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Summary: In the relapsed/refractory setting for treatment of large B‐cell lymphoma (LBCL), chimeric antigen receptor T‐cell (CAR‐T) therapy has emerged as an effective treatment modality. Patients often have aggressive disease that requires prompt treatment in the form of bridging therapy (BT) for disease stabilisation while CAR‐T cells are manufactured. Patients (n = 75) undergoing CAR‐T therapy infusion for LBCL at our institution were identified. A total of 52 (69·3%) received BT and 23 (30·7%) received no BT (NBT). BT modalities included systemic BT (SBT) in 28 patients, radiation BT (RBT) in 14, and high‐dose steroid BT (HDS) in 10. There was no difference in incidence of cytokine release syndrome or immune effector cell‐associated neurotoxicity syndrome between BT and NBT (P = 0·18 and P = 0·53 respectively). Prolonged cytopenias at Day 180 were more common in BT than NBT (50% vs. 13·3%, P = 0·04). The SBT and RBT subgroups had more cytopenias at Day 180 compared to the HDS and NBT subgroups (58·3% and 57·1% vs. 20% and 13·3% respectively, P = 0·04). Disease response at last follow‐up, progression‐free survival and overall survival were similar between BT, NBT, and BT subgroups. In summary, BT can be safely considered in patients undergoing CAR‐T therapy. However, those undergoing BT with SBT or RBT are at higher risk of prolonged cytopenias after CAR‐T therapy. [ABSTRACT FROM AUTHOR]

In this paper, advanced interval type-2 fuzzy sliding mode control (AIT2FSMC) for robot manipulator is proposed. The proposed AIT2FSMC is a combination of interval type-2 fuzzy system and sliding mode control. For resembling a feedback linearization (FL) control law, interval type-2 fuzzy system is designed. For compensating the approximation error between the FL control law and interval type-2 fuzzy system, sliding mode controller is designed, respectively. The tuning algorithms are derived in the sense of Lyapunov stability theorem. Two-link rigid robot manipulator with nonlinearity is used to test and the simulation results are presented to show the effectiveness of the proposed method that can control unknown system well. [ABSTRACT FROM AUTHOR]

An advanced fuzzy potential field method for mobile robot obstacle avoidance is proposed. The potential field method primarily deals with the repulsive forces surrounding obstacles, while fuzzy control logic focuses on fuzzy rules that handle linguistic variables and describe the knowledge of experts. The design of a fuzzy controller—advanced fuzzy potential field method (AFPFM)—that models and enhances the conventional potential field method is proposed and discussed. This study also examines the rule-explosion problem of conventional fuzzy logic and assesses the performance of our proposed AFPFM through simulations carried out using a mobile robot. [ABSTRACT FROM AUTHOR]

This study confirms that botulinum neurotoxin type A (BoNT-A) decreases capsular contracture and elucidates a possible mechanism. Silicone blocks were implanted subcutaneously in 20 mice. The experimental groups received BoNT-A (1, 2<5 or 5U) instilled into the subcutaneous pocket. After 30 days, periprosthetic capsules were harvested and evaluated. The effect of BoNT-A on the differentiation of human dermal fibroblasts to myofibroblasts in culture was examined by Western blot analysis. Changes in transforming growth factor-beta1 (TGF-β1) expression in cultured fibroblasts were determined by enzyme-linked immunosorbent assay (ELISA). In in vivo study, the thickness of capsules (P <0·05) and the number of alpha-smooth muscle actin (α-SMA)+ cells in capsules (P <0·05) were significantly decreased in the experimental groups. TGF-β1 was significantly underexpressed in the experimental groups (P <0·05). In in vitro study, BoNT-A did not significantly affect fibroblast viability. Western blot analysis showed that α-SMA protein levels were significantly decreased in the experimental groups (P <0·05). Based on ELISA, the amount of TGF-β1 was significantly decreased in the experimental groups (P <0·05), especially cells treated with a high dose of BoNT-A (P <0·001). This study confirms that BoNTA prevents capsular formation around silicone implants, possibly by blocking TGF-β1 signalling and interrupting the differentiation of fibroblasts to myofibroblasts. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis No previous ultrasound (US) studies have investigated the diagnostic accuracy of specific US-based diagnostic protocol for cervical lymph node (LN) lesions in a tuberculosis-endemic area. This study aimed to assess the accuracy of US-based diagnosis of cervical LNs in a tuberculosis-endemic area. Study Design This was a retrospective cohort study. Methods We enrolled 495 consecutive patients who underwent US examination of the LNs in the neck. A single radiologist carried out the US examination, and established a US-based diagnosis at the time of the examination in each of the patients. We calculated the diagnostic accuracy of US for LNs in the neck by using the final results as a reference standard. Results Of 476 study cases, the number of tuberculous, nontuberculous benign, malignant, and indeterminate US category cases was 74, 224, 152, and 26, respectively. Confirmed diagnoses in these cases were as follow: tuberculous LN (n = 69), nontuberculous benign LN (n = 249), and malignant LN (n = 158). The sensitivity, specificity, positive and negative predictive values, and accuracy of tuberculous, malignant, and nontuberculous benign US categories were 90.9%, 96.4%, 81.1%, 98.4%, and 95.6%; 92.8%, 96.6%, 93.4%, 96.3%, and 95.3%; and 92.2%, 95.0%, 95.1%, 92.0%, and 93.6%, respectively. All US categories showed a high sensitivity and specificity. Conclusions The present US-based diagnostic protocol for cervical LNs in a tuberculosis-endemic area may be useful. Level of Evidence 4. Laryngoscope, 125:1113-1117, 2015 [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis To describe our tracheostomy procedure using a vertical skin incision and a horizontal intercartilaginous incision and to compare our postoperative results with those in the recent literature. Study Design Retrospective chart review and literature review. Methods One hundred eleven children underwent tracheostomy using a vertical skin incision and a horizontal intercartilaginous incision over a 9-year period. A retrospective chart review was undertaken with respect to the following variables: demographics, weight, primary diagnosis, surgical indication, follow-up duration, decannulation, interval between tracheostomy and decannulation, and complications experienced. In addition, the outcomes were compared to results from a literature review. Results Of the 111 patients, 56 had a history of prolonged intubation, 52 had upper airway obstruction, and three underwent tracheostomy for tracheobronchial toileting. Three (2.7%) patients experienced early major complications without major sequelae, and 14 (12.6%) experienced late major complications. Twenty-one (18.9%) patients were decannulated during the follow-up period, whereas 17 (17.8%) died of their primary disease or tracheostomy-related complications (15 died of their primary disease and two died of tracheostomy-related complications). The complication rates showed overall no differences, but our patient series showed significantly less stomal granulation tissue formation and non-significant trend for less suprastomal collapse as compared with previous literature. Conclusions Pediatric tracheostomy using a vertical skin incision and horizontal intercartilaginous incision is comparable with the conventional procedure in terms of complication and mortality rates. Future randomized controlled studies are mandatory to directly compare conventional tracheotomy using a vertical skin incision and a horizontal intercartilaginous incision with our procedure. Level of Evidence 4. Laryngoscope, 125:485-492, 2015 [ABSTRACT FROM AUTHOR]

The discrete Gaussian-Hermite moment (DGHM) is a global feature representation method that can be applied to square images. We propose a modified DGHM (MDGHM) method and an MDGHM-based scale-invariant feature transform (MDGHM-SIFT) descriptor. In the MDGHM, we devise a movable mask to represent the local features of a non-square image. The complete set of non-square image features are then represented by the summation of all MDGHMs. We also propose to apply an accumulated MDGHM using multi-order derivatives to obtain distinguishable feature information in the third stage of the SIFT. Finally, we calculate an MDGHM-based magnitude and an MDGHM-based orientation using the accumulated MDGHM. We carry out experiments using the proposed method with six kinds of deformations. The results show that the proposed method can be applied to non-square images without any image truncation and that it significantly outperforms the matching accuracy of other SIFT algorithms. [ABSTRACT FROM AUTHOR]

Purpose: The presence of two or more epileptogenic pathologies in patients with epilepsy is often observed, and the coexistence of focal cortical dysplasia (FCD) with hippocampal sclerosis (HS) is one of the most frequent clinical presentations. Although surgical resection has been an important treatment for patients with refractory epilepsy associated with FCD, there are few studies on the surgical treatment of FCD accompanied by HS, and treatment by resection of both neocortical dysplastic tissue and hippocampus is still controversial. Methods: We retrospectively recruited epilepsy patients who had undergone surgical treatment for refractory epilepsy with the pathologic diagnosis of FCD and the radiologic evidence of HS. We evaluated the prognostic roles of clinical factors, various diagnostic modalities, surgical procedures, and the severity of pathology. Results: A total of 40 patients were included, and only 35.0% of patients became seizure free. Complete resection of the epileptogenic area (p = 0.02), and the presence of dysmorphic neurons or balloon cells on histopathology (p = 0.01) were associated with favorable surgical outcomes. Patients who underwent hippocampal resection were more likely to have a favorable surgical outcome (p = 0.02). Conclusions: We show that patients with complete resection of epileptogenic area, the presence of dysmorphic neurons or balloon cells on histopathology, or resection of hippocampus have a higher chance of a favorable surgical outcome. We believe that this observation is useful in planning of surgical procedures and predicting the prognoses of individual patients with FCD patients accompanied by HS. [ABSTRACT FROM AUTHOR]

Background : Capsicum plaster at a classical Chinese acupoint is an alternative to acupuncture, which has been used as a supplemental therapy to opioid analgesics for pain control during the postoperative period. We investigated the postoperative analgesic efficacy of capsicum plaster at Zusanli (ST-36) points after pediatric hernia repair. Methods : This double-blind, sham-controlled study was designed in 108 children, aged 4 month to 9 year, undergoing unilateral hernia repair, and was randomly assigned to three treatment regimens: group Zusanli (Z) = capsicum plaster at Zusanli acupoints and placebo tape on the shoulder as a nonacupoint, group Sham (S) = capsicum plaster on the shoulders and placebo tape at Zusanli acupoints, and group control (C) = placebo tape at Zusanli acupoints and on the shoulder. The postoperative pain scores and analgesic requirements during 24 h postoperatively were assessed. Results : Total meperidine consumption was significantly lower in group Z (0.87 ± 0.35 mg-1·kg-1) compared with group C (1.27 ± 0.41 mg-1·kg-1) and S (1.22 ± 0.45 mg-1·kg-1) ( P < 0.001). The pain scores on both the objective pain scale (OPS) and the Children Hospital of Ontario Pain Scale (CHEOPS), were significantly lower in group Z compared with the other groups at 6 and 24 h postoperatively, but not at the 10 min and 1 h postoperative time periods. Conclusions : Placement of capsicum plaster at the Zusanli points reduces pain and postoperative opioid consumption in children undergoing inguinal hernia repair, but not in the first six postoperative hours. [ABSTRACT FROM AUTHOR]