Artificial intelligence (AI) has shown promise for diagnosing prostate cancer in biopsies. However, results have been limited to individual studies, lacking validation in multinational settings. Competitions have been shown to be accelerators for medical imaging innovations, but their impact is hindered by lack of reproducibility and independent validation. With this in mind, we organized the PANDA challenge—the largest histopathology competition to date, joined by 1,290 developers—to catalyze development of reproducible AI algorithms for Gleason grading using 10,616 digitized prostate biopsies. We validated that a diverse set of submitted algorithms reached pathologist-level performance on independent cross-continental cohorts, fully blinded to the algorithm developers. On United States and European external validation sets, the algorithms achieved agreements of 0.862 (quadratically weighted κ, 95% confidence interval (CI), 0.840–0.884) and 0.868 (95% CI, 0.835–0.900) with expert uropathologists. Successful generalization across different patient populations, laboratories and reference standards, achieved by a variety of algorithmic approaches, warrants evaluating AI-based Gleason grading in prospective clinical trials.

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The sedative effects of epidural anesthesia without volatile and IV anesthetics and quantification of the degree of epidural anesthesia-induced sedation have not been investigated. In the current study we evaluated the effects of epidural anesthesia on the bispectral index (BIS) during the awake phase and during general anesthesia. After placing the epidural catheter, the patients were randomly allocated to 2 groups receiving either 5 mL of epidural saline (group S) or the same volume of 0.75% ropivacaine (group R). The BIS measurements during the awake phase were performed at 7, 12, 13, 14, 22, and 23 min after the epidural injection. General anesthesia was then induced with propofol and vecuronium and maintained with 0.75% sevoflurane. From approximately 10 min after tracheal intubation, the BIS measurements were made at 1-min intervals for 10 min. The BIS during the awake phase was significantly lower in group R than in group S (P < 0.05). The BIS during general anesthesia was significantly lower in group R than in group S (P < 0.0001). Epidural anesthesia decreased the BIS during the awake phase and during general anesthesia. The decrease of the BIS associated with epidural anesthesia was more prominent during general anesthesia than during the awake phase.

CdSe quantum dots are often used in industry as fluorescent materials. In this study, CdSe quantum dots were synthesized using Fusarium oxysporum. The cadmium and selenium concentration, pH, and temperature for the culture of F. oxysporum (Fusarium oxysporum) were optimized for the synthesis, and the CdSe quantum dots obtained from the mycelial cells of F. oxysporum were observed by transmission electron microscopy. Ultra-thin sections of F. oxysporum showed that the CdSe quantum dots were precipitated in the intracellular space, indicating that cadmium and selenium ions were incorporated into the cell and that the quantum dots were synthesized with intracellular metabolites. To reveal differences in F. oxysporum metabolism, cell extracts of F. oxysporum, before and after CdSe synthesis, were compared using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The results suggested that the amount of superoxide dismutase (SOD) decreased after CdSe synthesis. Fluorescence microscopy revealed that cytoplasmic superoxide increased significantly after CdSe synthesis. The accumulation of superoxide may increase the expression of various metabolites that play a role in reducing Se4+ to Se2− and inhibit the aggregation of CdSe to make nanoparticles.