Miracle-dz/UniFAR-FTUs huggingface dataset:
Compared With Elastin Stains, h-Caldesmon and Desmin Offer Superior Detection of Vessel Invasion in Gastric, Pancreatic, and Colorectal Adenocarcinomas

Background. The presence of vessel invasion is considered indicative of a poor prognosis in many malignant tumors. We aimed to compare the sensitivity of elastin stains (van Gieson’s and orcein methods) with 2 smooth muscle markers (h-caldesmon and desmin) in gastric, pancreatic, and colorectal adenocarcinoma specimens. Materials and Methods. We used 27 (29.3%) gastric, 35 (38.0%) pancreatic, and 30 (32.6%) colorectal resection specimens. We applied a provisional classification of vessel invasion patterns: type A, a focus with a nearby artery unaccompanied by a vein; type T, a focus at the invasive front without an unaccompanied artery; and type X, foci that only appeared by any of the 4 stains used. Results. There were 369 foci. The smooth muscle markers were more sensitive than the elastin stains, and h-caldesmon more sensitive than desmin, in all types. Among the 139 type A foci, 33 (23.7%) were positive by desmin and h-caldesmon, whereas the elastin stains were not (P = .001). h-Caldesmon was the only positive marker in 11 (7.9%; P = .011). Among the 78 type T foci, 21 (26.9%) were positive by desmin and h-caldesmon, when both elastin stains were negative (P = .000). In 16 (20.5%) foci, h-caldesmon was the only positive marker (P = .002). Among 152 type X foci, 91 (59.9%) were positive by all markers, 26 (17.1%) by both desmin and h-caldesmon, and 9 (5.9%) by only the 2 elastin stains (P = .001). Conclusion. We recommend these stains for suspect foci in gastric, pancreatic, and colorectal adenocarcinoma specimens. They might highlight both predictable and unpredictable foci.
ACTG2-Associated Visceral Myopathy With Chronic Intestinal Pseudoobstruction, Intestinal Malrotation, Hypertrophic Pyloric Stenosis, Choledochal Cyst, and a Novel Missense Mutation

Primary visceral myopathy caused by a pathogenic mutation in the gene encoding the enteric smooth muscle actin gamma 2 (ACTG2) affects gastrointestinal and genitourinary tracts and often presents as chronic intestinal pseudoobstruction. We present a case of pediatric onset chronic intestinal pseudoobstruction associated with a novel missense ACTG2 mutation c.439G>T/p.G147C. In addition to the known disease manifestations of feeding intolerance and intestinal malrotation, our patient had a late-onset hypertrophic pyloric stenosis and a late-onset choledochal cyst, the former of which has not previously been described in patients with ACTG2-associated visceral myopathy.
Aging increases cell-to-cell transcriptional variability upon immune stimulation

Single-cell sequencing of mouse immune cells reveals how aging destabilizes a conserved transcriptional activation program. Aging and variability among immune cells How and why the immune system becomes less effective with age are not well understood. Martinez-Jimenez et al. performed single-cell sequencing of CD4+ T cells in old and young mice of two species. In young mice, the gene expression program of early immune activation was tightly regulated and conserved between species. However, as mice aged, the expression of genes involved in pathways responding to immune cell stimulation was not as robust and exhibited increased cell-to-cell variability. Science, this issue p. 1433 Aging is characterized by progressive loss of physiological and cellular functions, but the molecular basis of this decline remains unclear. We explored how aging affects transcriptional dynamics using single-cell RNA sequencing of unstimulated and stimulated naïve and effector memory CD4+ T cells from young and old mice from two divergent species. In young animals, immunological activation drives a conserved transcriptomic switch, resulting in tightly controlled gene expression characterized by a strong up-regulation of a core activation program, coupled with a decrease in cell-to-cell variability. Aging perturbed the activation of this core program and increased expression heterogeneity across populations of cells in both species. These discoveries suggest that increased cell-to-cell transcriptional variability will be a hallmark feature of aging across most, if not all, mammalian tissues.
Open Ankle Arthrodesis With a Fibular-Sparing Technique

Background: Many ankle arthrodesis techniques excise the fibula or require a fibular osteotomy. Advantages of fibular preservation include increased surface area for bony union, preservation of the peroneal groove, prevention of valgus drift in cases of delayed union, and facilitation of future ankle arthroplasty. The goal of this study was to evaluate fusion rate and clinical outcomes of a novel open fibular-sparing ankle arthrodesis technique. Methods: A total of 50 consecutive ankle arthrodeses using this technique were included in this study. These consisted of 46 patients with an average age of 52 (range, 30 to 71) years. Outcomes assessed postoperatively included radiographs, complications, patient satisfaction, and functional scoring. Results: At an average of 28 (range, 19 to 56) months postoperatively, 38 patients (42 ankles) were available for review. Of the 42 cases, 39 (93%) achieved union at an average of 12 weeks postoperatively. Of patients, 86% reported being “completely satisfied” with the outcome. Average AOFAS Ankle-Hindfoot Scale was 84 ± 12 and average Foot Function Index pain subscale was 1 ± 0.9. Two ankles (5%) were fused in excessive varus; no patient required revision surgery for malalignment. Conclusion: This method of open ankle arthrodesis preserved the fibula and had a high fusion rate with good patient outcome scores. Level of Evidence: Level IV, retrospective case series.
Mass seasonal bioflows of high-flying insect migrants

Mass movement of “invisibles” We know a lot about vertebrate migrations globally. However, the majority of animals that live on this planet are invertebrates, and we know very little about their movements. Hu et al. monitored the migration of large and small insects over the southern United Kingdom for a decade. They found that more than a trillion insects move across this region annually. The movement of such a large biomass has considerable impacts on the ecosystems between which the insects migrate. Science, this issue p. 1584 Long-term measurements above the United Kingdom reveal that trillions of insects migrate above our heads annually. Migrating animals have an impact on ecosystems directly via influxes of predators, prey, and competitors and indirectly by vectoring nutrients, energy, and pathogens. Although linkages between vertebrate movements and ecosystem processes have been established, the effects of mass insect “bioflows” have not been described. We quantified biomass flux over the southern United Kingdom for high-flying (>150 meters) insects and show that ~3.5 trillion insects (3200 tons of biomass) migrate above the region annually. These flows are not randomly directed in insects larger than 10 milligrams, which exploit seasonally beneficial tailwinds. Large seasonal differences in the southward versus northward transfer of biomass occur in some years, although flows were balanced over the 10-year period. Our long-term study reveals a major transport process with implications for ecosystem services, processes, and biogeochemistry.
Elimination of overflow oscillations in fixed-point state-space digital filters with saturation arithmetic: an LMI approach

A novel, linear-matrix inequality (LMI) based, criterion for the nonexistence of overflow oscillations in fixed-point state-space digital filter employing saturation arithmetic is presented. The criterion is based on a unique characterization (as prevailing in the filter under consideration) of the saturation nonlinearities, namely, an "effective" reduction of the sector.
Ankle Arthrodesis vs TTC Arthrodesis

Background: It is believed that patients with an ankle arthrodesis (AA) have better outcomes than after a tibiotalocalcaneal (TTC) arthrodesis due to preservation of subtalar motion. However, there are no studies comparing actual functional outcomes and patient satisfaction between AA and TTC arthrodesis. Methods: We retrospectively analyzed patient satisfaction and functional outcomes of patients after an AA and TTC arthrodesis using a postal survey. A total of 173 patients who underwent TTC and 100 AA patients from 2002 to 2010 were identified with a minimum of 24 months follow-up. In all, 53 AA and 64 TTC arthrodesis patients were included in the study, with the remainder lost to follow-up. A return to activity questionnaire and SF-12 scores were used to compare functional outcomes. The mean follow-up time was 63 months. Results: Both groups showed good outcomes with a low visual analogue pain score (2.7 for AA and 2.8 for TTC), high satisfaction score (90.6% for AA and 87.5% for TTC), and return to work (77.4% for AA and 73.0% for TTC). In all, 84.6% of AA and 81.0% of TTC patients would have the surgery again. There were no significant differences between the 2 groups for these parameters. However, when asked if their desired activity level was met, fewer AA patients met their desired level (58.5% for AA and 66.5% for TTC, P = .02). AA patients were also more likely to feel their level was unmet due to the foot and ankle (85.6% for AA vs 25.7% for TTC, P < .001). Conclusions: Both AA and TTC arthrodesis were associated with good functional outcomes and satisfaction. AA patients had higher postoperative activity expectations and were less likely to meet them. When they failed to meet these expectations, they were much more likely to attribute it to their operated ankle. We believe it is because of the different ways the 2 groups of patients are counseled preoperatively, which highlights the importance of managing patient expectations. Level of Evidence: Level III, retrospective comparative study.
Reconstruction of Calcaneal Fracture Malunion With Osteotomy and Subtalar Joint Salvage

Background: The goal of this study was to discuss the outcomes of treating calcaneal fracture malunion by restoring the subtalar joint with a reconstructive osteotomy. Methods: From May 2005 to November 2008, 24 patients (26 feet) with calcaneal malunions after a displaced intra-articular calcaneal fracture were treated by osteotomy and autogenous bone graft. The subtalar joint was preserved. The mean time from initial injury to reconstructive operation was 5.7 months (95% confidence interval, 4.5-8.8 months). The displaced posterior facet was restored through a reconstructive osteotomy, whereas the bone defect in the calcaneus after reduction was filled with the exostosis that had been removed; iliac bone graft was used if necessary. All patients were evaluated clinically and radiographically at a minimum of 24 months. Twenty patients (21 feet) were followed for a mean of 34.2 months (29.0-39.4 months). Results: According to American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hindfoot score, the average score was 85.9 points (95% confidence interval, 81.5-90.4 points), which was significantly higher than the preoperative assessment. Radiographs showed that Böhler’s angle, Gissane’s angle, talus declination angle, and width and height of calcaneus were improved to a great extent. Six patients had wound edge necrosis, and 2 had superficial infection. One patient required a subtalar fusion for subtalar arthritis at 2 years after surgery. Conclusions: Restoring the subtalar joint with a reconstructive osteotomy and autogenous bone graft was an effective treatment method for selected calcaneal fracture malunions. It reconstructed calcaneal morphology and preserved the subtalar joint. Level of Evidence: Level IV, retrospective case series.
Apparent and Real Age Estimation in Still Images with Deep Residual Regressors on Appa-Real Database

After decades of research, the real (biological) age estimation from a single face image reached maturity thanks to the availability of large public face databases and impressive accuracies achieved by recently proposed methods. The estimation of “apparent age” is a related task concerning the age perceived by human observers. Significant advances have been also made in this new research direction with the recent Looking At People challenges. In this paper we make several contributions to age estimation research. (i) We introduce APPA-REAL, a large face image database with both real and apparent age annotations. (ii)We study the relationship between real and apparent age. (iii) We develop a residual age regression method to further improve the performance. (iv) We show that real age estimation can be successfully tackled as an apparent age estimation followed by an apparent to real age residual regression. (v) We graphically reveal the facial regions on which the CNN focuses in order to perform apparent and real age estimation tasks.
OULU-NPU: A Mobile Face Presentation Attack Database with Real-World Variations

The vulnerabilities of face-based biometric systems to presentation attacks have been finally recognized but yet we lack generalized software-based face presentation attack detection (PAD) methods performing robustly in practical mobile authentication scenarios. This is mainly due to the fact that the existing public face PAD datasets are beginning to cover a variety of attack scenarios and acquisition conditions but their standard evaluation protocols do not encourage researchers to assess the generalization capabilities of their methods across these variations. In this present work, we introduce a new public face PAD database, OULU-NPU, aiming at evaluating the generalization of PAD methods in more realistic mobile authentication scenarios across three covariates: unknown environmental conditions (namely illumination and background scene), acquisition devices and presentation attack instruments (PAI). This publicly available database consists of 5940 videos corresponding to 55 subjects recorded in three different environments using high-resolution frontal cameras of six different smartphones. The high-quality print and videoreplay attacks were created using two different printers and two different display devices. Each of the four unambiguously defined evaluation protocols introduces at least one previously unseen condition to the test set, which enables a fair comparison on the generalization capabilities between new and existing approaches. The baseline results using color texture analysis based face PAD method demonstrate the challenging nature of the database.
The Clinical Neuroscience of Post Stroke Depression

Post stroke depression or PSD is believed to occur in ten to forty percent of all patients who survive stroke. These mood disturbances overlap with primary major depressive disorder in terms of symptom profile, natural history and response to antidepressant medications. Cognitive changes, especially impairments in executive functions, are commonly encountered in PSD. This may be the result of disruption to fronto-thalam o-cortical circuits in PSD. Both functional limitations following stroke and biological mechanisms may play important roles in the pathophysiology of PSD. Antidepressants are clinically effective in managing these mood disturbances and may have an important role in the prophylaxis of depression following stroke. PSD provides a naturalistic model that facilitates the study of the clinical correlates and neurobiological mechanisms that may be relevant in the pathophysiology of vascular depression.
Removal torque and histomorphometric evaluation of bioceramic grit-blasted/acid-etched and dual acid-etched implant surfaces: an experimental study in dogs.

BACKGROUND Surface modifications to dental implants have been used in an attempt to accelerate the osseointegration process. The objective of this study was to biomechanically/histomorphometrically evaluate a bioceramic grit-blasted and acid-etched surface (BGB/AA; test) versus a dual acid-etched implant surface (control) in a beagle dog model. METHODS Control and BGB/AA implants were subjected to a series of physicochemical characterization tools, including scanning electron microscopy (SEM), atomic force microscopy (AFM), and auger photoelectron spectroscopy (APS). The animal model included the placement of 72 implants along the proximal tibiae of six beagle dogs, which remained in place for 2 or 4 weeks. After euthanization, half of the specimens were biomechanically tested (removal torque), and the other half was non-decalcified processed to slides of approximately 30 microm thickness for histomorphologic and histomorphometric (percentage of bone-to-implant contact [%BIC]) evaluation. Analysis of variance at the 95% confidence level and the Tukey post hoc test were used for multiple comparisons. RESULTS SEM and AFM showed that surface microtextures were qualitatively and quantitatively different and that the BGB/AA surface presented higher submicrometer average roughness values (R(a)) and root mean square (RMS) values compared to control surfaces. Ca and P were detected at the BGB/AA surface by APS. Higher degrees of bone organization were observed along the perimeter of the BGB/AA surface compared to control, despite the non-significant differences in %BIC between the surfaces (P >0.25). Significantly higher removal torque was observed for the BGB/AA implants at both time periods (P <0.0001). CONCLUSION According to the biomechanical and histomorphologic results, early biomechanical fixation was positively affected by the BGB/AA surface compared to the dual-acid etched surface.
Arthroscopic Treatment of Ankle Anterior Bony Impingement

Background: Arthroscopic treatment of anterior ankle bony impingement provides good results, with a tendency to decrease over time. The purpose of this study was to analyze the factors affecting long-term results. Methods: Eighty consecutive patients with a mean age of 37.3 years were treated between 2000 and 2004. Impingement lesions were identified according to Scranton-McDermott classification. Preoperative ankle osteoarthritis was documented by van Dijk scale upon the x-rays. Bone spurs were analyzed and classified according to location and size. The associated chondral lesions were classified following the International Cartilage Repair Society (ICRS) criteria. Patient data, foot morphology, and previous traumas were recorded. Patients were evaluated after a mean of 104.6 months follow-up with the American Orthopaedic Foot and Ankle Society (AOFAS) scale. The influence of different factors on outcomes was statistically analyzed. Results: The mean preoperative AOFAS score was 50.9, while at follow-up it was 70.7 (P < .05). The different grades of Scranton-McDermott impingement classification did not affect the results, but the different grades of van Dijk scale significantly affected the result but not the preoperative stage. Tibial localized spurs had better outcome at follow-up. The grade of the chondral lesions significantly affected the outcome. Other factors negatively affecting the results were age, cavus foot morphology, and history of previous ankle fracture. Conclusion: Arthroscopic treatment provides overall good results, but the long-term presence of associated conditions such as chondral lesions, advanced age, and previous trauma are relevant as prognostic factors. Based on these results, a new classification for bony impingement syndrome system is proposed. Level of Evidence: Level IV, case series.
Trends in Treatment of Advanced Ankle Arthropathy by Total Ankle Replacement or Ankle Fusion

Background: Total ankle replacement (TAR) and ankle fusion (AF) are the 2 major operative options for treatment of advanced ankle arthropathy; there is, however, no large epidemiologic study comparing nationwide trends of these 2 procedures. The current study used a nationwide database to compare epidemiologic profiles of TAR and AF. Methods: Data collected for the Nationwide Inpatient Sample (NIS) from 2000 to 2010 were reviewed. Procedures were identified by searching for ICD-9-CM codes 81.11 (AF) and 81.56 (TAR). Patients’ demographics and comorbidities, geographic distribution, and cost of procedures were compared. Results: The NIS analysis identified 2666 TAR and 16 419 AF cases which was extrapolated to 13 145 TAR and 80 426 AF nationwide. Spearman’s ρ showed an increase in the number of AF per year while the number of TAR cases remained relatively flat per year until 2006, after which there was a steady increase in the number of TAR performed. Patients receiving a TAR tended to be older, female, and white. Patients who underwent AF were more likely to be obese or diabetic than TAR patients. Both TAR and AF were performed more frequently in private urban hospitals through 2007. However, in 2010, the number of TAR procedures was greater in academic centers compared to private urban hospitals. Conclusions: Despite recent increases in the number of TAR implanted, AF was still performed more than 6 times more frequently for advanced ankle arthropathy. A trend was demonstrated toward an increasing number of TAR being implanted in academic centers, and in patients with more underlying comorbidities than was previously seen. Level of Evidence: Level II, prognostic study.
Mechanistic basis for a molecular triage reaction

Deciding a protein's fate Protein synthesis inside cells is finely balanced with protein degradation to maintain homeostasis. Shao et al. show how differential affinities and binding kinetics of three chaperones regulate the fate of tail-anchored (TA) membrane proteins. The chaperone SGTA binds to TA proteins and quickly transfers them to the targeting factor TRC40 through the C-terminal domain of the quality-control module BAG6. Proteins that dissociate from SGTA can either rebind or, at a slower rate, be bound by the C-terminal domain of BAG6. The latter puts them on a path to degradation. This hierarchy means that biosynthesis has the higher priority, but excess free TA proteins are degraded. Science, this issue p. 298 Reconstitution of a protein triage pathway shows how relative binding affinities and kinetics regulate protein fate. Newly synthesized proteins are triaged between biosynthesis and degradation to maintain cellular homeostasis, but the decision-making mechanisms are unclear. We reconstituted the core reactions for membrane targeting and ubiquitination of nascent tail-anchored membrane proteins to understand how their fate is determined. The central six-component triage system is divided into an uncommitted client-SGTA complex, a self-sufficient targeting module, and an embedded but self-sufficient quality control module. Client-SGTA engagement of the targeting module induces rapid, private, and committed client transfer to TRC40 for successful biosynthesis. Commitment to ubiquitination is dictated primarily by comparatively slower client dissociation from SGTA and nonprivate capture by the BAG6 subunit of the quality control module. Our results provide a paradigm for how priority and time are encoded within a multichaperone triage system.