Miracle-dz/UniFAR-FTUs huggingface dataset:
Cellulitis and Abscess Caused by Aeromonas hydrophila: A Case Report

Skin and soft tissue infections are most commonly caused by staphylococci or streptococci. Rarely, they can develop due to bacteria of the genus Aeromonas after contact with contaminated water and soil following trauma. A 75-year-old female diabetic patient applied to the infectious diseases outpatient clinic with complaints of swelling, pain, redness, tenderness, erythema and warmth in her lower leg. The patient had a skin deformity as a result of a previous traffic accident and she had gone to thermal springs 2 weeks before. Streaking suggestive of lymphangitis, redness, bullous lesions and right lower extremity edema were noted. Leukocyte count was 18 300/μL (87% neutrophils), C-reactive protein was 26.1 mg/dL, erythrocyte sedimentation rate was 57 mm/h, hemoglobin was 10.3 mg/dL, and albumin was 2.3 gr/dL. Vascular pathology was not detected in the lower extremity venous Doppler examination. In superficial soft tissue ultrasonography examination, diffuse thickening of skin and subcutaneous area, 3×5 cm diameter small fluid collection defined as cellulitis and abscess in the lower right leg were observed. On the second day of admission, Aeromonas hydrophila was isolated from the drainage culture of abscess. Isolated strain was resistant to penicillin, ampicillin and cefazolin, and susceptible to trimethoprim-sulfamethoxazole, ciprofloxacin and secondand third-generation cephalosporins. She was treated with ciprofloxacin 400 mg IV bid and ceftriaxone 2 gr IV qd, and treatment was completed to 14 days. She was discharged from the hospital 16 days after admission with recovery. As noted in this case study, the cellulitis in the setting of soft tissue trauma and exposure to water and soil should alert the clinician regarding the possibility of infection with Aeromonas. Klimik Dergisi 2019; 32(1): 99-101.
From Triangulation to Simplex Mesh : a Simple and Efficient Transformation

In the field of 3D images, relevant information can be difficult to interpret without further computer-aided processing. Generally, and this is particularly true in medical imaging, a segmentation process is run and coupled with a visualization of the delineated structures to help understanding the underlying information. To achieve the extraction of the boundary structures, deformable models are frequently used tools. Amongst all techniques, Simplex Meshes are valuable models thanks to their good propensity to handle a large variety of shape alterations altogether with a fine resolution and stability. However, despite all these great characteristics, Simplex Meshes are lacking to cope satisfyingly with other related tasks, as rendering, mechanical simulation or reconstruction from iso-surfaces. As a consequence, Triangulation Meshes are often preferred. In order to face this problem, we propose an accurate method to shift from a model to another, and conversely. For this, we are taking advantage of the fact that triangulation and simplex meshes are topologically duals, turning it into a natural swap between these two models. A difficulty arise as they are not geometrically equivalent, leading to loss of information and to geometry deterioration whenever a transformation between these dual meshes takes place. Therefore, some effort as to be carried out to minimizing the shape degradation using an appropriate interpolation to find the position of the vertices in the dual mesh. An accurate and effective transformation technique is described in this paper, where we present a direct method to perform an interpolation of a simplex mesh to obtain its dual, and/or vice-versa. This original method is based on the distance minimization between the tangent planes of the mesh and vertices of each face. Finally, probing resulting mesh shiftings in both directions are commented.
Interactively Exploring Hierarchical Clustering Results

To date, work in microarrays, sequenced genomes and bioinformatics has focused largely on algorithmic methods for processing and manipulating vast biological data sets. Future improvements will likely provide users with guidance in selecting the most appropriate algorithms and metrics for identifying meaningful clusters-interesting patterns in large data sets, such as groups of genes with similar profiles. Hierarchical clustering has been shown to be effective in microarray data analysis for identifying genes with similar profiles and thus possibly with similar functions. Users also need an efficient visualization tool, however, to facilitate pattern extraction from microarray data sets. The Hierarchical Clustering Explorer integrates four interactive features to provide information visualization techniques that allow users to control the processes and interact with the results. Thus, hybrid approaches that combine powerful algorithms with interactive visualization tools will join the strengths of fast processors with the detailed understanding of domain experts.
Optimal DAPT duration: Each in their own time

Meta-analysis of randomized trials shows no significant difference in major adverse cardiovascular events between shorter (3–6 months) and longer (12–24 months) durations of clopidogrel-based dual antiplatelet therapy (DAPT) after drug eluting stent (DES) implantation. Shorter durations (6 months) of DAPT should be considered in lower risk patients undergoing DES implantation in current practice. Further research should define the optimal agents and duration of DAPT after percutaneous coronary intervention based on patient specific factors.
Fault detection based on Lyapunov exponents estimation for stabilized mechanical systems

We study a stabilizable mechanical system in the vicinity of an equilibrium position. This position, as a rule, is unstable, and the system is underactuated. It is assumed that faults affect the technical process and its control. We suggest a fault diagnosis technique based on estimation of Lyapunov characteristic exponents of measured variables. A model of a linear switching system is involved for the system with faults description, and a common quadratic Lyapunov function is used to evaluate the deviation of the maximum exponent with respect to the default system. A scheme of fault magnitude estimation is suggested related to the degree of this deviation. An example of a 2-degree of freedom system is presented to illustrate the procedure.
Draft Genome Sequence of a Salmonella enterica subsp. enterica Serovar Gallinarum bv. Gallinarum Isolate Associated with Fowl Typhoid Outbreaks in Brazil

ABSTRACT Salmonella enterica subsp. enterica serovar Gallinarum bv. Gallinarum strains are bird pathogens causing fowl typhoid (FT). Isolate BR_RS12 was obtained from a poultry flock with FT in 2014. The sequencing of this genome will enable to track the origin of the recent outbreaks in Brazil.
Strategies through the lifecourse to improve maternal, newborn, child, and adolescent health

Since the formation of WHO in the 1940s, global and national programmes have used ‘maternal and child health’ (MCH) as the foundation. However, over subsequent decades specific aspects have been neglected, notably newborns, stillbirths, and adolescents. Adopting a lifecycle approach brings attention to these target populations, with a shift from MCH to RMNCH+A (reproductive, maternal, newborn, child health, and adolescents). Two thirds of maternal, newborn, and child deaths could be prevented with essential, integrated packages of care. These interventions should be connected through time (across the life course) and place (across different levels of care from communities to facilities, and different types of care including preventive, curative, and palliative care). This enhances cost-effectiveness, uptake of services and health promotion, and is a concept known as the ‘continuum of care’.
Identification of a novel mutation in the arginine vasopressin-neurophysin II gene affecting the sixth intrachain disulfide bridge of the neurophysin II moiety.

OBJECTIVE Most mutations of the arginine vasopressin-neurophysin II (AVP-NPII) gene cause autosomal dominant familial neurohypophyseal diabetes insipidus (adFNDI). Such mutations are predicted to alter the three-dimensional structure of the prohormone, which accumulates in the cell body, ultimately leading to neuronal degeneration and hormonal deficit. In this study we describe the case of a 26-year-old female reporting a long-lasting history of polyuria/polydipsia. The father of the patient was affected by diabetes insipidus and was under desmopressin treatment until the time of his death. Nevertheless, the patient had never been subjected to endocrine evaluation. DESIGN AND METHODS Clinical and genetic studies were performed. An 8-h fluid deprivation test plus desmopressin challenge and a 5% saline solution test were performed, in order to confirm the diagnosis. DNA was extracted from peripheral blood lymphocytes and subjected to direct sequencing of the entire coding region of the AVP-NPII gene. RESULTS AND CONCLUSIONS Clinical assessment of the patient confirmed the diagnosis of neurohypophyseal diabetes insipidus. Desmopressin treatment was started, which effectively reversed the polyuria/ polydipsia syndrome. Genetic analysis revealed a novel mutation (1665T>A) in exon 2 of the AVP-NPII gene, disrupting one of the disulfide bonds present in the NPII moiety which play a fundamental role in determining the proper folding of the molecule. In summary, in the present study we have described a novel mutation of the AVP-NPII gene, which is consistent with the malfolding/toxicity hypothesis underlying the pathogenesis of adFNDI.
Role of germline aberrations affecting CTNNA1, MAP3K6 and MYD88 in gastric cancer susceptibility

Background In approximately 10% of all gastric cancer (GC) cases, a heritable cause is suspected. A subset of these cases have a causative germline CDH1 mutation; however, in most cases the cause remains unknown. Our objective was to assess to what extent these remaining cases may be explained by germline mutations in the novel candidate GC predisposing genes CTNNA1, MAP3K6 or MYD88. Methods We sequenced a large cohort of unexplained young and/or familial patients with GC (n=286) without a CDH1germline mutation for germline variants affecting CTNNA1, MAP3K6 and MYD88 using a targeted next-generation sequencing approach based on single-molecule molecular inversion probes. Results Predicted deleterious germline variants were not encountered in MYD88, but recurrently observed in CTNNA1 (n=2) and MAP3K6 (n=3) in our cohort of patients with GC. In contrast to deleterious variants in CTNNA1, deleterious variants in MAP3K6 also occur frequently in the general population. Conclusions Based on our results MAP3K6 should no longer be considered a GC predisposition gene, whereas deleterious CTNNA1 variants are confirmed as an infrequent cause of GC susceptibility. Biallelic MYD88 germline mutations are at most a very rare cause of GC susceptibility as no additional cases were identified.
Abnormal Ca2+ homeostasis, atrial arrhythmogenesis, and sinus node dysfunction in murine hearts modeling RyR2 modification

Ryanodine receptor type 2 (RyR2) mutations are implicated in catecholaminergic polymorphic ventricular tachycardia (CPVT) thought to result from altered myocyte Ca2+ homeostasis reflecting inappropriate “leakiness” of RyR2-Ca2+ release channels arising from increases in their basal activity, alterations in their phosphorylation, or defective interactions with other molecules or ions. The latter include calstabin, calsequestrin-2, Mg2+, and extraluminal or intraluminal Ca2+. Recent clinical studies additionally associate RyR2 abnormalities with atrial arrhythmias including atrial tachycardia (AT), fibrillation (AF), and standstill, and sinus node dysfunction (SND). Some RyR2 mutations associated with CPVT in mouse models also show such arrhythmias that similarly correlate with altered Ca2+ homeostasis. Some examples show evidence for increased Ca2+/calmodulin-dependent protein kinase II (CaMKII) phosphorylation of RyR2. A homozygotic RyR2-P2328S variant demonstrates potential arrhythmic substrate resulting from reduced conduction velocity (CV) in addition to delayed afterdepolarizations (DADs) and ectopic action potential (AP) firing. Finally, one model with an increased RyR2 activity in the sino-atrial node (SAN) shows decreased automaticity in the presence of Ca2+-dependent decreases in ICa, L and diastolic sarcoplasmic reticular (SR) Ca2+ depletion.
Exercise for People in Early- or Mid-Stage Parkinson Disease: A 16-Month Randomized Controlled Trial

Background Exercise confers short-term benefits for individuals with Parkinson disease (PD). Objective The purpose of the study was to compare short- and long-term responses among 2 supervised exercise programs and a home-based control exercise program. Design The 16-month randomized controlled exercise intervention investigated 3 exercise approaches: flexibility/balance/function exercise (FBF), supervised aerobic exercise (AE), and home-based exercise (control). Setting This study was conducted in outpatient clinics. Patients The participants were 121 individuals with PD (Hoehn & Yahr stages 1–3). Interventions The FBF program (individualized spinal and extremity flexibility exercises followed by group balance/functional training) was supervised by a physical therapist. The AE program (using a treadmill, bike, or elliptical trainer) was supervised by an exercise trainer. Supervision was provided 3 days per week for 4 months, and then monthly (16 months total). The control group participants exercised at home using the National Parkinson Foundation Fitness Counts program, with 1 supervised, clinic-based group session per month. Measurements Outcomes, obtained by blinded assessors, were determined at 4, 10, and 16 months. The primary outcome measures were overall physical function (Continuous Scale—Physical Functional Performance [CS-PFP]), balance (Functional Reach Test [FRT]), and walking economy (oxygen uptake [mL/kg/min]). Secondary outcome measures were symptom severity (Unified Parkinson's Disease Rating Scale [UPDRS] activities of daily living [ADL] and motor subscales) and quality of life (39-item Parkinson's Disease Quality of Life Scale [PDQ-39]). Results Of the 121 participants, 86.8%, 82.6%, and 79.3% completed 4, 10, and 16 months, respectively, of the intervention. At 4 months, improvement in CS-PFP scores was greater in the FBF group than in the control group (mean difference=4.3, 95% confidence interval [CI]=1.2 to 7.3) and the AE group (mean difference=3.1, 95% CI=0.0 to 6.2). Balance was not different among groups at any time point. Walking economy improved in the AE group compared with the FBF group at 4 months (mean difference=−1.2, 95% CI=−1.9 to −0.5), 10 months (mean difference=−1.2, 95% CI=−1.9 to −0.5), and 16 months (mean difference=−1.7, 95% CI=−2.5 to −1.0). The only secondary outcome that showed significant differences was UPDRS ADL subscale scores: the FBF group performed better than the control group at 4 months (mean difference=−1.47, 95% CI=−2.79 to −0.15) and 16 months (mean difference=−1.95, 95% CI=−3.84 to −0.08). Limitations Absence of a non-exercise control group was a limitation of the study. Conclusions Findings demonstrated overall functional benefits at 4 months in the FBF group and improved walking economy (up to 16 months) in the AE group.
Efficient design and implementation of LTE UE link-layer protocol stack

3GPP Long Term Evolution (LTE) and its enhancement has become the main candidate of 4G standards. Due to the requirements on high data rate and low latency for broadband wireless communication systems, LTE air-interface protocol stack must be designed and implemented with high data processing efficiency. Following a general description of the LTE user equipment (TIE), this paper analyzes the main challenges in the link-layer protocol stack design and implementation, including the data processing efficiency, synchronization, flexibility and portability. A reference design of LTE TIE link-layer protocol stack software is then presented with several design methodologies. A memory access optimization and light-weighted thread model are proposed to improve the data processing efficiency, while a hardware triggered synchronization mechanism is exploited to maintain synchronous between the link-layer protocol stack and the physical layer. Finally, the platform flexibility and portability is achieved by employing interface abstraction and adapters. Extensive system level testing shows that the proposed LTE TIE protocol stack software achieves high data rate and low data processing latency in a hardware resource restricted platform, which can be further extended to commercial LTE TIE products.
ICF-CY code set for infants with early delay and disabilities (EDD Code Set) for interdisciplinary assessment: a global experts survey

Abstract Purpose: Comprehensive description of functioning is important in providing early intervention services for infants with developmental delay/disabilities (DD). A code set of the International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY) could facilitate the practical use of the ICF-CY in team evaluation. The purpose of this study was to derive an ICF-CY code set for infants under three years of age with early delay and disabilities (EDD Code Set) for initial team evaluation. Methods: The EDD Code Set based on the ICF-CY was developed on the basis of a Delphi survey of international professionals experienced in implementing the ICF-CY and professionals in early intervention service system in Taiwan. Results: Twenty-five professionals completed the Delphi survey. A total of 82 ICF-CY second-level categories were identified for the EDD Code Set, including 28 categories from the domain Activities and Participation, 29 from body functions, 10 from body structures and 15 from environmental factors. Conclusions: The EDD Code Set of 82 ICF-CY categories could be useful in multidisciplinary team evaluations to describe functioning of infants younger than three years of age with DD, in a holistic manner. Future validation of the EDD Code Set and examination of its clinical utility are needed. Implications for Rehabilitation The EDD Code Set with 82 essential ICF-CY categories could be useful in the initial team evaluation as a common language to describe functioning of infants less than three years of age with developmental delay/disabilities, with a more holistic view. The EDD Code Set including essential categories in activities and participation, body functions, body structures and environmental factors could be used to create a functional profile for each infant with special needs and to clarify the interaction of child and environment accounting for the child's functioning.
Practice guidelines for the management of bacterial meningitis.

Allan R. Tunkel, Barry J. Hartman, Sheldon L. Kaplan, Bruce A. Kaufman, Karen L. Roos, W. Michael Scheld, and Richard J. Whitley Drexel University College of Medicine, Philadelphia, Pennsylvania; Weill Cornell Medical Center, New York, New York; Baylor College of Medicine, Houston, Texas; Medical College of Wisconsin, Milwaukee; Indiana University School of Medicine, Indianapolis; University of Virginia School of Medicine, Charlottesville; and University of Alabama at Birmingham
A programmable digital pulse width modulator providing versatile pulse patterns and supporting switching frequencies beyond 15 MHz

This paper describes the implementation of a novel and highly versatile digital pulse width modulator (DPWM) -probably the most critical component in any digitally controlled switching power converter. Its new architecture, composed of a delay-locked loop (DLL) and programmable DPWM module, allows the generation of high resolution, high switching frequency (f/sub m/) PWM signals. The DPWM IC was designed using a standard 0.35-/spl mu/m CMOS process and supports switching frequencies beyond 15 MHz.
Control en lazo cerrado de un Inversor Multinivel Alimentado en Corriente

Los inversores tiene como finalidad la conversion de energia electrica de tipo directa a una de tipo alterna, donde la capacidad del manejo de potencia en topologias tradicionales se ve limitada por la capacidad de los dispositivos de conmutacion empleados, las topologias de inversores multinivel pueden manejar mayor potencia ya que su principal ventaja es que dividen los esfuerzos de tension y corriente de los dispositivos de conmutacion, ademas de que a mayor cantidad de niveles los requerimientos se filtrado para la salida se ven reducidos. Por ello aun son interes de estudio enfocado en: variantes a las estructuras basicas y nuevas tecnicas de modulacion o esquemas de control [1-2]. Existen dos tipos de alimentacion para las topologias multinivel: alimentados en tension o voltaje y alimentados en corriente. Dentro de las estructuras basicas alimentadas en voltaje se encuentran: diodo fijador,capacitor flotado y cascada [3]. Mientras que dentro de las topologias multinivel alimentadas en corriente se tienen: multi-celdas, o etapas con entrada elevadora. En este articulo se describen brevemente algunas topologias de inversor multinivel alimentado en corriente y su tecnica de modulacion, posteriormente se describe con mayor profundidad el funcionamiento de una topologia en particular asi como la descripcion del control empleado para la regulacion de la corriente de salida.
Neurodevelopmental Outcomes After Neonatal Surgery for Major Noncardiac Anomalies

CONTEXT: Increasing concerns have been raised about the incidence of neurodevelopmental delay in children with noncardiac congenital anomalies (NCCA) requiring neonatal surgery. OBJECTIVE: This study aimed to determine the incidence and potential risk factors for developmental delay after neonatal surgery for major NCCA. DATA SOURCES: A systematic search in PubMed, Embase and the Cochrane Library was performed through March 2015. STUDY SELECTION: Original research articles on standardized cognitive or motor skills tests. DATA EXTRACTION: Data on neurodevelopmental outcome, the Bayley Scales of Infant Development, and risk factors for delay were extracted. RESULTS: In total, 23 eligible studies were included, reporting on 895 children. Meta-analysis was performed with data of 511 children, assessed by the Bayley Scales of Infant Development at 12 and 24 months of age. Delay in cognitive development was reported in a median of 23% (3%–56%). Meta-analysis showed a cognitive score of 0.5 SD below the population average (Mental Development Index 92 ± 13, mean ± SD; P < .001). Motor development was delayed in 25% (0%–77%). Meta-analysis showed a motor score of 0.6 SD below average (Psychomotor Development Index 91 ± 14; P < .001). Several of these studies report risk factors for psychomotor delay, including low birth weight, a higher number of congenital anomalies, duration of hospital admission, and repeated surgery. LIMITATIONS: All data were retrieved from studies with small sample sizes and various congenital anomalies using different neurodevelopmental assessment tools. CONCLUSIONS: Cognitive and motor developmental delay was found in 23% of patients with NCCA. Meta-analysis showed that the mean neurodevelopmental outcome scores were 0.5 SD below the normative score of the healthy population.
Neurofibromatosis-related phaeochromocytoma: two cases with large tumours and elevated plasma methoxytyramine

Summary We present two cases of adrenal phaeochromocytoma in patients with a previous diagnosis of neurofibromatosis type 1 (NF1). One had an adrenergic phenotype. The other had a more noradrenergic phenotype. Both had large primary tumours, which increases the likelihood of malignancy. Both also had elevated plasma-free methoxytyramine, which has been linked with malignancy even in non-SDHB phaeochromocytomas. Learning points Phaeochromocytoma can have varied clinical presentations. Methoxytyramine can be useful in the biochemical work-up of both SDHB-positive and SDHB-negative phaeochromocytoma. The utility of methoxytyramine as a marker of malignancy in NF1-related phaeochromocytoma is unclear, and cases with elevated titres warrant longer follow-up.