Can Reinforcement Learning Be Applied to Surgery?

Background: Remarkable progress has recently been made in the field of artificial intelligence (AI).Objective: We sought to investigate whether reinforcement learning could be used in surgery in the future.Methods: We created simple 2D tasks (Tasks 1–3) that mimicked surgery. We used a neural network library, Keras, for reinforcement learning. In Task 1, a Mac OS X with an 8 GB memory (MacBook Pro, Apple, USA) was used. In Tasks 2 and 3, a Ubuntu 14. 04LTS with a 26 GB memory (Google Compute Engine, Google, USA) was used.Results: In the task with a relatively small task area (Task 1), the simulated knife finally passed through all the target areas, and thus, the expected task was learned by AI. In contrast, in the task with a large task area (Task 2), a drastically increased amount of time was required, suggesting that learning was not achieved. Some improvement was observed when the CPU memory was expanded and inhibitory task areas were added (Task 3).Conclusions: We propose the combination of reinforcement learning and surgery. Application of reinforcement learning to surgery may become possible by setting rules, such as appropriate rewards and playable (operable) areas, in simulated tasks

Analysis of human synovial and bone marrow mesenchymal stem cells in relation to heat-inactivation of autologous and fetal bovine serums

<p>Abstract</p> <p>Background</p> <p>Though sera are essential for Mesenchymal stem cells (MSCs), the effect of heat-inactivation remains unknown. Autologous human serum is recommended for clinical use; however, it is unclear whether differentiation potentials are maintained. To examine whether heat-inactivation of serum affected the proliferation and whether autologous human serum influenced their multipotentiality.</p> <p>Methods</p> <p>After whole blood collection, human synovium and bone marrow were harvested. Nucleated cells were expanded with autologous human serum and FBS.</p> <p>Results</p> <p>Heat-inactivation of autologous human serum enhanced proliferation of synovial MSCs. Heat-inactivation of each types of serum didn't affect calcification of synovial MSCs. The induction of calcification increased ALP activity, with the exception of bone marrow MSCs with autologous human serum. For adipogenesis of synovial MSCs, the Oil Red-O positive colony forming efficiency with autologous human serum was similar to or less than that with FBS.</p> <p>Conclusion</p> <p>These clarified the processing of human autologous serum and the influence of different sera for differentiation of synovial and bone marrow MSCs.</p

Author Correction: Longitudinal assessment of tumor development using cancer avatars derived from genetically engineered pluripotent stem cells.

An amendment to this paper has been published and can be accessed via a link at the top of the paper

Effects of HLA-DRB1 alleles on susceptibility and clinical manifestations in Japanese patients with adult onset Still’s disease

BackgroundHLA-DRB1 alleles are major determinants of genetic predisposition to rheumatic diseases. We assessed whether DRB1 alleles are associated with susceptibility to particular clinical features of adult onset Still’s disease (AOSD) in a Japanese population by determining the DRB1 allele distributions.MethodsDRB1 genotyping of 96 patients with AOSD and 1,026 healthy controls was performed. Genomic DNA samples from the AOSD patients were also genotyped for MEFV exons 1, 2, 3, and 10 by direct sequencing.ResultsIn Japanese patients with AOSD, we observed a predisposing association of DRB1*15:01 (p = 8.60 × 10−6, corrected p (Pc) = 0.0002, odds ratio (OR) = 3.04, 95% confidence interval (95% CI) = 1.91–4.84) and DR5 serological group (p = 0.0006, OR = 2.39, 95% CI = 1.49–3.83) and a protective association of DRB1*09:01 (p = 0.0004, Pc = 0.0110, OR = 0.34, 95% CI = 0.18–0.66) with AOSD, and amino acid residues 86 and 98 of the DRβ chain were protectively associated with AOSD. MEFV variants were identified in 49 patients with AOSD (56.3%). The predisposing effect of DR5 was confirmed only in patients with AOSD who had MEFV variants and not in those without MEFV variants. Additionally, DR5 in patients with AOSD are associated with macrophage activation syndrome (MAS) and steroid pulse therapy.ConclusionThe DRB1*15:01 and DR5 are both associated with AOSD susceptibility in Japanese subjects. A protective association between the DRB1*09:01 allele and AOSD was also observed in these patients. Our data also highlight the effects of DRB1 alleles in susceptibility to AOSD