Miracle-dz/UniFAR-FTUs huggingface dataset:
Nonsquamous Malignancies of Vagina and Vulva: 23-Year Experience at a Tertiary Center in the United Kingdom

Under 10% of gynaecological cancers are diagnosed in the vulva and vagina, mostly squamous cell carcinomas. Melanoma, Paget disease, basal cell carcinomas, and other cancers can present with vulval/vaginal symptoms. The pathology information system of a tertiary referral center for vulvo-vaginal cancers was searched for cancers of the vulva and vagina from 1996 to 2019. Squamous carcinomas were excluded, and the remaining entities were catalogued. A total of 221 nonsquamous cancers were found, including 135 vaginal and 86 vulval cases. One hundred eight cases of metastatic carcinomas from the endometrium, cervix, ovary, bowel, bladder, kidney, and breast formed the largest category. Basal cell carcinomas constituted the second largest category. Others included melanomas, Paget disease, and adenoid cystic carcinomas. Primary adenocarcinomas included porocarcinoma, mammary type carcinoma, enteric type carcinoma, clear cell carcinoma, Bartholin gland adenocarcinoma and malignant transformation of hidradenoma papilliferum. The vulva and vagina can harbor a wide range of nonsquamous malignancies. The most challenging of these are adenocarcinomas which can be metastatic from other sites. The dominance of metastatic carcinomas in this series is likely to reflect consultation practice of specialist pathologists.
Clinician Perspectives on Providing Concussion Assessment and Management via Telehealth: A Mixed-Methods Study

Objective: To examine clinician perspectives regarding the use of telehealth for concussion assessment and management. Setting: A Pan-Canadian survey. Participants: Twenty-five purposively sampled multidisciplinary clinician-researchers with concussion expertise (female, n = 21; physician, n = 11; and other health professional, n = 14). Design: Sequential mixed-method design: (1) electronic survey and (2) semistructured interviews with focus groups via videoconference. Qualitative descriptive design. Main Outcome Measures: Survey: A 59-item questionnaire regarding the suitability of telehealth to perform recommended best practice components of concussion assessment and management. Focus groups: 10 open-ended questions explored survey results in more detail. Results: Clinicians strongly agreed that telehealth could be utilized to obtain a clinical history (96%), assess mental status (88%), and convey a diagnosis (83%) on initial assessment; to take a focused clinical history (80%); to monitor functional status (80%) on follow-up; and to manage symptoms using education on rest (92%), planning and pacing (92%), and sleep recommendations (91%); and to refer to a specialist (80%). Conversely, many clinicians believed telehealth was unsuitable to perform a complete neurologic examination (48%), cervical spine (38%) or vestibular assessment (61%), or to provide vestibular therapy (21%) or vision therapy (13%). Key benefits included convenience, provision of care, and patient-centered approach. General and concussion-specific challenges included technology, quality of care, patient and clinician characteristics, and logistics. Strategies to overcome identified challenges are presented. Conclusions: From the perspective of experienced clinicians, telehealth is suited to manage symptomatic concussion patients presenting without red flags or following an initial in-person assessment, but may have limitations in ruling out serious pathology or providing return-to-sport clearance without an in-person physical examination.
The importance of cache domains in α2δ proteins and the basis for their gabapentinoid selectivity

ABSTRACT In this hybrid review, we have first collected and reviewed available information on the structure and function of the enigmatic cache domains in α2δ proteins. These are organized into two double cache (dCache_1) domains, and they are present in all α2δ proteins. We have also included new data on the key function of these domains with respect to amino acid and gabapentinoid binding to the universal amino acid–binding pocket, which is present in α2δ-1 and α2δ-2. We have now identified the reason why α2δ-3 and α2δ-4 do not bind gabapentinoid drugs or amino acids with bulky side chains. In relation to this, we have determined that the bulky amino acids Tryptophan and Phenylalanine prevent gabapentin from inhibiting cell surface trafficking of α2δ-1. Together, these novel data shed further light on the importance of the cache domains in α2δ proteins.
Arthroscopic versus Open Distal Hemitrapeziectomy without Interposition: 2-Year Results of a Randomized Controlled Trial

Background: Distal hemitrapeziectomy is suggested as an alternative for total trapeziectomy for carpometacarpal thumb joint osteoarthritis, when the scaphotrapeziotrapezoidal joint is unaffected. This can be performed as an arthroscopic or open procedure, with suggested advantages for the less invasive arthroscopic technique. To determine which technique has better outcome on subjective and objective measures, the authors performed a prospective, randomized, controlled trial. Methods: The authors randomized 90 thumbs in the open (n = 45) and arthroscopic (n = 45) groups and evaluated results preoperatively and at 3-, 12- and 24-month follow-up. The primary outcome was the Patient-Rated Wrist and Hand Evaluation (PRWHE) to assess pain and function. Also, the authors evaluated pinch, grip, and range of motion, together with return to work, satisfaction, and complications. Results: Full follow-up was obtained in 62 thumbs (open group, n = 32; arthroscopic group, n = 30). For both groups, the PRWHE improved from preoperatively to 12- and 24-month follow-up. Also, grip power, key pinch, and tip pinch improved at final follow-up for both groups. Between groups, there were no clinically important differences between PRWHE, power of grip or pinch, and range of motion. Operation time was shorter for the open group; also, return to work was slightly shorter after open surgery. Satisfaction was comparable between groups. Conclusions: This study shows good functional improvement and pain reduction obtained with a hemitrapeziectomy. No arthroscopic benefits could be substantiated in the results. Because of shorter operation time for the open procedure, and because of equal outcomes compared to the arthroscopic technique, we prefer open hemitrapeziectomy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.
Energy and Numerical Weather Prediction

Since the study of energy transformations and the numerical integration of simplifiied equations are sometimes used as alternative approaches to the same physical problem, it is often desirable that the simplified equations conserve total energy under reversible adiabatic processes. Preferably, the equations should also conserve the sum of kinetic energy and available potential energy, and they should describe the tendency for static stability to increase as kinetic energy is released. It is found that if the equation of balance is used as a filtering approximation, all the terms in the vorticity equation which involve both the rotational and the divergent part of the wind field should be retained, while, if the geostrophic equation is used, all of these terms in the vorticity equation should be omitted, if the equations are to possess suitable energy invariants. An n-layer model with the appropriate energy invariants is developed. The two-layer model may be the simplest possible model with variable static stability. The model appears to be suitable for theoretical studies of the general circulation. DOI: 10.1111/j.2153-3490.1960. tb01323.x
High Precision Photometry from EulerCam and TRAPPIST: The Case of WASP-42, WASP-49 and WASP-50

Abstract Transiting extrasolar planets provide unmatched insights into the structure and composition of close-in planets. When a planet transits its host star, its radius is known, which together with radial velocity measurements, allows accessing the planetary density. We present results obtained using the Euler and TRAPPIST telescopes that aim at reaching very high accuracy on the parameters derived from transit lightcurves. Here, we show the case of the recently discovered WASP-42b and WASP-49b and new observations of WASP-50b.
Derivation and Validation of Clinical Phenotypes of the Cardiopulmonary Bypass–Induced Inflammatory Response

BACKGROUND: Precision medicine aims to change treatment from a “one-size-fits-all” approach to customized therapies based on the individual patient. Applying a precision medicine approach to a heterogeneous condition, such as the cardiopulmonary bypass (CPB)–induced inflammatory response, first requires identification of homogeneous subgroups that correlate with biological markers and postoperative outcomes. As a first step, we derived clinical phenotypes of the CPB-induced inflammatory response by identifying patterns in perioperative clinical variables using machine learning and simulation tools. We then evaluated whether these phenotypes were associated with biological response variables and clinical outcomes. METHODS: This single-center, retrospective cohort study used Cleveland Clinic registry data from patients undergoing cardiac surgery with CPB from January 2010 to March 2020. Biomarker data from a subgroup of patients enrolled in a clinical trial were also included. Patients undergoing emergent surgery, off-pump surgery, transplantation, descending thoracoabdominal aortic surgery, and planned ventricular assist device placement were excluded. Preoperative and intraoperative variables of patient baseline characteristics (demographics, comorbidities, and laboratory data) and perioperative data (procedural data, CPB duration, and hemodynamics) were analyzed to derive clinical phenotypes using K-means–based consensus clustering analysis. Proportion of ambiguously clustered was used to assess cluster size and optimal cluster numbers. After clusters were formed, we summarized perioperative profiles, inflammatory biomarkers (eg, interleukin [IL]-6 and IL-8), kidney biomarkers (eg, urine neutrophil gelatinase–associated lipocalin [NGAL] and IL-18), and clinical outcomes (eg, mortality and hospital length of stay). Pairwise standardized difference was reported for all summarized variables. RESULTS: Of 36,865 eligible cardiac surgery cases, 25,613 met inclusion criteria. Cluster analysis derived 3 clinical phenotypes: α, β, and γ. Phenotype α (n = 6157 [24%]) included older patients with more comorbidities, including heart and kidney failure. Phenotype β (n = 10,572 [41%]) patients were younger and mostly male. Phenotype γ (n = 8884 [35%]) patients were 58% female and had lower body mass index (BMI). Phenotype α patients had worse outcomes, including longer hospital length of stay (mean = 9 days for α versus 6 for both β [absolute standardized difference {ASD} = 1.15] and γ [ASD = 1.08]), more kidney failure, and higher mortality. Inflammatory biomarkers (IL-6 and IL-8) and kidney injury biomarkers (urine NGAL and IL-18) were higher with the α phenotype compared to β and γ immediately after surgery. CONCLUSIONS: Deriving clinical phenotypes that correlate with response biomarkers and outcomes represents an initial step toward a precision medicine approach for the management of CPB-induced inflammatory response and lays the groundwork for future investigation, including an evaluation of the heterogeneity of treatment effect.
A Character Formula for Generalized Kac-Moody Superalgebras

Abstract In [1], Borcherds defined generalized Kac-Moody (denoted by GKM for short) algebras and gave a character formula for lowest weight modules of these algebras. In this paper we give a character formula for lowest weight modules of GKM superalgebras. For any standard result about contragredient superalgebras that have an immediate generalization to GKM superalgebras see [3] and [4]. All vector spaces are assumed to be over the real field.
From Relational Uncertainty to Interpersonal Sensitivity: A Substantive Grounded Theory for Nursing Education

Abstract AIM The aim of our study was to understand how nursing students develop interpersonal competencies during a faculty-supervised practicum. BACKGROUND Researchers have studied the interpersonal competencies of nursing students in a fragmented way. METHOD A constructivist grounded theory approach was used for the study. RESULTS Four categories emerged from the data: Coping With Practicum-Related Challenges and Insecurities, Learning to Identify the Interpersonal Dimension of Nursing Care, Pedagogical Influence: Promoting (De)constructive Processes for Learning and Care, and Transforming the Self as a Nurse Through Interpersonal Relationships. A core category, From Relational Uncertainty to Interpersonal Sensitivity: A Transition of the Nursing Self Within Reflective Environments of Practice, also emerged. CONCLUSION The interpersonal competencies of nursing students develop in reflective environments within practicums because of interactions with patients and under the influence and modeling of the educator. Acknowledging the importance of interactions with the educator and patients within practicums can contribute to promoting more thoughtful follow-up processes from educators.
Assessing the Mental Health Impact of the COVID-19 Pandemic on US Fire-Based Emergency Medical Services Responders

When organizational attributes like management commitment and communication are favorable, they are known to positively influence safety behaviors, morale, and well-being. Fire departments should focus on improving overall safety culture as a way to address the mental health burden of fire and rescue service work. Objective This study aimed to examine the COVID-19 pandemic's impact on fire service safety culture, behavior and morale, levers of well-being, and well-being outcomes. Methods Two samples (Stress and Violence against fire-based EMS Responders [SAVER], consisting of 3 metropolitan departments, and Fire service Organizational Culture of Safety [FOCUS], a geographically stratified random sample of 17 departments) were assessed monthly from May to October 2020. Fire department–specific and pooled scores were calculated. Linear regression was used to model trends. Results We observed concerningly low and decreasing scores on management commitment to safety, leadership communication, supervisor sensegiving, and decision-making. We observed increasing and concerning scores for burnout, intent to leave the profession, and percentage at high risk for anxiety and depression. Conclusions Our findings suggest that organizational attributes remained generally stable but low during the pandemic and impacted well-being outcomes, job satisfaction, and engagement. Improving safety culture can address the mental health burden of this work.
Identification and characterization of MDR virulent Salmonella spp isolated from smallholder poultry production environment in Edo and Delta States, Nigeria

Salmonella is responsible for some foodborne disease cases worldwide. It is mainly transmitted to humans through foods of animal origin through the consumption of poultry products. The increased international trade and the ease of transboundary movement could propel outbreaks of local origin to translate into severe global threats. The present study aimed to characterize Salmonella serovars isolated from poultry farms in Edo and Delta States, Nigeria. A total of 150 samples (faecal, water and feed) were collected from ten poultry farms between January and August 2020 and analyzed for Salmonella characterization using standard bacteriological and molecular methods. Salmonella serovars identified include: Salmonella Enteritidis [n = 17 (39.5%)], Salmonella Typhimurium [n = 13 (30.2%)] and other Salmonella serovars [n = 13 (30.2%)]. All Salmonella serovars were cefotaxime and ampicillin resistant. The presence of the invA gene ranged from 9(69.2%) to 15(88.2%). The spvC gene ranged from 2(14.4%) to 10(58.8%). All Salmonella serovars had sdiA gene. The Salmonella isolates produced some extracellular virulence factors (such as protease, lipase, β-hemolytic activity, and gelatinase), while 13(30.2%) of the overall isolates formed strong biofilms. In conclusion, the detection of multiple antibiotic-resistant Salmonella serovars in faecal sources, which also exhibited virulence determinants, constituted a public health risk as these faecal samples have the potential as manure in the growing of crops. These pathogens can be transmitted to humans nearby and through poultry products, resulting in difficult-to-treat infections and economic loss.
What drives horizontal logistics collaboration? A grounded theory analysis of Chinese logistics service providers

Horizontal logistics collaboration is characterized by the highly professional cooperation of logistics service providers at the same level of the supply chain, which is an effective way to optimize the development and sustainability of modern logistics. Conducting a coding analysis of data from 41 in-depth interviews, this study constructs a theoretical framework of the driving force of horizontal logistics collaboration among Chinese logistics service providers to synchronously improve service, market, efficiency, and emergency competitiveness through cooperation with peer competitors to enhance sustainable comprehensive competitiveness. The four driving forces encourage logistics service providers to adjust their thoughts in the planning stage, change their behavior in the implementation stage, and transform their strategy in the evaluation stage. The results also indicate differences between China and other countries in the driving force, effective utilization of logistics workers, cross-institutional collaboration of state-owned enterprises, and integration of artificial intelligence technology. Finally, we propose relevant recommendations for managers.
A New Hessian Preconditioning Method Applied to Variational Data Assimilation Experiments Using NASA General Circulation Models

Abstract An analysis is provided to show that Courtier's et al. method for estimating the Hessian preconditioning is not applicable to important categories of cases involving nonlinearity. An extension of the method to cases with higher nonlinearity is proposed in the present paper by designing an algorithm that reduces errors in Hessian estimation induced by lack of validity of the tangent linear approximation. The new preconditioning method was numerically tested in the framework of variational data assimilation experiments using both the National Aeronautics and Space Administration (NASA) semi-Lagrangian semi-implicit global shallow-water equations model and the adiabatic version of the NASA/Data Assimilation Office (DAO) Goddard Earth Observing System Version 1 (GEOS-1) general circulation model. The authors' results show that the new preconditioning method speeds up convergence rate of minimization when applied to variational data assimilation cases characterized by strong nonlinearity. Finally, the.
Multicolor Photometry and Stellar Population Synthesis Study of the Interacting Galaxies of the Leo Triplet

This paper studies the nearby interacting group the Leo Triplet using multicolor photometry data obtained with the National Astronomical Observatories of China 60 cm/90 cm Schmidt telescope. The observation covers the entire area of the three galaxies (NGC 3623, NGC 3627, and NGC 3628), and spectral energy distributions (SEDs) of each galaxy are obtained. By comparing the observed SEDs of each part of the galaxies with the theoretical ones generated by instantaneous burst evolutionary synthesis models with different metallicities (Z = 0.0001, 0.008, 0.02, and 0.05), two-dimensional relative age distribution maps of the three galaxies were obtained. NGC 3623 exhibits a very weak age gradient from the bulge to the disk. This gradient is absent in NGC 3627. The ages of the dominant stellar populations of NGC 3627 and NGC 3628 are consistent, and this consistency is model independent (0.5-0.6 Gyr, Z = 0.02), but the ages of NGC 3623 are systematically older (0.7-0.9 Gyr, Z = 0.02). The results indicate that NGC 3627 and NGC 3628 have undergone synchronous evolution and that the interaction has likely triggered starbursts in both galaxies. For NGC 3623, however, the weak age gradient may indicate recent star formation in its bulge, which has caused its color to turn blue. Evidence is found for a potential bar existing in the bulge of NGC 3623, and my results support the view that NGC 3623 does interact with NGC 3627 and NGC 3628.
Transethosomes: A Promising Challenge for Topical Delivery Short Title: Transethosomes for Topical Delivery

Abstract Skin provides an excellent barrier to molecular transport, as the stratum corneum is the most formidable barrier to the passage of most pharmaceuticals. Various attempts have been made to improve drug administration into the body through intact skin. Though very few routes are as attractive as the topical route, drug transport through the skin is challenging. To overcome the challenges, researchers have found a system in which the drug is encapsulated into the vesicle, penetrating deeper into the skin to hit the target site. Vesicular systems like transethosome, an ultra- deformable vesicle (UDV), tend to accumulate in the skin layers. Since transethosomes have small particle size and can easily alter the shape of vesicles compared to other vesicular systems, they can penetrate through the layers of skin. Hence, the drug encapsulated into transethosomes can easily reach the target site. Transethosomes consist of ethanol and phospholipids along with an edge activator. Ethanol and edge activator help to enhance the skin permeation of transethosomes. Various methods of preparation of transethosomes, comparison of transethosomes with other lipid vesicles, characterization of transethosomes, and application of transethosomes have been covered in this review. Transethosomes can deliver a different variety of drugs, such as anticancer, corticosteroids, proteins and peptides, analgesics
Multiple symmetry protected BIC lines in two dimensional synthetic parameter space

Abstract Bound states in the continuum (BICs) have attracted significant interest in recent years due to their unique optical properties, such as infinite quality factor and wave localization. In order to improve the optical performance of BICs based devices, more degrees of freedom are required to tune BICs in high-dimension parameter space for practical applications. To effectively tune more BICs, we form a 2D synthetic parameter space based on a nanohole metasurface array. Multiple symmetry protected BIC modes with high Q factors can be achieved at high-order symmetry point. Through manipulating asymmetry parameters, BIC lines formed by a series of BIC modes can be found in the 2D synthetic parameter space. Moreover, the electric field distributions are investigated to demonstrate the generation and evolution of BICs. By measuring the absorption spectra, the tuning of multiple BICs with synthetic asymmetry parameters is experimentally explored, which agrees well with theoretical results. Therefore, our design can provide new insight for a variety of on-chip applications, such as nonlinear devices, integrated nanolasing array, and high-resolution sensors for infrared molecular detection.