Miracle-dz/UniFAR-FTUs huggingface dataset:
Does an Incidental Meckel's Diverticulum Warrant Resection?

Meckel's diverticulum (MD) is the most common gastrointestinal malformation. The management of symptomatic Meckel's diverticulum has been undecidedly resection; however, the management of incidental Meckel's diverticulum has been fraught in comparison. As a systematic literature review, PubMed, PubMed Central (PMC), and MEDLINE were used. The search phrase utilized was "Meckel Diverticulum/Surgery [Mesh]" and resection incidental. The search was completed on July 18, 2020 and was limited to 1980 until the day of the search. Searches resulted in 62 initial articles on PubMed. On initial screening, 23 of these articles met the criteria. The references of these 23 articles were screened for relevant studies, yielding a total of 31 studies of which all were assessed for quality. Four articles made a recommendation for no resection. Twelve studies made a recommendation for resection. Ten studies concluded that resection should be completed in the presence of risk factors. Lastly, five studies made no clear recommendation. In recent literature, there has been a shift towards resection for all or in those with high-risk factors. In the future, it will be necessary for researchers to determine if resection is recommended for all patients with incidental MD or in those with risk factors. If only in those with risk factors, it will be important that research is completed to create evidence-based guidelines to support the risk factors.
Immune surveillance activation after neoadjuvant therapy for esophageal adenocarcinoma and complete response

ABSTRACT After neoadjuvant chemoradiotherapy for esophageal adenocarcinoma, up to 29% of patients have a pathological complete response (pCR). What to do afterward is still under debate. The aim of this prospective study was to define which local markers of immune response might act as predictors of pCR and of recurrence after pCR. The peritumoral healthy mucosa of the surgical specimen was sampled at esophagectomy and analyzed by immunohistochemistry, flow cytometry and Real-Time PCR. One hundred and twenty-three patients received neoadjuvant therapy for esophageal adenocarcinoma and were included in the study. Significantly higher rate of natural killer (NK) cells (CD57+), intraepithelial CD8 + T lymphocytes and degranulating T- and NK-cells (CD107+) were observed in the healthy mucosa of patients with pCR. Moreover, pCR was characterized by a lower immune-check points gene expression level. T-cell activation markers mRNA levels were significantly lower in patients with pCR and recurrent disease, showing an excellent accuracy in the prediction of the postoperative recurrence. Costimulatory molecules mRNA relative levels tended to be lower in patients with pCR and recurrent disease, showing a good accuracy in the prediction of postoperative recurrence in patients with pCR. The immune profile identified in this study might further be tested in large prospective trials as marker of pCR after neoadjuvant therapy and as predictor of recurrence after pCR.
Identification of tumor-infiltrating immune cells and prognostic validation of tumor-infiltrating mast cells in adrenocortical carcinoma: results from bioinformatics and real-world data

ABSTRACT Objective The purpose of this study was to explore the composition of tumor-infiltrating immune cells (TIIC) and prognostic significance of tumor-infiltrating mast cells (TIMC) in adrenocortical carcinoma (ACC). Methods The gene expression profiles of ACC were downloaded from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GSE90713, GSE12368). The abundance of TIICs in ACC samples was calculated by CIBERSORT algorithm and immunohistochemistry was used to identify mast cells of 39 tumor samples from Fudan University Shanghai Cancer Center (FUSCC). Differentially expressed genes (DEGs) were analyzed by LIMMA package using R software. Survival analysis was analyzed by Kaplan-Meier method and Cox regression models. Results The abundance of mast cells (p = .008) was positively correlated with ACC patients’ outcome in TCGA cohort and was also positively correlated with both overall survival (p < .05) and progression-free survival (p < .05) in FUSCC cohort. Different TIMC infiltrations showed significant changes in signaling pathways including DNA replication, nuclear chromosome segregation, and meiotic cell cycle process of ACC. In addition, elevated expression of eight hub genes (KIF18A, CDCA8, SKA1, CEP55, BUB1, CDK1, SGOL1, SGOL2) related to the abundance of TIMC in ACC was significantly correlated with the poor prognosis of the patients. Conclusion In conclusion, higher TIMC infiltration was positively correlated with ACC patients’ outcome in both TCGA and FUSCC cohort. Lower TIMC infiltration and elevated expression of hub genes (KIF18A, CDCA8, SKA1, CEP55, BUB1, CDK1, SGOL1, SGOL2) are markedly correlated with aggressive progression and poor prognosis, which might shed lights on novel targets for treatment strategies.
Penggunaan Ampas Tahu untuk Meningkatkan Gizi Pakan Domba Lokal

This study was carried out to evaluate the performance of lambs that given different amounts of soya cake waste. The amounts were 0, 100, 200 and 300 g as treatment 1, 2, 3 and 4. Twenty four male indigenous lambs fed ad libitum native grass hay (12.45 ± 1.67 kg) were devided into four groups. Randomized complete design was applied to this study. The effect of treatments was evaluated by analyses of variance and Duncan test. The results showed that the increase of soya cake waste, increased the intake of dry matter, crude protein, TDN, daily gain and feed efficiency (P Key words: soy cake waste, lamb, hay, daily gain, feed efficiency
A meta-analysis comparing responses of Asian versus non-Asian cancer patients to PD-1 and PD-L1 inhibitor-based therapy

ABSTRACT Background Subgroup analysis of clinical trials of PD-1/PD-L1 inhibitors have reported ethnic differences in outcomes. We systematically collected published data and performed a meta-analysis to compare therapeutic efficacy in Asian and non-Asian patients receiving PD-1/PD-L1 inhibitors. Methods Eligible studies included phase II and III prospective clinical trials with available subgroup data on Asian versus non-Asian populations. Overall survival (OS) and progression-free survival (PFS) were used to evaluate differences in outcome between Asian versus non-Asian cancer patients. Results A total of 11,020 cancer patients from 19 prospective randomized controlled clinical trials were included. The overall estimated HR for OS was 0.69 with 95% CI of 0.61–0.77 in Asian versus 0.82 with 95% CI of 0.77–0.88 in non-Asian patients. The estimated hazard ratio (HR) for PFS measured 0.54 (95% CI, 0.32–0.76) and 0.69 (95% CI, 0.54–0.85) in Asian and non-Asian patients, respectively. Pooled ratios of OS HRs and PFS HRs reported in Asian versus non-Asian cancer patients were 0.84 (95% CI, 0.75–0.94) and 0.78 (95% CI, 0.59–0.97), respectively. Conclusions This meta-analysis shows for the first time that Asian cancer patients have a significantly improved survival benefit than non-Asian patients receiving PD-1/PD-L1 inhibitor-based therapy.
Features of extrahepatic metastasis after radiofrequency ablation for hepatocellular carcinoma

BACKGROUND Extrahepatic metastasis (EHM) of hepatocellular carcinoma (HCC) is associated with poor outcomes. However, the clinical features and risk factors of EHM of HCC after radiofrequency ablation (RFA) remain unclear. AIM To elucidate the characteristics and risk factors of EHM after RFA for HCC. METHODS From January 2008 to December 2017, we retrospectively enrolled 661 patients who underwent RFA as first-line treatment for HCC at 2 tertiary hospitals. The inclusion criteria were age ≥ 18 years, a diagnosis of HCC, and treatment-naivety. Abdominal computed tomography (CT) or magnetic resonance imaging (MRI) and alpha-fetoprotein measurements were routinely performed at 1 mo after RFA and followed-up at intervals of 3-6 mo. Univariate analyses were performed using the chi-squared test or Student’s t-test, and univariate and multivariate analyses were performed via logistic regression, as appropriate. RESULTS EHM was diagnosed in 44 patients (6.7%) during a median follow-up period of 1204 days. The 10-year cumulative rate of HCC recurrence and EHM was 92.7% and 33.7%, respectively. Initial recurrence was most often intrahepatic, and the rate of extrahepatic recurrence at initial recurrence was only 1.2%. The median time to the diagnosis of EHM was 2.68 years, and 68.2% of patients developed EHM within 2 years of the first recurrence, regardless of recurrence-free survival and 75.0% of patients developed EHM within 5 years after first recurrence. EHM was mostly diagnosed via abdominal CT/MRI in 33 (75.0%) and 38 of 44 patients (86.4%) with EHM had either positive abdominal CT scan results or serum AFP level elevation. In multivariate analysis, recurrence-free survival < 2 years, ablation zone/tumor size < 2, and alpha-fetoprotein level > 400 IU/mL were associated with a high EHM risk. CONCLUSION EHM occurs following multiple intrahepatic recurrences after RFA and combined contrast-enhanced abdominal CT and serum AFP were useful for surveillance. Patients especially with high-risk factors require close follow-up for EHM.
B lymphocytes contribute to stromal reaction in pancreatic ductal adenocarcinoma

ABSTRACT Pancreatic ductal adenocarcinoma (PDAC) is characterized by a prominent stromal reaction that has been variably implicated in both tumor growth and tumor suppression. B-lymphocytes have been recently implicated in PDAC progression but their contribution to the characteristic stromal desmoplasia has never been assessed before. In the present work, we aimed to verify whether B-lymphocytes contribute to stromal cell activation in PDAC. CD19+ B-lymphocytes purified from peripheral blood of patients with PDAC were cultivated in the presence of human pancreatic fibroblasts and cancer-associated fibroblasts. Released pro-fibrotic soluble factors and collagen production were assessed by ELISA and Luminex assays. Quantitative RT-PCR was used to assess fibroblast activation in the presence of B cells. The expression of selected pro-fibrotic and inflammatory molecules was confirmed on PDAC tissue sections by multi-color immunofluorescence studies. We herein demonstrate that B-cells from PDAC patients (i) produce the pro-fibrotic molecule PDGF-B and stimulate collagen production by fibroblasts; (ii) express enzymes implicated in extracellular matrix remodeling including LOXL2; and (iii) produce the chemotactic factors CCL-4, CCL-5, and CCL-11. In addition we demonstrate that circulating plasmablasts are expanded in the peripheral blood of patients with PDAC, stimulate collagen production by fibroblasts, and infiltrate pancreatic lesions. Our results indicate that PDAC is characterized by perturbations of the B-cell compartment with expansion of B-lymphocyte subsets that directly contribute to the stromal reaction observed at disease site. These findings provide an additional rationale for modulating B-cell activity in patients with pancreatic cancer.
Risk Factors of Perinatal Asphyxia Among Newborns Delivered at Public Hospitals in Addis Ababa, Ethiopia: Case–Control Study

Background Perinatal asphyxia determines the newborn’s future health status and viability with risk factors yet to be completely understood. It measures the status of the healthcare delivery of an organization including antenatal, intranatal, and postnatal care. In Ethiopia, 31.6% of neonatal mortality was attributed to perinatal asphyxia. This study aimed to assess the risk factors of perinatal asphyxia. Methods An unmatched case–control study was conducted on 213 (71 cases selected using lottery method and 142 controls systematically) subjects in Addis Ababa from November 1, 2018 to June 30, 2019. Data were collected using a structured questionnaire through face-to-face interviews, entered to Epi data version 4.4, and exported to SPSS version 25 for analysis. Logistic regression was used for analysis. Variables with p< 0.25 in bivariate analysis were taken to multivariable analysis. Statistical significance was declared at P<0.05 and findings were presented using texts and tables. Results A total of 210 newborns (70 cases and 140 controls) and their mothers were included with an overall response rate of 98.5%. Antepartum hemorrhage [AOR=7.17; 95% CI 1.73–29.72], low birth weight [AOR=2.87; 95% CI 1.01–8.13], preterm birth [AOR=3.4; 95% CI 1.04–11.16], caesarean section delivery [AOR=2.75; 95% CI 1.01–7.42], instrumental delivery [AOR=4.88; 95% CI 1.35–17.61], fetal distress [AOR=4.77; 95% CI 1.52–14.92] and meconium-stained amniotic fluid [AOR=9.02; 95% CI 2.96–30.24] were significantly associated with perinatal asphyxia. Hence, efforts ought to go to improve the quality of antenatal and intra-natal services.
Potential lung attack and lethality generated by EpCAM-specific CAR-T cells in immunocompetent mouse models

ABSTRACT The tumoricidal efficiency of human CAR-T cells is generally evaluated using immune-deficient mouse models; however, due to their immune-incompetency and the species-specific reactivity of a target antigen, these models are problematic to imitate CAR-T-induced adverse effects in the clinic. Epithelial cell adhesion molecule (EpCAM) is a tumor-associated antigen overtly presented on the cell surface of various carcinomas, making it an attractive target for CAR-T therapy. Here, we developed an anti-mouse EpCAM CAR to evaluate its safety and efficacy in immunocompetent mouse models. As previously reported for their human equivalents, murine EpCAM CAR-T cells exhibit promising anti-tumor efficacy in vitro and in vivo. However, after CAR-T infusion, various dose-depended toxicities including body weight loss, cytokine-release syndrome (CRS), and death were observed in both tumor-bearing and tumor-free mice. Pathological examination revealed unexpected and severe pulmonary immunopathology due to basal EpCAM expression in normal lung. While our study validates EpCAM CAR-T’s potent anti-tumor efficacy, it also reveals that EpCAM CAR-T cells used for the treatment of solid tumors may cause lethal toxicity and should, therefore, be evaluated in patients with caution.
The physiological basis of hypoxia avoidance behaviours in fish

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The Comparative Study of Cervical Shear Wave Elastography Between Twin and Singleton Pregnancy

Objective To compare the cervical shear wave elastography (SWE) by using transvaginal ultrasound (TVS) between twin and singleton pregnant women. Materials and Methods This was a prospective cohort study involving the twin and singleton pregnant women who attended the antenatal care at Ramathibodi Hospital, Bangkok, Thailand. The participants who met the inclusion criteria were serially measured the shear wave speed (SWS) by using TVS at early, mid-, and third trimester. The changes in SWS with advancing gestational age between twin and singleton pregnancies were evaluated. The gestational age at delivery and spontaneous preterm delivery rate were also analyzed. Results A total of 36 twin pregnancies and 38 singleton pregnancies were analyzed. No significant difference in baseline characteristics, except the age of participants (twin pregnancies 33.1±4.6 years, singleton pregnancies 29.9±5.4 years, p-value = 0.006) was observed. The cervical SWS decreased with advancing gestational age in both twin and singleton pregnancy, but there was a statistically significant difference of cervical SWS at the lower point in mid-trimester (twin pregnancies 2.27±0.4, singleton pregnancies 2.71±0.6 m/s, p-value = 0.001). However, no significant difference in cervical SWS at the upper point and the lower point in the early and third trimester was demonstrated. Even though the gestational age at delivery between both groups revealed a significant difference (twin pregnancies 35.9±2.8, singleton pregnancies 37.6±2.9 wk., p-value = 0.008) but the spontaneous preterm delivery rate did not differ significantly (twin pregnancies 22.2%, singleton pregnancies 15.8%, p-value = 0.483). Conclusion The mid-trimester cervical SWS measurement at the lower point detects the difference in cervical softness between twin pregnancies and singleton pregnancies. The cervical SWS might be an additional option for monitoring the change in cervical softness in twin pregnancies.
Physical Performance and Risk of Postoperative Delirium in Older Adults Undergoing Aortic Valve Replacement

Background Delirium is a major risk factor for poor recovery after surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). It is unclear whether preoperative physical performance tests improve delirium prediction. Objective To examine whether physical performance tests can predict delirium after SAVR and TAVR, and adapt an existing delirium prediction rule for cardiac surgery, which includes Mini-Mental State Examination (MMSE), depression, prior stroke, and albumin level. Design Prospective cohort, 2014–2017. Setting Single academic center. Subjects A total of 187 patients undergoing SAVR (n=77) or TAVR (n=110). Methods The Short Physical Performance Battery (SPPB) score was calculated based on gait speed, balance, and chair stands (range: 0–12 points, lower scores indicate poor performance). Delirium was assessed using the Confusion Assessment Method. We fitted logistic regression to predict delirium using SPPB components and risk factors of delirium. Results Delirium occurred in 35.8% (50.7% in SAVR and 25.5% in TAVR). The risk of delirium increased for lower SPPB scores: 10–12 (28.2%), 7–9 (34.5%), 4–6 (37.5%) and 0–3 (44.1%) (p-for-trend=0.001). A model that included gait speed <0.46 meter/second (OR, 2.7; 95% CI, 1.2–6.4), chair stands time ≥11.2 seconds (OR, 3.5; 95% CI, 1.0–12.4), MMSE <24 points (OR, 2.9; 95% CI, 1.3–6.4), isolated SAVR (OR, 5.4; 95% CI, 2.1–13.8), and SAVR and coronary artery bypass grafting (OR, 15.8; 95% CI, 5.5–45.7) predicted delirium better than the existing prediction rule (C statistics: 0.71 vs 0.61; p=0.035). Conclusion Assessing physical performance, in addition to cognitive function, can help identify high-risk patients for delirium after SAVR and TAVR.
A Widow-Maker and a Doppelganger: An Anomalous Case of the Coronaries

The anomalous origin of the left circumflex (LCX) artery from the right coronary sinus is a relatively rare condition. A ‘double’ left anterior descending (LAD) artery is probably the rarest of coronary artery anomalies. We present a case of acute myocardial infarction with a clot and a critical distal stenosis in the left main stem (LMS) supplying a dual LAD and an aberrant origin of the LCX.
IL-6 −572C>G and CARD8 304T>A Genetic Polymorphisms are Associated with the Absolute Neutrophil Count in Patients with Hematological Malignancies Under Chemotherapy: An Application of Multilevel Models to a Preliminary Pharmacogenetic Study

Purpose Neutropenia is a common event in patients undergoing cytotoxic chemotherapy for the treatment of a hematological malignancy. Some polymorphisms, as IL-6 −572C>G (rs1800796), IL-1β −31 G>A (rs1143627), and CARD8 304T>A (rs2043211), in genes related to the inflammatory process, could affect the level of absolute neutrophil count (ANC) after chemotherapy. Since an efficient inflammatory process enhances neutrophil survival, we hypothesize that these polymorphisms are associated with ANC. Patients and Methods We carried out a prospective cohort study in two hospitals in Santiago, Chile. The patients included were adults diagnosed with acute myeloblastic leukemia, acute lymphoblastic leukemia, or non-Hodgkin’s lymphoma, undergoing cytotoxic chemotherapy. We use a multilevel linear regression model to test our hypothesis. The best model was selected using the Akaike’s information criterion (AIC). Results We analyzed 1726 hemograms and ANCs from 172 hospitalizations from 32 patients. The results show that CC and CG genotypes of IL-6 −572 C>G polymorphism are associated with higher ANCs compared with the GG genotype (Ln (ANC) ~ 0.81 IC95% 0.02–1.55). Similarly, TT and AT genotypes of CARD8 304T>A polymorphism were related to higher ANCs compared with AA (Ln (ANC) ~ 0.95 IC95% 0.02–1.82). IL-1β genetic polymorphism had no statistically significant association with ANC. Conclusion IL-6 rs1800796 −572C>G and CARD8 rs2043211 304T>A polymorphisms are associated with the absolute neutrophil count in patients undergoing cytotoxic chemotherapy for treatment of hematological malignancies. Our findings might be useful to improve the safety of chemotherapy through predictive ANC models.
Megacraspedus cottiensis sp. nov. (Lepidoptera, Gelechiidae) from northern Italy – a case of taxonomic confusion

Abstract Megacraspedus cottiensissp. nov. is described from the western Alps (prov. Torino, Italy). The dorsal habitus and genitalia for both the male and brachypterous female are provided. The new species belongs to the M. faunierensis species group based on genitalia morphology and DNA barcodes, and was hitherto confused with M. neli Huemer & Karsholt, 2018 from the southwestern Alps. However, it clearly differs in morphology and DNA barcode sequences from that species and from M. faunierensis Huemer & Karsholt, 2018. The new species is suspected of being a regional endemic of the Cottian Alps.
Gender Differences in the Clinical and Polysomnographic Characteristics Among Australian Aboriginal Patients with Obstructive Sleep Apnea

Background In this study, we assessed the clinical and polysomnographic (PSG) characteristics according to gender among Australian Aboriginal men and woman diagnosed to have obstructive sleep apnea (OSA). Methods In this retrospective study, all adult Aboriginal patients over 18 years of age diagnosed to have OSA with an apnea hypopnea index (AHI) > 5/hour over a 5 year period were included. Results Of the 337 patients (168 females and 169 males), who underwent a diagnostic PSG, 297 (88%) were diagnosed to have OSA (AHI) >5/hour), 154/297 males (52%) and 143/297 females (48%). Amongst male and female patients with OSA, 63% and 37% were in the severe spectrum (AHI>30/hour). The male cohort had higher stage N1 NREM sleep (P<0.001), reduced N3 NREM sleep (P<0.001), higher AHI severity (P<0.001), higher NREM AHI (P<0.001), and high arousal index (P<0.005). REM sleep-related AHI was higher among female patients with all severity of OSA, along with severe oxygen desaturation during REM sleep. Among patients with severe OSA, the female cohort were younger (age 46 years vs 49 years, P=0.030) and had higher BMI with all severity of OSA, while males had larger neck circumference compared to females. Hypertension increased the odds of severe OSA versus the combined odds of mild and moderate OSA for both genders. Conclusion This study highlights some important differences in the way sleep apnea manifests in Australian Aboriginal males and females and further studies are warranted to explore avenues to look for a physiological basis for these observations and targeted interventions.