Miracle-dz/UniFAR-FTUs huggingface dataset:
Fertility-sparing surgery for women with stage I cervical cancer of 4 cm or larger: a systematic review

Objective To investigate current evidence on oncological, fertility and obstetric outcomes of patients with stage I cervical cancer of 4 cm or larger undergoing fertility-sparing surgery (FSS). Methods Systematic review of studies including women affected by stage I cervical cancer ≥4 cm who underwent FSS. Main outcome measures: disease-free survival (DFS), overall survival (OS), pregnancy rate, live birth rate, premature delivery rate. Results Fifteen studies met all eligibility criteria for this systematic review, involving 48 patients affected by cervical cancer ≥4 cm who completed FSS. Three patients (6.3%) experienced a recurrence and one of them (2.1%) died of disease. The 5-year DFS rate was 92.4%. The 5-year OS rate was 97.6%. A significantly shorter 5-year DFS was reported for high-risk patients (G3, non-squamous histotype, diameter ≥5 cm) compared with low-risk (74.7% vs. 100%; log-rank test, p=0.024). Data about fertility outcomes were available for 12 patients. Five patients out of 12 (41.7%) attempted to conceive with an estimated pregnancy rate of 80%, a live birth rate of 83.3% and a premature delivery rate of 20%. Conclusion Women with high tumor grade, aggressive histology and tumor size ≥5 cm have a higher risk of recurrence. Oncologic outcomes are encouraging among low-risk patients; however, the lack of high-quality studies makes it difficult to draw any firm conclusions. Prospective multicentric clinical trials with a proper selection of inclusion/exclusion criteria should be conducted in women with low-risk factors, strong desire to preserve their fertility and high likelihood to conceive.
Machine Learning of Bacterial Transcriptomes Reveals Responses Underlying Differential Antibiotic Susceptibility

Antibiotic resistance is an imminent threat to global health. Patient treatment regimens are often selected based on results from standardized antibiotic susceptibility testing (AST) in the clinical microbiology lab, but these in vitro tests frequently misclassify drug effectiveness due to their poor resemblance to actual host conditions. ABSTRACT In vitro antibiotic susceptibility testing often fails to accurately predict in vivo drug efficacies, in part due to differences in the molecular composition between standardized bacteriologic media and physiological environments within the body. Here, we investigate the interrelationship between antibiotic susceptibility and medium composition in Escherichia coli K-12 MG1655 as contextualized through machine learning of transcriptomics data. Application of independent component analysis, a signal separation algorithm, shows that complex phenotypic changes induced by environmental conditions or antibiotic treatment are directly traced to the action of a few key transcriptional regulators, including RpoS, Fur, and Fnr. Integrating machine learning results with biochemical knowledge of transcription factor activation reveals medium-dependent shifts in respiration and iron availability that drive differential antibiotic susceptibility. By extension, the data generation and data analytics workflow used here can interrogate the regulatory state of a pathogen under any measured condition and can be applied to any strain or organism for which sufficient transcriptomics data are available. IMPORTANCE Antibiotic resistance is an imminent threat to global health. Patient treatment regimens are often selected based on results from standardized antibiotic susceptibility testing (AST) in the clinical microbiology lab, but these in vitro tests frequently misclassify drug effectiveness due to their poor resemblance to actual host conditions. Prior attempts to understand the combined effects of drugs and media on antibiotic efficacy have focused on physiological measurements but have not linked treatment outcomes to transcriptional responses on a systems level. Here, application of machine learning to transcriptomics data identified medium-dependent responses in key regulators of bacterial iron uptake and respiratory activity. The analytical workflow presented here is scalable to additional organisms and conditions and could be used to improve clinical AST by identifying the key regulatory factors dictating antibiotic susceptibility.
Clinical Profiles of Childhood Astrovirus-, Sapovirus-, and Norovirus-Associated Acute Gastroenteritis in Pediatric Emergency Departments in Alberta, 2014-2018.

BACKGROUND Infections by previously under-diagnosed viruses astrovirus and sapovirus are poorly characterized compared to norovirus, the most common cause of acute gastroenteritis. METHODS Children <18-years-old with acute gastroenteritis were recruited from pediatric emergency departments in Alberta, Canada, 2014-2018. We described and compared the clinical course of acute gastroenteritis in children with astrovirus, sapovirus, and norovirus. RESULTS Astrovirus was detected in 56/2,688 children (2.1%), sapovirus in 146/2,688 (5.4%), and norovirus in 486/2,688 (18.1%). At illness onset, ~60% of astrovirus cases experienced each of diarrhea and vomiting. Among sapovirus and norovirus cases, 35% experienced diarrhea at onset and 80%/91% (sapovirus/norovirus) vomited; however, diarrhea became more prevalent than vomiting around day 4 of illness. Over the full course of illness, diarrhea was 18% (95% CI 8%, 29%) more prevalent among children with astrovirus than norovirus infections, as well as longer with greater maximal events; there were median 4.0 fewer maximal vomiting events (95% CI 2.0, 5.0). Vomiting continued median 24.8 hours longer (95% CI 9.6, 31.7) among children with sapovirus vs. norovirus. Differences between these viruses were otherwise minimal. CONCLUSION Sapovirus infections attended in the emergency department are more similar to norovirus than previously reported, while astrovirus infections have several distinguishable characteristics.
Tumor PD-L1 expression is associated with outcomes in stage III non-small cell lung cancer (NSCLC) patients treated with consolidation durvalumab

Background Durvalumab is an anti-PD-L1 immune checkpoint inhibitor approved for consolidation therapy for patients with stage III non-small cell lung cancer (NSCLC) after chemoradiation. The purpose of our study was to evaluate the association between the degree of tumor PD-L1 expression and outcomes of stage III NSCLC patients treated with durvalumab. Methods We conducted a retrospective analysis of all the patients who received durvalumab between July 2017 and July 2019 at our facilities and were diagnosed with or progressed to stage III NSCLC before durvalumab consolidation. Patients were divided into groups based on the degree of PD-L1 expression: <1%, 1–49%, and 50–100%. Overall survival and progression-free survival were estimated by the Kaplan-Meier method and the Multivariate Cox proportional hazard model was used to assess the effect of PD-L1 expression level on OS and PFS, adjusting for age and gender. Results We identified 121 patients with stage III NSCLC that underwent durvalumab consolidation. Of them, 29.8% had PD-L1 expression of 50–100%, 24.8% had PD-L1 expression of 1–49%, and 27.3% had PD-L1 expression of <1%, while 18.2% were not tested for PD-L1 expression. The rate of cancer progression in the group with 50–100% PD-L1 expression was 16.7% compared to 60% in the 1–49% expression group and 54.6% in the <1% expression group, and the 1-year survival rates were higher in the 50–100% group (97%) compared to the 1–49% group and the <1% group (73% and 78%, respectively; P=0.028). Survival analysis via Kaplan-Meier revealed a significant difference in both PFS (P<0.0001) and OS (P<0.028) based on the extent of PD-L1 expression. Multivariate analysis revealed that a PD-L1 expression >50% was the only factor that was significantly associated with improved PFS (HR =0.205, P=0.0004) and OS (HR =0.339, P=0.04). Conclusions Our study demonstrated that patients whose tumors had >50% PD-L1 expression had significantly longer progression-free survival and overall survival than those with lower PD-L1 expression. This suggests that the degree of tumor PD-L1 expression may play a role in predicting benefit from durvalumab for these patients.
Atypical Facial Emotion Recognition in Children with Autism Spectrum Disorders: Exploratory Analysis on the Role of Task Demands

People with autism spectrum disorders (ASDs) have difficulty with socio-emotional functioning; however, research on facial emotion recognition (FER) remains inconclusive. Individuals with ASD might be using atypical compensatory mechanisms that are exhausted in more complex tasks. This study compared response accuracy and speed on a forced-choice FER task using neutral, happy, sad, disgust, anger, fear and surprise expressions under both timed and non-timed conditions in children with and without ASD (n = 18). The results showed that emotion recognition accuracy was comparable in the two groups in the non-timed condition. However, in the timed condition, children with ASD were less accurate in identifying anger and surprise compared to children without ASD. This suggests that people with ASD have atypical processing of anger and surprise that might become challenged under time pressure. Understanding these atypical processes, and the environmental factors that challenge them, could be beneficial in supporting socio-emotional functioning in people ASD.
Intimate partner violence (IPV) in male and female orthopaedic trauma patients: a multicentre, cross-sectional prevalence study

Objectives Identify the proportion of patients attending fracture clinics who had suffered intimate partner violence (IPV) within the past year. Design Powered cross-sectional study using validated participant self-reported questionnaires. Setting and participants Adult trauma patients (no gender/age exclusions) attending one of three Scottish adult fracture clinics over 16-month period (from October 2016 to January 2018). Primary outcome measure Number of participants answering ‘yes’ to the Woman Abuse Screening Tool question: ‘In your current relationship over the past twelve months, has your partner ever abused you physically/emotionally/sexually? ’ Results Of 336 respondents, 46% (156/336 known) were women with 65% aged over 40 (212/328 known). The overall prevalence of IPV within the preceding 12 months was 12% 39/336) for both male and female patients. The lifetime prevalence of IPV among respondents was 20% (68/336). 38% of patients who had experienced IPV within the past 12 months had been physically abused (11/29). None of the patients were being seen for an injury caused by abuse. Two-thirds of respondents thought that staff should ask routinely about IPV (55%, 217/336), but only 5% had previously been asked about abuse (18/336). Conclusions This is the first study worldwide investigating the prevalence of IPV in fracture clinics for both male and female patients. 12-month prevalence of IPV in fracture clinic patients is significant and not affected by gender in this study. Patients appear willing to disclose abuse within this setting and are supportive of staff asking about abuse. This presents an opportunity to identify those at risk within this vulnerable population.
Nesting Ecology and Colony Survival of Two Invasive Polistes Wasps (Hymenoptera: Vespidae) in New Zealand

Abstract We examined the abundance, nesting ecology, and colony survival of two invasive species of paper wasp, Polistes dominula Christ (Hymenoptera:Vespidae) and Polistes chinensis Pérez (Hymenoptera:Vespidae), within their invaded range in New Zealand. The more recent invader, P. dominula, exhibited a strong habitat preference, reaching the highest abundances within suburban areas with an average of 87.4 wasps per 1,000 m2. Coastal habitats were also found to be suitable environments for P. dominula, although wasp abundance in these areas was comparatively lower than suburban sites at 26.5 wasps per 1,000 m2. Although P. chinensis were observed to build more nests in coastal habitats, this was not reflected in the abundance of adult wasps in these areas. Nests of P. dominula were larger and more productive, likely a result of the multiple founding and earlier emergence of workers compared to P. chinensis. Both species exhibited significant differences in nest survival, with P. dominula observed to have a higher colony survival rate, particularly in suburban habitats where this species utilized man-made substrates as nesting sites. Neither species nested within forest sites and translocated nests of P. dominula failed to thrive within forest habitats. Findings of this research suggest that P. dominula will not pose a threat to species inhabiting forested areas. Instead, biodiversity managers should focus their efforts on suburban and coastal environments as native species in these areas will require the greatest protection.
How Americans communicate affection: findings from a representative national sample

ABSTRACT Humans are highly social beings who need intimate relationships to thrive and survive. Integral to human physical and emotional wellness is the need for affection. A substantial body of evidence has found that expressing and receiving affection with significant others is associated with a multitude of positive health outcomes. The primary goal of the current study was to create a generalizable typology of affectionate behaviors embedded within close relationships and experienced within the daily lives of U.S. American adults from across the country. The study identified 13 discrete forms of daily affectionate communication. Implications for such a typology of daily affection within the United States are discussed.
How Stories Shape Regional Development: Collective Narratives and High-Technology Entrepreneurship in Waterloo, Canada

abstract The Waterloo region in Canada has emerged as an unlikely competitor in high-technology markets, challenging theories based on path dependency, population density, anchor firms, and military spending. While theorists and residents attribute the rise of high-technology entrepreneurship to cooperation, evidence of collaboration is sparse. This article resolves this puzzle by explaining how ideas can coordinate action in loosely coupled systems. Dense, cross-cutting civic networks may not have supported task-specific cooperation, but they facilitated the construction and diffusion of collective narratives. Conventionally understood to leverage locational assets, the Waterloo case demonstrates how storytelling can also soften geographic constraints. Success stories inspired entrepreneurs by reconceptualizing what was possible, peer-to-peer mentoring helped firms to navigate local constraints, and external marketing enabled the region to access resources it could not mobilize internally. By documenting the importance of storytelling as a form of collective action, the Waterloo case illuminates a broader array of strategies available to local change agents and smaller regions.
Body-powered variable impedance: An approach to augmenting humans with a passive device by reshaping lifting posture

By adding impedance to human joints via a soft and passive exosuit, we changed human motor patterns in intended ways. The movement patterns appropriate for exercise and manual labor do not always correspond to what people instinctively choose for better comfort. Without expert guidance, people can even increase the risk of injury by choosing a comfortable posture rather than the appropriate one, notably when lifting objects. Even in situations where squatting is accepted as a desirable lifting strategy, people tend to choose the more comfortable strategy of stooping or semisquatting. The common approach to correcting lifting posture, immobilizing vulnerable joints via fixation, is insufficient for preventing back injuries sustained from repetitive lifting. Instead, when lifting small but heavy objects, the entire kinetic chain should cooperate to achieve a series of squat-lifting patterns. Inspired by the observation that force fields affect the coordination of voluntary human motion, we devised a passive exosuit embedded with a body-powered variable-impedance mechanism. The exosuit adds impedance to the human joints according to how far the wearer’s movement is from the squat-lifting trajectories so that it hinders stooping but facilitates squatting. In an experiment that entailed lifting a small 10-kg box, 10 first-time users changed their voluntary lifting motion closer to squatting on average. Simulation results based on recorded kinematic and kinetic data showed that this postural change reduced the compression force, shear force, and moment on the lumbosacral joint. Our work demonstrates the potential of using an exosuit to help people move in a desirable manner without requiring a complicated, bulky mechanical system.
Letters to the Editor

All the Letters to the Editor in this issue are in the same PostScript or PDF file. Contents Going in circles David Wheeler and Niran Charoenkul Mahanakorn University of Technology, Bangkok 10530, Thailand (davidw@mut.ac.th ) `First Steps' Prize Bill Jarvis 6 Peggy's Mill Road, Edinburgh EH4 6JY
Direction-Specific Effects of Artificial Skin-Stretch on Stiffness Perception and Grip Force Control

When interacting with an object, we use kinesthetic and tactile information to create our perception of the object’s properties and to prevent its slippage using grip force control. We previously showed that applying artificial skin-stretch together with, and in the same direction as, kinesthetic force increases the perceived stiffness. Here, we investigated the effect of the direction of the artificial stretch on stiffness perception and grip force control. We presented participants with kinesthetic force together with negative or positive artificial stretch, in the opposite or the same direction of the natural stretch due to the kinesthetic force, respectively. Our results showed that artificial skin-stretch in both directions augmented the perceived stiffness; however, the augmentation caused by the negative stretch was consistently lower than that caused by the positive stretch. Additionally, we proposed a computational model that predicts the perceptual effects based on the preferred directions of the stimulated mechanoreceptors. When examining the grip force, we found that participants applied higher grip forces during the interactions with positive skin-stretch in comparison to the negative skin-stretch, which is consistent with the perceptual results. These results may be useful in tactile technologies for wearable haptic devices, teleoperation, and robot-assisted surgery.
Design of Polycentric Assistive Device for Knee Joint*

Movements of knee joints are relative motions between tibia and femur, which include rolling and sliding. Conventional wearable knee assistive device utilized a hinge joint and generates nonnegligible mismatched motions under deep flexions. To assist the knee motion including the deep flexion, we developed a polycentric assistive device for knee joints (PAD-KJ) by using two gears with the same module and different radii. These radii were designed so that the center of the smaller gear moves on the trajectory of the knee joint with small error. According to the results of parametric design, the minimum error was about 3 mm to the model trajectory of knee joint. We also proposed a torque generator for this joint. The combination of a lever arm and a linear spring with the pair of gears successfully generated the assistive torque for standing motions. According to an evaluation test, the maximum torque of the single unit was about 1.2 Nm and the assistive torque in real usage will be 4.8 Nm.
Design of a SIW Variable Phase Shifter for Beamforming Antenna Systems

The main objective of this article is to design a controllable broadband phase-shifter based on the Integrated Substrate Waveguide (SIW) technique using PIN diodes buried in the substrate to switch between ON and OFF states. The proposed geometry is designed and optimized by numerical EM simulator (HFSS). The proposed phase shifter is designed to operate across a large bandwidth ranging from 8 GHz to 12GHz. The simulation results show that a maximum differential phase of 136 deg was achieved with acceptable return loss and insertion loss.
Towards a seamless experimental protocol for human arm impedance estimation in an interactive dynamic task

The estimation of the human endpoint impedance interacting with a physical environment provides modelling insights both for the field of human movement science and for the design of innovative controllers for collaborative robotics based on physical human-robot interaction. Most of the existing human impedance estimation methods described in the literature rely on controlled environments closer to a laboratory than to an industrial setting. In this paper, a force perturbation method is proposed without any specific requirements on neither the force nor the position trajectories and without additional sensors placed on the human. The method is illustrated through an experimental study on a benchmark interaction task. The task was selected to be sufficiently variable for preventing the use of average trajectories and the perturbations used for the estimations are sufficiently low amplitude and short to not deteriorate the human performance in the task. The obtained impedance model parameters are in adequacy with the ones found in the literature, suggesting the validity of the proposed approach. The low constraints on the experimental settings make it applicable even out of the lab, for example, in human-robot collaboration in manufacturing environments, to adjust the robot behaviour to changes in the state of the operator (fatigue, stress) or to adjust to a variety of human operators with different interaction strategies.
Performance Study of Low Inertia Magnetorheological Actuators for Kinesthetic Haptic Devices*

A challenge to high quality virtual reality (VR) simulations is the development of high-fidelity haptic devices that can render a wide range of impedances at both low and high frequencies. To this end, a thorough analytical and experimental assessment of the performance of magnetorheological (MR) actuators is performed and compared to electric motor (EM) actuation. A 2 degrees-of-freedom dynamic model of a kinesthetic haptic device is used to conduct the analytical study comparing the rendering area, rendering bandwidth, gearing and scaling of both technologies. Simulation predictions are corroborated by experimental validation over a wide range of operating conditions. Results show that, for a same output force, MR actuators can render a bandwidth over 52.9% higher than electric motors due to their low inertia. Unlike electric motors, the performance of MR actuators for use in haptic devices are not limited by their output inertia but by their viscous damping, which must be carefully addressed at the design stage.