Miracle-dz/UniFAR-FTUs huggingface dataset:
Effectiveness of Immersive Virtual Reality on Orthopedic Surgical Skills and Knowledge Acquisition Among Senior Surgical Residents

Key Points Question What is the quantifiable skill and knowledge transfer for surgical trainees using immersive virtual reality to learn both pathology recognition and complex procedural skills? Findings In this randomized clinical trial of 18 senior orthopedic surgery residents, those trained using immersive virtual reality demonstrated significant improvements in knowledge and procedural metrics compared with a control group receiving technical video instruction. A transfer effectiveness ratio of 0.79 was demonstrated, indicating that immersive virtual reality substituted for 47.4 minutes of equivalent real operating room training. Meaning These findings suggest that immersive virtual reality may play a significant role in the future of procedural training, supplementing and perhaps augmenting traditional teaching and effectively reducing early surgical learning curves.
Preliminary Evidence on Abatacept Safety and Efficacy in Refractory Juvenile Localized Scleroderma.

OBJECTIVES To evaluate the safety and efficacy of abatacept treatment for refractory juvenile localized scleroderma (jLS) in a retrospective study. METHODS A multicentre cohort study was performed to evaluate jLS subjects treated with abatacept with follow-up for 12 months to maximum of 24 months. Assessments at 6 month intervals included skin activity measures and physician global assessment of activity (PGA-A). Descriptive statistical analysis was performed. RESULTS Eighteen subjects were studied with median age 13.4 years, the majority had linear scleroderma subtype, and musculoskeletal involvement. All had previously failed methotrexate and/or mycophenolate mofetil (MMF) treatment and glucocorticoids. Abatacept was added to the subject's maintenance DMARD treatment; 13 also received glucocorticoids at start of abatacept.No serious adverse events occurred. Skin activity and PGA-A scores declined in nearly all by 6 months and continued to improve from 6 to 12 months. At 12 months, 15 (83%) subjects were considered responders, two (11%) treatment failures, and one dropped out for adverse event. Response was sustained for 11 (61%) subjects to 18 months and 8 (44%) to 24 months. Overall, 4 (22%) subjects were treatment failures and 3 (16.7%) discontinued abatacept for adverse event. Active musculoskeletal problems improved in most affected subjects. Ten subjects were able to discontinue initial glucocorticoid and 6 concomitant DMARD treatment. CONCLUSION Abatacept was found to be safe and effective for jLS subjects refractory to standard of care treatment. Subjects experienced improvement in both skin and musculoskeletal activity. Prospective studies should be performed to more fully evaluate abatacept's efficacy.
Changes of body composition and circulating neopterin, omentin‐1, and chemerin in response to thylakoid‐rich spinach extract with a hypocaloric diet in obese women with polycystic ovary syndrome: A randomized controlled trial

This trial evaluated the effects of thylakoid‐rich spinach extract supplementation combined with a hypocaloric diet on body composition and serum levels of neopterin, chemerin, and omentin‐1 in obese women with polycystic ovary syndrome (PCOS). In this randomized controlled trial, 48 obese women with PCOS, aged 20–45 years old, were recruited and randomly divided into thylakoid (n = 24) and placebo (n = 24) groups. They received a low‐calorie diet with 5 g/day thylakoid‐rich spinach extract or a low‐calorie diet with 5 g/day placebo for 12 weeks. The mean age of the participants of the thylakoid group was 31.86 years, and the placebo group was 32.04 years. Thylakoid‐rich spinach extract supplementation with a low‐calorie diet increased serum levels of omentin‐1 (10.90 vs. 3.87 ng/L; p < .001) and decreased fat mass (−5.19 vs. −1.35 kg; p < .001) and serum levels of neopterin (−0.66 vs. −0.38 nmol/L; p = .003) and chemerin (−41.24 vs. −11.26 ng/L; p < .001) in the thylakoid group compared to the placebo group. A significant improvement in omentin‐1, chemerin, and neopterin by thylakoid‐rich spinach extract supplementation was under the influence of weight change and insulin resistance status throughout the study. A significant decrease in the other anthropometric indices and insulin resistance was also observed in the thylakoid group, compared to the placebo group (p < .001, for all parameters). Thylakoid‐rich spinach extract combined with a low‐calorie diet increased circulating omentin‐1 and decreased fat mass, abdominal obesity, as well as circulating chemerin, neopterin, and insulin in obese women with PCOS.
On the initialization of soil carbon models and its effects on model predictions for England and Wales

The initial distribution of carbon (C) between model pools can strongly influence predictions of soil C models. Models are often initialized by assuming that C stocks are near steady state, but in many cases this is unrealistic. We explored different ways of initializing the DAYCENT model over the range of soils and climate in England and Wales. We ran the model for the main soil types on arable land and managed grass, identified by taking the top five soil‐land use combinations in each of 87 50‐km grid squares, giving 376 ‘sites’ distributed across the two countries. We compared three initialization methods: (i) using the soil C contents and pool distributions (‘soil microbe C’, ‘slow C’ and ‘passive C’ in DAYCENT) predicted for steady state under the prevailing conditions; (ii) using the steady‐state pool distributions but with the true, initial soil C content; and (iii) by fitting the initial pool distribution to the rates of change in soil C observed in the National Soil Inventory (NSI) of England and Wales during the 1980s and 1990s. The calculated mean net primary production (NPP), and hence C inputs to the soil, was realistic for arable land and permanent grass in England and Wales. The calculated rates of change in soil C were sensitive to the initialization method. Method 1 predicted little change with the actual climate over the NSI survey period and simulated management, but Methods 2 and 3 predicted losses of C. Methods 2 and 3 gave similar trends averaged across soil types and locations, but there were large differences for individual soils and locations. The relationships between losses and the mean soil C content were approximately linear with Methods 2 and 3, but the slopes differed. The predicted losses varied with different climate scenarios applied over the NSI survey period. The predicted differences between climate scenarios were less sensitive to initialization method than to C content. We discuss generic implications for modelling.
High‐intensity interval training and essential amino acid supplementation: Effects on muscle characteristics and whole‐body protein turnover

The purpose of this study was to compare the independent and combined effects of high‐intensity interval training (HIIT) and essential amino acids (EAA) on lean mass, muscle characteristics of the quadriceps, and 24‐hr whole‐body protein turnover (WBPT) in overweight and obese adults. An exploratory aim was to evaluate potential modulatory effects of sex. Sixty‐six adults (50% female; Age: 36.7 ± 6.0 yrs; %BF: 36.0 ± 7.8%) were assigned to 8 wks of: (a) HIIT, 2 days/wk; (b) EAA supplementation, 3.6 g twice daily; (c) HIIT + EAA; or (d) control. At baseline, 4 wks, and 8 wks, total body, thigh LM and muscle characteristics were measured via dual‐energy x‐ray absorptiometry and B‐mode ultrasound, respectively. In a subsample, changes in WBPT was measured using [N15]alanine. Differences between groups were assessed using linear mixed models adjusted for baseline values, followed by 95% confidence intervals on adjusted mean change scores (Δ). HIIT and HIIT + EAA improved thigh LM (Δ: +0.17 ± 0.05 kg [0.08, 0.27]; +0.22 ± 0.05 kg [0.12,0.31]) and vastus lateralis cross‐sectional area (Δ: +2.73 ± 0.52 cm2 [1.69,3.77]; +2.64 ± 0.53 cm2 [1.58,3.70]), volume (Δ: +54.50 ± 11.69 cm3 [31.07, 77.92]; +62.39 ± 12.05 cm3 [38.26, 86.52]), and quality (Δ: −5.46 ± 2.68a.u. [−10.84, −0.09]; −7.97 ± 2.76a.u.[−13.49, −2.45]). Protein synthesis, breakdown, and flux were greater with HIIT + EAA and EAA compared to HIIT (p < .05). Sex differences were minimal. Compared to women, men tended to respond more to HIIT, with or without EAA. For women, responses were greater with HIIT + EAA than HIIT. In overweight and obese adults, 8 weeks of HIIT, with or without EAA, improved thigh LM size and quality; EAA may enhance muscular adaptation via increases in protein turnover, supporting greater improvements in muscular size and quality.
Effects of cigarette smoking on SARS‐CoV‐2 receptor ACE2 expression in the respiratory epithelium†

Due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) pandemic, the world is currently facing high morbidity and mortality rates as well as severe disruption to normal societal and social structures. SARS‐CoV‐2 uses the ACE2 receptor for cellular entry. In a recent publication of The Journal of Pathology, Liu and coworkers highlight the effects of cigarette smoking on ACE2 expression in the respiratory epithelium. The authors studied the effects of acute cigarette smoke exposure in a murine model and confirmed their findings in human lung tissues and gene expression datasets. Their findings demonstrate that cigarette smoking increases ACE2 expression specifically at the apical surface of the airway epithelium. Smoking cessation resulted in lower ACE2 expression, with implications for attenuating the risk of transmission of the virus. The role of ACE2 expression in the development of COVID‐19 symptoms is still under investigation, with conflicting results from experimental models on the role of ACE2 expression in SARS‐CoV‐2‐induced lung injury. In this commentary, we highlight the implications and limitations of the study of Liu et al as well as future therapeutic strategies directed towards ACE2. © 2020 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
Coevolved mutualists experience fluctuating costs and benefits over time

Understanding how mutualisms persist over time requires investigations of how mutualist species coevolve and adapt to the interaction. In particular, the key factors in the evolution of mutualisms are the costs and benefits mutualists experience during the interaction. Here, we used a yeast nutritional mutualism to test how mutualists coevolve and adapt in an obligate mutualism. We allowed two yeast mutualists to evolve together for 15 weeks (about 150 generations), and then we tested if the mutualists had coevolved using time‐shift assays. We also examined two mutualistic traits associated with the costs and benefits: resource use efficiency and commodity production. We found that the mutualists quickly coevolved. Furthermore, the changes in benefits and costs were nonlinear and varied with evolutionary changes occurring in the mutualist partner. One mutualist initially evolved to reduce mutualistic commodity production and increase efficiency in mutualistic resource use; however, this negatively affected its mutualist partner that evolved reduced commodity production and resource use efficiency. As a result, the former increased commodity production, resulting in an increase in benefits for its partner. The quick, nonlinear, and asynchronous evolution of yeast mutualists closely resembles antagonistic coevolutionary patterns, supporting the view that mutualisms should be considered as reciprocal exploitation.
The role of androgen and its related signals in PCOS

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women at reproductive age. However, the underlying pathogenic mechanisms have not been completely understood. Hyperandrogenism is an important clinic feature in patients with PCOS, suggesting its pathologic role in the development and progression of PCOS. However, the actual role of androgen and the related signals in PCOS and PCOS‐related complications have not yet been clarified. In this review, we surveyed the origin and effects of androgen on PCOS and the related complications, highlighted the cellular signals affecting androgen synthesis and summarized the pathological processes caused by hyperandrogenism. Our review well reveals the important mechanisms referring the pathogenesis of PCOS and provides important clues to the clinic strategies in patients with PCOS.
14-days of ketone supplementation lowers glucose and improves vascular function in obesity: a randomized crossover trial.

BACKGROUND Postprandial hyperglycemia increases systemic inflammation and is a risk factor for cardiovascular disease. A ketone monoester (KME) drink containing β-hydroxybutyrate (β-OHB) rapidly lowers plasma glucose, which may be a strategy protecting against postprandial hyperglycemia. We hypothesized that KME would attenuate 2-hour postprandial glucose, lower systemic inflammation, and improve vascular function in adults with obesity. METHODS In a randomized crossover design, 14 participants with obesity (age = 56±12 yrs; BMI = 32.8±7.7 kg/m 2) consumed KME (12 g β-OHB) or placebo 15-minutes prior to each meal for 14-days with all meals provided and matched between conditions. Postprandial glycemia was assessed by continuous glucose monitoring. Vascular function and inflammation were assessed before and after treatment periods. RESULTS Postprandial glucose was 8.0% lower in KME versus placebo (g=0.735; p=0.011) and 24-hour average glucose reduced by 7.8% (g=0.686; p=0.0001). Brachial artery flow-mediated dilation increased from 6.2±1.5% to 8.9±3.3% in KME (g=1.05; p=0.0004) with no changes in placebo (condition X time interaction, p=0.004). There were no changes in plasma cytokines; however, LPS-stimulated monocyte caspase-1 activation was lower following KME supplementation versus placebo (stimulation x condition x time interaction; p=0.004). The KME supplement was well tolerated by participants and adherence to the supplementation regimen was very high. CONCLUSIONS In adults with obesity, 14-days of pre-meal KME supplementation improves glucose control, enhances vascular function, and may reduce cellular inflammation. KME supplementation may be a viable, non-pharmacological approach to improving and protecting vascular health in people with heightened cardiometabolic risk.
Evaluation of 2 Commercially Systems for Detection of Serum Squamous Cell Carcinoma Antigen in Pan Squamous Cell Carcinoma

Background: This study compared the analytical performance of the Elecsys 602 (Roche Diagnostics) system with the I2000 (Abbott laboratories) system for the quantitative measurement of squamous cell carcinoma antigen (SCCA) to assess its role as an indicator in pan squamous cell carcinoma. Methods: 435 serum samples included pan squamous cell cancer group (n = 318) and healthy subjects (n = 52) and non-squamous cell group (n = 41) and benign diseases group (n = 24) were measured by 2 systems and compared. Results: The within-run precision coefficient of variation (CV) for Abbott and Roche systems were 3.34-4.88% and 0.95 -1.96%, and the total precision CV were 2.89-9.48% and 3.97-5.38%, respectively. Good correlation was showed in Abbott and Roche systems (slopes = 0.749, r = 0.9658). Serum SCCA in the groups of nasopharyngeal carcinomas, lung squamous cell carcinoma, esophageal squamous cell carcinoma, bladder cancer and cervical squamous cell carcinoma under the curve area (AUC) was more than 0.5, while the AUC in the non- nasopharyngeal carcinomas head and neck squamous cell carcinoma was less than 0.5. The AUC of 2 systems was statistically different in lung squamous cell carcinoma and nasopharyngeal carcinomas (P < 0.05). The levels of SCCA of 2 systems were similarities in esophageal squamous cell carcinoma(stage IV vs. stage 0a-II)and bladder cancer(stage I vs. stage Oa)and cervical squamous cell carcinoma(stage IIB-III vs. stage I-IIA), which advanced stage had higher level of SCCA than early stage. But the SCCA levels of 2 systems were inconsistent in bladder cancer (stage II-IV vs. stage Oa in Abbott), head and neck squamous cell carcinoma (stage IV vs. stage Oa-I in the Roche) and lung squamous cell carcinoma (stage III vs. stage I-II in the Roche). (P < 0.05) Conclusions: 2 systems correlated well in SCCA detection of squamous cell carcinoma, but there were individual differences. Serum SCCA may also contribute to the diagnosis of bladder cancer.
Suppression of Experimental Autoimmune Encephalomyelitis by ILT3.Fc

Key Points The onset and evolution of EAE in C57BL/6 mice is significantly delayed by ILT3.Fc. ILT3.Fc inhibits T cell production of IL-17 and IFN-γ and migration through BMEC. Deletion of CD8 T cells abrogates the inhibitory effect of ILT3.Fc. Multiple sclerosis (MS) is a chronic autoimmune disease of the CNS that is characterized by demyelination, axonal loss, gliosis, and inflammation. The murine model of MS is the experimental autoimmune encephalopathy (EAE) induced by immunization of mice with myelin oligodendrocyte glycoprotein (MOG)35–55. Ig-like transcript 3 (ILT3) is an inhibitory cell surface receptor expressed by tolerogenic human dendritic cells. In this study, we show that the recombinant human ILT3.Fc protein binds to murine immune cells and inhibits the release of proinflammatory cytokines that cause the neuroinflammatory process that result in paralysis. Administration of ILT3.Fc prevents the rapid evolution of the disease in C57BL/6 mice and is associated with a profound reduction of proliferation of MOG35–55–specific Th1 and Th17 cells. Inhibition of IFN-γ and IL-17A in mice treated with ILT3.Fc is associated with delayed time of onset of the disease and its evolution to a peak clinical score. Neuropathological analysis shows a reduction in inflammatory infiltrates and demyelinated areas in the brains and spinal cords of treated mice. These results indicate that inhibition of Th1 and Th17 development provides effective suppression of EAE and suggests the feasibility of a clinical approach based on the use of ILT3.Fc for treatment of MS. Furthermore, our results open the way to further studies on the effect of the human ILT3.Fc protein in murine experimental models of autoimmunity and cancer.
Transposition Effects in an Aksharic Writing System: The Case of Hindi

We tested for transposition effects (TEs) in Hindi (a Modern Indo-Aryan language) using unprimed lexical decision. TEs are defined as less accurate and slower responses to transposed-nonwords (e.g., ‹psate›, formed from base-word ‹paste›) than corresponding replaced-nonwords (e.g., ‹pzute›). In Hindi’s orthography, letters map transparently to phonemes (except schwa), but the letters are arranged into “akshars,” (‹[Cn]V›) which encode open syllables. This formal characteristic makes Hindi’s orthography typologically “aksharic. ” We used TEs to determine whether the orthography’s typological units, letters and akshars, are also functional units for readers. We conducted three visual word recognition experiments with adult readers whose native language was Hindi. In Experiment 1, we found TEs for consonant (‹C›) and matra (‹M›, a vowel diacritic) letters, using different stimulus sets for each type of transposition. In the next two experiments, we used the same base words to form all of the transposed and replaced items. In Experiment 2, we replicated the findings of Experiment 1 in a different stimulus set; additionally, we found TEs for transpositions between a ‹C› letter and a ‹CM› akshar. In Experiment 3, we replicated results of the first two experiments by finding TEs for both consonants and matras in another stimulus set; additionally, we found similar TEs for ‹CM› akshars. These results show that ‹C› and ‹M› letters are functional units for Hindi readers; the transposition results for ‹CM› akshars are tentative. TEs for letters show that the aksharic grouping of letters does not prevent readers from decoding the constituent letters of akshars. Hindi is read alphabetically.
Usefulness of two-point Dixon T2-weighted imaging in thyroid-associated ophthalmopathy: comparison with conventional fat saturation imaging in fat suppression quality and staging performance.

OBJECTIVE To compare the two-point Dixon T2 weighted imaging (T2WI) with conventional fat-sat T2WI in fat suppression (FS) quality and staging performance for patients with TAO. METHODS We enrolled 37 thyroid-associated ophthalmopathy (TAO) patients and 15 healthy controls who underwent both coronal two-point Dixon and fat-sat T2WI. Qualitative (overall imaging quality, FS uniformity) and quantitative [signal intensity ratio of extraocular muscle (EOM-SIR)] parameters were assessed between the two-point Dixon T2WI and fat-sat T2WI. Additionally, water fraction of intraorbital fat (IF-WF) was measured on Dixon image. Dixon-EOM-SIR, Fat-sat-EOM-SIR and Dixon-IF-WF values were compared between active and inactive TAO groups, and the diagnostic efficiency for the active phase were evaluated. RESULTS Two-point Dixon T2WI showed significantly higher overall image quality score, FS uniformity score as well as EOM-SIR value than fat-sat T2WI in both TAO and control groups (all p < 0.05). Active TAOs had significantly higher Dixon-EOM-SIR (p < 0.001), Fat-sat-EOM-SIR (p < 0.001) and Dixon-IF-WF (p = 0.001) than inactive TAOs. ROC curves analyses indicated that Dixon-EOM-SIR ≥3.32 alone demonstrated the highest staging sensitivity (75.0%). When integrating Dixon-EOM-SIR ≥3.32 and Dixon-IF-WF ≥0.09, improved staging efficiency and specificity could be achieved (area under the curve, 0.872; specificity, 97.1%). CONCLUSION Compared with conventional fat-sat technique, two-point Dixon T2WI offers better image quality, as well as improved staging sensitivity and specificity for TAO. Dixon T2WI is suggested to be used to evaluate the patients with TAO in clinical practice. ADVANCES IN KNOWLEDGE Two-point Dixon T2WI offers better image quality than fat-sat T2WI. Dixon-EOM-SIR alone demonstrated the highest staging sensitivity. Combining with Dixon-IF-WF showed improved staging efficiency and specificity. Dixon T2WI is suggested to be used to evaluate TAO patients in clinical practice.