Miracle-dz/UniFAR-FTUs huggingface dataset:
Changes in Peripheral Blood Mononuclear Cells - Novel Evidence for an Immunomodulatory Aspect in Bell’s Palsy?

Background : Patients with Bell’s Palsy (BP): a very common neuropathy of the facial nerve-showed significant decreases of T- and B-lymphocytes in earlier studies. Besides a viral infection an autoimmune process leading to this disease has been discussed. Methods : 15 patients with BP and 15 healthy, age-matched individuals were included in this study. In addition to routine blood parameters peripheral blood mononuclear cells (PBMCs) were isolated by Ficoll density gradient. Afterwards, in CD14 + (monocytes), CD68 + (macrophages), CD3 + (T-lymphocytes) or CD19 + (B-lymphocytes) the percentage of cells, expressing pro-inflammatory (CD40, TNF- α , and COX-2), pro-apoptotic (Caspase-3, PARP), pro-adhesive (CD38) and oxidative stress-related (MnSOD) proteins were measured by two-color fluorescence-activated cell sorter analyses. Results: In comparison to healthy individuals, patients with BP revealed significantly elevated plasma levels of C-reactive protein and total leukocyte count, while levels of T- and B-lymphocytes were significantly decreased. In BP patients all subpopulations under test showed a significant increase in percentage of CD38 + as well as of pro-inflammatory (CD40 + , TNF- α + ) cells; additionally monocytes showed a significant increase in percentage of MnSOD positive cells. Conclusions: Our data shows new evidence for an involvement of the immune system in BP. Therefore, we suggest that future investigations of PBMCs in BP patients represent a very promising approach to further elucidate possible pathomechanisms. doi:10.4021/ jnr108 w
Analysis of cell‐free fetal DNA in maternal blood for detection of trisomy 21, 18 and 13 in a general pregnant population and in a high risk population – a systematic review and meta‐analysis

The aim of this study was to review the performance of non‐invasive prenatal testing (NIPT) for detection of trisomy 21, 18 and 13 (T21, T18 and T13) in a general pregnant population as well as to update the data on high‐risk pregnancies.
Metastatic and locally advanced pancreatic endocrine carcinomas: analysis of factors associated with disease progression.

PURPOSE Knowledge of clinical course of pancreatic endocrine carcinomas (PECs) is poor. This study aimed to determine the time to progression of advanced PECs, and to identify predictors capable of selecting subgroups with higher risk of progression. PATIENTS AND METHODS In this multicenter retrospective analysis, patients with advanced PECs were enrolled. Staging was according to European Neuroendocrine Tumors Society guidelines. Grading was based on proliferation index using Ki67 immunohistochemistry. The primary end point was progression-free survival (PFS), which was assessed using the Kaplan-Meier method. The Cox regression proportional hazard model was used to identify predictors for tumor progression. RESULTS Two hundred two patients with PECs were enrolled, including 172 with well-differentiated and 30 with poorly differentiated endocrine carcinomas. There were 34 patients with stage III and 168 with stage IV tumors. G1 tumors were present in 19.7% of patients, whereas 60.1% of patients had G2 tumors, and the remaining 20.2% had G3 tumors. Disease progression occurred in 166 patients (82.2%), at a median interval of 10 months (interquartile range, 5 to 22) from diagnosis. Median PFS was 14 months. Different PFS were observed depending on G grade (P < .001) and tumor differentiation (P < .001) and in patients who did not receive any antitumor treatment (P = .002). The major risk factor for progression was the proliferation index Ki67 (hazard ratio, 1.02 for each increasing unit; P < .001). Overall 5-year survival was 44.1%. CONCLUSION The vast majority of patients with advanced PECs undergo disease progression. The major risk factor for progression is Ki67 index, which should lead physicians dealing with PECs to plan appropriate follow-up programs and therapeutic strategies.
Reliability in cardiotocography interpretation – impact of extended on‐site education in addition to web‐based learning: an observational study

Previous studies have shown poor reproducibility in cardiotocography (CTG) interpretation. Studies evaluating the Swedish web‐based CTG‐education program have not proven to increase accurate CTG assessments. The aim of this study was to evaluate whether an extended education can improve inter‐ and intra‐observer reliability in CTG interpretation.
Low-Rank Tensor Decomposition-Aided Channel Estimation for Millimeter Wave MIMO-OFDM Systems

We consider the problem of downlink channel estimation for millimeter wave (mmWave) MIMO-OFDM systems, where both the base station (BS) and the mobile station (MS) employ large antenna arrays for directional precoding/beamforming. Hybrid analog and digital beamforming structures are employed in order to offer a compromise between hardware complexity and system performance. Different from most existing studies that are concerned with narrowband channels, we consider estimation of wideband mmWave channels with frequency selectivity, which is more appropriate for mmWave MIMO-OFDM systems. By exploiting the sparse scattering nature of mmWave channels, we propose a CANDECOMP/PARAFAC (CP) decomposition-based method for channel parameter estimation (including angles of arrival/departure, time delays, and fading coefficients). In our proposed method, the received signal at the MS is expressed as a third-order tensor. We show that the tensor has the form of a low-rank CP, and the channel parameters can be estimated from the associated factor matrices. Our analysis reveals that the uniqueness of the CP decomposition can be guaranteed even when the size of the tensor is small. Hence the proposed method has the potential to achieve substantial training overhead reduction. We also develop Cramér-Rao bound (CRB) results for channel parameters and compare our proposed method with a compressed sensing-based method. Simulation results show that the proposed method attains mean square errors that are very close to their associated CRBs and present a clear advantage over the compressed sensing-based method.
Sexually transmitted infections in the military: new challenges for an old problem

The report by Harbertson et al 1 in this journal addresses sexually transmitted infections (STIs) and sexual behaviours in US Service Members. The authors documented STIs as a current problem in shipboard personnel and highlighted evolving military sexual networks that must be evaluated and understood if STI prevention and control programmes are to be effective.1 During 2012–2014, Harbertson et al collected questionnaire data on 2453 members of the US Navy and Marine Corps who were deployed on ships to describe them demographically, define their risk behaviours for STIs and ascertain their STI histories. Their results revealed a population with an average age of 26 years, with 10% reporting a history of an STI sometime prior to deployment.1 The last time a similar shipboard questionnaire study of US Service Members was published was 1993.1 ,2 In the earlier study, Malone et al 2 evaluated 1755 Sailors and Marines with a mean age of 23 years, and 22% reported ever having had an STI. The Harbertson and Malone studies are similar in that both used questionnaires to assess STIs and risk factors for acquiring STIs in Service Members deployed on ships.1 ,2 The dissimilarities are striking and important. Malone studied only men; 21% of Harbertson’s group were women.1 ,2 (Deployment of women on US Navy combatant ships began in 1994.3) Harbertson noted that women now comprise ∼17% of shipboard crews.1 Malone's study focused on risk factors for STIs following the historical paradigm of a military consisting …
Clinical significance and molecular characteristics of circulating tumor cells and circulating tumor microemboli in patients with small-cell lung cancer.

PURPOSE Circulating tumor cells (CTCs) may have utility as surrogate biomarkers and "virtual" biopsies. We report the clinical significance and molecular characteristics of CTCs and CTC clusters, termed circulating tumor microemboli (CTM), detected in patients with small-cell lung cancer (SCLC) undergoing standard treatment. PATIENTS AND METHODS Serial blood samples from 97 patients receiving chemotherapy were analyzed using EpCam-based immunomagnetic detection and a filtration-based technique. Proliferation status (Ki67) and apoptotic morphology were examined. Associations of CTC and CTM number with clinical factors and prognosis were determined. RESULTS CTCs were present in 85% of patients (77 of 97 patients) and were abundant (mean ± standard deviation = 1,589 ± 5,565). CTM and apoptotic CTCs were correlated with total CTC number and were detected in 32% and 57% of patients, respectively. Pretreatment CTCs, change in CTC number after one cycle of chemotherapy, CTM, and apoptotic CTCs were independent prognostic factors. Overall survival was 5.4 months for patients with ≥ 50 CTCs/7.5 mL of blood and 11.5 months (P < .0001) for patients with less than 50 CTCs/7.5 mL of blood before chemotherapy (hazard ratio = 2.45; 95% CI, 1.39 to 4.30; P = .002). Subpopulations of apoptotic and of proliferating solitary CTCs were detected, whereas neither were observed within cell clusters (CTM), implicating both protection from anoikis and relative resistance to cytotoxic drugs for cells within CTM. CONCLUSION Both baseline CTC number and change in CTC number after one cycle of chemotherapy are independent prognostic factors for SCLC. Molecular comparison of CTCs to cells in CTM may provide novel insights into SCLC biology.
Relative abundance of EGFR mutations predicts benefit from gefitinib treatment for advanced non-small-cell lung cancer.

PURPOSE Our aim was to determine whether abundance of epidermal growth factor receptor (EGFR) mutations in tumors predicts benefit from treatment with EGFR-tyrosine kinase inhibitors (TKIs) for advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS We detected EGFR mutations in 100 lung cancer samples using direct DNA sequencing and amplification refractory mutation system (ARMS). Mutation-positive tumors by both methods carried high abundance of EGFR mutations. Tumors that were mutation positive by ARMS but mutation negative by direct DNA sequencing harbored low abundance of EGFR mutations. Mutation-negative tumors by both methods carried wild-type EGFR. All patients received gefitinib treatment. The correlation between EGFR mutation abundance and clinical benefit from gefitinib treatment was analyzed. RESULTS Of 100 samples, 51 and 18 harbored high and low abundances of EGFR mutations, respectively; 31 carried wild-type EGFR. Median progression-free survival (PFS) was 11.3 (95% CI, 7.4 to 15.2) and 6.9 months (95% CI, 5.5 to 8.4) in patients with high and low abundances of EGFR mutations, respectively (P = .014). Median PFS of patients with low abundance of EGFR mutations was significantly longer than that of those with wild-type tumors (2.1 months; 95% CI, 1.0 to 3.2; P = .010). Objective response rates (ORRs) were 62.7%, 44.4%, and 16.1%, and overall survival (OS) rates were 15.9 (95% CI, 13.4 to 18.3), 10.9 (95% CI, 2.7 to 19.1), and 8.7 months (95% CI, 4.6 to 12.7) for patients with high abundance of EGFR mutations, low abundance of EGFR mutations, and wild-type EGFR, respectively. The difference between patients with high and low abundances of EGFR mutations was not significant regarding ORR and OS. CONCLUSION The relative EGFR mutation abundance could predict benefit from EGFR-TKI treatment for advanced NSCLC.
Variability of lung tumor measurements on repeat computed tomography scans taken within 15 minutes.

PURPOSE We use changes in tumor measurements to assess response and progression, both in routine care and as the primary objective of clinical trials. However, the variability of computed tomography (CT) -based tumor measurement has not been comprehensively evaluated. In this study, we assess the variability of lung tumor measurement using repeat CT scans performed within 15 minutes of each other and discuss the implications of this variability in a clinical context. PATIENTS AND METHODS Patients with non-small-cell lung cancer and a target lung lesion ≥ 1 cm consented to undergo two CT scans within a period of minutes. Three experienced radiologists measured the diameter of the target lesion on the two scans in a side-by-side fashion, and differences were compared. RESULTS Fifty-seven percent of changes exceeded 1 mm in magnitude, and 33% of changes exceeded 2 mm. Median increase and decrease in tumor measurements were +4.3% and -4.2%, respectively, and ranged from 23% shrinkage to 31% growth. Measurement changes were within ± 10% for 84% of measurements, whereas 3% met criteria for progression according to Response Evaluation Criteria in Solid Tumors (RECIST; ≥ 20% increase). Smaller lesions had greater variability of percent measurement change (P = .005). CONCLUSION Apparent changes in tumor diameter exceeding 1 to 2 mm are common on immediate reimaging. Increases and decreases less than 10% can be a result of the inherent variability of reimaging. Caution should be exercised in interpreting the significance of small changes in lesion size in the care of individual patients and in the interpretation of clinical trial results.
Adjuvant tamoxifen reduces subsequent breast cancer in women with estrogen receptor-positive ductal carcinoma in situ: a study based on NSABP protocol B-24.

PURPOSE The NSABP (National Surgical Adjuvant Breast and Bowel Project) B-24 study demonstrated significant benefit with adjuvant tamoxifen in patients with ductal carcinoma in situ (DCIS) after lumpectomy and radiation. Patients were enrolled without knowledge of hormone receptor status. The current study retrospectively evaluated the relationship between receptors and response to tamoxifen. PATIENTS AND METHODS Estrogen (ER) and progesterone receptors (PgR) were evaluated in 732 patients with DCIS (41% of original study population). An experienced central laboratory determined receptor status in all patient cases with available paraffin blocks (n = 449) by immunohistochemistry (IHC) using comprehensively validated assays. Results for additional patients (n = 283) determined by various methods (primarily IHC) were available from enrolling institutions. Combined results were evaluated for benefit of tamoxifen by receptor status at 10 years and overall follow-up (median, 14.5 years). RESULTS ER was positive in 76% of patients. Patients with ER-positive DCIS treated with tamoxifen (v placebo) showed significant decreases in subsequent breast cancer at 10 years (hazard ratio [HR], 0.49; P < .001) and overall follow-up (HR, 0.60; P = .003), which remained significant in multivariable analysis (overall HR, 0.64; P = .003). Results were similar, but less significant, when subsequent ipsilateral and contralateral, invasive and noninvasive, breast cancers were considered separately. No significant benefit was observed in ER-negative DCIS. PgR and either receptor were positive in 66% and 79% of patients, respectively, and in general, neither was more predictive than ER alone. CONCLUSION Patients in NSABP B-24 with ER-positive DCIS receiving adjuvant tamoxifen after standard therapy showed significant reductions in subsequent breast cancer. The use of adjuvant tamoxifen should be considered for patients with DCIS.
Consciência da doença na demência: resultados preliminares em pacientes com doença de Alzheimer leve e moderada

OBJECTIVE: To evaluate the presence and the level of awareness of disease in mild and moderate Alzheimer's disease (AD). METHOD: Cross-sectional evaluation of patients with mild/moderate AD (n=42) assessed by Assessment of Psychosocial Impact of the Dementia Diagnosis (APSID), Mini-mental State Examination (MMSE) and Clinical Dementia Rating Scale (CDR). RESULTS: Awareness of disease and its consequences were present in 66.7% patients with mild AD (n=18). In moderate AD (n=24), 20.8% presented total awareness, 45.8% presented only awareness of cognitive symptoms. Unawareness of disease was observed in 33.3%. CONCLUSIONS: The present data show association between awareness and level of severity of disease. CDR 1 patients show a better recognition of cognitive and daily life activity symptoms, whereas CDR 2 patients recognized their cognitive symptoms but failed to appraise their severity and consequences in daily life activities.
Anti‐oxidant vitamins and mental performance of the elderly

A double‐blind placebo controlled trial was carried out to examine the effects of supplementation with anti‐oxidant vitamins on mental performance in the elderly. The participants were assigned to either placebo or vitamin groups and assessed at 4, 8 and 12 months. Blood samples were taken to determine vitamin levels at these times. The results showed little effect of supplementation on mental performance and few associations between plasma levels of the vitamins and mental functioning. These results are in contrast to results from assessment of mood, intelligence and cognitive failure which demonstrated beneficial effects of increased levels of vitamin C. Copyright © 1999 John Wiley & Sons, Ltd.
‘I wanted to safeguard the baby’: a qualitative study to understand the experiences of Option B+ for pregnant women and the potential implications for ‘test-and-treat’ in four sub-Saharan African settings

Objective To explore what influences on engagement with Option B+ in four sub-Saharan African settings. Methods In-depth interviews were conducted in 2015, with 22 HIV-positive women who had been pregnant since Option B+ was available, and 15 healthcare workers (HCWs) involved in HIV service delivery. Participants were purposely selected from four health and demographic surveillance sites in Malawi, Tanzania and Uganda. A thematic content analysis was conducted to investigate what influenced engagement with Option B+. Results Feeling ‘ready’ was key to pregnant women accepting antiretroviral treatment (ART) on the same day as diagnosis at antenatal clinic; this was influenced by previous knowledge of HIV-positive status, interactions with HCWs and relationship with their partners. The desire to protect their unborn infant was the main issue that motivated women to initiate treatment, temporarily over-riding barriers to starting ART. Many HCWs recognised that pressurising women into starting ART may lead them to stop treatment following delivery. However, their own responsibility to protect the infant sometimes drove HCWs to use strong persuasive techniques to initiate pregnant women onto ART as early as possible, occasionally causing women to disengage. Conclusions Protecting the baby superseded feelings of unpreparedness for lifelong ART and may explain poor retention observed in Option B+ programmes. Women may benefit from more time to accept their status, and counselling on the long-term value of ART beyond the pregnancy and breastfeeding period. Strategies to promote readiness for same-day initiation of lifelong treatment are urgently needed, and may provide important lessons for universal test-and-treat implementation.
A Floating-Gate-Based Field-Programmable Analog Array

A field-programmable analog array (FPAA) with 32 computational analog blocks (CABs) and occupying 3 × 3 mm2 in 0.35-μm CMOS is presented. Each CAB has a wide variety of subcircuits ranging in granularity from multipliers and programmable offset wide-linear-range Gm blocks to nMOS and pMOS transistors. The programmable interconnects and circuit elements in the CAB are implemented using floating-gate (FG) transistors, the total number of which exceeds fifty thousand. Using FG devices eliminates the need for SRAM to store configuration bits since the switch stores its own configuration. This system exhibits significant performance enhancements over its predecessor in terms of achievable dynamic range (> 9 b of FG voltage) and speed (≈ 20 gates/s) of accurate FG current programming and isolation between ON and OFF switches. An improved routing fabric has been designed that includes nearest neighbor connections to minimize the penalty on bandwidth due to routing parasitic. A maximum bandwidth of 57 MHz through the switch matrix and around 5 MHz for a first-order low-pass filter is achievable on this chip, the limitation being a “program” mode switch that will be rectified in the next chip. Programming performance improved drastically by implementing the entire algorithm on-chip with an SPI digital interface. Measured results of the individual subcircuits and two system examples including an AM receiver and a speech processor are presented.
Wilms tumors arising at young age: a genetic basis to distinguish subgroups for individualized therapy.

TO THE EDITOR: We read with interest the report by Perlman et al that WT1 mutations and 11p15 loss of heterozygosity predict a relapse risk in children with very low–risk Wilms tumors (VLRWTs) treated with surgery alone. VLRWT is defined as a stage I Wilms tumor (WT) occurring in patients younger than 24 months of age and having a tumor volume less than 550 g. The authors confirm in this study that WTs in children younger than 24 months have a higher frequency of WT1 mutations, as was described by us and by other authors previously. Our study included only patients with constitutional mutations in WT1 and confirmed Knudson’s two-hit hypothesis, which states that patients with constitutional mutations have a younger age of onset and more often develop bilateral tumors. In our long-term follow-up of 19 patients from International Society of Pediatric Oncology Study 9/German Society of Pediatric Oncology (SIOP9/GPOH) with WT1 mutations, we have observed that 16 of these mutations were present in the germ line. Unfortunately, Perlman et al have not addressed this important question, because they have analyzed tumor material only, although constitutional DNA was available for loss of heterozygosity studies. This is important, because it is not surprising that patients with germline mutations have a higher risk of developing metachronous tumors. In addition, we have shown previously that the four tumors occurring in one patient were independent tumors. It is, therefore, an interesting question—whether local relapses in patients with constitutional mutations are frequently new independent tumors instead of recurrences. Deduced from this, the higher risk for relapse might be explained by the presence of constitutional mutations in WT1. In the study of Perlman et al, nine patients with VLRWT had a WT1 mutation, and five experienced relapse (four, pulmonary metastasis; one, local relapse). It is interesting to compare the results from patients with WT1 mutations and surgery alone with those from our study, in which patients with WT1 mutant were treated with chemotherapy. A comparison of the results is shown in Table 1. It can be seen that, in our study, the relapse rate of patients with or without WT1 is not significantly different when patients are treated according to the
A 530 Mpixels/s 4096x2160@60fps H.264/AVC High Profile Video Decoder Chip

The increased resolution of Quad Full High Definition (QFHD) offers significantly enhanced visual experience. However, the corresponding huge data throughput of up to 530 Mpixels/s greatly challenges the design of real-time video decoder VLSI with the extensive requirement on both DRAM bandwidth and computational power. In this work, a lossless frame recompression technique and a partial MB reordering scheme are proposed to save the DRAM access of a QFHD video decoder chip. Besides, pipelining and parallelization techniques such as NAL/slice-parallel entropy decoding are implemented to efficiently enhance its computational power. The chip supporting H.264/AVC high profile is fabricated in 90 nm CMOS and verified. It delivers a maximum throughput of 4096×2160@60fps, which is at least 4.3 times higher than the state-of-the-art. DRAM bandwidth requirement is reduced by typically 51%, which fits the design into a 64-bit LPDDR SDRAM interface and results in 58% DRAM power saving. Meanwhile, the core energy is saved by 54% by pipelining and parallelization.