Miracle-dz/UniFAR-FTUs huggingface dataset:
Gleason grading: consensus and controversy.

An important milestone in the history of pathology occurred on 28 December 2008 with the death of Donald F. Gleason (Fig. 1) at the ageof 88 years.Despite the formulationofmore than 40 grading systems for prostate cancer, the scheme proposed byGleason in 1966 and further validated in 1974 has gained almost universal acceptance amongst genitourinary and general pathologists as a prognostic marker. An important feature of Gleason grading is that it does not rely on detailed assessment of nuclear morphology, but is based upon architectural changes that are best evaluated at low power magnification. The original classification proposed by Dr Gleason consisted of nine distinctive growth patterns, however, subsequent survival studies showed a lack of prognostic discrimination for some of these patterns. As a result, the original nine patterns were grouped into the five grades, and these were to form the basis of prostate cancer grading for over 30 years. Over recent years there have been considerable changes relating to the diagnosis and treatment of prostate cancer. The introduction of prostate cancer screening, albeit in most cases on a patient-directed basis, has meant that now cancers are diagnosed following thin core biopsy, with the majority of cancers being found to be organ-confined. This is in marked contradistinction to the results reported in Gleason’s 1974 study, where 86% of men had extraprostatic disease, 8% had tumours palpable on rectal examination and in 6% of patients tumours were diagnosed following transurethral prostatic resection. With the advent of thin core biopsy and radical prostatectomy it has become clear that, as originally defined, some aspects of the Gleason grading system do not accord with subsequent clinical behaviour. In 2004 a limited consensus meeting held in Stockholm, Sweden, determined the need for a review of the criteria of the Gleason grading system. In 2005 a consensus conference, under the auspices of the International Society of Urological Pathology (ISUP), was convened in San Antonio, with the purpose of addressing recognised areas of controversy relating to Gleason grading. At the 2005 meeting, the various criteria for each of Gleason’s grades were reviewed and consensus was obtained for revision of a number of the features of Gleason scoring. In summary the recommendations were as follows:
Differential expression of molecular chaperones in brain of patients with Down syndrome

Heat shock proteins (HSPs) in their molecular capacity as chaperones have been reported to regulate the apoptotic pathway and also play a critical role in protein conformational diseases such as Alzheimer's disease (AD). As all Down syndrome (DS) brains display AD‐like neuropathology, neuronal loss in DS was shown to be mediated by apoptosis. We decided to investigate the expression patterns of HSPs in seven brain regions of adults with DS using two‐dimensional polyacrylamide gel electrophoresis (2‐DE). Following 2‐DE, approximately 120 protein spots were successfully identified by matrix‐assisted laser desorption/ionization – mass spectrometry (MALDI‐MS) followed by quantification of the identified proteins. We unambiguously identified and quantified nine different chaperone proteins. Accordingly, all but three chaperone proteins did exhibit a significant change in expression. HSP 70 RY, heat shock cognate (HSC) 71 and glucose‐regulated protein (GRP) 75 showed a significant decrease (P<0.05) in DS temporal cortex whereas HSP 70.1 and GRP 78 were significantly increased (P<0.05) in cerebellum. Whilst T‐complex 1 (TCP‐1) epsilon subunit showed a significant decrease (P<0.05) in parietal cortex, a similar extent of increase (P<0.05) as that observed in cerebellum was obtained in parietal levels of GRP 78. Alpha‐crystallin B, HSP 60 and GRP 94 did not show any detectable changes in expression patterns. This report presents the first approach to quantify nine different chaperones simultaneously at the protein level in different brain regions and provides evidence for aberrant chaperone expression patterns in DS. The relevance of this aberrant expression patterns are discussed in relation to the biochemical and neuropathological abnormalities in DS brain.
Compact Modular Cycloidal Motor With Embedded Shape Memory Alloy Wires

In this study, we develop a rotary motor using embedded shape memory alloy (SMA) wires, with the aim of realizing a novel compact and modular motor that can generate high-torque bidirectional continuous rotation. Thus, we focus on designing the motion transmission mechanism and torque amplifier of the motor. The designed motion transmission mechanism that functions to convert the contraction/expansion of the SMA wires to rotational motion enables the motor to generate continuous rotation with relatively short-length SMA wires. Additionally, a double-disc cycloidal speed reducer designed as the torque amplifier allows the motor to reliably generate high torque with a compact structure due to its simple configuration, size variability, and torque amplification functionality. One of the advantages of the motor is that an actuating module could be additionally incorporated into the motor to achieve higher torque. In this case, the overall size and weight of the motor are marginally increased although the output torque capacity almost doubles. Hence, the energy density of the motor significantly increases. The study describes the main concept, operating principle, design, and experimental results of the output torque capacity, positioning characteristics, and frequency response of the proposed motor.
A Simplified PWM Strategy for a Neutral-Point-Clamped (NPC) Three-Level Converter With Unbalanced DC Links

A simplified pulse width modulation (PWM) strategy for a neutral-point-clamped three-level converter with unbalanced dc links is proposed in this paper to achieve high-quality line-to-line output voltages and to maximize the linear modulation range. The simplified strategy takes the direct output voltage modulation by calculating the special solutions of the voltage-second balance equations without detecting the position of the reference vector in the asymmetrical and complicated space voltage vector diagrams to reduce the calculation time. A novel solution based on the state transition is proposed to extend the maximum linear modulation index to 1.15. Furthermore, the asymmetric control of the split dc link by the proposed PWM is implemented by adjusting the special solutions. The difference between the conventional space vector PWM and the proposed strategy is conducted to illustrate the advantages of the simplified strategy. The effectiveness of the proposed modulation strategy is verified by simulation and experiment results.
Parsing Chinese Text Based on Semantic Class

This paper proposes a novel Chinese syntactic parsing model based on semantic class, which is a variant of normal lexicalized statistical model. It attempts to make use of the syntactic and semantic similarity between Chinese words and then produces a more knowledgeable estimate of the probability of grammar rules. A simple but effective unsupervised method is designed to determine the proper semantic class of given words. Semantic class is used to improve the performance of parsing model. We evaluate our methods on the widely used Penn Chinese Treebank. Experimental results show that it outperforms a famous lexicalized model significantly on appropriate semantic class levels.
Predicting Cycle Time Distributions for Integrated Processing Workstations: An Aggregate Modeling Approach

To predict cycle time distributions of integrated processing workstations, detailed simulation models are almost exclusively used; these models require considerable development and maintenance effort. As an alternative, we propose an aggregate model that is a lumped-parameter representation of the workstation. The aggregate model is a single server with a work-in-process dependent aggregate process time distribution and overtaking distribution. The lumped parameters are determined directly from arrival and departure events measured at the workstation. An extensive simulation study and an industry case demonstrate that the aggregate model can accurately predict the cycle time distribution of integrated processing workstations in semiconductor manufacturing.
Gender Differences in Gluteus Medius Muscle Activity Exist in Soccer Players Performing a Forward Jump

The purpose of this study was to evaluate gender differences in muscle activity while landing from a forward jump. Eight male and 8 female division-one varsity soccer athletes participated in this study. Subjects performed five trials of a 100 cm forward jump single leg landing. Surface electromyography (EMG) was collected at the gluteus medius, vastus lateralis, lateral hamstring, and medial gastrocnemius. Data were interpreted by VICON workstation and analyzed with Acknowledge software. Average root mean square of 200 ms following initial heel contact from landing were normalized to static one-leg stance and used in data analysis. A fixed-effect multivariate analysis of variance showed average gluteus medius activity was significantly higher in males (7.16 ± 3.16) than in females (2.62 ± 0.95). There were no differences between genders for any of the other muscles collected. Gender-specific neuromuscular strategies used to attenuate the forces of landing may involve more gluteus medius muscle activity in males than in females.
Defining Teacher Leadership: Affirming the Teacher Leader Model Standards.

Although there is no common definition for teacher leadership, the concept is continually advanced as a key component for both the success of schools and the professionalization of teachers (Boles & Troen, 1994; Dozier, 2007; Greenlee, 2007; Lieberman, 1987; Smith, 1999). Teachers need to be given opportunities to leave the isolation of their classrooms to collaborate with others in order to build leadership capacity (Dozier, 2007). While there are some teachers who view teacher leadership as formal administrative roles, others view it as any opportunity in which teachers contribute to the decision making process (Donaldson & Johnson, 2007). Whichever way it is defined, it is commonly accepted that teacher leadership capacity is underdeveloped in most schools (Greenlee, 2007). The Institute for Educational Leadership (2001) provided a broad and progressive definition. It suggested that teacher leadership is not necessarily about power, but about teachers extending their presence beyond the classroom by seeking additional challenges and growth opportunities. Teachers have long been accustomed to working in isolation within the boundaries of their own classrooms. Going beyond the classroom by providing input at meetings, sharing best practices, working
Association between the functional polymorphism C-159T in the CD14 promoter gene and nasal polyposis: potential role in asthma.

BACKGROUND Nasal polyposis (NP) is a chronic inflammatory disease that is frequently associated with allergy and asthma. Corticosteroid therapy and surgical removal of polyps are the 2 most common treatment strategies for NP. Various allergic and inflammatory mediators are thought to play a major role in the pathophysiology of this disorder. The CD14 gene is located on chromosome 5q31-32, which is considered a critical region for several allergic and atopic diseases, including asthma. Consequently, variations in CD14 could have functional effects on the etiology and severity of allergy and asthma. The aim of this study was to investigate the association between the polymorphism C-159T in the CD14 gene of patients with NP and controls. METHODS The study population comprised 106 patients with NP diagnosed based on computed tomography scan of the paranasal sinus, endoscopy, and histological examination. Findings were compared with those from 87 controls. The frequency of C-159T was determined using polymerase chain reaction-restriction fragment length polymorphism analysis. DNA was extracted using the salting out technique. RESULTS A significant association was observed between C-159T and NP (P = .04). Patients with the CC genotype at position -159 of the CD14 promoter region had an increased risk of asthma (OR, 3.83, 95% CI, 0.99-13.91; P < .02). However, we did not find an association between the distribution of C-159T and serum immunoglobulin E level. CONCLUSIONS A genetic variation in the CD14 promoter might play a role in the pathogenesis of NP and in the incidence of asthma.
Cognition, Health Literacy, and Actual and Perceived Medicare Knowledge Among Inner-City Medicare Beneficiaries

Poor Medicare knowledge is associated with worse health outcomes, especially in low-income patients. We examined the association of health literacy and cognition with actual and perceived Medicare knowledge in a sample of inner-city older adults. We conducted a cross-sectional analysis of data on 336 adults ages 65 years and older with Medicare coverage recruited from senior centers and low-income housing facilities in Manhattan, New York. Actual Medicare knowledge was determined by a summary score of 9 true/false questions about the Medicare program and perceived Medicare knowledge with a single item. Validated measures were used to assess health literacy and general cognition. Among respondents, 63.1% had high actual Medicare knowledge, and 36.0% believed that they knew what they needed to know about Medicare. Actual and perceived Medicare knowledge were poorly correlated (r = −.01, p > .05). In multivariable models, low health literacy was significantly associated with actual Medicare knowledge (β = −8.30, SE = 2.71, p < .01) but not perceived Medicare knowledge (β = 0.37, SE = 0.22, p = .09). Individuals with low health literacy were more likely to perceive their Medicare knowledge as adequate when actual Medicare knowledge was low (adjusted odds ratio = 3.30, 95% confidence interval [1.20, 9.05], p < .05). These results show that older adults with low health literacy are more likely to have poor understanding of the Medicare program and yet more likely to believe that their understanding of the program is adequate. This combination of factors may place them at increased risk for poor access to information about the Medicare program and diminish their ability to make fully informed choices.
Increased DNA methyltransferase expression in rhabdomyosarcomas

In normal somatic cells, the methylation pattern of DNA is stably maintained by DNA (cytosine‐5‐)‐methyltransferase (DNA methyltransferase). Increased expression of DNA methyltransferase has been detected in many types of human cancer and has been thought to play an important role in tumorigenesis. In our study, we developed a standardized reverse transcription‐polymerase chain reaction (RT‐PCR) assay to determine the mRNA levels of DNA methyltransferase in rhabdomyosarcoma, the most common soft tissue cancer in children. Using this assay, expression of DNA methyltransferase was analyzed for 32 rhabdomyosarcomas and 12 normal skeletal muscle samples. All tumor samples, of which 18 were embryonal and 14 were alveolar subtype, showed increased expression of DNA methyltransferase after normalization to β‐actin. Compared to normal skeletal muscle, the average increase of DNA methyltransferase expression was 6.7‐fold (6.7 ±0.96) in the embryonal tumors and 3.7‐fold (3.7 ± 0.46) in the alveolar rhabdomyosarcomas. The difference in the average increase of the DNA methyltransferase expression was statistically significant in the 2 rhabdomyosarcoma subtypes, which have distinct etiologies and clinical behaviors. Our results are consistent with previous reports that an increase in DNA methyltransferase activity is associated with neoplastic transformation; however, the role of increased DNA methyltransferase expression in the development and progression of rhabdomyosarcoma needs to be investigated in future studies. Int. J. Cancer 83:10–14, 1999. © 1999 Wiley‐Liss, Inc.
Induction of a Storage Phenotype and Abnormal Intracellular Localization of Apical Glycoproteins Are Two Independent Responses to GalNAcα-O-bn

Our previous studies on an inhibitor of O-glycosylation of glycoproteins, Gal-NAcα-O-bn, in the model of enterocytic HT-29 cells, have shown at the cellular level an alteration of the normal localization of apical glycoproteins, and at the biochemical level an in situ synthesis and storage of sialylated GalNAcα-O-bn oligosaccharides. The purpose of this study was to examine if a relation existed between these two events, using different cell lines. Intracellular storage of GalNAcα-O-bn metabolites occurred in HT-29 and CAPAN-1 cells but not in Caco-2 cells. On the other hand, an accumulation of endosomal/lysosomal compartments was observed in HT-29 and CAPAN-1 cells but not in Caco-2 cells. These data focused on a GalNAcα-O-bn-derived storage phenotype in HT-29 and CAPAN-1 cells. The apical membrane glycoproteins MUC1 and CEA showed an abnormal localization inside intracytoplasmic vesicles in HT-29 cells, whereas they kept their normal localization in Caco-2 and CAPAN-1 cells. Studies on the glycosylation of these apical glycoproteins showed that GalNAcα-O-bn inhibited the glycosylation in a cell-specific manner. The alteration in the apical targeting of glycoproteins, and the appearance of a GalNAcα-O-bn-derived storage phenotype are two independent and cell type-specific events. The former depends on the inhibition pattern of the glycosylation of endogenous glycoproteins, whereas the latter is connected to the intracellular accumulation of GalNAcα-O-bn metabolites.
Treatment of Vaginal Cuff Evisceration

BACKGROUND: Laparoscopic and robotic-assisted hysterectomies are associated with higher rates of vaginal cuff dehiscence and evisceration than are open and vaginal hysterectomies. With the rising prevalence of minimally invasive hysterectomy, gynecologists should know how to manage this rare but potentially serious condition. Urgent laparotomy historically was recommended for management of vaginal cuff evisceration to allow for complete bowel evaluation. More recently, successful outcomes using a less-invasive vaginal or combined vaginal and laparoscopic approach have been reported. TECHNIQUE: Patients are selected for transvaginal repair of vaginal cuff evisceration if there is no clinical evidence of peritonitis or ischemic injury to the prolapsed bowel segment. Under general anesthesia and after administration of intravenous antibiotics, the bowel is copiously irrigated and replaced into the abdomen. The vaginal cuff is sharply debrided of any necrotic tissue, and a full-thickness closure is performed using a delayed absorbable monofilament suture. EXPERIENCE: We have successfully managed four cases of vaginal cuff evisceration through a transvaginal approach without intraoperative or postoperative complications. CONCLUSION: Vaginal cuff dehiscence and evisceration can be treated by transvaginal bowel reduction and cuff closure when the bowel appears uninjured and there are no signs of peritonitis.
Comparative study for the effect of photodynamic therapy, imiquimod immunotherapy and combination of both therapies on 40 lesions of actinic keratosis in Japanese patients

We treated 12, 15 and 13 Japanese actinic keratosis (AK) lesions with 5‐aminolevulinic acid photodynamic therapy (PDT), 5% imiquimod cream and combination of both therapies, respectively, and compared the effects. Patients underwent the second course, when AK lesions remained after the first course. Efficacy was evaluated 1 month after each treatment. Combination therapy cleared all AK lesions only after the first course, while PDT and imiquimod therapy cleared 41.7% and 66.7% of AK lesions after the first course, respectively. All residual AK lesions after the first course were cleared by the second courses of PDT or imiquimod therapy. During the course, erosion and crust developed significantly more frequently in combination therapy (P < 0.001). Most Japanese AK lesions can be satisfactorily treated with either PDT or imiquimod monotherapy. However, only severe cases may better be treated with combination therapy, which show higher efficacy even though adverse events occur frequently.
Diagnostic accuracy of ultrasonograph guided fine-needle aspiration cytologic in staging of axillary lymph node metastasis in breast cancer patients: a meta-analysis.

PURPOSE To evaluate the diagnostic accuracy of ultrasonograph and fine-needle aspiration cytologic examination (USG-FNAC) in the staging of axillary lymph node metastasis in breast cancer patients. METHODS We conducted an electronic search of the literature addressing the performance of USG-FNAC in diagnosis of axillary lymph node metastasis in databases such as Pubmed, Medline, Embase, Ovid and Cochrane library. We introduced a series of diagnostic test indices to evaluate the performance of USG-FNAC by the random effect model (REM), including sensitivity, specificity, likelihood ratios, and diagnostic odds ratios and area under the curve (AUC). RESULTS A total of 20 studies including 1371 cases and 1289 controls were identified. The pooled sensitivity was determined to be 0.66 (95% CI 0.64-0.69), specificity 0.98 (95% CI 0.98-0.99), positive likelihood ratio 22.7 (95% CI 15.0-34.49), negative likelihood ratio 0.32 (95% CI 0.25-0.41), diagnostic OR 84.2 (95% CI 53.3-133.0). Due to the marginal threshold effect found in some indices of diagnostic validity, we used a summary SROC curve to aggregate data, and obtained a symmetrical curve with an AUC of 0.942. CONCLUSION The results of this meta-analysis indicated that the USG-FNAC techniques have acceptable diagnostic validity indices and can be used for early staging of axillary lymph node in breast cancer patients.
Indoxyl sulfate counteracts endothelial effects of erythropoietin through suppression of Akt phosphorylation.

BACKGROUND Erythropoietin (EPO) is used to treat anemia in patients with chronic kidney disease (CKD). A wide variation in individual response to EPO, however, is often observed, causing EPO resistance. EPO exhibits not only hematopoietic but also extra-hematopoietic functions such as endothelial effects. Indoxyl sulfate, a uremic toxin, is involved in endothelial dysfunction, and consequently, the pathogenesis of CKD-associated cardiovascular disease. The aim of the present study was to determine the effect of indoxyl sulfate on the extra-hematopoietic functions of EPO in human umbilical vein endothelial cells (HUVECs). METHODS AND RESULTS HUVECs were incubated with or without indoxyl sulfate or an Akt inhibitor, and then stimulated with or without EPO. Indoxyl sulfate suppressed EPO-induced survival/proliferation, anti-apoptosis function, phosphorylation of endothelial nitric oxide synthase, and the expression of thrombospondin-1, an erythroid-stimulating factor, in HUVECs. Although EPO induced phosphorylation of both Akt and extracellular signal-regulated kinases (ERK) in HUVECs, indoxyl sulfate suppressed phosphorylation of Akt but not ERK. An Akt kinase inhibitor or Akt small interfering RNA suppressed all the EPO-induced cellular effects in HUVECs. As a site of action of indoxyl sulfate on EPO signaling, indoxyl sulfate attenuated EPO-induced tyrosine phosphorylation of EPO receptor (EPOR) in HUVECs. CONCLUSIONS Indoxyl sulfate negatively regulates the EPOR-Akt pathway in endothelial cells, and might contribute to EPO resistance and endothelial dysfunction in patients with CKD.