Miracle-dz/UniFAR-FTUs huggingface dataset:
Robot-assisted versus open radical prostatectomy : the day after

Contrary to the available systematic reviews of non-randomized comparative studies, the recent Australian RCT demonstrated that robot-assisted (RARP) and retropubic radical prostatectomy (RRP) yield similar functional outcomes at 12 weeks follow-up. Conversely, the same trial confirmed that RARP has been associated with lower estimated blood loss (EBL), better pain control and equivalent complication rate in comparison with RRP. The Authors discussed some critical aspects influencing the interpretation of the results of the Royal Brisbane & Women’s Hospital (RBWH) trial and the implications for patients, urologists and health system providers. A cc ep te d A rt ic le This article is protected by copyright. All rights reserved. Introduction Sixteen years after the execution of the first robot-assisted radical prostatectomy (RARP), Yaxley et al have been published an interim analysis of the first randomized controlled trial (RCT) comparing RARP and retropubic radical prostatectomy (RRP) [1]. Contrary to the available systematic reviews of nonrandomized comparative studies [2, 3], the RCT demonstrated that the two techniques yield similar functional outcomes at 12 weeks follow-up [1]. Conversely, the Australian trial confirmed that RARP has been associated with lower estimated blood loss (EBL), better pain control and equivalent complication rate in comparison with RRP [1, 4]. Some critical aspects could influence the interpretation of the results of the Royal Brisbane & Women’s Hospital (RBWH) trial. 1) Only 25% of the observed cases were enrolled and randomized. We could speculate that patients accepting to be randomized had either baseline health-related quality of life (HRQoL), or expectations or psychological profile that satisfaction after surgery was the same regardless of the approach, thereby leading them to self-report not dissimilar functional outcomes. 2) At the study start, the robotic surgeon had performed a 2-yr fellowship plus 200 RARPs, whereas the open surgeon had about 1500 RRPs under his belt [1]. Therefore, the different experience of two surgeons involved in the study may have negatively influenced the robotic functional outcomes. 3) Surgical techniques used during the different steps of the procedures can influence the primary endpoints of the trial, regardless of the approach used. Surprisingly, no information concerning specific details of the surgical techniques eventually adopted to improve early urinary continence or potency recovery were reported for both arms of the study. 4) The choice of the primary outcomes could be questionable. Indeed, urinary continence and potency rates could be probably considered as more appealing and appropriate endpoints to compare two surgical approaches instead of more generic urinary and sexual functions evaluated using the corresponding domains of Expanded Prostate Index Composite (EPIC).
Dual Stain With SATB2 and CK20/Villin Is Useful to Distinguish Colorectal Carcinomas From Other Tumors

Objectives Small sample size limits the number of immunostains that may be attempted in colorectal carcinoma (CRC) biopsy specimens. We investigated the utility of dual stain with special AT-rich sequence binding protein 2 (SATB2) or caudal-type homeobox 2 (CDX2) and cytokeratin 20 (CK20) or villin in identifying CRC. Methods Tissue microarrays with 222 CRCs and 375 other carcinomas were built. Dual stain was performed pairing nuclear stains CDX2 or SATB2 with CK20 or villin. Results All four single stains showed excellent sensitivity (93%-99%) but variable specificity (56%-88%) for CRC. All four dual stains also showed excellent sensitivity (90%-96%) while much improved specificity (88%-98%) compared with single stains. SATB2 dual stain (with CK20 or villin) showed a higher specificity than CDX2 dual stain (with CK20 or villin) with a comparable sensitivity. Conclusions SATB2 dual stain shows the greatest potential clinical utility in identifying CRC and is superior to CDX2 dual stain. More important, SATB2 dual stain could be helpful for specimens with limited tissues or those having a nonclassic staining pattern.
Published in final edited form as: Title: Characterization of Perfluorocarbon Relaxation Times and their Influence on the Optimization of Fluorine-19 MRI at 3 Tesla

The two main challenges that prevent the translation of fluorine-19 (F) MRI for inflammation monitoring or cell tracking into clinical practice are 1) the relatively low signal-to-noise ratio generated by the injected perfluorocarbons (PFC), which necessitates long scan times, and 2) the need for regulatory approval and a high biocompatibility of PFCs that are also suitable for MRI. ABL-101, an emulsion of perfluoro(t-butylcyclohexane), is a third-generation PFC that is already used in clinical trials, but has not yet been used for F MRI. The objective of this study was therefore to assess the performance of ABL-101 as a F MRI tracer. At magnetic field strengths of 3, 9.4, and 14.1T, the CF3 groups of ABL-101 generated a large well-separated singlet with T2/T1 ratios >0.27, >0.14 and >0.05, respectively. All relaxation times decreased with the increase of magnetic field strength. The detection limit of ABL-101 in a 0.25mm voxel at 3T, 37°C and with a 3-minute acquisition time was 7.21mM. After intravenous injection, the clearance half-lives of the ABL-101 F MR signal in mouse (n=3) spleen and liver were 6.85±0.45 days and 3.20±0.35 days, respectively. These results demonstrate that ABL-101 has F MR characteristics that are similar to those of PFCs developed specifically for MRI, while it has clearance half-lives similar to PFCs that have previously been used in large doses in non-MRI clinical trials. Overall, ABL-101 is thus a very promising candidate tracer for future clinical trials that use F MRI for cell tracking or the monitoring of inflammation.
Evaluation of a Mindfulness-Based Mobile App Aimed at Promoting Awareness of Weight-Related Behaviors in Adolescents: A Pilot Study

Background Mindfulness-based interventions are reported to be highly acceptable and have positive effects on youth, yet most are clinic- or school-based aimed at emotional regulation or academic performance. To provide flexible program delivery, we developed and tested a standalone mindfulness-based app aimed at improving weight-related behaviors (eg, diet, physical activity, sleep) in adolescents. Objective Our objective was to assess the feasibility, acceptability, and utility of a mindfulness-based mobile app. Methods In a single-arm pilot study, 15 adolescents (14-18 years) were prompted to access the app once a day, every day for 6 weeks. Outcomes were measured by in-app and poststudy surveys, and descriptive statistical analyses were performed. Time within a mindfulness state was self-reported during weekly timed practices. Results The app was rated highly for content and encouraging the practice of activities to promote mindfulness states. Teens reported increased awareness of eating behaviors and high adherence, particularly during physically active practices. Average self-reported time spent in a mindfulness state increased 2.5 times by week 6 (78 [SD 17] seconds) compared to week 1 (31 [SD 21] seconds). Conclusions The high acceptability and utility ratings of the app, increases in reported time in mindfulness states, and high frequency of participation, including mindful eating and physical activity, suggest the mindfulness-based mobile app has the potential to improve awareness of weight-related behaviors.
Dance for Adults With Fibromyalgia—What Do We Know About It? Protocol for a Scoping Review

Background Fibromyalgia is a chronic disorder characterized by widespread muscular tenderness, pain, fatigue, and cognitive difficulties. Nonpharmacological treatment options, such as physical activity, are important for people with fibromyalgia. There are strong recommendations to support engagement in physical activity for symptom management among adults with fibromyalgia. Dance is a mode of physical activity that may allow individuals with fibromyalgia to improve their physical function, health, and well-being. Dance has the potential to promote improved pain processing while simultaneously providing the health and social benefits of engaging in physical activity that contributes to symptom management. However, we are unaware of current evidence on dance as a nonpharmacological/physical activity intervention for adults with fibromyalgia. Objective The aims of the study are to provide an overview of the extant evidence to understand how dance is used for individuals with fibromyalgia; to examine the extent, range, and nature of research activity in the area; and to determine the value of undertaking a full systematic review. Methods Scoping reviews are useful to comprehensively and systematically map the literature and identify key evidence, or research gaps. The search strategy will involve electronic databases including Medline, Embase, Cochrane Library, PsycInfo, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Literature in the Health Sciences in Latin America and the Caribbean (LILACS), Allied and Complementary Medicine (AMED), International Bibliography of Theatre and Dance, Physiotherapy Evidence Database (PEDro), Trip, Proquest Theses/Dissertations, Web of Science, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. The study will be mapped in seven stages: (1) identifying the research questions, (2) identifying relevant studies, (3) selecting the studies, (4) charting the data, (5) collating, summarizing and reporting the results, (6) consulting, and (7) disseminating the knowledge. Results The search, title, and abstract are now completed; full text screening was carried out and authors are awaiting interlibrary loans and translations. Data extraction will start shortly after full text ‘screening’ is completed. Completion is expected in Fall 2017. Conclusions To our knowledge this will be the first attempt to systematically identify knowledge of dance as a potential intervention for adults with fibromyalgia. This scoping review offers a feasible means for describing the evidence specific to dance and fibromyalgia; results will provide unique insights concerning the breadth and depth of literature in the area. An analysis of this body of literature as a whole may reveal new research directions or unknown ways this intervention could strengthen current management approaches of the disease.
Understanding vasopressor intervention and weaning: risk prediction in a public heterogeneous clinical time series database

Background The widespread adoption of electronic health records allows us to ask evidence-based questions about the need for and benefits of specific clinical interventions in critical-care settings across large populations. Objective We investigated the prediction of vasopressor administration and weaning in the intensive care unit. Vasopressors are commonly used to control hypotension, and changes in timing and dosage can have a large impact on patient outcomes. Materials and Methods We considered a cohort of 15 695 intensive care unit patients without orders for reduced care who were alive 30 days post-discharge. A switching-state autoregressive model (SSAM) was trained to predict the multidimensional physiological time series of patients before, during, and after vasopressor administration. The latent states from the SSAM were used as predictors of vasopressor administration and weaning. Results The unsupervised SSAM features were able to predict patient vasopressor administration and successful patient weaning. Features derived from the SSAM achieved areas under the receiver operating curve of 0.92, 0.88, and 0.71 for predicting ungapped vasopressor administration, gapped vasopressor administration, and vasopressor weaning, respectively. We also demonstrated many cases where our model predicted weaning well in advance of a successful wean. Conclusion Models that used SSAM features increased performance on both predictive tasks. These improvements may reflect an underlying, and ultimately predictive, latent state detectable from the physiological time series.
Incidence of Brain Infarcts, Cognitive Change, and Risk of Dementia in the General Population: The AGES-Reykjavik Study (Age Gene/Environment Susceptibility-Reykjavik Study)

Background and Purpose— The differentiation of brain infarcts by region is important because their cause and clinical implications may differ. Information on the incidence of these lesions and association with cognition and dementia from longitudinal population studies is scarce. We investigated the incidence of infarcts in cortical, subcortical, cerebellar, and overall brain regions and how prevalent and incident infarcts associate with cognitive change and incident dementia. Methods— Participants (n=2612, 41% men, mean age 74.6±4.8) underwent brain magnetic resonance imaging for the assessment of infarcts and cognitive testing at baseline and on average 5.2 years later. Incident dementia was assessed according to the international guidelines. Results— Twenty-one percent of the study participants developed new infarcts. The risk of incident infarcts in men was higher than the risk in women (1.8; 95% confidence interval, 1.5–2.3). Persons with both incident and prevalent infarcts showed steeper cognitive decline and had almost double relative risk of incident dementia (1.7; 95% confidence interval, 1.3–2.2) compared with those without infarcts. Persons with new subcortical infarcts had the highest risk of incident dementia compared with those without infarcts (2.6; 95% confidence interval, 1.9–3.4). Conclusions— Men are at greater risk of developing incident brain infarcts than women. Persons with incident brain infarcts decline faster in cognition and have an increased risk of dementia compared with those free of infarcts. Incident subcortical infarcts contribute more than cortical and cerebellar infarcts to incident dementia which may indicate that infarcts of small vessel disease origin contribute more to the development of dementia than infarcts of embolic origin in larger vessels.
Impacted and transmigrant mandibular canines incidence, aetiology, and treatment: a systematic review

Background The incidence of impacted and transmigrant mandibular canines in the mandible is not as high as that in the maxilla; consequently, it is more difficult to find clinical guidelines derived from sound studies based on large patient samples. Objectives The aim of this systematic review was to summarize currently available data pertaining to the incidence and aetiology of impacted and transmigrant mandibular canines and the success rates of different treatment strategies. Methods This review was registered with PROSPERO (CRD42014006175) and was conducted using PRISMA and CRD (Centre for Reviews and Dissemination, University of York) statement. A computerized search of studies published up to February 2016 was conducted using the following databases: PubMed, Cochrane Central Register of Controlled Clinical trials, ISI Web of Knowledge, and Scopus. To identify any relevant publications not included in this list, we manually searched the references lists of the selected articles. The Newcastle-Ottawa Scale quality assessment tool was utilized to classify the included articles. Results In total, 630 articles were identified after the removal of duplicates. A total of 13 studies published between 2001 and 2015 met all the eligibility criteria and were included for the final analysis. The sample size in these studies ranged from 14 to 112873 teeth, while their methodological quality ranged from low to medium. Conclusions According to the findings from our review, the incidence of canine impaction in the mandible ranges from 0.92 to 5.1 per cent, while that of canine transmigration ranges from 0.1 to 0.31 per cent. Various etiologies may play a role, including odontomes (up to 20 per cent) and lateral incisor anomalies (16 per cent). Surgical extraction (89 per cent in some studies) and orthodontic traction (20-32 per cent) are the most commonly used treatment strategies, with the latter showing a failure rate of 17 per cent in two studies.
Centrosome centering and decentering by microtubule network rearrangement

The centrosome is positioned at the cell center by pushing and pulling forces transmitted by microtubules (MTs). Centrosome decentering is often considered to result from asymmetric, cortical pulling forces exerted in particular by molecular motors on MTs, and controlled by external cues affecting the cell cortex locally. Here we used numerical simulations to investigate the possibility that it could equally result from the redistribution of pushing forces due to a reorientation of MTs. We first showed that MT gliding along cell edges and pivoting around the centrosome regulate MT rearrangement and thereby direct the spatial distribution of pushing forces, while the number, dynamics and stiffness of MTs determine the magnitude of these forces. By modulating these parameters, we identified different regimes, involving both pushing and pulling forces, characterized either by robust centrosome centering, robust off-centering or “reactive” positioning. In those latter conditions weak asymmetric cues can induce a misbalance of pushing and pulling forces resulting in an abrupt transition from a centered to an off-centered position. Altogether these results point at the central role played by the configuration of the MTs on the distribution of pushing forces that position the centrosome. We suggest that asymmetric external cues should not be seen as direct driver of centrosome decentering and cell polarization, but rather as inducers of an effective reorganization of the MT network, fostering centrosome motion to the cell periphery.
Discovery of EGF Receptor Inhibitors That Are Selective for the d746-750/T790M/C797S Mutant through Structure-Based de Novo Design.

Next-generation epidermal growth factor receptor (EGFR) inhibitors against the d746-750/T790M/C797S mutation were discovered through two-track virtual screening and de novo design. A number of nanomolar inhibitors were identified using 2-aryl-4-aminoquinazoline as the molecular core and the modified binding energy function involving a proper dehydration term, which provides important structural insight into the key principles for high inhibitory activities against the d746-750/T790M/C797S mutant. Furthermore, some of these EGFR inhibitors showed a greater than 1000-fold selectivity for the d746-750/T790M/C797S mutant over the wild type, as well as nanomolar activity against the mutant.
Exploring the impact and use of patients’ feedback about their care experiences in general practice settings—a realist synthesis

Abstract Background Policy encourages health care providers to listen and respond to feedback from patients, expecting that it will enhance care experiences. Enhancement of patients’ experiences may not yet be a reality, particularly in primary health care settings. Objective To identify the issues that influence the use and impact of feedback in this context. Design and Setting A realist synthesis of studies of the use of patient feedback within primary health care settings. Methods Structured review of published studies between 1971 and January 2015. Results Eighteen studies were reported in 20 papers. Eleven studies reported patient survey scores as a primary outcome. There is little evidence that formal patient feedback led to enhanced experiences. The likelihood of patient feedback to health care staff stimulating improvements in future patients’ experiences appears to be influenced predominantly by staff perceptions of the purpose of such feedback; the validity and type of data that is collected; and where, when and how it is presented to primary health care teams or practitioners and teams’ capacity to change. Conclusions There is limited research into how patient feedback has been used in primary health care practices or its usefulness as a stimulant to improve health care experience. Using a realist synthesis approach, we have identified a number of contextual and intervention-related factors that appear to influence the likelihood that practitioners will listen to, act on and achieve improvements in patient experience. Consideration of these may support research and improvement work in this area.
Presence of Obstetrics Cholestasis in Mothers Presenting with Pruritus in Pregnancy: In a Low Resource South Asian Setting

Obstetric cholestasis (also referred to as intrahepatic cholestasis of pregnancy—ICP) is a pruritic form of reversible cholestasis that is associated with significant fetal risks. There is a paucity of research regarding pregnancy outcomes of the mothers with obstetric cholestasis in the South Asian setting. Hence, the objective of this study was to determine the prevalence of obstetric cholestasis among mothers presenting with pruritus during pregnancy and to describe the characteristics and outcomes for those diagnosed with ICP in comparison with those with pruritus in the absence of ICP. Methods: All mothers presenting with pruritus to De Soyza Maternity hospital in Colombo Sri Lanka, between 1st January 2011 to 1st January 2014, were recruited for the study. A standard set of biochemical tests were used for diagnosis of ICP. An interviewer administered questionnaire and patient records were used for data collection. Presentation, characteristics and pregnancy outcomes were assessed and compared for mothers with ICP against those with pruritus in the absence of ICP. Results: The prevalence of ICP in the study population was found to be 27% (n = 27). Generalized pruritus with pruritus of the palms and soles was identified as the commonest pattern of pruritus for diagnosed with ICP. Delivery before 37 weeks (p = 0.001), meconium stained liquor (p = 0.004), placental abruption (p = 0.005), postpartum hemorrhage (p = 0.005), bleeding manifestation (p = 0.006), preterm labor (p = 0.031) and fetal distress (p = 0.035) were found to be significantly associated with the presence of ICP. Conclusions: Nearly 1/3 of mothers presenting with pruritus in pregnancy in Sri Lanka are affected by ICP which is associated with an increase in a wide range of adverse maternal and fetal outcomes compared to those with pruritus in the absence of ICP.