Miracle-dz/UniFAR-FTUs huggingface dataset:
Video Archiving and Communication System (VACS): A Progressive Approach, Design, Implementation, and Benefits for Surgical Videos

Objectives As endoscopic, laparoscopic, and robotic surgical procedures become more common, surgical videos are increasingly being treated as records and serving as important data sources for education, research, and developing new solutions with recent advances in artificial intelligence (AI). However, most hospitals do not have a system that can store and manage such videos systematically. This study aimed to develop a system to help doctors manage surgical videos and turn them into content and data. Methods We developed a video archiving and communication system (VACS) to systematically process surgical videos. The VACS consists of a video capture device called SurgBox and a video archiving system called SurgStory. SurgBox automatically transfers surgical videos recorded in the operating room to SurgStory. SurgStory then analyzes the surgical videos and indexes important sections or video frames to provide AI reports. It allows doctors to annotate classified indexing frames, “data-ize” surgical information, create educational content, and communicate with team members. Results The VACS collects surgical and procedural videos, and helps users manage archived videos. The accuracy of a convolutional neural network learning model trained to detect the top five surgical instruments reached 96%. Conclusions With the advent of the VACS, the informational value of medical videos has increased. It is possible to improve the efficiency of doctors’ continuing education by making video-based online learning more active and supporting research using data from medical videos. The VACS is expected to promote the development of new AI-based products and services in surgical and procedural fields.
Fatal exudative dermatitis in island populations of red squirrels (Sciurus vulgaris): spillover of a virulent Staphylococcus aureus clone (ST49) from reservoir hosts

Fatal exudative dermatitis (FED) is a significant cause of death of red squirrels (Sciurus vulgaris) on the island of Jersey in the Channel Islands where it is associated with a virulent clone of Staphylococcus aureus, ST49. S. aureus ST49 has been found in other hosts such as small mammals, pigs and humans, but the dynamics of carriage and disease of this clone, or any other lineage in red squirrels, is currently unknown. We used whole-genome sequencing to characterize 228 isolates from healthy red squirrels on Jersey, the Isle of Arran (Scotland) and Brownsea Island (England), from red squirrels showing signs of FED on Jersey and the Isle of Wight (England) and a small number of isolates from other hosts. S. aureus was frequently carried by red squirrels on the Isle of Arran with strains typically associated with small ruminants predominating. For the Brownsea carriage, S. aureus was less frequent and involved strains associated with birds, small ruminants and humans, while for the Jersey carriage S. aureus was rare but ST49 predominated in diseased squirrels. By combining our data with publicly available sequences, we show that the S. aureus carriage in red squirrels largely reflects frequent but facile acquisitions of strains carried by other hosts sharing their habitat (‘spillover’), possibly including, in the case of ST188, humans. Genome-wide association analysis of the ruminant lineage ST133 revealed variants in a small number of mostly bacterial-cell-membrane-associated genes that were statistically associated with squirrel isolates from the Isle of Arran, raising the possibility of specific adaptation to red squirrels in this lineage. In contrast there is little evidence that ST49 is a common carriage isolate of red squirrels and infection from reservoir hosts such as bank voles or rats, is likely to be driving the emergence of FED in red squirrels.
Akzeptanz von digitalen Gesundheitstechnologien bei leichter bis mittelgradiger Depression – Eine qualitative Analyse aus der Perspektive von Betroffenen, Angehörigen und Leistungserbringern

Zusammenfassung Ziel der Studie Die Nutzer*innenakzeptanz von digitalen Gesundheitstechnologien bei leicht- bis mittelgradiger Depression ist bislang rudimentär erforscht und wird in vorliegender Studie untersucht. Methodik Es wurden problemzentrierte Einzelinterviews mit 3 Betroffenen, 3 Angehörigen und 13 Leistungserbringern (v. a. Medizin, Psychologie, Pflege) durchgeführt und qualitativ ausgewertet. Ergebnisse Entlang der Unified Theory of Acceptance and Use of Technology wurden Haltungen von Betroffenen, Angehörigen und Leistungserbringern dargestellt. Die Leistungserwartung und unterstützenden Rahmenbedingungen stellen bedeutsame Prädiktoren für die Nutzungsintention dar. Schlussfolgerung Die Ergebnisse bieten eine Basis, um im Folgeschritt die Kernbedürfnisse und Haltungen zu priorisieren. Im Sinne eines ethischen, nachhaltigen und ökonomischen Einsatzes ist weitere Forschung zur Nutzer*innenakzeptanz notwendig.
Timing of continuous renal replacement therapy in patients with acute non-ST-segment elevation myocardial infarction complicated with cardiac and renal insufficiency.

OBJECTIVE To explore the efficacy of different timing options for continuous renal replacement therapy (CRRT) in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and cardiac and renal insufficiency. METHODS Eighty-eight patients with acute NSTEMI complicated with cardiac and renal insufficiency received PCI treatment after achieving a stable condition and were randomly divided into the control group (n = 44) and the research group (n = 44). The control group was given CRRT after percutaneous coronary intervention (PCI), and the research group was treated with CRRT before and after PCI. The clinical treatment efficacy, cardiac function indexes (left ventricular ejection fraction (LVEF), cardiac output (CO), and left ventricular end diastolic diameter (LVEDD)), renal function indexes (creatinine (Cr), glomerular filtration rate (GFR), neutrophil gelatinase-associated lipocalin (NGAL)), quality of life (QoL) and incidence of major adverse cardiovascular events were compared between the two groups. RESULTS After treatment, the overall effective rate in the research group was higher than that in the control group (P < 0.05); LVEF, CO, GFR and QoL score were higher, while LVEDD value, creatinine level, NGAL level and the incidence of major adverse cardiovascular events were lower in the research group than in the control group (P < 0.05). CONCLUSION For patients with acute NSTEMI complicated with cardiac and renal insufficiency, the use of CRRT before and after PCI can effectively ameliorate cardiac and renal function, and significantly improve quality of life with a good prognosis.
Nurse practitioner and physician assistant onboarding in a family medicine practice

ABSTRACT The nurse practitioner (NP) and physician assistant (PA) professions are rapidly growing. Historically, these professions have filled a health care delivery gap caused by lack of health care access and physician shortages. Many medical practices are more accustomed to adding new physicians as compared with adding new NPs or PAs. This article describes one institution's approach to develop and implement a successful NP/PA onboarding program. Several key components are discussed, including (1) established roles and responsibilities, (2) a clear timeline of the onboarding period including a foundational curriculum, (3) the mentor–mentee relationship, (4) the onboarding checklist, and (5) the onboarding itinerary. The objective was to have our NPs/PAs on a regular patient calendar within the 6-month period. The success rate with this has been 86%. In addition, there has been a 90% retention of NP/PA hires over the past 3 years. The authors believe this approach to NP/PA onboarding serves the patients well, providing excellent patient outcomes and patient experience.
Sex-based dimorphism of anticancer immune response and molecular mechanisms of immune evasion

Purpose: We previously demonstrated that sex influences response to immune checkpoint inhibitors. In this article, we investigate sex-based differences in the molecular mechanisms of anticancer immune response and immune evasion in patients with NSCLC. Experimental Design: We analyzed (i) transcriptome data of 2,575 early-stage NSCLCs from seven different datasets; (ii) 327 tumor samples extensively characterized at the molecular level from the TRACERx lung study; (iii) two independent cohorts of 329 and 391 patients, respectively, with advanced NSCLC treated with anti–PD-1/anti–PD-L1 drugs. Results: As compared with men, the tumor microenvironment (TME) of women was significantly enriched for a number of innate and adaptive immune cell types, including specific T-cell subpopulations. NSCLCs of men and women exploited different mechanisms of immune evasion. The TME of females was characterized by significantly greater T-cell dysfunction status, higher expression of inhibitory immune checkpoint molecules, and higher abundance of immune-suppressive cells, including cancer-associated fibroblasts, MDSCs, and regulatory T cells. In contrast, the TME of males was significantly enriched for a T-cell–excluded phenotype. We reported data supporting impaired neoantigens presentation to immune system in tumors of men, as molecular mechanism explaining the findings observed. Finally, in line with our results, we showed significant sex-based differences in the association between TMB and outcome of patients with advanced NSCLC treated with anti–PD-1/PD-L1 drugs. Conclusions: We demonstrated meaningful sex-based differences of anticancer immune response and immune evasion mechanisms, that may be exploited to improve immunotherapy efficacy for both women and men.
Is domestic agricultural production sufficient to meet national food nutrient needs in Brazil?

Reducing the impacts of agriculture on the environment is one of the greatest challenges of this century. In Brazil, it is often argued that more land use change is needed to achieve food security. However, analyses seeking to understand the dynamics between agricultural production for exports and food intended for the Brazilian population have not approached the question if national agriculture is sufficient to provide Brazilians with the necessary nutrients, according to nutritional recommendations. In this sense, we sought to combine supply and dietary requirements for food (calories and nutrients) to assess trends in nutrient production and how future population projections and possible changes in diets would affect land necessity for nutritional security. We use sub-national data on agricultural production, population, Food Balance Sheets from FAO, and a compilation of nutritional information on the Brazilian agricultural production. Our results show that, in the last three decades, Brazil produced enough food calories to feed on average 115% of its population. We found that the agricultural land in 2017, without any expansion, is sufficient to feed, at least, 105% of projected population in 2060, considering the same productivity and dietary patterns. In a vegan diet scenario, less than 10% of the land dedicated to agricultural production in the past 30 years would be required. Despite limitations on supplying certain micro-nutrients, a vegan diet would require even less land in the future. We conclude that Brazilian agriculture could deliver enough food to meet Brazilians’ nutritional needs without further land expansion. Food production is compatible with environmental conservation in Brazil, especially if meat consumption is reduced.
The preventive effect of seamless nursing care on pressure ulcer and related complications in elderly inpatients.

OBJECTIVE To study the preventive effect of seamless nursing care on pressure ulcer and related complications in elderly inpatients. METHODS This study was performed in 132 elderly patients aged over 65 years. According to the random number table, these patients were allocated to the control group (n=66) and the experimental group (n=66). Patients in the control group received routine care, while those in the experimental group received both routine care and seamless nursing care. The number and grade of pressure ulcer during hospitalization, average length of stay, satisfaction in care, and incidence of complications during hospitalization were compared between the two groups. RESULTS The incidence of pressure ulcer in the experimental group, which consisted of grade 1 pressure ulcer (2 cases) was significantly lower than that in the control group (P=0.001), which consisted of grade 1 pressure ulcer (9 cases) and grade 2 pressure ulcer (5 cases). The incidence of complications (wound infection and muscle aches) in the experimental group was significantly lower than that in the control group (P<0.05). Compared with the control group, the average length of stay in the experimental group was decreased (P<0.001). Satisfaction with care in the experimental group was significantly higher than that in the control group (P<0.01). CONCLUSION Seamless nursing care contributes to the reduced number of pressure ulcer, reduced incidence of related complications, and improved satisfaction with care.
The Emerging Role of the Innate Immune Response in Idiosyncratic Drug Reactions

Idiosyncratic drug reactions (IDRs) range from relatively common, mild reactions to rarer, potentially life-threatening adverse effects that pose significant risks to both human health and successful drug discovery. Most frequently, IDRs target the liver, skin, and blood or bone marrow. Clinical data indicate that most IDRs are mediated by an adaptive immune response against drug-modified proteins, formed when chemically reactive species of a drug bind to self-proteins, making them appear foreign to the immune system. Although much emphasis has been placed on characterizing the clinical presentation of IDRs and noting implicated drugs, limited research has focused on the mechanisms preceding the manifestations of these severe responses. Therefore, we propose that to address the knowledge gap between drug administration and onset of a severe IDR, more research is required to understand IDR-initiating mechanisms; namely, the role of the innate immune response. In this review, we outline the immune processes involved from neoantigen formation to the result of the formation of the immunologic synapse and suggest that this framework be applied to IDR research. Using four drugs associated with severe IDRs as examples (amoxicillin, amodiaquine, clozapine, and nevirapine), we also summarize clinical and animal model data that are supportive of an early innate immune response. Finally, we discuss how understanding the early steps in innate immune activation in the development of an adaptive IDR will be fundamental in risk assessment during drug development. Significance Statement Although there is some understanding that certain adaptive immune mechanisms are involved in the development of idiosyncratic drug reactions, the early phase of these immune responses remains largely uncharacterized. The presented framework refocuses the investigation of IDR pathogenesis from severe clinical manifestations to the initiating innate immune mechanisms that, in contrast, may be quite mild or clinically silent. A comprehensive understanding of these early influences on IDR onset is crucial for accurate risk prediction, IDR prevention, and therapeutic intervention.
Association between sarcoidosis and diabetes mellitus: a systematic review and meta-analysis

ABSTRACT Background: Sarcoidosis is multisystem inflammatory granulomatosis that can potentially affect any organ of the human body. We aimed to estimate the prevalence of diabetes mellitus (DM) in sarcoidosis patients and determine the association between sarcoidosis and DM.Method: All relevant articles reporting the prevalence of DM in sarcoidosis published until September 19th, 2020, were retrieved from ten electronic databases. We used the random effect model to perform the meta-analysis.Results: After screening 2,122 records, we included 19 studies (n = 18,686,162). The prevalence of DM in sarcoidosis patients was 12.7% (95% CI 10–16.1). The prevalence was highest in North America with 21.3% (13.5–31.8), followed by Europe 10.4 (7.9–13.7) and Asia 10% (1.8–39.7). Sarcoidosis patients had higher rates of DM compared to controls (OR 1.75; 95% CI 1.49–2.05). Sensitivity analysis, after removing the largest weighted study, did not reveal any effect on the significance of the results (OR 1.73; 95% CI 1.33–2.25). Conclusion: The prevalence of DM in sarcoidosis is considerably high, with increased odds of DM in sarcoidosis compared to healthy controls. Further research with a wide range of confounders is required to confirm the association of sarcoidosis with DM.
Head‐to‐head comparison between 18F‐DOPA PET/CT and 68Ga‐DOTA peptides PET/CT in detecting intestinal neuroendocrine tumours: A systematic review and meta‐analysis

The imaging of intestinal neuroendocrine tumours (NETs) relies on functional positron emission tomography (PET) tracers; these tumours can be studied by means of both 68Ga‐DOTA peptides and 18F‐fluorodihydroxyphenyl‐ l‐alanine (18F‐DOPA) PET/computed tomography (CT). As yet, it is unclear which of these two modalities offers the better sensitivity. We therefore conducted a meta‐analysis to assess the available data.
An analysis of the dynamic changes in the self-efficacy and quality of life of elderly patients with chronic obstructive pulmonary disease following community-based rehabilitation.

OBJECTIVE This study aimed to investigate the effects of community-based rehabilitation (CBR) on the self-efficacy and quality of life in elderly patients with chronic obstructive pulmonary disease (COPD). METHOD Eighty-one elderly patients with COPD admitted to our hospital were recruited as the study cohort and were randomly divided into a control group (n=41) and a study group (n=40). The control group underwent outpatient rehabilitative treatment, and the study group additionally underwent CBR. The treatment effects of the two groups at 1 month, 3 months, and 6 months of intervention were assessed using their pulmonary function and quality of life scores. RESULTS After completion of the CBR, the patients in the study group and the control group were scored using the CSES scale, which did not differ at 1 month of intervention, but the scores were higher in the study group than they were in the control group at 3 and 6 months of intervention (P < 0.05). The patients in the study group also scored higher on the WHOQOL-BREF scale than the control group (P < 0.05). CONCLUSION CBR improves the self-efficacy and quality of life in elderly patients with COPD.
Ex Vivo MR Histology and Cytometric Feature Mapping Connect Three-dimensional in Vivo MR Images to Two-dimensional Histopathologic Images of Murine Sarcomas.

Purpose To establish a platform for quantitative tissue-based interpretation of cytoarchitecture features from tumor MRI measurements. Materials and Methods In a pilot preclinical study, multicontrast in vivo MRI of murine soft-tissue sarcomas in 10 mice, followed by ex vivo MRI of fixed tissues (termed MR histology), was performed. Paraffin-embedded limb cross-sections were stained with hematoxylin-eosin, digitized, and registered with MRI. Registration was assessed by using binarized tumor maps and Dice similarity coefficients (DSCs). Quantitative cytometric feature maps from histologic slides were derived by using nuclear segmentation and compared with registered MRI, including apparent diffusion coefficients and transverse relaxation times as affected by magnetic field heterogeneity (T2* maps). Cytometric features were compared with each MR image individually by using simple linear regression analysis to identify the features of interest, and the goodness of fit was assessed on the basis of R2 values. Results Registration of MR images to histopathologic slide images resulted in mean DSCs of 0.912 for ex vivo MR histology and 0.881 for in vivo MRI. Triplicate repeats showed high registration repeatability (mean DSC, >0.9). Whole-slide nuclear segmentations were automated to detect nuclei on histopathologic slides (DSC = 0.8), and feature maps were generated for correlative analysis with MR images. Notable trends were observed between cell density and in vivo apparent diffusion coefficients (best line fit: R2 = 0.96, P < .001). Multiple cytoarchitectural features exhibited linear relationships with in vivo T2* maps, including nuclear circularity (best line fit: R2 = 0.99, P < .001) and variance in nuclear circularity (best line fit: R2 = 0.98, P < .001). Conclusion An infrastructure for registering and quantitatively comparing in vivo tumor MRI with traditional histologic analysis was successfully implemented in a preclinical pilot study of soft-tissue sarcomas. Keywords: MRI, Pathology, Animal Studies, Tissue Characterization Supplemental material is available for this article. © RSNA, 2021.
The Effects of Focal Electrically Administered Seizure Therapy Compared With Ultrabrief Pulse Right Unilateral Electroconvulsive Therapy on Suicidal Ideation

Background Preliminary data suggest that focal electrically administered seizure therapy (FEAST) has antidepressant effects and less adverse cognitive effects than traditional forms of electroconvulsive therapy (ECT). This study compared the impact of FEAST and ultrabrief pulse, right unilateral (UB-RUL) ECT on suicidal ideation. Methods At 2 sites, patients in a major depressive episode were treated openly with FEAST or UB-RUL ECT, depending on their preference. The primary outcome measure was scores on the Beck Scale for Suicide Ideation (SSI). Scores on the suicide item of the Hamilton Rating Scale for Depression (HRSD-SI) provided a secondary outcome measure. Results Thirty-nine patients were included in the intent-to-treat sample (FEAST, n = 20; UB-RUL ECT, n = 19). Scores on both the SSI and HRSD-SI were equivalently reduced with both interventions. Both responders and nonresponders to the interventions showed substantial reductions in SSI and HRSD-SI scores, although the magnitude of improvement was greater among treatment responders. Conclusions Although limited by the open-label, nonrandomized design, FEAST showed comparable effects on suicidal ideation when compared with routine use of UB-RUL ECT. These results are encouraging and support the need for further research and a noninferiority trial.