Miracle-dz/UniFAR-FTUs huggingface dataset:
Fibrin glue reinforcement of choledochotomy closure suture line for prevention of bile leak in patients undergoing laparoscopic common bile duct exploration and primary closure

Background: Laparoscopic common bile duct (CBD) exploration (LCBDE) allows cholecystectomy and the removal of CBD stones to be performed during the same sitting, thereby decreasing hospital stay. CBD exploration through choledochotomy can be closed primarily with an absorbable suture material but can lead to biliary leakage postoperatively. In this study, we tried to find a solution to further lower the incidence of bile leakage using fibrin glue to reinforce the sutures put on choledochotomy suture line. Patients and Methods: This study was conducted at a tertiary care teaching hospital in New Delhi, India. Twenty patients with CBD stones documented on magnetic resonance cholangiopancreatography with CBD diameter of 9 mm or more were included in this study. Patients were randomized into two groups, namely – Group “A” in which choledochotomy was closed with polyglactin 4-0 suture and suture line reinforced with fibrin glue and Group “B” in which choledochotomy was closed with polyglactin 4-0 suture alone. Both the groups were evaluated and compared on clinical parameters such as operative time, drain content, drain output, number of days drain was required, blood loss and transfusion requirements, length of postoperative hospital stay, and conversion to open surgery. Results: The operative time for Group A ranged from 60 to 210 min (mean: 131.50 min) and Group B ranged from 65 to 300 min (mean: 140 min). In Group A, there was no case of bile leak but there was bile leak in 2 cases in Group B, minimum 0 and maximum 900 ml with a mean of 97 ml and P= 0.147 with no statistically significant difference in bile leak in test and control groups. The minimum and maximum serous drainage in Group A was nil and 80 ml (mean: 11 ml) and in Group B was nil and 270 ml (mean: 72.50 ml). P value came as 0.028 which was statistically significant. Thus, serous leakage in Group A was significantly less than in Group B. The drains in Group A were removed from 2 to 4 days (mean: 3 days) while in Group B from 2 to 9 days (mean: 3.9 days). The patients in Group A stayed in hospital postoperatively from 3 to 8 days (mean: 5.30) while in Group B, it ranged from 3 to 10 days with a mean of 5 days. Conclusion: Fibrin glue application on CBD decreases bile leakage but in statistically insignificant manner. Fibrin glue application on CBD can significantly decrease postoperative serous drainage after LCBDE. Fibrin glue application on CBD is safe and easy technique without any significant adverse effects and can help less experienced surgeons performing LCBDE.
A multicentric community survey on animal exposures among humans in India

Background: Rabies is a 100% fatal disease. There are inadequate data on animal exposures and rabies postexposure prophylaxis (PEP) from community-based field surveys in India. Objectives: The main objective of the study is to estimate the incidence of animal exposures (bite, scratch, or lick) in the study population and to describe the rabies PEP among the cases. Methods: A descriptive survey was conducted in seven states of India between July and November, 2017. In each state, multistage sampling methodology was followed for selection of district, taluka/tehsil, block, and clusters within the block. The primary sampling unit was a household (HH). A case was a patient with animal exposure (bite, scratch, or lick) in the last 1 year from the date of survey. The animal exposure was categorized based on the WHO guidelines (Category-I, Category-II, and Category-III). The patients with the history of multiple animal exposures any time during the survey period was considered as a single case. Results: A total of 1012 HHs were surveyed covering a population of 4294. 3016 (70.2%) participants were from rural settings and 1278 (29.8%) were living in urban settings. 2181 (50.8%) participants were male and 2113 (49.2%) were female. The annual incidence of animal exposure was 1.26% (confidence interval [CI]: 0.93%–1.59%). The annual incidence in urban setting was 1.33% (0.70 - 1.96) and rural settings were 1.23% (CI: 0.84 - 1.62). Majority (68.5%) of the cases were from rural settings, 61.2% of the cases were in the age group of 15–60 years. Among the 43 cases who had received PEP, 21 had Category-II exposures, of whom 66.7% had completed vaccination with either five doses intramuscular or four doses intradermal route. Similarly, 22 had Category-III exposures and only 4 (18.2%) cases had received rabies immunoglobulin and completed rabies vaccination. Six ( 11.1%) cases did not receive PEP. There was no report of human rabies case. Conclusion: The incidence of animal exposure was 1.26%. Rabies PEP in the cases was not satisfactory.
Neural crest derived stem cells from dental pulp and tooth-associated stem cells for peripheral nerve regeneration

The peripheral nerve injuries, representing some of the most common types of traumatic lesions affecting the nervous system, are highly invalidating for the patients besides being a huge social burden. Although peripheral nervous system owns a higher regenerative capacity than does central nervous system, mostly depending on Schwann cells intervention in injury repair, several factors determine the extent of functional outcome after healing. Based on the injury type, different therapeutic approaches have been investigated so far. Nerve grafting and Schwann cell transplantation have represented the gold standard treatment for peripheral nerve injuries, however these approaches own limitations, such as scarce donor nerve availability and donor site morbidity. Cell based therapies might provide a suitable tool for peripheral nerve regeneration, in fact, the ability of different stem cell types to differentiate towards Schwann cells in combination with the use of different scaffolds have been widely investigated in animal models of peripheral nerve injuries in the last decade. Dental pulp is a promising cell source for regenerative medicine, because of the ease of isolation procedures, stem cell proliferation and multipotency abilities, which are due to the embryological origin from neural crest. In this article we review the literature concerning the application of tooth derived stem cell populations combined with different conduits to peripheral nerve injuries animal models, highlighting their regenerative contribution exerted through either glial differentiation and neuroprotective/neurotrophic effects on the host tissue.
Taking central nervous system regenerative therapies to the clinic: curing rodents versus nonhuman primates versus humans

The central nervous system is known to have limited regenerative capacity. Not only does this halt the human body’s reparative processes after central nervous system lesions, but it also impedes the establishment of effective and safe therapeutic options for such patients. Despite the high prevalence of stroke and spinal cord injury in the general population, these conditions remain incurable and place a heavy burden on patients’ families and on society more broadly. Neuroregeneration and neural engineering are diverse biomedical fields that attempt reparative treatments, utilizing stem cells-based strategies, biologically active molecules, nanotechnology, exosomes and highly tunable biodegradable systems (e.g., certain hydrogels). Although there are studies demonstrating promising preclinical results, safe clinical translation has not yet been accomplished. A key gap in clinical translation is the absence of an ideal animal or ex vivo model that can perfectly simulate the human microenvironment, and also correspond to all the complex pathophysiological and neuroanatomical factors that affect functional outcomes in humans after central nervous system injury. Such an ideal model does not currently exist, but it seems that the nonhuman primate model is uniquely qualified for this role, given its close resemblance to humans. This review considers some regenerative therapies for central nervous system repair that hold promise for future clinical translation. In addition, it attempts to uncover some of the main reasons why clinical translation might fail without the implementation of nonhuman primate models in the research pipeline.
Efficient Contextual Representation Learning With Continuous Outputs

Abstract Contextual representation models have achieved great success in improving various downstream natural language processing tasks. However, these language-model-based encoders are difficult to train due to their large parameter size and high computational complexity. By carefully examining the training procedure, we observe that the softmax layer, which predicts a distribution of the target word, often induces significant overhead, especially when the vocabulary size is large. Therefore, we revisit the design of the output layer and consider directly predicting the pre-trained embedding of the target word for a given context. When applied to ELMo, the proposed approach achieves a 4-fold speedup and eliminates 80% trainable parameters while achieving competitive performance on downstream tasks. Further analysis shows that the approach maintains the speed advantage under various settings, even when the sentence encoder is scaled up.
Role of decidual natural killer cells at the Maternal–Fetal interface during pregnancy

Pregnancy is a complicated process with intricate cell-to-cell crosstalk and immune regulation. Decidual natural killer (NK) cells account for 50%–70% of decidual immune cells in early pregnancy, suggesting that they play important roles in various events, such as embryo implantation and vascular remodeling. Many studies have shown that decidual NK cells interact with other cells either through direct contact or the secretion factors such as cytokines and chemokines. Hence, this review aimed to present the phenotypic characteristics, classification, and functions of decidual NK cells at the maternal–fetal interface during pregnancy.
Improving Cycling Behaviors of Dockless Bike-Sharing Users Based on an Extended Theory of Planned Behavior and Credit-Based Supervision Policies in China

Motivating users’ civilized cycling plays a significant role in alleviating the troubles of dockless bike-sharing programs (DBSPs) and promoting the sustainable development of bike-sharing organizations. Based on the theory of planned behavior (TPB) and observed practices in China, this study develops a theoretical framework to examine how attitudes (ATT), subjective norms (SN), perceived behavioral control (PBC), and personal norms (PN) motivate users’ civilized cycling behavior through civilized cycling intentions. Furthermore, the moderating effect of perceived policy effectiveness (PPE) between users’ civilized cycling intention and their actual behavior is tested. Using structural equation model-multiple group analysis (SEM-MGA) for a sample of 874 valid questionnaire responses in Beijing and Shanghai, China, our results reveal that (1) ATT, PBC, and PN are positively related to both users’ civilized cycling intentions and their actual behavior, while SN positively affect users’ civilized cycling intention only; (2) users’ civilized cycling intentions mediate the relationship between the four influencing factors and their actual behavior; and (3) PPE plays a moderating role for the effect of users’ civilized cycling intentions on their actual civilized cycling behavior. Our results indicate that the four influencing factors can encourage users’ civilized cycling behavior, especially when civilized cycling intention exists. Policies like credit-based supervision mechanisms could promote users’ civilized-cycling intentions, which could then be transformed into actual behavior.
Immune Response Modulation by Caliciviruses

Noroviruses and Sapoviruses, classified in the Caliciviridae family, are small positive-stranded RNA viruses, considered nowadays the leading cause of acute gastroenteritis globally in both children and adults. Although most noroviruses have been associated with gastrointestinal disease in humans, almost 50 years after its discovery, there is still a lack of comprehensive evidence regarding its biology and pathogenesis mainly because they can be neither conveniently grown in cultured cells nor propagated in animal models. However, other members of this family such as Feline calicivirus (FCV), Murine norovirus (MNV), Rabbit hemorrhagic disease virus (RHDV), and Porcine sapovirus (PS), from which there are accessible propagation systems, have been useful to study the calicivirus replication strategies. Using cell cultures and animal models, many of the functions of the viral proteins in the viral replication cycles have been well-characterized. Moreover, evidence of the role of viral proteins from different members of the family in the establishment of infection has been generated and the mechanism of their immunopathogenesis begins to be understood. In this review, we discuss different aspects of how caliciviruses are implicated in membrane rearrangements, apoptosis, and evasion of the immune responses, highlighting some of the pathogenic mechanisms triggered by different members of the Caliciviridae family.
Preference for Object Relative Clauses in Chinese Sentence Comprehension: Evidence From Online Self-Paced Reading Time

Most prior studies have reported that subject-extracted relative clauses (SRCs) are easier to process than object-extracted relative clauses (ORCs). However, whether such an SRC preference is universal across different languages remains an open question. Several reports from Chinese have provided conflicting results; thus, in the present study, we conducted two self-paced reading experiments to examine the comprehension of Chinese relative clauses. The results demonstrated a clear ORC preference that Chinese ORCs were easier to comprehend than Chinese SRCs. These findings were most compatible with the prediction of the integration cost account, which claims that the processing difference between SRCs and ORCs arises at the point of dependency formation. The ORC preference in Chinese poses a challenge to the universality of the SRC preference assumed by the structural distance hypothesis and highlights the values of cross-linguistic research.
The Impact of Obesity on Thyroid Autoimmunity and Dysfunction: A Systematic Review and Meta-Analysis

Background: To help inform decision making in the clinical setting, we carried out a systematic review and meta-analysis to estimate the association of thyroid disease risks with obesity. Methods: Pubmed, Embase, Web of Science, Cochrane database and Google Scholar electronic databases were searched from inception to October 31, 2018 without language restrictions to explore the relationship between thyroid disorders and obesity. The relative risk (RR) or odds risk (OR) for thyroid disorders were pooled using the SPSS and STATA software. Results: A total of 22 studies were included in the study. (1) Meta-analysis showed that obesity was significantly associated with an increased risk of hypothyroidism (RR = 1.86, 95% CI 1.63–2.11, P < 0.001). Meta-analyses after stratification further showed that obese population had increased risks of overt hypothyroidism (RR = 3.21, 95% CI 2.12–4.86, P < 0.001) and subclinical hypothyroidism (RR = 1.70, 95% CI 1.42–2.03, P < 0.001). (2) Further meta-analysis also showed obesity was clearly associated with Hashimoto's thyroiditis (RR = 1.91, 95% CI 1.10–3.32, P = 0.022), but not with Graves' disease. (3) In the meta-analysis of antibodies, obesity was correlated with positive thyroid peroxidase antibody (TPOAb) (RR = 1.93, 95% CI 1.31–2.85, P = 0.001), but not with positive thyroglobulin antibody (TGAb). Conclusions: Obesity was significantly related to hypothyroidism, HT, and TPOAb, implying that prevention of obesity is crucial for thyroid disorders. Systematic Review Registration: PROSPERO: CRD42018096897.
Correlation Between Thalamus-Related Functional Connectivity and Serum BDNF Levels During the Periovulatory Phase of Primary Dysmenorrhea

The thalamus is a key region for the transmission of nociceptive information in the central modulation of pain and has been studied in the setting of numerous chronic pain conditions. Brain-derived neurotrophic factor (BDNF) is considered an important modulator for mediating nociceptive pathways in chronic pain. The present study aimed to investigate whether there was thalamus-related abnormal functional connectivity or relevant serum BDNF level alterations during periovulation in long-term primary dysmenorrhea (PDM). Thalamic subregions were defined according to the Human Brainnetome Atlas. Functional connectivity analyses were performed in 36 patients in the periovulatory phase and 29 age-, education-, and gender-matched healthy controls. Serum BDNF levels were evaluated by enzyme-linked immunosorbent assay and a significantly higher BDNF level was detected in PDM patients. Compared with HCs, PDM patients had abnormal functional connectivity of thalamic-subregions, mainly involving with prefrontal cortex, sensorimotor cortex, and temporal cortex. In addition, the functional connectivity of thalamic-subregions showed significant interactive effect correlated with serum BDNF level between PDM and HCs. It has been suggested that there were maladaptive or adoptive alteration associated with chronic menstrual pain even without the ongoing menstrual pain. BDNF might play a role in the development and chronicity of central nervous system dysfunction. These findings provided more accurate information about the involvement of the thalamus in the pathophysiology of PDM.
Response Dynamics in an Olivocerebellar Spiking Neural Network With Non-linear Neuron Properties

Sensorimotor signals are integrated and processed by the cerebellar circuit to predict accurate control of actions. In order to investigate how single neuron dynamics and geometrical modular connectivity affect cerebellar processing, we have built an olivocerebellar Spiking Neural Network (SNN) based on a novel simplification algorithm for single point models (Extended Generalized Leaky Integrate and Fire, EGLIF) capturing essential non-linear neuronal dynamics (e.g., pacemaking, bursting, adaptation, oscillation and resonance). EGLIF models specifically tuned for each neuron type were embedded into an olivocerebellar scaffold reproducing realistic spatial organization and physiological convergence and divergence ratios of connections. In order to emulate the circuit involved in an eye blink response to two associated stimuli, we modeled two adjacent olivocerebellar microcomplexes with a common mossy fiber input but different climbing fiber inputs (either on or off). EGLIF-SNN model simulations revealed the emergence of fundamental response properties in Purkinje cells (burst-pause) and deep nuclei cells (pause-burst) similar to those reported in vivo. The expression of these properties depended on the specific activation of climbing fibers in the microcomplexes and did not emerge with scaffold models using simplified point neurons. This result supports the importance of embedding SNNs with realistic neuronal dynamics and appropriate connectivity and anticipates the scale-up of EGLIF-SNN and the embedding of plasticity rules required to investigate cerebellar functioning at multiple scales.
Significance of Participants’ Expectations in Managing the Placebo Effect in Antidepressant Research

Unraveling complexities behind the response to treatment marked the placebo effect as a legitimate subject of scientific inquiry, even though it was conceived as a safeguard against the bias and uncertainty that accompany biomedical research (1–3). As the placebo effect comes under scrutiny regarding treatment specificity, it has been postulated that most of its effects are driven by participants’ expectations (4, 5). Such an argument has substantial empirical backing, and the placebo effect is now commonly referred to as an expectation-related effect. Attempts to distinguish it from other possible effects related to scientific methodology in general (regression to mean, the course of the disease, response bias, etc.) are numerous (1, 6). Participants’ expectations are defined as beliefs about the nature and the possibility of improvement as a consequence of receiving therapeutic intervention (4). In this article, the terms expectations and expectancies are used interchangeably, but it is important to note that they are commonly defined differently. Expectations refer to the measurable beliefs that can be verbalized by individuals, while expectancy refers to psychologically driven predictions that can exist and act without an individual’s full awareness (4, 7).
Evaluation of Cervical Intraepithelial Neoplasia Occurrence Following the Recorded Onset of Persistent High-Risk Human Papillomavirus Infection: A Retrospective Study on Infection Duration

Objectives: Persistent high-risk human papillomavirus infection is a major factor in the development of cervical intraepithelial neoplasia and cervical cancer. However, the exact point during this infection that cervical intraepithelial neoplasia develops has eluded researchers. Therefore, we designed a study investigating infection duration between the recorded onset of persistent high-risk human papillomavirus infection and cervical intraepithelial neoplasia development. Methods: Basic descriptive statistics, including the Chi-square test and the Kaplan-Meier method, were used to retrospectively analyze data of 277 women who underwent human papillomavirus genotyping, exhibited persistent high-risk human papillomavirus infection, were cervical cytology negative at enrollment, and developed cervical intraepithelial neoplasia at some point during follow-up. Results: Mean number of cervical cytology and human papillomavirus tests was 2.31 per patient (range: 2–8). Human papillomavirus 16, 52, 58, and 33 accounted for 21.64% (132/610), 21.64% (132/610), 15.90% (97/610), and 10.66% (65/610) of infections, respectively. 42.24% (117/277) and 57.76% (160/277) of women were diagnosed with cervical intraepithelial neoplasia 1 and cervical intraepithelial neoplasia 2+ after persistent high-risk human papillomavirus infection, with mean follow-up times of 18.15 (11.81) and 19.82 (13.31) months, respectively. Cervical intraepithelial neoplasia occurred between 4 and 70 months following the recorded onset of persistent high-risk human papillomavirus infection and 73.65% (204/277) of women developed cervical intraepithelial neoplasia within 24 months. Conclusion: Human papillomavirus 16, 52, 58, and 33 were the most prevalent high-risk human papillomavirus types in a group of women in which the majority developed cervical intraepithelial neoplasia within 24 months of persistent infection.