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Susceptibility to temporary hearing threshold shifts (TTS) in harbor porpoises (Phocoena phocoena) depends in part on the frequency of the fatiguing sound (the sound causing the shift). The TTS induced and the pattern of recovery were documented in a female porpoise after exposure for one hour to a continuous one-sixth-octave noise band centered at 8 kHz. This fatiguing sound was emitted at average received sound pressure levels (SPLs) between 126 and 144 dB re 1 µPa, resulting in average sound exposure levels (SELs) of 162 to 180 dB re 1 µPa2s. Hearing thresholds for narrow-band sweeps centered at 8, 11.3, and 16 kHz were determined before and after exposure. Control sessions were used to determine which SELs resulted in statistically significant TTS in the first four minutes after the fatiguing sound stopped (TTS1-4). At 8 kHz, the lowest SEL that resulted in significant TTS (4.4 dB) was 174 dB re 1 µPa2s; at 11.3 kHz, the lowest SEL 1-4 that resulted in significant TTS1-4 (4.9 dB) was 168 dB re 1 µPa2s; and at 16 kHz, the lowest SEL that resulted in significant TTS1-4 (1.3 dB) was 174 dB re 1 µPa2s. The hearing frequency that was most affected was 11.3 kHz, half an octave above the fatiguing sound's center frequency. The equal-energy hypothesis was tested by exposing the porpoise to the same noise band with SPLs of 137 to 153 dB re 1 µPa and exposure durations between two and 80 minutes; all seven combinations resulted in the same fatiguing SEL of 174 dB re 1 µPa2s; and for these combinations, the equal-energy hypothesis was upheld. The results add to the body of data on TTS-onset SELs that were used to generate a revised auditory weighting function and, thus, enhance regulatory protection of wild harbor porpoises that are exposed to anthropogenic noise at sea. [ABSTRACT FROM AUTHOR]

(1) Background: Due to similar clinical presentation and a lack of specific biomarkers, initial differentiation between Takotsubo syndrome (TTS) and non-ST-segment elevation myocardial infarction (NSTEMI) remains challenging in daily practice. Heat Shock Protein 70 (HSP70) is a novel biomarker that is recognized for its potential in the diagnosis and differentiation of cardiovascular conditions. (2) Methods: Data from a total of 156 patients were analyzed (32.1% NSTEMI, 32.7% TTS, and 35.3% controls). Serum concentrations of HSP70 were determined using ELISA and compared between patients and controls. ROC curve analysis, logistic regression analysis and propensity-score-weighted logistic regression were conducted. (3) Results: Concentrations of HSP70 were highest in patients with TTS (median 1727 pg/mL vs. ACS: median 1545 pg/mL vs. controls: median 583 pg/mL, p < 0.0001). HSP70 was predictive for TTS in binary logistic regression analysis (B(SE) = 0.634(0.22), p = 0.004), which even remained significant after correction for possible confounders in propensity-score-weighted analysis. ROC curve analysis also revealed a significant association of HSP70 with TTS (AUC: 0.633, p = 0.008). (4) Conclusions: Based on our findings, HSP70 constitutes a promising biomarker for discrimination between TTS and NSTEMI, especially in combination with established cardiovascular biomarkers like pBNP or high-sensitivity cardiac troponin. [ABSTRACT FROM AUTHOR]

This article examines the use of cardiac biomarkers to diagnose Takotsubo syndrome (TTS), a condition characterized by abnormal left ventricular wall motion. The study validates previously proposed ratios of cardiac biomarkers in distinguishing TTS from acute coronary syndrome (ACS) using data from the International Takotsubo (InterTAK) Registry. The results indicate that these ratios have moderate success in accurately diagnosing TTS, with values ranging from 0.5 to 0.8 on the receiver-operating characteristic (ROC) curve. The study emphasizes the need for new biomarkers to improve TTS diagnosis. The article also includes financial disclosures from the authors, ensuring transparency and avoiding conflicts of interest. The authors state that they have no funding for the current contribution and have obtained ethical approval for the study, providing the pre-registered clinical trial number. [Extracted from the article]

Three-dimensional (3D) printing has paved the way in pharmaceutical applications. This innovative methodology presents novel and inventive remedies for patients and the pharmaceutical sector. Moreover, the benefits of this approach encompass the mitigation of adverse effects, customization of formulations for patients with rare medical conditions, and enhancement of therapeutic effectiveness. The objective of our review was to offer a comprehensive survey of the advancements observed in the drug delivery systems that were produced. A thorough inspection has assessed the diverse dosage forms developed using the three-dimensional printing technique (3DP), especially in the last five years. The pharmaceutical industry places significant emphasis on the benefits of developing dosage forms with intricate designs and geometries, incorporating multiple active ingredients, and tailored release profiles due to their versatility and related advantages. Drug delivery systems can be classified into different modalities, tablets, capsules, suppositories, transdermal delivery systems, microneedles, vaginal delivery systems, and nanoscale dosage forms. The utilization of our classification system facilitates researchers' task of evaluating publications and effectively pinpointing further opportunities for research exploration. [ABSTRACT FROM AUTHOR]

Neurodegenerative diseases (NDs), including Parkinson's and Alzheimer's disease, pose a significant challenge to global health, and early detection tools are crucial for effective intervention. The adaptation of online screening forms and machine learning methods can lead to better and wider diagnosis, potentially altering the progression of NDs. Therefore, this study examines the diagnostic efficiency of machine learning models using Montreal Cognitive Assessment test results (MoCA) to classify scores of people with Parkinson's disease (PD) and healthy subjects. For data analysis, we implemented both rule-based modeling using rough set theory (RST) and classic machine learning (ML) techniques such as logistic regression, support vector machines, and random forests. Importantly, the diagnostic accuracy of the best performing model (RST) increased from 80.0% to 93.4% and diagnostic specificity increased from 57.2% to 93.4% when the MoCA score was combined with temporal metrics such as IRT—instrumental reaction time and TTS—submission time. This highlights that online platforms are able to detect subtle signs of bradykinesia (a hallmark symptom of Parkinson's disease) and use this as a biomarker to provide more precise and specific diagnosis. Despite the constrained number of participants (15 Parkinson's disease patients and 16 healthy controls), the results suggest that incorporating time-based metrics into cognitive screening algorithms may significantly improve their diagnostic capabilities. Therefore, these findings recommend the inclusion of temporal dynamics in MoCA assessments, which may potentially improve the early detection of NDs. [ABSTRACT FROM AUTHOR]

Video 1Use of a novel Dual Action Tissue through-the-scope clip for endoscopic closure.

This is a revision of the online November 2021 Brighton thrombosis with thrombocytopenia syndrome (TTS) case definition and a new Brighton Collaboration case definition for vaccine-induced immune thrombocytopenia and thrombosis (VITT). These case definitions are intended for use in clinical trials and post-licensure pharmacovigilance activities to facilitate safety data comparability across multiple settings. They are not intended to guide clinical management. The case definitions were developed by a group of subject matter and Brighton Collaboration process experts as part of the Coalition for Epidemic Preparedness Innovations (CEPI)-funded Safety Platform for Evaluation of vACcines (SPEAC). The case definitions, each with defined levels of diagnostic certainty, are based on relevant published evidence and expert consensus and are accompanied by specific guidelines for TTS and VITT data collection and analysis. The document underwent peer review by a reference group of vaccine safety stakeholders and haematology experts to ensure case definition useability, applicability and scientific integrity. [ABSTRACT FROM AUTHOR]

To determine their frequency-dependent susceptibility to noise-induced temporary hearing threshold shift (TTS), two California sea lions (Zalophus californianus) were exposed for 60 min to a continuous one-sixth-octave noise band (NB) centered at 32 kHz as the fatiguing sound, at sound pressure levels of 132 to 156 dB re 1 µPa (sound exposure levels [SELs] of 168 to 192 dB re 1 µPa2s). Using a psychoacoustic technique, TTSs were quantified at the center frequency of the fatiguing sound and at half an octave and one octave above the center frequency (at 32, 44.8, and 63 kHz). When significant TTS occurred, higher SELs resulted in greater TTSs. TTSs and hearing recovery patterns were similar in both sea lions. The mean onset of TTS1-4 min (defined as 6 dB TTS) in sea lion F01 is estimated to occur after exposure to an SEL of 179 dB re 1 µPa²s (at hearing test frequency 44.8 kHz). After exposure to an SEL of 180 dB re 1 µPa2s, a mean TTS1-4 min of 6.7 dB was measured at hearing test frequency 44.8 kHz. In California sea lions, TTS onset levels are not as closely related (especially at the lower and higher frequencies) to the unmasked hearing thresholds (audiograms) as was previously assumed. [ABSTRACT FROM AUTHOR]

In the contemporary era, image captioning has emerged as an indispensable tool. Furthermore, there are integrated applications designed to produce and descriptions for images, and these operations are reliant on DNN models. The procedure for creating a narrative for an image is referred to as image description. This process entails the identification of key objects and the relationships that exist among these objects within an image. The ultimate goal is to generate sentences that are both syntactically and semantically accurate and convert those audio into speech. In the following discourse, we introduce a learning model designed to expound upon object and craft description by leveraging the synergy of computer vision and machine translation. The objective of this paper is to identify various objects within an image, discern the connections and interactions among these objects, and subsequently formulate descriptive captions and those description into audio form. The dataset employed in this study is Flickr8k, and the primary programming language utilized is Python3. We will implement a machine learning technique known as Transfer Learning, utilizing the model to showcase the experiment. Additionally, this paper will delve into the functions and architecture of the various networks that are integral to the process. The generation of image captions represents a crucial component within the realms of Vision and NLP. Image description generators hold significant potential applications in the field of Image Segmentation, as exemplified by their use in platforms like Facebook and Google Photos. Furthermore, these tools can be extended to analyze video frames, offering substantial automation in interpreting visual content. Notably, their utility extends to aiding visually impaired individuals, representing a significant contribution to accessibility and inclusion. [ABSTRACT FROM AUTHOR]

Transport Trade Services (TTS) Group is the leading company that offers integrated logistics services on the Danube in Romania. The paper provides a pertinent image of the company, outlining several financial analysis indicators for the 2018-2022 period. The Discounted Cash Flow model and sensitivity analysis are two methods used to assess the intrinsic value of the company's stock price, the valuation resulting in a target price of 35.7 RON and a current price of 26.85 RON. With its listing on the Bucharest Stock Exchange, the company has experienced rapid growth and a sound financial health. TTS exhibits positive long-term prospects, consolidated through its increasing profitability and sustainable practices and projects. [ABSTRACT FROM AUTHOR]

Chloroplast and mitochondrial DNA (cpDNA and mtDNA) are apart from nuclear DNA (nuDNA) in a eukaryotic cell. The transcription system of chloroplasts differs from those of mitochondria and eukaryotes. In contrast to nuDNA and animal mtDNA, the transcription of cpDNA is still not well understood, primarily due to the unresolved identification of transcription initiation sites (TISs) and transcription termination sites (TTSs) on the genome scale. In the present study, we characterized the transcription of chloroplast (cp) genes with greater accuracy and comprehensive information using PacBio full-length transcriptome data from Arabidopsis thaliana. The major findings included the discovery of four types of artifacts, the validation and correction of cp gene annotations, the exact identification of TISs that start with G, and the discovery of polyA-like sites as TTSs. Notably, we proposed a new model to explain cp transcription initiation and termination at the whole-genome level. Four types of artifacts, degraded RNAs and splicing intermediates deserve the attention from researchers working with PacBio full-length transcriptome data, as these contaminant sequences can lead to incorrect downstream analysis. Cp transcription initiates at multiple promoters and terminates at polyA-like sites. Our study provides new insights into cp transcription and new clues to study the evolution of promoters, TISs, TTSs and polyA tails of eukaryotic genes.

TSS (Total Suspended Solid) is an optical turbidity parameter to assess water quality and provide essential information for the water environment. Particularly, the degradation of watersheds creates immense pressure on water quality, especially in arid and semiarid regions. However, concentrations of TTS in water are also due to the effects of pollution, and activities on the surface. Therefore, factual information regarding determining the effective depth of TSS is essential for the estimation of the water column. To address this problem, we collected 100 water samples from 10 different sites of the wells at Medokan Ayu District, Surabaya (Indonesia). To investigate the TSS concentrations. The results showed that the quality of well water for the turbidity parameter did not exceed the standard of clean water quality, where the highest value was found in well 7: 17.97 NTU, for the Manganese parameter in wells that exceeded the quality standard, it was found in Well 2: 1.4 mg/L. , well 5: 1.7 mg/L, well 6: 1.8 mg/L, well 7 : 8.6 mg/L and well 9: 4.3 mg/L. Well TSS parameters that exceed quality standards are found at Well 1: 1,200 mg/L, Well 3: 1,200 mg/L, Well 5: 800 mg/L, Well 6: 1,600 mg/L, Well 7: 1,600 mg/L, Well 8 : 1,200 mg/L, Well 9 : 1,200 mg/L, and Well 10 : 1,200 mg/L. The pattern of distribution of pollution levels using surfer software mapping, three wells have the highest concentrations of Manganese, TSS, and Turbidity found in wells number 6, 7, and 9

Pemanfaatan teknologi informasi dan komunikasi dalam pembelajaran semakin luas, salah satunya dimanfaatkan guru untuk pembuatan media pembelajaran. Berdasar hasil supervisi akademik Kepala sekolah diketahui bahwa kompetensi guru dalam pembuatan media pembelajaran berbasis teknologi informasi masih rendah. Penelitian bertujuan untuk mengetahui apakah melalui workshop dapat meningkatkan kompetensi guru dalam pembuatan media Crossword Puzzle dan Canva serta untuk mengetahui bagaimana langkah pelaksanaan workshop untuk meningkatkan kompetensi guru dalam pembuatan media Crossword Puzzle dan Canva. Jenis penelitian yang digunakan adalah penelitian tindakan sekolah. Subyek penelitian ini adalah para guru SMA Negeri 1 Tempel yang berjumlah 24 orang. Obyek penelitian adalah kompetensi guru dalam pembuatan media Crossword Puzzle dan Canva. Penelitian dilaksanakan dalam 2 siklus yang tiap siklus terdiri atas 2 pertemuan. Tiap pertemuan meliputi 4 tindakan yaitu perencanaan, pelaksanaan, observasi, dan refleksi. Pengumpulan data melalui observasi, tes pemahaman materi, dan penilaian produk workshop. Simpulan hasil workshop telah terjadi peningkatan kompetensi guru dalam pembuatan media pembelajaran sebanyak 79,17% pada siklus I dan 83,33% pada siklus II.

Shayan Hobbi,1,2 Patrick Saunders-Hastings,3 Cindy Ke Zhou,4 Jeffrey Beers,1 Ananth Srikrishnan,1 Aaron Hettinger,5,6 Aarthi Shenoy,5 Timothy Burrell,1 Keran Moll,1 Patricia C Lloyd,4 Steven A Anderson,4 Azadeh Shoaibi,4 Hui-Lee Wong4 1IBM Consulting, Bethesda, MD, USA; 2Accenture Federal Services, Arlington, VA, USA; 3Accenture, Ottawa, Ontario, Canada; 4Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA; 5MedStar Health Research Institute, Washington, DC, USA; 6School of Medicine, Georgetown University, Washington, DC, USACorrespondence: Patrick Saunders-Hastings, Accenture, 45 O’Connor Street, Suite 1100, Ottawa, Ontario, K1P 1A4, Canada, Tel +1 343 998 3459, Email p.saunders.hastings@accenture.comIntroduction: Thrombosis with thrombocytopenia syndrome (TTS) has been reported following receipt of adenoviral vector-based COVID-19 vaccines. However, no validation studies evaluating the accuracy of International Classification of Diseases-10-Clinical Modification (ICD-10-CM)-based algorithm for unusual site TTS are available in the published literature.Methods: The purpose of this study was to assess the performance of clinical coding to 1) leverage literature review and clinical input to develop an ICD-10-CM-based algorithm to identify unusual site TTS as a composite outcome and 2) validate the algorithm against the Brighton Collaboration’s interim case definition using laboratory, pathology, and imaging reports in an academic health network electronic health record (EHR) within the US Food and Drug Administration (FDA) Biologics Effectiveness and Safety (BEST) Initiative. Validation of up to 50 cases per thrombosis site was conducted, with positive predictive values (PPV) and 95% confidence intervals (95% CI) calculated using pathology or imaging results as the gold standard.Results: The algorithm identified 278 unusual site TTS cases, of which 117 (42.1%) were selected for validation. In both the algorithm-identified and validation cohorts, over 60% of patients were 56 years or older. The positive predictive value (PPV) for unusual site TTS was 76.1% (95% CI 67.2– 83.2%) and at least 80% for all but one individual thrombosis diagnosis code. PPV for thrombocytopenia was 98.3% (95% CI 92.1– 99.5%).Discussion: This study represents the first report of a validated ICD-10-CM-based algorithm for unusual site TTS. A validation effort found that the algorithm performed at an intermediate-to-high PPV, suggesting that the algorithm can be used in observational studies including active surveillance of COVID-19 vaccines and other medical products.Keywords: thrombosis with thrombocytopenia syndrome, TTS, COVID-19, validation, electronic health records

Abstract Background Spontaneous Coronary Artery Dissection (SCAD) and Takotsubo Syndrome (TTS) are two different entities with several shared risk factors, but their management is different. They can co-exist in patients with chest pain which affects their management. We present two cases of combined SCAD and TTS in patients presented with chest pain. Case presentation Case 1: 80F admitted with typical chest pain and dynamic ECG changes on the background of known anxiety/depression and social stresses. Her coronary angiogram showed SCAD affecting distal LAD. The left ventriculogram (LV gram) showed apical ballooning consistent with Takotsubo Syndrome (TTS). Patient was discharged on aspirin as well as angiotensin receptor blocker (ARB). Case 2: 60F admitted with typical chest pain in the setting of emotional trauma on the background of known cardiovascular risk factors. She was found to have ST elevation in inferior leads with no reciprocal changes. Subsequently, coronary angiogram showed SCAD affecting mid-left anterior descending artery (LAD) with normal distal wrap around LAD. Her LV gram showed apical ballooning consistent with TTS. However, transthoracic echocardiogram showed akinetic left ventricular apex. She was discharged on aspirin as well as an ACE inhibitor and warfarin to prevent LV thrombus. Conclusions SCAD and TTS can co-exist in patients with chest pain. It is important to identify SCAD in patients with TTS as it may affect their short as well as long-term management.

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Background: The aim of this study was to propose and validate a novel indicator that characterizes the potential effects of exposure to hand–arm vibration (HAV) and evaluates the increasing risk of neurosensory components of hand–arm vibration syndrome (HAVS). The author focused on a quantity calculated from ascending and descending thresholds and residual shifts in vibrotactile perception thresholds (VPTs) observed at the fingertips in the recovery process after exposure to HAV. Methods: Thirty subjects—10 old exposed (G1), 10 old non-exposed (G2), and 10 young non-exposed subjects (G3)—were required to perform a series of grip tasks with exposure to two intensities of HAV, which was followed by 90 s of vibration perception measurements at the tip of each subject’s right index finger. Vibrotactile perception was measured every 5 min for 30 min. Results: Mean differences between ascending and descending thresholds (VPTWs) for G2 and G3 remained nearly unchanged over time after exposure to HAV. In contrast, the mean VPTWs for G1 gradually increased over time after exposure to HAV. The mean VPTWs for G1 were always larger than those for G2 and G3. TTS recovery was observed at 125 Hz under both of the HAV exposure conditions in each group. TTSs of nearly zero were observed for the low-HAV condition in G3. TTS recovery after exposure to HAV was not observed at 31.5 Hz in any of the subject groups. Regardless of elapsed time, the mean TTSs for G2 and G3 were smaller than those for G1. Negative TTS values showing a lower TTS than the baseline were sometimes observed for the low-HAV condition in G3. Conclusions: VPTWs can be a screening parameter that detects potential patients with only neurosensory components observed as an early sign of HAVS.

Simple Summary: Takotsubo syndrome (TTS), also known as "broken heart" syndrome, is a rare but serious heart event associated with physical or emotional stress. Patients usually complain about intense chest pain and difficulty in breathing, resembling acute myocardial infarction. Cancer patients are more likely to suffer from TTS and the condition has been linked with the use of several anticancer remedies, such as chemotherapy and targeted therapy. Immunotherapy is a new, viable option for many patients and is currently used in the management of several cancers. There are emerging reports of TTS in cancer patients treated with immunotherapy; however, its causality on TTS development remains uncertain. As TTS may be life-threatening and impact anticancer management, it is crucial to identify any possible association with immunotherapy. In this literature review, we tried to explore the extent of the condition in immunotherapy-treated patients, and to provide information regarding accurate diagnosis, management, and outcomes. Background: There are emerging reports of Takotsubo syndrome (TTS) in cancer patients treated with immune checkpoint inhibitors (ICIs); however, the association of the two remains uncertain. Methods: A systematic literature review was performed in the PubMed database and web sources (Google Scholar) according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. Case reports/series or studies including cancer patients treated with ICIs and presenting with TTS were considered. Results: Seventeen cases were included in the systematic review. Most patients were males (59%) with median age of 70 years (30–83). Most common tumor types were lung cancer (35%) and melanoma (29%). Most patients were on first-line immunotherapy (35%) and after the first cycle (54%) of treatment. The median time on immunotherapy at the time of TTS presentation was 77 days (1–450). The most used agents were pembrolizumab and the combination of nivolumab–ipilimumab (35%, respectively). Potential stressors were recognized in 12 cases (80%). Six patients (35%) presented with concurrent cardiac complications. Corticosteroids were used in the management of eight patients (50%). Fifteen patients (88%) recovered from TTS, two patients (12%) relapsed, and one patient died. Immunotherapy was reintroduced in five cases (50%). Conclusion: TTS may be associated with immunotherapy for cancer. Physicians should be alert for TTS diagnosis in any patient with myocardial infarction-like presentation under treatment with ICIs. [ABSTRACT FROM AUTHOR]

Background: Spontaneous Coronary Artery Dissection (SCAD) and Takotsubo Syndrome (TTS) are two different entities with several shared risk factors, but their management is different. They can co-exist in patients with chest pain which affects their management. We present two cases of combined SCAD and TTS in patients presented with chest pain. Case presentation: Case 1: 80F admitted with typical chest pain and dynamic ECG changes on the background of known anxiety/depression and social stresses. Her coronary angiogram showed SCAD affecting distal LAD. The left ventriculogram (LV gram) showed apical ballooning consistent with Takotsubo Syndrome (TTS). Patient was discharged on aspirin as well as angiotensin receptor blocker (ARB). Case 2: 60F admitted with typical chest pain in the setting of emotional trauma on the background of known cardiovascular risk factors. She was found to have ST elevation in inferior leads with no reciprocal changes. Subsequently, coronary angiogram showed SCAD affecting mid-left anterior descending artery (LAD) with normal distal wrap around LAD. Her LV gram showed apical ballooning consistent with TTS. However, transthoracic echocardiogram showed akinetic left ventricular apex. She was discharged on aspirin as well as an ACE inhibitor and warfarin to prevent LV thrombus. Conclusions: SCAD and TTS can co-exist in patients with chest pain. It is important to identify SCAD in patients with TTS as it may affect their short as well as long-term management. [ABSTRACT FROM AUTHOR]

This paper presents an investigation of speaker adaptation using a continuous vocoder for parametric text-to-speech (TTS) synthesis. In purposes that demand low computational complexity, conventional vocoder-based statistical parametric speech synthesis can be preferable. While capable of remarkable naturalness, recent neural vocoders nonetheless fall short of the criteria for real-time synthesis. We investigate our former continuous vocoder, in which the excitation is characterized employing two one-dimensional parameters: Maximum Voiced Frequency and continuous fundamental frequency (F0). We show that an average voice can be trained for deep neural network-based TTS utilizing data from nine English speakers. We did speaker adaptation experiments for each target speaker with 400 utterances (approximately 14 minutes). We showed an apparent enhancement in the quality and naturalness of synthesized speech compared to our previous work by utilizing the recurrent neural network topologies. According to the objective studies (Mel-Cepstral Distortion and F0 correlation), the quality of speaker adaptation using Continuous Vocoder-based DNN-TTS is slightly better than the WORLD Vocoder-based baseline. The subjective MUSHRA-like test results also showed that our speaker adaptation technique is almost as natural as the WORLD vocoder using Gated Recurrent Unit and Long Short Term Memory networks. The proposed vocoder, being capable of real-time synthesis, can be used for applications which need fast synthesis speed. [ABSTRACT FROM AUTHOR]

• " We showed a poor completion rate of only 30%. There was a high percentage of previously undetected injuries within the study population who received a TTS. This may suggest the possibility that many injuries are missed within the remaining 70% population that did not receive a TTS." • "The inclusion criteria of this audit are wider than the comparative studies. Rather than limiting it to patients who had triggered a trauma call, we chose to expand the inclusion criteria to be more representative of patients who we thought could benefit from a TTS." • "Arguably, the inclusion criteria of this audit are more representative of patients who need tertiary surveys." A tertiary trauma survey (TTS) is a structured, comprehensive top-to-toe examination following major trauma [1]. Literature suggests that the ideal time frame for the initial TTS should be completed within 24-hours of a patient's admission and repeated at important moments [2–4]. Evidence suggests that formal TTS reduces the rate of missed injuries by up to 38% [2]. To determine the rate of TTS being conducted in trauma patients in a tertiary hospital without an admitting trauma service. We performed a retrospective analysis of adult trauma patients admitted to Middlemore Hospital (MMH) over six months. To be included, patients were either deemed to have a significant mechanism of injury or triggered a trauma call when arriving in the Emergency Department. We identified 246 patients who met our criteria for requiring a TTS. 74 (30%) had a TTS completed. Of those completed, 22 (30%) were documented using a standardised form. 35 (47%) were done within the ideal timeframe (24 h); a further 21 (28%) were done within 48 h. House Officers (Junior Medical Officers) conducted the majority (80%), with the remainder being done by final-year medical students (12%), Registrars (Residents) (4%) and Consultants (Attendings) (4%). Of the 74 TTS that were completed, 21 (28%) detected a possible new injury, with 22% leading to further investigations being ordered. 14 (19%) were found to have a previously undetected, clinically significant injury on TTS (defined as 'injuries requiring further clinical intervention'). Most patients (90%) were admitted to either General Surgery or Orthopaedics. Sixty-two (54%) of patients admitted to General Surgery received a TTS; compared to just 11 (10%) admitted under Orthopaedics and 1 of 24 (4%) admitted to other specialities (including Hands, Plastics, Maxillo-Facial, Gynaecology and Medicine). 30% of patients requiring a TTS received one. 19% of TTS conducted detected clinically significant injuries. [ABSTRACT FROM AUTHOR]

Chloroplast and mitochondrial DNA (cpDNA and mtDNA) are apart from nuclear DNA (nuDNA) in a eukaryotic cell. The transcription system of chloroplasts differs from those of mitochondria and eukaryotes. In contrast to nuDNA and animal mtDNA, the transcription of cpDNA is still not well understood, primarily due to the unresolved identification of transcription initiation sites (TISs) and transcription termination sites (TTSs) on the genome scale. In the present study, we characterized the transcription of chloroplast (cp) genes with greater accuracy and comprehensive information using PacBio full-length transcriptome data from Arabidopsis thaliana. The major findings included the discovery of four types of artifacts, the validation and correction of cp gene annotations, the exact identification of TISs that start with G, and the discovery of polyA-like sites as TTSs. Notably, we proposed a new model to explain cp transcription initiation and termination at the whole-genome level. Four types of artifacts, degraded RNAs and splicing intermediates deserve the attention from researchers working with PacBio full-length transcriptome data, as these contaminant sequences can lead to incorrect downstream analysis. Cp transcription initiates at multiple promoters and terminates at polyA-like sites. Our study provides new insights into cp transcription and new clues to study the evolution of promoters, TISs, TTSs and polyA tails of eukaryotic genes. [ABSTRACT FROM AUTHOR]

Text-to-speech (TTS) technology is the process by which the computer is made to speak. It uses natural language processing concepts. Despite the advancement of technology that allows information to be stored electronically, textual information remains the most common way of exchanging information. Using text documents is problematic for visually impaired people in many scenarios, such as reading text on the move and accessing text under less-than-ideal conditions. The goal is to allow blind users to touch the printed text and receive the real-time transmission of the words. The development of such systems requires the use of such systems, requires the use of two technologies that are central to these systems, namely optical character recognition (OCR) to extract text information (Text Information Extraction) and text-to-voice (TTS) to convert this text in question. Text information extraction is the first and most important function of any assistive reading system and is an integral part of OCR because this process determines the intelligibility of the extracted word. Recent developments in computer vision, digital cameras, and computers make it possible to develop cameras and products that combine computer vision technology with other existing useful products such as optical character recognition systems used to recognize words. She can recognize characters, words, and sentences without any mistakes. OCR has a high recognition rate which is the electronic conversion of photographed images of typed or typed text into computer-readable text. Developments in computer technology make it possible to help these individuals by developing camera-based products. People with poor vision need portable assistance to read this printed text. The need to develop a voice-assisted text-to-speech system using the optical character recognition method with different sets of input and speech output is simulated. [ABSTRACT FROM AUTHOR]

In this paper, we propose a simple modelling method that accurately describes the time-dependent viscoelastic behaviour of thermoplastic and thermosetting solid polymers. We performed short-term creep and stress relaxation tests on representative samples of three major classes of polymers: an amorphous, a semi-crystalline thermoplastic and a thermosetting polymer. Then, to investigate the relationship between the model parameters and the material composition, we also tested thermoplastic matrix composites with different plasticiser contents. From the short-term tests, master curves were constructed with the use of the time–temperature superposition principle. Then, the temperature dependence of the obtained shift factors was described using the Arrhenius model. The resulting creep compliance and relaxation modulus master curves were normalised and modelled with a two-parameter cumulative Gumbel distribution function (CDF) and its complementary distribution function (CCDF). For the creep and stress relaxation master curves, the median error of modelling was less than 16 % and 16.5 % in all cases, respectively. Furthermore, it was less than 2 % for the thermosetting polymer, making this model an excellent tool for describing the creep and stress relaxation behaviour of thermosetting systems. In the case of the plasticised composites, we found a strong relationship between the material composition and the location parameter of the Gumbel model. Based on this, we developed a method that can be used to estimate the evolution of the creep compliance curve for any arbitrary OLA content (between 0 wt% and 16 wt%) at any desired temperature (between 22 °C and 70 °C). [Display omitted] • Long-term viscoelastic behaviour can be modelled with Gumbel distribution function. • The location parameter of the model can be related to the material composition. • The median error for creep over 32 years was less than 2 % for the tested thermoset. [ABSTRACT FROM AUTHOR]