Miracle-dz/UniFAR-FTUs huggingface dataset:
T-Cell Infiltration and Adaptive Treg Resistance in Response to Androgen Deprivation With or Without Vaccination in Localized Prostate Cancer

Purpose: Previous studies suggest that androgen deprivation therapy (ADT) promotes antitumor immunity in prostate cancer. Whether a vaccine-based approach can augment this effect remains unknown. Patients and Methods: We conducted a neoadjuvant, randomized study to quantify the immunologic effects of a GM-CSF–secreting allogeneic cellular vaccine in combination with low-dose cyclophosphamide (Cy/GVAX) followed by degarelix versus degarelix alone in patients with high-risk localized prostate adenocarcinoma who were planned for radical prostatectomy. Results: Both Cy/GVAX plus degarelix and degarelix alone led to significant increases in intratumoral CD8+ T-cell infiltration and PD-L1 expression as compared with a cohort of untreated, matched controls. However, the CD8+ T-cell infiltrate was accompanied by a proportional increase in regulatory T cells (Treg), suggesting that adaptive Treg resistance may dampen the immunogenicity of ADT. Although Cy/GVAX followed by degarelix was associated with a modest improvement in time-to-PSA progression and time-to-next treatment, as well as an increase in PD-L1, there was no difference in the CD8+ T-cell infiltrate as compared with degarelix alone. Gene expression profiling demonstrated that CHIT1, a macrophage marker, was differentially upregulated with Cy/GVAX plus degarelix compared with degarelix alone. Conclusions: Our results highlight that ADT with or without Cy/GVAX induces a complex immune response within the prostate tumor microenvironment. These data have important implications for combining ADT with immunotherapy. In particular, our finding that ADT increases both CD8+ T cells and Tregs supports the development of regimens combining ADT with Treg-depleting agents in the treatment of prostate cancer.
Morphine and Phoenix dactylifera (dates) effects on the histological features of male rat reproductive organs

Background: Previous studies have shown that morphine negatively effects male fertility while Phoenix dactylifera (dates) could cure male infertility by the exhibition of antagonist effects. This study was conducted to assess the possible ameliorating effects of dates on the histological features of morphine-induced male rat reproductive organs. Materials and Methods: Adult male Sprague Dawley rats age 7–9 weeks old, 200–250 g body weight (BW) were divided into six rats per each group: Group 1, force-fed with distilled water, 1 ml/kg BW for 35 days (control); Group 2, intramuscularly (IM) injected with morphine, 20 mg/kg BW for 7 days followed by force-fed with distilled water for 28 days; Group 3, force-fed with distilled water for 7 days followed by crude P. dactylifera extract, 200 mg/kg for 28 days; Group 4, injected (IM) with morphine, 20 mg/kg BW for 7 days followed by force-fed of crude P. dactylifera extract, 200 mg/kg for 28 days. Rats were sacrificed on day 36. The seminal vesicle (SV) and prostate gland (PG) were removed and fixed before histological processes. Results: In morphine-treated rats, the SV showed the absence of honeycomb-like appearance with flattened columnar cells while in the PG, eosinophilic secretion was noted to be absent from glandular lumina as compared to the control group. Administration of P. dactylifera extract in Group 4 showed improvement in histoarchitecture of the SV and PG with complex mucosal infoldings and glands luminal filled with secretion. Conclusion: P. dactylifera extract has a protective effect against the adverse effects of morphine on the male rat reproductive organs.
The day‐to‐day stability of the ruminal and fecal microbiota in lactating dairy cows

In this study, we examined differences between the microbiota of the ruminal fluid (DR) and feces (DF) from five lactating dairy cows over three consecutive days using 16S rRNA gene sequence‐based analysis. Results showed significant differences between the microbial communities of the DR and DF. In particular, the relative abundance of the phyla Firmicutes and Actinobacteria was significantly lower (q < 0.001) in DR compared with DF, while the relative abundance of Bacteroidetes was significantly higher in DF than that of DR (q < 0.001). A significantly higher relative abundance of the genera Bifidobacterium, 5‐7N15, Clostridium, Epulopiscium, SMB53, Turicibacter, Dorea, Roseburia, and Akkermansia was observed in the DF, while a higher relative abundance of the genera Prevotella, Butyrivibrio, CF231, RFN20, and Succiniclasticum was observed in the DR. A further analysis using the functional prediction program PICRUSt showed that sequences belonging to the 5‐7N15, Akkermansia, Bifidobacterium, Clostridium, Dorea, Epulopiscium, Roseburia, and Turicibacter were significantly and positively correlated with glycan biosynthesis and metabolism, while CF231, Prevotella, RFN20, and Succiniclasticum were significantly and positively correlated with amino acid, lipid, carbohydrate, other amino acid, cofactors, and vitamins metabolism. No significant differences were observed across the three consecutive days in either the DR or DF ecosystems, with no significant differences in the diversity or abundance at the phylum and genus levels suggested that there is a limited day‐to‐day variability in the gut microbiota.
Construct validity and test-retest reliability of the World Mental Health Japan version of the World Health Organization Health and Work Performance Questionnaire Short Version: a preliminary study

The aim of the study was to investigate test-retest reliability and construct validity of the World Mental Health Japan (WMHJ) version of World Health Organization Health and Performance Questionnaire (WHO-HPQ) short version according the COSMIN standard. We conducted two consecutive surveys of 102 full-time employees recruited through an Internet survey company in Japan, with a two-week interval in 2018. We calculated Pearson’s correlation (r) of measures of the WHO-HPQ with other presenteeism scales (Stanford Presenteeism Scale, Work Functioning Impairment Scale, and perceived relative presenteeism), health and psychosocial job conditions. We tested the test-retest reliability (intraclass correlation, ICC) among those who reported no change of job performance during the follow-up. Among 92 (90%) respondents, the absolute presenteeism significantly correlated with WFun and perceived relative presenteeism (r=−0.341 and −0.343, respectively, p=0.001) and psychological distress (r=−0.247, p=0.018). The absolute/relative absenteeism did not significantly correlate with the other covariates. The test-retest reliability over a two-week period was high for the WHO-HPQ absolute presenteeism (ICC, 0.73), while those for absolute/relative absenteeism measures were moderate. The study found an adequate level of test-retest reliability, but limited support for the construct validity of the absolute presenteeism measure of the WMHJ version of the WHO-HPQ. Further research is needed to investigate the construct validity of the WHO-HPQ measures in a larger sample.
Enterocutaneous fistula after emergency general surgery: Mortality, readmission, and financial burden

BACKGROUND The burden of enterocutaneous fistula (ECF) after emergency general surgery (EGS) has not been rigorously characterized. We hypothesized that ECF would be associated with higher rates of postdischarge mortality and readmissions. METHODS Using the 2016 National Readmission Database, we conducted a retrospective study of adults presenting for gastrointestinal (GI) surgery. Cases were defined as emergent if they were nonelective admissions with an operation occurring on hospital day 0 or 1. We used International Classification of Diseases, 10th Revision, code K63.2 (fistula of intestine) to identify postoperative fistula. We measured mortality rates and 30- and 90-day readmission rates censuring discharges occurring in December or from October to December, respectively. RESULTS A total of 135,595 patients underwent emergency surgery; 1,470 (1.1%) developed ECF. Mortality was higher in EGS patients with ECF than in those without (10.1% vs. 5.4%; odds ratio [OR], 1.99; 95% confidence interval [CI], 1.67–2.36) among patients who survived the index admission. Readmission rates were higher for EGS patients with ECF than without at 30 days (31.0% vs. 12.6%; OR, 3.12; 95% CI, 2.76–3.54) and at 90 days (51.1% vs. 20.1%; OR, 4.15; 95% CI, 3.67–4.70). Similar increases were shown in elective GI surgery. CONCLUSIONS Enterocutaneous fistula after GI EGS is associated with significantly increased odds of mortality and readmission, with rates continuing to climb out to at least 90 days. Processes of care designed to mitigate risk in this high-risk cohort should be developed. LEVEL OF EVIDENCE Prognostic and Epidemiological Study, Level III.
Report on fluorescence lifetime imaging using multiphoton laser scanning microscopy targeting sentinel lymph node diagnostics

Abstract. Significance: Sentinel lymph node (SLN) biopsy is an important method for metastasis staging in, e.g., patients with malignant melanoma. Tools enabling prompt histopathological analysis are expected to facilitate diagnostics; optical technologies are explored for this purpose. Aim: The objective of this exploratory study was to investigate the potential of adopting multiphoton laser scanning microscopy (MPM) together with fluorescence lifetime analysis (FLIM) for the examination of lymph node (LN) tissue ex vivo. Approach: Five LN tissue samples (three metastasis positive and two negative) were acquired from a biobank comprising tissues from melanoma patients. Tissues were deparaffinized and subjected to MPM-FLIM using an experimental MPM set-up equipped with a time correlated single photon counting module enabling FLIM. Results: The data confirm that morphological features similar to conventional histology were observed. In addition, FLIM analysis revealed elevated morphological contrast, particularly for discriminating between metastatic cells, lymphocytes, and erythrocytes. Conclusions: Taken together, the results from this investigation show promise for adopting MPM-FLIM in the context of SLN diagnostics and encourage further translational studies on fresh tissue samples.
Medical Error Reporting: Status Quo and Perceived Barriers in an Orthopedic Center in Iran

Background: Medical error reporting is fundamental for improving patient safety. We surveyed healthcare professionals to evaluate their experience of adverse events witness and reporting, knowledge about adverse events, attitude toward own and colleagues' errors, and perceived barriers in reporting errors. Methods: This cross-sectional study was conducted on healthcare professionals from May to October 2017 at Chamran hospital, which is the largest referral orthopedic center in southern Iran. The self-administered questionnaire comprised 32 items covering five domains: (1) demographic and professional characteristics, (2) medical error witness and reporting, (3) actual and perceived knowledge regarding type of events and the status of completed training courses, (4) attitude toward reporting one's own and colleagues' errors, and (5) perceived barriers in error reporting. Questionnaire validity and reliability was proven in our previous study. Results: From a total of 210 participants, 164 returned completed questionnaires (response rate = 78.1%); 87 (53%) were physicians and 77 (47%) were nurses. Underreporting was common, particularly among physicians. Out of physicians and nurses, 57.1% and 49.4% had poor knowledge, respectively. Participants reported their own or colleagues' errors alike, but physicians tended to only provide verbal warning to their colleagues (36.8%), and nurses stated they would report the colleagues' errors, if it was serious (32.4%). Fear of blame and punishment and fear of legal ramification were the most important perceived barriers. Conclusions: Improvements in current medical error registry system, implementing effective educational courses, and modifying the curricula for students seem to be necessary to resolve the problem of underreporting and poor knowledge level.
A Brain-Inspired Framework for Evolutionary Artificial General Intelligence

From the medical field to agriculture, from energy to transportation, every industry is going through a revolution by embracing artificial intelligence (AI); nevertheless, AI is still in its infancy. Inspired by the evolution of the human brain, this article demonstrates a novel method and framework to synthesize an artificial brain with cognitive abilities by taking advantage of the same process responsible for the growth of the biological brain called “neuroembryogenesis. ” This framework shares some of the key behavioral aspects of the biological brain, such as spiking neurons, neuroplasticity, neuronal pruning, and excitatory and inhibitory interactions between neurons, together making it capable of learning and memorizing. One of the highlights of the proposed design is its potential to incrementally improve itself over generations based on system performance, using genetic algorithms. A proof of concept at the end of this article demonstrates how a simplified implementation of the human visual cortex using the proposed framework is capable of character recognition. Our framework is open source, and the code is shared with the scientific community at http://www.feagi. org.
Underwater Endoscopic Repair of Superior Canal Dehiscence.

: Superior canal dehiscence (SCD) is a bony defect of the superior semicircular canal (SCC). Patients with SCD Syndrome (SCDS) may experience symptoms such as aural fullness, pulsatile tinnitus, hyperacusis, autophony, or pressure or noise-induced vertigo . The defect can be repaired in various ways, but there is potential for loss of perilymphatic fluid during transmastoid approaches that could result in postoperative sensorineural hearing loss . We hypothesize that if the procedure were performed "underwater" in balanced salt solution (BSS), loss of perilymphatic fluid would be minimized. CASE REPORT:: A 55-year-old male presented with right-sided autophony, pulsatile tinnitus, and hyperacusis. Audiometric testing demonstrated a low-frequency airbone gap and a supranormal bone-conduction threshold at 4 kHz. Ocular VEMP responses were increased amplitude. Temporal bone imaging revealed a SCC dehiscence.The patient was taken to the operating room for an underwater, endoscopic repair of the SCC using a transmastoid approach. A cortical mastoidectomy was performed using Landmarx image navigation. BSS filled the mastoid and a 0-degree endoscope with endoscrub was used to see the SCC underwater. The SCC was entered near the ampullated end with a bur. A stepwise plugging process included applying strips of wet and dried fascia and bone dust. The non-ampullated end was similarly plugged. BSS was suctioned, and under microscopic visualization, labyrinthotomies were capped with bone chips. The patient tolerated the procedure well and was discharged the next day. There was no sensorineural hearing loss postoperatively. CONCLUSION:: SCDS may be addressed surgically using multiple approaches. An underwater endoscopic repair of the SCC may be safe and effective surgical treatment.SDC video link: http://links.lww. com/MAO/A808.
Bootstrapping promotes the RSFC‐behavior associations: An application of individual cognitive traits prediction

Resting state functional connectivity records enormous functional interaction information between any pair of brain nodes, which enriches the prediction of individual phenotypes. To reduce the high dimensional features in prediction, correlation analysis is a common way for feature selection. However, rs-fMRI signal exhibits typically low signal-to-noise ratio and correlation analysis is sensitive to outliers and data distribution, which may bring unstable and uninformative features to subsequent prediction. To alleviate this problem, a bootstrapping-based feature selection framework was proposed and applied on three widely used regression models: connectome-based predictive model (CPM), support vector regression (SVR) and least absolute shrinkage and selection operator (LASSO). A large open-source dataset from Human Connectome Project (HCP) was adopted in the study and a series of cognitive traits were acted as the prediction targets. To systematically investigate the influences of different parameter settings on the bootstrapping-based framework, a total of 216 parameter combinations were evaluated through the R value between the predicted and real cognitive traits, and the best identified performance among them was chosen out as the final prediction accuracy for each cognitive trait. By using bootstrapping without replacement, the best performances of CPM with positive and negative feature sets, SVR and LASSO averagely increased by 28.0%, 33.2%, 11.6% and 24.3% in R values in contrast to the baseline method without bootstrapping. By using bootstrapping with replacement, these best performances increased by 22.1%, 22.9%, 9.4% and 19.6%. Furthermore, the bootstrapping-based feature selection methods could effectively refine the original feature sets obtained from correlation analysis, which thus retained the more stable and informative feature sets. The results demonstrate that bootstrapping-based feature selection is an easy-to-use and effective method to improve RSFC prediction of cognitive traits and is highly recommended in future RSFC prediction studies.
FPGA Realization of Hodgkin-Huxley Neuronal Model

One of the appealing cases of the neuromorphic research area is the implementation of biological neural networks. The current study offers Multiplierless Hodgkin-Huxley Model (MHHM). This modified model may reproduce various spiking behaviors, like the biological HH neurons, with high accuracy. The presented modified model, in comparison to the original HH model, due to its exact similarity to the original model, has more top performances in the case of FPGA saving and more achievable frequency (speed-up). In this approach, the proposed model has a 69 % saving in FPGA resources and also the maximum frequency of 85 MHz that is more than other similar works. In this modification, all spiking behaviors of the original model have been generated with low error calculations. To validate the MHHM neuron, this proposed model has been implemented on digital hardware FPGA. This approach demonstrates that the original HH model and the proposed model have high similarity in terms of higher performance and digital hardware cost reduction.
Surgical outcome of stapled and handsewn anastomosis in lower gastrointestinal malignancies: A prospective study

Background: In spite of the wide range of intestinal anastomotic techniques, surgeons are still not so confident with colorectal anastomosis. Invention of surgical staplers has provided some procedural advantages and sense of security to surgeons as well as to patients, in respect to sphincter-saving procedures and thereby improving the quality of life. Outcome measures of applying these devices should be evaluated to see its efficacy and cost-effectiveness over conventional handsewn technique in treatment plan. The result of such comparative study may help surgeons to improve results of their technique. The aim of this prospective study is to observe the results of using stapler in comparison to handsewn colorectal anastomosis. Patients and Methods: A total of 60 patients were selected, of which 30 underwent “stapled” and 30 underwent “handsewn” anastomosis. The two groups were compared on the following points (i) mean operating time (min), (ii) resumption of oral feeding, (iii) wound infection rate, (iv) anastomotic leak rate, (v) duration of hospital stay and return to work in days. The procedures were evaluated and presented. Results: The stapling procedure took shorter operative time compared to the handsewn anastomosis with a mean of 123 ± 21.1 min and 161.5 ± 27.8 min respectively (P < 0.001). Oral feeding was started earlier in patients who underwent stapler anastomosis 4.0 ± 1.0 days, as compared to handsewn anastomosis 5.0 ± 0.83 days (P value = 0.001). There was no significant difference between the two groups in postoperative hospital stay; it was 7.8 ± 1.76 days and in controls group it was 8.1 ± 2.12 (P > 0.0137). Conclusion: Application of the stapler in treating lower gastrointestinal malignancies demonstrated better effects in terms of mean operating time, resumption of oral feeds, and hospital stay.
Safety and Efficacy of Long-Term Ripasudil 0.4% Instillation for the Reduction of Intraocular Pressure in Japanese Open-Angle Glaucoma Patients.

Purpose: Rho-associated kinase-inhibitor ripasudil 0.4% eye drops are reportedly effective for the reduction of intraocular pressure (IOP) in glaucoma patients. However, the previous studies investigated the efficacy of IOP reduction for only about 1 year. Here, we evaluated the safety and efficacy of long-term ripasudil instillation in Japanese open-angle glaucoma (OAG) patients. Methods: This study involved 312 eyes of 312 Japanese OAG patients newly initiated with ripasudil treatment at Kyoto Prefectural University of Medicine and Oike-Ikeda Eye Clinic, Kyoto, Japan. In all patients, adverse events leading to discontinuation of ripasudil treatment were investigated. Of the 312 patients, 129 patients able to continue ripasudil administration for over 12-months post-treatment initiation were enrolled to investigate the long-term efficacy. IOP data at 0-, 1-, 3-, 6-, 12-, 18-, and 24-months post initiation of continuous ripasudil use were obtained, and the IOP values at each time point were then compared. The first period (from 1-6 months) and second period (from 12-24 months) IOP data were also compared based on the mixed model. Results: IOP at each time-point post-treatment initiation was significantly reduced compared with that at pre initiation (P < 0.05). Differences in IOP between the first and second periods of the study were not statistically significant (P = 0.058). Adverse events leading to discontinuation of treatment included blepharitis (15.7%) and conjunctival hyperemia (9.0%). Conclusions: We found that in Japanese OAG patients, 24-month ripasudil eye drop instillation is both safe and effective for lowering IOP and that blepharitis is the primary adverse event for discontinuation of use.