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Recent advancements in question-answering systems have significantly enhanced the capability of computers to understand and respond to queries in natural language. This paper presents a comprehensive review of the evolution of question answering systems, with a focus on the developments over the last few years. We examine the foundational aspects of a question answering framework, including question analysis, answer extraction, and passage retrieval. Additionally, we delve into the challenges that question answering systems encounter, such as the intricacies of question processing, the necessity of contextual data sources, and the complexities involved in real-time question answering. Our study categorizes existing question answering systems based on the types of questions they address, the nature of the answers they produce, and the various approaches employed to generate these answers. We also explore the distinctions between opinion-based, extraction-based, retrieval-based, and generative answer generation. The classification provides insight into the strengths and limitations of each method, paving the way for future innovations in the field. This review aims to offer a clear understanding of the current state of question answering systems and to identify the scaling needed to meet the rising expectations and demands of users for coherent and accurate automated responses in natural language.

Background Predicting difficult intubation (DI) is a key challenge, as no single clinical predictor is sufficiently valid to predict the outcome. We evaluated the effectiveness of four upper airway ultrasonographic parameters in predicting DI. The validity of the models using combinations of ultrasonography-based parameters was also investigated. Methods This prospective, observational, double-blinded cohort trial enrolled 1,043 surgical patients classified as American Society of Anesthesiologists physical status I–III without anticipated difficult airway. Preoperatively, their tongue thickness (TT), invisibility of hyoid bone (VH), and anterior neck soft tissue thickness from the skin to thyrohyoid membrane (ST) and hyoid bone (SH) were measured by sublingual and submandibular ultrasonography. The logistic regression, Youden index, and receiver operator characteristic analysis results were reported. Results Overall, 58 (5.6%) patients were classified as DI. The TT, SH, ST, and VH had accuracies of 78.4%, 85.0%, 84.7%, and 84.9%, respectively. The optimal values of TT, SH, and ST for predicting DI were > 5.8 cm (sensitivity: 84.5%, specificity: 78.1%, AUC: 0.880), > 1.4 cm (sensitivity: 81%, specificity: 85.2%, AUC: 0.898) and > 2.4 cm (sensitivity: 75.9%, specificity: 85.2%, AUC: 0.885) respectively. VH had a sensitivity and specificity of 72.4% and 85.6% (AUC: 0.790). The AUC values of the five models (with combinations of three or four parameters) ranged from 0.975–0.992. ST and VH had a significant impact on the individual models. Conclusions SH had the best accuracy. Individual parameters showed limited validity. The model including all four parameters offered the best diagnostic value.

The mechanical properties of the extracellular matrix (ECM) are important in maintaining normal physiological function, and changes in ECM mechanics drive disease. The biochemical structure of the ECM is modified with aging and in diseases such as diabetes. One mechanism of ECM modification is the non-enzymatic reaction between sugars and ECM proteins resulting in formation of advanced glycation end products (AGEs). Some AGE reactions result in formation of molecular crosslinks within or between matrix proteins, but it is not clear how sugar-mediated biochemical modification of the ECM translates to changes in kidney ECM mechanical properties. AGE-mediated changes in ECM mechanics may have pathological consequences in diabetic kidney disease. To determine how sugars alter the mechanical properties of the kidney ECM, we employ custom methodologies to evaluate the mechanical properties of isolated tubular basement membrane (TBM) and glomerular ECM. Results show that the mechanical properties of TBM and glomerular ECM stiffness were altered by incubation in glucose and ribose. Mechanical behavior of TBM and glomerular ECM were further evaluated using mechanical models for hyperelastic materials in tension and compression. Increased ECM stiffness following sugar modification corresponded to increased crosslinking as determined by ECM fluorescence and reduced pepsin extractability of sugar modified ECM. These results show that sugar-induced modifications significantly affect the mechanical properties of kidney ECM. AGE-mediated changes in ECM mechanics may be important in progression of chronic diseases including diabetic kidney disease.

Ventriculoperitoneal (VP) shunts complications are most often divided into 2 broad categories: mechanical failure and infection. We report a case of a migrated VP shunt with subsequent development of a pseudocyst around the patient's breast implant, a rare complication. We review the literature of VP shunt complications, including the increasing number of reported breast-related complications, and discuss proposed mechanisms by which migration may occur. With the increase in patients with breast augmentation procedures, there is potential for an increase in the number of reported cases of VP shunt migration. Keywords: VP shunt complication, Breast implant

Accidental finding of yellow colored CSF may pose a sudden dilemma to the mind of anesthesiologist whether to perform the block or not. Yellow coloration of CSF can be due to subarachnoid bleed or raised protein in the CSF. Anesthesiologists should have a working knowledge of this subject which will help in managing the cases peri-operatively with improved outcome.