Miracle-dz/UniFAR-FTUs huggingface dataset:
Combined Use of Delamanid and Bedaquiline to Treat Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis: A Systematic Review

The new drugs delamanid and bedaquiline are increasingly being used to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB). The World Health Organization, based on lack of evidence, recommends their use under specific conditions and not in combination. No systematic review has yet evaluated the efficacy, safety, and tolerability of delamanid and bedaquiline used in combination. A search of peer-reviewed, scientific evidence was carried out, aimed at evaluating the efficacy/effectiveness, safety, and tolerability of delamanid and bedaquiline-containing regimens in individuals with pulmonary/extrapulmonary disease, which were bacteriologically confirmed as M/XDR-TB. We used PubMed to identify any relevant manuscripts in English up to the 23 December 2016, excluding editorials and reviews. Three out of 75 manuscripts retrieved satisfied the inclusion criteria, whilst 72 were excluded for dealing with only one drug (three studies), being recommendations (one study) or identifying need for their use (one study), focusing on drug resistance aspects (six studies) or being generic reviews/other studies (61 papers). The studies retrieved reported two XDR-TB cases observed for six months and achieving consistent sputum smear and culture conversion. Case 2 experienced a short break of bedaquiline, which was re-started after introducing verapamil. After a transient and symptom-free increase of the QT interval from week 5 to 17, it then decreased below the 500 ms threshold.
A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial of Endoscopic Steroid Injection Therapy for Recalcitrant Esophageal Peptic Strictures

BACKGROUND AND AIMS:The aim of the study was to examine whether endoscopic intralesional corticosteroid injection into recalcitrant peptic esophageal strictures reduces the need for repeat stricture dilation.METHODS:Patients with a peptic esophageal stricture and recurrent dysphagia having had at least one dilation in the preceding 18 months were enrolled in a prospective randomized, double-blind study comparing steroid and sham injection. After endoscopic confirmation of recurrent stricture, patients were randomized to receive either 0.5 cc/quadrant triamcinolone (40 mg/cc) or sham injection into the stricture followed by balloon dilation of the stricture. Patients were stratified by the number of dilations required in the preceding 18 months, severity of dysphagia, the presence of esophagitis, stricture severity, and prior therapy with a proton-pump inhibitor. Patients and their physicians were blinded to the type of intervention received. Baseline dysphagia questionnaires were completed. Post-procedurally all patients were placed on a standardized proton-pump inhibitor regimen and standardized telephone follow-up questionnaires were completed at 1 wk and at 1, 3, 6, 9, and 12 months. The original sample-size calculation of 60 patients could not be met in a timely fashion because of a low incidence of recalcitrant peptic stricture patients.RESULTS:A total of 30 patients were enrolled, 15 in the steroid group (10 men, mean age 66 yr) and 15 in the sham group (11 M, mean age 67 yr). Patients were followed for 1 yr, unless they underwent an antireflux operation or died. Two patients, one per group, died of non-esophageal causes at 1 and 12 months. Four patients had fundoplication, two in each group, unrelated to stricture or dysphagia. Two patients in the steroid group (13%) and nine in the sham group (60%) required repeat dilation (p= 0.011). CONCLUSIONS:In patients with recalcitrant peptic esophageal stricture, steroid injection into the stricture combined with acid suppression significantly diminishes both the need for repeat dilation and the average time to repeat dilation compared to sham injection and acid suppression alone.
Cloned receptors and cardiovascular responses to adenosine.

Four subtypes of adenosine receptors have recently been cloned from thyroid, brain and testis. In this review we have summarised properties of these purinergic receptors. The cloned A1 and A2 subtypes are probably similar or identical to receptors that exist on cardiac and vascular tissues, respectively. A comparison of the amino acid sequences of A1, A2a, and A2b receptors reveals several stretches of conserved amino acids that are unique to adenosine receptors, primarily in the membrane spanning regions. Species differences in A1 receptors indicate that minor changes in receptor structure can produce marked changes in ligand binding properties and may facilitate the identification of amino acids involved in ligand recognition. A confusing A1 receptor subclassification system of putative A1a, A1b, and A3 subtypes has emerged based on subtle rank order potency differences for various ligands among tissues. cDNAs corresponding to these A1 subtypes have not yet been isolated. Atrial A1 receptors activate K+ channels and inhibit adenylyl cyclase. These two pathways appear to be independently up and down regulated, suggesting the existence either of atrial A1 receptor subtypes or of differential regulation of the coupling of a single receptor to distinct GTP binding proteins. An adenosine receptor distinct from A1 and A2 receptors has been cloned from testis and designated TGPCR, or A3, although it differs from the pharmacologically defined A3 receptor. We suggest that the current A1/A3 receptor subtype nomenclature be abandoned and superseded by a nomenclature based solely on receptor cDNAs. In addition to the cloned adenosine receptors, a novel A4 subtype has been proposed based on pharmacological and electrophysiological criteria. (ABSTRACT TRUNCATED AT 250 WORDS)
High-intensive focused ultrasound in localized prostate cancer.

BACKGROUND AND PURPOSE The results of the standard treatment for prostate cancer-radical prostatectomy-are not entirely satisfactory. A new local therapy, transrectal high-intensive focused ultrasound (HIFU), has been developed. We reviewed our experience with HIFU for palliation of localized prostate cancer. PATIENTS AND METHODS Our series included 65 men with confirmed prostate cancer without detectable metastases who were not suitable candidates for radical prostatectomy. After prophylactic suprapubic cystostomy, the patients were treated using the Ablatherm version 2.32 under spinal anesthesia. The effects were monitored by serum prostate specific antigen assays, digital rectal examination, and biopsy. The mean follow-up is 10 months (range 1-18 months). RESULTS There were no intraoperative or postoperative deaths, and there have been no deaths from prostate cancer. Residual cancer was detected in 35% of the patients in whom only biopsy-positive portions of the prostate were treated and 17% of those in whom the entire gland was treated. Retreatment was performed 1 month after the first session in these patients. The prostate volume increased an average of 30% after treatment, but by 3 months, the gland was 10% to 20% smaller than its original size. Three patients suffered complications secondary to overheating of the rectal wall or treatment too close to the external urethral sphincter. CONCLUSION The low morbidity, minimal invasiveness, avoidance of systemic side effects, and potentially curative effect make HIFU a potentially useful option for the treatment of localized prostate cancer.
The ‘Double Lung Point’: An Ultrasound Sign Diagnostic of Transient Tachypnea of the Newborn

Background: Transient tachypnea of the newborn (TTN) is a mild form of neonatal respiratory distress which early in its course needs to be differentiated from other severe respiratory disorders. At present the diagnosis is based on radiological findings and clinical course. Lung sonography in TTN has not yet been assessed. Objectives: The aim of the study was to define the ultrasonographic appearance of TTN and evaluate its clinical relevance. Methods: Lung sonography was performed in 32 newborn infants with radiological and clinical signs of TTN within the first hour after birth and the findings were compared with those of 60 normal infants, 29 with respiratory distress syndrome, 6 with pneumonia, 5 with pulmonary hemorrhage and 5 with atelectasis. Results: In the infants with TTN, lung sonography showed a difference in lung echogenicity between the upper and lower lung areas. There were very compact comet-tail artifacts in the inferior fields while these were rare in the superior fields. We designated this finding the ‘double lung point’ and it was not observed in healthy infants, infants with respiratory distress syndrome, actelectasis, pneumothorax, pneumonia, or pulmonary hemorrhage. Sensitivity and specificity of the double lung point was 100% for the diagnosis of TTN. Conclusion: We found lung sonography reliable for the early diagnosis of TTN. We suggest that it should become the first approach for imaging of neonatal respiratory distress although further prospective studies with good blinding need to be performed.
A W-band wavelet generator using 0.13-μm InP HEMTs for multi-gigabit communications based on ultra-wideband impulse radio

A wavelet generator (WG) based on simple ultra-wideband impulse radio (UWB-IR) architecture has been developed to use for multi-gigabit communications systems that utilize the W-band millimeter wave (75–110 GHz). The W-band WG radiates a pulse signal, or a wavelet, whose full width at half maximum is less than 80 ps, which makes it possible to realize a 12.5-Gb/s ON/OFF keying transmitter. The WG consists of only two components: a pulse generator (PG) and a band pass filter (BPF). The digital-based PG was fabricated by using 0.13-μm InP HEMTs and created a record short pulse of 7.6 ps and 0.8 Vpp. The BPF was designed to be a five-stage microstrip coupled line filter on an alumina substrate. The 3-dB pass band of the BPF was 78–93 GHz and its insertion loss was 1.5±0.1 dB. The group delay was 100±10 ps in the pass band. To the best of our knowledge, the WG is the first UWB-IR-based signal source that generates more than 10-Gb/s wavelets in the W-band.
SOCIAL COGNITION

Social cognitive neuroscience is a novel field of interdisciplinary research that examines socio-emotional cognition and behavior by emphasizing the neural substrates of these processes. Insights from this biological perspective have established that socio-emotional processing does not happen in a sequential order but in a recursive and interlinked fashion; that individual brain regions are not associated with one, but multiple, distinct social functions; and that brain regions are organized into dynamically interacting networks. These factors explain why it is difficult to pinpoint the neural substrates of particular social deficits in patients with brain diseases. With that said, there are specific brain regions that are highly specialized for the perception, regulation, and modulation of emotion and behavior. This article will review key aspects of social processing beginning with their underlying neural substrates, including (1) perception of social signals, (2) social and emotional evaluation, and (3) behavioral response generation and selection. Case studies will be used to illustrate the real-life social deficits resulting from distinct patterns of neuroanatomic damage, highlighting the brain regions most critical for adequate social behavior. Continuum Lifelong Learning Neurol 2010;16(4):69-85.
Digital Skin Blood Flow as an Indicator for Intravascular Injection of Epinephrine-Containing Simulated Epidural Test Dose in Sevoflurane-Anesthetized Adults

I designed this study to determine the efficacy of heart rate (HR), systolic blood pressure (SBP), and digital skin blood flow (DSBF) in detecting intravascular injection after a simulated epidural test dose containing 15 &mgr;g of epinephrine in sevoflurane-anesthetized adults. In addition, the testing threshold using DSBF was derived. Eighty patients were randomized to receive either 0.5 minimum alveolar anesthetic concentration (MAC) sevoflurane or 1.0 MAC sevoflurane and nitrous oxide in oxygen (n = 40 for each sevoflurane concentration). Each group of patients was further randomized to receive either 3 mL of 1.5% lidocaine containing 15 &mgr;g of epinephrine IV or 3 mL of saline IV (n = 20 each). HR, SBP, and DSBF were monitored for 5 min after injection. By using the HR (positive if ≥10 bpm increase) and SBP (positive if ≥15 mm Hg increase) criteria, a positive response rate to epinephrine was 95% for both variables during 0.5 MAC and 90% during 1.0 MAC sevoflurane anesthesia. Injection of the test dose resulted in peak DSBF decrease by 87% ± 8% and 81% ± 12% at 52 ± 10 and 53 ± 13 s in the sevoflurane 0.5 and 1.0 MAC groups, respectively. Positive DSBF criterion, as determined from peak increases during saline administration, was a decrease in DSBF ≥15%. Using this value, the sensitivity, specificity, positive predictive value, and negative predictive value were 100% in both sevoflurane groups. In conclusion, DSBF was superior to conventional hemodynamic criteria for detection of an intravascular injection of epidural test dose.
Stochastic H2/H&#8734;Control with (x,u,v)-dependent Noise

In this paper, finite and infinite horizon stochastic H<inf>2</inf>/H<inf>∞</inf>control problems with all state, control input and external disturbance-dependent noise are studied. It is shown that the existence condition of finite horizon stochastic H<inf>2</inf>/H<inf>∞</inf>control is equivalent to the solvability of four coupled matrix-valued differential equations, and that of infinite horizon stochastic H<inf>2</inf>/H<inf>∞</inf>control is equivalent to the solvability of four coupled matrix-valued algebraic equations.
Surrogate Light Chain-Mediated Interaction of a Soluble Pre-B Cell Receptor with Adherent Cell Lines1

Signals initiated by the precursor B cell receptor (pre-BCR) are critical for B cell progenitors to mature into precursor B cells. The pre-BCR consists of a homodimer of μH chains, the covalently associated surrogate L (SL) chain composed of VpreB and λ5, and the transmembrane signal molecules Igα and Igβ. One way to explain how maturation signals are initiated in late progenitor B cells is that the pre-BCR is transported to the cell surface and interacts from there with a ligand on stroma cells. To address this hypothesis, we first produced soluble Fab-like pre-BCR and BCR fragments, as well as SL chain, in baculovirus-infected insect cells. Flow cytometry revealed that, in contrast to Fab-like BCR fragments, the soluble pre-BCR binds to the surface of stroma and several other adherent cell lines, but not to B and T lymphoid suspension cells. The specific binding of the soluble pre-BCR to stroma cells is saturable, sensitive to trypsin digestion, and not dependent on bivalent cations. The binding of pre-BCR seems to be independent of the H chain of IgM (μH chain), because SL chain alone was able to interact with stroma cells. Finally, soluble pre-BCR specifically precipitated a 135-kDa protein from ST2 cells. These findings not only demonstrate for the first time the capacity of a pre-BCR to specifically bind to a structure on the surface of adherent cells, but also suggest that the pre-BCR interacts via its SL chain with a putative ligand on stroma cells.
Surgical resection of cutaneous head and neck lesions: does aspirin use increase hemorrhagic risk?

OBJECTIVE To determine whether the antiplatelet agent aspirin increases hemorrhagic risk in patients undergoing surgical resection of cutaneous head and neck lesions. DESIGN Retrospective cohort study. SETTING Regional referral center. Patients All cases of cutaneous head and neck lesions surgically resected during a 10-year period were included. MAIN OUTCOME MEASURES Outcome measures were incidence of significant postoperative hemorrhage, defined as postoperative hematoma or hemorrhage necessitating surgical reexploration; and total postoperative hemorrhage, defined as any hemorrhage lasting longer than 4 hours despite external pressure, requiring medical review, and resulting in prolongation of the patient's hospital stay or readmission to the hospital. RESULTS Seven hundred eleven patients (974 cases) were eligible for inclusion, of whom 320 were receiving aspirin therapy at the time of surgery. The incidence of significant postoperative hemorrhage in the aspirin and nonaspirin groups was 5 (1.6%) and 0, respectively (P = .004), and aspirin use was the only risk factor for significant postoperative hemorrhage. The incidence of total postoperative hemorrhage in the aspirin and nonaspirin groups was 7 (2.2%) and 1 (0.1%), respectively (P = .002). At multivariate analysis, aspirin use and local flap reconstruction were independent risk factors for total postoperative hemorrhage. Cases receiving aspirin therapy who also underwent local flap reconstruction were at exponential (124-fold) increased risk of total postoperative hemorrhage compared with cases with neither risk factor. CONCLUSIONS Aspirin intake at the time of surgery to resect cutaneous head and neck lesions confers a small but statistically increased risk of postoperative hemorrhage. This risk is particularly pronounced in patients undergoing local flap reconstruction.
Imaging in rectal cancer with emphasis on local staging with MRI

Abstract Imaging in rectal cancer has a vital role in staging disease, and in selecting and optimizing treatment planning. High-resolution MRI (HR-MRI) is the recommended method of first choice for local staging of rectal cancer for both primary staging and for restaging after preoperative chemoradiation (CT-RT). HR-MRI helps decide between upfront surgery and preoperative CT-RT. It provides high accuracy for prediction of circumferential resection margin at surgery, T category, and nodal status in that order. MRI also helps assess resectability after preoperative CT-RT and decide between sphincter saving or more radical surgery. Accurate technique is crucial for obtaining high-resolution images in the appropriate planes for correct staging. The phased array external coil has replaced the endorectal coil that is no longer recommended. Non-fat suppressed 2D T2-weighted (T2W) sequences in orthogonal planes to the tumor are sufficient for primary staging. Contrast-enhanced MRI is considered inappropriate for both primary staging and restaging. Diffusion-weighted sequence may be of value in restaging. Multidetector CT cannot replace MRI in local staging, but has an important role for evaluating distant metastases. Positron emission tomography-computed tomography (PET/CT) has a limited role in the initial staging of rectal cancer and is reserved for cases with resectable metastatic disease before contemplating surgery. This article briefly reviews the comprehensive role of imaging in rectal cancer, describes the role of MRI in local staging in detail, discusses the optimal MRI technique, and provides a synoptic report for both primary staging and restaging after CT-RT in routine practice.
Improvement of Performances in Bilateral Teleoperation by Using FPGA

Bilateral teleoperation has been needed in many areas, such as space activities, work on an atomic power plant, minimally invasive surgery, etc. In bilateral teleoperation, transfer of keen tactile sense, which is as if the operator directly touches the environment, is required. Sensing of wide-frequency-bandwidth force information is required in achieving the transferring of a keen tactile sensation. A bilateral controller based on acceleration control with disturbance observers is available to achieve transfer of a keen tactile sensation. In this bilateral controller, the frequency bandwidth of sensed force is determined by the cutoff frequency of a low-pass filter used in the disturbance observer. The cutoff frequency is in inverse proportion to a sampling period. Therefore, shortening of the sampling period improves performance of bilateral teleoperation. In this paper, a bilateral-teleoperation system using a field-programmable gate array (FPGA) is introduced. The FPGA is an large scale integration where a user can design its internal logic. When the motion controller is implemented on an FPGA, it operates faster than that implemented in a personal computer with a real-time operating system. The sampling period is shortened from 100 to 10 mus by using an FPGA. The implemented controller is evaluated by experiments.
Resection of pancreatic neuroendocrine tumors: results of 70 cases.

HYPOTHESIS Neuroendocrine tumors of the pancreas can be managed surgically with excellent outcomes. DESIGN Retrospective case series. SETTING Academic medical center. PATIENTS Seventy consecutive patients who underwent resection for pancreatic neuroendocrine tumors between January 1, 1990, and December 31, 2005. INTERVENTIONS Pancreaticoduodenectomy, distal pancreatectomy, or enucleation. MAIN OUTCOME MEASURES Postoperative morbidity, mortality, and long-term survival. RESULTS Of the 70 patients, 50 (71.4%) had nonfunctional tumors. Thirty-seven patients (52.9%) had neuroendocrine carcinomas and 13 (18.6%) had benign islet cell neoplasms. Twenty patients had functional tumors. Of these 20 patients, 16 had insulinomas, 2 had glucagonomas, and 2 had gastrinomas. Twenty-seven patients underwent pancreaticoduodenectomy, 32 had distal pancreatectomy, and 11 underwent enucleation. Patients undergoing enucleation as compared with those not undergoing enucleation were younger (mean age, 39 vs 51 years, respectively; P = .009) and had smaller tumors (mean tumor size, 2 vs 5 cm, respectively; P<.001). Postoperative complications occurred in 13 patients (48.1%) after pancreaticoduodenectomy, in 4 patients (12.5%) after distal pancreatectomy, and in 0 patients after enucleation. There were no perioperative mortalities. With a median follow-up of 50 months, the 5-year actuarial survival for the patients with malignant neuroendocrine carcinomas (n = 37) was 77%, and all of the patients with functional tumors are alive. The presence of lymphovascular invasion closely approached significance when survival was evaluated (P = .06). Lymph node status, perineural invasion, and liver metastasis did not impact survival. CONCLUSIONS This single-institutional case series demonstrates that pancreatic neuroendocrine tumors can be safely resected without mortality and with minimal morbidity. The presence of lymphovascular invasion can be used to classify neuroendocrine tumors as malignant, and this appears to predict survival. Patients with malignant tumors can expect long-term survival even in the setting of metastatic disease.