Miracle-dz/UniFAR-FTUs huggingface dataset:
Reliability and Validity of a New Computer-Based Triage Decision Support Tool: ANKUTRIAGE

Abstract Objective: Triage is a tool used to determine patients’ severity of illness or injury within minutes of arrival. This study aims to assess the reliability and validity of a new computer-based triage decision support tool, ANKUTRIAGE, prospectively. Methods: ANKUTRIAGE, a 5-level triage tool was established considering 2 major factors, patient’s vital signs and characteristics of the admission complaint. Adult patients admitted to the ED between July and October, 2019 were consecutively and independently double triaged by 2 assessors using ANKUTRIAGE system. To measure inter-rater reliability, quadratic-weighted kappa coefficients (Kw) were calculated. For the validity, associations among urgency levels, resource use, and clinical outcomes were evaluated. Results: The inter-rater reliability between users of ANKUTRIAGE was excellent with an agreement coefficient (Kw) greater than 0.8 in all compared groups. In the validity phase, hospitalization rate, intensive care unit admission and mortality rate decreased from level 1 to 5. Likewise, according to the urgency levels, resource use decreased significantly as the triage level decreased (P < 0.05). Conclusions: ANKUTRIAGE proved to be a valid and reliable tool in the emergency department. The results showed that displaying the key discriminator for each complaint to assist decision leads to a high inter-rater agreement with good correlation between urgency levels and clinical outcomes, as well as between urgency levels and resource consumptions.
Management of aortic arch hypoplasia in neonates and infants

To The Editor, With great interest, I have read the article “Management of aortic arch hypoplasia in neonates and infants” by Mehmet A. Onalan et al. It was a privilege for me to read such a well‐written paper, and I applaud the authors' exceptional efforts. I concur with the article's conclusion that one‐stage repair with appropriate outcomes can treat aortic arch reformation in infants and neonates with tubular arch hypoplasia and that in neonates with co‐morbidities, a palliative two‐ stage approach should be explored. However, it seemed that a few additional points would have enhanced the end of the piece. In the first place, the study's retrospective nature raises several problems due to the possibility of recollection bias and incorrect patient reporting, which may have been mitigated if the investigators had included current cases at the time. Second, doing a single‐ centered study may result in bias due to differences in health, socioeconomic, and environmental variables and the constrained statistical analysis. Thirdly, the authors should have explained the surgical technique more thoroughly. Research conducted between 1990 and 1993 showed that 13 infants with severe aortic arch hypoplasia underwent excision and carotid flap plasty. For neonates with substantial aortic arch hypoplasia, resection combined with carotid flap plasty is regarded as an effective initial step in a phased repair. In addition, the patients' ethnicity should have been indicated by the authors throughout the research, as this would have revealed more about a diverse community. As per a study, some patients with aortic arch hypoplasia suffer from persistent arch blockage, while others acquire hypertension as a long‐term consequence after coarctation surgery. A neonate with a hypoplastic aortic arch might provide the surgeon with several complications. As the complexity of the arch's architecture and any related pathologies develops, so make these difficulties. In addition to the technical difficulties inherent in surgical repair, the decision‐making process can be challenging. Imaging that is precise and exhaustive is a crucial beginning step. Currently, insufficient evidence raises uncertainty on the optimal surgical plan and method. This is significant because decisions taken during the neonatal era can affect not only the immediate management but also the patient's long‐term outcome. Consequently, it is advised to approach these decisions with much deliberation, thoroughness, and deliberation. Therefore, aortic arch repair for tubular arch hypoplasia in newborns and children without accompanying intracardiac lesions can be accomplished with great short‐ and long‐term outcomes. At intermediate follow‐up following patch aortoplasty, there are few problems associated with the repair site. Alternative perfusion and surgical methods are required to enhance outcomes in newborns with intracardiac abnormalities undergoing arch rebuilding.
A model‐based meta‐analysis of immune‐related adverse events during immune checkpoint inhibitors treatment for NSCLC

Immune checkpoint inhibitors (ICIs) have become a vital part of the therapeutic landscape for non‐small cell lung cancer (NSCLC) in recent years benefiting from their remarkable efficacy. However, ICIs are associated with potentially life‐threatening immune‐related adverse events (irAEs). This study aims to quantify dose dependence and additional influencing factors of both any grade and grade greater than or equal to 3 irAEs in patients with NSCLC treated by ICIs. The trial‐level irAE data was collected and pooled from 129 cohorts in 81 clinical studies. A logit‐transformed meta‐regression model was applied to derive the quantitative relationship of irAE rate and ICI exposure. Programmed cell death‐1 (PD‐1) or programmed cell death ligand‐1 (PD‐L1) inhibitors showed no dose dependence in patients with NSCLC, whereas cytotoxic T lymphocyte–associated antigen 4 (CTLA‐4) inhibitors exhibited a statistically significant dose dependence when used alone or combined with PD‐1 or PD‐L1 inhibitors. Besides, therapy line and combination of ICIs with chemotherapy or target therapy were significant covariates. Hopefully, the results of this study can improve clinicians’ awareness of irAEs and be helpful for clinical decisions during ICI treatment for NSCLC.
A Novel Layered Bidirectional Equalizer Based on a Buck-Boost Converter for Series-Connected Battery Strings

To eliminate the influence of the inconsistency on the cycle life and the available capacity of battery packs, and improve the balancing speed, a novel inductor-based layered bidirectional equalizer (IBLBE) is proposed. The equalizer is composed of two layers of balancing circuits connected in parallel. Each layer contains multiple balancing sub-circuits based on buck-boost converters. These balancing sub-circuits can equalize the corresponding cells simultaneously, and allow the dynamic adjustment of equalization path and equalization threshold. Analysis and simulation results demonstrate the IBLBE has a higher level balancing speed than other equalizers based on switched-capacitor or switched-inductor converters, and reduces the balancing time by 30% compared to existing inductor-based parallel architecture equalizers (PAEs). Experimental results are presented to validate the analysis and effectiveness of the proposed equalizer.
Physics of defects in metal halide perovskites

Metal halide perovskites are widely used in optoelectronic devices, including solar cells, photodetectors, and light-emitting diodes. Defects in this class of low-temperature solution-processed semiconductors play significant roles in the optoelectronic properties and performance of devices based on these semiconductors. Investigating the defect properties provides not only insight into the origin of the outstanding performance of perovskite optoelectronic devices but also guidance for further improvement of performance. Defects in perovskites have been intensely studied. Here, we review the progress in defect-related physics and techniques for perovskites. We survey the theoretical and computational results of the origin and properties of defects in perovskites. The underlying mechanisms, functions, advantages, and limitations of trap state characterization techniques are discussed. We introduce the effect of defects on the performance of perovskite optoelectronic devices, followed by a discussion of the mechanism of defect treatment. Finally, we summarize and present key challenges and opportunities of defects and their role in the further development of perovskite optoelectronic devices.
The legacy of kinesins in the pollen tube 30 years later

The pollen tube is fundamental in the reproduction of seed plants. Particularly in angiosperms, we now have much information about how it grows, how it senses extracellular signals, and how it converts them into a directional growth mechanism. The expansion of the pollen tube is also related to dynamic cytoplasmic processes based on the cytoskeleton (such as polymerization/depolymerization of microtubules and actin filaments) or motor activity along with the two cytoskeletal systems and is dependent on motor proteins. While a considerable amount of information is available for the actomyosin system in the pollen tube, the role of microtubules in the transport of organelles or macromolecular structures is still quite uncertain despite that 30 years ago the first work on the presence of kinesins in the pollen tube was published. Since then, progress has been made in elucidating the role of kinesins in plant cells. However, their role within the pollen tube is still enigmatic. In this review, I will postulate some roles of kinesins in the pollen tube 30 years after their initial discovery based on information obtained in other plant cells in the meantime. The most concrete hypotheses predict that kinesins in the pollen tube enable the short movement of specific organelles or contribute to generative cell or sperm cell transport, as well as mediate specific steps in the process of endocytosis.
Non-linear susceptibility to interferences in declarative memory formation

After encoding, memories go through a labile state followed by a stabilization process known as consolidation. Once consolidated they can enter a new labile state after the presentation of a reminder of the original memory, followed by a period of restabilization (reconsolidation). During these periods of lability the memory traces can be modified. Currently, there are studies that show a rapid stabilization after 30 min, while others show that stabilization occurs after longer periods (e.g. 6 h). Here we investigate the effect of an interference treatment on declarative memory consolidation, comparing distinct time intervals after acquisition. On day 1, participants learned a list of non-syllable pairs (List 1). Immediately after, 30 min, 3 h or 8 h later, they received an interference list (List 2) that acted as an amnesic agent. On day 2 (48 h after training) participants had to recall List 1 first, followed by List 2. We found that the List 1 memory was susceptible to interference when the List 2 was administered immediately or 3 h after learning; however, shortly after acquisition (e.g. 30 min) the List 1 memory becomes transiently protected against interference. We propose the possibility that this rapid memory protection could be induced by a fast and transient neocortical integration (where the memory is transiently protected) becoming partially independent from the hippocampus followed by a hippocampal re-engagement where the memory becomes susceptible to interferences again. Our results open a discussion about the contribution of molecular and systemic aspects to memory consolidation.
Prescribing trend of tapentadol in a Sydney local health district

Tapentadol, an opioid with mu‐opioid receptor agonism and noradrenaline reuptake inhibition, has been increasingly used in Australia since 2011. However, data on hospital prescribing trends and indications are scarce. This study aimed to investigate hospital prescribing trends of tapentadol, oxycodone and tramadol in a Sydney local health district (LHD) and the indications for tapentadol hospital prescriptions in an Australian tertiary hospital.
Exploring the potential of exosomes in diagnosis and drug delivery for pancreatic ductal adenocarcinoma

Pancreatic cancer (PC) is a cancer of the digestive system, and pancreatic ductal adenocarcinoma (PDAC) accounts for approximately 90% of all PC cases. Exosomes derived from PDAC (PDAC‐exosomes) promote PDAC development and metastasis. Exosomes are nanoscale vesicles secreted by most cells, which can carry biologically active molecules and mediate communication and cargo transportation among cells. Recent studies have focused on transforming exosomes into good drug delivery systems (DDSs) to improve the clinical treatment of PDAC. This review considers PDAC as the main research object to introduce the role of PDAC‐exosomes in PDAC development and metastasis. This review focuses on the following two themes: (a) the great potential of PDAC‐exosomes as new diagnostic markers for PDAC, and (b) the transformation of exosomes into potential DDSs.
The Learning Curve and Importance of Collaboration in Endoscopic Thyroidectomy Via Breast Areola Approach: A Single Surgical Team’s Experience of 100 Patients

Background: Endoscopic thyroidectomy is popular among young patients because of its excellent cosmetic outcomes. But it takes a long time to become proficient and competent for surgeons. In addition, collaboration plays a critical role in endoscopic thyroidectomy. Our research aims to evaluate the learning curve of endoscopic thyroidectomy via breast areola approach, provide details of this approach, and demonstrate the importance of collaboration. Methods: The authors retrospectively analyzed 100 cases of benign and malignant thyroid disease who underwent endoscopic thyroidectomy via breast areola approach between January 2015 and December 2020, which were performed by the same group of surgeons with little experience of endoscopic thyroidectomy. The learning curve was analyzed by moving average method. The mean operation time, blood loss, tumor size, postoperative complications were used to determine learning curve progression. Results: The learning curve in the first 30 cases were uplifted, stable at 30 to 60 cases and declined in the following cases. The mean operation time and blood loss decreased significant after the first 30 cases and again after the first 60 cases. And there was no difference in postoperative complications. Conclusions: A well-trained surgeon with experience in conventional open thyroidectomy can significantly reduce the total operation time by studying the learning curve. The key steps including establishment of working space and reaching for recurrent laryngeal nerve. A stable level can be achieved after 30 cases. More than 60 cases are required to become proficient. A successful endoscopic thyroid surgery requires a stable team.
Canadian Stroke Best Practice Recommendations

Abstract The seventh edition of the Canadian Stroke Best Practice Recommendations for Rehabilitation and Recovery following Stroke includes a new section devoted to the provision of virtual stroke rehabilitation. This consensus statement uses Grading of Recommendations, Assessment, Development and Evaluations methodology and Appraisal of Guidelines for Research & Evaluation II principles. A literature search was conducted using PubMed, Embase, and Cochrane databases. An expert writing group reviewed all evidence and developed recommendations, as well as consensus-based clinical considerations where evidence was insufficient for a recommendation. All recommendations underwent internal and external review. These recommendations apply to hospital, ambulatory care, and community-based settings where virtual stroke rehabilitation is provided. This guidance is relevant to health professionals, people living with stroke, healthcare administrators, and funders. Recommendations address issues of access, eligibility, consent and privacy, technology and planning, training and competency (for healthcare providers, patients and their families), assessment, service delivery, and evaluation. Virtual stroke rehabilitation has been shown to safely and effectively increase access to rehabilitation therapies and care providers, and uptake of these recommendations should be a priority in rehabilitation settings. They are key drivers of access to high-quality evidence-based stroke care regardless of geographical location and personal circumstances in Canada.
Thinking for the future: Phytoextraction of cadmium using primed plants for sustainable soil clean-up.

Cadmium (Cd) soil contamination is a global problem for food security due to its ubiquity, toxicity at low levels, persistence, and bioaccumulation in living organisms. Humans' intake of heavy metals is usually due to direct contact with contaminated soil, through the food chain (Cd accumulation in crops and edible plants) or through drinking water in cases of coupled groundwater-surface water systems. Phytoextraction is one of the eco-friendly, sustainable solutions that can be used as a method for soil clean-up with the possibility of re-use of extracted metals through phytomining. Phytoextraction is often limited by the tolerance level of hyperaccumulating plants and the restriction of their growth. Mechanisms of hyperaccumulation of heavy metals in tolerant species have been studied, but there are almost no data on mechanisms of further improvement of the accumulation capacity of such plants. Priming can influence plant stress tolerance by the initiation of mild stress cues resulting in acclimation of the plant. The potential of plant priming in abiotic stress tolerance has been extensively investigated using different types of molecules that are supplemented exogenously to plant organs (roots, leaves etc.), resulting in enhanced tolerance of abiotic stress. This review focuses on mechanisms of enhancement of plant stress tolerance in hyperaccumulating plants for their exploitation in phytoextraction processes. This article is protected by copyright. All rights reserved.
Product Recognition for Unmanned Vending Machines

Recently, the emerging concept of “unmanned retail” has drawn more and more attention, and the unmanned retail based on the intelligent unmanned vending machines (UVMs) scene has great market demand. However, existing product recognition methods for intelligent UVMs cannot adapt to large-scale categories and have insufficient accuracy. In this article, we propose a method for large-scale categories product recognition based on intelligent UVMs. It can be divided into two parts: 1) first, we explore the similarities and differences between products through manifold learning, and then we build a hierarchical multigranularity label to constrain the learning of representation; and 2) second, we propose a hierarchical label object detection network, which mainly includes coarse-to-fine refine module (C2FRM) and multiple granularity hierarchical loss (MGHL), which are used to assist in capturing multigranularity features. The highlights of our method are mine potential similarity between large-scale category products and optimization through hierarchical multigranularity labels. Besides, we collected a large-scale product recognition dataset GOODS-85 based on the actual UVMs scenario. Experimental results and analysis demonstrate the effectiveness of the proposed product recognition methods.
Perioperative care bundles for the prevention of surgical-site infections: meta-analysis

Abstract Background Care bundles are used widely to prevent surgical-site infections (SSIs). Recent systematic reviews suggested larger effects from bundles with more interventions. These reviews were largely based on uncontrolled before–after studies and did not consider their biases. The aim of this meta-analysis was to determine the effectiveness of care bundles to prevent SSIs and explore characteristics of effective care bundles. Methods A systematic review, reanalysis, and meta-analysis of available evidence were undertaken. RCTs, controlled before–after studies, and uncontrolled before–after studies with sufficient data for reanalysis as interrupted time series studies (ITS) were eligible. Studies investigating the use of a care bundle, with at least one intraoperative intervention, compared with standard care were included. Results Four RCTs, 1 controlled before–after study, and 13 ITS were included. Pooled data from RCTs were heterogeneous. Meta-analysis of ITS resulted in a level change of −1.16 (95 per cent c.i.−1.78 to −0.53), indicating a reduction in SSI. The effect was larger when the care bundle comprised a higher proportion of evidence-based interventions. Meta-regression analyses did not show statistically significant associations between effect estimates and number of interventions, number of evidence-based interventions, or proportion of evidence-based interventions. Conclusion Meta-analysis of ITS indicated that perioperative care bundles prevent SSI. This effect is inconsistent across RCTs. Larger bundles were not associated with a larger effect, but the effect may be larger if the care bundle contains a high proportion of evidence-based interventions. No strong evidence for characteristics of effective care bundles was identified.
Molecular subtype classification of low‐grade gliomas using magnetic resonance imaging‐based radiomics and machine learning

In 2016, the World Health Organization (WHO) updated the glioma classification by incorporating molecular biology parameters, including low‐grade glioma (LGG). In the new scheme, LGGs have three molecular subtypes: isocitrate dehydrogenase (IDH)‐mutated 1p/19q‐codeleted, IDH‐mutated 1p/19q‐noncodeleted, and IDH‐wild type 1p/19q‐noncodeleted entities. This work proposes a model prediction of LGG molecular subtypes using magnetic resonance imaging (MRI). MR images were segmented and converted into radiomics features, thereby providing predictive information about the brain tumor classification. With 726 raw features obtained from the feature extraction procedure, we developed a hybrid machine learning‐based radiomics by incorporating a genetic algorithm and eXtreme Gradient Boosting (XGBoost) classifier, to ascertain 12 optimal features for tumor classification. To resolve imbalanced data, the synthetic minority oversampling technique (SMOTE) was applied in our study. The XGBoost algorithm outperformed the other algorithms on the training dataset by an accuracy value of 0.885. We continued evaluating the XGBoost model, then achieved an overall accuracy of 0.6905 for the three‐subtype classification of LGGs on an external validation dataset. Our model is among just a few to have resolved the three‐subtype LGG classification challenge with high accuracy compared with previous studies performing similar work.