Miracle-dz/UniFAR-FTUs huggingface dataset:
Robotics in neurosurgery: state of the art and future technological challenges

The use of robotic technologies to assist surgeons was conceptually described almost thirty years ago but has only recently become feasible. In Neurosurgery, medical robots have been applied to neurosurgery for over 19 years. Nevertheless this field remains unknown to most neurosurgeons. The intrinsic characteristics of robots, such as high precision, repeatability and endurance make them ideal surgeon's assistants. Unfortunately, limitations in the current available systems make its use limited to very few centers in the world. During the last decade, important efforts have been made between academic and industry partnerships to develop robots suitable for use in the operating room environment. Although some applications have been successful in areas of laparoscopic surgery and orthopaedics, Neurosurgery has presented a major challenge due to the eloquence of the surrounding anatomy. This review focuses on the application of medical robotics in neurosurgery. The paper begins with an overview of the development of the medical robotics, followed by the current clinical applications in neurosurgery and an analysis of current limitations. We discuss robotic applications based in our own experience in the field. Next, we discuss the technological challenges and research areas to overcome those limitations, including some of our current research approaches for future progress in the field Copyright © 2004 Robotic Publications Ltd.
Reactive oxygen species involved in prenylflavonoids, icariin and icaritin, initiating cardiac differentiation of mouse embryonic stem cells

The significant promoting effects of some prenylflavonoids on cardiac differentiation of mouse embryonic stem (ES) cells via reactive oxygen species (ROS) signaling pathway were investigated. The most effective differentiation was facilitated by icariin (ICA), followed by icaritin (ICT), while desmethylicaritin (DICT) displayed the weakest but still significant inducible effect. Contrarily, DICT demonstrated the strongest anti‐oxidative activity while ICA displayed only little in vitro, which was well matched with the hydroxyl (OH) numbers and the positions in the molecular structures. Therefore, ROS signaling cascades were assumed to be involved in prenylflavonoids induced cardiomyogenesis. Treatment with ICA, intracellular ROS in embryoid bodies was rapidly elevated, which was abolished by the NADPH‐oxidase inhibitor apocynin; elimination of intracellular ROS by vitamin E or pyrrolidine dithiocarbamate (PDTC) inhibited ICA induced cardiomyogenesis; ROS‐sensitive extracellular‐regulated kinase 1, 2 (ERK1, 2) and p38 activation were further observed, the cardiomyogenesis was significantly inhibited in the presence of ERK1, 2 or p38 inhibitor U0126 or SB203580, indicating the roles of NADPH‐ROS‐MAPKs signaling cascades in prenylflavonoids induced cardiac differentiation. There was no difference in Nox4 NADPH oxidase expression between ICA and ICT treatments, however, ROS concentration in EBs after ICT administration was lower than that after ICA treatment, followed by less activation of ERK1, 2, and p38. These results revealed that the significant promoting effects of prenylflavonoids on cardiac differentiation was at least partly via ROS signaling cascades, and the facilitating abilities preferentially based on the nature of prenylflavonoids themselves, but anti‐oxidative activity determined by the OH numbers and the positions in the structures do influence the cardiomyogenesis in vitro. J. Cell. Biochem. 103: 1536–1550, 2008. © 2007 Wiley‐Liss, Inc.
Decreasing phosphodiesterase 5A activity contributes to platelet cGMP accumulation during storage of apheresis‐derived platelet concentrates

Platelet storage lesion (PSL) considerably decreases the quality of platelets (PLTs) in concentrates characterized by a loss of signaling responses to agonists and impaired PLT activation, secretion, and aggregation. To understand the role of inhibitory signaling pathways in the mechanism of PSL, the basal state of the cyclic nucleotide (CN)‐dependent signaling systems in stored PLTs was investigated.
Comparison of a Vasopeptidase Inhibitor with Neutral Endopeptidase and Angiotensin-Converting Enzyme Inhibitors on Bradykinin Metabolism in the Rat Coronary Bed

The in vitro effects of omapatrilat, a dual vasopeptidase inhibitor that simultaneously inhibits neutral endopeptidase (NEP) and angiotensin-converting enzyme (ACE), on exogenous bradykinin metabolism after a single passage through the coronary bed were compared with that of a NEP inhibitor (retrothiorphan, 25 n M), an ACE inhibitor (enalaprilat, 130 n M), and omapatrilat (25 n M). Bradykinin and inhibitors were infused into isolated Langendorff rat hearts perfused at 1 ml/min followed by reperfusion at 10 ml/min. Residual bradykinin was quantified in the coronary effluent by enzyme-linked immunosorbent assay to calculate bradykinin recovery and its kinetic parameters (Vmax/Km). Bradykinin degradation rate at 1 ml/min was 4.56 ± 0.39 1/min per gram without inhibitors and was significantly reduced to 2.57 ± 0.19 1/min per gram in the presence of enalaprilat, to 2.97 ± 0.38 1/min per gram with retrothiorphan, to 1.82 ± 0.17 1/min per gram with both enalaprilat and retrothiorphan, and to 1.14 ± 0.35 1/min per gram with omapatrilat. In a second set of experiments, the effect of a 14-day treatment of rats with either ACE inhibitors (enalapril, quinapril, and ramipril), a NEP inhibitor (candoxatril), or omapatrilat on exogenous bradykinin metabolism was studied in Langendorff perfused hearts isolated from these long-term treated rats. In untreated rats, bradykinin degradation at a coronary perfusion of 1 ml/min was 4.35 ± 0.41 1/min per gram. This value was reduced by 30% for the NEP inhibitor, by 50% for all ACE inhibitors, and by 75% for omapatrilat. All inhibitors administered either short term or long term significantly reduced bradykinin degradation during a single passage through the coronary bed. However, omapatrilat administration resulted in the greatest protection from bradykinin breakdown than ACE or NEP inhibitors alone.
[Analysis of prognostic factors for patients with traumatic acute subdural hematomas treated by surgery].

OBJECTIVE To analyze the factors correlated with the surgical prognosis of patients with traumatic acute subdural hematoma (ASDH). METHODS A total of 117 surgical patients for traumatic ASDH between January 2007 and August 2012 were retrospectively reviewed. The clinical factors correlated with prognosis were statistically analyzed.Glasgow outcome score (GOS) was used for prognostic evaluations and favorable prognosis was defined as 4-5 points. RESULTS The percentage of patients with favorable prognosis was 43.59% and the mortality 39.32%. The factors correlated with favorable prognosis included age <40 years, pre-operative GCS >8, no pre-operative herniation, duration between injury and surgical depression ≤ 4 h, without injury of drainage vein, mild brain edema and good brain palpation; the factors correlated with mortality included age >60 years, pre-operative GCS ≤ 8, pre-operative herniation, duration between injury and surgical depression >4 h, injury of drainage vein, serious brain edema and weak brain palpation Logistic regression confirmed preoperative GCS >8, no preoperative herniation, injury of drainage vein and postoperative good brain palpation were independent factors associated with favorable prognosis. CONCLUSION Patients with age <40 years, preoperative GCS>8, no preoperative herniation, injury of drainage vein and postoperative good brain palpation tend to have favorable prognoses.
Uniportal versus biportal video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis.

BACKGROUND Video-assisted thoracoscopic sympathectomy had replaced open surgery. The aim of this study was to compare the outcomes of using a single port and two ports to perform video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis. METHODS Between April 2006 and February 2008, 20 cases underwent video-assisted thoracoscopic sympathectomy through one port (uniportal group) and 25 cases through two ports (biportal group). The variables including the operating time, hospital stay, pain scores, postoperative complications, incidence of symptom recurrence and patient satisfaction were compared. The mean postoperative follow-up period was 11.5 months (range, 3 - 25 months). RESULTS The hands of all patients were warm and dry after operation. No conversion to open surgery was necessary, and no operative mortality was recorded in either group. The mean inpatient pain scores were significantly higher in the biportal group (1.2 +/- 0.6) than that in the uniportal group (0.8 +/- 0.5, P = 0.025). For the first three weeks after operation, four out of 20 (20%) patients in the uniportal group constantly suffered from mild or moderate residual pain while eight out of 25 (32%) cases in the biportal group (P = 0.366). Among them, two cases in the uniportal group and five cases in the biportal group need to take analgesics. Our mean operative time (bilateral sympathectomy) in the uniportal group ((39.5 +/- 10.0) minutes) was shorter than that in biportal group ((49.7 +/- 10.6) minutes, P = 0.02). There were no significant differences between two groups in terms of the mean hospital stay, compensatory sweating, and patient satisfaction. Two patients in the biportal group and three in the uniportal group experienced a unilateral pneumothorax. None of them required chest drainage. No patient experienced Horner's syndrome, and no recurrent symptoms were observed in either groups. CONCLUSIONS Both uniportal and biportal video-assisted thoracoscopic sympathectomy are effective, safe, and minimally invasive for palmar hyperhidrosis. Comparing with the biportal approach, the uniportal approach causes less postoperative pain and less operative time, and is a more reasonable procedure in treatment of palmar hyperhidrosis.
ROUTINE: The Development of a Physical Activity Promoting Journey Planner Web App

Behavior change apps are widespread, but the scientific base of the app-concept is rarely disclosed. The aim of this article is to present the methodological approach used for the development of a so-called “fitness feedback demonstrator” within an already existing journey planner web app to motivate people to increase their physical activity behavior while using public transport. Firstly, we introduce the behavior change theories applied for the design of the feedback, followed by the analysis of focus-group discussions about the desired content of the fitness feedback. Secondly, we describe how we conducted a field test to measure the number of steps taken when using public transport. Finally, we used the feedback from potential users in terms of design/attractiveness and comprehensibility of the added fitness information. The “fitness feedback demonstrator” is a good practical example of how to make use of the different research expertise to develop a theory-based tool to encourage persons to integrate physical activity into their daily routines.
Satellite and mobile wireless transmission of focused assessment with sonography in trauma.

OBJECTIVES Focused assessment with sonography in trauma (FAST) can define life-threatening injuries in austere settings with remote real-time review by experienced physicians. This study evaluates vest-mounted microwave, satellite, and LifeLink communications technology for image clarity and diagnostic accuracy during remote transmission of FAST examinations. METHODS Using a SonoSite, FAST was obtained on three patients with pericardial and intraperitoneal effusions and two control subjects in a remotely located U.S. Army Combat Support Hospital. A miniature vest-mounted video transmitter attached to the SonoSite sent wireless ultrasound video 20 m to a receiving antenna. The signal was then transferred over VSAT satellite systems at 512 kilobaud per second (kbps), INMARSAT satellite systems at 64 kbps, and over LifeLink on a moving ambulance through a metropolitan wireless traffic-management network. Clarity and absence or presence of effusions were recorded by 15 staff emergency physicians. RESULTS Average sensitivity, specificity, and accuracy were 87% (95% confidence interval [CI]=79% to 95%), 85% (95% CI=81% to 89%), and 86% (95% CI=82% to 90%) for the Premier Wireless Vest; 98% (95% CI=97% to 99%), 83% (95% CI=75% to 91%), and 86% (95% CI=82% to 90%) for VSAT; 95% (95% CI=94% to 96%), 70% (95% CI=58% to 82%), and 75% (95% CI=70% to 80%) for INMARSAT; and 82% (95% CI=73% to 91%), 83% (95% CI=74% to 92%), and 82% (95% CI=78% to 86%) for LifeLink with clarity of 3.0 (95% CI=2.7 to 3.3), 2.9 (95% CI=2.6 to 3.2), 1.3 (95% CI=1.2 to 1.4), and 2.1 (95% CI=1.8 to 2.4), respectively. CONCLUSIONS Accuracy correlated with clarity. Roaming vest transmission of FAST provides interpretable, diagnostic imagery at the distances used in this study. VSAT provided the best clarity and diagnostic value with the lighter, more portable INMARSAT serving a lesser role for remote clinical interpretation. LifeLink performed well, and further infrastructure improvements may increase clarity and accuracy.
QoS based telemedicine technologies for rural healthcare emergencies

Telemedicine systems are becoming prevalent in today's healthcare scenarios, especially in India where a large portion of the population resides in remote and rural regions where availability of specialty healthcare is scant. Many such telemedicine system implementations can be found in the existing literature. Since critical data are being transmitted over these networks, the reliability of these systems is highly important. This paper discusses about the quality of service (QoS) requirements for achieving reliability for such systems. The paper discusses the importance and acceptance of such rescue vehicles which are equipped with the telemedicine facilities. This involves the role of paramedic assistance, multiple access technologies along with acquisition and remission of vital parameters such as electrocardiogram (ECG), blood pressure (BP), pulse rate (PR) etc. to a specialist doctor at the remote hospital. A comprehensive survey has been done among the various stakeholders of the proposed system. The paper focuses on the need for the QoS mechanisms in the proposed telemedicine system for the rural rescue and health care emergencies.
High‐intensity sprint training inhibits mitochondrial respiration through aconitase inactivation

Intense exercise training is a powerful stimulus that activates mitochondrial biogenesis pathways and thus increases mitochondrial density and oxidative capacity. Moderate levels of reactive oxygen species (ROS) during exercise are considered vital in the adaptive response, but high ROS production is a serious threat to cellular homeostasis. Although biochemical markers of the transition from adaptive to maladaptive ROS stress are lacking, it is likely mediated by redox sensitive enzymes involved in oxidative metabolism. One potential enzyme mediating such redox sensitivity is the citric acid cycle enzyme aconitase. In this study, we examined biopsy specimens of vastus lateralis and triceps brachii in healthy volunteers, together with primary human myotubes. An intense exercise regimen inactivated aconitase by 55‐72%, resulting in inhibition of mitochondrial respiration by 50‐65%. In the vastus, the mitochondrial dysfunction was compensated for by a 15‐72% increase in mitochondrial proteins, whereas H2O2 emission was unchanged. In parallel with the inactivation of aconitase, the intermediary metabolite citrate accumulated and played an integral part in cellular protection against oxidative stress. In contrast, the triceps failed to increase mitochondrial density, and citrate did not accumulate. Instead, mitochondrial H2O2 emission was decreased to 40% of the pretraining levels, together with a 6‐fold increase in protein abundance of catalase. In this study, a novel mitochondrial stress response was highlighted where accumulation of citrate acted to preserve the redox status of the cell during periods of intense exercise. —Larsen, F. J., Schiffer, T. A. , Ørtenblad, N. , Zinner, C. , Morales‐Alamo, D. , Willis, S. J., Calbet, J. A. , Holmberg, H. ‐C. , Boushel, R. High‐intensity sprint training inhibits mitochondrial respiration through aconitase inactivation. FASEB J. 30, 417‐427 (2016). www.fasebj. org
Consensus in Self-Similar Hierarchical Graphs and Sierpiński Graphs: Convergence Speed, Delay Robustness, and Coherence

The hierarchical graphs and Sierpiński graphs are constructed iteratively, which have the same number of vertices and edges at any iteration, but exhibit quite different structural properties: the hierarchical graphs are nonfractal and small-world, while the Sierpiński graphs are fractal and “large-world. ” Both graphs have found broad applications. In this paper, we study consensus problems in hierarchical graphs and Sierpiński graphs, focusing on three important quantities of consensus problems, that is, convergence speed, delay robustness, and coherence for first-order (and second-order) dynamics, which are, respectively, determined by algebraic connectivity, maximum eigenvalue, and sum of reciprocal (and square of reciprocal) of each nonzero eigenvalue of Laplacian matrix. For both graphs, based on the explicit recursive relation of eigenvalues at two successive iterations, we evaluate the second smallest eigenvalue, as well as the largest eigenvalue, and obtain the closed-form solutions to the sum of reciprocals (and square of reciprocals) of all nonzero eigenvalues. We also compare our obtained results for consensus problems on both graphs and show that they differ in all quantities concerned, which is due to the marked difference of their topological structures.
The use of English as a lingua franca in the Japanese second language classroom

Abstract Despite the growing interest surrounding the use and role of the first language in the second language classroom, the vast majority of research in the field has been conducted in classrooms where English is taught as a second language in English-speaking countries. Very little research has investigated the role of English as a lingua franca (ELF) in other language learning environments, such as those in which Japanese is learnt as a second language (JSL) in Japan. This paper investigates the purposes for which ELF is employed, and the perspectives of learners from multilingual and multicultural backgrounds on the use of ELF, in the JSL classroom. The findings show that English is employed to varying degrees in relation to proficiency level, and that learners themselves are generally welcoming of this use. The author suggests that learners seek security and comfort in what they already know, with ELF easing the gap between their L1 and their developing Japanese skills.
Laryngeal papillomatosis: Recurrence after 33‐year remission

After repeated laryngeal papilloma excisions, a 4‐year‐old Caucasian male became symptom‐free. Benign squamous papilloma recurred in the larynx and trachea at age 37 after a gunshot wound, prolonged nasogastric intubation, several laparotomies, endotracheal anesthesias, and massive weight loss. This case and others in the literature suggest that current therapy produces prolonged remission, not “cure. ” Its course reinforces accumulating evidence for the existence of human papilloma viruses (HPV) whose DNA apparently becomes incorporated into host laryngeal cell DNA, supporting an hypothesis that HPV remains in normal‐appearing epithelium adjacent to papilloma. Like herpes zoster varicella virus, HPV may lie dormant until reactivated by host immunosuppression, trauma, malnutrition or sepsis, features also present in the patient described. Repeated intubation probably injured and destroyed cells, releasing viral material.
Influence of Acute-Phase Parasite Load on Pathology, Parasitism, and Activation of the Immune System at the Late Chronic Phase of Chagas’ Disease

ABSTRACT To obtain low and high parasite loads in the acute phase of Chagas’ disease, A/J mice were infected with 103 or 105Trypanosoma cruzi trypomastigotes of the Y strain and treated on day 6 with benznidazol. One year later, chronically infected mice were screened for subpatent parasitemias, tissue pathology, and immune response. Mice infected with the high parasite inoculum showed higher levels of chronic parasitemias, heart and striated muscle inflammation, and activation of the immune system than did mice infected with the low inoculum. Concerning the activation of the immune system, the main findings for high-dose-infected mice were (i) increased numbers of splenocytes, with preferential expansion of CD8+ and B220− CD5− cells, many of them bearing a macrophage phenotype; (ii) higher frequencies of B (B220+), CD4+, and CD8+ large lymphocytes; (iii) a shift of CD4+ cells towards a CD45RBLow phenotype; (iv) increased frequencies of both CD45RBLow and CD45RBHigh large CD4+cells; (v) augmented numbers of total immunoglobulin (Ig)-secreting cells, with predominance of IgG2a-producing cells; and (vi) increased production of gamma interferon and interleukin 4. In addition, these mice presented lower IgM and higher IgG2a and IgG1 parasite-specific serum antibody levels. Our results indicate that the parasite load at the acute phase of T. cruzi infection influences the activation of the immune system and development of Chagas’ disease pathology at the late chronic phase of the disease.
Humoral response after administration of E1-deleted adenoviruses: immune privilege of the subretinal space.

An important limitation of E1-deleted recombinant adenoviruses in gene therapy is the immune response that they engender and that rapidly destroys transduced cells. Transduced cells of the outer retina appear to be an exception. To determine whether differences in immune sequestration of the outer retina contribute to the increased stability of transgene expression in this tissue, we examined the systemic humoral response to an E1-deleted adenovirus injected into the subretinal space. Subretinal injection of Ad.CMVlacZ in mature immunocompetent mice resulted in minimal circulating antibody production. In contrast, subcutaneous administration of equivalent doses of Ad.CMVlacZ resulted in high-titer antibody production against adenoviral proteins. Circulating antibodies in systemically immunized animals had minimal effect on retinal transgene expression patterns measured 2 weeks after subretinal injection of Ad.CMVlacZ. Histologic examination showed minimal retinal toxicity attributable to subretinal adenovirus in naive or immunized mice, although 3/18 (14%) of eyes from the latter set contained a localized granulomatous infiltrate at the ocular injection site. The data demonstrate that the subretinal space is an immune-privileged site regarding humoral immunity. Further, short-term transduction efficiency is not affected by the presence of anti-adenoviral antibodies. The retina may be a favorable environment for replication-defective virus-mediated genetic therapy.