A wideband linear tunable CDTA and its application in field programmable analogue array

This document is the Accepted Manuscript version of the following article: Hu, Z., Wang, C., Sun, J. et al. ‘A wideband linear tunable CDTA and its application in field programmable analogue array’, Analog Integrated Circuits and Signal Processing, Vol. 88 (3): 465-483, September 2016. Under embargo. Embargo end date: 6 June 2017. The final publication is available at Springer via https://link.springer.com/article/10.1007%2Fs10470-016-0772-7 © Springer Science+Business Media New York 2016In this paper, a NMOS-based wideband low power and linear tunable transconductance current differencing transconductance amplifier (CDTA) is presented. Based on the NMOS CDTA, a novel simple and easily reconfigurable configurable analogue block (CAB) is designed. Moreover, using the novel CAB, a simple and versatile butterfly-shaped FPAA structure is introduced. The FPAA consists of six identical CABs, and it could realize six order current-mode low pass filter, second order current-mode universal filter, current-mode quadrature oscillator, current-mode multi-phase oscillator and current-mode multiplier for analog signal processing. The Cadence IC Design Tools 5.1.41 post-layout simulation and measurement results are included to confirm the theory.Peer reviewedFinal Accepted Versio

Communication Research

Contains reports on seven research projects.Rockefeller FoundationCarnegie Foundatio

Communication Research

Contains reports on nine research projects.Bell Telephone Laboratories, Incorporate

The determination of the pituitary gland, optic chiasm, and intercavernous distance measurements in healthy subjects according to age and gender

Background: This paper was undertaken to determine the morphometry of pituitary gland diameter, pituitary gland height, intercavernous distance, optic chiasm diameter and optic chiasm height in skulls of Turkish population aged between 18 and 60 years. Materials and methods: It was a retrospective study in which 292 subjects were included 187 females and 105 males, ranging from 18 up to 60 years. Subjects underwent brain magnetic resonance imaging in the Radiology Department. Statistical analysis was performed with SPSS 21.00 programme. ANOVA test, χ2 test, and Pearson correlation analysis were used to determine the relation and significance between measurements and age group. The p < 0.05 value was considered as significant. Results: The groups were divided into five groups according to age. The overall means and standard deviations of the measurements were: pituitary gland width, 13.09 ± 1.99 mm; pituitary gland height, 4.91 ± 1.10 mm; intercavernous distance, 15.93 ± 3.05 mm; optic chiasm width, 12.82 ± 1.27 mm; and optic chiasm height, 2.80 ± 0.49 mm in females, respectively whereas, the same measurements were 12.96 ± 1.74 mm; 4.79 ± 0.95 mm; 16.08 ± 3.11 mm; 13.13 ± 1.37 mm; 2.86 ± 0.70 mm in males, respectively. Height of the pituitary gland reached a maximum in the age group of 18 to 20 years in both females and males and there was a decrease in the pituitary gland height in the subsequent age groups. Conclusions: Knowledge of the variation in the size of pituitary gland, intercavernous distance and optic chiasm is important to evaluate the dimensions of these structures for clinical and pathological processes

Communication Research

Contains reports on six research projects.Rand Corporatio

Recommendations for the diagnosis of pediatric tuberculosis

Tuberculosis (TB) is still the world's second most frequent cause of death due to infectious diseases after HIV infection, and this has aroused greater interest in identifying and managing exposed subjects, whether they are simply infected or have developed one of the clinical variants of the disease. Unfortunately, not even the latest laboratory techniques are always successful in identifying affected children because they are more likely to have negative cultures and tuberculin skin test results, equivocal chest X-ray findings, and atypical clinical manifestations than adults. Furthermore, they are at greater risk of progressing from infection to active disease, particularly if they are very young. Consequently, pediatricians have to use different diagnostic strategies that specifically address the needs of children. This document describes the recommendations of a group of scientific societies concerning the signs and symptoms suggesting pediatric TB, and the diagnostic approach towards children with suspected disease

Pilot study to define criteria for Pituitary Tumors Centers of Excellence (PTCOE):results of an audit of leading international centers

Purpose: The Pituitary Society established the concept and mostly qualitative parameters for defining uniform criteria for Pituitary Tumor Centers of Excellence (PTCOEs) based on expert consensus. Aim of the study was to validate those previously proposed criteria through collection and evaluation of self-reported activity of several internationally-recognized tertiary pituitary centers, thereby transforming the qualitative 2017 definition into a validated quantitative one, which could serve as the basis for future objective PTCOE accreditation. Methods: An ad hoc prepared database was distributed to nine Pituitary Centers chosen by the Project Scientific Committee and comprising Centers of worldwide repute, which agreed to provide activity information derived from registries related to the years 2018–2020 and completing the database within 60 days. The database, provided by each center and composed of Excel® spreadsheets with requested specific information on leading and supporting teams, was reviewed by two blinded referees and all 9 candidate centers satisfied the overall PTCOE definition, according to referees’ evaluations. To obtain objective numerical criteria, median values for each activity/parameter were considered as the preferred PTCOE definition target, whereas the low limit of the range was selected as the acceptable target for each respective parameter. Results: Three dedicated pituitary neurosurgeons are preferred, whereas one dedicated surgeon is acceptable. Moreover, 100 surgical procedures per center per year are preferred, while the results indicated that 50 surgeries per year are acceptable. Acute post-surgery complications, including mortality and readmission rates, should preferably be negligible or nonexistent, but acceptable criterion is a rate lower than 10% of patients with complications requiring readmission within 30 days after surgery. Four endocrinologists devoted to pituitary diseases are requested in a PTCOE and the total population of patients followed in a PTCOE should not be less than 850. It appears acceptable that at least one dedicated/expert in pituitary diseases is present in neuroradiology, pathology, and ophthalmology groups, whereas at least two expert radiation oncologists are needed. Conclusion: This is, to our knowledge, the first study to survey and evaluate the activity of a relevant number of high-volume centers in the pituitary field. This effort, internally validated by ad hoc reviewers, allowed for transformation of previously formulated theoretical criteria for the definition of a PTCOE to precise numerical definitions based on real-life evidence. The application of a derived synopsis of criteria could be used by independent bodies for accreditation of pituitary centers as PTCOEs.</p

Standards of care for medical management of acromegaly in pituitary tumor centers of excellence (PTCOE)

Purpose: A series of consensus guidelines on medical treatment of acromegaly have been produced in the last two decades. However, little information is available on their application in clinical practice. Furthermore, international standards of acromegaly care have not been published. The aim of our study was to report current standards of care for medical therapy of acromegaly, using results collected through an audit performed to validate criteria for definition of Pituitary Tumor Centers of Excellence (PTCOE). Methods: Details of medical treatment approaches to acromegaly were voluntarily provided by nine renowned international centers that participated in this audit. For the period 2018–2020, we assessed overall number of acromegaly patients under medical treatment, distribution of patients on different treatment modalities, overall biochemical control rate with medical therapy, and specific control rates for different medical treatment options. Results: Median number of total patients and median number of new patients with acromegaly managed annually in the endocrinology units of the centers were 206 and 16.3, respectively. Median percentage of acromegaly patients on medical treatment was 48.9%. Among the patients on medical treatment, first-generation somatostatin receptor ligand (SRL) monotherapy was used with a median rate of 48.7%, followed by combination therapies with a median rate of 29.3%. Cabergoline monotherapy was used in 6.9% of patients. Pegvisomant monotherapy was used in 7 centers and pasireotide monotherapy in 5 centers, with median rates of 7.9% and 6.3%, respectively. Conclusions: Current standards of care in PTCOEs include use of first-generation SRLs as the first medical option in about 50% of patients, as recommended by consensus guidelines. However, some patients are kept on this treatment despite inadequate control suggesting that cost-effectiveness, availability, patient preference, side effects, and therapeutic inertia may play a possible role also in PTCOE. Moreover, at odds with consensus guidelines, other monotherapies for acromegaly appear to have a marginal role as compared to combination therapies as extrapolated from PTCOE practice data. Presence of uncontrolled patients in each treatment category suggest that further optimization of medical therapy, as well as use of other therapeutic tools such as radiosurgery may be needed

Storylines of family medicine V:ways of thinking-honing the therapeutic self

Storylines of Family Medicine is a 12-part series of thematically linked essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'V: ways of thinking-honing the therapeutic self', authors present the following sections: 'Reflective practice in action', 'The doctor as drug-Balint groups', 'Cultivating compassion', 'Towards a humanistic approach to doctoring', 'Intimacy in family medicine', 'The many faces of suffering', 'Transcending suffering' and 'The power of listening to stories.' May readers feel a deeper sense of their own therapeutic agency by reflecting on these essays.</p