Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison of the Seventh and Eighth Edition of American Joint Committee on Cancer (AJCC) Staging for Selected and Nonselected Oropharyngeal Squamous Cell Carcinomas

Abstract Objectives The eighth edition American Joint Committee on Cancer (AJCC) Staging incorporates significant changes to the seventh edition in the staging of oropharyngeal squamous cell carcinomas (OPSCC). An important change was the inclusion of OPSCC associated with the human papilloma virus (HPV). Our goal is to compare the performance of both staging systems for patients with HPV-selected and unselected clinical characteristics for OPSCC. Methods Using the Surveillance, Epidemiology, and End Results (SEER) database, 2004-2016, we identified patients with likely HPV-associated OPSCC based on surrogate markers (white males aged <65 years old with squamous cell carcinomas of the tonsil and base of tongue), excluding those who underwent surgery. We re-classified these patients using seventh and eighth edition staging for HPV-selected OPSCC and compared the prediction performance of both staging editions for overall survival (OS) and disease-specific survival (DSS). We performed the same analysis for clinically unselected patients with OPSCC. Results Our analysis included 9554 patients with a median follow-up of 67 months. Comparing the eighth versus seventh edition for our HPV-selected cohort, clinical staging changed for 92.3% of patients and 10-year OS was 62.2%, 61.2%, 35.3%, and 15.5% for Stage I, II, III, and IV, versus 52.9%, 59.2%, 61.6%, 55.1%, 38.3%, and 15.5% for stage I, II, III, IVA, IVB, and IVC, respectively. A similar pattern was observed for 10-year DSS. The concordance statistics for our HPV-selected cohort were improved for both AJCC 7 (0.6260) and AJCC 8 (0.6846) compared with the unselected cohort, 0.5860 and 0.6457 for AJCC 7 and 8, respectively. Conclusion The overall performance of discrimination improved from AJCC 7 to AJCC 8 for both clinically selected and unselected patients, but more notably for our HPV-selected cohort. Despite the lack of statistically significant differentiation between Stages I and II in AJCC 8 in either groups, markedly improved discrimination was observed between Stages I/II, III, and IV in the HPV-selected cohort.
Near infrared spectroscopic evaluation of biochemical and crimp properties of knee joint ligaments and patellar tendon

Knee ligaments and tendons play an important role in stabilizing and controlling the motions of the knee. Injuries to the ligaments can lead to abnormal mechanical loading of the other supporting tissues (e.g., cartilage and meniscus) and even osteoarthritis. While the condition of knee ligaments can be examined during arthroscopic repair procedures, the arthroscopic evaluation suffers from subjectivity and poor repeatability. Near infrared spectroscopy (NIRS) is capable of non-destructively quantifying the composition and structure of collagen-rich connective tissues, such as articular cartilage and meniscus. Despite the similarities, NIRS-based evaluation of ligament composition has not been previously attempted. In this study, ligaments and patellar tendon of ten bovine stifle joints were measured with NIRS, followed by chemical and histological reference analysis. The relationship between the reference properties of the tissue and NIR spectra was investigated using partial least squares regression. NIRS was found to be sensitive towards the water (R2CV = .65) and collagen (R2CV = .57) contents, while elastin, proteoglycans, and the internal crimp structure remained undetectable. As collagen largely determines the mechanical response of ligaments, we conclude that NIRS demonstrates potential for quantitative evaluation of knee ligaments.
Clinical Implication of Simultaneous Intensity-modulated Radiotherapy Boost to Tumor Bed for Cervical Cancer with Full-thickness Stromal Invasion

Abstract Objective The objective of this study was to retrospectively explore the clinical implications of simultaneous intensity-modulated radiotherapy (IMRT) boost to the tumor bed in cervical cancer with full-thickness stromal invasion (FTSI). Patients and Methods Patients diagnosed with the International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB and IIA cervical cancer with confirmed FTSI were included. Patients received pelvic IMRT from a dose of 50.4 Gy in 28 fractions with (or without) a simultaneous integrated boost (SIB) to 58.8 Gy in 28 fractions for the tumor bed. The progression-free survival (PFS), overall survival (OS), and pelvic-PFS (p-PFS) were analyzed using the Kaplan–Meier method, and independent prognostic factors were explored by Cox regression analyses. Results Patients without a tumor bed boost had a poor prognosis. The 5-year OS was 81.3% versus 58.3% and the 5-year PFS rates were 75.0% versus 57.6% (boost vs non-boost). The FIGO stage, pathology, adjuvant chemotherapy, and tumor bed boost were independent factors affecting both the 5-year OS and PFS. Subgroup analysis showed that the SIB group had a higher 5-year OS, PFS, and p-PFS for different stages, lymph node status, and risk groups than the non-SIB group. Recurrence occurred in 268 of 910 (29.5%) patients without SIB and 49 of 293 (16.7%) with SIB. Among patients with recurrence, 113 of 282 (40.1%) in the non-boost group compared with 14 of 51 (23.0%) patients in the boost group had a pelvic recurrence. Tumor bed boost resulted in an increase in the mean radiation dose to the intestine, rectum, and bladder, although there were no differences in the rates of acute and late toxicities between the 2 groups. Conclusion Tumor bed boost by external beam radiotherapy (EBRT) is an effective and safe method for patients with FTSI and risk factors. Compared with the standard prophylactic radiation, tumor bed boost by EBRT was not associated with increased acute and late toxicities.
Efficacy and safety of tripterygium wilfordii multiglycosides in idiopathic membranous nephropathy

Abstract Objective: Tripterygium wilfordii multiglycosides has been demonstrated to be effective in reducing proteinuria and alleviate edema in patients with chronic kidney disease. We aim to evaluate its efficacy and safety in idiopathic membranous nephropathy. Methods and analysis: This is an randomized, open-labeled, controlled clinical trial. Twenty eligible patients with idiopathic membranous nephropathy will be randomly assigned into the intervention group and the control group at a rate of 1:1. Patients in the intervention group will receive tripterygium wilfordii multiglycosides tablets (1–1.5 mg/kg body weight/d, orally) in addition to the original treatment of angiotensin converting enzyme inhibitor/angiotensin receptor blocker, while the control group will continue with the original treatment of angiotensin converting enzyme inhibitor/angiotensin receptor blocker. The treatment course is 6 months, and clinical variables of patients will be measured at baseline and each monthly follow-up. The primary efficacy outcome measure is absolute decrease in urinary protein quantity after 6 months of treatment compared with baseline at randomization. The secondary efficacy outcome measures include absolute decrease in urine albumin-creatinine ratio in spot urine after 6 months of treatment compared with baseline at randomization, the percentage of patients who reached effective clinical response, and the percentage of patients who developed composite renal endpoint. Safety outcome measures include incidence of adverse events, incidence of serious adverse events, and death.
Intraepithelial and Lamina Propria Lymphocytes Do Not Correlate With Symptoms or Exposures in Microscopic Colitis

INTRODUCTION: Microscopic colitis, a common cause of diarrhea, is characterized by a largely normal appearance of the mucosa but increased numbers of lymphocytes in the epithelium and lamina propria on microscopy. We sought to determine whether T-cell percentage was associated with exposures or symptoms. METHODS: We conducted a case-control study that enrolled patients referred for colonoscopy for diarrhea. Patients were classified as microscopic colitis cases or controls by an experienced pathologist. Participants provided information on symptoms and exposures during a telephone or internet survey. Research biopsies from the ascending colon and descending colon were examined using immunofluorescence stains for CD3, CD8, and FOXP3 to determine percent T cells per total epithelial or lamina propria cells. Digital images were analyzed by regions of interest using Tissue Studio. RESULTS: There were 97 microscopic colitis cases and 165 diarrhea controls. There was no association between demographic factors and percentage of intraepithelial or lamina propria T cells. In cases, the mean percent T cells were similar in the right colon and left colon. There was no association between mean percent T cells and stool frequency or consistency. There was no association with irritable bowel syndrome, abdominal pain, or medications purported to cause microscopic colitis. DISCUSSION: The lack of association between the density of T cells and medications raises further doubts about their role in disease etiology. Loose and frequent stools in patients with microscopic colitis are not correlated with T-cell density.
Data Transformation in the Processing of Neuronal Signals: A Powerful Tool to Illuminate Informative Contents

Neuroscientists seek efficient solutions for deciphering the sophisticated unknowns of the brain. Effective development of complicated brain-related tools is the focal point of research in neuroscience and neurotechnology. Thanks to today’s technological advancements, the physical development of high-density and high-resolution neural interfaces has been made possible. This is where the critical bottleneck in receiving the expected functionality from such devices shifts to transferring, processing, and subsequently analyzing the massive neurophysiological extra-cellular data recorded. To respond to this inevitable concern, a spectrum of neuronal signal processing techniques have been proposed to extract task-related informative content of the signals conveying neuronal activities, and eliminate the irrelevant contents. Such techniques provide powerful tools for a wide range of neuroscience research, from low-level perception to high-level cognition. Data transformations are among the most efficient processing techniques that serve this purpose by properly changing the data representation. Mapping the data from its original domain (i.e., the time-space domain) to a new representational domain, data transformations change the viewing angle of observing the informative content of the data. This paper reviews the employment of data transformations in order to process neuronal signals and their three key applications, including spike detection, spike sorting, and data compression.
[Evaluation of bioceramic putty repairmen iRoot and mineral trioxide aggregate in mature permanent teeth pulpotomy].

OBJECTIVE To evaluate the clinical characteristics and effectiveness of pulpotomy in mature permanent teeth with bioceramic putty repairmen iRoot and mineral trioxide aggregate (MTA). METHODS Pulpotomy was performed on mature permanent premolars and molars with carious exposures at the Department of General Dentistry of Peking University School and Hospital of Stomatology, from November 2017 to September 2019. The patients were randomly divided into 2 groups, Group iRoot (n=22) and Group MTA (n=21). In Group iRoot, bioceramic putty repairmen iRoot was used as pulp capping agent, while in Group MTA, mineral trioxide aggregate was used as pulp capping agent. All the patients had signed informed consent forms. The clinical efficacy was evaluated by clinical examinations (temperature and electrical activity test) and imaging examinations 3, 6, and 12 months after surgery. Blinding was used for the patients and evaluators, but due to the obvious differences in the properties of the two pulp capping agents, the blinding method was not used for the treatment provider (the attending physician). RESULTS There was no significant difference in gender, average age, dentition and tooth position distribution between the two groups (P>0.05). In the study, 7 cases were lost to follow-up 12 months after operation (4 cases in Group iRoot, and 3 cases in Group MTA). One case in each of the two groups had transient sensitivity at the end of the 3-month follow-up, and the pulp vitality was normal at the end of the 6-month follow-up. One case in Group iRoot showed sensitivity at the end of the 12-month follow-up. The success rates of the two groups at the end of 12-month follow-up were 100%, and the cure rates were 94.4% (Group iRoot) and 100% (Group MTA), respectively, and the difference was not statistically significant (P>0.05). No cases in Group iRoot had obvious crown discoloration, while 3 cases in Group MTA had. CONCLUSION The clinical characteristics and effectiveness of pulpotomy in mature permanent teeth with bioceramic putty repairmen iRoot were similar with MTA. Bioceramic putty repairmen iRoot is an acceptable material when used in pulpotomy of mature permanent teeth. Because it is not easy to cause tooth discoloration after treatment and is convenient to operate, bioceramic putty repairmen iRoot has a better clinical application prospect.
Neuromelanin‐MRI to Quantify and Track Nigral Depigmentation in Parkinson's Disease: A Multicenter Longitudinal Study Using Template‐Based Standardized Analysis

Clinical diagnosis and monitoring of Parkinson's disease (PD) remain challenging because of the lack of an established biomarker. Neuromelanin‐magnetic resonance imaging (NM‐MRI) is an emerging biomarker of nigral depigmentation indexing the loss of melanized neurons but has unknown prospective diagnostic and tracking performance in multicenter settings.
Remodeling of the tumor/tumor microenvironment ecosystem during KRAS G12C inhibitor clinical resistance in lung cancer

KRAS G12C inhibitors such as sotorasib and adagrasib are often effective in KRAS G12C–driven non–small cell lung cancer (NSCLC) patients. However, acquired resistance limits long-term patient survival. In this issue of the JCI, Tsai et al. present a comprehensive genetic analysis of multiple tumors with acquired sotorasib resistance obtained through an autopsy of a patient with KRAS G12C–mutant NSCLC. This analysis of pre- and posttreatment tumors uncovered cancer cell–intrinsic and –extrinsic features of resistance, including reactivation of KRAS-mediated signaling, reprogramming of metabolism, epithelial-mesenchymal transition, and tumor microenvironment changes. This elegant study demonstrates the multifaceted nature of KRAS G12C inhibitor clinical resistance and potential avenues to overcome resistance.
Prenatal hydronephrosis: Bridging pre‐ and postnatal management

Urinary tract dilation (UTD), including hydronephrosis (HN) is the most common prenatally detected anomaly and affects up to 1%–2% of pregnancies. Postnatally, it resolves without surgical intervention in approximately 75%–80% of children, however this may take several years to occur, necessitating repeated clinic visits and additional invasive testing for many. For the remainder, a surgical intervention will be offered to relieve obstruction or to correct vesicoureteral reflux. During the monitoring period, many of these infants will be offered continuous antibiotic prophylaxis for the prevention of urinary tract infections, however this remains a controversial topic among pediatric urologists and nephrologists. Herein, we present an up‐to‐date review of the early management of prenatally detected UTD including timing of postnatal imaging, the use of antibiotics, when circumcision may be beneficial and long term outcomes of the most common HN etiologies. We also propose a decision making tool to help guide the care of infants with UTD.
Sex Differences in the Use of Cardiovascular Drugs: A Survey of Patients in a Single Center.

OBJECTIVE Patients and medical professionals have a common misconception that cardiovascular diseases (CVD) predominantly affect men, which can lead to less prescribing of cardiovascular drugs to women. This study examined whether there were sex differences in the administration of cardiovascular (CV) drugs in patients admitted to the intensive care unit of the Internal Medicine Clinic of Foča University Hospital (ICFUH). MATERIALS AND METHODS The study comprised 332 patients hospitalized at the ICFUH from January 1st to June 30th, 2019. The following data on leading CVD and risks related to CV drug administration were collected: age, hyperlipidemia (HLD), diabetes mellitus (DM), chronic kidney disease (CKD), liver disease (LD), heart failure (HF), hypertension (HTN), myocardial infarction (MI), and stroke (S). The amount of the CV drugs of interest (statins, antiplatelet drugs, calcium channel blockers, ACE inhibitors, beta blockers, diuretics) administered during hospitalization was expressed as the Defined Daily Dose (DDD)/100 bed-days (BD) for patients of both sexes separately. RESULTS During hospitalization in the intensive care unit of ICFUH, female patients were less likely to be treated with statins than male patients (30.1 vs. 57.5 DDD/100 BD, P<0.05). There was no difference between sexes regarding the use of antihypertensive drugs. Women were less likely to be treated by antiplatelet therapy, more precisely by acetylsalicylic acid (30.4 vs. 36.9 DDD/100 BD, P<0.05). CONCLUSION Our study indicates that there were sex differences in CV drug administration in ICFUH. Presuming that drugs used during hospitalization were at least partially a continuation of the previous therapy prescribed by the family doctor, it is possible that such differences exist in primary care.
Preoperative Statin Use is Associated With Lower Incidence of Limb Loss After Lower Extremity Endovascular Interventions

Background Statin therapy is the primary lipid-lowering agent used in peripheral artery disease (PAD) patients. Although the benefits of statins have been described in the literature, most studies have focused on postoperative statin use and outcomes in major upper body vasculature. Our study aimed to assess the impact of statin therapy on postoperative outcomes of lower extremity endovascular interventions including mortality and amputation rates. Methods American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2012 to 2019 was utilized for this study. Patients were divided into 2 groups: those on preoperative statins (Group I) and those not on statins (Group II). Univariate and multivariate analyses were performed to assess statin’s effect on postoperative outcomes. Results A total of 12,217 patients (72.7%) were in Group I and 4599 patients (27.3%) were in Group II. The distribution of primary outcomes was as follows: Amputation (Group I: 3% vs Group II: 3.9%, P <.05) and Mortality (Group I: 1.6% vs Group II: 1.9%, P = .086). Statin use was associated with decreased amputation rates. Patients with tissue loss were 5 times more likely to undergo amputations (AOR: 5.58 [CI 2.29-13.63] P < .01) within 30-days postoperatively as compared to those whose presenting symptoms were claudication. Conclusion Statin therapy was associated with a decreased limb loss within 30-days after intervention at the time of lower extremity endovascular intervention. Patients presenting with rest pain and tissue loss had a higher incidence of limb loss than claudicants.
Synergistic Upper-Limb Functional Muscle Connectivity Using Acoustic Mechanomyography

Functional muscle network is a critical concept in describing functional synergistic muscle synchronization and functional connectivity needed for the execution of complex motor tasks. Muscle network is typically derived from decomposition of intermuscular coherence (IMC) at different frequency bands of multichannel electromyography (EMG) measurements, which potentially limits out-of-clinic applications. In this investigation, we introduce muscle network analysis to assess the functional coordination and functional connectivity of muscles based on mechanomyography (MMG). We focus on a targeted group of muscles vital for activities of daily living (ADLs) in the upper-limb. Functional muscle networks are evaluated for ten able-bodied participants and three upper-limb amputees. Muscle activity was acquired from a custom-made wearable armband of MMG sensors placed over four superficial muscles around the forearm (flexor carpi radialis (FCR), brachioradialis (BR), extensor digitorum communis (EDC), and flexor carpi ulnaris (FCU)) while participants performed four different hand gestures. Muscle connectivity analysis at multiple frequency bands shows significant topographical differences across gestures for low (i.e., $< $5 Hz) and high (i.e., $>$12 Hz) activation frequencies as well as observable network differences between amputee and non-amputee subjects. Results demonstrate MMG can be used for the analysis of functional muscle connectivity and mapping of synergistic functional synchronization of upper-limb muscles in complex movement tasks. The new physiological modality provides key insights into neural circuitry of motor coordination. Findings further offer the concomitant outcomes of demonstrating feasibility of MMG to map muscle coherence from a neurophysiological perspective and providing a mechanistic basis for its translation in human-robot interface.
Beyond Game Design for Broadening Participation: Building New Clubhouses of Computing for Girls

The absence of women in IT has been a vexing issue for over two decades. Most attempts to broaden participation in computing have focused on "unlocking the clubhouse" to a more diverse group of participants. One popular approach has been to ask girls to program games, which developed into the Game Design Movement, a series of studies and tools to help develop and empower females as designers of interactive digital media. This paper examines the rationales and successes behind the Game Design Movement in order to outline new strategies for broadening participation in computing. Rather than simply "unlocking the clubhouses" through expanded game-making activities, we argue here that educators and researchers should devote themselves to "building new clubhouses" altogether by focusing on using new programmable materials, interactive activities, and both in-person and online communities that leverage the traditions of girls' play worlds and the cultural practices of women's crafting communities.