Miracle-dz/UniFAR-FTUs huggingface dataset:
The medial wall of the cavernous sinus. Part 2: Selective medial wall resection in 50 pituitary adenoma patients.

OBJECTIVEPituitary adenomas often invade the medial wall of the cavernous sinus (CS), but this structure is generally not surgically removed because of the risk of vascular and cranial nerve injury. The purpose of this study was to report the surgical outcomes in a large series of cases of invasive pituitary adenoma in which the medial wall of the CS was selectively removed following an anatomically based, stepwise surgical technique.METHODSThe authors' institutional database was reviewed to identify cases of pituitary adenoma with isolated invasion of the medial wall, based on an intraoperative evaluation, in which patients underwent an endoscopic endonasal approach with selective resection of the medial wall of the CS. Cases with CS invasion beyond the medial wall were excluded. Patient complications, resection, and remission rates were assessed.RESULTSFifty patients were eligible for this study, 15 (30%) with nonfunctional adenomas and 35 (70%) with functional adenomas, including 16 growth hormone-, 10 prolactin-, and 9 adrenocorticotropic hormone (ACTH)-secreting tumors. The average tumor size was 2.3 cm for nonfunctional and 1.3 cm for functional adenomas. Radiographically, 11 cases (22%) were Knosp grade 1, 23 (46%) Knosp grade 2, and 16 (32%) Knosp grade 3. Complete tumor resection, based on intraoperative impression and postoperative MRI, was achieved in all cases. The mean follow-up was 30 months (range 4-64 months) for patients with functional adenomas and 16 months (range 4-30 months) for those with nonfunctional adenomas. At last follow-up, complete biochemical remission (using current criteria) without adjuvant treatment was seen in 34 cases (97%) of functional adenoma. No imaging recurrences were seen in patients who had nonfunctional adenomas. A total of 57 medial walls were removed in 50 patients. Medial wall invasion was histologically confirmed in 93% of nonfunctional adenomas and 83% of functional adenomas. There were no deaths or internal carotid artery injuries, and the average blood loss was 378 ml. Four patients (8%) developed a new, transient cranial nerve palsy, and 2 of these patients required reoperation for blood clot evacuation and fat graft removal. There were no permanent cranial nerve palsies.CONCLUSIONSThe medial wall of the CS can be removed safely and effectively, with minimal morbidity and excellent resection and remission rates. Further follow-up is needed to determine the long-term results of this anatomically based technique, which should only be performed by very experienced endonasal skull base teams.
Physiological responses of ionotropic histamine receptors, PxHCLA and PxHCLB, to neurotransmitter candidates in a butterfly, Papilio xuthus

ABSTRACT Histamine is the only known neurotransmitter released by arthropod photoreceptors. Synaptic transmission from photoreceptors to second-order neurons is mediated by the activation of histamine-gated chloride channels (HCLs). These histaminergic synapses have been assumed to be conserved among insect visual systems. However, our understanding of the channels in question has thus far been based on studies in flies. In the butterfly Papilio xuthus, we have identified two candidate histamine-gated chloride channels, PxHCLA and PxHCLB, and studied their physiological properties using a whole-cell patch-clamp technique. We studied the responses of channels expressed in cultured cells to histamine as well as to other neurotransmitter candidates, namely GABA, tyramine, serotonin, d-/l-glutamate and glycine. We found that histamine and GABA activated both PxHCLA and PxHCLB, while the other molecules did not. The sensitivity to histamine and GABA was consistently higher in PxHCLB than in PxHCLA. Interestingly, simultaneous application of histamine and GABA activated both PxHCLA and PxHCLB more strongly than either neurotransmitter individually; histamine and GABA may have synergistic effects on PxHCLs in the regions where they co-localize. Our results suggest that the physiological properties of the histamine receptors are basically conserved among insects, but that the response to GABA differs between butterflies and flies, implying variation in early visual processing among species. Summary: Identification and characterization of two histamine-gated chloride channels in the visual system of Papilio; both channels respond to histamine as well as to GABA.
ARCHER: Aggressive Rewards to Counter bias in Hindsight Experience Replay

Experience replay is an important technique for addressing sample-inefficiency in deep reinforcement learning (RL), but faces difficulty in learning from binary and sparse rewards due to disproportionately few successful experiences in the replay buffer. Hindsight experience replay (HER) was recently proposed to tackle this difficulty by manipulating unsuccessful transitions, but in doing so, HER introduces a significant bias in the replay buffer experiences and therefore achieves a suboptimal improvement in sample-efficiency. In this paper, we present an analysis on the source of bias in HER, and propose a simple and effective method to counter the bias, to most effectively harness the sample-efficiency provided by HER. Our method, motivated by counter-factual reasoning and called ARCHER, extends HER with a trade-off to make rewards calculated for hindsight experiences numerically greater than real rewards. We validate our algorithm on two continuous control environments from DeepMind Control Suite - Reacher and Finger, which simulate manipulation tasks with a robotic arm - in combination with various reward functions, task complexities and goal sampling strategies. Our experiments consistently demonstrate that countering bias using more aggressive hindsight rewards increases sample efficiency, thus establishing the greater benefit of ARCHER in RL applications with limited computing budget.
The nationwide distribution and trends of hepatitis C virus genotypes in mainland China

Comprehensive data on hepatitis C virus (HCV) genotypes distribution is critical for treatment regimen selection, vaccine design, and drug development. This study aimed to understand the dynamic distribution of HCV genotypes in Mainland China. Three hundred sixty‐two studies published from January 1993 to December 2017 involving 64 891 samples (5133 injecting drug users, 2748 volunteer blood donors, 1509 former paid plasma donors, 160 sexually encounters, and 1992 human immunodeficiency virus (HIV)/HCV coinfection patients) were eligible for the quantitative synthesis estimation. Pooled proportion of HCV genotypes (and 95% confidence intervals [CIs]) was estimated through the Freeman‐Tukey double arcsine transformation by period, region, and risk group. A sharp decline of the subtype 1b was observed in all regions except in northwestern and central regions. The genotypes 3 and 6 showed an obvious increase in southern and southwestern regions and have already spread nationwide. After 2010, subtype 1b was the most dominant variant in all regions and risk groups, accounting for 54.0% (95% CI, 51.9‐56.1) of all national infections. Subtype 2a was the second most prevalent strain in all regions except in the south and southwest, with 15.4% (95% CI, 13.1‐17.8) national infections. The subtype 6a in southern region and 3b and 3a in southwestern region had a higher proportion of infections than that in other regions. In addition, the genotypes 3 and 6 are already prevalent in almost all risk groups. The distribution of HCV genotypes were sharply shifting in China in the past three decades. The HCV subtype 1b posed a sharp decline, whereas genotypes 3 and 6 played an increasing role in the regional and populational HCV pandemic.
Detection of betacyanin in red-tube spinach (Spinacia oleracea) and its biofortification by strategic hydroponics

Betacyanins have been reported as water-soluble, nitrogenous pigments found in the order Caryophyllales, and they are known for powerful natural antioxidant. The biofortification of secondary metabolites such as anthocyanins and betacyanins has recently been performed in food crops by metabolic engineering through genetic modification. However, the distribution of genetically modified foods is strictly regulated. Therefore, we aimed to develop a new method for biofortifying natural antioxidants, betacyanins, without genetic modification. We first detected the presence of betacyanins in red-tube spinach (Spinacia oleracea) through ultraviolet-visible spectroscopy and mass spectrometry. We then hydroponically cultivated plants in the presence of three candidate compounds for betacyanin biofortification: dopamine, Ca2+, and sucrose. Liquid chromatography–tandem mass spectrometry (LC–MS/MS) and antioxidant activity analyses showed that sucrose was most successful in biofortifying betacyanins, and reverse transcription polymerase chain reaction (RT-PCR) indicated that several genes involved in betacyanin biosynthesis were induced by sucrose. Therefore, strategic hydroponics represents a new approach for cultivating betacyanin-enriched vegetables.
Visualization of zinc pyrithione particles deposited on the scalp from a shampoo by tape‐strip sampling and scanning electron microscopy/energy dispersive X‐ray spectroscopy measurement

Zinc pyrithione (ZnPT) is widely used as an anti‐fungal active in commercial anti‐dandruff (AD) shampoos. The AD efficacy of ZnPT is highly dependent on the deposition of ZnPT particles onto the scalp during the process of shampoo application and rinse‐off. Since ZnPT materials with different particle sizes and morphologies have different deposition behaviours, the measurement of the actual ZnPT deposition is critical to understand the AD performance delivered by different ZnPT shampoos. The aim of this study is to develop a robust and reliable method for visualizing the particle size and morphology of ZnPT deposited on the scalp from AD shampoos.
Positioning control of hydraulic cylinder with unknown friction using on/off directional control valve

In this study, a prediction-based positioning control scheme is proposed for the hydraulic cylinder controlled by a solenoid operated on/off directional control valve. The discrete-valued input, low switching frequency and significant delay of directional control valve make the control problem very complex. Only a discrete-valued control input can be used here; meanwhile, the input has switching frequency constraint and time-delay. Existing methods such as pulse-width modulation control and sliding-mode control are not suitable for this problem, because chattering may arise due to the control input restrictions. The newly proposed prediction-based positioning control scheme consists of two parts: a switching law based on predictions of future states and learning algorithms which learn required predictive models online. According to accurate predictions, the switching law can control the hydraulic cylinder to target position in an optimal way, and chattering is avoided. Meanwhile, the required predictive models are identified by a generalized growing and pruning for radial basis function network and a recursive least square estimation algorithm in real time. Essentially, the problems caused by input restrictions, time-delay and model uncertainty are solved by the accurate identifications to some well-designed models. The control scheme is verified by physical experiments. Fast and accurate positioning control can be achieved for the hydraulic cylinder with unknown nonlinear friction.
Initial outcomes of endovenous laser ablation with 1940 nm diode laser in the treatment of incompetent saphenous veins

Objectives To investigate the initial outcomes of 1940 nm diode laser in the treatment of incompetent saphenous veins. Methods This was a prospective observational study. We treated 89 patients with 160 incompetent saphenous veins using a 1940 nm diode laser and bare fiber. The laser’s power was set to 4.5 W with a mean linear endovenous energy density of 50.4 J/cm. Results The one-month closure rate was 100%. The post-procedural pain score at 6 h, 1 day, 10 days, and 1 month was 0.85 ± 1.04, 0.65 ± 1.01, 0.82 ± 1.25, and 0.47 ± 0.82, respectively. Complications encountered included paresthesia (3.8%) and thrombophlebitis (4.4%), whereas no cases of endovenous heat-induced thrombosis were observed. Conclusion The 1940 nm laser and bare fiber at 50.4 J/cm showed satisfactory initial outcomes with less pain and fewer complications, in the treatment of incompetent saphenous veins.
Effect of perforation size and furcal lesion on stress distribution in mandibular molars: a finite element analysis

AIM To compare the effect of furcal perforations of various sizes on the biomechanical response of mandibular first molars with or without periodontal bone loss at the furcal region via three-dimensional (3D) finite element analysis (FEA). METHODOLOGY The 3D geometric basic model was reconstructed from the micro-computed tomographic images of an extracted mandibular first molar. Five different models were constructed from this molar in group 1 as follows: intact molar model, root filled (RCF) model and three models with furcal perforations (1, 2 and 3 mm in diameter) repaired with a calcium silicate-based cement (CSC). In group 2, a lesion simulating bone resorption at the furcal region was modelled on the models in group 1. A force of 200 N was applied to simulate normal occlusal loads. Static linear FEA was performed using the Abaqus software (Abaqus 6.14; ABAQUS Inc., Providence, RI, USA). The maximum principal stresses (Pmax ) and maximum displacement magnitude were evaluated. RESULTS The range of Pmax values of the models in group 1, from high to low, was as follows: RCF + 3 mm perforation > RCF + 2 mm perforation > RCF + 1 mm perforation > RCF > intact model, and the range of Pmax values of the models in group 2 was as follows: RCF + 3 mm perforation + furcal lesion > RCF + 2 mm perforation + furcal lesion > RCF + 1 mm perforation + furcal lesion > RCF + furcal lesion > intact model + furcal lesion. All of the models in group 2 exhibited lower Pmax values and higher maximum displacement magnitude than their counterparts without lesions in group 1. CONCLUSIONS The size of the furcal perforation affected the accumulation and distribution of stress within the models. Mandibular molar teeth with large furcal perforations treated with a calcium silicate-based cement may be associated with an increased risk of fracture whether or not accompanied by bone resorption.
Baseline IGFBP - 3 as the Key Element to Predict Growth Response to Growth Hormone and IGF - 1 Therapy in Subjects with Non - GH Deficient Short Stature and IGF - 1 Deficiency

Background Short stature in children represents a heterogeneous group with different etiologies. Primary Insulin like growth factor 1 (IGF - 1) deficiency in short stature can present with normal or elevated growth hormone (GH) production. Currently there is no model that can reliably predict response to recombinant (r)GH therapy and/or rIGF - 1 therapy in children with non - GH deficient short stature. Hypothesis Baseline Insulin like growth factor binding protein 3 (IGFBP - 3) along with ∆ IGF - 1 in the first 3 months of GH therapy level can be a marker of growth response to the rGH and/or rIGF - 1 therapy in children with non - growth hormone deficiency short stature. Objectives To study the relationship between baseline IGFBP - 3 and IGF - 1 levels and the response to rGH and rIGF - 1 therapy in children with short stature, normal GH secretion and low IGF - 1 SDS. Methods 43 children, age 9.07 ± 2.75 years with height -2.72 ± 0.7 SD and baseline IGF - 1 of -2.76 ± 0.58 SD, who passed the growth hormone releasing hormone (GHRH) stimulation test were included in a retrospective chart review. They were treated with rGH therapy with a mean dose of 0.46 ± 0.1 mg/kg/week. Growth velocity (GV), IGF - 1 and IGFBP - 3 levels were done at 3 and 6 months of therapy. Subjects with poor response to rGH after 6 months of therapy were switched to rIGF - 1 therapy at 0.24 mg/kg/day for the next 6 months. Subjects were divided according to their growth rate into responders to rGH (N = 23); non - responders to rGH, responders to rIGF - 1 (N = 14) and non - responders to rGH and rIGF-1 (N = 6). Results There was no correlation between GV and peak GH level at GHRH test. Growth velocity positively correlated with ΔIGF - 1 SD among subjects treated with rGH therapy. Height SD positively correlated with IGFBP - 3 SD. Baseline IGFBP - 3 also inversely correlated with GH peak during GHRH test. Conclusions In subjects with short stature and low IGF - 1 level, baseline IGFBP - 3 levels can predict the growth response to rGH and/or rIGF - 1 therapy.
Trends in Visits to Acute Care Venues for Treatment of Low-Acuity Conditions in the United States From 2008 to 2015

Importance Over the past 2 decades, a variety of new care options have emerged for acute care, including urgent care centers, retail clinics, and telemedicine. Trends in the utilization of these newer care venues and the emergency department (ED) have not been characterized. Objective To describe trends in visits to different acute care venues, including urgent care centers, retail clinics, telemedicine, and EDs, with a focus on visits for treatment of low-acuity conditions. Design, Setting, and Participants This cohort study used deidentified health plan claims data from Aetna, a large, national, commercial health plan, from January 1, 2008, to December 31, 2015, with approximately 20 million insured members per study year. Descriptive analysis was performed for health plan members younger than 65 years. Data analysis was performed from December 28, 2016, to February 20, 2018. Main Outcomes and Measures Utilization, inflation-adjusted price, and spending associated with visits for treatment of low-acuity conditions. Low-acuity conditions were identified using diagnosis codes and included acute respiratory infections, urinary tract infections, rashes, and musculoskeletal strains. Results This study included 20.6 million acute care visits for treatment of low-acuity conditions over the 8-year period. Visits to the ED for the treatment of low-acuity conditions decreased by 36% (from 89 visits per 1000 members in 2008 to 57 visits per 1000 members in 2015), whereas use of non-ED venues increased by 140% (from 54 visits per 1000 members in 2008 to 131 visits per 1000 members in 2015). There was an increase in visits to all non-ED venues: urgent care centers (119% increase, from 47 visits per 1000 members in 2008 to 103 visits per 1000 members in 2015), retail clinics (214% increase, from 7 visits per 1000 members in 2008 to 22 visits per 1000 members in 2015), and telemedicine (from 0 visits in 2008 to 6 visits per 1000 members in 2015). Utilization and spending per person per year for low-acuity conditions had net increases of 31% (from 143 visits per 1000 members in 2008 to 188 visits per 1000 members in 2015) and 14% ($70 per member in 2008 to $80 per member in 2015), respectively. The increase in spending was primarily driven by a 79% increase in price per ED visit for treatment of low-acuity conditions (from $914 per visit in 2008 to $1637 per visit in 2015). Conclusions and Relevance From 2008 to 2015, total acute care utilization for the treatment of low-acuity conditions and associated spending per member increased, and utilization of non-ED acute care venues increased rapidly. These findings suggest that patients are more likely to visit urgent care centers than EDs for the treatment of low-acuity conditions.
Frailty Among Patients Receiving Hemodialysis: Evolution of Components and Associations With Mortality

BACKGROUND Understanding how components of frailty change over time and how they can be modeled as time-dependent predictors of mortality could lead to better risk prediction in the dialysis population. METHODS We measured frailty at baseline, 12 months, and 24 months among 727 patients receiving hemodialysis in Northern California and Atlanta. We examined the likelihood of meeting frailty components (weight loss, exhaustion, low physical activity, weak grip strength, and slow gait speed) as a function of time in logistic regression analysis and association of frailty components with mortality in time-updated multivariable Cox models. RESULTS Physical activity and gait speed declined, exhaustion and grip strength did not change, and the odds of meeting the weight loss criterion declined with time. All five components were associated with higher mortality in multivariable analyses, but gait speed was the strongest individual predictor. All frailty components except physical inactivity were independently associated with mortality when all five components were included in the same model. The number of frailty components met was associated with mortality in a gradient that ranged from a hazard ratio of 2.73 for one component to 10.07 for five components met; the model including all five components was the best model based on Akaike information criterion. CONCLUSIONS Measurement of all frailty components was necessary for optimal mortality prediction, and the number of components met was strongly associated with mortality in this cohort.
The effect of genotype and traditional food processing methods on in-vitro protein digestibility and micronutrient profile of sorghum cooked products

Sorghum (Sorghum bicolor (L.) Moench) is one of the principal staple for millions of people in sub-Saharan Africa serving as the main sources of protein. However, protein digestibility is low in sorghum and this may be affected by processing methods. In this study 15 sorghum cultivars and one variety each of maize (Zea maize) and tef (Eragrostis tef) all of Ethiopian origin were investigated for in-vitro protein digestibility (IVPD), activity and concentration of anti-nutritional factors and micro nutrient profile in raw flour and various cooked food samples. Kafirin composition content and composition was also determined from raw flour samples of the sorghum cultivars. IVPD was significantly different between genotypes with both maize and tef superior to sorghum both in cooked and uncooked state except for the high lysine genotype Wetet Be-gunchie. Cooking significantly reduced IVPD in all crops but had only minor effect in maize. Results revealed a highly significant interaction between genotype and food processing methods where, occasionally, genotypes with highest IVPD under one processing method ended up to be the lowest under another. Trypsin inhibitor levels had a significant and negative correlation with IVPD (r2 = 0.1), while changes in phytic acid concentration and intrinsic phytase levels during processing followed opposite trends to each other. Processing increased mineral levels by 20–44% for iron and 4–29% for zinc perhaps due to degradation of phytic acid. Results demonstrated that protein digestibility and the concentration of anti- nutritional factors varied widely depending on the food type. Identification of specific genotypes for a specific food product may help improve the nutritional quality of sorghum based foods.
A Hybrid Multi-Criteria approach using a Genetic Algorithm for Recommending Courses to University Students

This paper describes a multiple criteria approach based on a hybrid method of Collaborative Filtering (CF) and Content-Based Filtering (CBF) for discovering the most relevant criteria which could aﬀect the elective course recommendation for university students. In order to determine which factors are the most important, it is proposed a genetic algorithm which automatically discovers the importance of the diﬀer-ent criteria assigning weights to each one of them. We have carried out an in-depth study using a real data set with more than 1700 ratings of Computer Science graduates at University of Cordoba. We have used diﬀerent proposals and diﬀerent weights for each criterion in order to discover what is the combination of multiple criteria which provides better results.