Miracle-dz/UniFAR-FTUs huggingface dataset:
Intraoperative Cerebral Angiography: Superficial Temporal Artery Method and Results

OBJECTIVETo report the method for and results of intraoperative cerebral angiography performed via the superficial temporal artery, for assessment of cerebral aneurysm surgery. METHODSAll patients undergoing craniotomies for treatment of intracranial aneurysms were prospectively entered into a database. A policy of performing angiography via the superficial temporal artery in appropriate cases was instituted. This procedure was performed with retrograde catheterization of the superficial temporal artery, as it coursed over the zygomatic arch, with an 18-gauge, 1.88-inch, intravenous catheter and hand injection of contrast material, with intraoperative digital subtraction fluoroscopic guidance. RESULTSThirty-six patients who underwent 38 craniotomies for clipping of 43 aneurysms underwent intraoperative angiography via the superficial temporal artery. There were six unexpected findings (14%), including four unexpected arterial occlusions and two unexpected residual aneurysms. One aneurysm was observed to be patent when it was punctured, after intraoperative angiography had indicated no filling of the aneurysm. Additional clips were placed. Three patients (8%) developed multiple arterial infarctions in the territory of the injected carotid artery, for which multiple causes were possible. Adequate angiographic images could usually be obtained with this method. CONCLUSIONIntraoperative angiography via the superficial temporal artery is simple and is not associated with substantial complications. It is a reasonable alternative to transfemoral angiography for detection of adverse consequences of intracranial aneurysm clipping.
High Blood Neutrophil-to-Lymphocyte Ratio Is an Indicator of Poor Prognosis in Malignant Mesothelioma Patients Undergoing Systemic Therapy

Purpose: Asbestos-induced chronic inflammation is implicated in the pathogenesis of malignant mesothelioma (MM). We have investigated blood neutrophil-to-lymphocyte ratio (NLR), an index of systemic inflammation, as a prognostic factor in MM patients. Experimental Design: Patients with MM who had systemic therapy at participating institutes were studied. Potential prognostic factors such as age, gender, performance status, histologic subtype, and baseline laboratory parameters, including NLR, were analyzed. Overall survival from commencement of therapy was determined by the Kaplan–Meier method. Multivariate analyses using Cox Regression model were performed with significant factors (P ≤ 0.05) to determine their independent effect. Results: A total of 173 MM patients undergoing systemic therapy including 119 patients receiving first-line therapy and 54 patients receiving second- or third-line therapy were included in this retrospective evaluation. Forty-two percent of patients had an elevated NLR at baseline. The following variables were predictive of survival: female gender (P = 0.044), epithelioid histologic subtype (P < 0.001), baseline white blood cell count less than 8.3 × 109/L (P = 0.008), baseline platelet count 400 × 109/L or less (P = 0.05), and NLR of 5 or less (P < 0.001). After multivariate analysis, histologic epithelioid subtype [hazard ratio (HR) = 2.0; 95% confidence interval (CI) = 1.3–2.9; P = 0.001], and NLR less than 5 (HR = 2.7; 95% CI = 1.8–3.9; P < 0.001) remained independent predictors. The 1-year survival rate was 60% versus 26%, whereas the 2-year survival rate was 34% versus 10% for NLR less than 5 and 5 or greater, respectively. In the separate analyses of chemotherapy-naive and previously treated patient groups, NLR was an independent predictor of survival in both groups. Conclusion: Our results indicate that NLR is an independent predictor of survival for patients with MM undergoing systemic therapy. Clin Cancer Res; 16(23); 5805–13. ©2010 AACR.
Octyl-2-cyanoacrylate Tissue Glue (Dermabond) versus Monocryl 6 × 0 Sutures in Lip Closure

Objective: To assess the value of octyl-2-cyanoacrylate tissue glue in lip closure versus Monocryl stitches. Design: Closure of a cleft lip can be done using transcutaneous Monocryl 6 × 0 sutures or using octyl-2-cyanoacrylate tissue glue (Dermabond). In 15 consecutive patients, the cleft lip was closed with Monocryl 6 × 0 and in another 15 consecutive patients, Dermabond was applied. Outcome parameters were complications, satisfaction of the parents with the cosmetic result, and the cosmetic result as judged by professionals. Satisfaction of the parents was assessed using a questionnaire and a visual analog scale. The cosmetic result as judged by professionals was measured by rating standardized pictures according to a visual analog scale. Setting: A tertiary referral center for children with craniofacial anomalies. Results: Complications were equal in both patient groups (p = .273). Satisfaction of the parents, as well as the professionals, with the cosmetic result did not show significant differences between the Monocryl 6 × 0 and the Dermabond groups (p = .922 and .983, respectively). However, parents were significantly more positive about the cosmetic result than the professionals were (p = .000). Conclusion: The results of lip closure using Dermabond tissue glue equal the cosmetic results of lip closure using transcutaneous Monocryl 6 × 0 sutures.
Adjacent Segment Degeneration: Observations in a Goat Spinal Fusion Study

Study Design. The adjacent discs of 13 goats, originally used in a lumbar spinal fusion model study, were analyzed for symptoms of intervertebral disc degeneration by means of magnetic resonance imaging (MRI), macroscopy, and histology. These goats were followed for 6 months and the results were compared with 6 control goats. Objective. To evaluate the development of adjacent segment disc degeneration in vivo in a goat lumbar spinal fusion model. Summary of Background Data. There is ongoing debate on whether adjacent segment degeneration (ASD) develops through increased biomechanical load on discs adjacent to fusion sites, or by the natural process of pre-existing degenerative disease. Animal models offer an opportunity to separate these factors by evaluating the development of ASD in nondegenerated animal spines. Methods. In a spinal fusion model study 2 segments (L3-L4 and L1-L2) were fixated and followed for 3 months (n = 6) and 6 months (n = 7) in 13 skeletally mature goats. Two adjacent discs (T13-L1 and L4-L5), 1 interjacent disc (L2-L3) and a control disc (L5-L6) were analyzed by means of magnetic resonance imaging, macroscopy, and histology. These results were compared with the discs of 6, nonoperated “normal” goats. Results. No differences were observed in the adjacent and interjacent intervertebral discs after both follow-up periods. However, severe degenerative changes were observed in the L5-L6 level, originally included as controls. Conclusion. Large animal fusion models offer an excellent opportunity to study ASD in vivo, as pre-existing degenerative disc disease is not present and biomechanical effects of the fusion can be studied more isolated. Our results suggest that adjacent disc degeneration does not develop in our spinal goat fusion model. There is, however, an increased risk of disc degeneration in the L5-L6 level through an unclear mechanism.
Adaptive filtered backstepping control for integrated missile guidance and autopilot

In this paper, we study integrated guidance and control system considering the input saturation and state constraints for homing missiles. Command filters are exploited in the control design to deal with the state and actuator constraints. And auxiliary systems are introduced into the integrated guidance and control models to analyze the constraint effect. An adaptive law is adopted to compensate unknown uncertainties in the varying-time system. The proposed control scheme guarantees the desired interception performance and the stability of the missile dynamics. And nonlinear 6-DOF simulations are included to demonstrate the effectiveness of our approach.
Numerical study of two synchronous machines aimed to be used in an off-shore wind power application

The present paper deals with the study of two synchronous machines with magnets to compensate rotor leakage flux. Both structures, aimed to be used in an off shore wind energy conversion, have been designed using analytical approaches. Studies are carried out using numerical modeling in order to characterize both structures and quantify their performance when loaded by an inductive load.
Distribution of cone density, spacing and arrangement in adult healthy retinas with adaptive optics flood illumination

The aim of this article is to analyse cone density, spacing and arrangement using an adaptive optics flood illumination retina camera (rtx1™) on a healthy population. Cone density, cone spacing and packing arrangements were measured on the right retinas of 109 subjects at 2°, 3°, 4°, 5° and 6° of eccentricity along 4 meridians. The effects of eccentricity, meridian, axial length, spherical equivalent, gender and age were evaluated. Cone density decreased on average from 28 884 ± 3 692 cones/mm2, at 2° of eccentricity, to 15 843 ± 1 598 cones/mm2 at 6°. A strong inter-individual variation, especially at 2°, was observed. No important difference of cone density was observed between the nasal and temporal meridians or between the superior and inferior meridians. However, the horizontal and vertical meridians differed by around 14% (T-test, p<0.0001). Cone density, expressed in units of area, decreased as a function of axial length (r2 = 0.60), but remained constant (r2 = 0.05) when cone density is expressed in terms of visual angle supporting the hypothesis that the retina is stretched during the elongation of the eyeball. Gender did not modify the cone distribution. Cone density was slightly modified by age but only at 2°. The older group showed a smaller density (7%). Cone spacing increased from 6,49 ± 0,42 μm to 8,72 ± 0,45 μm respectively between 2° and 6° of eccentricity. The mosaic of the retina is mainly triangularly arranged (i.e. cells with 5 to 7 neighbors) from 2° to 6°. Around half of the cells had 6 neighbors.
Differences between self-reported and observed physical functioning in independent older adults

Abstract Background: Understanding whether there is an agreement between older persons who provide information on their functional status and clinicians who assess their function is an important step in the process of creating sound outcome instruments. Objectives: To examine whether there is agreement between self-reported and clinician assessment of similar performance items in older adults. Methods: Fifty independent older adults aged 70–91 years (mean age 80.3 ± 5.2 years) who live in the community were examined separately and blindly in two data collection sessions. Self-reported and observed lower and upper extremity physical tasks were compared. Life Function and Disability Instrument (LLFDI) was used in both sessions. We performed intra-class correlation coefficients (ICC) as indices of agreement and “mountain plots” that were based on a cumulative distribution curve. Associations between self-reported and observed function with Fear of Fall Scale (FES) and Geriatric Depression Scale (GDS) were also assessed. Results: ICCs were high between self-reported lower extremity function and observed lower extremity function (ICC = 0.83), and were poorer for self-reported and observed upper extremity function (ICC = 0.31). In both comparisons, mountain plots revealed a right shift that was larger for upper than lower extremity functions, indicating systematic differences in self-reported and observed assessments. Associations with FES and GDS were higher for self-reported than observed function. Conclusion: There is a systematic bias between self-reported and clinician observation. Professionals should be aware that information provided by patients and observation of activity assessed by clinicians could differ substantially, especially for upper extremity function. Implications for Rehabilitation There is a systematic bias between self-reported and clinician assessment of similar performance items in older adults. In general, older adults overestimate their physical function or clinicians underestimate older adults function. The bias between self-reported and clinician assessment for upper extremity function is larger than that for lower extremity function. The conclusions regarding agreement across upper extremity and lower extremity function scores are not different when using mountain plots graphs versus relying solely on the value of the ICCs. However, the graphs expand our understanding of the direction and magnitude of score differences. Professionals should be aware that information provided by patients and assessment by clinicians could differ substantially, especially for upper extremity function.
Termination of tyrphostin AG1478 application results in different recovery of EGF receptor tyrosine residues 1045 and 1173 phosphorylation in A431 cells

Tyrphostin AG1478 is known as a specific and reversible inhibitor of TK (tyrosine kinase) activity of the EGFR [EGF (epidermal growth factor) receptor]. It is attractive as an anticancer agent for cancers with elevated EGFR TK levels. However, post‐application effects of AG1478 are not well studied. We have analysed EGFR phosphorylation after termination of AG1478 application using human epidermoid carcinoma A431 cells. It was found that AG1478 inhibitory action is fast, but not fully reversible: removal of tyrphostin resulted in incomplete restoration of the overall EGFR phosphorylation. Analysing the state of two individual autophosphorylation sites of internalized EGFR, Tyr1045 and Tyr1173, we demonstrated that phosphorylation of Tyr1173 involved in stimulation of the MAPK (mitogen‐activated protein kinase) cascade was restored much more efficiently than that in position 1045, which binds the ubiquitin ligase c‐Cbl and is necessary for targeting the receptor for lysosomal degradation. c‐Cbl association with EGFR abolished by AG1478 was not reestablished after tyrphostin cessation. As a consequence, ubiquitination‐dependent EGFR delivery to lysosomes was blocked, while phosphorylation of ERK1/2 (extracellular‐signal‐regulated kinase 1/2) was even increased. Thus, after termination of AG1478, the intracellular level of the inhibitor can be reached at which mitogenic signalling will be restored, whereas the EGFR negative regulation due to lysosomal degradation will not.
Research on the Arithmetic of Non-unit Voltage Protection for EHV Transmission Line Based on Wavelet Analysis

This paper presents a new non-unit voltage protection algorithm for extra high voltage (EHV) transmission lines. This scheme is developed using wavelet analysis, in which the singularity of fault transient voltage signals in one terminal is utilized to discriminate clearly between internal and external faults. Lipschitz exponent (LE) is obtained from wavelet modulus maximum to detect singularity of signals. A typical 500-kV EHV transmission system has been simulated by ATP to evaluate the scheme. The simulation results show that this scheme is capable of providing correct responses under various system configurations and fault conditions
Long-term treatment with recombinant insulin-like growth factor (IGF)-I in children with severe IGF-I deficiency due to growth hormone insensitivity.

CONTEXT Children with severe IGF-I deficiency due to congenital or acquired defects in GH action have short stature that cannot be remedied by GH treatment. OBJECTIVES The objective of the study was to examine the long-term efficacy and safety of recombinant human IGF-I (rhIGF-I) therapy for short children with severe IGF-I deficiency. DESIGN Seventy-six children with IGF-I deficiency due to GH insensitivity were treated with rhIGF-I for up to 12 yr under a predominantly open-label design. SETTING The study was conducted at general clinical research centers and with collaborating endocrinologists. SUBJECTS Entry criteria included: age older than 2 yr, sd scores for height and circulating IGF-I concentration less than -2 for age and sex, and evidence of resistance to GH. INTERVENTION rhIGF-I was administered sc in doses between 60 and 120 microg/kg twice daily. MAIN OUTCOME MEASURES Height velocity, skeletal maturation, and adverse events were measured. RESULTS Height velocity increased from 2.8 cm/yr on average at baseline to 8.0 cm/yr during the first year of treatment (P < 0.0001) and was dependent on the dose administered. Height velocities were lower during subsequent years but remained above baseline for up to 8 yr. The most common adverse event was hypoglycemia, which was observed both before and during therapy. It was reported by 49% of treated subjects. The next most common adverse events were injection site lipohypertrophy (32%) and tonsillar/adenoidal hypertrophy (22%). CONCLUSIONS Treatment with rhIGF-I stimulates linear growth in children with severe IGF-I deficiency due to GH insensitivity. Adverse events are common but are rarely of sufficient severity to interrupt or modify treatment.
An Analysis of the Cost-Effectiveness of Selected Protocols for the Prevention of Neonatal Group B Streptococcal Infection

To determine the expected neonatal outcome in a hypothetical obstetric population with various screening and intrapartum management protocols for the prevention of neonatal group B streptococcal infections. Methods: We used decision analysis to investigate the performance of various antenatal and intrapartum group B streptococcal screening protocols combined with selective or universal intrapartum antibiotic prophylaxis in preventing neonatal early-onset group B streptococcal disease. Population characteristics, screening test performance, and treatment efficacy profiles were abstracted from previous investigations. Results: In the absence of screening or treatment, the estimated neonatal attack rate and mortality rate were 3.6 and 0.60 cases per 1000 neonates, respectively. Universal antenatal screening at 26-28 weeks' gestation and selective intrapartum prophylaxis (treatment of colonized women with risk factors) or nonselective prophylaxis (treatment of all colonized women) had attack rates of 1.64 and 1.08 and mortality rates of 0.21 and 0.18 cases per 1000 neonates, respectively. Rapid intrapartum screening and selective prophylaxis had an estimated attack rate of 1.92-2.58 and a mortality rate of 0.26-0.40 cases per 1000 neonates, with results dependent upon the time required to attain test results. Similarly, rapid intrapartum screening and nonselective prophylaxis had an attack rate of 1.44-2.30 and a mortality rate of 0.24-0.38 cases per 1000 neonates. Empirical prophylaxis of all women delivering prematurely, regardless of culture status, had an attack rate of 2.40 and mortality rate of 0.36 cases per 1000 neonates. Conclusions: Under ideal circumstances, antenatal group B streptococcal screening at 26-28 weeks' gestation with vaginal-rectal cultures and subsequent intrapartum prophylaxis is associated with lower projected neonatal attack and mortality rates than protocols using rapid intrapartum screening methods. However, in a non-research population, difficulties frequently encountered with antenatal screening procedures may minimize these differences.
Identification of the Functional Initiation Codons of a Phase-Variable Gene of Haemophilus influenzae, lic2A, with the Potential for Differential Expression

ABSTRACT Simple sequence repeats located within reading frames mediate phase-variable ON/OFF switches in gene expression by generating frameshifts. Multiple translation initiation codons in different reading frames are found upstream of most Haemophilus influenzae tetranucleotide repeat tracts, raising the possibility of multiple active reading frames and more than two levels of gene expression for these loci. Phase variation between three levels of gene expression (strong, weak, and none) was observed when lic2A was fused to a lacZ reporter gene. The lic2A 5′ CAAT repeat tract is preceded by four 5′ ATG codons (x, y, z1, and z2) in two reading frames. Each of these initiation codons was inactivated by site-directed mutagenesis. Strong expression from frame 1 was associated with x but not y. Weak expression from frame 2 was mainly dependent on the z2 codon, and there was no expression from frame 3. Using monoclonal antibodies specific for a digalactoside epitope of lipopolysaccharide whose synthesis requires Lic2A, two levels (strong and undetectable) of antibody reactivity were detected, suggesting that weak expression of lic2A is not discernible at the phenotypic level. Inactivation of the x initiation codon resulted in loss of strong expression of the digalactoside epitope and elevated killing by human serum. The failure to detect more than two phenotypes for lic2A, despite clear evidence of weak expression from the z1/z2 initiation codons, leaves open the question of whether or not multiple initiation codons are associated with more complex patterns of phenotypic variation rather than classical phase-variable switching between two phenotypes.
Factors Associated with Anastomotic Failure after Microvascular Reconstruction of the Breast

The prevalence of anastomotic failure resulting in return to the operating room and flap necrosis after microvascular breast reconstruction ranges from 1 to 5 percent. The purpose of this study was to review a set of factors that may be associated with this occurrence. Microvascular reconstruction of the breast was performed in 198 women from January of 1998 to July of 2002. The mean age for all women was 47.7 years. There were 158 unilateral and 41 bilateral reconstructions, for a total of 240 flaps. The specific flaps included the free transverse rectus abdominis musculocutaneous flap (n = 176), the deep inferior epigastric perforator flap (n = 58), and the superior gluteal artery perforator flap (n = 6). Upon recognition of anastomotic failure, women were immediately returned to the operating room. Factors that were considered relevant to anastomotic failure included the choice of recipient vessel, timing of reconstruction, previous chest wall radiation therapy, previous axillary lymph node dissection, tobacco use, diabetes mellitus, patient age, and hematoma. Patient follow-up ranged from 5 to 59 months. Descriptive statistics, Fisher’s exact test, and exact logistic regression were used for analyses and to summarize data. Of the 240 flaps, return to the operating room was necessary for 20 (8.3 percent), total necrosis occurred in nine (3.8 percent), and the rate of flap salvage was 55 percent (11 of 20 flaps). Venous occlusion was responsible for 16 of the 20 returns and eight of the nine failures. Statistical analysis demonstrated that both return to the operating room and flap necrosis were significantly associated with venous occlusion, delayed reconstruction, and hematoma. Previous lymph node dissection and previous radiation therapy had only a weak association with return to the operating room. The results of this study demonstrate that venous occlusion is responsible for return to the operating room and flap necrosis in the majority of cases. Age, tobacco use, choice of recipient vessel, and diabetes mellitus were not associated with anastomotic failure. The significance of delayed reconstruction may be related to its frequent association with previous lymph node dissection and/or radiation therapy resulting in perivascular fibrosis.