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The agentive structures in JE and ON identified in the AS2-HP corpus (a corpus of caregivers' speech) refer to groups of people of different sizes, ranging from unity (mainly represented by JE) to internal plurality (specific to ON), or even totality in the case of generic uses. By questioning the notions of indefiniteness, collective agentivity and massive perception, this article reveals a continuum that organizes the 'agent-action' relationship, which varies according to the pronoun used in the agentive structure: those in ON alone make the event predicate more salient than the enunciator. The latter, which in this corpus always refers to a group of caregivers, is intended to highlight the action rather than the people performing the action. Conversely, agentivity in NOUS ON emphasizes the enunciator: the subject is presented as a class, which takes precedence over the event predicate. Halfway between these two ends of the gradient, we find agentive structures in JE, where agent and action are perfectly equal: the agent takes full responsibility for his action and does so on an individual basis. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to compare the results of single versus double row (TEO) in massive tears of the posterosuperior rotator cuff in patients older than 70 years old. Methods: Between October 2019 and July 2022, 46 patients, older than 70 years old, were operated on, in two centers, by one surgeon (FM), in one center, we performed a single-row repair, while in the other a double row, transosseous equivalent. Patients were paired by age and gender. All patients were studied with a preoperative MRI along with preoperative age and gender adjusted constant score. Postoperative patients were evaluated at the end of the FU. Mean time of FU for single row was 3.2 years (2–4.1) and for TOE was 3.5 years (2.4–3). Mean age for SR patients was 71.15 years (70–82) and for TOE was 74.8 years (70–81). We were able to evaluate 20 pairs of patients (15 pairs of females and five pairs of males). Results: CS differed in both groups of patients. Patients operated on with TOE had a better, but non-significant CS 81.3 (TOE) versus 75.7 (SR) p > 0.05. The patients operated own with TOE showed statistically significant better arm abduction strength than patients operated on with SR (p < 0.05). There was a trend for patients operated on with TOE to have a better ROM and less pain. Discussion: The results of our work show that patients older than 70 years old, with repairable RCT operated on with a transosseous equivalent, have a trend to have a better CS and a significantly better strength than patients operated on with SR. [ABSTRACT FROM AUTHOR]

Introduction: Laparoscopic splenectomy has become the preferred approach because it offers several advantages over traditional open surgery, including smaller incisions, decreased postoperative pain, reduced blood loss and shorter hospital stays. For mild to moderately enlarged spleens, it has become the procedure of choice. Although it can be more challenging for massively enlarged spleens, with proper planning and surgical expertise, the procedure can be performed safely. Aim: To assess the indications and outcomes of laparoscopic splenectomy across a range of spleen sizes, from normal to massively enlarged spleens, in a tertiary care hospital. Materials and Methods: A retrospective descriptive study was conducted in the Department of Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India, from May 2018 to May 2023. A total of 41 patients were included in the study. Patients aged 18 to 65 years who had undergone elective laparoscopic splenectomies, with no cutoff for spleen size, were included. The endpoints of the study were to measure perioperative parameters such as operative time, blood loss, postoperative complications, hospital stay and analysis of indications. Continuous variables were expressed as mean±SD and categorical variables were summarised as frequencies and percentages. Results: The study group consisted of 20 (48.80%) males and 21 (51.20%) females. The mean age was 43.42±11.28 years. The most common indication for splenectomy was Immune Thrombocytopenic Purpura (ITP) (n=15), followed by hereditary spherocytosis (n=7). The mean spleen size of 26 patients was 12±1.62 cm; in seven patients, it was 17±0.76 cm; and in eight patients, it was 23.5±2.29 cm. The largest spleen operated on measured 28 cm in size. One patient required conversion to open surgery due to bleeding. Conclusion: Laparoscopic splenectomy is a safe method associated with a low risk of perioperative complications. Proper planning and a reproducible operative technique are critical for success in laparoscopic splenectomy, even for massive spleens.

Pathology of the long head of the biceps tendon is commonly associated with massive rotator cuff tears (MRCTs), which account for roughly one third of all rotator cuff tears. Treatment options for this condition include tenotomy, tenodesis, augmentation, and the use of the tendon as a graft for partial superior capsule reconstruction. Augmentation and superior capsular reconstruction are evolving techniques in the management of MRCTs. However, similar to the lack of consensus on the treatment of MRCTs, there are no clear guidelines for the management of concurrent biceps tendon pathology.

Cognitive Internet of Things (CIoT) is a new subfield of the Internet of Things (IoT) that aims to integrate cognition into the IoT's architecture and design. Various CIoT applications require techniques to inevitably extract machine-understandable concepts from unprocessed sensory data to provide value-added insights about CIoT devices and their users. The time series classification, which is used for the concept's extraction poses challenges to many applications across various domains, i.e., dimensionality reduction strategies have been suggested as an effective method to decrease the dimensionality of time series. The most common approach for time-series classification is the symbolic aggregate approximation (SAX). However, its main drawback is that it does not select the most significant point from the segment during the piecewise aggregate approximation (PAA) stage. The situation is cumbersome when data is heterogeneous and massive. Therefore, this research presents a novel technique for the selection of the most significant point from a segment during the PAA stage in SAX. The proposed technique chooses the maximum informative point as the most significant point using the probabilistic interpretation of sensory data with an appropriate copula design. The appropriate copula is selected using the minimum akaike information criteria (AIC) value. Subsequently, the modified SAX considers the maximum informative points instead of a selection of mean/max/extreme data points on a given segment during the PAA stage. The experimental evaluation of the environmental dataset reveals that the proposed method is more accurate and computationally efficient than classic SAX. Also, for cross-validation it computes the entropy of the information point (i-value) from each dataset to verify the successful transformation of normal data points to information points. [ABSTRACT FROM AUTHOR]

Rotation plays an important role in the structure and evolution of massive stars. It leads to deviation from spherical symmetry for very fast rotating stars, mixing in otherwise unmixed radiative regions and generally increased mass loss. In addition, magnetic fields interact with rotation and lead to significant transport of angular momentum. In this article, we review the various rotational and magnetic instabilities present in massive stars and their implementation in one-dimensional stellar evolution codes. We then focus on their impact on the evolution of single rotating stars. Finally, we compare rotating models to observations and discuss ways to disentangle between various uncertainties. [ABSTRACT FROM AUTHOR]

The young open cluster NGC 6231 hosts a rich population of O-type binary stars. We study several of these eccentric short-period massive eclipsing binaries and assess their fundamental parameters. The properties of these systems make them interesting targets to study tidally induced apsidal motion. The analysis of apsidal motion offers a powerful means to obtain information about the internal structure of the stars. Indeed, since the rate of apsidal motion in a binary system is proportional to the internal structure constants of the stars composing it, its value gives direct insight into the internal structure and evolutionary state of these stars. Stellar evolution models are constructed based on the observationally-determined fundamental parameters and a theoretical rate of apsidal motion is inferred. The results are striking: Adopting standard stellar evolution models yields a theoretical rate of apsidal motion much larger than the observational value. This discrepancy results from the standard models predicting too low an efficiency of internal mixing and thus too homogenous stars in terms of density. By enforcing the theoretical rates of apsidal motion to match the observational values, enhanced mixing is required, through a large overshooting parameter and/or additional turbulent/rotational mixing. Our analysis leads to the conclusion that the chemically mixed cores in those massive stars must be more extended than anticipated from standard models. [ABSTRACT FROM AUTHOR]

Floating car GPS data serves as the foundation for processing traffic information, with the rapid increase in the number of monitored vehicles, a massive amount of GPS data is generated, posing great challenges to map matching. To address the shortcomings of traditional matching methods in terms of matching efficiency and accuracy, this paper proposed a real time parallel map matching algorithm for massive GPS data that ensured both high matching accuracy and computational efficiency. This paper firstly reconstructed an efficient and accurate real-time map matching algorithm for streaming data by introducing a comprehensive weight factor that considered velocity and direction to enhance the offline map matching algorithm that relied on historical trajectories. Then, it introduced the Spark Streaming distributed computing framework to achieve real-time and parallel computation of the map matching algorithm, significantly improving the efficiency of real-time map matching. Experimental results demonstrate that the proposed algorithm achieves more than a 10% increase in matching accuracy compared to conventional topological matching algorithms on complex road sections, with an overall matching accuracy of over 95%. In terms of matching efficiency, it achieves approximately a fourfold improvement compared to an equivalent number of standalone servers. The experimental results show that the proposed algorithm achieves real-time map matching of 80 million GPS data points on a computing cluster composed of 11 machines, proving that the proposed algorithm can achieve real-time vehicle matching in urban areas. [ABSTRACT FROM AUTHOR]

In this introduction to the special issue on massive urbanisation, the collective that has prepared this issue reviews the thinking and experiences that have been important to them. The reflections centre on the use of 'massive' in Jamaican patois, where it has two countervailing meanings. On the one hand, it means an inordinate lack of sensitivity to the real conditions taking place, a sense of extreme self‐inflation beyond reason. On the other, it means a collectivity coming into being without a set form, but reflective of a desire for collaboration and mutuality. Massive urbanisation thus means here both the voluminous expansion of speculative accumulation, extraction of land value, replication of vast inequities and disfunction, and the continuous emergence of new forms of urban inhabitation, a constant remaking of the social field by what has been called the urban majority. All of the contributions attempt to work with this sense of doubleness, amplifying the creation of particular atmospheres of the urban as a materiality of its heterogeneity. A collective of urban researchers working in nine major regions of the Global South came together over the past 18 months to think through the notion of the massive beyond its conventional connotations of mushrooming populations and a voluminous and explosive mass beyond apprehension or control. The collective also sought to think of urban extensiveness as something involving the temporality of dreams, ambivalent desires, improvised manoeuvres, and unruly inclinations in addition to the generalisation of commodity forms and capital accumulation. [ABSTRACT FROM AUTHOR]

Irreparable massive rotator cuff tears can significantly impact daily life; and these types of tears can be difficult to repair completely, especially in younger patients who are more active and have higher functional requirements. Since its introduction by Mihata and the colleagues, superior capsular reconstruction (SCR) has gained popularity in the treatment of irreparable massive rotator cuff tears and has shown promising short-term results. A variety of studies have focused on the clinical and biomechanical outcomes of this procedure. This article reviews the biomechanics, indications for the surgical procedure, graft options, surgical technique, and rehabilitation from SCR.

Introduction: Subacute massive pulmonary embolism is a potentially fatal condition that can manifest in various clinical ways in a young patient, from mild and nonspecific to lethal. The incidence of pulmonary embolism in the younger population should not be overlooked, whether it involves individuals with certain risk factors, either genetic or acquired, or individuals with unidentified risk factors. Case Presentation: We are presenting two young patients, aged 35 and 37, who had a protracted course of disease and clinical manifestations at least 15 days before admission. The first patient had nonspecific pains and sensations in the chest area and coughed up blood on two occasions. The day before admission, he had an intense one-hour swimming workout. The second patient had rapid fatigue and choking, which led to an echocardiogram of the heart and a treadmill test that was terminated at the second level due to poor condition, as stated by the patient himself. He came in due to intense pain in the epigastrium, preceded by a loss of consciousness. In both patients, a diagnosis of massive PTE was made: the first by Multi-Slice Computed Tomography of the pulmonary artery (MSCTPA) and the second by clinical autopsy. The first patient received thrombolytic therapy and was discharged with NOACs (Apixaban) after 10 days of hospitalization. Conclusion: It is always necessary to keep in mind the possibility of PTE, even in younger patients and in cases with subtle clinical presentations, even without identified predisposing factors.

We study the apsidal motion in close eccentric massive binaries. Measuring the rate of apsidal motion in such a system gives insight into the internal structure and evolutionary state of the stars. We focus on CPD-41° 7742, for which independent studies in the past showed large discrepancies in the longitude of periastron of the orbit, hinting at the presence of apsidal motion. We perform a consistent analysis of all observational data to solve this apparent discrepancy and report the first determination of apsidal motion in this system. This study confirms the need for enhanced mixing in the stellar evolution models of the primary star to reproduce the observational properties. This points towards larger convective cores than usually considered. [ABSTRACT FROM AUTHOR]

Glomus tumors originate from perivascular, temperature-regulating bodies. They are generally located at the fingertips, rarely around the shoulder girdle. This paper reports a deltoid glomus tumor larger in size than ever previously reported. The intramuscular mass, asymptomatic for 10 years, had enlarged to the extent of causing pain. Tumor size and localization suggested the presence of malignancy, indicating wide resection as appropriate surgical action. Incisional biopsy revealed benign morphology. Surgical treatment achieved complete pain relief. This is the largest glomus tumor reported to date. Marginal excision is the treatment of choice when there is no suspicion of malignancy, but due to our suspicions, we performed a wide resection of the tumor. Neither the diagnostic biopsy at the commencement of resection nor the post-surgical pathology later indicated malignancy. [ABSTRACT FROM AUTHOR]

In recent years, transformer-based models have played a significant role in advancing language modeling for natural language processing. However, they require substantial amounts of data and there is a shortage of high-quality non-English corpora. Some recent initiatives have introduced multilingual datasets obtained through web crawling. However, there are notable limitations in the results for some languages, including Spanish. These datasets are either smaller compared to other languages or suffer from lower quality due to insufficient cleaning and deduplication. In this paper, we present esCorpius-m, a multilingual corpus extracted from around 1 petabyte of Common Crawl data. It is the most extensive corpus for some languages with such a level of high-quality content extraction, cleanliness, and deduplication. Our data curation process involves an efficient cleaning pipeline and various deduplication methods that maintain the integrity of document and paragraph boundaries. We also ensure compliance with EU regulations by retaining both the source web page URL and the WARC shared origin URL. [ABSTRACT FROM AUTHOR]

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The management of massively bleeding patients has undergone paradigm shift. With the evolution of bundle of care in form of damage control resuscitation, early blood-based resuscitation has emerged as one of the pillars of treatment; focused at preventing shock, coagulopathy, and thrombocytopenia. Military has always relied on low-titer O whole blood (LTOWB) to provide balanced hemostatic resuscitation for bleeding patients in combat casualties. Good results from military practice have led to questioning of practices followed in civilian bleeding trauma patients. With the realization that cold-stored platelets are functionally superior for immediate hemostasis, there is renewed interest in role of LTOWB in providing early hemostatic resuscitation to massively bleeding patients. Not only does LTOWB provide all the components but it also has an advantage of simplifying resuscitation logistics by providing all the components in one bag instead of three, in situations where delay of every minute leads to increased mortality. It can provide blood-based resuscitation in scenarios where it may not otherwise be possible. It can be used across all blood groups. This review explores the concerns regarding the use of LTOWB, historical perspective, advantages, and disadvantages. Several studies have shown that LTOWB is noninferior, as compared to components, and is a safe practice, without significant transfusion-related adverse events. The use of LTOWB in bleeding patients needs further studies to explore its efficacy and safety versus component therapy.

Purpose: The purpose of this study was to retrospectively evaluate the clinical, arthroscopic and radiological outcomes of autologous osteoperiosteal transplantation for massive cystic osteochondral defects of the talus. Methods: Cases of autologous osteoperiosteal transplantation for medial massive cystic defects of the talus between 2014 and 2018 were reviewed. The visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), and Ankle Activity Scale (AAS) were assessed preoperatively and postoperatively. The Magnetic Resonance Observation of Cartilage Tissue (MOCART) system and the International Cartilage Repair Society (ICRS) score were evaluated after surgery. The ability to return to daily activity and sport, as well as complications, were recorded. Results: Twenty-one patients were available for follow-up, with a mean follow-up of 60.1 ± 11.7 months. All subscales of preoperative FAOS had significant (P < 0.001) improvement at the final follow-up. The mean AOFAS and VAS scores significantly (P < 0.001) improved from 52.4 ± 12.4 preoperatively to 90.9 ± 5.2 at the last follow-up and from 7.9 ± 0.8 to 1.5 ± 0.9, respectively. The mean AAS decreased from 6.0 ± 1.4 preinjury to 1.4 ± 0.9 postinjury and then increased to 4.6 ± 1.4 at the final follow-up (P < 0.001). All 21 patients resumed daily activities after a mean of 3.1 ± 1.0 months. Fifteen patients (71.4%) returned to sports after a mean of 12.9 ± 4.1 months. All patients underwent follow-up MRI with a mean MOCART score of 68.6 ± 5.9. Eleven patients underwent second-look arthroscopy, and the average ICRS was 9.4 ± 0.8. No donor site morbidity was found in any patient during the follow-up. Conclusion: Autologous osteoperiosteal transplantation provided favourable clinical, arthroscopic and radiographic outcomes in patients with massive cystic osteochondral defects of the talus during a minimum 3-year follow-up. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

A decade ago, massively open online courses (MOOCs) were heralded as the solution to universal, global access to higher education. While they failed to reach this vision, primarily because of teaching-by-telling and learning-by-listening (a PDF of the residential classroom), MOOCs provided the foundational models and infrastructure for emergency remote learning in the pandemic. Reports of remote learning's death post-pandemic are greatly exaggerated, since the world is now irreversibly hybrid—and will stay that way because many people and organizations value the new opportunities this presents. From now on, when students leave the shelter of classrooms to interact with the world beyond schooling, they must have skills for adept performance both face-to-face and across distance. Colleges, universities, and regions that force all teaching and learning to be face-to-face are dooming their graduates to reduced agency in every other aspect of life. As discussed in recent reports from Harvard, MIT, and Stanford, innovative approaches to digital learning were developed during the pandemic that are now improving campus-based learning. Insights from these approaches offer the opportunity for student engagement at scale, taking advantage of strengths of online instruction such as collapsing time, bridging space, personalizing via rich datastreams, using AI-based instructional assistants and learning partners, delivering content and experience across universities, and sustaining online learning communities after formal instruction ends. Combined, these advances can enable next-generation massive digital hybrid learning, a means to achieve the aspirational vision of universal global access to higher education. A coalition of higher education institutions could begin to realize this vision, an essential step in enabling all learners to survive and thrive in our increasingly turbulent, disruptive global economy and civilization. [ABSTRACT FROM AUTHOR]

The pathological effects of acute pulmonary embolism (APE) on the right ventricle are one of the most important determinants of mortality in patients with APE. Frontal QRS-T angle (fQRSTa) predicts ventricular pathology and poor prognosis in many different cardiovascular diseases. In this study, we investigated whether there is a significant relationship between fQRSTa and APE severity. A total of 309 patients were included in this retrospective study. The severity of APE was classified as massive (high risk), submassive (intermediate risk), or nonmassive (low risk). fQRSTa calculated from standard ECGs. fQRSTa was significantly higher in massive APE patients (p < 0.001). fQRSTa was also found to be significantly higher in the in-hospital mortality group (p < 0.001). fQRSTa was an independent risk factor for the development of massive APE (odds ratio:1.033; 95% CI: 1.012–1.052; p < 0.001). Our study showed that increased fQRSTa predicts high-risk APE patients and mortality in APE patients. • Acute pulmonary embolism causes many different ECG findings. • Frontal QRS-T angle can provide information about prognosis in many different cardiovascular diseases. • Increased Frontal QRS-T angle is associated with severity and mortality of acute pulmonary embolism. [ABSTRACT FROM AUTHOR]

Massive goiter with retrosternal extension is most frequently found in the anterior mediastinum; however, 10%-15% of the cases are found in the posterior mediastinum. It may induce symptoms caused by tracheal, esophageal, and recurrent laryngeal nerve compression. Surgery for such a huge mass requires a high degree of experience to avoid serious complications, particularly if it weighs .500 g. Herein, we report the case of a 64-year-old man who complained of neck swelling which was gradually increasing in size during the past 19 years and breathing difficulty that worsened during the past years. A 31 £ 16 cm heterogeneous enhancing mass that expanded the thyroid gland with retrosternal extension, pushing the main vessels posterolaterally and compressing the trachea, was detected during computed tomography of the neck and chest. Total thyroidectomy was performed safely via a transcervical approach. The recovery period was uneventful, and the patient was discharged 5 days later. Given the rarity of a massive goiter that pushes the main vessels and compresses the trachea in the posterior mediastinum, this case report emphasizes the treatment options and outcome of this condition. [ABSTRACT FROM AUTHOR]

Purpose: Subacromial volume measurement on magnetic resonance images is relatively new. It has been shown that decreased subacromial volume increases after surgical repair of full-thickness rotator cuff tears. There is no study examining subacromial volume changes after superior capsular reconstruction (SCR). The purpose of this study was to compare subacromial volume changes on magnetic resonance images (MRI) after superior capsular reconstruction performed for primary irreparable rotator cuff tears. Methods: Patients who underwent an SCR procedure between 2017 and 2019 with a minimum 2-year postoperative follow-up were included in this retrospective study. Subacromial volume was measured on MRI using software. The preoperative and postoperative acromiohumeral distance, Constant Scores, graft thickness, and Hamada grades of the patients were evaluated. Results: A total of 18 patients with a mean age of 59.7 years (range: 49–74 years) underwent an SCR for massive irreparable cuff tear. The mean preoperative subacromial volume was 3.54 ± 0.39 cm3 (range 2.88–4.36 cm3), which increased to 4.46 ± 0.39 cm3 (range 3.75–5.32 cm3) postoperatively (p = < 0.001). The increase in subacromial volume and acromiohumeral distance did not correlate with Constant scores and graft thickness. We observed a significantly higher subacromial volume increase among Hamada grade 1 patients, compared to those with Hamada grade 2 (p = 0.011). Conclusions: We observed that subacromial volume significantly increased after superior capsular reconstruction. However, the increase in subacromial volume did not correlate with clinical scores, acromiohumeral distance changes, or graft thickness. Level of evidence: Level III – Retrospective Cohort Study. [ABSTRACT FROM AUTHOR]

Pillars of an underground mine are designed to ensure long-term stability and preserve the surface assets from the consequences of mining. However, long-term stability is never guaranteed. Over time, subsidence and collapses can occur, and the consequences are sometimes dramatic. Such collapses depend on the exploitation characteristics, the mechanical properties of the terrain, and the potential presence of water, but additional factors can play a major role. This study aims to identify the predisposing and triggering factors of the collapse, including stiff beds, cliffs, and faults. Back-analysis was carried out on a historic dramatic massive collapse of a chalk mine (Beaulieu, France, 1910). Numerical modelling (finite and distinct elements) was carried out to highlight the influence of mining geometry, the stiff bed, and the cliff. Then, the mechanism of the collapse of the Beaulieu mine was investigated. The results demonstrate the importance of the geometric configurations of the site for the development of such a phenomenon, particularly the cumulative effects of the excavation (extraction ratio), the cliff, and the stiff bed. These cumulative factors increase the risk of a massive collapse. This study has shown that the stability of abandoned room and pillar underground mines should cover three concepts: estimation of the stress state of the pillars, the strength of the pillars, and the presence of a cliff as well as a significant discontinuity crossing the rock mass which could be a fault. [ABSTRACT FROM AUTHOR]

Purpose: To compare various nonarthroplasty treatment options for massive, irreparable rotator cuff tears, including allograft bridging/augmentation, debridement, partial repair, superior capsule reconstruction (SCR), subacromial balloon spacer, and tendon transfer. Methods: A comprehensive search was conducted through the PubMed, MEDLINE, and EMBASE databases for all articles pertaining to nonarthroplasty treatment options for irreparable rotator cuff tears. Inclusion criteria included manuscripts published between 2009 and 2020 with at least 1 year follow-up and Level I–IV evidence. Articles were separated into six groups: debridement, arthroscopic and open repair, allograft bridging/augmentation, SCR, subacromial balloon spacer, and tendon transfer. Data points included range of motion (external rotation, abduction, forward flexion, and internal rotation), visual analog scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, Constant score, rate of revision surgery, and rate of conversion to arthroplasty. Results: A total of 83 studies and 3363 patients were included. All treatment options had statistically significant improvements in postoperative range of motion and patient-reported outcomes. Debridement had statistically significantly greater postoperative abduction and forward flexion range of motion, as well as better VAS pain scores, compared to the other treatment options. The SCR subgroup had the greatest improvement in ASES scores postoperatively. The overall revision rate was 7.2% among all surgical options, with the allograft bridging/augmentation group having the lowest rate of revision at 0–8.3%. The overall rate of conversion to arthroplasty was 7.2%, with debridement having the greatest rate of conversion at 15.4%. Conclusion: All six nonarthroplasty treatment options for irreparable rotator cuff tears resulted in statistically significant improvements in range of motion and patient-reported outcomes at 1 year follow-up or more, with low rates of revision and conversion to arthroplasty. Debridement had statistically significantly greater postoperative abduction and forward flexion range of motion, as well as better VAS pain scores, compared to the other treatment options. However, these conclusions should be interpreted with caution due to the heterogeneous nature of the data, lack of prospective randomized control trials, and short-term follow-up. The findings of this study highlight the complexity of irreparable, massive rotator cuff tears, and the need for an individualized approach when treating these patients. Level of evidence: Level IV. [ABSTRACT FROM AUTHOR]

Background: While massive and irreparable rotator cuff tears (MIRCTs) have been abundantly studied, inconsistent definitions in the literature and theories about pain and dysfunction related to them can be difficult to navigate when considering an individual patient. Purpose: To review the current literature for definitions and critical concepts that drive decision-making for MIRCTs. Study Design: Narrative review. Methods: A search of the PubMed database was performed to conduct a comprehensive literature review on MIRCTs. A total of 97 studies were included. Results: Recent literature reflects added attention to clarifying the definitions of "massive, "irreparable," and "pseudoparalysis." In addition, numerous recent studies have added to the understanding of what generates pain and dysfunction from this condition and have reported on new techniques for addressing them. Conclusion: The current literature provides a nuanced set of definitions and conceptual foundations on MIRCTs. These can be used to better define these complex conditions in patients when comparing current surgical techniques to address MIRCTs, as well as when interpreting the results of new techniques. While the number of effective treatment options has increased, high-quality and comparative evidence on treatments for MIRCTs is lacking. [ABSTRACT FROM AUTHOR]

Background Massive earlobe scarring/keloid formation can occur after ear piercing in individuals of African descent. Case report: A 14-year-old African girl with pierced ears in childhood presented with two progressively growing and disfiguring tumors on both earlobes. The maximum diameter of each lesion was 5.5 centimeters, and the weight of each lesion was approximately 20 grams. Histologically, there was a mixed pattern of keloid and hypertrophic scarring. Discussion: Massive keloids can occur after ear piercing in childhood. It is unclear why some individuals develop these massive keloids. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the functional outcome of partial reconstruction margin convergence in the treatment of massive, irreparable posterosuperior rotator cuff tear (RCT). Methods: This retrospective, single-center study included all patients that were operated by means of a partial repair and infraspinatus shift for a massive, posterosuperior cuff tear between 2009 and 2016, either in arthroscopic or mini-open technique. Outcome measures included sex- and age-adapted Constant Score (saCS), Western Ontario Rotator Cuff (WORC) Index, Disabilities of Arm, Shoulder and Hand Scores (DASH), and relative effect per patient (REPP). Results: Fifty-six shoulders in 54 patients (mean age: 66 ± 7 years) were evaluated at a mean follow-up of 40 ± 9 months. The mean tear size was Bateman 3.1 ± 0.7 and Patte 2.3 ± 0.4. All clinical scores showed improvement. The saCS improved from 64.1 ± 13.4 to 90.4 ± 13.7 (p < 0.0001), the DASH score from 51.8 ± 9.4 to 10.2 ± 13.4 (p < 0.0001) and the WORC index from 47.1% ± 8.6 to 87.9% ± 13.7 (p < 0.0001). The abduction strength of the affected side (1.7 ± 1.6 kg) was not restored to the same level as the contralateral side (5.4 ± 2.7 kg, p < 0.0001). Conclusion: Partial cuff repair for posterosuperior, massive cuff tears yields good clinical outcome with a low rate of complications and high proportion of good and excellent responders. Level of evidence: Level IV, therapeutic case series. [ABSTRACT FROM AUTHOR]

Background and Objectives: In paediatric trauma patients, there are limited prospective data regarding blood components and mortality, with some literature suggesting decreased mortality with high ratios of plasma and platelets to red blood cells (RBCs) in massive transfusions; however, most paediatric massive transfusions occur for non‐traumatic aetiologies and few studies assess blood product ratios in these children. This study's objective was to evaluate whether high blood product ratios or low deficits conferred a survival benefit in children with non‐traumatic life‐threatening bleeding. Materials and Methods: This is a secondary analysis of the five‐year, multicentre, prospective, observational massive transfusion epidemiology and outcomes in children study of children with life‐threatening bleeding from US, Canadian and Italian medical centres. Primary interventions were plasma:RBC and platelets:RBC (high ratio ≥1:2 ml/kg) and plasma and platelet deficits. The primary outcome was mortality at 6 h, 24 h and 28 days. Multivariate logistic regression models were used to determine independent associations with mortality. Results: A total of 222 children were included from 24 medical centres: 145 children (median [interquartile range] age 2.1 years [0.3–11.8]) with operative bleeding and 77 (8.0 years [1.2–14.7]) with medical bleeding. In adjusted analyses, neither blood product ratios nor deficits were associated with mortality at 6 h, 24 h or 28 days. Conclusion: This paper addresses a lack of prospective data in children regarding optimal empiric massive transfusion strategies in non‐traumatic massive haemorrhage and in finding no decrease in mortality with high plasma or platelet to RBC ratios or lower deficits supports an exploratory analysis for mortality. [ABSTRACT FROM AUTHOR]

Most massive rotator cuff tears (MCTs) are often successfully treated with nonoperative treatment; however, various surgical treatment options are available if conservative management fails. Several joint preserving techniques for MCT are commonly used, but the options are limited if an MCT is irreparable. Reverse total shoulder arthroplasty (RTSA) is gaining popularity over hemiarthroplasty as a treatment option for irreparable MCT, especially if glenohumeral degenerative changes are present. RTSA has been shown to have improved functional outcomes and range of motion postoperatively, particularly in the elderly and patients with pseudoparalysis. [ABSTRACT FROM AUTHOR]

The management of massively bleeding patients has undergone paradigm shift. With the evolution of bundle of care in form of damage control resuscitation, early blood-based resuscitation has emerged as one of the pillars of treatment; focused at preventing shock, coagulopathy, and thrombocytopenia. Military has always relied on low-titer O whole blood (LTOWB) to provide balanced hemostatic resuscitation for bleeding patients in combat casualties. Good results from military practice have led to questioning of practices followed in civilian bleeding trauma patients. With the realization that cold-stored platelets are functionally superior for immediate hemostasis, there is renewed interest in role of LTOWB in providing early hemostatic resuscitation to massively bleeding patients. Not only does LTOWB provide all the components but it also has an advantage of simplifying resuscitation logistics by providing all the components in one bag instead of three, in situations where delay of every minute leads to increased mortality. It can provide blood-based resuscitation in scenarios where it may not otherwise be possible. It can be used across all blood groups. This review explores the concerns regarding the use of LTOWB, historical perspective, advantages, and disadvantages. Several studies have shown that LTOWB is noninferior, as compared to components, and is a safe practice, without significant transfusion‑related adverse events. The use of LTOWB in bleeding patients needs further studies to explore its efficacy and safety versus component therapy. [ABSTRACT FROM AUTHOR]

Highlight Research • After bleaching disturbance and Acanthaster planci outbreaks, herbivore fishes species were dominated in MRP Pieh • This explains the marine recreational activities in utilization zone MRP Pieh have no impact on reducing fish biomass • After disturbance in MRP Pieh shows the coral reef fishes still endurance on bleaching event, and Acanthaster planci outbreak after disturbance in MRP Pieh shows the coral reef fishes still endurance on bleaching event and Acanthaster planci outbreak. However, the composition of corallivorous has decreased but has been an increase in herbivorous and carnivorous fish populations Abstract Pieh MRP encountered non-anthropogenic phenomena, precisely massive coral bleaching in 2016, 2017, and massive predators from Acanthaster planci outbreaks in 2018. This study aimed to understand the pattern of coral reef diversity in the core zone and utilization in the MRP area and compare it to non-MRPS locations that accept the same non-anthropogenic pressure conditions. Coral fish sampling using a UVC is categorized into three zones: the core zone, the utilization zone, and outside the MRP area. 8 Families of coral reef fishes were counted based on categories of level function in ecologies and economy. Taxonomic distinctiveness estimates were calculated mathematically for each sample, including species richness and taxonomic diversity were compared among zonation area. Pearson's Coefficient Correlation Matrix was used to measure the correlation relationship between zonation areas. There are 91 species of fish and 3002 individuals found. The richest family in the MRP Core Zone and MRP Utility Zone was Acanthuridae with 20 species and non-MRP has a lower species richness and abundance of fish communities. The dominant species in Pieh MRP was Ctenochaetus striatus with average abundant per site (21.3 ± 7.62, n = 3). Acanthuridae represents 55.98% of the total biomass in MRP-Core Zone, 63.13% in MRP-Utility Zone, and 41.55% in Non-MRP Area. This study showed the number of species and populations from corallivores fishes have decreased but has been an increase in herbivorous and carnivore diversity. The diversity indices (H') and ENS also shows no differ significantly between zonation.

In recent years, transformer-based models have played a significant role in advancing language modeling for natural language processing. However, they require substantial amounts of data and there is a shortage of high-quality non-English corpora. Some recent initiatives have introduced multilingual datasets obtained through web crawling. However, there are notable limitations in the results for some languages, including Spanish. These datasets are either smaller compared to other languages or suffer from lower quality due to insufficient cleaning and deduplication. In this paper, we present esCorpius-m, a multilingual corpus extracted from around 1 petabyte of Common Crawl data. It is the most extensive corpus for some languages with such a level of high-quality content extraction, cleanliness, and deduplication. Our data curation process involves an efficient cleaning pipeline and various deduplication methods that maintain the integrity of document and paragraph boundaries. We also ensure compliance with EU regulations by retaining both the source web page URL and the WARC shared origin URL.

In the present work, interstitial-free steel is rapidly cooled from the austenitic state, followed by isothermal holding at 630°C for 5 minutes in a thermo-mechanical simulator (Gleeble 3800®). The heat-treatment provides massive ferrite, Widmanstätten ferrite and pearlite, as the triplex-phase mixture. Massive ferrite, as the early decomposed product of austenite, arises by rapid cooling. Subsequent formation of Widmanstätten ferrite and pearlite during the isothermal holding is elusive in steel. The phase transformations account for a dramatic improvement in tensile strength by two-fold with a negligible reduction in elongation. Morphologically, massive ferrite is granular and contains recovered sub-grain boundaries inside the phase. The pearlite nucleates within a lath-shaped grain, unconventionally. Due to the low-temperature phase transformation (630°C) and a ppm level carbon in the alloy, the observed pearlitic structure is either underdeveloped or fragmented, which promotes cracks against the stronger Widmanstätten ferrite at an advancing front of the crack tip. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mixed epithelial-stromal tumours (MESTs) are a rare biphasic tumour that frequently arise in women from the renal and urogenital tract. They are also seen in men but are exceptionally uncommon with only few cases reported to originate from the seminal vesicles. Malignant transformation of its epithelial or stromal components is possible; however, by in large, these tumours are benign in nature. We report the case of a 48-year-old man with no remarkable medical or surgical history who presented with a huge expanding pelvic and intra-abdominal mass that required extensive surgical management including a pelvic exenteration. Histopathological analysis concluded the diagnosis of benign MEST originating from the seminal vesicles with no malignant features. No further systemic therapy was recommended for our patient. Given the technical intricacy in the operative resection of this tumour, we aim to present our findings and surgical management of this complex MEST. [ABSTRACT FROM AUTHOR]

A decade ago, massively open online courses (MOOCs) were heralded as the solution to universal, global access to higher education. While they failed to reach this vision, primarily because of teaching-by-telling and learning-by-listening (a PDF of the residential classroom), MOOCs provided the foundational models and infrastructure for emergency remote learning in the pandemic. Reports of remote learning’s death post-pandemic are greatly exaggerated, since the world is now irreversibly hybrid—and will stay that way because many people and organizations value the new opportunities this presents. From now on, when students leave the shelter of classrooms to interact with the world beyond schooling, they must have skills for adept performance both face-to-face and across distance. Colleges, universities, and regions that force all teaching and learning to be face-to-face are dooming their graduates to reduced agency in every other aspect of life. As discussed in recent reports from Harvard, MIT, and Stanford, innovative approaches to digital learning were developed during the pandemic that are now improving campus-based learning. Insights from these approaches offer the opportunity for student engagement at scale, taking advantage of strengths of online instruction such as collapsing time, bridging space, personalizing via rich datastreams, using AI-based instructional assistants and learning partners, delivering content and experience across universities, and sustaining online learning communities after formal instruction ends. Combined, these advances can enable next-generation massive digital hybrid learning, a means to achieve the aspirational vision of universal global access to higher education. A coalition of higher education institutions could begin to realize this vision, an essential step in enabling all learners to survive and thrive in our increasingly turbulent, disruptive global economy and civilization.

Recent Internet of Things (IoT) research aims to develop generic objects to learn, reason, and perceive their environment. Therefore, a new area has emerged known as cognitive IoT (CIoT). The cognitive Internet of Things integrates IoT with intelligence and behaves as well as humans through intelligent functionality. Several inferential tasks in CIoT require multiple hypothesis testing. The situation becomes cumbersome when the data is massive and heterogeneous. Thus, this research suggests a novel technique for multiple-hypothesis testing that uses a copula function to deal effectively with massive heterogeneous data. In addition, these data may contain missing or corrupted entries. Hence, it introduced probabilistic clustering, which reduces model inefficiency and takes control over the false discovery rate (FDR). Most of the variance from each cluster was extracted using kernel principal component analysis (KPCA) to reduce the processing burden at the fusion centre. Subsequently, it computes the p-value of each cluster's first principal component data and employs the Bonferroni method for multiple hypothesis testing. Finally, this research study evaluates the performance of the proposed algorithm on six-month environmental data, revealing that the proposed technique is efficient in terms of accuracy and computation time compared to other methods in the presence of massive heterogeneous data. [ABSTRACT FROM AUTHOR]

Purpose Hemostasis can be achieved by various methods, but it can be difficult to stop active bleeding in the pelvis. An effective method is described to stop massive active bleeding in the pelvis during colorectal surgery. Methods When there were massive bleedings in the pelvis, 3 to 5 Foley catheters were inserted through stab wounds on the abdomen. The tips of catheters were placed in the pelvis. Each balloon was inflated with 40 mL of sterile water. The water inside each balloon was removed gradually from the third postoperative day. If there is no further bleeding, all catheters were removed on the 7th postoperative day. Results There were 8 patients (4 males and 4 females) with massive pelvic bleeding encountered from January 1998 to December 2018. Four patients underwent low anterior resection for primary rectal cancer, 2 patients for colon cancer with pelvic recurrence, 1 patient for ovary cancer with pelvic recurrence, and 1 patient for presacral parachordoma with a bleeding tendency. All of the patients survived without further bleeding after surgery. Conclusion The technique is a simple method to control massive pelvic bleeding during colorectal surgery. It is also inexpensive and effective even in patients with a bleeding tendency.

Small, preliminary studies and the systematic reviews on superior capsular reconstruction (SCR) that collate data are at increased risk spin. This study's primary objective was to identify, describe, and account for the incidence of spin in systematic reviews of SCR. This study's secondary objective was to characterize the studies in which spin was identified to determine whether identifiable patterns of characteristics exist among studies with spin. This study was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using a predetermined protocol. A search was conducted on the PubMed and Embase databases for systematic reviews and meta-analyses on SCR. Screening and data extraction were conducted independently by 2 authors. Each included study's abstract was assessed for the presence of the 15 most common types of spin, with full texts reviewed during cases of disagreement or for clarification. General data that were extracted included study title, authors, publication year, journal, level of evidence, study design, funding source, reported adherence to PRISMA guidelines, preregistration of the study protocol, and primary and secondary outcome measures. Full texts were used in the assessment of study quality per AMSTAR 2. We identified 53 studies during our search, of which 17 met the inclusion criteria. At least 1 form of spin was observed in all 17 studies. The most common types of spin were type 5 ("The conclusion claims the beneficial effect of the experimental treatment despite a high risk of bias in primary studies") and type 9 ("Conclusion claims the beneficial effect of the experimental treatment despite reporting bias"), both of which were observed in 11 studies (11 of 17, 65%). A statistically significant association between lower level of evidence and type 5 ("The conclusion claims the beneficial effect of the experimental treatment despite a high risk of bias in primary studies") was observed (P =.0175). A statistically significant association was also found between more recent year of publication and the spin category misleading interpretation (P =.0398), and between lower AMSTAR 2 score and type 13 ("Failure to specify the direction of the effect when it favors the control intervention") (P =.0260). No other statistical associations between other study characteristics were observed. Spin is highly prevalent in abstracts of SCR systematic reviews and meta-analyses. An association was found between the presence of spin and lower level of evidence, year of publication, and AMSTAR 2 ratings. [ABSTRACT FROM AUTHOR]

Massive open online courses have been regarded as effective technological innovations that improve educational systems in the era of digitalisation. However, only 10% of the registered students complete their courses. This study aims to examine the motivational and technological factors and contextual features on students' continuous intention to use. A questionnaire was gathered from 315 of students in the UAE and revealed that social motivational and technological factors driven by the technology acceptance model and technology task fit theory significantly influenced the students' continuance intention to use. This study also revealed that contextual features including language use and course accreditation are important indicators determining students' behaviours toward the use. Hence, this study proposed an integrative model to explain ways to improve continuance intention to use. This study contributes to the sustainable use of massive open online courses in developing countries through an integrative model. [ABSTRACT FROM AUTHOR]

Summary: Studying deep learning framework in massive cellular system to optimize its performance is a challenge task. In this paper, multi‐cell massive cellular system with device‐to‐device (D2D) communication is studied, where D2D pairs and cellular users can share different orthogonal pilots to overcome interference at the cellular base station (BS). We propose data and pilot power controls scheme based on deep learning framework using convolutional neural network (CNN) for cellular and D2D users. The main focus is to obtain the optimal data and pilot powers (i.e., cellular pilot power, pCellular Userpilot, cellular data power, pCellular User, D2D pilot power, pD2Dpilot, and D2D data power, pD2D) for maximum spectral efficiency (SE). SE optimization problem is formulated with the goal of obtaining optimal transmit powers. Also, comparison between the proposed scheme and the iterative power control schemes (i.e., weighted minimum mean square error [MMSE] technique, bisection technique, and technique‐based geometric mean per‐cell max–min fairness) is provided. Results show that the proposed scheme can increase the sum SE of multi‐cell massive cellular system with D2D communications. [ABSTRACT FROM AUTHOR]