MEDITRON-70B: Scaling Medical Pretraining for Large Language Models

Large language models (LLMs) can potentially democratize access to medical knowledge. While many efforts have been made to harness and improve LLMs' medical knowledge and reasoning capacities, the resulting models are either closed-source (e.g., PaLM, GPT-4) or limited in scale (<= 13B parameters), which restricts their abilities. In this work, we improve access to large-scale medical LLMs by releasing MEDITRON: a suite of open-source LLMs with 7B and 70B parameters adapted to the medical domain. MEDITRON builds on Llama-2 (through our adaptation of Nvidia's Megatron-LM distributed trainer), and extends pretraining on a comprehensively curated medical corpus, including selected PubMed articles, abstracts, and internationally-recognized medical guidelines. Evaluations using four major medical benchmarks show significant performance gains over several state-of-the-art baselines before and after task-specific finetuning. Overall, MEDITRON achieves a 6% absolute performance gain over the best public baseline in its parameter class and 3% over the strongest baseline we finetuned from Llama-2. Compared to closed-source LLMs, MEDITRON-70B outperforms GPT-3.5 and Med-PaLM and is within 5% of GPT-4 and 10% of Med-PaLM-2. We release our code for curating the medical pretraining corpus and the MEDITRON model weights to drive open-source development of more capable medical LLMs

Laparoscopic Diagnosis and Treatment of Splenogonadal Fusion Associated with Intra-Abdominal Cryptorchidism

Splenogonadal fusion is a rare congenital anomaly in which there is a fusion between spleen and gonad. According to the literature, 37% of them had unnecessary orchiectomy. We present a patient with splenogonadal fusion in undescended testis, who was preserved from unnecessary orchiectomy. [Cukurova Med J 2013; 38(1.000): 135-137

Laparoscopic diagnosis and treatment of splenogonadal fusion associated with intra-abdominal cryptorchidism: A case report

Splenogonadal fusion is a rare congenital anomaly in which there is fusion between spleen and gonad. According to the literature 37% of them had unnecessary orchiectomy. We present a patient with splenogonadal fusion in undescended testis, who was preserved from unnecessary orchiectomy. [Cukurova Med J 2013; 38(4.000): 787-790

Laparoscopic Diagnosis and Treatment of Splenogonadal Fusion Associated with Intra-Abdominal Cryptorchidism: A Case Report

Splenogonadal füzyon, dalak ve gonadların kaynaşmasıyla oluşan nadir bir konjenital anomalidir. Literatüre göre bu olguların %37'sine gereksiz orşiektomi yapılmıştır. Bu olgu sunumunda, inmemiş testisinde splenogonadal füzyon bulunan ve gereksiz orşiektomiden korunan bir hasta bildirilmektedir.Splenogonadal fusion is a rare congenital anomaly in which there is a fusion between spleen and gonad. According to the literature 37% of them had unnecessary orchiectomy. We present a patient with splenogonadal fusion in undescended testis, who was prevented from having unnecessary orchiectomy

Pediatric Transumbilical Laparoendoscopic Single-site Nephroureterectomy: Initial Report REPLY

WOS: 000271992400060

Effects of HIV on Neuroelectric Responses: AERP and EDA

WOS: 000422853200002Aim We aimed to test our hypothesis that electroencephalography (EEG) responses and electrodermal activity (EDA) in response to auditory stimuli in HIV/AIDS patients will differ to those of healthy individuals. Method Data was collected from 20 AIDS patients receiving anti retroviral treatment for an average duration of five years and 20 healthy individuals matched for age/sex. Participants were presented with auditory stimuli consisting of pure sound tones with 1000 Hz (non-target) and 2000 Hz (target) frequency. Frontal EEG and EDA recordings were taken using a biopotential amplifier system. Results P1, N1, P2, N2 (p<0.001) responses obtained from the frontal region to target stimuli were higher in HIV group; while the P3 response was higher in control group. The latencies of all responses to target stimuli were significantly delayed in HIV group compared to control group. In HIV group, amplitudes of P1, N2 and P3 responses to target stimuli were found to be higher than to non-target stimuli; N1 and P2 responses to non-target stimuli had higher amplitude. Conclusion The findings of this study demonstrate the effects of HIV on both the peripheral (EDA) and central nervous system (EEG). The differences in neuroelectrical activity found between HIV patients and healthy individuals can be concluded to be due to the direct or indirect effects of the virus and antiretroviral medication on neurons. The method of simultaneous monitoring of auditory ERP and EDA may contribute to the detection of subclinical neural deterioration in HIV patients

Effects of Laparoscopic Ureterolithotomy and Simultaneous Trans-Trocar Semi-Rigid Ureteroscopy on Stone-Free Rate in the Treatment of Proximal Ureteral Stones

WOS: 000218668400005Objective This study presents the effects of the use of semi-rigid ureteroscopy simultaneously during laparoscopic ureterolithotomy on the stone-free rate and, the techniques used to perform laparoscopic ureterolithotomy less invasively. Materials and Methods Between November 2011 and July 2013, laparoscopic ureterolithotomy was performed in 19 patients with proximal ureteral stones. A history of failed shock wave lithotripsy (SWL) or semi-rigid ureteroscopy (sr-URS), presence of ureter stones >= 15 mm and/or impacted stones, or a socioeconomic status not allowing the patient to reach an advanced center for flexible ureteroscopy (f-URS) were identified as the surgical indications. Results Fourteen male (74%) and five female (26%) patients were enrolled in the study and the mean age was 36.4 +/- 15.11 (15-70) years. The stones were located on right side in five patients (26%) and left side in 14 patients (74%). The mean stone size was 16.2 +/- 3.55 mm (8-22). The mean operation time was 138.9 +/- 29.56 minutes (90-200). The mean urethral catheter and drain removal time was 31.2 +/- 24.28 (16-120) and 50.8 +/- 33.61 hours (18-168), respectively. There was no postoperative complication in long-term period and stone-free rate was 100%. Conclusion Laparoscopic ureterolithotomy is a feasible alternative in a patient who had previously failed minimally invasive methods and/or with large impacted proximal ureteral stone. Furthermore, to use semi-rigid ureteroscopy during the laparoscopic procedure increases the stonefree rate and prevents the need for an additional procedure in case of concurrent presence of small kidney stones