed from the thyroid and examined under a microscope, sometimes with molecular testing. Abstract While thyroid nodules are less common in children than in adults, they are more frequently malignant. However, pediatric data are scarce regarding the performance characteristics of imaging and cytopathology classification systems validated to predict the risk of malignancy (ROM) in adults and select those patients who require fine-needle aspiration (FNA) and possibly surgical resection. We retrospectively reviewed the electronic medical records of all patients 18 years of age or younger who underwent thyroid FNA at our institution from 1 July 2015 to 31 May 2022. Based on surgical follow-up from 74 of the 208 FNA cases, we determined the ROM for the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) ultrasound risk stratification system and The Bethesda System for Reporting Thyroid Cytopathology and added our results to those of pediatric cohorts from other institutions already published in the literature. We found the following ROMs for 1458 cases using ACR TI-RADS (TR): TR1. Benign: 2.2%, TR2. Not Suspicious: 9.3%, TR3. Mildly Suspicious: 16.6%, TR4. Moderately Suspicious: 27.0%, and TR5. Highly Suspicious 76.5%; and for 5911 cases using the Bethesda system: Bethesda I. Unsatisfactory: 16.8%, Bethesda II. Benign: 7.2%, Bethesda III: Atypia of Undetermined Significance: 29.6%, Bethesda IV. Follicular Neoplasm: 42.3%, Bethesda V. Suspicious for Malignancy: 90.8%, and Bethesda VI. Malignant: 98.8%. We conclude that ACR TI-RADS levels imply higher ROMs for the pediatric population than the corresponding suggested ROMs for adults, and, in order to avoid missing malignancies, we should consider modifying or altogether abandoning size cutoffs for recommending FNA in children and adolescents whose thyroid glands are smaller than those of adults. The Bethesda categories also imply higher ROMs for pediatric patients compared to adults.
Markov-Based Neural Networks for Heart Sound Segmentation: Using Domain Knowledge in a Principled Way

This work considers the problem of segmenting heart sounds into their fundamental components. We unify statistical and data-driven solutions by introducing <italic>Markov-based Neural Networks</italic> (MNNs), a hybrid end-to-end framework that exploits Markov models as statistical inductive biases for an Artificial Neural Network (ANN) discriminator. We show that an MNN leveraging a simple one-dimensional Convolutional ANN significantly outperforms two recent purely data-driven solutions for this task in two publicly available datasets: PhysioNet 2016 (Sensitivity: <inline-formula><tex-math notation="LaTeX">$0.947 \pm 0.02$</tex-math></inline-formula>; Positive Predictive Value : <inline-formula><tex-math notation="LaTeX">$0.937 \pm 0.025$</tex-math></inline-formula>) and the CirCor DigiScope 2022 (Sensitivity: <inline-formula><tex-math notation="LaTeX">$0.950 \pm 0.008$</tex-math></inline-formula>; Positive Predictive Value: <inline-formula><tex-math notation="LaTeX">$0.943 \pm 0.012$</tex-math></inline-formula>). We also propose a novel gradient-based unsupervised learning algorithm that effectively makes the MNN adaptive to unseen datum sampled from unknown distributions. We perform a cross dataset analysis and show that an MNN pre-trained in the CirCor DigiScope 2022 can benefit from an average improvement of 3.90% Positive Predictive Value on unseen observations from the PhysioNet 2016 dataset using this method.
Deep learning‐based high‐dimensional multiple regression estimator for chest x‐ray image classification in rapid cardiomegaly screening

Chest x‐ray (CXR) examination is a common first‐line, non‐invasive, and rapid screening method in clinical examinations. The posteroanterior (PA) and anteroposterior (AP) view modes can both be used to detect related cardiopulmonary diseases, such as pneumonitis, tuberculosis, pulmonary fibrosis, lung tumors, and cardiomegaly. Compared with cardiac computed tomography and cardiac magnetic resonance imaging methods, CXR examination has a short scanning duration and costs less, and is suitable for routine and follow‐up health examinations. Cardiomegaly is an asymptomatic disease in the early stage and cannot be detected through electrocardiography measurements. Thus, early cardiomegaly classes detections, such as cardiac hypertrophy and ventricular dilatation, can help make decisions regarding drug treatments and surgeries. In addition, an automatic assistive tool is required to differentiate between normal individuals and those with cardiomegaly to address the problem of manual inspection and labor shortage. Hence, PA view‐based CXR classification is used to develop a deep learning (DL)‐based high‐dimensional multiple regression analysis (MRA) model for CXR image classification in rapid cardiomegaly screening. This multilayer network model uses a two‐channel three‐layer convolution‐normalization‐pooling process with two‐dimensional (2D) multi convolution operations to enhance images and to extract feature patterns; and then a one‐dimensional feature conversion is used to estimate the four coordinate points of the maximal horizontal cardiac diameter (MHCD) and maximal horizontal thoracic diameter (MHTD), which can be used to estimate cardiothoracic ratio and detect cardiomegaly. For experimental tests, the training and testing datasets are collected from the National Institutes of Health CXR Image Database (Clinical Center, USA), and 10‐fold cross‐validation was used for model evaluation in terms of precision (%), recall (%), accuracy (%), and F1 score. These indexes are used to evaluate the feasibility of the proposed MRA estimator. In addition, the performances of the proposed model are compared with those of conventional DL‐based multilayer classifiers.
“Really? She Blicked the Baby?”

Children use syntax to guide verb learning. We asked whether the syntactic structure in which a novel verb occurs is meaningful to children even without a concurrent scene from which to infer the verb's semantic content. In two experiments, 2-year-olds observed dialogues in which interlocutors used a new verb in transitive (“Jane blicked the baby! ”) or intransitive (“Jane blicked! ”) sentences. The children later heard the verb in isolation (“Find blicking! ”) while watching a one-participant event and a two-participant event presented side by side. Children who had heard transitive dialogues looked reliably longer at the two-participant event than did those who had heard intransitive dialogues. This effect persisted even when children were tested on a different day, but disappeared when no novel verb accompanied the test events (Experiment 2). Thus, 2-year-olds gather useful combinatorial information about a novel verb simply from hearing it in sentences, and later retrieve that information to guide interpretation of the verb.
Structural Characterization of ISCR8, ISCR22, and ISCR23, Subgroups of IS91-Like Insertion Elements

ABSTRACT Analysis of ISCR8 (ISPps1) revealed that this group of insertion elements has to be subdivided into three subgroups: ISCR8, ISCR22, and ISCR23. The distinction of three subgroups is supported by phylogenetic analysis of the transposase open reading frames (ORFs). Comparison of over 20 complete and partial ISCR8/22/23 elements identified oriIS candidate sequences for all groups and a terIS candidate sequence for ISCR8. The oriIS sequences, their distance to the transposase ORFs, and the sequence of this intervening region are group specific, further supporting the definition of two new ISCR elements. ISCR8/22/23 have a very broad host range, including Gram-positive and Gram-negative bacteria, among which are several (opportunistic) pathogens. The IS often resides on plasmids or in the vicinity of other mobile elements and is mostly associated with genes for the degradation of halo- or nitro-aromatics. However, in one case ISCR8 was found in the neighborhood of an antibiotic resistance determinant in Klebsiella pneumoniae. ISCR8 resembles other IS91 family elements in mediating genetic rearrangements by homologous recombination between two copies. In Delftia acidovorans this led to the loss of the genes encoding dichlorprop cleavage. In conclusion, this study shows that ISCR8 could be a fully functional and active member of the IS91 family of insertion elements.
MRSSA: an iterative algorithm for similarity spreading over interrelated objects

We introduce the Multiple Relationship Similarity Spreading Algorithm (MRSSA) to enhance IR effectiveness. This method has similarity computed in an iterative "spreading" fashion for multiple object types, combining both inter- and intra-object relationships. We demonstrate the value of this approach in the context of the WWW, where the key objects are web pages and queries, Relationships considered are derived from hyperlinks (in- and out-links) and click-through logs.
The potential for inhaled treprostinil in the treatment of pulmonary arterial hypertension

Inhaled treprostinil is a safe and well-tolerated approved pharmaceutical for the treatment of pulmonary arterial hypertension. In a series of open-label studies and in the pivotal trial with 253 patients, this long-acting prostacyclin analogue demonstrated pronounced pulmonary selectivity of vasodilatory effects, improved physical capacity and excellent tolerability and safety following aerosol administration. For efficient treatment, only four daily inhalations of treprostinil are necessary compared with six to nine in iloprost aerosol therapy. This review describes in detail the development of inhaled treprostinil, starting with intravenous epoprostenol followed by inhaled iloprost and subcutaneous treprostinil, all three representing well-established and widely approved prostanoid therapies for pulmonary hypertension. In order to circumvent the drawbacks of intravenous epoprostenol, stable prostacyclin analogues with similar pharmacological properties have been investigated. In addition, alternative routes of administration have been proposed and evaluated, mainly inhaled and subcutaneous delivery. The concept of inhaled treprostinil was to combine the pulmonary selectivity of an aerosolized vasodilator with the long-acting effects of a stable prostacyclin analogue. Pulmonary arterial hypertension remains, however, a severe, life-threatening disease, in spite of the enormous progress in specific drug therapy over the last decade. Therefore, further improvement of drug therapy will be essential, with clear potential for inhaled treprostinil: a reduction of inhalation frequency and duration would markedly improve quality of life and compliance, and a longer-lasting local prostanoid effect might further enhance the efficacy of inhaled treprostinil. The advantageous pharmacological properties of treprostinil offer the opportunity to establish a convenient metered dose inhaler as a delivery system, to combine inhaled treprostinil with available or future drugs for pulmonary arterial hypertension, or to develop sustained release formulations of treprostinil suitable for inhalation based on liposomes or biodegradable nanoparticles.
Human Resource Management in Northern Europe: Trends, Dilemmas and Strategy

List of Contributors. Preface. 1. Human Resource Management in Northern Europe: Trends, Dilemmas and Strategies (Henrik Holt Larsen and Chris Brewster). 2. The Northern European Dimension: A Distinctive Environment for HRM (Chris Brewster and Henrik Holt Larsen). 3. Human Resource Management: A Strategic Approach (Chris Brewstern Henrik Holt Larsen and Wolfgang Mayrhofer). 4. Making Sense of the Drive for Competence: Bridging Individual and Organizational Learning (Pia Bramming and Henrik Holt Larsen). 5. Careers in Organizations: Theoretical Developments and Empirical Findings (Henrik Holt Larsen and Camilla Funck Ellehave). 6. Flexibility in HRM: Contradictions in Organizational Survival (Chris Brewster and Henrik Holt Larsen). 7. Communication in Organizations: Dialogue and Impact (Michael Morley, Wolfgang Mayrhofer and Chris Brewster). 8. Human Resource Costing and Accounting: Putting a Price on Human Resource Investments (Ulf Johanson and Henrik Holt Larsen). 9. Responsibility in Human Resource Management: The Role of the Line (Chris Brewster and Henrik Holt Larsen). 10. On the Road Again (Henrik Holt Larsen and Chris Brewster). Further Reading. Index.
Effect of serotonin on behavior, electrical activity of the brain, and seizure threshold of the newly hatched chick

SINCE THE RECENT DISCOVERY of relatively large amounts of naturally occurring serotonin in the brain,192 much attention has been directed toward the neuropharmacologic action of this substance. Evidence has been gathered indicating that serotonin is a possible neurotransmitter within the central nervous system;3 other investigators have attributed a synaptic inhibitory function to ~erotonin. ~ A problem common to these investigations employing a parenteral route of administration, however, is that serotonin crosses the blood-brain barrier with difficulty. Costa and Aprison6 have demonstrated that only 1% of injected serotonin is deposited in the brain. Bogdanski, Weissbach, and Udenfriende make the statement that “central pharmacological effects of serotonin are difficult to evaluate because the quantities which cross the blood brain barrier after parenteral administration are too small to permit chemical detection. ” With these data in mind, the present investigation was undertaken’, to determine the effects of various dosages of serotonin on external behavior, electrical activity of the central nervous system, and seizure threshold of an animal whose blood-brain barrier has not yet fully developed. Recalling the fact that the blood-brain barrier of the newborn is permeable to substances unable to penetrate the adult barrier, as evidenced by the disease kernicterus, the newly hatched chick was selected as the experimental animal. Studies of the blood-brain barrier of the embryonic and newly hatched chick using radioactive chloride and thiocyanate? have indicated that this animal does not develop a mature blood-brain barrier until three to four weeks after hatching. By using the chick, it was hoped that the neuropharmacologic action of serotonin could be more closely evaluated by achieving higher brain levels of serotonin than those previously attained in mature animals.
SCM-BP: An Intelligent Buffer Management Mechanism for Database in Storage Class Memory

A set of new storage media, called Storage Class Memory (SCM), has emerged as a quite promising solution to decrease the difference between HDD data access time and the time that processors can consume data. Four main characteristics may be highlighted in SCM: (i) non-volatility; (ii) low access time; (iii) high rates of IOPS, and (iv) read/write execution time asymmetry. The former three have a direct benefit for database systems. Notwithstanding, the latter one poses challenges for database systems. In fact, read-write speed ratio in SCMs can reach an 1-to-300 factor. For databases stored in HDs, disk access is a critical factor for database performance. The buffer manager is in charge of reducing the amount of disk access, maintaining the most used database pages in main-memory buffer. Most buffer-replacement policies have been proposed aiming at only avoiding disk access. Nonetheless, flushing too many changed pages from buffer to disk may reduce IOPS rates of SCMs. In this article, we propose the SCM-BP, an intelligent buffer replacement policy targeted to SCM devices. SCM-BP is able to autonomously adapt its behaviour and to choose the most efficient moment to do this. We provide an empirical study comparing SCM-BP to the widely used LRU policy. The results show the positive impact of our proposal to database system performance w.r. t buffer management when SCM media is used.
GENETIC AND EPIGENETIC REGULATION OF THE BOVINE IMMUNE SYSTEM : PRACTICAL IMPLICATIONS OF THE HIGH IMMUNE RESPONSE TECHNOLOGY

Identifying dairy cows with superior immune response (IR) reduces disease, increases farm profit, improves milk quality and increases animal well-being. In Canada, it costs the dairy producer $110 to $320 per case of mastitis, and it has been estimated that almost 1 out of every 5 dairy quarters in Canada is infected with a mastitis-causing pathogen (Canadian Bovine Mastitis Research Network, “What’s New in the World of Mastitis Research? ” http://www.medvet.umontreal.ca/rcrmb/dynamiques/PDF_AN/Results/NewspaperWhatsNew.pd f. 2009). The emergence of antibiotic resistant pathogens is of increasing concern to the producer, as well as to the public. Around the globe there is a concerted effort to limit the use of antibiotics, particularly in food-producing livestock. Therefore, in keeping with the European Unions’ proactive thinking that “prevention is better than cure”, alternative methods for disease control are earnestly being sought for animal agriculture. Various genetic approaches are being evaluated as suitable methods to enhance disease resistance of livestock. One of the most attractive options available is to make use of the animal’s own immune response genes to select for healthier animals with naturally superior immunity. This approach can work well on both conventional and organic dairy farms. This immunogenetic approach will be the focus of this article.
Renin and Prorenin Activate Pathways Implicated in Organ Damage in Human Mesangial Cells Independent of Angiotensin II Production

Background: The mechanism by which an activated renin-angiotensin system (RAS) leads to the development of renal diseases, such as fibrosis, is only partially explained by the downstream effects of angiotensin II. The discovery of a receptor that binds renin and prorenin, and the consequent production of profibrotic molecules, revealed a novel axis within the RAS pathway that may contribute to the pathogenesis of organ damage in patients with elevated renin and/or prorenin levels. Methods: To better understand the genes and networks underlying the receptor-mediated effects of renin and prorenin, a gene expression profiling study was performed on human mesangial cells in the presence of angiotensin-II-blocking agents. Results: Renin and prorenin induce highly overlapping gene expression signatures that are dependent, only in part, on the presence of the (pro)renin receptor. We found that 2 distinct pathways were activated by renin and prorenin: a TGFβ-dependent pathway and a TGFβ-independent pathway. Bioinformatic analysis was used to show that both pathways are highly enriched with genes implicated in fibrosis, hypertrophy and atherosclerosis. Conclusions: This study suggests that both renin and inactive prorenin are capable of inducing genetic programs that could contribute to end-organ damage and atherogenesis, through receptor-mediated angiotensin-independent mechanisms.
Suppression by Derepression in Threonine Dehydratase-Deficient Mutants of Bacillus subtilis

Partial suppressors of isoleucine-requiring mutants (Ile−), deficient in threonine dehydratase (TD), were studied. The suppression enables these auxotrophs to grow on the precursors homoserine or threonine as well as isoleucine. There are two genetically distinct classes of these suppressors: sprB, linked to threonine mutational sites, and sprA which is not linked to the Ile or Thr genetic region. SprA leads to the appearance of a low level of TD activity (2 to 4% of wild type) compared to <0.2% in Ile− mutants. This new TD activity is not activated by glutathione or adenosine monophosphate. Unlike the major TD, it is insensitive to inhibition by isoleucine and it is not coordinately controlled with dihydroxy acid dehydratase. Another class of auxotrophs, containing no suppressor mutation, can grow on isoleucine and homoserine or threonine because they possess structural gene mutations located near the terminus of the TD gene that result in partial impairment of TD. This TD activity (2% of wild type) is end product inhibited by isoleucine to a lesser extent than wild type TD. In this and a following paper, evidence is presented that sprA acts by derepressing a minor TD activity encoded within the threonine synthetic region. The major TD gene is separated from the region encoding the enzymes of threonine biosynthesis by 73% of the chromosome. Like the major TD, the minor TD catalyzes the first reaction in the conversion of threonine to isoleucine and is therefore closely related biochemically and genetically to the enzymes of the threonine synthetic region.
Internationally educated nurses’ descriptions of their access to structural empowerment while working in another country's health care context

AIM To examine internationally educated nurses' experiences of empowerment structures using Kanter's theory of structural empowerment. BACKGROUND There has been an increase in the number of nurses working in other countries worldwide and concerns have been raised regarding their working conditions. METHOD Semi-structured interviews were conducted with a purposive sample of 11 internationally educated nurses. Directed content analysis was used to analyse the data and Kanter's theory of empowerment was used as a framework. RESULTS Access to information was generally good. Access to support for their relationship with their managers varied. Regarding access to resources, nurses unfamiliar with clinical leadership found team leadership challenging. Access to in-house learning opportunities were reported as good. Access to informal power was more common than access to formal power. CONCLUSIONS The findings support Kanter's theory and demonstrate that internationally experienced nurses encountered varying degrees of access to empowering structures. Access to information and formal power was more general and related to the unit. Access to resources, support, opportunities and informal power were related to both the unit and the informants' specific situation as IENs. IMPLICATIONS FOR NURSING MANAGEMENT Managers need to support IENs when having a team leadership role, facilitate encounters between IENs and ordinary staff, and establishing mentorship for IENs.