Miracle-dz/UniFAR-FTUs huggingface dataset:
Robot-assisted radical prostatectomy in Hong Kong: a review of 235 cases.

OBJECTIVES To report the outcome of all robot-assisted laparoscopic radical prostatectomy (RALP) in the public health care system in Hong Kong. PATIENTS AND METHODS All patients who underwent RALP in the public health care system with at least 1 year of follow-up were evaluated. Data analysis included age, body mass index, preoperative prostate-specific antigen (PSA) level, D'Amico risk category, operative details, pathologic stage, follow-up continence, potency, and biochemical recurrence. RESULTS Between 2005 and 2009, 235 patients underwent RALP, with a mean age of 66.4±5.9 years and a mean preoperative PSA level of 11.0±10.5 ng/mL. Complications were 16 (7%) in total. There were 176 (74.9%) patients with pT(2) disease and 55 (23.4%) patients with pT(3) disease. The overall rate of positive surgical margins (PSM) was 20.7%. At postoperative 12 months, 72.5% of the patients were pad free. For those 83 preoperative potent patients having nerve-sparing surgery, the overall trifecta rate at 12 months was 37.3%. Multivariate analysis identified that pathologic T staging was significantly associated with PSM, with an odds ratio (OR) of 7.884 (95% confidence interval [CI]: 3.576-17.379; P<0.001) for the pT(3) group compared with the pT(2) group. When comparing D'Amico medium- and high-risk categories with low-risk categories, they were found to be significantly associated with biochemical failure (medium- compared with low-risk: OR=3.536, 95% CI: 1.253-10.173, P=0.016; high- compared with low-risk: OR=10.214, 95% CI: 2.958-35.274, P<0.001). CONCLUSIONS Our data demonstrate the feasibility, safety, and efficacy of RALP in low-to-intermediate volume centers. Our early oncologic outcomes were significantly correlated with pathologic stage and D'Amico risk stratification.
“It is great what we have learned from each other!” – Bedside teaching in interprofessional small groups using the example of Parkinson’s disease

Background: While patient care often involves interprofessional collaboration, interprofessional teaching formats with participants from medical and physiotherapy fields are still rare. Furthermore, interprofessional education often takes place as separate courses and is not integrated into the clinical curriculum. Therefore, the goal of this project was to develop and implement interprofessional content into bedside teaching. Course development: The clinical subject of the course was “Parkinson’s disease”, as this condition allowed for the exemplary demonstration of interprofessional teamwork and different competencies. Through interprofessional bedside teaching and a specific clinical context, interprofessionalism was intended to be integrated and experienced as natural part of clinical practice. The bedside teaching was complemented with work in break-out groups and a lecture. Evaluation: The course was first conducted in the winter semester 2021/22. Participants were medical and physiotherapy students. Teaching teams were also interprofessional. A concurrent evaluation was carried out using the University of the West of England Interprofessional Questionnaire (UWE-IP) before and after course participation. UWE-IP scores in all sub-scales indicated a positive attitude, except for the “Interprofessional Learning” scale among physiotherapy students, which reflected a neutral attitude. Significant group differences were observed in the same scale at the pre-course time point between medical and physiotherapy students (p<0.01) and among medical students before and after course participation (p=0.02). Conclusion: The course proved to be well-suited for integrating interprofessional content into clinical education and can serve as a model for future teaching units. The evaluation reflected a positive attitude toward interprofessional learning.
[Diagnostic ability of GDx VCC for glaucoma diagnosis].

PURPOSE To assess the diagnostic ability of scanning laser polarimetry (GDx VCC) to differentiate between normal and glaucomatous eyes. METHODS 417 eyes of 417 consecutive subjects were prospectively selected. They were classified into 60 healthy controls, 218 ocular hypertensive eyes, 68 glaucoma suspects, and 71 glaucomatous eyes, depending on intraocular pressure, optic nerve head morphology and standard automated perimetry results. All underwent a scanning laser polarimetry with the GDx VCC. Retinal nerve fiber layer (RNFL) parameters of the GDx-VCC were compared among the four groups. Receiver operating characteristic (ROC) curves were plotted between normal and glaucomatous eyes. The best parameters were defined according to the area under the ROC curve and the best sensitivity/specificity balance. RESULTS Most parameters of GDx-VCC exhibited differences between the glaucoma group and the rest of the groups. Some parameters were also different between healthy patients and glaucoma suspects. The best parameter was the nerve fiber indicator (NFI; area under the ROC curve: 0.876). NFI, superior normalized area, and inferior normalized area yielded the highest sensitivities at 85% and 90% fixed specificity. CONCLUSIONS Most RNFL parameters measured with the GDx-VCC provided good diagnostic ability for open-angle glaucoma. The best GDx-VCC parameter in differentiating between normal and glaucomatous eyes was the NFI.
Power spectrum analysis of heart rate variability to assess the changes in sympathovagal balance during graded orthostatic tilt.

BACKGROUND The powers of the low-frequency (LF) and high-frequency (HF) oscillations characterizing heart rate variability (HRV) appear to reflect, in their reciprocal relationship, changes in the state of the sympathovagal balance occurring during numerous physiological and pathophysiological conditions. However, no adequate information is available on the quantitative resolution of this methodology. METHODS AND RESULTS We studied 22 healthy volunteers (median age, 46.5 years) who were subjected after a rest period to a series of passive head-up tilt steps randomly chosen from the following angles: 15 degrees, 30 degrees, 45 degrees, 60 degrees, and 90 degrees. From the continuous ECG, after appropriate analog-to-digital conversion, a personal computer was used to compute, with an autoregressive methodology, time and frequency domain indexes of RR interval variability. Spectral and cross-spectral analysis with the simultaneously recorded respiratory signal excluded its contribution to LF. Age was significantly correlated to variance and to the absolute values in milliseconds squared of very-low-frequency (VLF), LF, and HF components. The tilt angle was correlated to both LF and HF (expressed in normalized units [nu]) and to the LF-to-HF ratio (r = .78, -.72, and .68; respectively). Lower levels of correlation were found with HF (in ms2) and RR interval. No correlation was present between tilt angle and variance, VLF, or LF (in ms2). Individual analysis confirmed that the use of nu provided the greatest consistency of results. CONCLUSIONS Spectral analysis of HRV, using nu or LF-to-HF ratio, appears to be capable of providing a noninvasive quantitative evaluation of graded changes in the state of the sympathovagal balance.
Identification and characterization of the eps (Exopolysaccharide) gene cluster from Streptococcus thermophilus Sfi6

We report the identification and characterization of the eps gene cluster of Streptococcus thermophilus Sfi6 required for exopolysaccharide (EPS) synthesis. This report is the first genetic work concerning EPS production in a food microorganism. The EPS secreted by this strain consists of the following tetrasaccharide repeating unit:-->3)-beta-D-Galp-(1-->3)-[alpha-D-Galp-(1-->6)]-beta-D- D-Galp-(1-->3)-alpha-D-Galp-D-GalpNAc-(1-->. The genetic locus The genetic locus was identified by Tn916 mutagenesis in combination with a plate assay to identify Eps mutants. Sequence analysis of the gene region, which was obtained from subclones of a genomic library of Sfi6, revealed a 15.25-kb region encoding 15 open reading frames. EPS expression in the non-EPS-producing heterologous host, Lactococcus lactis MG1363, showed that within the 15.25-kb region, a region with a size of 14.52 kb encoding the 13 genes epsA to epsM was capable of directing EPS synthesis and secretion in this host. Homology searches of the predicted proteins in the Swiss-Prot database revealed high homology (40 to 68% identity) for epsA, B, C, D, and E and the genes involved in capsule synthesis in Streptococcus pneumoniae and Streptococcus agalactiae. Moderate to low homology (37 to 18% identity) was detected for epsB, D, F, and H and the genes involved in capsule synthesis in Staphylococcus aureus for epsC, D, and E and the genes involved in exopolysaccharide I (EPSI) synthesis in Rhizobium meliloti for epsC to epsJ and the genes involved in lipopolysaccharide synthesis in members of the Enterobacteriaceae, and finally for eps K and lipB of Neisseria meningitidis. Genes (epsJ, epsL, and epsM) for which the predicted proteins showed little or no homology with proteins in the Swiss-Prot database were shown to be involved in EPS synthesis by single-crossover gene disruption experiments.
Receptor-mediated entry of diphtheria toxin into monkey kidney (Vero) cells: electron microscopic evaluation

To express toxicity in living cells, diphtheria toxin (DT) must cross a membrane barrier and reach its target in the cytosol. Here we examine the entry of DT into the toxin-sensitive monkey kidney (Vero) cells. Using electron microscopy we directly demonstrated for the first time that DT is internalized by receptor-mediated endocytosis, i.e., via clathrin-coated pits, and enters the endosomal system. Methylamine, which is known to protect cells from DT, stopped the movement of toxin to coated areas of the cell membrane. In the presence of amine, prebound biotinyl-DT was internalized, but toxicity was inhibited. Biochemical evidence revealed that methylamine maintained toxin molecules at a site accessible to neutralization by antitoxin. The data suggest that DT entering Vero cells in the presence of methylamine is sequestered within the cell and does not express toxicity.
Combining information from multiple sources in the diagnosis of autism spectrum disorders.

BACKGROUND Standard case criteria are proposed for combined use of the Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule to diagnose autism and to define the broader category of autism spectrum disorders. METHOD Single and combined Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule algorithms were compared to best estimate diagnoses in four samples: U.S. (n = 960) and Canadian (n = 232) participants 3 years and older, U.S. participants younger than 36 months (n = 270), and U.S. participants older than 36 months with profound mental retardation (n = 67). RESULTS Sensitivities and specificities of 80% and higher were obtained when strict criteria for an autism diagnosis using both instruments were applied in the U.S. samples, and 75% or greater in the Canadian sample. Single-instrument criteria resulted in significant loss of specificity. Specificity was poor in the sample with profound mental retardation. Lower sensitivity and specificity were also obtained when proposed criteria for broader spectrum disorders were applied. CONCLUSIONS The Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule make independent, additive contributions to the judgment of clinicians that result in a more consistent and rigorous application of diagnostic criteria.
Influence of demographic factors on prolonged length of stay in an emergency department

Background A prolonged length of stay in an emergency department is related to lower quality of care and adverse outcomes, which are often linked with overcrowding. Objective Examine the influence of demographic factors on prolonged length of stay in the emergency department. Methods This study used a cross-sectional design. It used secondary data for all patients admitted during the specific duration at the emergency department of a governmental hospital in Saudi Arabia. The independent variables were gender, age, disposition status, shift time, and clinical acuity (CTAS) level while the dependent variable was prolonged length of stay. Results The study shows that 30% of patients stay at the emergency department for four hours or more. The results also show a significant association between demographic factors which are age, gender, disposition status, shift time, clinical acuity (CTAS) level and prolonged length of stay in an emergency department. Based on the results males are more likely to stay in the emergency department than females (OR = 1.20; 95% CI = 1.04 to 1.38). Patients aged 60 and older are less likely to stay in the emergency department than patients aged 29 or smaller (OR = 0.58; 95% CI = 0.39 to 0.84). According to disposition status discharged patients after examination stays in the emergency department more than admitted patients after the examination (OR = 2.78; 95% CI = 1.67 to 4.99). Patients who come to the night shift are less likely to stay in the emergency department than patients who come in the morning shift (OR = 0.67; 95% CI = 0.56 to 0.81). Patients who are classified in level three of CTAS are less likely to stay in the emergency department than patients who are classified in level one (OR = 0.28; 95% CI = 0.88 to 0.023). Conclusion Demographic factors such as age, gender, shift time, disposition status and clinical acuity (CTAS) were important factors that needed to be considered to reduce the length of stay of patients in the emergency department. it is possible to formulate a machine learning model to predict the anticipated length of stay in the hospital for each patient. This prediction with an accepted margin of uncertainty will help the clinicians to communicate the evidence-based anticipated length of stay with the patient’s caregivers. In addition, hospital managers need to provide the emergency department with enough staff and materials to reduce the length of stay of patients.
Bullying victimization among adolescents: Prevalence, associated factors and correlation with mental health outcomes

Introduction Knowledge of the risk factors of bullying victimization in adolescents is crucial for the implementation of preventive measures. This study aimed to determine the prevalence and associated factors of bullying victimization and to identify its correlation with mental health outcomes among middle school students in Tunisia. Methods A cross-sectional study was conducted using a multi-stage cluster sampling technique to recruit a sample of 1111 students from 10 middle schools in El kef (Tunisia). The revised Olweus Bully/Victim Questionnaire was used to assess the prevalence and types of bullying victimization and the perceived efforts of others to counteract bullying. The Strengths and Difficulties Questionnaire (SDQ) was used for screening emotional and behavioral problems. Multivariate logistic regression analysis was conducted to determine associated factors of bullying victimization. Additionally, we tested whether emotional and behavioral problems were present for bullying victims. Results The findings reported that 45.8% (95%CI = 45.5–46.0), of the total number of participants experienced school bullying victimization. Multivariate logistic regression analysis, revealed that repeating a grade (OR = 1.82, 95%CI = 1.31–2.54), having a working father (OR = 17.68; 95%CI = 2.29–136,15), and having a working mother (OR = 1.88, 95%CI = 1.39–2.53) were the factors significantly associated with bullying victimization. Nevertheless, a higher mother’s educational level (OR = 0.76, 95%CI = 0.67–0.88) was a protective factor against bullying victimization. The self-reported SDQ revealed that the total difficulties score was significantly higher among victims (17.46 ± 5.30 vs. 20.86 ± 5.06, p<0.01). Conclusions This study showed that the prevalence of bullying in middle schools was high and it significantly led to mental health problems. National policies for bullying prevention within schools are potentially needed. Improving students’ problem-solving and soft skills is also essential.
Automatic Classification of Auroral Images From the Oslo Auroral THEMIS (OATH) Data Set Using Machine Learning

Based on their salient features we manually label 5,824 images from various Time History of Events and Macroscale Interactions during Substorms (THEMIS) all‐sky imagers; the labels we use are clear/no aurora, cloudy, moon, arc, diffuse, and discrete. We then use a pretrained deep neural network to automatically extract a 1,001‐dimensional feature vector from these images. Together, the labels and feature vectors are used to train a ridge classifier that is then able to correctly predict the category of unseen auroral images based on extracted features with 82% accuracy. If we only distinguish between a binary classification aurora and no aurora, the true positive rate increases to 96%. While this study paves the way for easy automatic classification of all auroral images from the THEMIS all‐sky imager chain, we believe that the methodology shown here is readily applied to all images from any other auroral imager as long as the data are available in digital form. Both the neural network and the ridge classifier are free, off‐the‐shelf computer codes; the simplicity of our approach is demonstrated by the fact that our entire analysis comprises about 50 lines of Python code. Automatically attaching labels to all available all‐sky imager data would enable statistical studies of unprecedented scope.
Short-term effects of lumbar posteroanterior mobilization in individuals with low-back pain.

OBJECTIVE To establish the short-term effects of lumbar posteroanterior mobilization in patients with low-back pain, compared with a control intervention. DESIGN Self-controlled cross-over design. MAIN OUTCOME MEASURES The force-displacement characteristics of the spine in response to the application of a posteroanterior force, lumbar flexion, and extension range of movement; pain during flexion, extension, and on worst movement; pain on posteroanterior loading; and overall pain relief. PATIENTS Twenty-six patients with nonspecific low-back pain who experienced pain on flexion or extension and whose pain settled quickly after provocation, from a physiotherapy clinic and university campus. METHODS Patients received posteroanterior mobilization and a control intervention in an order that was randomly allocated. The magnitude of force in treatment dose was selected by the treating physiotherapist. An observer who was blinded to the order of interventions performed all measurements. Outcome measures were recorded before and after each intervention, and change scores were calculated to quantify the effect of the intervention. RESULTS No significant differences were found between the mobilization and control interventions in relation to posteroanterior response or range of movement. The score for pain on worst movement showed significantly greater improvement for the mobilization than for the control procedure. CONCLUSIONS Lumbar posteroanterior mobilization was not observed to produce any objectively measurable change in the mechanical behavior of the lumbar spine of patients with low-back pain. Improvement in some pain variables was observed in comparison with a control procedure, but this may be due to a placebo effect.
More Action to Address the Impact of Smoking in Women.

Food and Drug Administration and thus cannot be used clinically in the United States at this time. The importance of breathing pattern, and the impact of inhalation of 100% oxygen on breathing pattern in infants, must also be further explored (12). More work needs to be done to determine the appropriate number of tests to perform in preschool children and the best choice of outcome to report (best, worst, or mean LCI, washout to 5 vs. 2.5%, etc.) (13, 14). This study by Stanojevic and colleagues strongly supports the use of MBW testing in clinical research in young children with CF (6). However, further investigation to define clinically significant changes in LCI and into the impact of MBW testing on clinical decision making is needed. We must link changes in LCI to meaningful, long-term clinical outcomes in CF; this study, connecting pulmonary exacerbations to LCI, and showing a clear divergence in disease progression in healthy children versus those with CF, represents an important first step in that direction. n
Tumor Evolution Inferred by Patterns of microRNA Expression through the Course of Disease, Therapy, and Recurrence in Breast Cancer

Purpose: Molecular evolution of tumors during progression, therapy, and metastasis is a major clinical challenge and the main reason for resistance to therapy. We hypothesized that microRNAs (miRNAs) that exhibit similar variation of expression through the course of disease in several patients have a significant function in the tumorigenic process. Experimental design: Exploration of evolving disease by profiling 800 miRNA expression from serial samples of individual breast cancer patients at several time points: pretreatment, posttreatment, lymph nodes, and recurrence sites when available (58 unique samples from 19 patients). Using a dynamic approach for analysis, we identified expression modulation patterns and classified varying miRNAs into one of the eight possible temporal expression patterns. Results: The various patterns were found to be associated with different tumorigenic pathways. The dominant pattern identified an miRNA set that significantly differentiated between disease stages, and its pattern in each patient was also associated with response to therapy. These miRNAs were related to tumor proliferation and to the cell-cycle pathway, and their mRNA targets showed anticorrelated expression. Interestingly, the level of these miRNAs was lowest in matched recurrent samples from distant metastasis, indicating a gradual increase in proliferative potential through the course of disease. Finally, the average expression level of these miRNAs in the pretreatment biopsy was significantly different comparing patients experiencing recurrence to recurrence-free patients. Conclusions: Serial tumor sampling combined with analysis of temporal expression patterns enabled to pinpoint significant signatures characterizing breast cancer progression, associated with response to therapy and with risk of recurrence. Clin Cancer Res; 22(14); 3651–62. ©2016 AACR.