Miracle-dz/UniFAR-FTUs huggingface dataset:
Staging Accuracy of Multiparametric MRI in Caucasian and African American Patients Undergoing Radical Prostatectomy.

PURPOSE to compare the performance of mpMRI for prediction of extra-prostatic extension (EPE) in African (AA) and Caucasian American (CA) men and to evaluate racial disparities in pathologic outcomes after radical prostatectomy (RP). METHODS we identified 975 patients who underwent RP with preoperative mpMRI between January 2013 and April 2019 at our institution. Multivariable logistic regression analysis was performed predicting pathological EPE, high-grade prostate cancer (PCa) [final pathology Gleason Grade Group (GGG)≥3] in the overall population, and pathological upgrading (defined as final pathology GGG≥3) in patients with diagnosis of GGG1-2 PCa. Adverse pathology was defined as pT3 and/or GGG≥3. RESULTS 221 (23%) patients were AA. Preoperatively 594 (60.9%) were GGG1-2 (low-risk group) and 381 (39.1%) GGG≥3 (high-risk group). In the low-risk group, rates of pathological EPE (18%vs12.8%, p-value=0.14), adverse pathology (18%vs13.4%, p-value=0.2) or upgrading (9.4%vs12.1%, p-value=0.4) were similar between races. Similarly, in the high-risk group, there was no difference in the rates of pathological EPE. At multivariable analysis, mpMRI predicted the presence of EPE (OR:1.80; 95% CI: 1.29-2.50) and high-grade PCa (OR:1.82; 95% CI: 1.25-2.67) on final pathology. Conversely, Race did not predict the outcomes of interest (all p-values>0.05). MpMRI showed comparable sensitivity (22.22%vs27.84%), specificity (89.2%vs79.2%), PPV (89.2%vs83.4%), and NPV (89.2%vs83.4%) between AA and CA men. CONCLUSIONS The accuracy of mpMRI at staging PCa was similar in AA and CA patients and no difference was found between races in pathologic outcomes after RP. These findings suggest that access to and use of advanced diagnostic tests may help mitigate PCa racial disparities.
Computational Modeling of Claudin Structure and Function

Tight junctions form a barrier to control passive transport of ions and small molecules across epithelia and endothelia. In addition to forming a barrier, some of claudins control transport properties of tight junctions by forming charge- and size-selective ion channels. It has been suggested claudin monomers can form or incorporate into tight junction strands to form channels. Resolving the crystallographic structure of several claudins in recent years has provided an opportunity to examine structural basis of claudins in tight junctions. Computational and theoretical modeling relying on atomic description of the pore have contributed significantly to our understanding of claudin pores and paracellular transport. In this paper, we review recent computational and mathematical modeling of claudin barrier function. We focus on dynamic modeling of global epithelial barrier function as a function of claudin pores and molecular dynamics studies of claudins leading to a functional model of claudin channels.
Oxidation of Sperm Nucleus in Mammals: A Physiological Necessity to Some Extent with Adverse Impacts on Oocyte and Offspring

Sperm cells have long been known to be good producers of reactive oxygen species, while they are also known to be particularly sensitive to oxidative damage affecting their structures and functions. As with all organic cellular components, sperm nuclear components and, in particular, nucleic acids undergo oxidative alterations that have recently been shown to be commonly encountered in clinical practice. This review will attempt to provide an overview of this situation. After a brief coverage of the biological reasons why the sperm nucleus and associated DNA are sensitive to oxidative damage, a summary of the most recent results concerning the oxidation of sperm DNA in animal and human models will be presented. The study will then attempt to cover the possible consequences of sperm nuclear oxidation on male fertility and beyond.
"Strokenomics": bending the cost curve in stroke care.

OBJECTIVE The mortality rates for stroke are decreasing, yet it remains a leading cause of disability and the principal neurological diagnosis in patients discharged to nursing homes. The societal and economic burdens of stroke are substantial, with the total annual health care costs of stroke expected to reach $240.7 billion by 2030. Mechanical thrombectomy has been shown to improve functional outcomes compared to medical therapy alone. Despite an incremental cost of $10,840 compared to medical therapy, the improvement in functional outcomes and decreased disability have contributed to the cost-effectiveness of the procedure. In this study the authors describe a physician-led device bundle purchase program implemented for the delivery of stroke care. METHODS The authors retrospectively reviewed the clinical and radiographic data and device-associated charges of 45 consecutive patients in whom a virtual "stroke bundle" model was used to purchase mechanical thrombectomy devices. RESULTS Use of the stroke bundle to purchase mechanical thrombectomy devices resulted in an average savings per case of $2900.93. Compared to the traditional model of charging for devices à la carte, this represented an average savings of 25.2% per case. The total amount of savings for these initial 45 cases was $130,542.00. Thrombolysis in Cerebral Infarction scale grade 2b or 3 recanalization occurred in 38 patients (84.4%) using these devices. CONCLUSIONS Purchasing devices through a bundled model resulted in substantial cost savings while maintaining the therapeutic efficacy of the procedure, further pushing the already beneficial long-term cost-benefit curve in favor of thrombectomy.
Self-selection of food ingredients and agricultural by-products by the house cricket, Acheta domesticus (Orthoptera: Gryllidae): A holistic approach to develop optimized diets

The house cricket, Acheta domesticus L. (Orthoptera: Gryllidae) is one of the most important species of industrialized insects in the United States. Within the past five years the market of cricket powder as a food ingredient has been growing with increasing consumer interest on more sustainable sources of food. However, high labor costs of cricket production and high prices of cricket feed formulations result in cricket powder market prices much higher than other protein-rich food ingredients, making cricket powder only competitive within the novelty food market. In this study new diets formulated using by-products were developed using dietary self-selection followed by regression analysis. Crickets selected among seven different combinations of ingredients. Consumption ratios of food ingredients and by-products were used to determine macro and micro-nutrient intake. Regression analysis was used to determine the individual nutrient intake effect on cricket biomass production. Intake of vitamin C, sterol, manganese, and vitamins B1 and B5 had the most significant impact on live biomass production. Four diets were formulated based on this information and compared with a reference (Patton’s 13) and a commercial diet. Although, crickets reared on Patton’s diet 13 produced the most dry-weight biomass and developed the fastest, diet 4 (consisting of 92% by-products) generated the most profit (with a cost of $0.39 USD per kg) after an economic analysis that did not include the commercial formulation. Dry-weight biomass production was not significantly different among the four new diets and the commercial diet. This study demonstrated the value of dietary self-selection studies in developing oligidic insect diets and in studies of insect nutrition. This is the first such study involving farmed edible crickets and agricultural by-products. Four new cricket diet formulations contain between 62 and 92% agricultural by-products are included.
Maturity Related Differences in Body Composition Assessed by Classic and Specific Bioimpedance Vector Analysis among Male Elite Youth Soccer Players

The aim of this study was to analyze the efficiency of classic and specific bioelectrical impedance vector analysis (BIVA) in the assessment of maturity related differences in body composition among male elite youth soccer players, and to provide bioelectrical impedance reference data for this category. A group of 178 players (aged 12.1 ± 1.6 years) were registered in a professional Italian soccer team participating in the first division (Serie A). They were divided into three groups according to their maturity status while bioelectrical resistance and reactance were obtained. The classic and specific BIVA procedures were applied, which correct bioelectrical values for body height and body geometry, respectively. Percentage of fat mass (FM%) and total body water (TBW (L)) were estimated from bioelectrical values. Age-specific z-scores of the predicted age at peak height velocity identified 29 players as earlier-, 126 as on time-, and 23 as later-maturing. TBW was higher (p < 0.01) in adolescents classified as “early” maturity status compared to the other two groups and classic BIVA confirmed these results. Conversely, no differences in FM% were found among the groups. Specific vector length showed a higher correlation (r = 0.748) with FM% compared with the classic approach (r = 0.493). Classic vector length showed a stronger association (r = −0.955) with TBW compared with specific (r = −0.263). Specific BIVA turns out to be accurate for the analysis of FM% in athletes, while classic BIVA shows to be a valid approach to evaluate TBW. An original data set of bioelectric impedance reference values of male elite youth soccer players was provided.
Conjugation in Euplotes raikovi (Protista, Ciliophora): New Insights into Nuclear Events and Macronuclear Development from Micronucleate and Amicronucleate Cells

Ciliates form a distinct group of single-celled eukaryotes that host two types of nuclei (micro and macronucleus) in the same cytoplasm and have a special sexual process known as conjugation, which involves mitosis, meiosis, fertilization, nuclear differentiation, and development. Due to their high species diversity, ciliates have evolved different patterns of nuclear events during conjugation. In the present study, we investigate these events in detail in the marine species Euplotes raikovi. Our results indicate that: (i) conjugation lasts for about 50 h, the longest stage being the development of the new macronucleus (ca. 36 h); (ii) there are three prezygotic micronuclear divisions (mitosis and meiosis I and II) and two postzygotic synkaryon divisions; and (iii) a fragment of the parental macronucleus fuses with the new developing macronucleus. In addition, we describe for the first time conjugation in amicronucleate E. raikovi cells. When two amicronucleate cells mate, they separate after about 4 h without evident nuclear changes; when one amicronucleate cell mates with a micronucleate cell, the micronucleus undergoes regular prezygotic divisions to form migratory and stationary pronuclei, but the two pronuclei fuse in the same cell. In the amicronucleate cell, the parental macronucleus breaks into fragments, which are then recovered to form a new functional macronucleus. These results add new information on the process of conjugation in both micronucleate and amicronucleate Euplotes cells.
Advanced Technology Use by Care Professionals

Advanced technology is a primary solution for the shortage of care professionals and increasing demand for care, and thus acceptance of such technology is paramount. This study investigates factors that increase use of advanced technology during elderly care, focusing on current use of advanced technology, factors that influence its use, and care professionals’ experiences with the use. This study uses a mixed-method design. Logfiles were used (longitudinal design) to determine current use of advanced technology, questionnaires assessed which factors increase such use, and in-depth interviews were administered to retrieve care professionals’ experiences. Findings suggest that 73% of care professionals use advanced technology, such as camera monitoring, and consult clients’ records electronically. Six of nine hypotheses tested in this study were supported, with correlations strongest between performance expectancy and attitudes toward use, attitudes toward use and satisfaction, and effort expectancy and performance expectancy. Suggested improvements for advanced technology include expanding client information, adding report functionality, solving log-in problems, and increasing speed. Moreover, the quickest way to increase acceptance is by improving performance expectancy. Care professionals scored performance expectancy of advanced technology lowest, though it had the strongest effect on attitudes toward the technology.
Current Knowledge and Future Perspectives on Mesenchymal Stem Cell-Derived Exosomes as a New Therapeutic Agent

Mesenchymal stem cells (MSCs) are on the cusp of regenerative medicine due to their differentiation capacity, favorable culture conditions, ability to be manipulated in vitro, and strong immunomodulatory activity. Recent studies indicate that the pleiotropic effects of MSCs, especially their immunomodulatory potential, can be largely attributed to paracrine factors. Exosomes, vesicles that are 30-150 nanometers in diameter that function in cell-cell communication, are one of the key paracrine effectors. MSC-derived exosomes are enriched with therapeutic miRNAs, mRNAs, cytokines, lipids, and growth factors. Emerging evidences support the compelling possibility of using MSC-derived exosomes as a new form of therapy for treating several different kinds of disease such as heart, kidney, immune diseases, neural injuries, and neurodegenerative disease. This review provides a summary of current knowledge and discusses engineering of MSC-derived exosomes for their use in translational medicine.
The American Association for the Surgery of Trauma (AAST) emergency surgery guidelines for acute pancreatitis: Are we missing significant opportunities for reflection?

D r. Crandall and colleagues have published a wonderfully interesting document calling for additional study within multiple areas of emergency general surgery. While we certainly agree with the majority of this gap analysis, the discussion of evidence supporting the management of acute pancreatitis lacks a number of recent critical findings/ concepts. Similarly, preceding guidelines from the American Association for the Surgery of Trauma (AAST) also omit relevant and nuanced clinical care concepts surrounding severe acute pancreatitis. This field has been remarkably dynamic and achieved tremendous evolution in our understanding of pathophysiology and optimal treatments since the referenced guidelines from 2002 and 2007. Although there have been two iterations of the international collaborative known as the Atlanta criterion, numerous defunct terms resurface in the AAST guideline. These include, but are not limited to, pancreatic “phlegmon” and “abscess. ” Maintaining a common lexicon (both in terminology and meaning) is essential moving forward to ensure comparable and extrapolatable research. Furthermore, patients with hemorrhage in the setting of acute pancreatitis are nearly always more critically ill than those with walled off pancreatic necrosis (WOPN) (either infected or sterile). Dividing grades based on infected (grade IV) versus noninfected (grade III) is also confusing. The reality is that many patients with infected necrosis have surprisingly few symptoms, while others are truly critically ill. We observe this on a daily basis on busy pancreatitis services, as well as in recent literature that outlines no overall differences in patient outcomes in infected versus noninfected cohorts. More specifically, three publications (2015–2019) confirm no difference in the mortality of patients with necrotizing pancreatitis in infected versus noninfected groups. This observation even extends to patient mortality in thosewith necrotizing pancreatitis and persistent organ failure (28% vs. 34%). The frequency of these observations confirms that
Can Traditional Fermented Food Products Protect Mothers Against Lactational Mastitis.

Background/Objective: Various dietary factors, including the daily food intake during pregnancy and lactation can play a role in the development of lactational mastitis (LM). To investigate the effect of the most commonly consumed fermented foods (FF) during pregnancy and lactation in Turkey and other factors described in the literature regarding childbirth and breastfeeding on the development of LM. Materials and Methods: The study included 607 volunteers in the lactational period, of whom 303 had LM and 304 had no mastitis event. The data on sociodemographics, childbirth, and breastfeeding, and the consumption frequency of six types of FF were collected through a face-to-face questionnaire. Results: The variables significantly and independently associated with LM were birth week (odds ratio [OR] = 80.83, 95% confidence interval [CI]: 1.12-1.94), birth weight (OR = 0.63, CI: 1.24-1.79), time to breastfeeding after birth (OR = 0.79, CI: 1.62-2.31), breastfeeding length (OR = 0.12, CI: 2.25-2.78), breast preference (OR = 0.13, CI: 2.83-3.42), use of cream on nipples (OR = 0.81, CI: 1.31-1.97), use of oral probiotics (OR = 0.29, CI: 1.86-2.92), and receiving breastfeeding education from an expert (OR = 0.22, CI: 1.22-2.34). According to the multinominal logistic regression analysis, the daily consumption of kefir (OR = 0.69, CI: 1.18-2.22), homemade yogurt (OR = 0.78, CI: 1.14-1.87), conventional yogurt (OR = 0.81, CI: 1.24-2.46), boza (OR = 0.79, CI: 2.19-2.99), tarhana (OR = 0.52, CI: 2.47-2.81), and pickles (OR = 0.22, CI: 1.22-2.34) significantly reduced the risk of LM development. The diversity of consumed FF was also found to be protective against LM (OR = 0.34, CI: 1.34-2.35). Conclusion: Kefir, homemade and conventional yogurt, boza, tarhana, and pickles can protect breastfeeding mothers and also reduce the risk of LM development.
Impact of a systematic evaluation of connective tissue disease on diagnosis approach in patients with interstitial lung diseases

Abstract To date, there is no clear agreement regarding which is the best method to detect a connective tissue disease (CTD) during the initial diagnosis of interstitial lung diseases (ILD). The aim of our study was to explore the impact of a systematic diagnostic strategy to detect CTD-associated ILD (CTD-ILD) in clinical practice, and to clarify the significance of interstitial pneumonia with autoimmune features (IPAF) diagnosis in ILD patients. Consecutive patients evaluated in an ILD Diagnostic Program were divided in 3 groups: IPAF, CTD-ILD, and other ILD forms. Clinical characteristics, exhaustive serologic testing, high resolution computed tomography (HRCT) images, lung biopsy specimens, and follow-up were prospectively collected and analyzed. Among 139 patients with ILD, CTD was present in 21 (15.1%), 24 (17.3%) fulfilled IPAF criteria, and 94 (67.6%) were classified as other ILD forms. Specific systemic autoimmune symptoms such as Raynaud phenomenon (19%), inflammatory arthropathy (66.7%), and skin manifestations (38.1%) were more frequent in CTD-ILD patients than in the other groups (all P < .001). Among autoantibodies, antinuclear antibody was the most frequently found in IPAF (42%), and CTD-ILD (40%) (P = .04). Nonspecific interstitial pneumonia, detected by HRCT scan, was the most frequently seen pattern in patients with IPAF (63.5%), or CTD-ILD (57.1%) (P < .001). In multivariate analysis, a suggestive radiological pattern by HRCT scan (odds ratio [OR] 15.1, 95% confidence interval [CI] 4.7–48.3, P < .001) was the strongest independent predictor of CTD-ILD or IPAF, followed by the presence of clinical features (OR 14.6, 95% CI 4.3–49.5, P < .001), and serological features (OR 12.4, 95% CI 3.5–44.0, P < .001). This systematic diagnostic strategy was useful in discriminating an underlying CTD in patients with ILD. The defined criteria for IPAF are fulfilled by a considerable proportion of patients referred for ILD.
Global Transcriptomic Analysis of Zebrafish Glucagon Receptor Mutant Reveals Its Regulated Metabolic Network

The glucagon receptor (GCGR) is a G-protein-coupled receptor (GPCR) that mediates the activity of glucagon. Disruption of GCGR results in many metabolic alterations, including increased glucose tolerance, decreased adiposity, hypoglycemia, and pancreatic α-cell hyperplasia. To better understand the global transcriptomic changes resulting from GCGR deficiency, we performed whole-organism RNA sequencing analysis in wild type and gcgr-deficient zebrafish. We found that the expression of 1645 genes changes more than two-fold among mutants. Most of these genes are related to metabolism of carbohydrates, lipids, and amino acids. Genes related to fatty acid β-oxidation, amino acid catabolism, and ureagenesis are often downregulated. Among gcrgr-deficient zebrafish, we experimentally confirmed increases in lipid accumulation in the liver and whole-body glucose uptake, as well as a modest decrease in total amino acid content. These results provide new information about the global metabolic network that GCGR signaling regulates in addition to a better understanding of the receptor’s physiological functions.
Hepatotoxicity Modeling Using Counter-Propagation Artificial Neural Networks: Handling an Imbalanced Classification Problem

Drug-induced liver injury is a major concern in the drug development process. Expensive and time-consuming in vitro and in vivo studies do not reflect the complexity of the phenomenon. Complementary to wet lab methods are in silico approaches, which present a cost-efficient method for toxicity prediction. The aim of our study was to explore the capabilities of counter-propagation artificial neural networks (CPANNs) for the classification of an imbalanced dataset related to idiosyncratic drug-induced liver injury and to develop a model for prediction of the hepatotoxic potential of drugs. Genetic algorithm optimization of CPANN models was used to build models for the classification of drugs into hepatotoxic and non-hepatotoxic class using molecular descriptors. For the classification of an imbalanced dataset, we modified the classical CPANN training algorithm by integrating random subsampling into the training procedure of CPANN to improve the classification ability of CPANN. According to the number of models accepted by internal validation and according to the prediction statistics on the external set, we concluded that using an imbalanced set with balanced subsampling in each learning epoch is a better approach compared to using a fixed balanced set in the case of the counter-propagation artificial neural network learning methodology.