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Sample records for previously unexplained features

  1. Chronic, unexplained pain

    NARCIS (Netherlands)

    Snijders, T.J.

    2012-01-01

    Chronic, unexplained pain (CUP) is a common clinical problem. The core symptom in this heterogeneous group of patients is pain for which no medical explanation is found. Patients also have many other characteristics (symptoms and psychosocial features) in common. Pathophysiologically, increased

  2. Clinical, epidemiologic, histopathologic and molecular features of an unexplained dermopathy.

    Science.gov (United States)

    Pearson, Michele L; Selby, Joseph V; Katz, Kenneth A; Cantrell, Virginia; Braden, Christopher R; Parise, Monica E; Paddock, Christopher D; Lewin-Smith, Michael R; Kalasinsky, Victor F; Goldstein, Felicia C; Hightower, Allen W; Papier, Arthur; Lewis, Brian; Motipara, Sarita; Eberhard, Mark L

    2012-01-01

    Morgellons is a poorly characterized constellation of symptoms, with the primary manifestations involving the skin. We conducted an investigation of this unexplained dermopathy to characterize the clinical and epidemiologic features and explore potential etiologies. A descriptive study was conducted among persons at least 13 years of age and enrolled in Kaiser Permanente Northern California (KPNC) during 2006-2008. A case was defined as the self-reported emergence of fibers or materials from the skin accompanied by skin lesions and/or disturbing skin sensations. We collected detailed epidemiologic data, performed clinical evaluations and geospatial analyses and analyzed materials collected from participants' skin. We identified 115 case-patients. The prevalence was 3.65 (95% CI = 2.98, 4.40) cases per 100,000 enrollees. There was no clustering of cases within the 13-county KPNC catchment area (p = .113). Case-patients had a median age of 52 years (range: 17-93) and were primarily female (77%) and Caucasian (77%). Multi-system complaints were common; 70% reported chronic fatigue and 54% rated their overall health as fair or poor with mean Physical Component Scores and Mental Component Scores of 36.63 (SD = 12.9) and 35.45 (SD = 12.89), respectively. Cognitive deficits were detected in 59% of case-patients and 63% had evidence of clinically significant somatic complaints; 50% had drugs detected in hair samples and 78% reported exposure to solvents. Solar elastosis was the most common histopathologic abnormality (51% of biopsies); skin lesions were most consistent with arthropod bites or chronic excoriations. No parasites or mycobacteria were detected. Most materials collected from participants' skin were composed of cellulose, likely of cotton origin. This unexplained dermopathy was rare among this population of Northern California residents, but associated with significantly reduced health-related quality of life. No common underlying medical

  3. Clinical, epidemiologic, histopathologic and molecular features of an unexplained dermopathy.

    Directory of Open Access Journals (Sweden)

    Michele L Pearson

    Full Text Available BACKGROUND: Morgellons is a poorly characterized constellation of symptoms, with the primary manifestations involving the skin. We conducted an investigation of this unexplained dermopathy to characterize the clinical and epidemiologic features and explore potential etiologies. METHODS: A descriptive study was conducted among persons at least 13 years of age and enrolled in Kaiser Permanente Northern California (KPNC during 2006-2008. A case was defined as the self-reported emergence of fibers or materials from the skin accompanied by skin lesions and/or disturbing skin sensations. We collected detailed epidemiologic data, performed clinical evaluations and geospatial analyses and analyzed materials collected from participants' skin. RESULTS: We identified 115 case-patients. The prevalence was 3.65 (95% CI = 2.98, 4.40 cases per 100,000 enrollees. There was no clustering of cases within the 13-county KPNC catchment area (p = .113. Case-patients had a median age of 52 years (range: 17-93 and were primarily female (77% and Caucasian (77%. Multi-system complaints were common; 70% reported chronic fatigue and 54% rated their overall health as fair or poor with mean Physical Component Scores and Mental Component Scores of 36.63 (SD = 12.9 and 35.45 (SD = 12.89, respectively. Cognitive deficits were detected in 59% of case-patients and 63% had evidence of clinically significant somatic complaints; 50% had drugs detected in hair samples and 78% reported exposure to solvents. Solar elastosis was the most common histopathologic abnormality (51% of biopsies; skin lesions were most consistent with arthropod bites or chronic excoriations. No parasites or mycobacteria were detected. Most materials collected from participants' skin were composed of cellulose, likely of cotton origin. CONCLUSIONS: This unexplained dermopathy was rare among this population of Northern California residents, but associated with significantly reduced health

  4. Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients).

    Science.gov (United States)

    Chiara, Mussi; Gianluigi, Galizia; Pasquale, Abete; Alessandro, Morrione; Alice, Maraviglia; Gabriele, Noro; Paolo, Cavagnaro; Loredana, Ghirelli; Giovanni, Tava; Franco, Rengo; Giulio, Masotti; Gianfranco, Salvioli; Niccolò, Marchionni; Andrea, Ungar

    2013-01-01

    To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age 82 ± 7 years, range 65-101). Falls were defined "accidental" (fall explained by a definite accidental cause), "medical" (fall caused directly by a specific medical disease), "dementia-related" (fall in patients affected by moderate-severe dementia), and "unexplained" (nonaccidental falls, not related to a clear medical or drug-induced cause or with no apparent cause). According to the anamnestic features of the event, older patients had a lower tendency to remember the fall. Patients with accidental fall remember more often the event. Unexplained falls were frequent in both groups of age. Accidental falls were more frequent in younger patients, while dementia-related falls were more common in the older ones. Patients with unexplained falls showed a higher number of depressive symptoms. In a multivariate analysis a higher GDS and syncopal spells were independent predictors of unexplained falls. In conclusion, more than one third of all falls in patients hospitalized in orthopaedic wards were unexplained, particularly in patients with depressive symptoms and syncopal spells. The identification of fall causes must be evaluated in older patients with a fall-related injury.

  5. Laparoscopy in unexplained abdominal pain: surgeon's perspective

    International Nuclear Information System (INIS)

    Abdullah, M.T.; Waqar, S.H.; Zahid, M.A.

    2016-01-01

    Unexplained abdominal pain is a common but difficult presenting feature faced by the clinicians. Such patients can undergo a number of investigations with failure to reach any diagnosis. The objective of this study was to evaluate the use of laparoscopy in the diagnosis and management of patients with unexplained abdominal pain. Methods: This cross-sectional study was conducted at Pakistan Institute of Medical Sciences Islamabad from January 2009 to December 2013. This study included 91 patients of unexplained abdominal pain not diagnosed by routine clinical examination and investigations. These patients were subjected to diagnostic laparoscopy for evaluation of their conditions and to confirm the diagnosis. These patients presented 43% of patients undergoing investigations for abdominal pain. Patients diagnosed with gynaecological problems were excluded to see surgeon's perspective. The findings and the outcomes of the laparoscopy were recorded and data was analyzed. Results: Unexplained abdominal pain is common in females than in males. The most common laparoscopic findings were abdominal tuberculosis followed by appendicitis. Ninety percent patients achieved pain relief after laparoscopic intervention. Conclusion: Laparoscopy is both beneficial and safe in majority of patients with unexplained abdominal pain. General surgeons should acquire training and experience in laparoscopic surgery to provide maximum benefit to these difficult patients. (author)

  6. Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients

    Directory of Open Access Journals (Sweden)

    Mussi Chiara

    2013-01-01

    Full Text Available To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age 82±7 years, range 65–101. Falls were defined “accidental” (fall explained by a definite accidental cause, “medical” (fall caused directly by a specific medical disease, “dementia-related” (fall in patients affected by moderate-severe dementia, and “unexplained” (nonaccidental falls, not related to a clear medical or drug-induced cause or with no apparent cause. According to the anamnestic features of the event, older patients had a lower tendency to remember the fall. Patients with accidental fall remember more often the event. Unexplained falls were frequent in both groups of age. Accidental falls were more frequent in younger patients, while dementia-related falls were more common in the older ones. Patients with unexplained falls showed a higher number of depressive symptoms. In a multivariate analysis a higher GDS and syncopal spells were independent predictors of unexplained falls. In conclusion, more than one third of all falls in patients hospitalized in orthopaedic wards were unexplained, particularly in patients with depressive symptoms and syncopal spells. The identification of fall causes must be evaluated in older patients with a fall-related injury.

  7. A new rapid and effective method for treatment of unexplained infertility

    DEFF Research Database (Denmark)

    Edelstam, G.; Sjosten, A.; Bjuresten, K.

    2008-01-01

    BACKGROUND: Artificial insemination (intrauterine insemination by husband or artificial insemination by husband) is often tried as first treatment for couples with unexplained infertility. Perturbation has previously proved to increase the chance of achieving pregnancy for these couples. The effect...... and insemination cycles for couples with unexplained infertility. METHODS: In a prospective, open study, the patients were randomized, the day before ovulation, during a clomiphene citrate stimulated cycle to either perturbation with low-dose local anaesthetic or no perturbation before insemination. RESULTS......: The perturbation treatment significantly enhanced the clinical pregnancy rate and was well tolerated. No complications were noted. The combined treatment of clomiphene citrate, perturbation and insemination can be used as a cost-effective, first-line treatment for couples with unexplained infertility...

  8. Unexplained infertility: association with inherited thrombophilia.

    Science.gov (United States)

    Fatini, Cinzia; Conti, Lucia; Turillazzi, Valentina; Sticchi, Elena; Romagnuolo, Ilaria; Milanini, Maria Novella; Cozzi, Cinzia; Abbate, Rosanna; Noci, Ivo

    2012-05-01

    Unexplained infertility represents one of the most common diagnoses in fertility care. Attention is being paid to the association between inherited thrombophilia and infertility causes. In this study we investigated the prevalence of inherited thrombophilia according to infertility causes. We studied Prothrombin gene G20210A mutation, Factor V Leiden, deficiencies in protein S and C and antithrombin in 930 Caucasian infertile women referred to Fertility Center of the Department of Sciences for Woman and Child's Health, University of Florence, of whom 230 with unexplained, 195 female and 283 male infertility, and in 240 women who have conceived naturally without hormonal stimulation therapy. A significant relationship between inherited thrombophilia [OR 95%CI 1.97 (1.05-3.68), p = 0.03] and unexplained infertility was observed, whereas no association between thrombophilia and female and male infertility was found. Significantly higher prevalence of prothrombin gene mutation in unexplained infertile women in comparison to that observed in fertile women was observed (5.7% vs 2.1% p = 0.04); the prevalence of the other thrombophilia determinants was higher, even if not significantly, in the unexplained infertile group. This study demonstrates the relationship between inherited thrombophilia and unexplained infertility, thus suggesting the contribution of genetic components in modulating unexplained infertility, behind anovulation, male and tubal factor. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. A new rapid and effective method for treatment of unexplained infertility

    DEFF Research Database (Denmark)

    Edelstam, G.; Sjosten, A.; Bjuresten, K.

    2008-01-01

    BACKGROUND: Artificial insemination (intrauterine insemination by husband or artificial insemination by husband) is often tried as first treatment for couples with unexplained infertility. Perturbation has previously proved to increase the chance of achieving pregnancy for these couples. The effe...

  10. Unexplained somatic symptoms during major depression: prevalence and clinical impact in a national sample of Italian psychiatric outpatients.

    Science.gov (United States)

    Perugi, Giulio; Canonico, Pier Luigi; Carbonato, Paolo; Mencacci, Claudio; Muscettola, Giovanni; Pani, Luca; Torta, Riccardo; Vampini, Claudio; Fornaro, Michele; Parazzini, Fabio; Dumitriu, Arina

    2011-01-01

    The aim of this study was to explore the prevalence and impact of unexplained somatic symptoms during major depression. A total of 560 consecutive outpatients with a major depressive episode according to the DSM-IV (text revision) were evaluated in 30 psychiatric facilities throughout Italy. 'Unexplained' somatic symptoms were evaluated using the 30-item Somatic Symptoms Checklist (SSCL-30). Somatic symptoms were considered explained if they were best accounted for as coming from a concomitant physical illness or side effects. Patients evaluated their own mood symptomatology using the Zung questionnaires for depression and anxiety and the Hypomania Checklist-32. According to the SSCL-30, only 90 subjects (16.1%) had no unexplained somatic symptoms, while 231 (41.3%) had 1-5 unexplained symptoms and 239 (42.7%) had more than 5. Asthenia was the most commonly observed unexplained somatic symptom (53% of patients). Unexplained somatic symptoms were more common in females and among those suffering from major depression and depression not otherwise specified rather than in patients with recurrent major depression and bipolar disorders. No relationship between unexplained somatic symptoms and hypomanic features was observed. The presence of a large number of unexplained somatic symptoms is associated with more severe depression and higher rates of misdiagnosis and inappropriate treatment. Copyright © 2011 S. Karger AG, Basel.

  11. [The diagnostic value of medical thoracoscopy for unexplained pleural effusion].

    Science.gov (United States)

    Jiang, Shu-juan; Mu, Xiao-yan; Zhang, Song; Su, Li-li; Ma, Wei-xia

    2013-05-01

    To explore the endoscopic features of patients with unexplained pleural effusion, and to evaluate the diagnostic value of medical thoracoscopy. A retrospective analysis of 2380 patients with unexplained pleural effusion (1320 males and 1060 females; age 15-94 years) in Shandong Provincial Hospital from 1992 to 2011 were performed .The diagnosis was confirmed by medical thoracoscopy. The endoscopic findings of malignant pleural effusion mostly showed nodules of varying sizes. The nodules could be grape-like, cauliflower-like, fused into masses, or diffused small nodules . The appearance of cancerous nodules was more diversified compared to tuberculous nodules. Tuberculous pleurisy was manifested as diffuse pleural congestion and miliary changes, multiple small gray-white nodules, fibrin deposition and adhesion in the pleural cavity, pleural thickening and loculation . The pathological diagnosis was as follows: pleural metastases in 899 (37.8%), primary pleural mesothelioma in 439 (18.4%), tuberculous pleurisy in 514 (21.6%), non-specific inflammation in 226 (9.5%), empyema in 190 (8.0%), hepatic pleural effusion in 36 (1.5%) and pleural effusion of unknown causes in 76 (3.2%) cases. The diagnostic positive rate of medical thoracoscopy was 96.8%. No serious complications were observed. Medical thoracoscopy is a relatively safe procedure and has an important application value in the diagnosis of unexplained pleural effusion.

  12. Perinatal outcomes of women with a prior history of unexplained recurrent miscarriage.

    LENUS (Irish Health Repository)

    Dempsey, Mark

    2014-05-14

    Abstract Objective: We sought to determine subsequent pregnancy outcomes in a cohort of women with a history of unexplained RM who were not receiving medical treatment. Study Design: This was a prospective cohort study, of women with a history of three unexplained consecutive first trimester losses, who were recruited and followed in their subsequent pregnancy. Control patients were healthy pregnant patients with no previous adverse perinatal outcome. Results: A total of 42 patients with a history of unexplained RM were recruited to the study. 9 (21.4%) experienced a further first trimester miscarriage, 1 case of ectopic and 1 case of partial molar pregnancy. 74% (23\\/31) of the RM cohort had a vaginal delivery. There was one case of severe pre-eclampsia. The RM group delivered at a mean gestational age of 38+2 weeks and with a mean birth-weight of 3.23kg. None of the neonates were under the 10(th) centile for gestational age. Overall, there was no significant difference in pregnancy outcomes between the two cohorts. Conclusion: Our study confirms the reassuring prognosis for achieving a live birth in the unexplained RM population with a very low incidence of adverse events with the majority delivering appropriately grown fetuses at term.

  13. The resource utilisation of medically unexplained physical symptoms

    Directory of Open Access Journals (Sweden)

    Kimberley Lee

    2016-08-01

    Full Text Available Objectives: As patients with medically unexplained physical symptoms may present frequently to hospital settings and receive potentially unnecessary investigations and treatments, we aimed to assess the frequency and type of medically unexplained physical symptoms presentations to clinical services and estimate the associated direct healthcare costs. Methods: This study was undertaken at the largest district health board in New Zealand. All patients with a diagnosed presentation of medically unexplained physical symptoms in 2013 were identified using the district health board’s clinical coding system. The clinical records (medical and psychiatric of 49 patients were examined in detail to extricate all medically unexplained physical symptoms–related secondary care activity within 6 months before or after their medically unexplained physical symptoms presentation. Standardised national costing methodology was used to calculate the associated healthcare costs. Results: In all, 49% of patients attended hospital settings at least twice during 2013. The majority of presentations were for neurological or respiratory concerns. The total cost for the sample was GBP89,636 (median: GBP1,221. Costs were most significant in the areas of inpatient admissions and emergency care. Conclusion: Medically unexplained physical symptoms result in frequent presentations to hospital settings. The costs incurred are substantial and comparable to the costs of chronic medical conditions with identifiable pathology. Improving recognition and management of medically unexplained physical symptoms has potential to offer more appropriate and cost-effective healthcare outcomes.

  14. Atypical Vitamin B-6 Deficiency A Rare Cause of Unexplained Neonatal and Infantile Epilepsies

    DEFF Research Database (Denmark)

    Baumgart, A.; von Spiczak, S.; Verhoeven-Duif, N. M.

    2014-01-01

    ALDH7A1 and PNPO deficiencies are rare inborn errors of vitamin B-6 metabolism causing perinatal seizure disorders. The phenotypic variability, however, is broad. To assess the frequency of these deficiencies in unexplained infantile epilepsy, we screened 113 patients for mutations in both genes...... pyridoxine treatment. "Hidden" vitamin B-6 deficiencies might be rare but treatable causes of unexplained epilepsy extending beyond the classical phenotypes........ We identified 1 patient with an epilepsy phenotype resembling Dravet syndrome and likely pathogenic mutations in ALDH7A1. Presenting features were highly atypical of pyridoxine-dependent epilepsy, including febrile seizures, response to anticonvulsive drugs, and periods of seizure freedom without...

  15. The Prevalence of Celiac Disease in Children with Unexplained Failure to Thrive in South West of Iran

    Directory of Open Access Journals (Sweden)

    Mehri Taheri

    2017-04-01

    Full Text Available Background Celiac disease (CD, considered as a common chronic and genetic diseases that caused by hypersensitivity to gluten. Failure to thrive (FTT, is one of three major clinical features of CD during childhood. The current study aimed to determine the prevalence of celiac disease in children with unexplained FTT in South West of Iran. Materials and Methods  This cross‑sectional study was conducted on 433 children 9-month to 6 years old that diagnosed as unexplained FTT referred to Abuzar Children's Hospital, Ahvaz, South West of Iran, in 2014. In this study, we examined the serum levels of anti-transglutaminase antibody (anti-tTG in children with unexplained FTT. Data were analyzed using SPSS version 16.0 software. Results  The results showed that the prevalence of CD in children with unexplained FTT in was 8.8%. The mean scores of children's anti-tTG serum levels in both gender and age groups, showed no significant difference (P> 0.05. Conclusion  At current study, the prevalence of CD in children with FTT was 8.8%. Since the CD is an important cause of unexplained FTT in children, the early screening and diagnosis and dietary management can be decrease the risk for long-term complications in these children.

  16. CHRONIC UNEXPLAINED OROFACIAL PAIN

    Directory of Open Access Journals (Sweden)

    Aleš Vesnaver

    2002-04-01

    Full Text Available Background. Chronic unexplained orofacial pain is frequently the cause of prolonged suffering for the patient and an unsolvable problem for the therapist. Pathophysiology of the onset of this type of pain is virtually unknown. Still, it is possible to divide chronic orofacial pain into several separate categories, according to its onset, symptoms and therapy. All forms of this type of pain have a strong psychological component.Methods. A retrograde review was conducted, in which patients’ records, treated in 1994 for chronic unexplained orofacial pain, were followed through a 5 year period. The modalities of treatment then and at present were compared.Conclusions. Except for trigeminal neuralgia, where carbamazepine remains the first choice drug, treatment of chronic facial pain has changed considerably.

  17. Clinical Correlates of Unexplained Infertility in Southeastern Nigeria ...

    African Journals Online (AJOL)

    Context: In the absence of any obvious aetiological factor, a couple is said to have unexplained infertility. It is desirable to identify factors associated with unexplained infertility in this environment and to ascertain if there is a causal relationship between infertility and uterine leiomyomata. Objective: The study is aimed at ...

  18. GPIHBP1 autoantibodies in a patient with unexplained chylomicronemia

    DEFF Research Database (Denmark)

    Hu, Xuchen; Dallinga-Thie, Geesje M.; Hovingh, G. Kees

    2017-01-01

    into the frequency of the GPIHBP1 autoantibody syndrome in patients with unexplained chylomicronemia. Methods We used enzyme-linked immunosorbent assays to screen for GPIHBP1 autoantibodies in 33 patients with unexplained chylomicronemia and then used Western blots and immunocytochemistry studies to characterize....... The patient had no history of autoimmune disease, but his plasma was positive for antinuclear antibodies. Conclusions One of 33 patients with unexplained chylomicronemia had the GPIHBP1 autoantibody syndrome. Additional studies in large lipid clinics will be helpful for better defining the frequency...

  19. Opinions about 'unexplained subfertility'

    NARCIS (Netherlands)

    Batstra, L; van de Wiel, HBM; Schuiling, GA

    2002-01-01

    The term 'unexplained subfertility' applies to the situation in which a couple, despite serious attempts, does not achieve pregnancy, while according to current knowledge no physiological or anatomical abnormalities can be found. In this paper, possible causes of this phenomenon are reviewed and

  20. Kisspeptin, unexplained infertility and embryo implantation

    Directory of Open Access Journals (Sweden)

    Aaida Mumtaz

    2017-03-01

    Full Text Available Background Kisspeptin (KP is a neuropeptide that causes the release of the gonadotropin releasing hormone, which controls hypothalamo pituitary ovarian axis and exerts a number of peripheral effects on reproductive organs. The primary objective of this study was to compare baseline KP levels in females with different types of infertility and identify possible correlations with risk of failure to conceive, preclinical abortion and pregnancy after intracytoplasmic sperm injection (ICSI. Materials and Methods A longitudinal cohort study was carried out from August 2014 until May 2015 by recruiting 124 female patients undergoing ICSI, after obtaining ethical approval from the Australian Concept Infertility Medical Center. Cause of infertility due to male, female and unexplained factors was at a frequency of 32 (24%, 33 (31% and 59 (45% among the individuals respectively. KP levels were measured by ELISA assay before the initiation of the ICSI treatment protocol. Outcome of ICSI was categorized into three groups of non-pregnant with beta-human chorionic gonadotropin (β-hCG25 mIU/ml and no cardiac activity, and clinical pregnancy declared upon confirmation of cardiac activity. Results based on cause of infertility and outcome groups were analyzed by one-way ANOVA. Results Females with unexplained infertility had significantly lower levels of KP when compared with those with male factor infertility (176.69 ± 5.03 vs. 397.6 ± 58.2, P=0.001. Clinical pregnancy was observed in 28 (23% females of which 17 (71% had a female cause of infertility. In the non-pregnant group of 66 (53% females, common cause of infertility was unexplained 56(85%. A weak positive correlation of KP levels with fertilized oocytes and endometrial thickness was observed (P=0.04 and 0.01 respectively. Conclusion Deficiency of KP in females with unexplained infertility was associated with reduced chances of implantation after ICSI.

  1. Altered autonomic nervous system activity in women with unexplained recurrent pregnancy loss.

    Science.gov (United States)

    Kataoka, Kumie; Tomiya, Yumi; Sakamoto, Ai; Kamada, Yasuhiko; Hiramatsu, Yuji; Nakatsuka, Mikiya

    2015-06-01

    Autonomic nervous system activity was studied to evaluate the physical and mental state of women with unexplained recurrent pregnancy loss (RPL). Heart rate variability (HRV) is a measure of beat-to-beat temporal changes in heart rate and provides indirect insight into autonomic nervous system tone and can be used to assess sympathetic and parasympathetic tone. We studied autonomic nervous system activity by measuring HRV in 100 women with unexplained RPL and 61 healthy female volunteers as controls. The degree of mental distress was assessed using the Kessler 6 (K6) scale. The K6 score in women with unexplained RPL was significantly higher than in control women. HRV evaluated on standard deviation of the normal-to-normal interval (SDNN) and total power was significantly lower in women with unexplained RPL compared with control women. These indices were further lower in women with unexplained RPL ≥4. On spectral analysis, high-frequency (HF) power, an index of parasympathetic nervous system activity, was significantly lower in women with unexplained RPL compared with control women, but there was no significant difference in the ratio of low-frequency (LF) power to HF power (LF/HF), an index of sympathetic nervous system activity, between the groups. The physical and mental state of women with unexplained RPL should be evaluated using HRV to offer mental support. Furthermore, study of HRV may elucidate the risk of cardiovascular diseases and the mechanisms underlying unexplained RPL. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  2. Feature binding and attention in working memory: a resolution of previous contradictory findings.

    Science.gov (United States)

    Allen, Richard J; Hitch, Graham J; Mate, Judit; Baddeley, Alan D

    2012-01-01

    We aimed to resolve an apparent contradiction between previous experiments from different laboratories, using dual-task methodology to compare effects of a concurrent executive load on immediate recognition memory for colours or shapes of items or their colour-shape combinations. Results of two experiments confirmed previous evidence that an irrelevant attentional load interferes equally with memory for features and memory for feature bindings. Detailed analyses suggested that previous contradictory evidence arose from limitations in the way recognition memory was measured. The present findings are inconsistent with an earlier suggestion that feature binding takes place within a multimodal episodic buffer Baddeley, ( 2000 ) and support a subsequent account in which binding takes place automatically prior to information entering the episodic buffer Baddeley, Allen, & Hitch, ( 2011 ). Methodologically, the results suggest that different measures of recognition memory performance (A', d', corrected recognition) give a converging picture of main effects, but are less consistent in detecting interactions. We suggest that this limitation on the reliability of measuring recognition should be taken into account in future research so as to avoid problems of replication that turn out to be more apparent than real.

  3. Prolonged unexplained fatigue in paediatrics

    NARCIS (Netherlands)

    Bakker, R.J.

    2010-01-01

    Prolonged Unexplained Fatigue in Paediatrics. Fatigue, as the result of mental or physical exertion, will disappear after rest, drinks and food. Fatigue as a symptom of illness will recover with the recovering of the illness. But when fatigue is ongoing for a long time, and not the result of

  4. Basic psychological need experiences, fatigue, and sleep in individuals with unexplained chronic fatigue.

    Science.gov (United States)

    Campbell, Rachel; Tobback, Els; Delesie, Liesbeth; Vogelaers, Dirk; Mariman, An; Vansteenkiste, Maarten

    2017-12-01

    Grounded in self-determination theory, this study tested the hypothesis that the satisfaction and frustration of the psychological needs for autonomy, competence, and relatedness would relate to fatigue and subjective and objective sleep parameters, with stress and negative sleep cognitions playing an explanatory role in these associations. During a stay at a sleep laboratory in Belgium, individuals with unexplained chronic fatigue (N = 160; 78% female) underwent polysomnography and completed a questionnaire at 3 different points in time (i.e., after arrival in the sleep lab, before bedtime, and the following morning) that assessed their need-based experiences and stress during the previous week, fatigue during the preceding day, and sleep-related cognitions and sleep during the previous night. Results indicated that need frustration related to higher stress, which in turn, related to higher evening fatigue. Need frustration also related to poorer subjective sleep quality and shorter sleep duration, as indicated by both subjective and objective shorter total sleep time and subjective (but not objective) longer sleep latency. These associations were accounted for by stress and negative sleep cognitions. These findings suggest that health care professionals working with individuals with unexplained chronic fatigue may consider focusing on basic psychological needs within their therapeutic approach. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Evidence of small-fiber polyneuropathy in unexplained, juvenile-onset, widespread pain syndromes.

    Science.gov (United States)

    Oaklander, Anne Louise; Klein, Max M

    2013-04-01

    We tested the hypothesis that acquired small-fiber polyneuropathy (SFPN), previously uncharacterized in children, contributes to unexplained pediatric widespread pain syndromes. Forty-one consecutive patients evaluated for unexplained widespread pain beginning before age 21 had medical records comprehensively analyzed regarding objective diagnostic testing for SFPN (neurodiagnostic skin biopsy, nerve biopsy, and autonomic function testing), plus histories, symptoms, signs, other tests, and treatments. Healthy, demographically matched volunteers provided normal controls for SFPN tests. Age at illness onset averaged 12.3 ± 5.7 years; 73% among this poly-ethnic sample were female (P = .001). Sixty-eight percent were chronically disabled, and 68% had hospitalizations. Objective testing diagnosed definite SFPN in 59%, probable SFPN in 17%, and possible SFPN in 22%. Only 1 of 41 had entirely normal SFPN test results. Ninety-eight percent of patients had other somatic complaints consistent with SFPN dysautonomia (90% cardiovascular, 82% gastrointestinal, and 34% urologic), 83% reported chronic fatigue, and 63% had chronic headache. Neurologic examinations identified reduced sensation in 68% and vasomotor abnormalities in 55%, including 23% with erythromelalgia. Exhaustive investigations for SFPN causality identified only history of autoimmune illnesses in 33% and serologic markers of disordered immunity in 89%. Treatment with corticosteroids and/or intravenous immune globulin objectively and subjectively benefited 80% of patients (12/15). More than half among a large series of patients with childhood-onset, unexplained chronic widespread pain met rigorous, multitest, diagnostic criteria for SFPN, which extends the age range of acquired SFPN into early childhood. Some cases appeared immune-mediated and improved with immunomodulatory therapies.

  6. Identity work and illness careers of patients with medically unexplained symptoms

    DEFF Research Database (Denmark)

    Rossen, Camilla Blach; Buus, Niels; Stenager, Elsebeth

    2018-01-01

    often experience being met with mistrust and feel their identity threatened as a consequence of being illegitimately ill. There is a strong tendency in health care towards assessment thorough standardized so-called assessment packages. The study used a case study approach. Ethnographic fieldwork......This article reports a case study of the illness career and identity work of patients who have had medically unexplained symptoms for many years with a particular emphasis on their interactions with a specialized and standardized health care system. Patients with medically unexplained symptoms...... assessment with limited time can lead to a diagnostic limbo and that patients and health care professionals keep on searching for legitimate explanations for the patients' still unexplained symptoms. Consequently the patients were left in a constant identity negotiation....

  7. Sexual function in infertile women with polycystic ovary syndrome and unexplained infertility.

    Science.gov (United States)

    Diamond, Michael P; Legro, Richard S; Coutifaris, Christos; Alvero, Ruben; Robinson, Randal D; Casson, Peter A; Christman, Gregory M; Huang, Hao; Hansen, Karl R; Baker, Valerie; Usadi, Rebecca; Seungdamrong, Aimee; Bates, G Wright; Rosen, R Mitchell; Schlaff, William; Haisenleder, Daniel; Krawetz, Stephen A; Barnhart, Kurt; Trussell, J C; Santoro, Nanette; Eisenberg, Esther; Zhang, Heping

    2017-08-01

    While female sexual dysfunction is a frequent occurrence, characteristics in infertile women are not well delineated. Furthermore, the impact of infertility etiology on the characteristics in women with differing androgen levels observed in women with polycystic ovary syndrome and unexplained infertility has not been assessed. The objective of the study was to determine the characteristics of sexual dysfunction in women with polycystic ovary syndrome and unexplained infertility. A secondary data analysis was performed on 2 of Eunice Kennedy Shriver National Institute of Child Health and Human Development Cooperative Reproductive Medicine Networks clinical trials: Pregnancy in Polycystic Ovary Syndrome Study II and Assessment of Multiple Intrauterine Gestations From Ovarian Stimulation. Both protocols assessed female sexual function using the Female Sexual Function Inventory and the Female Sexual Distress Scale. Women with polycystic ovary syndrome had higher weight and body mass index than women with unexplained infertility (each P polycystic ovary syndrome. The mean Female Sexual Function Inventory total score increased slightly as the free androgen index increased, mainly as a result of the desire subscore. This association was more pronounced in the women with unexplained infertility. Reproductive-age women with infertility associated with polycystic ovary syndrome and unexplained infertility, despite phenotypic and biochemical differences in androgenic manifestations, do not manifest clinically significant differences in sexual function. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Unexplained infertility: identification of anti sperm antibodies using radiometric immunoassay

    International Nuclear Information System (INIS)

    Megahed, Y.M.; Elnabarawy, F.; Hamada, T.; Ayiad, S.K.

    1992-01-01

    Several methods have been employed to measure anti sperm antibodies with variable sensitivity and specificity in serum and secretion of infertile patients. All of them are not precise means for identification of the presence of anti sperm antibodies for patients with unexplained infertility (Haas et al, 1980). Therefore, the modified radiolabelled anti globulin test, that has been used successfully to identify and quantitate the antibodies directed towards other human cell surfaces, was applied. A total number of 128 subjects in different groups were studied to quantitate the circulating anti sperm antibodies using the modified procedure. The present data revealed that the highest and the most significant incidence were found in the patients secretions (semen and cervical mucus) with unexplained infertility, as well as in the group of males with varicocele. Therefore it is greatly advisable to use the modified radiolabelled technique as a quantitative assay, which will be helpful in management of infertility in patients with unexplained and mediated infertility.3 tab., 4 fig

  9. Overtreatment in couples with unexplained infertility.

    Science.gov (United States)

    Kersten, F A M; Hermens, R P G M; Braat, D D M; Hoek, A; Mol, B W J; Goddijn, M; Nelen, W L D M

    2015-01-01

    What is the percentage of overtreatment, i.e. fertility treatment started too early, in couples with unexplained infertility who were eligible for tailored expectant management? Overtreatment occurred in 36% of couples with unexplained infertility who were eligible for an expectant management of at least 6 months. Prognostic models in reproductive medicine can help to identify infertile couples that would benefit from fertility treatment. In couples with unexplained infertility with a good chance of natural conception within 1 year, based on the Hunault prediction model, an expectant management of 6-12 months, as recommended in international fertility guidelines, prevents unnecessary treatment. A retrospective cohort study in 25 participating clinics, with follow-up of all couples who were seen for infertility in 2011-2012. In all, 9818 couples were seen for infertility in the participating clinics. Couples were eligible to participate if they were diagnosed with unexplained infertility and had a good prognosis of natural conception (>30%) within 1 year based on the Hunault prediction model. Data to assess overtreatment were collected from medical records. Multilevel regression analyses were performed to investigate associations of overtreatment with patient and clinic characteristics. Five hundred and forty-four couples eligible for expectant management were included in this study. Among these, overtreatment, i.e. starting medically assisted reproduction within 6 months, occurred in 36%. The underlying quality indicators showed that in 34% no prognosis was calculated and that in 42% expectant management was not recommended. Finally, 16% of the couples for whom a correct recommendation of expectant management for at least 6 months was made, started treatment within 6 months anyway. Overtreatment was associated with childlessness, higher female age and a longer duration of infertility. No associations between overtreatment and clinic characteristics were found. The

  10. Cross-cultural differences in the epidemiology of unexplained fatigue syndromes in primary care.

    Science.gov (United States)

    Skapinakis, Petros; Lewis, Glyn; Mavreas, Venetsanos

    2003-03-01

    Unexplained fatigue has been extensively studied but most of the samples used were from Western countries. To present international data on the prevalence of unexplained fatigue and fatigue as a presenting complaint in primary care. Method Secondary analysis of the World Health Organization study of psychological problems in general health care. A total of 5438 primary care attenders from 14 countries were assessed with the Composite International Diagnostic Interview. The prevalence of unexplained fatigue of 1-month duration differed across centres, with a range between 2.26 (95% CI 1.17-4.33) and 15.05 (95% CI 10.85-20.49). Subjects from more-developed countries were more likely to report unexplained fatigue but less likely to present with fatigue to physicians compared with subjects from less developed countries. In less-developed countries fatigue might be an indicator of unmet psychiatric need, but in more-developed countries it is probably a symbol of psychosocial distress.

  11. Massive immunoglobulin treatment in women with four or more recurrent spontaneous primary abortions of unexplained aetiology.

    Science.gov (United States)

    Yamada, H; Kishida, T; Kobayashi, N; Kato, E H; Hoshi, N; Fujimoto, S

    1998-09-01

    The aim of this trial was to investigate the efficacy of massive i.v. immunoglobulin (MIVIg) treatment for women with a history of recurrent spontaneous abortion (RSA) due to unexplained aetiology. The study included nine women (11 pregnancies) with a history of four or more consecutive RSA with unexplained aetiology and no live births. The mean number of fetal losses was 4.5 (range 4-6 abortions). Over the course of 5 days, immunoglobulin (20 g/day) was infused i.v. at gestational weeks 4-7. No additional infusions were carried out. Two pregnancies out of the 11 conceptions resulted in missed abortions at gestational weeks 6 and 7 respectively. Mosaicism (46XX/ 48XX, +16, +20), and tetraploidy (92XXXX) were found by chromosome analyses of the two aborti. Eight out of the other nine pregnancies resulted in full term deliveries of healthy neonates. One pregnancy developed intrauterine growth retardation and fetal distress, resulting in a premature delivery (30 gestational weeks) by Caesarean section. Thus, excluding the two abortions with chromosome aberrations, the MIVIg treatment was effective in all nine pregnancies of RSA women with unexplained aetiology. This MIVIg treatment (100 g administered in early gestation) may be a beneficial alternative to previous IVIg infusion methods, and should be further evaluated in a multicentric, placebo-controlled study, employing a larger number of homogeneous patients who fall into a high risk category of first trimester abortions.

  12. Unexplained mental retardation: is brain MRI useful?

    Energy Technology Data Exchange (ETDEWEB)

    Decobert, Fabrice; Merzoug, Valerie; Kalifa, Gabriel; Adamsbaum, Catherine [Saint Vincent de Paul Hospital, Department of Radiology, 75674 Paris Cedex 14 (France); Grabar, Sophie [Cochin Hospital, Department of Biostatistics and Medical Information, Paris (France); Ponsot, Gerard [Saint Vincent de Paul Hospital, Department of Neuropaediatrics, Paris (France); Des Portes, Vincent [Saint Vincent de Paul Hospital, Department of Neuropaediatrics, Paris (France); Debrousse Hospital, Department of Neuropaediatrics, Lyon (France)

    2005-06-01

    Mental retardation (MR), defined as an IQ below 70, is a frequent cause of consultation in paediatrics. To evaluate the yield of brain MRI in the diagnostic work-up of unexplained MR in children. Patients and methods: The MRI features and clinical data of 100 patients (age 1-18 years) affected with non-progressive MR of unknown origin were compared to an age-matched control group (n=100). Two radiologists conducted an independent review of the MRI scans. Univariate and multivariate analyses showed a higher incidence of brain anomalies in the MR group than in the control group (53 vs 17, OR=5.7 [2.9-11.1]), for signal abnormalities within the periventricular white matter (OR=20.3 [2.6-155.3]), lateral ventricular dilatation (OR=15.6 [2.0-124]), mild corpus callosum abnormalities (shortness, atrophy) (OR=6.8 [1.8-25.6]) and subtle cerebellar abnormalities, including fissure enlargement (OR=5.2 [1.1-26.2]). The diagnostic value of MRI abnormalities was considered good in 5% of patients (Alexander disease n=1, diffuse cortical malformation n=1, leukomalacia n=1, vermian agenesis n=1, commissural agenesis n=1), and weak in 48% of patients, in whom non-specific abnormalities did not lead to a diagnosis. Some clinical features resulted in a significantly higher percentage of abnormal MRI scans: abnormal neurological examination (82% vs 47%, P=0.008), abnormal skull circumference (66% vs 49%, P=0.04). Motor delay was associated with cerebellar abnormalities (P=0.01). (orig.)

  13. Unexplained mental retardation: is brain MRI useful?

    International Nuclear Information System (INIS)

    Decobert, Fabrice; Merzoug, Valerie; Kalifa, Gabriel; Adamsbaum, Catherine; Grabar, Sophie; Ponsot, Gerard; Des Portes, Vincent

    2005-01-01

    Mental retardation (MR), defined as an IQ below 70, is a frequent cause of consultation in paediatrics. To evaluate the yield of brain MRI in the diagnostic work-up of unexplained MR in children. Patients and methods: The MRI features and clinical data of 100 patients (age 1-18 years) affected with non-progressive MR of unknown origin were compared to an age-matched control group (n=100). Two radiologists conducted an independent review of the MRI scans. Univariate and multivariate analyses showed a higher incidence of brain anomalies in the MR group than in the control group (53 vs 17, OR=5.7 [2.9-11.1]), for signal abnormalities within the periventricular white matter (OR=20.3 [2.6-155.3]), lateral ventricular dilatation (OR=15.6 [2.0-124]), mild corpus callosum abnormalities (shortness, atrophy) (OR=6.8 [1.8-25.6]) and subtle cerebellar abnormalities, including fissure enlargement (OR=5.2 [1.1-26.2]). The diagnostic value of MRI abnormalities was considered good in 5% of patients (Alexander disease n=1, diffuse cortical malformation n=1, leukomalacia n=1, vermian agenesis n=1, commissural agenesis n=1), and weak in 48% of patients, in whom non-specific abnormalities did not lead to a diagnosis. Some clinical features resulted in a significantly higher percentage of abnormal MRI scans: abnormal neurological examination (82% vs 47%, P=0.008), abnormal skull circumference (66% vs 49%, P=0.04). Motor delay was associated with cerebellar abnormalities (P=0.01). (orig.)

  14. Risk of gastrointestinal cancer in patients with unexplained chest/epigastric pain and normal upper endoscopy: a Danish 10-year follow-up study

    DEFF Research Database (Denmark)

    Munk, Estrid Muff; Drewes, Asbjørn Mohr; Gorst-Rasmussen, Anders

    2007-01-01

    Unexplained chest/epigastric pain is a common symptom in the general population. However, it has not previously been studied whether such pain could be a marker of subsequent gastrointestinal cancer. We aimed to estimate the risk of gastrointestinal cancers in a Danish 10-year follow-up study amo...

  15. Investigation of Mental Health in Patients with Medically ‎Unexplained Physical Symptoms‎

    Directory of Open Access Journals (Sweden)

    Frough Riahi

    2016-02-01

    Full Text Available Objective: Medically unexplained symptoms are physical symptoms, which cannot be explained by organic ‎causes. This study aimed to investigate mental health in patients with medically unexplained ‎physical symptoms. ‎Method: One hundred outpatients who were admitted to the Electro Diagnosis Clinic of Imam Khomeini ‎hospital, Ahvaz/Iran, participated in this study. Data were collected using physical examination, ‎paraclinical examinations, and SCL-90-R, and analyzed through multivariate analysis of variance ‎‎ (MANOVA, Chi-square test and Fisher’s exact test. ‎Results: The findings revealed significant differences between clients with medically explained and ‎unexplained symptoms in obsessive compulsive and somatization (p<0.05. Differences in ‎depression, anxiety, phobia, psychosis, aggression and paranoia were not significant (p>0.05.‎Conclusion: The present study suggested an association between some psychological problems and somatic ‎symptoms. Therefore, screening for psychological impairments can improve clinical outcomes.

  16. Prediction of thrombophilia in patients with unexplained recurrent pregnancy loss using a statistical model.

    Science.gov (United States)

    Wang, Tongfei; Kang, Xiaomin; He, Liying; Liu, Zhilan; Xu, Haijing; Zhao, Aimin

    2017-09-01

    To establish a statistical model to predict thrombophilia in patients with unexplained recurrent pregnancy loss (URPL). A retrospective case-control study was conducted at Ren Ji Hospital, Shanghai, China, from March 2014 to October 2016. The levels of D-dimer (DD), fibrinogen degradation products (FDP), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fg), and platelet aggregation in response to arachidonic acid (AA) and adenosine diphosphate (ADP) were collected. Receiver operating characteristic curve analysis was used to analyze data from 158 UPRL patients (≥3 previous first trimester pregnancy losses with unexplained etiology) and 131 non-RPL patients (no history of recurrent pregnancy loss). A logistic regression model (LRM) was built and the model was externally validated in another group of patients. The LRM included AA, DD, FDP, TT, APTT, and PT. The overall accuracy of the LRM was 80.9%, with sensitivity and specificity of 78.5% and 78.3%, respectively. The diagnostic threshold of the possibility of the LRM was 0.6492, with a sensitivity of 78.5% and a specificity of 78.3%. Subsequently, the LRM was validated with an overall accuracy of 83.6%. The LRM is a valuable model for prediction of thrombophilia in URPL patients. © 2017 International Federation of Gynecology and Obstetrics.

  17. Yield and Pitfalls of Ajmaline Testing in the Evaluation of Unexplained Cardiac Arrest and Sudden Unexplained Death: Single-Center Experience With 482 Families.

    Science.gov (United States)

    Tadros, Rafik; Nannenberg, Eline A; Lieve, Krystien V; Škorić-Milosavljević, Doris; Lahrouchi, Najim; Lekanne Deprez, Ronald H; Vendrik, Jeroen; Reckman, Yolan J; Postema, Pieter G; Amin, Ahmad S; Bezzina, Connie R; Wilde, Arthur A M; Tan, Hanno L

    2017-12-11

    This study evaluated the yield of ajmaline testing and assessed the occurrence of confounding responses in a large cohort of families with unexplained cardiac arrest (UCA) or sudden unexplained death (SUD). Ajmaline testing to diagnose Brugada syndrome (BrS) is routinely used in the evaluation of SUD and UCA, but its yield, limitations, and appropriate dosing have not been studied in a large cohort. We assessed ajmaline test response and genetic testing results in 637 individuals from 482 families who underwent ajmaline testing for SUD or UCA. Overall, 89 individuals (14%) from 88 families (18%) had a positive ajmaline test result. SCN5A mutations were identified in 9 of 86 ajmaline-positive cases (10%). SCN5A mutation carriers had positive test results at significantly lower ajmaline doses than noncarriers (0.75 [range: 0.64 to 0.98] mg/kg vs. 1.03 [range: 0.95 to 1.14] mg/kg, respectively; p genetic diagnosis accounting for UCA/SUD (5 cases) or noncosegregation of positive ajmaline response and arrhythmia (2 cases). The rate of confounding responses was significantly higher in positive ajmaline responses obtained at >1 mg/kg than in those obtained at ≤1 mg/kg (7 of 48 vs. 0 of 41 individuals; Fisher's exact test: p = 0.014). In line with previous, smaller studies, a positive ajmaline response was observed in a large proportion of UCA/SUD families. Importantly, our data emphasize the potential for confounding possibly false-positive ajmaline responses in this population, particularly at high doses, which could possibly lead to a misdiagnosis. Clinicians should consider all alternative causes in UCA/SUD and avoid ajmaline doses >1 mg/kg. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  18. Explained and unexplained tissue loss in corals from the Tropical Eastern Pacific

    Science.gov (United States)

    Rodriguez-Villalobos, Jenny Carolina; Work, Thierry M.; Calderon-Aguilera, Luis Eduardo; Reyes-Bonilla, Hector; Hernández, Luis

    2015-01-01

    Coral reefs rival rainforest in biodiversity, but are declining in part because of disease. Tissue loss lesions, a manifestation of disease, are present in dominant Pocillopora along the Pacific coast of Mexico. We characterized tissue loss in 7 species of Pocillopora from 9 locations (44 sites) spanning southern to northern Mexico. Corals were identified to species, and tissue loss lesions were photographed and classified as those explainable by predation and those that were unexplained. A focal predation study was done concurrently at 3 locations to confirm origin of explained lesions. Of 1054 cases of tissue loss in 7 species of corals, 84% were associated with predation (fish, snails, or seastar) and the remainder were unexplained. Types of tissue loss were not related to coral density; however there was significant geographic heterogeneity in type of lesion; one site in particular (Cabo Pulmo) had the highest prevalence of predator-induced tissue loss (mainly pufferfish predation). Crown-of-thorns starfish, pufferfish, and snails were the most common predators and preferred P. verrucosa, P. meandrina, and P. capitata, respectively. Of the 9 locations, 4 had unexplained tissue loss with prevalence ranging from 1 to 3% with no species predilection. Unexplained tissue loss was similar to white syndrome (WS) in morphology, indicating additional study is necessary to clarify the cause(s) of the lesions and the potential impacts to dominant corals along the Pacific coast of Mexico.

  19. Use of Implantable Loop Recorders to Unravel the Cause of Unexplained Syncope

    Directory of Open Access Journals (Sweden)

    Dr. Aniket Puri, DM, FACC, FAPSIC, FSCAI

    2013-03-01

    Full Text Available Syncope is a symptom of many underlying disease states, which range from the relatively benign to the life threatening. There are numerous investigations done for patients with recurrent unexplained syncope which may have very low yield when it comes to making a definitive diagnosis. Recently, the implantable loop recorder (ILR for continuous monitoring of the cardiac rhythm has been launched in India. This review will briefly discuss these current availabel strategies and focus on the usefulness of an ILR in the definitive diagnosis and treatment of patients with a recurrent unexplained syncope.

  20. Lower FOXO3 mRNA expression in granulosa cells is involved in unexplained infertility.

    Science.gov (United States)

    Yamamoto, Hikaru; Yamashita, Yoshiki; Saito, Natsuho; Hayashi, Atsushi; Hayashi, Masami; Terai, Yoshito; Ohmichi, Masahide

    2017-06-01

    The aim of this study was to investigate whether FOXO1 and FOXO3 mRNA expression in granulosa cells is the cause of unexplained infertility. Thirty-one patients aged infertility and 18 with male partner infertility as a control group) whose serum anti-Müllerian hormone level was >0.5 ng/μL were enrolled in the study. All patients underwent oocyte retrieval under a short protocol from June 2012 to October 2013. Real-time PCR was carried out using mRNA extracted from granulosa cells retrieved from mature follicles. We compared FOXO1 and FOXO3 mRNA expression ratios in granulosa cells between the unexplained infertility group and the male infertility group. The relation between FOXO1 and FOXO3 mRNA expression ratios in granulosa cells and assisted reproduction technology clinical outcome was also examined. FOXO3 mRNA expression ratio was significantly lower in the unexplained infertility group than in the male infertility group. Moreover, FOXO3 mRNA expression ratio showed a positive correlation with both the number of retrieved oocytes and serum anti-Müllerian hormone level. A positive correlation was also identified between FOXO1 mRNA expression and total dose of hMG. As well, the number of retrieved oocytes in the unexplained infertility group was statistically lower than that in the male infertility group. A lower FOXO3 mRNA expression in granulosa cells leads to poor oocyte development in patients with unexplained infertility undergoing controlled ovarian stimulation for in vitro fertilization-embryo transfer. © 2017 Japan Society of Obstetrics and Gynecology.

  1. Value of hysteroscopy in management of unexplained infertility

    Directory of Open Access Journals (Sweden)

    Aisha M. Elbareg

    2014-12-01

    Conclusion: As a cause of unexplained infertility, subtle uterine abnormalities are diagnosed only during hysteroscopy and they are relatively common in infertility women. Although the presence of these abnormalities is not detected by the basic investigations for infertility, their correction seems to be necessary when infertility is desired and other infertility causes are excluded.

  2. New parvovirus in child with unexplained diarrhea, Tunisia.

    Science.gov (United States)

    Phan, Tung G; Sdiri-Loulizi, Khira; Aouni, Mahjoub; Ambert-Balay, Katia; Pothier, Pierre; Deng, Xutao; Delwart, Eric

    2014-11-01

    A divergent parvovirus genome was the only eukaryotic viral sequence detected in feces of a Tunisian child with unexplained diarrhea. Tusavirus 1 shared 44% and 39% identity with the nonstructural protein 1 and viral protein 1, respectively, of the closest genome, Kilham rat parvovirus, indicating presence of a new human viral species in the Protoparvovirus genus.

  3. Diminished Frequency of Menstrual and Peripheral Blood NKT-Like Cells in Patients With Unexplained Recurrent Spontaneous Abortion and Infertile Women.

    Science.gov (United States)

    Hosseini, Samira; Shokri, Fazel; Pour, Soheila Ansari; Khoshnoodi, Jalal; Jeddi-Tehrani, Mahmood; Zarnani, Amir-Hassan

    2018-01-01

    Systemic monitoring of immune system may not precisely outline the local immune status in the uterus. This survey is a continuation of our previous studies on potential usefulness of menstrual blood (MB) immunophenotyping as a tool for investigation of immunological disturbances in pregnancy-related disorders. Peripheral blood (PB) and MB from healthy fertile (n = 15), unexplained recurrent spontaneous abortion (URSA; n = 15), and unexplained infertile women (n = 8) were collected simultaneously in the second day of their menstrual cycle and frequency of natural killer T (NKT)-like cell subpopulations were assessed by flow cytometry. Menstrual blood of all experimental groups contained higher percentage of TCRαβ + , CD45RO + , and CD16 - NKT-like cells compared to corresponding PB. Frequency of MB NKT-like cells in unexplained infertile participants was lower than fertile and URSA groups. Compared to normal participants, patients with URSA had lower frequency of PB TCRαβ + and higher CD16 + , while in infertile woman frequencies of PB CD45RO + , CD45RO - , CD16 - , IL17 + , and MB CD45RO + NKT-like cells were lower. Although, PB and MB seemingly have the same histological nature, our results showed that MB contained different composition of NKT-like subsets with different cytokine profiles and could be viewed as one potential biological sample for evaluation of patients with infertility and URSA.

  4. Do attitudes of families concerned influence features of children who claim to remember previous lives?

    Science.gov (United States)

    Pasricha, Satwant K

    2011-01-01

    Reported cases of nearly 2600 children (subjects) who claim to remember previous lives have been investigated in cultures with and without belief in reincarnation. The authenticity in most cases has been established. To study the influence of attitudes of parents of the subjects, families of the deceased person with whom they are identified and attention paid by others on the features of the cases. The study is based on field investigations. Data is derived from analysis of a larger series of an ongoing project. Information on initial and subsequent attitudes of subjects' mothers was available for 292 and 136 cases, respectively; attitudes of 227 families of deceased person (previous personality) with whom he is identified, and the extent of attention received from outsiders for 252 cases. Observations and interviews with multiple firsthand informants on both sides of the case as well as some neutral informants supplemented by examination of objective data were the chief methods of investigation. The initial attitude of mothers varied from encouragement (21%) to neutral or tolerance (51%) to discouragement (28%). However, it changed significantly from neutrality to taking measures to induce amnesia in their children for previous life memories due to various psychosocial pressures and prevalent beliefs. Families of the previous personalities, once convinced, showed complete acceptance in a majority of cases. Outside attention was received in 58% cases. The positive attitude of parents might facilitate expression of memories but subsequently attitudes of persons concerned do not seem to alter features of the cases.

  5. Dysautonomia: an Explanation for the Medically Unexplained?

    Directory of Open Access Journals (Sweden)

    Senthil Chandrasekaram

    2016-07-01

    Full Text Available Objective: To identify dysautonomia as a collection of conditions with variable presentation that may be mistaken for medically unexplained symptoms. Methods: Case series. Results: Tilt table testing and 24 h electrocardiographic monitoring provided useful diagnostic tools to confirm the diagnosis. Conclusion: A greater awareness and recognition of the disorders that result from dysautonomia and recognition of the disability that results from these disorders will improve patients’ quality of life.

  6. 'Could I be imagining this?' - the dialectic struggles of people with persistent unexplained back pain.

    Science.gov (United States)

    Toye, Francine; Barker, Karen

    2010-01-01

    To explore how patients with persistent unexplained pain interpret and utilise the biopsychosocial model. This might have an impact on the outcome from treatment programmes that adopts a biopsychosocial approach. We conducted three interviews with 20 patients attending a pain management programme for persistent unexplained back pain; prior to attending the course, immediately following the course and at 1 year. We used the methods of grounded theory. Patients battled through several dialectic tensions in an attempt to legitimise their pain: First, patients wanted a medical diagnosis but also recognised that psychosocial factors contributed to their pain. Second, although the outward appearance of pain was important to legitimacy, it was also important not to appear 'too ill'. Third, meeting others with unexplained pain reinforced credibility, but patients also described how they were not 'like the others'. Finally, although holding on to one's self was important, patients also described an acceptance of loss. These dialectic tensions are likely to have an impact on a person's decision to embrace the biopsychosocial model, and might therefore effect their outcome. Health care professionals should be sensitive to the cultural ambiguity of patients with persistent unexplained pain.

  7. An uncommon cause of unexplained nonbloody diarrhea: When mind knows eyes may see

    Directory of Open Access Journals (Sweden)

    Hemanta Kumar Nayak

    2016-01-01

    Full Text Available Collagenous colitis (CC is characterized by chronic secretory diarrhea with the apparently normal gross appearance of the colonic mucosa. A biopsy is usually diagnostic. The symptoms of CC appear most commonly in the elderly. In CC, the major microscopic characteristic is a thickened collagen layer beneath the colonic mucosa. The reported case represents unexplained nonbloody diarrhea of a systemic lupus erythematosus patient, on extensive evaluation found to have CC. This case highlights the importance of considering a rare possibility of CC as a differential in a patient of unexplained nonbloody diarrhea.

  8. Functional status in patients with medically unexplained physical symptoms : Coping styles and their relationship with depression and anxiety

    NARCIS (Netherlands)

    Sempértegui, Gabriela A; Karreman, A.; van Hout, G.C.M.; Bekker, M.H.J.

    2017-01-01

    This study examined how coping styles are related to functional status in patients with medically unexplained physical symptoms and to what extent depression and anxiety account for this relationship. In 90 Dutch adult patients presenting medically unexplained physical symptoms, coping styles,

  9. Unexplained Absences and Risk of Death and Injury Among Nursing Home Residents: A Systematic Review.

    Science.gov (United States)

    Woolford, Marta H; Weller, Carolina; Ibrahim, Joseph E

    2017-04-01

    Unexplained absence of nursing home (NH) residents is one of the most challenging issues related to the care of older people. The aim of this review was to examine the death and injury outcomes of unexplained absence of NH residents. We searched MEDLINE, CINAHL, EMBASE, PsycINFO, AgeLine, and Cochrane Library to identify qualitative and quantitative studies published in the English language. Data on death and injury were collated, and aggregate proportions were calculated where possible. Nine studies were identified; most (n = 6) were conducted in the United States. Persons with dementia formed the study population in all studies. There were 1440 individual unexplained absences reported across the 9 studies. We calculated a rate of 82 deaths and 61 injuries per 1000 incidents of unexplained absence. Extreme temperatures were the most common cause of death. Most individuals left by foot, and were found within a 1-mile radius of place last seen in green vegetation and waterways. This review provides valuable insight into death and injury outcomes. Further studies are recommended to improve understanding and prevent adverse outcomes. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  10. Emphysema and bronchiectasis in COPD patients with previous pulmonary tuberculosis: computed tomography features and clinical implications

    Directory of Open Access Journals (Sweden)

    Jin J

    2018-01-01

    Full Text Available Jianmin Jin,1 Shuling Li,2 Wenling Yu,2 Xiaofang Liu,1 Yongchang Sun1,3 1Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 2Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 3Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China Background: Pulmonary tuberculosis (PTB is a risk factor for COPD, but the clinical characteristics and the chest imaging features (emphysema and bronchiectasis of COPD with previous PTB have not been studied well.Methods: The presence, distribution, and severity of emphysema and bronchiectasis in COPD patients with and without previous PTB were evaluated by high-resolution computed tomography (HRCT and compared. Demographic data, respiratory symptoms, lung function, and sputum culture of Pseudomonas aeruginosa were also compared between patients with and without previous PTB.Results: A total of 231 COPD patients (82.2% ex- or current smokers, 67.5% male were consecutively enrolled. Patients with previous PTB (45.0% had more severe (p=0.045 and longer history (p=0.008 of dyspnea, more exacerbations in the previous year (p=0.011, and more positive culture of P. aeruginosa (p=0.001, compared with those without PTB. Patients with previous PTB showed a higher prevalence of bronchiectasis (p<0.001, which was more significant in lungs with tuberculosis (TB lesions, and a higher percentage of more severe bronchiectasis (Bhalla score ≥2, p=0.031, compared with those without previous PTB. The overall prevalence of emphysema was not different between patients with and without previous PTB, but in those with previous PTB, a higher number of subjects with middle (p=0.001 and lower (p=0.019 lobe emphysema, higher severity score (p=0.028, higher prevalence of panlobular emphysema (p=0.013, and more extensive centrilobular emphysema (p=0.039 were observed. Notably, in patients with

  11. Clinical Usefulness of SPECT-CT in Patients with an Unexplained Pain in Metal on Metal (MOM) Total Hip Arthroplasty.

    Science.gov (United States)

    Berber, Reshid; Henckel, Johann; Khoo, Michael; Wan, Simon; Hua, Jia; Skinner, John; Hart, Alister

    2015-04-01

    SPECT-CT is increasingly used to assess painful knee arthroplasties. The aim of this study was to evaluate the clinical usefulness of SPECT-CT in unexplained painful MOM hip arthroplasty. We compared the diagnosis and management plan for 19 prosthetic MOM hips in 15 subjects with unexplained pain before and after SPECT-CT. SPECT-CT changed the management decision in 13 (68%) subjects, Chi-Square=5.49, P=0.24. In 6 subjects (32%) pain remained unexplained however the result reassured the surgeon to continue with non-operative management. SPECT-CT should be reserved as a specialist test to help identify possible causes of pain where conventional investigations have failed. It can help reassure surgeons making management decisions for patients with unexplained pain following MOM hip arthroplasty. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Why reassurance fails in patients with unexplained symptoms--an experimental investigation of remembered probabilities.

    Directory of Open Access Journals (Sweden)

    Winfried Rief

    2006-08-01

    Full Text Available BACKGROUND: Providing reassurance is one of physicians' most frequently used verbal interventions. However, medical reassurance can fail or even have negative effects. This is frequently the case in patients with medically unexplained symptoms. It is hypothesized that these patients are more likely than patients from other groups to incorrectly recall the likelihoods of medical explanations provided by doctors. METHODS AND FINDINGS: Thirty-three patients with medically unexplained symptoms, 22 patients with major depression, and 30 healthy controls listened to an audiotaped medical report, as well as to two control reports. After listening to the reports, participants were asked to rate what the doctor thinks the likelihood is that the complaints are caused by a specific medical condition. Although the doctor rejected most of the medical explanations for the symptoms in his verbal report, the patients with medically unexplained complaints remembered a higher likelihood for medical explanations for their symptoms. No differences were found between patients in the other groups, and for the control conditions. When asked to imagine that the reports were applicable to themselves, patients with multiple medical complaints reported more concerns about their health state than individuals in the other groups. CONCLUSIONS: Physicians should be aware that patients with medically unexplained symptoms recall the likelihood of medical causes for their complaints incorrectly. Therefore, physicians should verify correct understanding by using check-back questions and asking for summaries, to improve the effect of reassurance.

  13. Non-visualized pregnancy losses are prognostically important for unexplained recurrent miscarriage

    DEFF Research Database (Denmark)

    Kolte, A M; van Oppenraaij, R H; Quenby, S

    2014-01-01

    consecutive pregnancy losses before 12 weeks' gestation, and we included only women with unexplained RM after thorough evaluation. It is uncertain whether the findings apply to other definitions of RM and among women with known causes for their miscarriages. WIDER IMPLICATIONS OF THE FINDINGS: To our......STUDY QUESTION: Are non-visualized pregnancy losses (biochemical pregnancy loss and failed pregnancy of unknown location combined) in the reproductive history of women with unexplained recurrent miscarriage (RM) negatively associated with the chance of live birth in a subsequent pregnancy? SUMMARY...... ANSWER: Non-visualized pregnancy losses contribute negatively to the chance for live birth: each non-visualized pregnancy loss confers a relative risk (RR) for live birth of 0.90 (95% CI 0.83; 0.97), equivalent to the RR conferred by each additional clinical miscarriage. WHAT IS KNOWN ALREADY: The number...

  14. Unexplained infertility as primary presentation of celiac disease, a case report and literature review

    Directory of Open Access Journals (Sweden)

    Mohammadreza Ghadir

    2011-01-01

    Full Text Available Background: Celiac sprue (gluten sensitive enteropathy is an autoimmune disease which is hereditary and its pathology mainly bases on immunologic intolerance to gluten. It has a vast variety of signs and symptoms and its clinical features range from a silent disease to a typical gastrointestinal disorder. In this study we reviewed and summarized some other related issues about this disease and its relation with infertility.Case: The case is a 26 years old lady who had referred to a gynecologist because of infertility for 2 years and later it revealed that she has celiac sprue.Conclusion: Screening for its silent or subtle types especially among suspicious cases such as unexplained infertility seems to be a cost effective action. Meanwhile, in time administration of a gluten-free diet can lead to an almost complete cure

  15. Magnetic poles and a still unexplained phenomenon

    International Nuclear Information System (INIS)

    Trower, W.P.

    1981-01-01

    A review is given of ideas about magnetic monopoles. Attention is drawn to the still unexplained observations of Schein, Haskin and Glasser (1954), in which electron-positron pairs were produced in large numbers by a cosmic-ray interaction. Their experiment has been simulated in 300 GeV pN interactions at Fermilab, giving a production limit of 10 -7 per proton interaction. The explanation for this phenomenon may lie in magnetic monopoles, or it may be similar to that invoked to explain the so-called Centauro events. (A.W.)

  16. Submicroscopic subtelomeric aberrations in Chinese patients with unexplained developmental delay/mental retardation

    Directory of Open Access Journals (Sweden)

    Wang Liwen

    2010-05-01

    Full Text Available Abstract Background Subtelomeric imbalance is widely accepted as related to developmental delay/mental retardation (DD/MR. Fine mapping of aberrations in gene-enriched subtelomeric regions provides essential clues for localizing critical regions, and provides a strategy for identifying new candidate genes. To date, no large-scale study has been conducted on subtelomeric aberrations in DD/MR patients in mainland China. Methods This study included 451 Chinese children with moderate to severe clinically unexplained DD/MR. The subtelomere-MLPA (multiplex ligation dependent probe amplification and Affymetrix human SNP array 6.0 were used to determine the subtelomeric copy number variations. The exact size and the breakpoint of each identified aberration were well defined. Results The submicroscopic subtelomeric aberrations were identified in 23 patients, with a detection rate of 5.1%. 16 patients had simple deletions, 2 had simple duplications and 5 with both deletions and duplications. The deletions involved 14 different subtelomeric regions (1p, 2p, 4p, 6p, 7p, 7q, 8p, 9p, 10p, 11q, 14q, 15q, 16p and 22q, and duplications involved 7 subtelomeric regions (3q, 4p, 6q, 7p, 8p, 12p and 22q. Of all the subtelomeric aberrations found in Chinese subjects, the most common was 4p16.3 deletion. The sizes of the deletions varied from 0.6 Mb to 12 Mb, with 5-143 genes inside. Duplicated regions were 0.26 Mb to 11 Mb, with 6-202 genes inside. In this study, four deleted subtelomeric regions and one duplicated region were smaller than any other previously reported, specifically the deletions in 11q25, 8p23.3, 7q36.3, 14q32.33, and the duplication in 22q13. Candidate genes inside each region were proposed. Conclusions Submicroscopic subtelomeric aberrations were detected in 5.1% of Chinese children with clinically unexplained DD/MR. Four deleted subtelomeric regions and one duplicated region found in this study were smaller than any previously reported, which

  17. Medically Unexplained Physical Symptoms in Military Health (Symptomes physiques medicalement inexpliques dans la sante militaire)

    Science.gov (United States)

    2017-12-01

    REPORT TR-HFM-175 Medically Unexplained Physical Symptoms in Military Health (Symptômes physiques médicalement inexpliqués dans la santé militaire...STO TECHNICAL REPORT TR-HFM-175 Medically Unexplained Physical Symptoms in Military Health (Symptômes physiques médicalement inexpliqués dans...The General Internist 10-7 10.5.1 The Health Psychologist 10-8 10.5.2 Medical Specialists 10-8 10.5.3 The Physiatrist 10-9 10.5.4 The Physical

  18. Biased ART: a neural architecture that shifts attention toward previously disregarded features following an incorrect prediction.

    Science.gov (United States)

    Carpenter, Gail A; Gaddam, Sai Chaitanya

    2010-04-01

    Memories in Adaptive Resonance Theory (ART) networks are based on matched patterns that focus attention on those portions of bottom-up inputs that match active top-down expectations. While this learning strategy has proved successful for both brain models and applications, computational examples show that attention to early critical features may later distort memory representations during online fast learning. For supervised learning, biased ARTMAP (bARTMAP) solves the problem of over-emphasis on early critical features by directing attention away from previously attended features after the system makes a predictive error. Small-scale, hand-computed analog and binary examples illustrate key model dynamics. Two-dimensional simulation examples demonstrate the evolution of bARTMAP memories as they are learned online. Benchmark simulations show that featural biasing also improves performance on large-scale examples. One example, which predicts movie genres and is based, in part, on the Netflix Prize database, was developed for this project. Both first principles and consistent performance improvements on all simulation studies suggest that featural biasing should be incorporated by default in all ARTMAP systems. Benchmark datasets and bARTMAP code are available from the CNS Technology Lab Website: http://techlab.bu.edu/bART/. Copyright 2009 Elsevier Ltd. All rights reserved.

  19. Depressive Symptoms and Orthostatic Hypotension Are Risk Factors for Unexplained Falls in Community-Living Older People.

    Science.gov (United States)

    Menant, Jasmine C; Wong, Alfred K W; Trollor, Julian N; Close, Jacqueline C T; Lord, Stephen R

    2016-05-01

    To investigate risk factors for unexplained falls in older community-dwelling individuals. Prospective cohort study. Community population, Sydney, Australia. Older adults (N = 529; mean age 79.8 ± 4.4, 52.2% female). Participants provided information demographic, medical, and medication characteristics and completed cardiovascular (tilt table test, pulse wave velocity), cognitive, and sensorimotor assessments at baseline. Falls were then recorded in monthly fall diaries for 12 months. Unexplained fallers (UFs) were those who reported falls due to a blackout, dizziness, feeling faint, or "found themselves suddenly on the ground." Of the 523 participants available at follow-up, 238 (45.5%) reported one or more falls; 35 participants fulfilled the definition of UFs. UFs were more likely than balance-related fallers (BFs) (n = 203) and nonfallers (n = 291) to have orthostatic hypotension (39.4%, 20.5% and 22.4%, respectively) and depressive symptoms (24.2%, 10.1%, and 7.9% respectively). More UFs (88.6%) than BFs (70.9%) had injurious falls. A multivariate logistic regression model revealed that depressive symptoms and orthostatic hypotension were significant and independent determinants of UF status. Approximately 15% of fallers had unexplained falls, which were more likely to result in injuries. Depressive symptoms and orthostatic hypotension increased the risk of unexplained falls, whereas cognitive deficits and sensorimotor and balance impairments did not. Future research should investigate whether psychotherapy and physical exercise to improve mood and medication reviews and nonpharmacological therapies for the treatment of orthostatic hypotension and depression are effective at reducing the risk of unexplained falls in older people. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  20. Big Five personality traits and medically unexplained symptoms in later life

    NARCIS (Netherlands)

    Dijk, van S. D. M.; Hanssen, D. J. C.; Naarding, P.; Lucassen, P.; Comijs, H.; Voshaar, R. Oude

    2016-01-01

    Background: Personality dysfunction has been postulated as the most clinically salient problem of persons suffering from medically unexplained symptoms (MUS) but empirical studies are scarce. This study aims to compare the personality profile of older patients suffering from MUS with two comparison

  1. Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

    Energy Technology Data Exchange (ETDEWEB)

    Blokhuis, Gijsbert J.; Diender, Marije G.; Oyen, Wim J.G. [Radboud University Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); Bleeker-Rovers, Chantal P. [Radboud University Medical Center, Division of Infectious Diseases, Department of Internal Medicine, Nijmegen (Netherlands); Draaisma, Jos M.T. [Radboud University Medical Center, Department of Paediatrics, Nijmegen (Netherlands); Geus-Oei, Lioe-Fee de [Radboud University Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); University of Twente, MIRA Institute for Biomedical Technology and Technical Medicine, Biomedical Photonic Imaging Group, Enschede (Netherlands)

    2014-10-15

    Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression. All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis. FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively. FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. (orig.)

  2. Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

    International Nuclear Information System (INIS)

    Blokhuis, Gijsbert J.; Diender, Marije G.; Oyen, Wim J.G.; Bleeker-Rovers, Chantal P.; Draaisma, Jos M.T.; Geus-Oei, Lioe-Fee de

    2014-01-01

    Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression. All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis. FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively. FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. (orig.)

  3. Blame, shame and hopelessness: medically unexplained symptoms and the 'heartsink' experience.

    Science.gov (United States)

    Stone, Louise

    2014-04-01

    'Heartsink' patients present a moral dilemma. We recognise their suffering, but at the same time struggle with the feelings they trigger in us. Patients also experience negative feelings. Without a diagnosis they lack a narrative or vocabulary to make sense of their own suffering. This article explores some of the challenges faced and strategies utilised when managing patients with medically unexplained symptoms. Doctors and patients often experience frustration and helplessness in consultations around medically unexplained symptoms. Without a diagnosis, patients lack social legitimacy as 'sick' people with 'real' illnesses. They often describe feeling blamed for their own distress. Because of this, they can experience deep feelings of worthlessness and shame. Patients with a history of abuse can be particularly vulnerable. Management includes validating their suffering, helping them construct appropriate explanations for their distress and providing empathic interpersonal care, while minimising the risk of iatrogenic harm.

  4. Unexplained Drownings and the Cardiac Channelopathies: A Molecular Autopsy Series

    Science.gov (United States)

    Tester, David J.; Medeiros-Domingo, Argelia; Will, Melissa L.; Ackerman, Michael J.

    2011-01-01

    OBJECTIVE: To determine the prevalence and spectrum of mutations associated with long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT) in a seemingly unexplained drowning cohort. PATIENTS AND METHODS: From September 1, 1998, through October 31, 2010, 35 unexplained drowning victims (23 male and 12 female; mean ± SD age, 17±12 years [range, 4-69 years]) were referred for a cardiac channel molecular autopsy. Of these, 28 (20 male and 8 female) drowned while swimming, and 7 (3 male and 4 female) were bathtub submersions. Polymerase chain reaction, denaturing high-performance liquid chromatography, and DNA sequencing were used for a comprehensive mutational analysis of the 3 major LQTS-susceptibility genes (KCNQ1, KCNH2, and SCN5A), and a targeted analysis of the CPVT1-associated, RYR2-encoded cardiac ryanodine receptor was conducted. RESULTS: Of the 28 victims of swimming-related drowning, 8 (28.6%) were mutation positive, including 2 with KCNQ1 mutations (L273F, AAPdel71-73 plus V524G) and 6 with RYR2 mutations (R414C, I419F, R1013Q, V2321A, R2401H, and V2475F). None of the bathtub victims were mutation positive. Of the 28 victims who drowned while swimming, women were more likely to be mutation positive than men (5/8 [62.5%] vs 3/20 [15%]; P=.02). Although none of the mutation-positive, swimming-related drowning victims had a premortem diagnosis of LQTS or CPVT, a family history of cardiac arrest, family history of prior drowning, or QT prolongation was present in 50%. CONCLUSION: Nearly 30% of the victims of swimming-related drowning hosted a cardiac channel mutation. Genetic testing should be considered in the postmortem evaluation of an unexplained drowning, especially if a positive personal or family history is elicited. PMID:21964171

  5. Unexplained weight loss in an elderly patient. Delayed diagnosis of thyrotoxicosis

    International Nuclear Information System (INIS)

    Weiss, R.J.

    1989-01-01

    Because the presenting symptoms of hyperthyroidism are often misleading in elderly patients, diagnosis depends on a high degree of clinical suspicion. The presence of unexplained weight loss, atrial fibrillation, or heart failure (especially in a patient without a history of heart problems) justifies testing for thyrotoxicosis

  6. Unexplained weight loss in an elderly patient. Delayed diagnosis of thyrotoxicosis

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, R.J. (Medical College of Pennsylvania, Philadelphia (USA))

    1989-11-01

    Because the presenting symptoms of hyperthyroidism are often misleading in elderly patients, diagnosis depends on a high degree of clinical suspicion. The presence of unexplained weight loss, atrial fibrillation, or heart failure (especially in a patient without a history of heart problems) justifies testing for thyrotoxicosis.

  7. Increase of tumor necrosis factor receptor 1 expression in women with unexplained early spontaneous abortion

    Institute of Scientific and Technical Information of China (English)

    YAN Chun-fang; YU Xue-wen; JIN Hui; LI Xu

    2004-01-01

    To investigate membrane tumor necrosis factor receptor 1 protein expression level in decidua andconcentration of soluble tumor necrosis factor receptor 1 in serum in women with unexplained early spontaneous abortion,threatened abortion, and compare the levels with healthy pregnant women. Methods: Thirty-seven women with unexplainedearly spontaneous abortion, 27 women with threatened abortion, and 34 healthy pregnant women undergoing artificial abortionof pregnancy at 6 - 10 weeks of gestation were selected. Decidual samples were collected when women were undergoing arti-ficial abortion, and blood samples were collected at the same time. The level of membrane tumor necrosis factor receptor 1 indecidua was detected by flow cytometer, and the concentration of soluble tumor necrosis factor receptor 1 in sera was mea-sured with an enzyme-linked immunosorbent assay. Results: The ercentages of membrane tumor necrosis factor receptor 1positive decidual cells were 16.42 ± 7.10 Mean ± SD for women with unexplained early spontaneous abortion and 13.14 ±6.30 for healthy pregnant women ( P < 0.05). Serum oncentration of soluble tumor necrosis factor receptor 1 was signifi-cantly higher in women with unexplained early spontaneous abortion than in healthy pregnant women and in women withthreatened abortion, and no difference was found between healthy pregnant women and women with threatened abortion.Conclusion: Women with unexplained early spontaneous abortion present significantly higher expression of tumor necrosisfactor receptor 1 than healthy pregnant women, suggesting that over-expression of tumor necrosis factor receptor 1 may cont-ribute to the development of early spontaneous abortion.

  8. Urinary tract infections in neonates with unexplained pathological indirect hyperbilirubinemia: Prevalence and significance

    Directory of Open Access Journals (Sweden)

    Elif Bahat Ozdogan

    2018-06-01

    Conclusion: We suggest that the neonates with unexplained pathological jaundice should be tested for possible UTI. Consequently, all newborns with UTI shall be evaluated by the urinary US and followed up for recurrent UTI.

  9. Unexplained lower abdominal pain associated with sacroiliac joint dysfunction: report of 2 cases.

    Science.gov (United States)

    Morimoto, Daijiro; Isu, Toyohiko; Kim, Kyongsong; Matsumoto, Ryoji; Isobe, Masanori

    2011-01-01

    A 25-year-old woman and a 31-year-old man presented with chronic lower back pain and unexplained lower abdominal pain. Both patients had groin tenderness at the medial border of the anterior superior iliac spine. The results of radiographical and physical examinations suggested sacroiliac joint dysfunction. Sacroiliac joint injection relieved their symptoms, including groin tenderness. In our experience, groin tenderness is highly specific for sacroiliac joint dysfunction. We speculate that spasm of the iliac muscle can cause groin pain and tenderness. Groin pain and a history of unexplained abdominal pain, with lower back pain, are symptoms that suggest sacroiliac joint dysfunction. Additionally, compression of the iliac muscle is a simple and useful maneuver; therefore, it can be used as a screening test for sacroiliac joint dysfunction, alongside other provocation tests.

  10. Screening for primary creatine deficiencies in French patients with unexplained neurological symptoms

    NARCIS (Netherlands)

    Cheillan, D.; Curt, M.J.; Briand, G.; Salomons, G.S.; Mention-Mulliez, K.; Dobbelaere, D.; Cuisset, J.M.; Lion-Francois, L.; Portes, V.D.; Chabli, A.; Valayannopoulos, V.; Benoist, J.F.; Pinard, J.M.; Simard, G.; Douay, O.; Deiva, K.; Afenjar, A.; Heron, D.; Rivier, F.; Chabrol, B.; Prieur, F.; Cartault, F.; Pitelet, G.; Goldenberg, A.; Bekri, S.; Gerard, M.; Delorme, R.; Tardieu, M.; Porchet, N.; Vianey-Saban, C.; Vamecq, J.

    2012-01-01

    A population of patients with unexplained neurological symptoms from six major French university hospitals was screened over a 28-month period for primary creatine disorder (PCD). Urine guanidinoacetate (GAA) and creatine:creatinine ratios were measured in a cohort of 6,353 subjects to identify PCD

  11. General practitioners' views on reattribution for patients with medically unexplained symptoms: a questionnaire and qualitative study

    Directory of Open Access Journals (Sweden)

    Salmon Peter

    2008-08-01

    Full Text Available Abstract Background The successful introduction of new methods for managing medically unexplained symptoms in primary care is dependent to a large degree on the attitudes, experiences and expectations of practitioners. As part of an exploratory randomised controlled trial of reattribution training, we sought the views of participating practitioners on patients with medically unexplained symptoms, and on the value of and barriers to the implementation of reattribution in practice. Methods A nested attitudinal survey and qualitative study in sixteen primary care teams in north-west England. All practitioners participating in the trial (n = 74 were invited to complete a structured survey. Semi-structured interviews were undertaken with a purposive sub-sample of survey respondents, using a structured topic guide. Interview transcripts were used to identify key issues, concepts and themes, which were grouped to construct a conceptual framework: this framework was applied systematically to the data. Results Seventy (95% of study participants responded to the survey. Survey respondents often found it stressful to work with patients with medically unexplained symptoms, though those who had received reattribution training were more optimistic about their ability to help them. Interview participants trained in reattribution (n = 12 reported that reattribution increased their confidence to practice in a difficult area, with heightened awareness, altered perceptions of these patients, improved opportunities for team-building and transferable skills. However general practitioners also reported potential barriers to the implementation of reattribution in routine clinical practice, at the level of the patient, the doctor, the consultation, diagnosis and the healthcare context. Conclusion Reattribution training increases practitioners' sense of competence in managing patients with medically unexplained symptoms. However, barriers to its implementation are

  12. Unexplained week-to-week variation in BNP and NT-proBNP is low in chronic heart failure patients during steady state

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Nielsen, Per H

    2006-01-01

    BACKGROUND: The usefulness of brain-natriuretic-peptide (BNP) and N-terminal-pro-brain-natriuretic-peptide (NT-proBNP) for monitoring of chronic heart failure (CHF) patients has been questioned because of high levels of unexplained variation. AIMS: Week-to-week total variance (CV(T)), unexplained...

  13. [The usefullness of implantable loop recorders for evaluation of unexplained syncope and palpitations].

    Science.gov (United States)

    Kristjánsdóttir, Ingibjörg; Reimarsdóttir, Guđrun; Arnar, Davíđ O

    2012-09-01

    Syncope is a common complaint and determining the underlying cause can be difficult despite extensive evaluation. The purpose of this study was to evaluate the usefulness of an implantable loop recorder for patients with unexplained syncope and palpitations. This was a retrospective analysis of 18 patients, five of whom still have the device implanted. All patients had undergone extensive evaluation for their symptoms before getting the loop recorder implanted and this was therefore a highly select group. Of the thirteen patients where use of the device was completed, the mean age was 65±20 years. The loop recorder was in use for a mean time of 20±13 months. Unexplained syncope, eleven of thirteen, was the most common indication. The other two received the loop recorder for unexplained palpitations. Four patients had sick sinus syndrome during monitoring, three had supraventricular tachycardia and one had ventricular tachycardia. Further three had typical symptoms but no arrhythmia was recorded and excluding that as a cause. Two patients had no symptoms the entire time they had the loop recorder. Of the five patients still with the device three had syncope as the indication for monitoring and two have the device as a means of evaluating the results of treatment for arrhythmia. This study on our initial experience with implantable loop recorders shows that these devices can be useful in the investigation of the causes of syncope and palpitations.

  14. Clusters of sudden unexplained death associated with the mushroom, Trogia venenata, in rural Yunnan Province, China.

    Directory of Open Access Journals (Sweden)

    Guo-Qing Shi

    Full Text Available INTRODUCTION: Since the late 1970's, time-space clusters of sudden unexplained death (SUD in northwest Yunnan, China have alarmed the public and health authorities. From 2006-2009, we initiated enhanced surveillance for SUD to identify a cause, and we warned villagers to avoid eating unfamiliar mushrooms. METHODS: We established surveillance for SUD, defined as follows: sudden onset of serious, unexplained physical impairment followed by death in <24 hours. A mild case was onset of any illness in a member of the family or close socially related group of a SUD victim within 1 week of a SUD. We interviewed witnesses of SUD and mild case-persons to identify exposures to potentially toxic substances. We tested blood from mild cases, villagers, and for standard biochemical, enzyme, and electrolyte markers of disease. RESULTS: We identified 33 SUD, a 73% decline from 2002-2005, distributed among 21 villages of 11 counties. We found a previously undescribed mushroom, Trogia venenata, was eaten by 5 of 7 families with SUD clusters compared to 0 of 31 other control-families from the same villages. In T. venenata-exposed persons SUD was characterized by sudden loss of consciousness during normal activities. This mushroom grew nearby 75% of 61 villages that had time-space SUD clusters from 1975 to 2009 compared to 17% of 18 villages with only single SUD (p<0.001, Fisher's exact test. DISCUSSION: Epidemiologic data has implicated T. venenata as a probable cause of clusters of SUD in northwestern Yunnan Province. Warnings to villagers about eating this mushroom should continue.

  15. Medically unexplained physical symptoms, misunderstood and wrongly treated? A semiotic perspective on chronic pain.

    Science.gov (United States)

    Busvold, Kari Irene H; Bondevik, Hilde

    2018-06-01

    Medically unexplained physical symptoms (MUPS) are a significant and increasing health issue in the western world. Chronic pain constitutes a considerable element of these symptoms, and the lack of a biomedical explanation of their cause challenges the clinical encounter. The limitations of biomedicine become evident in these encounters and expose the need for an expanded understanding of body and symptom. Semiotics, as an anti-dualistic meta-theory, closes the gap between natural science and the humanities and views the human body in an evolutionary and existential perspective. By focusing on interpretation and communication of signs as ongoing processes at all levels of life, biology and experience, the subjective and the measurable will be integrated. A special type of sign, the self-referential, is part of the body's internal communication. These signs may be viewed as the body's warnings to itself, for instance when the individual's consciousness, thought and action run counter to the organism's physiological and psychological needs. In a semiotic perspective, existential conditions may also activate the body's defense systems. In this context, the unexplained pain may be understood as a functional warning sign. The enhanced understanding of body and symptom that a semiotic approach calls for is relevant for the work of physiotherapists and may lead to more constructive clinical encounters with patients with unexplained chronic pain.

  16. Sudden onset unexplained encephalopathy in infants: think of cannabis intoxication.

    Science.gov (United States)

    Lavi, Eran; Rekhtman, David; Berkun, Yackov; Wexler, Isaiah

    2016-03-01

    The use of cannabis as both a therapeutic agent and recreational drug is common, and its availability is increasing as a result of legalization in many countries. Among older children, the manifestations of cannabis intoxication are numerous and include both neurological and systemic manifestations that are frequently non-specific. There have been only a few reports detailing cannabis intoxication in infants and toddlers. We describe three infants who presented to the emergency department with encephalopathic signs without prominent systemic manifestations. During the initial interview of caregivers, no history of exposure to neurotoxic agents was obtained. All three patients were subsequently diagnosed with cannabis intoxication based on urine toxic screens for delta-9-tetrahydrocannabinol (THC). The infants recovered with supportive care that included fluids and monitoring. The non-specific symptomatology of cannabis intoxication in infants together with the wide differential for unexplained acute onset encephalopathy may delay diagnosis and lead to inappropriate procedures and interventions such as antimicrobial treatments and imaging studies. Healthcare personnel of emergency rooms, urgent care centers, and general clinics should be aware of the potential risk of cannabis ingestion in young infants. A thorough medical history and toxic screen are warranted in all infants with unexplained decreased sensorium.

  17. An experiential mind-body approach to the management of medically unexplained symptoms.

    Science.gov (United States)

    Bakal, D; Steiert, M; Coll, P; Schaefer, J

    2006-01-01

    This article outlines an experiential mind-body framework for understanding and treating patients with medically unexplained symptoms. The model relies on somatic awareness, a normal part of consciousness, to resolve the mind-body dualism inherent in conventional multidisciplinary approaches. Somatic awareness represents a guiding healing heuristic which allows for a linear treatment application of the biopsychosocial model. The heuristic acknowledges the validity of the patient's physical symptoms and identifies psychological and social factors needed for the healing process. Somatic awareness is used to direct changes in coping styles, illness beliefs, medication dependence and personal dynamics that are necessary to achieve symptom control. The mind-body concept is consistent with and supported by neurobiological models which draw on central nervous system mechanisms to explain medically unexplained symptoms. The concept is also supported by a recent hypothesis concerning the role peripheral connective tissue may play in influencing illness and well-being. Finally, somatic awareness is described as having potential to enhance understanding and conscious use of inner healing mechanisms at the basis of the placebo effect.

  18. Opinion paper: the role of work in the management of medically unexplained physical symptoms.

    Science.gov (United States)

    Tobback, Els; Mariman, An; Clauwaert, Lies; Godderis, Lode; Heytens, Stefan; Ruppol, Patrick; Spooren, Daniel; Tytgat, Rita; De Muynck, Martine; Vogelaers, Dirk

    2018-05-04

    Patients with medically unexplained physical symptoms suffer from chronic fatigue and/or pain in combination with a variety of other symptoms. A flexible, biopsychosocial approach is needed for diagnostic screening and global management. It is crucial to involve the direct patient environment, including family, friends, colleagues as well as health providers, evaluation, and reintegration sector. The aim of this paper is to review the importance of work in the management of medically unexplained physical symptoms. In this paper, different actors involved explain their views and handling concerning work in the management of MUPS. Symptom severity and lack of understanding from the environment can negatively impact on earning an independent income from labor for years. Work, whether or not paid, is however, an important life domain with positive effects on physical, psychological, and social well-being. Therefore, health actors are pivotal in starting the professional reintegration process as soon as possible and should discuss this item from the early stage onward. Support services can be consulted in mutual interaction as required. A case manager, acting as a central intermediator within this multidisciplinary approach, may promote effective communication and coordination between the patients and their surrounding actors. The professional reintegration process should start as soon as possible within the management of medically unexplained physical symptoms. As such, the care sector, the evaluation sector, and the professional integration sector should collaborate and effectively communicate with each other.

  19. Effectiveness of a Blended Multidisciplinary Intervention for Patients with Moderate Medically Unexplained Physical Symptoms (PARASOL): Protocol for a Cluster Randomized Clinical Trial.

    Science.gov (United States)

    van Westrienen, Paula Elisabeth; Pisters, Martijn F; Toonders, Suze Aj; Gerrits, Marloes; Veenhof, Cindy; de Wit, Niek J

    2018-05-08

    Medically unexplained physical symptoms are an important health problem in primary care, with a spectrum from mild to chronic. The burden of chronic medically unexplained physical symptoms is substantial for patients, health care professionals, and society. Therefore, early identification of patients with moderate medically unexplained physical symptoms is needed in order to prevent chronicity. The preventive screening of medically unexplained physical symptoms (PRESUME) screening method was developed using data from the electronic medical record of the patients' general practitioner and demonstrated its prognostic accuracy to identify patients with moderate medically unexplained physical symptoms. In the next step, we developed a proactive blended and integrated mental health and physical therapy intervention program (PARASOL) to reduce complaints of moderate medically unexplained physical symptoms, stimulate self-management, and prevent chronicity. The primary objective of this study is to investigate the effectiveness of the blended PARASOL intervention on the impact of symptoms and quality of life in patients with moderate medically unexplained physical symptoms compared with usual care. Secondary objectives are to study the effect on severity of physical and psychosocial symptoms, general health, physical behavior, illness perception, and self-efficacy in patients with moderate medically unexplained physical symptoms as well as to determine the cost-effectiveness of the program. This paper presents the study protocol of a multicenter cluster randomized clinical trial. Adult patients with moderate medically unexplained physical symptoms will be identified from electronic medical record data using the PRESUME screening method and proactively recruited for participation in the study. Cluster randomization will be performed at the level of the participating health care centers. In total 248 patients with moderate medically unexplained physical symptoms (124

  20. Treatment of central sensitization in patients with 'unexplained' chronic pain: what options do we have?

    Science.gov (United States)

    Nijs, Jo; Meeus, Mira; Van Oosterwijck, Jessica; Roussel, Nathalie; De Kooning, Margot; Ickmans, Kelly; Matic, Milica

    2011-05-01

    Central sensitization accounts for chronic 'unexplained' pain in a wide variety of disorders, including chronic whiplash-associated disorders, temporomandibular disorders, chronic low back pain, osteoarthritis, fibromyalgia, chronic fatigue syndrome and chronic tension-type headache among others. Given the increasing evidence supporting the clinical significance of central sensitization in those with unexplained chronic pain, the awareness is growing that central sensitization should be a treatment target in these patients. This article provides an overview of the treatment options available for desensitizing the CNS in patients with chronic pain due to central sensitization. It focuses on those strategies that specifically target pathophysiological mechanisms known to be involved in central sensitization. In addition, pharmacological options, rehabilitation and neurotechnology options are discussed. Acetaminophen, serotonin-reuptake inhibitor drugs, selective and balanced serototin and norepinephrine-reuptake inhibitor drugs, the serotonin precursor tryptophan, opioids, N-methyl-d-aspartate (NMDA)-receptor antagonists, calcium-channel alpha(2)delta (a2δ) ligands, transcranial magnetic stimulation, transcutaneous electric nerve stimulation (TENS), manual therapy and stress management each target central pain processing mechanisms in animals that - theoretically - desensitize the CNS in humans. To provide a comprehensive treatment for 'unexplained' chronic pain disorders characterized by central sensitization, it is advocated to combine the best evidence available with treatment modalities known to target central sensitization. © 2011 Informa UK, Ltd

  1. High prevalence of antibodies against hepatitis E virus in HIV-infected patients with unexplained liver disease.

    Science.gov (United States)

    Merchante, Nicolás; Parra-Sánchez, Manuel; Rivero-Juárez, Antonio; Cifuentes, Celia; Camacho, Ángela; Macías, Juan; Martínez-Dueñas, Loreto; Pérez-Navarro, Elisabet; Rivero, Antonio; Pineda, Juan A

    2015-10-01

    To look for evidence of hepatitis E virus (HEV) exposure in HIV-infected patients with unexplained elevations of liver stiffness (LS). Case-control study conducted in 31 HIV-infected patients with unexplained elevations of LS and in 31 HIV-controls with normal LS, matched by age, sex and CD4 cell-counts. Serum HEV antibodies were tested by two ELISA procedures and by Immunoblot. We defined exposure to HEV as the detection of serum HEV antibodies by at least one of the two ELISA assays, provided that it was confirmed by Immunoblot. A real-time PCR RNA assay was conducted in all plasma samples to identify subjects with active HEV infection. Exposure to HEV was demonstrated, according to the criteria used in this study, in 9 (29%) of the cases, whereas it was shown in 5 (16%) of the controls (p=.3). Serum HEV RNA was detected in none of the controls and in only in one case. This patient had a documented chronic hepatitis E with progression to cirrhosis. HEV antibodies are frequently found in HIV-infected patients with unexplained liver disease. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  2. Isolated and unexplained dilation of the common bile duct on computed tomography scanscans

    Directory of Open Access Journals (Sweden)

    Naveen B. Krishna

    2012-07-01

    Full Text Available Isolated dilation of common bile duct (CBD with normal sized pancreatic duct and without identifiable stones or mass lesion (unexplained is frequently encountered by computed tomography/magnetic resonance imaging. We studied the final diagnoses in these patients and tried to elucidate factors that can predict a malignant etiology. This is a retrospective analysis of prospective database from a University based clinical practice (2002- 2008. We included 107 consecutive patients who underwent endoscopic ultrasound (EUS for evaluation of isolated and unexplained CBD dilation noted on contrast computed tomography scans. EUS examination was performed using a radial echoendoscope followed by a linear echoechoendoscope, if a focal mass lesion was identified. Fine-needle aspirates were assessed immediately by an attending cytopathologist. Main outcome measurements included i prevalence of neoplasms, CBD stones and chronic pancreatitis and ii performance characteristics of EUS/EUS-fine needle aspiration (EUS-FNA. A malignant neoplasm was found in 16 patients (14.9% of the study subjects, all with obstructive jaundice (ObJ. Six patients had CBD stones; three with ObJ and three with abnormal liver function tests. EUS findings suggestive of chronic pancreatitis were identified in 27 patients. EUSFNA had 97.3% accuracy (94.1% in subset with ObJ with a sensitivity of 81.2% and specificity of 100% for diagnosing malignancy. Presence of ObJ and older patient age were only significant predictors of malignancy in our cohort. Amongst patients with isolated and unexplained dilation of CBD, the risk of malignancy is significantly higher in older patients presenting with ObJ. EUS-FNA can diagnose malignancy in these patients with high accuracy besides identifying other potential etiologies including missed CBD stones and chronic pancreatitis.

  3. Unexplained structure in (μ,π) invariant mass distribution

    International Nuclear Information System (INIS)

    Ramm, C.A.

    2000-01-01

    Structures in invariant mass distributions from (μ,π) combinations in the range 0.380 μ -π 0.470 GeV from neutrino and kaon experiments are presented in comparable formats. No artifacts have been found to account for any part of the structure. Hypotheses that the similarities are due to recurrent statistical fluctuations are beyond credibility. My conclusion is that the similarities are overwhelming evidence that the structure is of an unexplained physical origin. It includes an enhancement which would accord with the decay of a narrow (μ,π) state of mass 0.429 GeV. The purpose of this report is to request and enable every experimenter with precise M μ , π distributions to investigate their degree of correspondence with these analyses (author)

  4. Platelet function in patients with a history of unexplained recurrent miscarriage who subsequently miscarry again.

    LENUS (Irish Health Repository)

    Dempsey, Mark Anthony

    2015-05-01

    This study was designed to evaluate platelet aggregation in pregnant women with a history of unexplained recurrent miscarriage (RM) and to compare platelet function in such patients who go on to have either another subsequent miscarriage or a successful pregnancy.

  5. Influence of Watchful Waiting on Satisfaction and Anxiety Among Patients Seeking Care for Unexplained Complaints

    NARCIS (Netherlands)

    van Bokhoven, Marloes A.; Koch, Hèlen; van der Weijden, Trudy; Grol, Richard P. T. M.; Kester, Arnold D.; Rinkens, Paula E. L. M.; Bindels, Patrick J. E.; Dinant, Geert-Jan

    2009-01-01

    PURPOSE We undertook a study to determine whether test-ordering strategy and other consultation-related factors influence satisfaction with and anxiety after a consultation among patients seeking care for unexplained complaints. METHODS A cluster-randomized clinical trial was conducted in family

  6. Systemic lupus erythematosus: Specific features of its course and therapy options

    Directory of Open Access Journals (Sweden)

    Aleksandr Mikhailovich Lila

    2015-01-01

    Full Text Available The prevalence of systemic lupus erythematosus (SLE varies greatly in different regions of the world. The disease is encountered in different age groups; however it is most common in young and adolescent women (its peak incidence is in the range of 15–25 years. Familial SLE cases are known. The course of SLE in pregnant women is noted to have features due to an increased risk for complications and to pharmacotherapeutic peculiarities. Risk factors for poor pregnancy outcomes, such as high disease activity at the time of conception, active lupus nephritis, and the presence of antiphospholipid antibodies (APA, are identified in patients with SLE. The paper presents antenatal fetal death predictors: proteinuria, thrombocytopenia, APA, and hypertension. When SLE is concurrent with secondary antiphospholipid syndrome (APS, the risk of poor pregnancy outcome is 30%. Management tactics for pregnant women with APS and a dosage regimen are shown to largely depend on history data (the presence (absence of nonplacental thromboses, the number of spontaneous abortions, prior therapy, etc.. There are four patient groups: 1 patients who have only anticardiolipin antibodies without previous pregnancy or one episode of unexplained abortion at less than 10 weeks’ gestation with no history of thrombosis; 2 those who have APS with no history of nonplacental thrombosis and have anticardiolipin antibodies and a history of two or more unexplained spontaneous abortions at less than 10 weeks’ gestation; 3 those who have APS and a history of nonplacental thromboses (who have taken warfarin prior to pregnancy; 4 those in whom standard therapy is ineffective during their next pregnancy. The paper presents therapy options for each patient group.It is concluded that effective therapeutic strategy for SLE, including that in pregnant women, implies patient monitoring to long maintain remission (low disease activity.

  7. The relationship between ataque de nervios and unexplained neurological symptoms: a preliminary analysis.

    Science.gov (United States)

    Interian, Alejandro; Guarnaccia, Peter J; Vega, William A; Gara, Michael A; Like, Robert C; Escobar, Javier I; Díaz-Martínez, Angélica M

    2005-01-01

    Within somatization, unexplained neurological symptoms (UNSs) have been shown to mark a distinct subgroup with greater clinical severity. However, some UNSs resemble ataque de nervios somatic symptoms. This raises questions about cultural factors related to Hispanics with somatization characterized by UNSs. To examine cultural factors, preliminary analyses examined the relationship between Hispanic ethnicity, UNSs, and ataque de nervios. Data were obtained from 127 primary care patients (95 Hispanic, 32 European American) with somatization. The Composite International Diagnostic Interview provided somatization data, whereas the Primary Care Evaluation of Mental Disorders was used for data on Axis I disorders. Ataque de nervios was assessed via a proxy measure. Within each ethnic group, cross-tabs examined the relationship between ataque de nervios and multiple UNSs, and ataque de nervios and selected Axis I disorders. Only among Hispanics, a significant overlap was found between ataque de nervios and having four or more UNSs (p nervios and a diagnosis of panic disorder (p = .05). Although equal percentages of European Americans and Hispanics experience multiple UNSs, these results show that the presentation of UNSs among some Hispanics may be qualitatively different, because it may involve features related to ataque de nervios. A diagnosis of panic disorder also appears to interact with cultural factors.

  8. Multiple unexplained fractures in infants and child physical abuse.

    Science.gov (United States)

    Cannell, John Jacob; Holick, Michael F

    2018-01-01

    When an infant presents with X-rays showing multiple unexplained fractures in various stages of healing (MUFVSH), the child is usually diagnosed with child abuse based on criteria of the Academy of Pediatrics' Committee on Child Abuse and Neglect (AAPCCAAN). Almost always, the infant is subsequently removed from the home and civil or criminal proceeding commence. It may be that healing infantile rickets or other poorly understood metabolic bone disorders of infancy are responsible for these x-rays. Activated vitamin D is a seco-steroid hormone, whose mechanism of action is genetic regulation. Lack of it can result in musculoskeletal defects known as rickets. Low calcium can also cause rickets. However, it is clear that experts for the state believe that the x-rays in these cases are so definitive as to be pathognomonic for child abuse. Therefore, if the caregivers deny abusing their infants, experts following American Academy of Pediatric's Committee on Child Abuse and Neglect. guidelines are essentially claiming that x-rays showing multiple unexplained fractures in various stages of healing are lie detector tests. However, it is not widely appreciated that the gold standard for the diagnosis of rickets is a bone biopsy, not x-rays, as radiologists miss biopsy proven rickets 80% of the time; that is, 4 out of 5 infants with rickets will have normal x-rays. In this article we provide reports of two cases and their outcomes. We discuss information about healing infantile rickets and an example of common sense medical conclusions in these cases. This information could lead to a significant reduction in the number of innocent parents having their infant removed or sent to prison. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. A unique and unexplained ricochet leak post PCI – Successfully treated with intra-coronary glue

    Directory of Open Access Journals (Sweden)

    Pravin K. Goel

    2014-01-01

    Full Text Available We herein describe a unique case of coronary artery perforation treated with covered stent with repeat cardiac tamponade resulting out of a fresh unexplained leak from a remote vessel (Ricochet and successfully treated with intra-coronary injection of sterile synthetic glue, cyanoacrylate.

  10. The cross-sectional relation between medically unexplained physical symptoms (MUPS) and the Cortisol Awakening Response

    NARCIS (Netherlands)

    Claassen-van Dessel, Nikki; van der Wouden, Johannes C.; Dekker, Joost; Rosmalen, Judith G. M.; van der Horst, Henriette E.

    Objectives: We aimed to assess the cross-sectional relation between levels of cortisol and specific symptom clusters, symptom severity and duration of symptoms in patients with medically unexplained physical symptoms (MUPS). Methods: Baseline data of a cohort of MUPS patients were used. We chose the

  11. Correlation between three-dimensional power Doppler and morphometric measurement of endometrial vascularity at the time of embryo implantation in women with unexplained recurrent miscarriage.

    Science.gov (United States)

    Chen, Xiaoyan; Saravelos, Sotirios H; Liu, Yingyu; Huang, Jin; Wang, Chi Chiu; Li, Tin Chiu

    2017-06-01

    Power Doppler in combination with three-dimensional (3D-PD) ultrasonography has been used as a noninvasive tool to evaluate the vascularity. However, it is unclear whether 3D-PD can accurately reflect endometrial vascularization and replace the invasive endometrial biopsy. This study aims to investigate the correlation between 3D-PD and micro vessel morphometric measurement of endometrial vascularity. Twenty-five women with unexplained recurrent miscarriage were recruited for 3D-PD and endometrial biopsy on precisely day LH + 7. Immunohistochemistry using vWF was employed to identify micro vessels in endometrial biopsy specimens followed by the use of morphometric technique to measure the mean vessel diameter and volume fractions. The vascularization index (VI), flow index (FI) and vascularization flow index (VFI) assessed by 3D-PD were calculated for both the endometrial and sub-endometrial regions. There were no significant correlations between any of the ultrasonographic measurements (endometrial thickness, endometrial volume, endometrial VI/FI/VFI, sub-endometrial volume, sub-endometrial VI/FI/VFI) and morphometric features (number of micro vessel, mean diameter of micro vessel and volume fraction measurement of vessel). This study indicates that endometrial vascularity assessed by 3D-PD could not be used to reflect changes in micro vessels of the endometrium at the time of embryo implantation in women with unexplained recurrent miscarriage.

  12. Expression of AIF-1 and RANTES in Unexplained Spontaneous Abortion and Possible Association with Alloimmune Abortion

    Institute of Scientific and Technical Information of China (English)

    Yong-hong LI; Hai-lin WANG; Ya-juan ZHANG

    2007-01-01

    Objective To investigate the effects of allograft inflammatory factor-1(AIF-1)and (RANTES) in sera and deciduas on unexplained early spontaneous abortion.Methods AIF-1 and RANTES were examined in sera and deciduas/endometria of 43 unexplained early spontaneous abortion women (group A),40 healthy women with early pregnancy(group B)and 20 healthy women with no pregnancy (group C). Immunohistochemistry and enzyme linked immunosorbent assay (ELISA) were used in this study. Results AIF-1 protein was expressed both in deciduas of group A and in endometria of group C.In group A, H scores in the recurrent abortion deciduas specimens were significantly greater than those in the first abortion;in endometrium,expression of AIF-1 was greater in the secretory than in proliferative phase of group C.In group B,concentrations of RANTES in sera were higher in 7th-8th week of pregnancy than in 6th-7th and >8th week of pregnancy;expression of AIF-1 protein showed a negative correlation with RASNTES concentration;a significant increase of the RANTES levels in sera and tissue was observed in group B. Conclusion These results demonstrate, for the first time,that AIF-1 are expressed in deciduas of unexplained spontaneous abortion suggesting that AIF-1 involve in alloimmune abortion; RANTES might act as a novel blocking antibody;AIF-1 and RANTES might act as reliable markers for diagnosis of early alloimmune abortion.

  13. Low temperature magneto-morphological characterisation of coronene and the resolution of previously observed unexplained phenomena

    Science.gov (United States)

    Potticary, Jason; Boston, Rebecca; Vella-Zarb, Liana; Few, Alex; Bell, Christopher; Hall, Simon R.

    2016-12-01

    The polyaromatic hydrocarbon coronene has been the molecule of choice for understanding the physical properties of graphene for over a decade. The modelling of the latter by the former was considered to be valid, as since it was first synthesised in 1932, the physical behaviour of coronene has been determined extremely accurately. We recently discovered however, an unforeseen polymorph of coronene, which exists as an enantiotrope with the previously observed crystal structure. Using low-temperature magnetisation and crystallographic measurements, we show here for the first time that the electronic and magnetic properties of coronene depend directly on the temperature at which it is observed, with hysteretic behaviour exhibited between 300 K and 100 K. Furthermore we determine that this behaviour is a direct result of the appearance and disappearance of the newly-discovered polymorph during thermal cycling. Our results not only highlight the need for theoretical models of graphene to take into account this anomalous behaviour at low temperatures, but also explain puzzling experimental observations of coronene dating back over 40 years.

  14. Response to parenteral iron therapy distinguish unexplained refractory iron deficiency anemia from iron-refractory iron deficiency anemia.

    Science.gov (United States)

    Akin, M; Sarbay, H; Guler, S; Balci, Y I; Polat, A

    2016-04-01

    We evaluated that response to parenteral iron therapy could be helpful in distinguishing the types of iron deficiency anemia. This study analyzed responses to IV iron sucrose therapy of 15 children with unexplained refractory iron deficiency anemia (URIDA). We compared the results at diagnosis, 6 weeks and 6 months after the therapy. Results were compared with responses of 11 patients' results with iron-refractory iron deficiency anemia (IRIDA) from our previous study. Six weeks after the start of treatment, ferritin, MCV, MCH and Hb values were in normal range in 10 patients. The increase in Hb, MCH, MCV, and ferritin values ranged 2.6-3.5 g/dL, 1.7-4.2 pg, 2-9 fL, and 13-25 ng/mL, respectively. In five patients, Hb, MCH, and MCV mean (range) values [11.2 g/dL (11-12.2), 24.5 pg (24-25.6), and 67 fL (65-70)] were nearly normal but ferritin mean (range) values [9.8 ng/mL (8-11)] were below normal. Six weeks after the start of treatment, Hb, MCH, MCV and ferritin values of patients with IRIDA were increased. The increase in Hb, MCH, MCV, and ferritin values ranged 0.8-2.7 g/dL, 1.7-4.2 pg, 2-9 fL, and 13-25 ng/mL, respectively. IRIDA is only partially responsive to parenteral iron supplementation. In conclusion, this study demonstrated that the response to intravenous iron therapy for the URIDA cases improved blood parameters more effectively than hereditary IRIDA. Response to parenteral iron therapy would be helpful to distinguish unexplained refractory IDA from hereditary IRIDA for clinicians who do not have access to hepcidin or TMPRS6 mutation analysis. © 2016 John Wiley & Sons Ltd.

  15. Diagnostic value of [18F]-FDG PET/CT in children with fever of unknown origin or unexplained signs of inflammation

    International Nuclear Information System (INIS)

    Jasper, Niklas; Daebritz, Jan; Frosch, Michael; Foell, Dirk; Loeffler, Markus; Weckesser, Matthias

    2010-01-01

    Fever of unknown origin (FUO) and unexplained signs of inflammation are challenging medical problems especially in children and predominantly caused by infections, malignancies or noninfectious inflammatory diseases. The aim of this study was to assess the diagnostic value of 18 F-FDG PET and PET/CT in the diagnostic work-up in paediatric patients. In this retrospective study, 47 FDG PET and 30 PET/CT scans from 69 children (median age 8.1 years, range 0.2-18.1 years, 36 male, 33 female) were analysed. The diagnostic value of PET investigations in paediatric patients presenting with FUO (44 scans) or unexplained signs of inflammation without fever (33 scans) was analysed. A diagnosis in paediatric patients with FUO or unexplained signs of inflammation could be established in 32 patients (54%). Of all scans, 63 (82%) were abnormal, and of the total number of 77 PET and PET/CT scans 35 (45%) were clinically helpful. In patients with a final diagnosis, scans were found to have contributed to the diagnosis in 73%. Laboratory, demographic or clinical parameters of the children did not predict the usefulness of FDG PET scans. This is the first larger study demonstrating that FDG PET and PET/CT may be valuable diagnostic tools for the evaluation of children with FUO and unexplained signs of inflammation. Depicting inflammation in the whole body, while not being traumatic, it is attractive for use especially in children. The combination of PET with CT seems to be superior, since the site of inflammation can be localized more accurately. (orig.)

  16. Non-visualized pregnancy losses are prognostically important for unexplained recurrent miscarriage.

    Science.gov (United States)

    Kolte, A M; van Oppenraaij, R H; Quenby, S; Farquharson, R G; Stephenson, M; Goddijn, M; Christiansen, O B

    2014-05-01

    Are non-visualized pregnancy losses (biochemical pregnancy loss and failed pregnancy of unknown location combined) in the reproductive history of women with unexplained recurrent miscarriage (RM) negatively associated with the chance of live birth in a subsequent pregnancy? Non-visualized pregnancy losses contribute negatively to the chance for live birth: each non-visualized pregnancy loss confers a relative risk (RR) for live birth of 0.90 (95% CI 0.83; 0.97), equivalent to the RR conferred by each additional clinical miscarriage. The number of clinical miscarriages prior to referral is an important determinant for live birth in women with RM, whereas the significance of non-visualized pregnancy losses is unknown. A retrospective cohort study comprising 587 women with RM seen in a tertiary RM unit 2000-2010. Data on the outcome of the first pregnancy after referral were analysed for 499 women. The study was conducted in the RM Unit at Rigshospitalet, Copenhagen, Denmark. We included all women with unexplained RM, defined as ≥3 consecutive clinical miscarriages or non-visualized pregnancy losses following spontaneous conception or homologous insemination. The category 'non-visualized pregnancy losses' combines biochemical pregnancy loss (positive hCG, no ultrasound performed) and failed PUL (pregnancy of unknown location, positive hCG, but on ultrasound, no pregnancy location established). Demographics were collected, including BMI, age at first pregnancy after referral and outcome of pregnancies prior to referral. Using our own records and records from other Danish hospitals, we verified the outcome of the first pregnancy after referral. For each non-visualized pregnancy loss and miscarriage in the women's reproductive history, the RR for live birth in the first pregnancy after referral was determined by robust Poisson regression analysis, adjusting for risk factors for negative pregnancy outcome. Non-visualized pregnancy losses constituted 37% of reported

  17. Are individuals within families with premature truly sudden unexplained death at risk during long-term follow-up?

    NARCIS (Netherlands)

    Van Der Werf, Christian; Stiekema, Lotte; Hofman, Nynke; Alders, Marielle; Van Der Wal, Allard C.; Tan, Hanno L.; Van Langen, Irene M.; Wilde, Arthur A.

    Introduction: After young sudden unexplained death (SUD), comprehensive cardiologic and genetic examination in surviving first-degree relatives unmasks inherited cardiac disease in ∼40% of families, enabling timely prophylactic treatment. It is unknown, however, whether individuals from

  18. Patients with persistent medically unexplained physical symptoms: A descriptive study from Norwegian general practice

    OpenAIRE

    Aamland, Aase; Malterud, Kirsti; Werner, Erik L.

    2014-01-01

    Background: Further research on effective interventions for patients with peristent Medically Unexplained Physical Symptoms (MUPS) in general practice is needed. Prevalence estimates of such patients are conflicting, and other descriptive knowledge is needed for development and evaluation of effective future interventions. In this study, we aimed to estimate the consultation prevalence of patients with persistent MUPS in general practice, including patients’ characteristics and...

  19. The comparison between Intrauterine Insemination and Fallopian Tube Sperm Perfusion Using FAST® System in Patients with Unexplained Infertility

    Directory of Open Access Journals (Sweden)

    Sepideh Peivandi

    2015-02-01

    Full Text Available Background: Controlled ovarian stimulation (COH with intrauterine insemination (IUI is commonly offered to infertile couples with patent fallopian tubes because it is simple, non-invasive and cost-effective technique. Another non-invasive method is fallopian tube sperm perfusion (FSP. This study was performed to compare the relative efficacy between FSP using fallopian sperm transfer (FAST system and standard IUI in patients with unexplained infertility. Materials and Methods: This prospective randomized study was conducted at the IVF Unit, Department of Gynecology and Obstetrics, Mazandaran University of Medical Sciences, Sari, Iran, from March 2011 to February 2012. A total of ninety patients with unexplained infertility underwent ovarian stimulation with clomiphene citrate and human menopausal gonadotropin (HMG. Patients were then randomly assigned into either group I (n=45 to undergo standard IUI or group II (n=45 to undergo FSP using FAST system. Results: The patients’ basic characteristics, including age, primary infertility and duration of infertility, were not significantly different between two study groups. In the group I, there were 9 pregnancies (a pregnancy rate per cycle of 20%, whereas in the group II, 8 pregnancies occurred (a pregnancy rate per cycle of 17.8%, p>0.05. Conclusion: FSP using FAST system offers no advantage over the standard IUI in order to increase pregnancy rate in patients with unexplained infertility.

  20. MRI as a problem-solving tool in unexplained failed total hip replacement following conventional assessment

    International Nuclear Information System (INIS)

    Johnston, Ciaran; Kerr, Jennifer; Ford, Stephanie; Eustace, Stephen; O'Byrne, John

    2007-01-01

    To evaluate MRI as a problem-solving tool for patients with an unexplained failed total hip replacement following conventional radiological assessment. Patients' informed consent was obtained in all cases. Institutional review board approval was obtained. Twenty-eight patients with unexplained failed total hip replacements following conventional radiological assessment underwent additional MR imaging with an optimised turbo-spin echo sequence. Images were reviewed by two musculoskeletal radiologists by consensus and compared with findings at surgery, or following response to image-guided intervention or clinical follow-up. Of the 28 patients, MRI revealed an unsuspected diagnosis explaining the cause of prosthesis failure in 15 patients. In eight of 15 patients in this group, subsequent minimally invasive image-guided intervention obviated the need for revision total hip replacement. No cause for prosthesis failure was identified in 13 patients. MRI may be successfully undertaken in patients following total hip replacement, and, when performed, it frequently leads to an unsuspected diagnosis, allowing informed patient treatment. In this study it allowed the identification of an unsuspected diagnosis in over 50% of cases. (orig.)

  1. Effect of clomiphene citrate on uterine hemodynamics in women with unexplained infertility

    Directory of Open Access Journals (Sweden)

    Omran E

    2018-04-01

    Full Text Available Eman Omran, Mohamed El-Sharkawy, Akmal El-Mazny, Mohamed Hammam, Wafaa Ramadan, Dina Latif, Dalia Samir, Sherine Sobh Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt Purpose: The aim of the study was to evaluate the effect of clomiphene citrate on uterine artery blood flow using pulsed Doppler and endometrial and subendometrial micro vascularization using 3D power Doppler in unexplained infertility. Patients and methods: In a prospective observational study at a university teaching hospital, the mid-luteal (peri-implantation endometrial thickness and volume, uterine artery pulsatility index (PI and resistance index (RI, endometrial and subendometrial vascularization index (VI, flow index (FI, and vascularization flow index (VFI, and serum estradiol and progesterone levels were compared between natural and clomiphene citrate stimulated cycles in the same group of 50 patients with unexplained infertility. Statistical analysis was done using paired t-test to compare different study variables. Results: The primary outcome, which was the endometrial flow index, was significantly lower in the stimulated cycles (mean ± SD: 23.89±7.96 vs 27.49±8.73, mean difference (95% CI: -3.6 (-2, -5.9; P=0.03. The mean ± SD of endometrial thickness (10.92±3.04 vs 12.46±3.08 mm; P=0.01, volume (4.57±1.28 vs 5.26±1.32 cm3; P=0.009, endometrial VI (0.86±0.15 vs 0.95%±0.21%; P=0.02, VFI (0.25±0.08 vs 0.31±0.12; P=0.004, subendometrial VI (1.93±0.68 vs 2.26%±0.75%; P=0.02, FI (26.81±9.16 vs 30.73±9.87; P=0.04, and VFI (0.68±0.18 vs 0.79±0.21; P=0.006 were significantly lower in the stimulated cycles. However, there were no significant differences in the uterine artery PI (P=0.12 and RI (P=0.08 or serum estradiol (P=0.54 and progesterone (P=0.37 levels between natural and stimulated cycles. Conclusion: Peri-implantation endometrial perfusion is significantly lower in clomiphene citrate stimulated

  2. Blood test ordering for unexplained complaints in general practice: the VAMPIRE randomised clinical trial protocol. [ISRCTN55755886

    NARCIS (Netherlands)

    van Bokhoven, Marloes A.; Koch, Hèlen; van der Weijden, Trudy; Grol, Richard P. T. M.; Bindels, Patrick J. E.; Dinant, Geert-Jan

    2006-01-01

    BACKGROUND: General practitioners (GPs) frequently order blood tests when they see patients presenting with unexplained complaints. Due to the low prevalence of serious pathology in general practice, the risk of false-positive test results is relatively high. This may result in unnecessary further

  3. Increased Prevalence of Celiac Disease in Patients with Unexplained Infertility in the United States: A Prospective Study

    Science.gov (United States)

    Lebwohl, Benjamin; Wang, Jeffrey; Lee, Susie K.; Murray, Joseph A.; Sauer, Mark V.; Green, Peter H. R.

    2011-01-01

    Celiac disease is an autoimmune disorder which can present with a variety of non-gastrointestinal manifestations. In women, it may manifest with an assortment of gynecologic or obstetric disorders. Some reports have linked female infertility with undiagnosed celiac disease. Though there are a number of studies from Europe and the Middle East, only two prior American studies have examined the prevalence of “silent” celiac disease in a female infertility population. We prospectively performed serologic screening for celiac disease in 188 infertile women (ages 25–39). While we did not demonstrate an increased prevalence of celiac disease in our overall infertile female population, we were able to detect a significantly increased prevalence (5.9%) of undiagnosed celiac disease among women presenting with unexplained infertility (n=51). Our findings suggest the importance of screening infertile female patients, particularly those with unexplained infertility, for celiac disease. PMID:21682114

  4. Lysosomal storage disorders: A review of the musculoskeletal features.

    Science.gov (United States)

    James, Rebecca A; Singh-Grewal, Davinder; Lee, Senq-J; McGill, Jim; Adib, Navid

    2016-03-01

    The lysosomal storage disorders are a collection of progressive, multisystem disorders that frequently present in childhood. Their timely diagnosis is paramount as they are becoming increasingly treatable. Musculoskeletal manifestations often occur early in the disease course, hence are useful as diagnostics clues. Non-inflammatory joint stiffness or pain, carpal tunnel syndrome, trigger fingers, unexplained pain crises and short stature should all prompt consideration of a lysosomal storage disorder. Recurrent ENT infections, hepatosplenomegaly, recurrent hernias and visual/hearing impairment - especially when clustered together - are important extra-skeletal features. As diagnostic and therapeutic options continue to evolve, children with lysosomal storage disorders and their families are facing more sophisticated options for screening and treatment. The aim of this article is to highlight the paediatric presentations of lysosomal storage disorders, with an emphasis on the musculoskeletal features. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  5. The effectiveness, safety, and economic evaluation of Korean medicine for unexplained infertile women: A multi-center, prospective, observational study protocol.

    Science.gov (United States)

    Kim, Su-Hyun; Jo, Junyoung; Kim, Dong-Il

    2017-12-01

    Infertility is a condition in which a woman has not been pregnant despite having had normal intercourse for 1 year. The number of unexplained infertile females is increasing because of late marriage customs, as well as environmental and lifestyle habits. In Korea, infertile females have been treated with Korean medicine (KM). However, these effects have not been objectively confirmed through clinical trials. Therefore, this study was conducted to demonstrate the effectiveness of herbal medicine treatment in infertile patients and to demonstrate the economic feasibility through economical evaluation with assisted reproductive technology.This study is designed as a multicenter, single-arm clinical trial. All participants included will be from 3 Korean Medicine hospitals in Korea and will voluntarily sign an informed consent agreement. All recruited patients will conduct related surveys and tests, and be provided with treatment according to their menstrual cycle. Patients will take herbal medicines for 4 menstruation cycles and receive acupuncture and moxibustion treatment at 3 times (menstrual cycle day 3, 8, 14) during 4 menstruation cycles. They will also undergo an approximately 4 menstrual cycle treatment period, and 3 menstrual cycle observation period. If pregnant during the study, participants will take the herbal medicine for implantation for about 15 days. In this study, the primary outcome will be the clinical pregnancy rate, whereas the secondary outcome will include the implantation rate, ongoing pregnancy rate, and live birth rate.Ultimately, this study will provide clinical data regarding the effectiveness and safety of KM treatment for females with unexplained infertility and important evidence for establishing standard KM treatments for unexplained infertility. Moreover, we will identify the most cost-effective way to treat unexplained infertility. Korean Clinical Trial Registry (CRIS), Republic of Korea: KCT0002235. Date: February 21, 2017

  6. Recognition of patients with medically unexplained physical symptoms by family physicians: results of a focus group study

    NARCIS (Netherlands)

    Boeft, M. den; Huisman, D.; Wouden, J.C. van der; Numans, M.E.; Horst, H.E. van der; Lucassen, P.L.B.J.; Olde Hartman, T.C.

    2016-01-01

    BACKGROUND: Patients with medically unexplained physical symptoms (MUPS) form a heterogeneous group and frequently attend their family physician (FP). Little is known about how FPs recognize MUPS in their patients. We conducted a focus group study to explore how FPs recognize MUPS and whether they

  7. The value of F-18 fluorodeoxyglucose positron emission tomography/computed tomography in asymptomatic examinees with unexplained elevated blood carcinoembryonic antigen levels

    Energy Technology Data Exchange (ETDEWEB)

    Li, Wenfeng [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Department of Radiation Oncology, Wenzhou (China); Yin, Weiwei [The First Affiliated Hospital of Wenzhou Medical University, Division of PET/CT, Department of Radiology, Wenzhou (China); Ou, Rongying [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Department of Gynaecology and Obstetrics, Wenzhou (China); Chen, Ting; Xiong, Lingling; Xu, Yunsheng [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Department of Dermatovenereology, Wenzhou (China); Cheng, Dezhi; Xie, Deyao [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Department of Cardiothoracic Surgery, Wenzhou (China); Zheng, Xiangwu; Zhao, Liang [The First Affiliated Hospital of Wenzhou Medical University, Laboratory for Advanced Interdisciplinary Research, Institutes of Translational Medicine, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Division of PET/CT, Department of Radiology, Wenzhou (China); The First Affiliated Hospital of Wenzhou Medical University, Institutes of Intelligent and Molecular Imaging, Wenzhou (China)

    2016-04-15

    Cancer is still a clinical challenge, with many efforts invested in order to achieve timely detection. Unexplained elevated blood carcinoembryonic antigen levels are occasionally observed in an asymptomatic population and considered as a risk factor of cancers. The purpose of this study was to determine the validity of 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography (F-18 FDG-PET/CT) for detecting cancer in an asymptomatic population with an unexplained elevation in blood carcinoembryonic antigen (CEA) levels. This retrospective study included a total of 1920 asymptomatic examinees conducted from August 2011 through September 2013. The participants underwent CEA assay and conventional medical imaging (CEA-conventional), or CEA assay and F-18 FDG-PET/CT (CEA-PET/CT). The validity of conventional medical imaging and CEA-PET/CT scanning for detecting cancer and early-stage cancer in an asymptomatic population with an unexplained elevation in blood CEA levels were evaluated. Sensitivity, specificity, cancer detection rate, missed cancer detection rate, early-stage cancer detection rate, and early-stage cancer ratio using the CEA-PET/CT scanning were 96.6 %, 100 %, 10.4 %, 0.4 %, 3.7 %, and 34.5 %, respectively. In contrast, the corresponding values obtained using the conventional medical imaging were 50.6 % (P < 0.0001), 100 % (P > 0.9999), 50.6 % (P < 0.0001), 99.9 % (P = 0.055), 2.6 % (P < 0.0001), 2.5 % (P = 0.04), 0.7 % (P = 0.0004), and 14.5 % (P = 0.002), respectively. The F-18 FDG-PET/CT scanning significantly improved the validity of the cancer detection program in the asymptomatic population with an unexplained elevation in CEA levels. (orig.)

  8. Paraoxonase-2 and paraoxonase-3: comparison of mRNA expressions in the placentae of unexplained intrauterine growth restricted and noncomplicated pregnancies.

    Science.gov (United States)

    Dikbas, Levent; Yapca, Omer Erkan; Dikbas, Neslihan; Gundogdu, Cemal

    2017-05-01

    Recent evidence suggests that oxidative stress is involved in the pathophysiology of many human diseases. It has been demonstrated that oxidative stress is associated with intrauterine growth restriction (IUGR), and the depletion of placental antioxidant systems has been suggested as a key factor in this disease. Our aims were to explore the possible role of antioxidant paraoxonase-2 (PON2) and paraoxonase-3 (PON3) in the pathophysiology of unexplained IUGR. We have studied the expression of mRNA for PON2, PON3 in placental tissues by using RT-qPCR. Two groups, consisting of normal (n = 18) and unexplained IUGR pregnancies (n = 20) were compared. Our results demonstrated that there were no significant differences in the mRNA expressions of PON2, PON3 between the two groups (p = 0.28, p = 0.90, respectively). PON2 and PON3 were down-regulated in IUGR. Antenatal steroid therapy had no effect on the expression mRNA in placentae of unexplained IUGR pregnancies compared to non-treated group. These results suggest that PON2, PON3 mRNA levels were not changed significantly in placentae of IUGR when compared to normal pregnant women.

  9. Chronic fatigue in patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome: validation of a Norwegian translation of the Fatigue Impact Scale.

    Science.gov (United States)

    Lind, Ragna; Berstad, Arnold; Hatlebakk, Jan; Valeur, Jørgen

    2013-01-01

    Patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome (IBS) suffer from several health complaints, including fatigue. The aim of the present study was to validate a Norwegian translation of the Fatigue Impact Scale (FIS), and to assess the impact of fatigue in patients with self-reported food hypersensitivity and IBS, as compared with healthy controls. Thirty-eight patients with unexplained self-reported food hypersensitivity and IBS, who participated in the validation of the FIS completed the following additional questionnaires: the Short Form of Nepean Dyspepsia Index for assessment of quality of life, the Subjective Health Complaint Inventory, and questionnaires for diagnosis and severity of IBS. Impact of fatigue was studied in 43 patients with unexplained self-reported food hypersensitivity, 70% diagnosed with IBS, and 42 healthy controls. Cronbach's α for the FIS was 0.98, indicating excellent agreement between individual items. Scores on the FIS correlated with scores on the Short Form of Nepean Dyspepsia Index (r = 0.50, P = 0.001), indicating good convergent validity, and were higher in patients (median 85.0, interquartile range 36.8-105.3) than in controls (median 14.0, interquartile range 3.0-29.0, P ≤ 0.0001). The Norwegian translation of the FIS performed excellently in patients with unexplained self-reported food hypersensitivity and IBS, with patients reporting significantly more impact of chronic fatigue than healthy controls.

  10. IVF or IUI as first-line treatment in unexplained subfertility: the conundrum of treatment selection markers.

    Science.gov (United States)

    Tjon-Kon-Fat, R I; Tajik, P; Zafarmand, M H; Bensdorp, A J; Bossuyt, P M M; Oosterhuis, G J E; van Golde, R; Repping, S; Lambers, M D A; Slappendel, E; Perquin, D; Pelinck, M J; Gianotten, J; Maas, J W M; Eijkemans, M J C; van der Veen, F; Mol, B W; van Wely, M

    2017-05-01

    Are there treatment selection markers that could aid in identifying couples, with unexplained or mild male subfertility, who would have better chances of a healthy child with IVF with single embryo transfer (IVF-SET) than with IUI with ovarian stimulation (IUI-OS)? We did not find any treatment selection markers that were associated with better chances of a healthy child with IVF-SET instead of IUI-OS in couples with unexplained or mild male subfertility. A recent trial, comparing IVF-SET to IUI-OS, found no evidence of a difference between live birth rates and multiple pregnancy rates. It was suggested that IUI-OS should remain the first-line treatment instead of IVF-SET in couples with unexplained or mild male subfertility and female age between 18 and 38 years. The question remains whether there are some couples that may have higher pregnancy chances if treated with IVF-SET instead of IUI. We performed our analyses on data from the INeS trial, where couples with unexplained or mild male subfertility and an unfavourable prognosis for natural conception were randomly allocated to IVF-SET, IVF in a modified natural cycle or IUI-OS. In view of the aim of this study, we only used data of the comparison between IVF-SET (201 couples) and IUI-OS (207 couples). We pre-defined the following baseline characteristics as potential treatment selection markers: female age, ethnicity, smoking status, type of subfertility (primary/secondary), duration of subfertility, BMI, pre-wash total motile count and Hunault prediction score. For each potential treatment selection marker, we explored the association with the chances of a healthy child after IVF-SET and IUI-OS and tested if there was an interaction with treatment. Given the exploratory nature of our analysis, we used a P-value of 0.1. None of the markers were associated with higher chances of a healthy child from IVF-SET compared to IUI-OS (P-value for interaction >0.10). Since this is the first large study that looked at

  11. Recurrent unexplained palpitations (RUP) study comparison of implantable loop recorder versus conventional diagnostic strategy.

    Science.gov (United States)

    Giada, Franco; Gulizia, Michele; Francese, Maura; Croci, Francesco; Santangelo, Lucio; Santomauro, Maurizio; Occhetta, Eraldo; Menozzi, Carlo; Raviele, Antonio

    2007-05-15

    The aim of the study was to compare the diagnostic yield and the costs of implantable loop recorder (ILR) with those of the conventional strategy in patients with unexplained palpitations. In patients with unexplained palpitations, especially in those with infrequent symptoms, the conventional strategy, including short-term ambulatory electrocardiogram (ECG) monitoring and electrophysiological study, sometimes fails to establish a diagnosis. We studied 50 patients with infrequent (1 min) palpitations. Before enrollment, patients had a negative initial evaluation, including history, physical examination, and ECG. Patients were randomized either to conventional strategy (24-h Holter recording, a 4-week period of ambulatory ECG monitoring with an external recorder, and electrophysiological study) (n = 24) or to ILR implantation with 1-year monitoring (n = 26). Hospital costs of the 2 strategies were calculated. A diagnosis was obtained in 5 patients in the conventional strategy group, and in 19 subjects in the ILR group (21% vs. 73%, p < 0.001). Despite the higher initial cost, the cost per diagnosis in the ILR group was lower than in the conventional strategy group (euro 3,056 +/- euro 363 vs. euro 6,768 +/- euro 6,672, p = 0.012). In subjects without severe heart disease and with infrequent palpitations, ILR is a safe and more cost-effective diagnostic approach than conventional strategy.

  12. Medically unexplained symptom reports are associated with a decreased response to the rubber hand illusion.

    Science.gov (United States)

    Miles, Eleanor; Poliakoff, Ellen; Brown, Richard J

    2011-10-01

    Medically unexplained symptoms (MUS) have been hypothesized to result from a distortion in perception, whereby top-down factors influence the process of body representation. Perceptual illusions provide a novel method of investigating this hypothesis. This study aimed to investigate whether self-reported unexplained symptoms are associated with altered experience of the rubber hand illusion (RHI). A non-clinical MUS group with high scores on the Somatoform Dissociation Questionnaire (SDQ), and a control group with low scores on this scale, were exposed to the RHI. Illusion experience was measured by self-reports and by proprioceptive alteration. After controlling for somatosensory amplification and trait anxiety, the low-SDQ group responded significantly more strongly to the RHI on both questionnaire and proprioceptive measures of the illusion. In contrast, the high-SDQ group scored significantly higher on the Perceptual Aberrations Scale, a measure of bodily distortions in daily life. These findings support the proposed link between MUS and disturbances in body representation, and suggest that a decreased reliance on current sensory inputs may contribute to symptom experience in susceptible individuals. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Sickness absence, marginality, and medically unexplained physical symptoms: a focus-group study of patients' experiences.

    Science.gov (United States)

    Aamland, Aase; Werner, Erik L; Malterud, Kirsti

    2013-06-01

    Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. Two focus-group discussions were conducted with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically unexplained. Systematic text condensation was applied for analysis. Inspired by theories of marginalization and coping, the authors searched for knowledge of how patients' positive resources can be mobilized to counteract processes of marginality. Analysis revealed how invisible symptoms and lack of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from professionals. Confidence from both personal and professional contacts is crucial. GPs have an important and appreciated role in this aspect.

  14. Improving GP communication in consultations on medically unexplained symptoms: a qualitative interview study with patients in primary care.

    NARCIS (Netherlands)

    Houwen, S. van; Lucassen, P.; Stappers, H.W.; Assendelft, P.J.J.; Dulmen, S. van; Olde Hartman, T.C.

    2017-01-01

    Background: Many GPs find the care of patients with medically unexplained symptoms (MUS) challenging. Patients themselves are often not satisfied with the care they receive. Aim: To explore the problems patients with MUS experience in communication during consultations, with the aim of improving

  15. Training medical specialists to communicate better with patients with medically unexplained physical symptoms (MUPS): a randomized, controlled trial.

    NARCIS (Netherlands)

    Weiland, A.; Blankenstein, A.H.; Saase, J.L.C.M. van; Molen, H.T. van der; Jacobs, M.E.; Abels, D.C.; Köse, N; Dulmen, S. van; Vernhout, R.M.; Arends, L.R.

    2015-01-01

    Background: Patients with medically unexplained physical symptoms (MUPS) are prevalent 25–50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don’t feel understood. We developed an

  16. A Comparison of Pattern of Pregnancy Loss in Women with Infertility Undergoing IVF and Women with Unexplained Recurrent Miscarriages Who Conceive Spontaneously

    Directory of Open Access Journals (Sweden)

    Vidya A. Tamhankar

    2015-01-01

    Full Text Available Objective. Women with infertility and recurrent miscarriages may have an overlapping etiology. The aim of this study was to compare the pregnancy loss in pregnancies after IVF treatment with spontaneous pregnancies in women with recurrent miscarriages and to assess differences related to cause of infertility. Methods. The outcome from 1220 IVF pregnancies (Group I was compared with 611 spontaneous pregnancies (Group II in women with recurrent miscarriages. Subgroup analysis was performed in Group I based on cause of infertility: tubal factor (392 pregnancies; male factor (610 pregnancies; and unexplained infertility (218 pregnancies. Results. The clinical pregnancy loss rate in Group I (14.3% was significantly lower than that of Group II (25.8%, p<0.001 and this was independent of the cause of infertility. However the timing of pregnancy loss was similar between Groups I and II. The clinical pregnancy loss rate in Group I was similar in different causes of infertility. Conclusions. The clinical pregnancy loss rate following IVF treatment is lower than that of women with unexplained recurrent miscarriages who conceived spontaneously. This difference persists whether the infertility is secondary to tubal factors, male factors, or unexplained cause.

  17. Comparative evaluation of pregnancy outcome in gonadotrophin-clomiphene combination vs clomiphene alone in polycystic ovarian syndrome and unexplained infertility-A prospective clinical trial

    Directory of Open Access Journals (Sweden)

    Shiuli Mukherjee

    2010-01-01

    Full Text Available Objectives: A large prospective clinical trial was conducted to compare the efficacy of single dose uFSH and clomiphene citrate combination with clomiphene citrate alone for ovulation induction to improve the pregnancy rate. Materials and Methods: The study was a randomized, prospective clinical trial. Totally, 1527 infertile women (4381 cycles with polycystic ovarian syndrome (PCOS (n=911/2573 cycles and unexplained infertility (n=616/1808 cycles were randomized into two groups. Group A received single dose of uFSH on D 3 of menstrual cycle along with clomiphene. Group B received clomiphene only for ovulation induction. We compared the pregnancy rate and miscarriage rate between two groups. Results: Group A had a pregnancy rate of 17% compared to 8.3% of Group B which was significantly higher (P=0.0001. The miscarriage rate was 11% in Group A and 10% in Group B which was not significant (P=0.99. Pregnancy rates in PCOS women were 22% in Group A and 9.3% in Group B which shows significantly higher pregnancy rate (P=0.0001 in anovulatory infertility. But in unexplained infertility, there was no significant difference in pregnancy rate between Group A (11% and Group B(6.3%. Miscarriage rates were 8.8% and 9.5% in Group A and Group B, respectively, in PCOS women and 14% and 13% in women with unexplained infertility. Conclusion: Addition of single dose of uFSH improves pregnancy outcome particularly in anovulatory infertility (WHO II. Correction of unexplained infertility may need more than simple correction of possible subtle ovulatory effect.

  18. Incidence, risk factors, and clinical characteristics of unexplained visual loss after intraocular silicone oil for macula-on retinal detachment

    NARCIS (Netherlands)

    Scheerlinck, Laura M.; Schellekens, Peter A.; Liem, Albert T.; Steijns, Daan; van Leeuwen, R

    2016-01-01

    Purpose: To investigate the incidence, risk factors, and clinical characteristics of unexplained visual loss after macula-on rhegmatogenous retinal detachment (RRD). Methods: Retrospective cohort of patients with primary macula-on rhegmatogenous retinal detachment treated by vitrectomy with gas or

  19. Clinical features in accelerated phase of chronic myeloid leukemia

    International Nuclear Information System (INIS)

    Naqi, N.; Ayub, M.

    2001-01-01

    Objective: To identify the clinical indicators of accelerated phase in chronic myeloid leukemia (CML) diagnosed on hematological findings. Design: An observational and prospective study. Place and Duration of Study: The study was conducted at Oncology department of Combined Military Hospital, Rawalpindi and Armed Forces Institute of Pathology from April 1998 to April 1999. Subjects and Methods: The study on 51 patients of Philadelphia positive CML in chronic phase and on hydroxyurea therapy were carried out. Clinical features and hematological parameters in the peripheral blood examination were recorded and statistical analysis carried out to document reliable clinically indicators of accelerated phase of CML in reference to those reported in the literature. Results: Clinical, presence of unexplained fever, re-enlargement of spleen after successful regression with hydroxyurea therapy, and bleeding diathesis were found to be statistically significant pointers of progression into accelerated phase of CML. In the hematological features, with the exception of peripheral basophilia, the findings in the peripheral blood were consistent with those reported in the literature. Conclusion: It is concluded that the occurrences of the clinical features in the follow-up of chronic myeloid leukemia patients herald the accelerated phase of the disease. (author)

  20. Mutations in DDX3X Are a Common Cause of Unexplained Intellectual Disability with Gender-Specific Effects on Wnt Signaling.

    Science.gov (United States)

    Snijders Blok, Lot; Madsen, Erik; Juusola, Jane; Gilissen, Christian; Baralle, Diana; Reijnders, Margot R F; Venselaar, Hanka; Helsmoortel, Céline; Cho, Megan T; Hoischen, Alexander; Vissers, Lisenka E L M; Koemans, Tom S; Wissink-Lindhout, Willemijn; Eichler, Evan E; Romano, Corrado; Van Esch, Hilde; Stumpel, Connie; Vreeburg, Maaike; Smeets, Eric; Oberndorff, Karin; van Bon, Bregje W M; Shaw, Marie; Gecz, Jozef; Haan, Eric; Bienek, Melanie; Jensen, Corinna; Loeys, Bart L; Van Dijck, Anke; Innes, A Micheil; Racher, Hilary; Vermeer, Sascha; Di Donato, Nataliya; Rump, Andreas; Tatton-Brown, Katrina; Parker, Michael J; Henderson, Alex; Lynch, Sally A; Fryer, Alan; Ross, Alison; Vasudevan, Pradeep; Kini, Usha; Newbury-Ecob, Ruth; Chandler, Kate; Male, Alison; Dijkstra, Sybe; Schieving, Jolanda; Giltay, Jacques; van Gassen, Koen L I; Schuurs-Hoeijmakers, Janneke; Tan, Perciliz L; Pediaditakis, Igor; Haas, Stefan A; Retterer, Kyle; Reed, Patrick; Monaghan, Kristin G; Haverfield, Eden; Natowicz, Marvin; Myers, Angela; Kruer, Michael C; Stein, Quinn; Strauss, Kevin A; Brigatti, Karlla W; Keating, Katherine; Burton, Barbara K; Kim, Katherine H; Charrow, Joel; Norman, Jennifer; Foster-Barber, Audrey; Kline, Antonie D; Kimball, Amy; Zackai, Elaine; Harr, Margaret; Fox, Joyce; McLaughlin, Julie; Lindstrom, Kristin; Haude, Katrina M; van Roozendaal, Kees; Brunner, Han; Chung, Wendy K; Kooy, R Frank; Pfundt, Rolph; Kalscheuer, Vera; Mehta, Sarju G; Katsanis, Nicholas; Kleefstra, Tjitske

    2015-08-06

    Intellectual disability (ID) affects approximately 1%-3% of humans with a gender bias toward males. Previous studies have identified mutations in more than 100 genes on the X chromosome in males with ID, but there is less evidence for de novo mutations on the X chromosome causing ID in females. In this study we present 35 unique deleterious de novo mutations in DDX3X identified by whole exome sequencing in 38 females with ID and various other features including hypotonia, movement disorders, behavior problems, corpus callosum hypoplasia, and epilepsy. Based on our findings, mutations in DDX3X are one of the more common causes of ID, accounting for 1%-3% of unexplained ID in females. Although no de novo DDX3X mutations were identified in males, we present three families with segregating missense mutations in DDX3X, suggestive of an X-linked recessive inheritance pattern. In these families, all males with the DDX3X variant had ID, whereas carrier females were unaffected. To explore the pathogenic mechanisms accounting for the differences in disease transmission and phenotype between affected females and affected males with DDX3X missense variants, we used canonical Wnt defects in zebrafish as a surrogate measure of DDX3X function in vivo. We demonstrate a consistent loss-of-function effect of all tested de novo mutations on the Wnt pathway, and we further show a differential effect by gender. The differential activity possibly reflects a dose-dependent effect of DDX3X expression in the context of functional mosaic females versus one-copy males, which reflects the complex biological nature of DDX3X mutations. Copyright © 2015 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  1. Medically unexplained physical symptoms: toward an alternative paradigm for diagnosis and treatment.

    Science.gov (United States)

    Ballas, Christos A; Staab, Jeffrey P

    2003-12-01

    The treatment of patients with unexplained medical symptoms is difficult because there is neither a clear etiology for the symptoms, nor a useful paradigm with which to understand and treat them. Patients with such symptoms are often referred to psychiatry with vague diagnoses of "somatization" or "hypochondriasis." Rather than considering somatoform diagnoses based on the number or diversity of physical symptoms, evolving research suggests an emphasis on the type of physical symptom as an indicator of Axis I pathology. This article links specific symptomatic complaints, such as chronic pain, chest pain, and dizziness, to the respective Axis I disorders associated with them, such as depression, panic disorder, and anxiety disorders.

  2. Unexplained Graft Dysfunction after Heart Transplantation—Role of Novel Molecular Expression Test Score and QTc-Interval: A Case Report

    Directory of Open Access Journals (Sweden)

    Khurram Shahzad

    2010-01-01

    Full Text Available In the current era of immunosuppressive medications there is increased observed incidence of graft dysfunction in the absence of known histological criteria of rejection after heart transplantation. A noninvasive molecular expression diagnostic test was developed and validated to rule out histological acute cellular rejection. In this paper we present for the first time, longitudinal pattern of changes in this novel diagnostic test score along with QTc-interval in a patient who was admitted with unexplained graft dysfunction. Patient presented with graft failure with negative findings on all known criteria of rejection including acute cellular rejection, antibody mediated rejection and cardiac allograft vasculopathy. The molecular expression test score showed gradual increase and QTc-interval showed gradual prolongation with the gradual decline in graft function. This paper exemplifies that in patients presenting with unexplained graft dysfunction, GEP test score and QTc-interval correlate with the changes in the graft function.

  3. A Randomized Double-Blind Controlled Trial Comparing Davanloo Intensive Short-Term Dynamic Psychotherapy as Internet-Delivered Vs Treatment as Usual for Medically Unexplained Pain: A 6-Month Pilot Study.

    Science.gov (United States)

    Chavooshi, Behzad; Mohammadkhani, Parvaneh; Dolatshahi, Behrouz

    2016-01-01

    Research has shown that Intensive Short-Term Dynamic Psychotherapy (ISTDP) can effectively decrease pain intensity and improve quality of life in patients with medically unexplained pain. Understanding that not all patients with medically unexplained pain have access to in-person ISTDP, this study aims to investigate the efficacy of an Internet-delivered ISTDP for individuals with medically unexplained pain using Skype in comparison with treatment as usual. In this randomized controlled trial, 100 patients were randomly allocated into Internet-delivered ISTDP (n = 50) and treatment-as- usual (n = 50) groups. Treatment intervention consisted of 16 weekly, hour-long therapy sessions. The primary outcome was perceived pain assessed using the Numeric Pain Rating Scale. The secondary outcome included Depression Anxiety Stress Scale-21, Emotion Regulation Questionnaire, Mindful Attention Awareness Scale, and Quality-of-Life Inventory. Blind assessments were conducted at the baseline, posttreatment, and at a 6-month follow-up. In the intention-to-treat analysis, pain symptoms in the intervention group were significantly reduced (p Skype can significantly improve pain intensity and clinical symptoms of medically unexplained pain. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  4. Next-generation sequencing of 34 genes in sudden unexplained death victims in forensics and in patients with channelopathic cardiac diseases

    DEFF Research Database (Denmark)

    Hertz, Christin Løth; Christiansen, Sofie Lindgren; Ferrero-Miliani, Laura

    2015-01-01

    Sudden cardiac death (SCD) is responsible for a large proportion of sudden deaths in young individuals. In forensic medicine, many cases remain unexplained after routine postmortem autopsy and conventional investigations. These cases are called sudden unexplained deaths (SUD). Genetic testing has...... been suggested useful in forensic medicine, although in general with a significantly lower success rate compared to the clinical setting. The purpose of the study was to estimate the frequency of pathogenic variants in the genes most frequently associated with SCD in SUD cases and compare the frequency...... to that in patients with inherited cardiac channelopathies. Fifteen forensic SUD cases and 29 patients with channelopathies were investigated. DNA from 34 of the genes most frequently associated with SCD were captured using NimbleGen SeqCap EZ library build and were sequenced with next-generation sequencing (NGS...

  5. Experiences of sickness absence, marginality and Medically Unexplained Physical Symptoms - A focus group study

    DEFF Research Database (Denmark)

    E.L., Werner; A, Aamland; Malterud, Kirsti

    2013-01-01

    PURPOSE: Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. METHODS: Two focus-group discussions were conducted...... of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from...

  6. Anti-Müllerian hormone levels in salpingectomized compared with nonsalpingectomized women with tubal factor infertility and women with unexplained infertility

    DEFF Research Database (Denmark)

    Grynnerup, Anna Garcia-Alix Haugen; Lindhard, Anette; Sørensen, Steen

    2013-01-01

    To investigate the consequence of salpingectomy on ovarian reserve by measuring anti-Müllerian hormone (AMH) levels before in vitro fertilization (IVF) treatment in salpingectomized women compared with nonsalpingectomized women with tubal factor infertility, women with unexplained infertility and...

  7. Burnout specific features in steam-water mixture annular flow in a tube

    International Nuclear Information System (INIS)

    Doroshchuk, V.E.

    1981-01-01

    Some unexplained burnout specific features in a steam-generating tube are analysed on the basis of experimental data. The following problems are considered: 1) the effect of the tube length and the state of the working medium (single-phase, two-phase) on burnout at the tube inlet; 2) the character of the specific thermal flow dependence at the moment of burnout appearance on the mass steam content q=f(x). It is found that the effect of the tube length on the burnout exists only in a relatively narrow range of the operating parameters. The run of the q=f(x) dependence is also explained [ru

  8. Ordering blood tests for patients with unexplained fatigue in general practice: what does it yield? Results of the VAMPIRE trial.

    NARCIS (Netherlands)

    Koch, H.; Bokhoven, M.A. van; Riet, G. ter; Alphen-Jager, J.T. van; Weijden, T.T. van der; Dinant, G.J.; Bindels, P.J.

    2009-01-01

    BACKGROUND: Unexplained fatigue is frequently encountered in general practice. Because of the low prior probability of underlying somatic pathology, the positive predictive value of abnormal (blood) test results is limited in such patients. AIM: The study objectives were to investigate the

  9. Ordering blood tests for patients with unexplained fatigue in general practice: what does it yield? Results of the VAMPIRE trial

    NARCIS (Netherlands)

    Koch, Hèlen; van Bokhoven, Marloes A.; ter Riet, Gerben; van Alphen-Jager, Jm Tineke; van der Weijden, Trudy; Dinant, Geert-Jan; Bindels, Patrick Je

    2009-01-01

    Background Unexplained fatigue is frequently encountered in general practice. Because of the low prior probability of underlying somatic pathology, the positive predictive value of abnormal (blood) test results is limited in such patients. Aim The study objectives were to investigate the

  10. Assessment of uterine, subendometrial blood flows and endometrial gland vascular endothelial growth factor (EG-VEGF in women with unexplained infertility

    Directory of Open Access Journals (Sweden)

    H. El-Zenneni

    2015-06-01

    Conclusion: Subendometrial, but not the uterine, blood flow and the EG-VEGF score seem to be significantly lower during the mid-luteal phase in women with unexplained infertility. This may suggest significantly poorer angiogenesis during the assumed peri-implantation period.

  11. Primary care consultations about medically unexplained symptoms: how do patients indicate what they want?

    Science.gov (United States)

    Salmon, Peter; Ring, Adele; Humphris, Gerry M; Davies, John C; Dowrick, Christopher F

    2009-04-01

    Patients with medically unexplained physical symptoms (MUS) are often thought to deny psychological needs when they consult general practitioners (GPs) and to request somatic intervention instead. We tested predictions from the contrasting theory that they are transparent in communicating their psychological and other needs. To test predictions that what patients tell GPs when they consult about MUS is related transparently to their desire for (1) emotional support, (2) symptom explanation and (3) somatic intervention. Prospective naturalistic study. Before consultation, patients indicated what they wanted from it using a self-report questionnaire measuring patients' desire for: emotional support, explanation and reassurance, and physical investigation and treatment. Their speech during consultation was audio-recorded, transcribed and coded utterance-by-utterance. Multilevel regression analysis tested relationships between what patients sought and what they said. Patients (N = 326) consulting 33 GPs about symptoms that the GPs designated as MUS. Patients who wanted emotional support spoke more about psychosocial problems, including psychosocial causes of symptoms and their need for psychosocial help. Patients who wanted explanation and reassurance suggested more physical explanations, including diseases, but did not overtly request explanation. Patients' wish for somatic intervention was associated only with their talk about details of such interventions and not with their requests for them. In general, patients with medically unexplained symptoms provide many cues to their desire for emotional support. They are more indirect or guarded in communicating their desire for explanation and somatic intervention.

  12. Nonlocal approach to the analysis of the stress distribution in granular systems. II. Application to experiment

    Science.gov (United States)

    Scott, J. E.; Kenkre, V. M.; Hurd, A. J.

    1998-05-01

    A theory of stress propagation in granular materials developed recently [Kenkre, Scott, Pease, and Hurd, preceding paper, Phys. Rev. E 57, 5841 (1998)] is applied to the compaction of ceramic and metal powders in pipes with previously unexplained experimental features such as nonmonotonic density and stress variation along the axis of cylindrical compacts.

  13. The black box in somatization: unexplained physical symptoms, culture, and narratives of trauma.

    Science.gov (United States)

    Waitzkin, H; Magaña, H

    1997-09-01

    Stimulated by our clinical work with patients who manifest unexplained "somatoform" symptoms in the primary care setting, this article addresses a theoretical black box in our understanding of somatization: how does culture mediate severe stress to produce symptoms that cannot be explained by the presence of physical illness? Despite various problems in his explanation of hysteria, Freud broke new ground by emphasizing narratives of traumatic experiences in the development and treatment of unexplained physical symptoms. Except in anthropologically oriented cultural psychiatry, contemporary psychiatry has traveled away from a focus on narrative in the study of somatization. On the other hand, recent interest in narrative has spread across many intellectual disciplines, including the humanities and literary criticism, psychology, history, anthropology, and sociology. We operationally define narratives as attempts at storytelling that portray the interrelationships among physical symptoms and the psychologic, social, or cultural context of these symptoms. Regarding somatization and trauma, we focus on the ways that narrative integrates the cultural context with traumatic life events. In explaining the black box, we postulate that extreme stress (torture, rape, witnessing deaths of relatives, forced migration, etc.) is processed psychologically as a terrible, largely incoherent narrative of events too awful to hold in consciousness. Culture patterns the psychologic and somatic expression of the terrible narrative. Methodologically, we have developed some techniques for eliciting narratives of severe stress and somatic symptoms, which we illustrate with observations from an ongoing research project. In designing interventions to improve the care of somatizing patients, we are focusing on the creation of social situations where patients may feel empowered to express more coherent narratives of their prior traumatic experiences.

  14. Mental health care use in medically unexplained and explained physical symptoms: findings from a general population study

    Directory of Open Access Journals (Sweden)

    van Eck van der Sluijs JF

    2016-08-01

    Full Text Available Jonna F van Eck van der Sluijs,1,2 Margreet ten Have,3 Cees A Rijnders,4 Harm WJ van Marwijk,5,6 Ron de Graaf,3 Christina M van der Feltz-Cornelis1,2 1Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, 2Tranzo Department, Tilburg University, Tilburg, 3Netherlands Institute of Mental Health and Addiction, Utrecht, 4Department of Residency training, GGz Breburg, Tilburg, the Netherlands; 5Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK; 6Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands Objective: The aim of this study was to explore mental health care utilization patterns in primary and specialized mental health care of people with unexplained or explained physical symptoms. Methods: Data were derived from the first wave of the Netherlands Mental Health Survey and Incidence Study-2, a nationally representative face-to-face cohort study among the general population aged 18–64 years. We selected subjects with medically unexplained symptoms (MUS only (MUSonly; n=177, explained physical symptoms only (PHYonly, n=1,952, combined MUS and explained physical symptoms (MUS + PHY, n=209, and controls without physical symptoms (NONE, n=4,168. We studied entry into mental health care and the number of treatment contacts for mental problems, in both primary care and specialized mental health care. Analyses were adjusted for sociodemographic characteristics and presence of any 12-month mental disorder assessed with the Composite International Diagnostic Interview 3.0. Results: At the primary care level, all three groups of subjects with physical symptoms showed entry into care for mental health problems significantly more often than controls. The adjusted odds ratios were 2.29 (1.33, 3.95 for MUSonly, 1.55 (1.13, 2.12 for PHYonly, and 2.25 (1.41, 3.57 for MUS + PHY. At the

  15. Chronic fatigue in patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome: validation of a Norwegian translation of the Fatigue Impact Scale

    Directory of Open Access Journals (Sweden)

    Lind R

    2013-07-01

    Full Text Available Ragna Lind,1 Arnold Berstad,2 Jan Hatlebakk,1,3 Jørgen Valeur21Department of Medicine, Haukeland University Hospital, Bergen, 2Unger-Vetlesen Institute, Department of Medicine, Lovisenberg Diakonale Hospital, Oslo, 3Department of Clinical Medicine, University of Bergen, Bergen, NorwayBackground: Patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome (IBS suffer from several health complaints, including fatigue. The aim of the present study was to validate a Norwegian translation of the Fatigue Impact Scale (FIS, and to assess the impact of fatigue in patients with self-reported food hypersensitivity and IBS, as compared with healthy controls.Methods: Thirty-eight patients with unexplained self-reported food hypersensitivity and IBS, who participated in the validation of the FIS completed the following additional questionnaires: the Short Form of Nepean Dyspepsia Index for assessment of quality of life, the Subjective Health Complaint Inventory, and questionnaires for diagnosis and severity of IBS. Impact of fatigue was studied in 43 patients with unexplained self-reported food hypersensitivity, 70% diagnosed with IBS, and 42 healthy controls.Results: Cronbach's α for the FIS was 0.98, indicating excellent agreement between individual items. Scores on the FIS correlated with scores on the Short Form of Nepean Dyspepsia Index (r = 0.50, P = 0.001, indicating good convergent validity, and were higher in patients (median 85.0, interquartile range 36.8–105.3 than in controls (median 14.0, interquartile range 3.0–29.0, P ≤0.0001.Conclusion: The Norwegian translation of the FIS performed excellently in patients with unexplained self-reported food hypersensitivity and IBS, with patients reporting significantly more impact of chronic fatigue than healthy controls.Keywords: irritable bowel syndrome, fatigue, food hypersensitivity, quality of life

  16. Training specialists to write appropriate reply letters to general practitioners about patients with medically unexplained physical symptoms; A cluster-randomized trial.

    NARCIS (Netherlands)

    A. Weiland (Anne); A.H. Blankenstein (Annette); M.H.A. Willems; J.L.C.M. van Saase (Jan); P.L.A. van Daele (Paul); H.T. van der Molen (Henk); G.B. Langbroek (Ginger B.); A. Bootsma (Aart); E.M. Vriens (Els M.); A. Oberndorff-Klein Woolthuis (Ardi); R. Vernhout (Rene); L.R. Arends (Lidia)

    2015-01-01

    textabstractObjective: To evaluate effects of a communication training for specialists on the quality of their reply letters to general practitioners (GPs) about patients with medically unexplained physical symptoms (MUPS). Methods: Before randomization, specialists included ≤3 MUPS patients in a

  17. Diagnosis and treatment of unexplained anemia with iron deficiency without overt bleeding

    DEFF Research Database (Denmark)

    Dahlerup, Jens Frederik; Eivindson, Martin; Jacobsen, Bent Ascanius

    2015-01-01

    A general overview is given of the causes of anemia with iron deficiency as well as the pathogenesis of anemia and the para-clinical diagnosis of anemia. Anemia with iron deficiency but without overt GI bleeding is associated with a risk of malignant disease of the gastrointestinal tract; upper...... gastrointestinal cancer is 1/7 as common as colon cancer. Benign gastrointestinal causes of anemia are iron malabsorption (atrophic gastritis, celiac disease, chronic inflammation, and bariatric surgery) and chronic blood loss due to gastrointestinal ulcerations. The following diagnostic strategy is recommended...... for unexplained anemia with iron deficiency: conduct serological celiac disease screening with transglutaminase antibody (IgA type) and IgA testing and perform bidirectional endoscopy (gastroscopy and colonoscopy). Bidirectional endoscopy is not required in premenopausal women

  18. Sick-listed employees with severe medically unexplained physical symptoms : burden or routine for the occupational health physician? A cross sectional study

    NARCIS (Netherlands)

    Hoedeman, Rob; Krol, Boudien; Blankenstein, Annette H.; Koopmans, Petra C.; Groothoff, Johan W.

    2010-01-01

    Background: The two primary objectives of this study were to the assess consultation load of occupational health physicians (OHPs), and their difficulties and needs with regard to their sickness certification tasks in sick-listed employees with severe medical unexplained physical symptoms (MUPS).

  19. Medically Unexplained Pain Is Not Caused by Psychopathology

    Directory of Open Access Journals (Sweden)

    Lucia Gagliese

    2000-01-01

    Full Text Available This paper highlights Professor Ronald Melzack's theoretical contributions to the understanding of psychological factors in pain. His work continues to have profound influences on pain theory, research, management and public policy. His ideas have been pivotal to the acceptance of the role of the brain and psychological factors in the experience of pain. This article briefly outlines the prevailing theories of the psychology of pain before the gate-control theory. Melzack's contributions argue against the simplistic linear thinking inherent in specificity theory, which leads to the attribution of pain to either 'organic' or 'psychogenic' causes. Nevertheless, Cartesian dualism continues to thrive. The authors illustrate the nature and extent to which dualistic thinking pervades the field, show that a dualistic conceptualization of pain introduces an element of distrust to the relationship between patient and health professional, and conclude that the available data fail to reach today's standards for an evidence-based approach to pain. The authors believe that medically unexplained pain is not a symptom of a psychological disorder and that it is time to abandon the thinking that separates mind and body. The challenge remains for proponents to provide the empirical evidence to prove that psychopathology causes pain and, in so doing, to specify the mechanisms by which it is generated.

  20. Nonlocal approach to the analysis of the stress distribution in granular systems. II. Application to experiment

    International Nuclear Information System (INIS)

    Scott, J.E.; Kenkre, V.M.; Hurd, A.J.

    1998-01-01

    A theory of stress propagation in granular materials developed recently [Kenkre, Scott, Pease, and Hurd, preceding paper, Phys. Rev. E 57, 5841 (1998)] is applied to the compaction of ceramic and metal powders in pipes with previously unexplained experimental features such as nonmonotonic density and stress variation along the axis of cylindrical compacts. copyright 1998 The American Physical Society

  1. Projecting the potential impact of the Cap-Score™ on clinical pregnancy, live births, and medical costs in couples with unexplained infertility.

    Science.gov (United States)

    Babigumira, Joseph B; Sharara, Fady I; Garrison, Louis P

    2018-01-01

    The Cap-Score™ was developed to assess the capacitation status of men, thereby enabling personalized management of unexplained infertility by choosing timed intrauterine insemination (IUI), versus immediate in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in individuals with a low Cap-Score™. The objective of this study was to estimate the differences in outcomes and costs comparing the use of the Cap-Score™ with timed IUI (CS-TI) and the standard of care (SOC), which was assumed to be three IUI cycles followed by three IVF-ICSI cycles. We developed and parameterized a decision-analytic model of management of unexplained infertility for women based on data from the published literature. We calculated the clinical pregnancy rates, live birth rates, and medical costs comparing CS-TI and SOC. We used Monte Carlo simulation to quantify uncertainty in projected estimates and performed univariate sensitivity analysis. Compared to SOC, CS-TI was projected to increase the pregnancy rate by 1-26%, marginally reduce live birth rates by 1-3% in couples with women below 40 years, increase live birth rates by 3-7% in couples with women over 40 years, reduce mean medical costs by $4000-$19,200, reduce IUI costs by $600-$1370, and reduce IVF costs by $3400-$17,800, depending on the woman's age. The Cap-Score™ is a potentially valuable clinical tool for management of unexplained infertility because it is projected to improve clinical pregnancy rates, save money, and, depending on the price of the test, increase access to treatment for infertility.

  2. Prevalence of somatoform disorders and medically unexplained symptoms in old age populations in comparison with younger age groups : A systematic review

    NARCIS (Netherlands)

    Hilderink, P. H.; Collard, R.; Rosmalen, J. G. M.; Voshaar, R. C. Oude

    Objective: To review current knowledge regarding the prevalence of somatization problems in later life by level of caseness (somatoform disorders and medically unexplained symptoms, MUS) and to compare these rates with those in middle-aged and younger age groups. Method: A systematic search of the

  3. Negotiating explanations: doctor-patient communication with patients with medically unexplained symptoms-a qualitative analysis.

    Science.gov (United States)

    den Boeft, Madelon; Huisman, Daniëlle; Morton, LaKrista; Lucassen, Peter; van der Wouden, Johannes C; Westerman, Marjan J; van der Horst, Henriëtte E; Burton, Christopher D

    2017-02-01

    Patients with medically unexplained physical symptoms (MUPS) seek explanations for their symptoms, but often find general practitioners (GPs) unable to deliver these. Different methods of explaining MUPS have been proposed. Little is known about how communication evolves around these explanations. To examine the dialogue between GPs and patients related to explanations in a community-based clinic for MUPS. We categorized dialogue types and dialogue outcomes. Patients were ≥18 years with inclusion criteria for moderate MUPS: ≥2 referrals to specialists, ≥1 functional syndrome/symptoms, ≥10 on the Patient Health Questionnaire-15 and GP's judgement that symptoms were unexplained. We analysed transcripts of 112 audio-recorded consultations (39 patients and 5 GPs) from two studies on the Symptoms Clinic Intervention, a consultation intervention for MUPS in primary care. We used constant comparative analysis to code and classify dialogue types and outcomes. We extracted 115 explanation sequences. We identified four dialogue types, differing in the extent to which the GP or patient controlled the dialogue. We categorized eight outcomes of the sequences, ranging from acceptance to rejection by the patient. The most common outcome was holding (conversation suspended in an unresolved state), followed by acceptance. Few explanations were rejected by the patient. Co-created explanations by patient and GP were most likely to be accepted. We developed a classification of dialogue types and outcomes in relation to explanations offered by GPs for MUPS patients. While it requires further validation, it provides a framework, which can be used for teaching, evaluation of practice and research. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Risk of Death in Infants Who Have Experienced a Brief Resolved Unexplained Event: A Meta-Analysis.

    Science.gov (United States)

    Brand, Donald A; Fazzari, Melissa J

    2018-06-01

    To estimate an upper bound on the risk of death after a brief resolved unexplained event (BRUE), a sudden alteration in an infant's breathing, color, tone, or responsiveness, previously labeled "apparent life-threatening event" (ALTE). The meta-analysis incorporated observational studies of patients with ALTE that included data on in-hospital and post-discharge deaths with at least 1 week of follow-up after hospital discharge. Pertinent studies were identified from a published review of the literature from 1970 through 2014 and a supplementary PubMed query through February 2017. The 12 included studies (n = 3005) reported 12 deaths, of which 8 occurred within 4 months of the event. Applying a Poisson-normal random effects model to the 8 proximate deaths using a 4-month time horizon yielded a post-ALTE mortality rate of about 1 in 800, which constitutes an upper bound on the risk of death after a BRUE. This risk is about the same as the baseline risk of death during the first year of life. The meta-analysis therefore supports the return-home approach advocated in a recently published clinical practice guideline-not routine hospitalization-for BRUE patients who have been evaluated in the emergency department and determined to be at lower risk. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. How the risky features of previous selection affect subsequent decision-making: evidence from behavioral and fMRI measures.

    Science.gov (United States)

    Dong, Guangheng; Zhang, Yifen; Xu, Jiaojing; Lin, Xiao; Du, Xiaoxia

    2015-01-01

    Human decision making is rarely conducted in temporal isolation. It is often biased and affected by environmental variables, particularly prior selections. In this study, we used a task that simulates a real gambling process to explore the effect of the risky features of a previous selection on subsequent decision making. Compared with decision making after an advantageous risk-taking situation (Risk_Adv), that after a disadvantageous risk-taking situation (Risk_Disadv) is associated with a longer response time (RT, the time spent in making decisions) and higher brain activations in the caudate and the dorsolateral prefrontal cortex (DLPFC). Compared with decisions after Risk_Adv, those after Risk_Disadv in loss trials are associated with higher brain activations in the left superior temporal gyrus (STG) and the precuneus. Brain activity and relevant RTs significantly correlated. Overall, people who experience disadvantageous risk-taking selections tend to focus on current decision making and engage cognitive endeavors in value evaluation and in the regulation of their risk-taking behaviors during decision making.

  6. Granulomatous lobular mastitis: report of a case with previously undescribed histopathological abnormalities.

    Science.gov (United States)

    Axelsen, R A; Reasbeck, P

    1988-10-01

    A 41-yr-old multiparous woman presented with a discrete breast lump which proved histologically to be an example of granulomatous lobular mastitis. The clinical and histological features were similar to those noted in previous reports. Additional histological features in the present case were an intense mononuclear cell infiltration of lobular and ductal epithelium, associated with nuclear fragments morphologically suggestive of apoptosis. These appearances, which have not previously been described, are illustrated, together with the more classical features of the condition well demonstrated by the present case. The novel histological features noted here suggest that the development of granulomatous lobular mastitis may be at least in part immunologically mediated, and that the cellular infiltrates seen may be a manifestation of cell-mediated destruction of mammary epithelium.

  7. Analytical Features: A Knowledge-Based Approach to Audio Feature Generation

    Directory of Open Access Journals (Sweden)

    Pachet François

    2009-01-01

    Full Text Available We present a feature generation system designed to create audio features for supervised classification tasks. The main contribution to feature generation studies is the notion of analytical features (AFs, a construct designed to support the representation of knowledge about audio signal processing. We describe the most important aspects of AFs, in particular their dimensional type system, on which are based pattern-based random generators, heuristics, and rewriting rules. We show how AFs generalize or improve previous approaches used in feature generation. We report on several projects using AFs for difficult audio classification tasks, demonstrating their advantage over standard audio features. More generally, we propose analytical features as a paradigm to bring raw signals into the world of symbolic computation.

  8. Antinuclear autoantibodies and pregnancy outcome in women with unexplained recurrent miscarriage.

    Science.gov (United States)

    Ticconi, Carlo; Pietropolli, Adalgisa; Borelli, Barbara; Bruno, Valentina; Piccione, Emilio; Bernardini, Sergio; Di Simone, Nicoletta

    2016-11-01

    To investigate whether antinuclear autoantibodies (ANA) could be related to the outcome of the successive pregnancy in women with unexplained recurrent miscarriage (uRM). Circulating ANA were measured by indirect immunofluorescence in 86 women with uRM before pregnancy, repeated in the first trimester of the successive gestation and correlated with pregnancy outcome. Forty-one women were ANA- and 45 were ANA+ before pregnancy. No relation was found between pre-pregnancy ANA status and the outcome of the successive pregnancy. However, when these women were monitored at 7th week during their pregnancy for ANA, of the 22 ANA+ women who remained ANA+ seven miscarriages (31.8%) were observed, whereas all of the 23 ANA+ women who became ANA- had pregnancies ongoing beyond the 20th week without miscarriage. ANA status could have a role in uRM. Disappearance of ANA in early pregnancy could have a favorable prognostic value in the successive pregnancy. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Unexplained severe illness possibly associated with consumption of Kombucha tea--Iowa, 1995.

    Science.gov (United States)

    1995-12-08

    Kombucha tea is a popular health beverage made by incubating the Kombucha mushroom in sweet black tea. Although advocates of Kombucha tea have attributed many therapeutic effects to the drink (1-3), its beneficial and/or adverse effects have not been determined scientifically. During April 1995, cases of unexplained severe illness (including one death) occurred in two persons in a rural town in northwestern Iowa who had been drinking Kombucha tea daily for approximately 2 months. Based on the findings of a preliminary investigation by the Iowa Department of Public Health (IDPH), on April 10 IDPH issued a news release recommending that persons refrain from drinking Kombucha tea until the role of the tea in the two cases of illness had been evaluated fully. This report summarizes the investigation of these cases by the IDPH, CDC, and the Food and Drug Administration (FDA).

  10. Medically unexplained physical symptoms and work functioning over 2 years: their association and the influence of depressive and anxiety disorders and job characteristics

    NARCIS (Netherlands)

    Boeft, M. den; Twisk, J.W.; Hoekstra, T.; Terluin, B.; Penninx, B.W.; Wouden, J.C. van der; Numans, M.E.; Horst, H.E. van der

    2016-01-01

    BACKGROUND: Medically unexplained physical symptoms (MUPS) are highly prevalent and may affect work functioning. In this study we aimed to assess the longitudinal association between MUPS and work functioning over 2 years and the influence of job characteristics and depressive and anxiety disorders

  11. The mysteries of leptons. New physics and unexplained phenomena

    Energy Technology Data Exchange (ETDEWEB)

    Merle, Alexander

    2009-12-09

    This doctoral thesis deals with the mysteries of the leptonic sector of the Standard Model of Elementary Particle Physics. After giving a short overview about the Standard Model itself, the text starts with introducing the so-called ''GSI anomaly'', the observation of a periodic modulation of the exponential decay law, which is still unexplained and has erroneously been attributed to neutrino oscillations. It is argued why this interpretation is incorrect and several further aspects of the phenomenon are discussed. Afterwards two topics of New Physics beyond the Standard Model are treated, double beta processes and lepton flavour violation. Some important phenomenological aspects of the former are discussed before performing a detailed calculation of the radiative process of neutrino-less double electron capture. In spite of the tiny rates, a detailed understanding of this process is important for setting proper experimental limits. The last part of the thesis starts with very general (and nearly model-independent) constraints for lepton flavour conservation, before discussing the interplay of structure and freedom in the Yukawa sector when a model is confronted with phenomenology. We also comment on a new mechanism that can indeed introduce some realistic structures leading to lepton flavour violating effects. (orig.)

  12. The mysteries of leptons. New physics and unexplained phenomena

    International Nuclear Information System (INIS)

    Merle, Alexander

    2009-01-01

    This doctoral thesis deals with the mysteries of the leptonic sector of the Standard Model of Elementary Particle Physics. After giving a short overview about the Standard Model itself, the text starts with introducing the so-called ''GSI anomaly'', the observation of a periodic modulation of the exponential decay law, which is still unexplained and has erroneously been attributed to neutrino oscillations. It is argued why this interpretation is incorrect and several further aspects of the phenomenon are discussed. Afterwards two topics of New Physics beyond the Standard Model are treated, double beta processes and lepton flavour violation. Some important phenomenological aspects of the former are discussed before performing a detailed calculation of the radiative process of neutrino-less double electron capture. In spite of the tiny rates, a detailed understanding of this process is important for setting proper experimental limits. The last part of the thesis starts with very general (and nearly model-independent) constraints for lepton flavour conservation, before discussing the interplay of structure and freedom in the Yukawa sector when a model is confronted with phenomenology. We also comment on a new mechanism that can indeed introduce some realistic structures leading to lepton flavour violating effects. (orig.)

  13. Evaluating Transcription Factor Activity Changes by Scoring Unexplained Target Genes in Expression Data.

    Directory of Open Access Journals (Sweden)

    Evi Berchtold

    Full Text Available Several methods predict activity changes of transcription factors (TFs from a given regulatory network and measured expression data. But available gene regulatory networks are incomplete and contain many condition-dependent regulations that are not relevant for the specific expression measurement. It is not known which combination of active TFs is needed to cause a change in the expression of a target gene. A method to systematically evaluate the inferred activity changes is missing. We present such an evaluation strategy that indicates for how many target genes the observed expression changes can be explained by a given set of active TFs. To overcome the problem that the exact combination of active TFs needed to activate a gene is typically not known, we assume a gene to be explained if there exists any combination for which the predicted active TFs can possibly explain the observed change of the gene. We introduce the i-score (inconsistency score, which quantifies how many genes could not be explained by the set of activity changes of TFs. We observe that, even for these minimal requirements, published methods yield many unexplained target genes, i.e. large i-scores. This holds for all methods and all expression datasets we evaluated. We provide new optimization methods to calculate the best possible (minimal i-score given the network and measured expression data. The evaluation of this optimized i-score on a large data compendium yields many unexplained target genes for almost every case. This indicates that currently available regulatory networks are still far from being complete. Both the presented Act-SAT and Act-A* methods produce optimal sets of TF activity changes, which can be used to investigate the difficult interplay of expression and network data. A web server and a command line tool to calculate our i-score and to find the active TFs associated with the minimal i-score is available from https://services.bio.ifi.lmu.de/i-score.

  14. Sudden unexplained death in childhood. An audit of the quality of Autopsy reporting

    LENUS (Irish Health Repository)

    Treacy, A

    2013-03-01

    Cases of sudden unexplained death in childhood (SUDC) in Ireland in children aged >1year and <5 years were examined in order to assess the quality of autopsy reporting. All SUDC cases are notified to and documented by the National Sudden Infant Death Register (NSIDR) in Ireland along with all cases of sudden infant death syndrome (SIDS) referring to sudden infant deaths less than one year of age. The database of the NSIDR in Ireland was interrogated and cases of SIDS and SUDC were compared over a fifteen-year period (1995-2009). SIDS cases whose autopsies were conducted in the same hospital in the same year as the index SUDC case were used for comparison. The autopsy report for each case was examined and modified Rushton(MR) scores 1\\r\

  15. Covert video monitoring in the assessment of medically unexplained symptoms in children.

    Science.gov (United States)

    Wallace, Dustin P; Sim, Leslie A; Harrison, Tracy E; Bruce, Barbara K; Harbeck-Weber, Cynthia

    2012-04-01

    Diagnosis of medically unexplained symptoms (MUS) occurs after thorough evaluations have failed to identify a physiological cause for symptoms. However, families and providers may wonder if something has been missed, leading to reduced confidence in behavioral treatment. Confidence may be improved through the use of technology such as covert video monitoring to better assess functioning across settings. A 12-year-old male presented with progressive neurological decline, precipitated by chronic pain. After thorough evaluation and the failure of standard treatments (medical, rehabilitative, and psychological) covert video monitoring revealed that the patient demonstrated greater abilities when alone in his room. Negative reinforcement was used to initiate recovery, accompanied by positive reinforcement and a rehabilitative approach. Covert video monitoring assisted in three subsequent cases over the following 3 years. In certain complex cases, video monitoring can inform the assessment and treatment of MUS. Discussion includes ethical and practical considerations.

  16. Writer identification using curvature-free features

    NARCIS (Netherlands)

    He, Sheng; Schomaker, Lambertus

    2017-01-01

    Feature engineering takes a very important role in writer identification which has been widely studied in the literature. Previous works have shown that the joint feature distribution of two properties can improve the performance. The joint feature distribution makes feature relationships explicit

  17. Medically unexplained physical symptoms and work functioning over 2 years : their association and the influence of depressive and anxiety disorders and job characteristics

    NARCIS (Netherlands)

    den Boeft, Madelon; Twisk, Jos W R; Hoekstra, T.; Terluin, Berend; Penninx, Brenda W J H; van der Wouden, Johannes C; Numans, Mattijs E.; van der Horst, Henriette E

    2016-01-01

    BACKGROUND: Medically unexplained physical symptoms (MUPS) are highly prevalent and may affect work functioning. In this study we aimed to assess the longitudinal association between MUPS and work functioning over 2 years and the influence of job characteristics and depressive and anxiety disorders

  18. IVF with planned single-embryo transfer versus IUI with ovarian stimulation in couples with unexplained subfertility: an economic analysis.

    Science.gov (United States)

    van Rumste, Minouche M E; Custers, Inge M; van Wely, Madelon; Koks, Carolien A; van Weering, Hans G I; Beckers, Nicole G M; Scheffer, Gabrielle J; Broekmans, Frank J M; Hompes, Peter G A; Mochtar, Monique H; van der Veen, Fulco; Mol, Ben W J

    2014-03-01

    Couples with unexplained subfertility are often treated with intrauterine insemination (IUI) with ovarian stimulation, which carries the risk of multiple pregnancies. An explorative randomized controlled trial was performed comparing one cycle of IVF with elective single-embryo transfer (eSET) versus three cycles of IUI-ovarian stimulation in couples with unexplained subfertility and a poor prognosis for natural conception, to assess the economic burden of the treatment modalities. The main outcome measures were ongoing pregnancy rates and costs. This study randomly assigned 58 couples to IVF-eSET and 58 couples to IUI-ovarian stimulation. The ongoing pregnancy rates were 24% in with IVF-eSET versus 21% with IUI-ovarian stimulation, with two and three multiple pregnancies, respectively. The mean cost per included couple was significantly different: €2781 with IVF-eSET and €1876 with IUI-ovarian stimulation (Pcosts per ongoing pregnancy were €2456 for IVF-eSET. In couples with unexplained subfertility, one cycle of IVF-eSET cost an additional €900 per couple compared with three cycles of IUI-ovarian stimulation, for no increase in ongoing pregnancy rates or decrease in multiple pregnancies. When IVF-eSET results in higher ongoing pregnancy rates, IVF would be the preferred treatment. Couples that have been trying to conceive unsuccessfully are often treated with intrauterine insemination (IUI) and medication to improve egg production (ovarian stimulation). This treatment carries the risk of multiple pregnancies like twins. We performed an explorative study among those couples that had a poor prognosis for natural conception. One cycle of IVF with transfer of one selected embryo (elective single-embryo transfer, eSET) was compared with three cycles of IUI-ovarian stimulation. The aim of this study was to assess the economic burden of both treatments. The Main outcome measures were number of good pregnancies above 12weeks and costs. We randomly assigned 58

  19. Cost-effectiveness analysis of preimplantation genetic screening and in vitro fertilization versus expectant management in patients with unexplained recurrent pregnancy loss.

    Science.gov (United States)

    Murugappan, Gayathree; Ohno, Mika S; Lathi, Ruth B

    2015-05-01

    To determine whether in vitro fertilization with preimplantation genetic screening (IVF/PGS) is cost effective compared with expectant management in achieving live birth for patients with unexplained recurrent pregnancy loss (RPL). Decision analytic model comparing costs and clinical outcomes. Academic recurrent pregnancy loss programs. Women with unexplained RPL. IVF/PGS with 24-chromosome screening and expectant management. Cost per live birth. The IVF/PGS strategy had a live-birth rate of 53% and a clinical miscarriage rate of 7%. Expectant management had a live-birth rate of 67% and clinical miscarriage rate of 24%. The IVF/PGS strategy was 100-fold more expensive, costing $45,300 per live birth compared with $418 per live birth with expectant management. In this model, IVF/PGS was not a cost-effective strategy for increasing live birth. Furthermore, the live-birth rate with IVF/PGS needs to be 91% to be cost effective compared with expectant management. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. The prevalence of mutations in KCNQ1, KCNH2, and SCN5A in an unselected national cohort of young sudden unexplained death cases

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Larsen, Maiken Kudahl; Berge, Knut Erik

    2012-01-01

    INTRODUCTION: Sudden unexplained death account for one-third of all sudden natural deaths in the young (1-35 years). Hitherto, the prevalence of genopositive cases has primarily been based on deceased persons referred for postmortem genetic testing. These deaths potentially may represent the worst...

  1. Encounters between medical specialists and patients with medically unexplained physical symptoms; influences of communication on patient outcomes and use of health care: a literature overview.

    NARCIS (Netherlands)

    Weiland, A.; Kraats, R.E. van de; Blankenstein, A.H.; Saase, J.L.C.M. van; Molen, H.T. van der; Bramer, W.M.; Dulmen, A.M. van; Arends, L.R.

    2012-01-01

    Medically unexplained physical symptoms (MUPS) burden patients and health services due to large quantities of consultations and medical interventions. The aim of this study is to determine which elements of communication in non-psychiatric specialist MUPS care influence health outcomes. Systematic

  2. What do patients choose to tell their doctors? Qualitative analysis of potential barriers to reattributing medically unexplained symptoms.

    Science.gov (United States)

    Peters, Sarah; Rogers, Anne; Salmon, Peter; Gask, Linda; Dowrick, Chris; Towey, Maria; Clifford, Rebecca; Morriss, Richard

    2009-04-01

    Despite both parties often expressing dissatisfaction with consultations, patients with medically unexplained symptoms (MUS) prefer to consult their general practitioners (GPs) rather than any other health professional. Training GPs to explain how symptoms can relate to psychosocial problems (reattribution) improves the quality of doctor-patient communication, though not necessarily patient health. To examine patient experiences of GPs' attempts to reattribute MUS in order to identify potential barriers to primary care management of MUS and improvement in outcome. Qualitative study. Patients consulting with MUS whose GPs had been trained in reattribution. A secondary sample of patients of control GPs was also interviewed to ascertain if barriers identified were specific to reattribution or common to consultations about MUS in general. Thematic analysis of in-depth interviews. Potential barriers include the complexity of patients' problems and patients' judgements about how to manage their presentation of this complexity. Many did not trust doctors with discussion of emotional aspects of their problems and chose not to present them. The same barriers were seen amongst patients whose GPs were not trained, suggesting the barriers are not particular to reattribution. Improving GP explanation of unexplained symptoms is insufficient to reduce patients' concerns. GPs need to (1) help patients to make sense of the complex nature of their presenting problems, (2) communicate that attention to psychosocial factors will not preclude vigilance to physical disease and (3) ensure a quality of doctor-patient relationship in which patients can perceive psychosocial enquiry as appropriate.

  3. New Tunneling Features in Polar III-Nitride Resonant Tunneling Diodes

    Directory of Open Access Journals (Sweden)

    Jimy Encomendero

    2017-10-01

    Full Text Available For the past two decades, repeatable resonant tunneling transport of electrons in III-nitride double barrier heterostructures has remained elusive at room temperature. In this work we theoretically and experimentally study III-nitride double-barrier resonant tunneling diodes (RTDs, the quantum transport characteristics of which exhibit new features that are unexplainable using existing semiconductor theory. The repeatable and robust resonant transport in our devices enables us to track the origin of these features to the broken inversion symmetry in the uniaxial crystal structure, which generates built-in spontaneous and piezoelectric polarization fields. Resonant tunneling transport enabled by the ground state as well as by the first excited state is demonstrated for the first time over a wide temperature window in planar III-nitride RTDs. An analytical transport model for polar resonant tunneling heterostructures is introduced for the first time, showing a good quantitative agreement with experimental data. From this model we realize that tunneling transport is an extremely sensitive measure of the built-in polarization fields. Since such electric fields play a crucial role in the design of electronic and photonic devices, but are difficult to measure, our work provides a completely new method to accurately determine their magnitude for the entire class of polar heterostructures.

  4. Undiagnosed pancreatic exocrine insufficiency and chronic pancreatitis in functional GI disorder patients with diarrhea or abdominal pain.

    Science.gov (United States)

    Talley, Nicholas J; Holtmann, Gerald; Nguyen, Quoc Nam; Gibson, Peter; Bampton, Peter; Veysey, Martin; Wong, James; Philcox, Stephen; Koloski, Natasha; Bunby, Lisa; Jones, Michael

    2017-11-01

    A previous UK study showed that 6.1% of patients with diarrhea-predominant irritable bowel syndrome (IBS-D) had evidence of severe pancreatic exocrine insufficiency (PEI), but these findings need replication. We aimed to identify the prevalence of PEI based on fecal elastase stool testing in consecutive outpatients presenting with chronic unexplained abdominal pain and/or diarrhea and/or IBS-D. Patients aged over 40 years presenting to hospital outpatient clinics from six sites within Australia with unexplained abdominal pain and/or diarrhea for at least 3 months and/or IBS-D were studied. Patients completed validated questionnaires and donated a stool sample in which elastase concentration was measured by ELISA. A concentration of abdominal CT. Two hundred eighteen patients (mean age of 60 years, 29.4% male) were studied. PEI was found in 4.6% (95% CI 2.2-8.3%) (n = 10), with five patients (2.3% (95% CI 0.8-5.3%) having severe PEI. Only male sex and heavy alcohol use were significantly associated with abnormal versus normal pancreatic functioning. Of seven patients who underwent endoscopic ultrasound or CT, two had features indicative of chronic pancreatitis. One in 50 patients with IBS-D or otherwise unexplained abdominal pain or diarrhea have an abnormal fecal elastase, but unexpected pancreatic insufficiency was detected in only a minority of these. This study failed to confirm the high prevalence of PEI among patients with unexplained GI symptoms previously reported. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  5. Internal versus external features in triggering the brain waveforms for conjunction and feature faces in recognition.

    Science.gov (United States)

    Nie, Aiqing; Jiang, Jingguo; Fu, Qiao

    2014-08-20

    Previous research has found that conjunction faces (whose internal features, e.g. eyes, nose, and mouth, and external features, e.g. hairstyle and ears, are from separate studied faces) and feature faces (partial features of these are studied) can produce higher false alarms than both old and new faces (i.e. those that are exactly the same as the studied faces and those that have not been previously presented) in recognition. The event-related potentials (ERPs) that relate to conjunction and feature faces at recognition, however, have not been described as yet; in addition, the contributions of different facial features toward ERPs have not been differentiated. To address these issues, the present study compared the ERPs elicited by old faces, conjunction faces (the internal and the external features were from two studied faces), old internal feature faces (whose internal features were studied), and old external feature faces (whose external features were studied) with those of new faces separately. The results showed that old faces not only elicited an early familiarity-related FN400, but a more anterior distributed late old/new effect that reflected recollection. Conjunction faces evoked similar late brain waveforms as old internal feature faces, but not to old external feature faces. These results suggest that, at recognition, old faces hold higher familiarity than compound faces in the profiles of ERPs and internal facial features are more crucial than external ones in triggering the brain waveforms that are characterized as reflecting the result of familiarity.

  6. A cross-sectional study of 'yaws' in districts of Ghana which have previously undertaken azithromycin mass drug administration for trachoma control.

    Directory of Open Access Journals (Sweden)

    Rosanna Ghinai

    2015-01-01

    Full Text Available Yaws, caused by Treponema pallidum ssp. pertenue, is reportedly endemic in Ghana. Mass distribution of azithromycin is now the cornerstone of the WHO yaws eradication campaign. Mass distribution of azithromycin at a lower target dose was previously undertaken in two regions of Ghana for the control of trachoma. Ongoing reporting of yaws raises the possibility that resistance may have emerged in T. pallidum pertenue, or that alternative infections may be responsible for some of the reported cases. We conducted a cross-sectional survey in thirty communities in two districts of Ghana where MDA for trachoma had previously been conducted. Children aged 5-17 years with ulcerative lesions compatible with yaws were enrolled. Samples for treponemal serology and lesion PCR were collected from all children. 90 children with 98 lesions were enrolled. Syphilis serology was negative in all of them. PCR for T. pallidum ssp pertenue was negative in all children, but Haemophilus ducreyi DNA was detected in 9 lesions. In these communities, previously treated for trachoma, we found no evidence of ongoing transmission of yaws. H. ducreyi was associated with a proportion of skin lesions, but the majority of lesions remain unexplained. Integration of diagnostic testing into both pre and post-MDA surveillance systems is required to better inform yaws control programmes.

  7. Comparative gene expression profiling of placentas from patients with severe pre-eclampsia and unexplained fetal growth restriction

    Directory of Open Access Journals (Sweden)

    Kurahashi Hiroki

    2011-08-01

    Full Text Available Abstract Background It has been well documented that pre-eclampsia and unexplained fetal growth restriction (FGR have a common etiological background, but little is known about their linkage at the molecular level. The aim of this study was to further investigate the mechanisms underlying pre-eclampsia and unexplained FGR. Methods We analyzed differentially expressed genes in placental tissue from severe pre-eclamptic pregnancies (n = 8 and normotensive pregnancies with or (n = 8 without FGR (n = 8 using a microarray method. Results A subset of the FGR samples showed a high correlation coefficient overall in the microarray data from the pre-eclampsia samples. Many genes that are known to be up-regulated in pre-eclampsia are also up-regulated in FGR, including the anti-angiogenic factors, FLT1 and ENG, believed to be associated with the onset of maternal symptoms of pre-eclampsia. A total of 62 genes were found to be differentially expressed in both disorders. However, gene set enrichment analysis for these differentially expressed genes further revealed higher expression of TP53-downstream genes in pre-eclampsia compared with FGR. TP53-downstream apoptosis-related genes, such as BCL6 and BAX, were found to be significantly more up-regulated in pre-eclampsia than in FGR, although the caspases are expressed at equivalent levels. Conclusions Our current data indicate a common pathophysiology for FGR and pre-eclampsia, leading to an up-regulation of placental anti-angiogenic factors. However, our findings also suggest that it may possibly be the excretion of these factors into the maternal circulation through the TP53-mediated early-stage apoptosis of trophoblasts that leads to the maternal symptoms of pre-eclampsia.

  8. Partial Epilepsy with Auditory Features

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2004-07-01

    Full Text Available The clinical characteristics of 53 sporadic (S cases of idiopathic partial epilepsy with auditory features (IPEAF were analyzed and compared to previously reported familial (F cases of autosomal dominant partial epilepsy with auditory features (ADPEAF in a study at the University of Bologna, Italy.

  9. Feature Selection for Chemical Sensor Arrays Using Mutual Information

    Science.gov (United States)

    Wang, X. Rosalind; Lizier, Joseph T.; Nowotny, Thomas; Berna, Amalia Z.; Prokopenko, Mikhail; Trowell, Stephen C.

    2014-01-01

    We address the problem of feature selection for classifying a diverse set of chemicals using an array of metal oxide sensors. Our aim is to evaluate a filter approach to feature selection with reference to previous work, which used a wrapper approach on the same data set, and established best features and upper bounds on classification performance. We selected feature sets that exhibit the maximal mutual information with the identity of the chemicals. The selected features closely match those found to perform well in the previous study using a wrapper approach to conduct an exhaustive search of all permitted feature combinations. By comparing the classification performance of support vector machines (using features selected by mutual information) with the performance observed in the previous study, we found that while our approach does not always give the maximum possible classification performance, it always selects features that achieve classification performance approaching the optimum obtained by exhaustive search. We performed further classification using the selected feature set with some common classifiers and found that, for the selected features, Bayesian Networks gave the best performance. Finally, we compared the observed classification performances with the performance of classifiers using randomly selected features. We found that the selected features consistently outperformed randomly selected features for all tested classifiers. The mutual information filter approach is therefore a computationally efficient method for selecting near optimal features for chemical sensor arrays. PMID:24595058

  10. Big Five personality traits and medically unexplained symptoms in later life.

    Science.gov (United States)

    van Dijk, S D M; Hanssen, D; Naarding, P; Lucassen, P; Comijs, H; Oude Voshaar, R

    2016-10-01

    Personality dysfunction has been postulated as the most clinically salient problem of persons suffering from medically unexplained symptoms (MUS) but empirical studies are scarce. This study aims to compare the personality profile of older patients suffering from MUS with two comparison groups and a control group. Ninety-six older patients with MUS were compared with 153 frequent attenders in primary care suffering from medically explained symptoms (MES), 255 patients with a past-month depressive disorder (DSM-IV-TR), and a control group of 125 older persons. The Big Five personality domains (NEO-Five-Factor Inventory) were compared between groups by multiple ANCOVAs adjusted for age, sex, education, partner status and cognitive functioning. Linear regression analyses were applied to examine the association between health anxiety (Whitley Index) and somatization (Brief Symptom Inventory). The four groups differed with respect to neuroticism (Ppersonality profile. Health anxiety and somatization were associated with a higher level of neuroticism and a lower level of extraversion and conscientiousness, irrespective whether the physical symptom was explained or not. Older patients with MUS have a specific personality profile, comparable to MES patients. Health anxiety and somatization may be better indicators of psychopathology than whether a physical symptom is medically explained or not. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  11. Can clinicians and scientists explain and prevent unexplained underperformance syndrome in elite athletes: an interdisciplinary perspective and 2016 update

    Science.gov (United States)

    Lewis, Nathan A; Collins, Dave; Pedlar, Charles R; Rogers, John P

    2015-01-01

    The coach and interdisciplinary sports science and medicine team strive to continually progress the athlete's performance year on year. In structuring training programmes, coaches and scientists plan distinct periods of progressive overload coupled with recovery for anticipated performances to be delivered on fixed dates of competition in the calendar year. Peaking at major championships is a challenge, and training capacity highly individualised, with fine margins between the training dose necessary for adaptation and that which elicits maladaptation at the elite level. As such, optimising adaptation is key to effective preparation. Notably, however, many factors (eg, health, nutrition, sleep, training experience, psychosocial factors) play an essential part in moderating the processes of adaptation to exercise and environmental stressors, for example, heat, altitude; processes which can often fail or be limited. In the UK, the term unexplained underperformance syndrome (UUPS) has been adopted, in contrast to the more commonly referenced term overtraining syndrome, to describe a significant episode of underperformance with persistent fatigue, that is, maladaptation. This construct, UUPS, reflects the complexity of the syndrome, the multifactorial aetiology, and that ‘overtraining’ or an imbalance between training load and recovery may not be the primary cause for underperformance. UUPS draws on the distinction that a decline in performance represents the universal feature. In our review, we provide a practitioner-focused perspective, proposing that causative factors can be identified and UUPS explained, through an interdisciplinary approach (ie, medicine, nutrition, physiology, psychology) to sports science and medicine delivery, monitoring, and data interpretation and analysis. PMID:27900140

  12. A study on phthalate metabolites, bisphenol A and nonylphenol in the urine of Chinese women with unexplained recurrent spontaneous abortion

    International Nuclear Information System (INIS)

    Peng, Fanli; Ji, Wenliang; Zhu, Feng; Peng, Danhong; Yang, Miao; Liu, Ran; Pu, Yuepu; Yin, Lihong

    2016-01-01

    Humans are widely exposed to phthalates, bisphenol A and nonylphenol owing to the ubiquitous use of these chemicals in consumer products. Increasing attention has been paid to exposure to phthalates, bisphenol A and nonylphenol because of their potential adverse effects on human fertility. A validated method was developed to investigate the three classes of environmental estrogen, mentioned above, in the urine of Chinese women of Nanjing area with unexplained recurrent spontaneous abortion. Solid-phase extraction coupled with ultra performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) was used. In this method, amounts of bisphenol A (BPA), nonylphenol (NP) and four phthalate metabolites, mono-n-butyl phthalate (MBP), mono-isobutyl phthalate (MiBP), mono-benzyl phthalate (MBzP) and mono-2-ethylhexyl phthalate (MEHP), along with their isotope labeled internal standards, were measured using UPLC-MS/MS operated in negative electrospray ionization multiple reaction monitoring mode. The limits of detection were 0.3 ng/mL for the four phthalate metabolites, and 0.5 ng/mL for bisphenol A and nonylphenol. For women with unexplained recurrent spontaneous abortion, the mean concentrations of MBP, MiBP, MBzP, MEHP, BPA and 4-n-NP were 6.52±6.04, 5.51±4.19, 0.53±0.42, 10.12±4.16, 7.13±7.42, 0.41±0.49 ng/mL (mean±SD), respectively. For the control group, the mean concentrations of the corresponding analytes were 4.15±3.57, 2.96±3.30, 0.46±0.49, 6.50±2.81, 4.43±2.23,0.48±0.43 ng/mL (mean±SD), respectively. Levels of MiBP and MEHP were significantly different between the two groups, using Wilcoxon rank sum tests. This method can be applied in epidemiological studies to explore the association between exposure to environmental estrogens and relevant adverse outcomes. - Highlights: • Studied on the exposure level of six analytes in Chinese women with unexplained recurrent spontaneous abortion. • Differences in MEHP and MiBP urine levels were

  13. A study on phthalate metabolites, bisphenol A and nonylphenol in the urine of Chinese women with unexplained recurrent spontaneous abortion

    Energy Technology Data Exchange (ETDEWEB)

    Peng, Fanli [Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009 (China); Ji, Wenliang; Zhu, Feng [Jiangsu Center for Disease Control and Prevention, Nanjing 210009 (China); Peng, Danhong [Department of Obstetrics and Gynecology, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing 210009 (China); Yang, Miao; Liu, Ran; Pu, Yuepu [Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009 (China); Yin, Lihong, E-mail: lhyin@seu.edu.cn [Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009 (China)

    2016-10-15

    Humans are widely exposed to phthalates, bisphenol A and nonylphenol owing to the ubiquitous use of these chemicals in consumer products. Increasing attention has been paid to exposure to phthalates, bisphenol A and nonylphenol because of their potential adverse effects on human fertility. A validated method was developed to investigate the three classes of environmental estrogen, mentioned above, in the urine of Chinese women of Nanjing area with unexplained recurrent spontaneous abortion. Solid-phase extraction coupled with ultra performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) was used. In this method, amounts of bisphenol A (BPA), nonylphenol (NP) and four phthalate metabolites, mono-n-butyl phthalate (MBP), mono-isobutyl phthalate (MiBP), mono-benzyl phthalate (MBzP) and mono-2-ethylhexyl phthalate (MEHP), along with their isotope labeled internal standards, were measured using UPLC-MS/MS operated in negative electrospray ionization multiple reaction monitoring mode. The limits of detection were 0.3 ng/mL for the four phthalate metabolites, and 0.5 ng/mL for bisphenol A and nonylphenol. For women with unexplained recurrent spontaneous abortion, the mean concentrations of MBP, MiBP, MBzP, MEHP, BPA and 4-n-NP were 6.52±6.04, 5.51±4.19, 0.53±0.42, 10.12±4.16, 7.13±7.42, 0.41±0.49 ng/mL (mean±SD), respectively. For the control group, the mean concentrations of the corresponding analytes were 4.15±3.57, 2.96±3.30, 0.46±0.49, 6.50±2.81, 4.43±2.23,0.48±0.43 ng/mL (mean±SD), respectively. Levels of MiBP and MEHP were significantly different between the two groups, using Wilcoxon rank sum tests. This method can be applied in epidemiological studies to explore the association between exposure to environmental estrogens and relevant adverse outcomes. - Highlights: • Studied on the exposure level of six analytes in Chinese women with unexplained recurrent spontaneous abortion. • Differences in MEHP and MiBP urine levels were

  14. The EPR: an unexplainable breach of the investment cost with respect to previous levels

    International Nuclear Information System (INIS)

    Dessus, Benjamin

    2012-01-01

    After having recalled some important figures published by the French Court of Audit in its report on the costs of the nuclear sector, the author comments the historic evolution of investment costs of the existing French nuclear reactors since the 1970's, and then the evolution of these costs for the different reactor types and generations. The author notably discusses the evolution of 'overnight' costs of the French nuclear reactors between 1978 and 2016, and outlines the huge increase noticed for the EPR

  15. Modelling the structure and kinematics of the Firework nebula: The nature of the GK Persei nova shell and its jet-like feature

    Science.gov (United States)

    Harvey, E.; Redman, M. P.; Boumis, P.; Akras, S.

    2016-10-01

    Aims: The shaping mechanisms of old nova remnants are probes for several important and unexplained processes, such as dust formation and the structure of evolved star nebulae. To gain a more complete understanding of the dynamics of the GK Per (1901) remnant, an examination of symmetry of the nova shell is explored, followed by a kinematical analysis of the previously detected jet-like feature in the context of the surrounding fossil planetary nebula. Methods: Faint-object high-resolution echelle spectroscopic observations and imaging were undertaken covering the knots which comprise the nova shell and the surrounding nebulosity. New imaging from the Aristarchos telescope in Greece and long-slit spectra from the Manchester Echelle Spectrometer instrument at the San Pedro Mártir observatory in Mexico were obtained, supplemented with archival observations from several other optical telescopes. Position-velocity arrays are produced of the shell, and also individual knots, and are then used for morpho-kinematic modelling with the shape code. The overall structure of the old knotty nova shell of GK Per and the planetary nebula in which it is embedded is then analysed. Results: Evidence is found for the interaction of knots with each other and with a wind component, most likely the periodic fast wind emanating from the central binary system. We find that a cylindrical shell with a lower velocity polar structure gives the best model fit to the spectroscopy and imaging. We show in this work that the previously seen jet-like feature is of low velocity. Conclusions: The individual knots have irregular tail shapes; we propose here that they emanate from episodic winds from ongoing dwarf nova outbursts by the central system. The nova shell is cylindrical, not spherical, and the symmetry axis relates to the inclination of the central binary system. Furthermore, the cylinder axis is aligned with the long axis of the bipolar planetary nebula in which it is embedded. Thus, the

  16. Patients' 'thingification', unexplained symptoms and response-ability in the clinical context: in response to 'Patients' substantialization of disease, the hybrid symptom and the metaphysical care', by Alexandra Parvan.

    Science.gov (United States)

    Eriksen, Thor Eirik; Kirkengen, Anna Luise

    2016-08-01

    The types of diseases, or categories of suffering, referred to as medically unexplained symptoms or syndromes (MUS) are the focus for the following commentary. Such cases seem to invite reflection. The very nature of such complex patterns of disease and suffering raises a number of fundamental epistemological and ontological issues. Furthermore, such health challenges can serve as the basis for an exploration of how the suffering person as well as the medical caretaker comes to grip with disease, incapacitation or suffering. We have structured our comments into two parts: first, we will describe medically unexplained health problems as the background for an inquiry into a process wherein patients reify their suffering in order to meet their doctors on equal terms, which carries a potential for alienation. Second, we will reflect on Alexandra Parvan's text as regards patients' 'substantialization' of their disease, the resulting 'hybrid symptom' and a proposed model for care and healing. © 2015 John Wiley & Sons, Ltd.

  17. Gaining knowledge from previously unexplained spectra-application of the PTM-Explorer software to detect PTM in HUPO BPP MS/MS data.

    Science.gov (United States)

    Chamrad, Daniel C; Körting, Gerhard; Schäfer, Heike; Stephan, Christian; Thiele, Herbert; Apweiler, Rolf; Meyer, Helmut E; Marcus, Katrin; Blüggel, Martin

    2006-09-01

    A novel software tool named PTM-Explorer has been applied to LC-MS/MS datasets acquired within the Human Proteome Organisation (HUPO) Brain Proteome Project (BPP). PTM-Explorer enables automatic identification of peptide MS/MS spectra that were not explained in typical sequence database searches. The main focus was detection of PTMs, but PTM-Explorer detects also unspecific peptide cleavage, mass measurement errors, experimental modifications, amino acid substitutions, transpeptidation products and unknown mass shifts. To avoid a combinatorial problem the search is restricted to a set of selected protein sequences, which stem from previous protein identifications using a common sequence database search. Prior to application to the HUPO BPP data, PTM-Explorer was evaluated on excellently manually characterized and evaluated LC-MS/MS data sets from Alpha-A-Crystallin gel spots obtained from mouse eye lens. Besides various PTMs including phosphorylation, a wealth of experimental modifications and unspecific cleavage products were successfully detected, completing the primary structure information of the measured proteins. Our results indicate that a large amount of MS/MS spectra that currently remain unidentified in standard database searches contain valuable information that can only be elucidated using suitable software tools.

  18. The $16,819 pay gap for newly trained physicians: the unexplained trend of men earning more than women.

    Science.gov (United States)

    Lo Sasso, Anthony T; Richards, Michael R; Chou, Chiu-Fang; Gerber, Susan E

    2011-02-01

    Prior research has suggested that gender differences in physicians' salaries can be accounted for by the tendency of women to enter primary care fields and work fewer hours. However, in examining starting salaries by gender of physicians leaving residency programs in New York State during 1999-2008, we found a significant gender gap that cannot be explained by specialty choice, practice setting, work hours, or other characteristics. The unexplained trend toward diverging salaries appears to be a recent development that is growing over time. In 2008, male physicians newly trained in New York State made on average $16,819 more than newly trained female physicians, compared to a $3,600 difference in 1999.

  19. Cost-effectiveness of primary offer of IVF vs. primary offer of IUI followed by IVF (for IUI failures) in couples with unexplained or mild male factor subfertility.

    Science.gov (United States)

    Pashayan, Nora; Lyratzopoulos, Georgios; Mathur, Raj

    2006-06-23

    In unexplained and mild male factor subfertility, both intrauterine insemination (IUI) and in-vitro fertilisation (IVF) are indicated as first line treatments. Because the success rate of IUI is low, many couples failing IUI subsequently require IVF treatment. In practice, it is therefore important to examine the comparative outcomes (live birth-producing pregnancy), costs, and cost-effectiveness of primary offer of IVF, compared with primary offer of IUI followed by IVF for couples failing IUI. Mathematical modelling was used to estimate comparative clinical and cost effectiveness of either primary offer of one full IVF cycle (including frozen cycles when applicable) or "IUI + IVF" (defined as primary IUI followed by IVF for IUI failures) to a hypothetical cohort of subfertile couples who are eligible for both treatment strategies. Data used in calculations were derived from the published peer-reviewed literature as well as activity data of local infertility units. Cost-effectiveness ratios for IVF, "unstimulated-IUI (U-IUI) + IVF", and "stimulated IUI (S-IUI) + IVF" were 12,600 pounds sterling, 13,100 pound sterling and 15,100 pound sterling per live birth-producing pregnancy respectively. For a hypothetical cohort of 100 couples with unexplained or mild male factor subfertility, compared with primary offer of IVF, 6 cycles of "U-IUI + IVF" or of "S-IUI + IVF" would cost an additional 174,200 pounds sterling and 438,000 pounds sterling, representing an opportunity cost of 54 and 136 additional IVF cycles and 14 to 35 live birth-producing pregnancies respectively. For couples with unexplained and mild male factor subfertility, primary offer of a full IVF cycle is less costly and more cost-effective than providing IUI (of any modality) followed by IVF.

  20. Cost-effectiveness of primary offer of IVF vs. primary offer of IUI followed by IVF (for IUI failures in couples with unexplained or mild male factor subfertility

    Directory of Open Access Journals (Sweden)

    Lyratzopoulos Georgios

    2006-06-01

    Full Text Available Abstract Background In unexplained and mild male factor subfertility, both intrauterine insemination (IUI and in-vitro fertilisation (IVF are indicated as first line treatments. Because the success rate of IUI is low, many couples failing IUI subsequently require IVF treatment. In practice, it is therefore important to examine the comparative outcomes (live birth-producing pregnancy, costs, and cost-effectiveness of primary offer of IVF, compared with primary offer of IUI followed by IVF for couples failing IUI. Methods Mathematical modelling was used to estimate comparative clinical and cost effectiveness of either primary offer of one full IVF cycle (including frozen cycles when applicable or "IUI + IVF" (defined as primary IUI followed by IVF for IUI failures to a hypothetical cohort of subfertile couples who are eligible for both treatment strategies. Data used in calculations were derived from the published peer-reviewed literature as well as activity data of local infertility units. Results Cost-effectiveness ratios for IVF, "unstimulated-IUI (U-IUI + IVF", and "stimulated IUI (S-IUI + IVF" were £12,600, £13,100 and £15,100 per live birth-producing pregnancy respectively. For a hypothetical cohort of 100 couples with unexplained or mild male factor subfertility, compared with primary offer of IVF, 6 cycles of "U-IUI + IVF" or of "S-IUI + IVF" would cost an additional £174,200 and £438,000, representing an opportunity cost of 54 and 136 additional IVF cycles and 14 to 35 live birth-producing pregnancies respectively. Conclusion For couples with unexplained and mild male factor subfertility, primary offer of a full IVF cycle is less costly and more cost-effective than providing IUI (of any modality followed by IVF.

  1. Study on the homocysteine metabolism of patients with unexplained repeated spontaneous abortion

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Objective:To study the metabolism abnormality of homocysteine(Hcy) in unexplained repeated spontaneous abortion(URSA).Methods:The level of Hcy in sera was measured with hyperpressure liquid chromatography(HPLC);Folic acid and vitamin B12 were detected by radioimmune assay;anticardiolipin antibody (ACA) was detected by ELISA.Results:(1)The level of serum Hcy in URSA group was significantly higher than that in control group,showing a statistical significant difference(P<0.01).The level of Hcy was correlated with ages,but not correlated with areas,numbers of miscarriage,gestation age,primary or secondary abortions.(2)The levels of folic acid and vitamin B12 in URSA group were significantly lower than those in control group.The levels of serum folic acid and vitamin B12 were not correlated with age,area,numbers of miscarriage and abortion periods.(3)ACA positive rate in URSA was significantly higher than that in control group.The level of Hcy in ACA(+) group was significantly higher than that in ACA(-) group among URSA patients.Conclusions:Hyperhomocysteinemia,low folic acid state,and ACA were all the independent risk factors for URSA.Lacking of folic acid and vitamin B12 is one of the important causes of hyperhomocysteinemia.ACA and hyperhomocysteinemia may have synergistic action in the occurrence of URSA.

  2. [Application of single nucleotide polymorphism-microarray and target gene sequencing in the study of genetic etiology of children with unexplained intellectual disability or developmental delay].

    Science.gov (United States)

    Gao, Z J; Jiang, Q; Cheng, D Z; Yan, X X; Chen, Q; Xu, K M

    2016-10-02

    Objective: To evaluate the application of single nucleotide polymorphism (SNP)-microarray and target gene sequencing technology in the clinical molecular genetic diagnosis of unexplained intellectual disability(ID) or developmental delay (DD). Method: Patients with ID or DD were recruited in the Department of Neurology, Affiliated Children's Hospital of Capital Institute of Pediatrics between September 2015 and February 2016. The intellectual assessment of the patients was performed using 0-6-year-old pediatric examination table of neuropsychological development or Wechsler intelligence scale (>6 years). Patients with a DQ less than 49 or IQ less than 51 were included in this study. The patients were scanned by SNP-array for detection of genomic copy number variations (CNV), and the revealed genomic imbalance was confirmed by quantitative real time-PCR. Candidate gene mutation screening was carried out by target gene sequencing technology.Causal mutations or likely pathogenic variants were verified by polymerase chain reaction and direct sequencing. Result: There were 15 children with ID or DD enrolled, 9 males and 6 females. The age of these patients was 7 months-16 years and 9 months. SNP-array revealed that two of the 15 patients had genomic CNV. Both CNV were de novo micro deletions, one involved 11q24.1q25 and the other micro deletion located on 21q22.2q22.3. Both micro deletions were proved to have a clinical significance due to their association with ID, brain DD, unusual faces etc. by querying Decipher database. Thirteen patients with negative findings in SNP-array were consequently examined with target gene sequencing technology, genotype-phenotype correlation analysis and genetic analysis. Five patients were diagnosed with monogenic disorder, two were diagnosed with suspected genetic disorder and six were still negative. Conclusion: Sequential use of SNP-array and target gene sequencing technology can significantly increase the molecular genetic etiologic

  3. Patch layout generation by detecting feature networks

    KAUST Repository

    Cao, Yuanhao

    2015-02-01

    The patch layout of 3D surfaces reveals the high-level geometric and topological structures. In this paper, we study the patch layout computation by detecting and enclosing feature loops on surfaces. We present a hybrid framework which combines several key ingredients, including feature detection, feature filtering, feature curve extension, patch subdivision and boundary smoothing. Our framework is able to compute patch layouts through concave features as previous approaches, but also able to generate nice layouts through smoothing regions. We demonstrate the effectiveness of our framework by comparing with the state-of-the-art methods.

  4. Hypothesis testing for differentially correlated features.

    Science.gov (United States)

    Sheng, Elisa; Witten, Daniela; Zhou, Xiao-Hua

    2016-10-01

    In a multivariate setting, we consider the task of identifying features whose correlations with the other features differ across conditions. Such correlation shifts may occur independently of mean shifts, or differences in the means of the individual features across conditions. Previous approaches for detecting correlation shifts consider features simultaneously, by computing a correlation-based test statistic for each feature. However, since correlations involve two features, such approaches do not lend themselves to identifying which feature is the culprit. In this article, we instead consider a serial testing approach, by comparing columns of the sample correlation matrix across two conditions, and removing one feature at a time. Our method provides a novel perspective and favorable empirical results compared with competing approaches. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Low-level APC mutational mosaicism is the underlying cause in a substantial fraction of unexplained colorectal adenomatous polyposis cases.

    Science.gov (United States)

    Spier, Isabel; Drichel, Dmitriy; Kerick, Martin; Kirfel, Jutta; Horpaopan, Sukanya; Laner, Andreas; Holzapfel, Stefanie; Peters, Sophia; Adam, Ronja; Zhao, Bixiao; Becker, Tim; Lifton, Richard P; Perner, Sven; Hoffmann, Per; Kristiansen, Glen; Timmermann, Bernd; Nöthen, Markus M; Holinski-Feder, Elke; Schweiger, Michal R; Aretz, Stefan

    2016-03-01

    In 30-50% of patients with colorectal adenomatous polyposis, no germline mutation in the known genes APC, causing familial adenomatous polyposis, MUTYH, causing MUTYH-associated polyposis, or POLE or POLD1, causing polymerase-proofreading-associated polyposis can be identified, although a hereditary aetiology is likely. This study aimed to explore the impact of APC mutational mosaicism in unexplained polyposis. To comprehensively screen for somatic low-level APC mosaicism, high-coverage next-generation sequencing of the APC gene was performed using DNA from leucocytes and a total of 53 colorectal tumours from 20 unrelated patients with unexplained sporadic adenomatous polyposis. APC mosaicism was assumed if the same loss-of-function APC mutation was present in ≥ 2 anatomically separated colorectal adenomas/carcinomas per patient. All mutations were validated using diverse methods. In 25% (5/20) of patients, somatic mosaicism of a pathogenic APC mutation was identified as underlying cause of the disease. In 2/5 cases, the mosaic level in leucocyte DNA was slightly below the sensitivity threshold of Sanger sequencing; while in 3/5 cases, the allelic fraction was either very low (0.1-1%) or no mutations were detectable. The majority of mosaic mutations were located outside the somatic mutation cluster region of the gene. The present data indicate a high prevalence of pathogenic mosaic APC mutations below the detection thresholds of routine diagnostics in adenomatous polyposis, even if high-coverage sequencing of leucocyte DNA alone is taken into account. This has important implications for both routine work-up and strategies to identify new causative genes in this patient group. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Determinants of fertility and reproductive success after hysteroscopic septoplasty for women with unexplained primary infertility: a prospective analysis of 88 cases.

    Science.gov (United States)

    Shokeir, Tarek; Abdelshaheed, Mahmoud; El-Shafie, Mohamed; Sherif, Lotfy; Badawy, Ahmed

    2011-03-01

    To evaluate prospectively the effect of hysteroscopic septoplasty as therapy for unexplained primary infertility in women with uterine septum as a sole cause for reproductive failure and to define the factors influencing reproductive success. In a prospective comparative study, we enrolled 103 infertile women with uterine septum as a sole cause for reproductive failure. They had had unexplained primary infertility >2 years and a follow-up >12 months. Uterine anomalies were diagnosed by means of hysterosalpingography (HSG) and 2D-transvaginal sonography (TVS) with intrauterine saline infusion. Hysteroscopic septoplasty was performed in the early follicular phase. Pregnancy rates (PR) according to patient and septum characteristics (septum size) were the main outcome measures. Follow-up was complete for 88 patients. The mean (±SD) age of the patients was 36.1±2.1 years. Forty-two patients became pregnant (40.7%). The mean (±SD) delay in conception was 7.5±2.6 months. Nearly 80% of the pregnant women conceived spontaneously. Of 44 pregnancies in 42 women, 36 live newborns were delivered. The PR was significantly higher in women size larger than one-half of their uterine length the PR was significantly higher than those with septum size uterine septum as a sole cause for reproductive failure seems to depend on patient age, duration of infertility before septoplasty, and septum size. Women with a septum size larger than one-half of their uterine length have a higher chance of successful pregnancy after hysteroscopic septoplasty. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  7. Infants' Developing Sensitivity to Object Function: Attention to Features and Feature Correlations

    Science.gov (United States)

    Baumgartner, Heidi A.; Oakes, Lisa M.

    2011-01-01

    When learning object function, infants must detect relations among features--for example, that squeezing is associated with squeaking or that objects with wheels roll. Previously, Perone and Oakes (2006) found 10-month-old infants were sensitive to relations between object appearances and actions, but not to relations between appearances and…

  8. Adversarial Feature Selection Against Evasion Attacks.

    Science.gov (United States)

    Zhang, Fei; Chan, Patrick P K; Biggio, Battista; Yeung, Daniel S; Roli, Fabio

    2016-03-01

    Pattern recognition and machine learning techniques have been increasingly adopted in adversarial settings such as spam, intrusion, and malware detection, although their security against well-crafted attacks that aim to evade detection by manipulating data at test time has not yet been thoroughly assessed. While previous work has been mainly focused on devising adversary-aware classification algorithms to counter evasion attempts, only few authors have considered the impact of using reduced feature sets on classifier security against the same attacks. An interesting, preliminary result is that classifier security to evasion may be even worsened by the application of feature selection. In this paper, we provide a more detailed investigation of this aspect, shedding some light on the security properties of feature selection against evasion attacks. Inspired by previous work on adversary-aware classifiers, we propose a novel adversary-aware feature selection model that can improve classifier security against evasion attacks, by incorporating specific assumptions on the adversary's data manipulation strategy. We focus on an efficient, wrapper-based implementation of our approach, and experimentally validate its soundness on different application examples, including spam and malware detection.

  9. An Integrated Account of Generalization across Objects and Features

    Science.gov (United States)

    Kemp, Charles; Shafto, Patrick; Tenenbaum, Joshua B.

    2012-01-01

    Humans routinely make inductive generalizations about unobserved features of objects. Previous accounts of inductive reasoning often focus on inferences about a single object or feature: accounts of causal reasoning often focus on a single object with one or more unobserved features, and accounts of property induction often focus on a single…

  10. Previously unreported abnormalities in Wolfram Syndrome Type 2.

    Science.gov (United States)

    Akturk, Halis Kaan; Yasa, Seda

    2017-01-01

    Wolfram syndrome (WFS) is a rare autosomal recessive disease with non-autoimmune childhood onset insulin dependent diabetes and optic atrophy. WFS type 2 (WFS2) differs from WFS type 1 (WFS1) with upper intestinal ulcers, bleeding tendency and the lack ofdiabetes insipidus. Li-fespan is short due to related comorbidities. Only a few familieshave been reported with this syndrome with the CISD2 mutation. Here we report two siblings with a clinical diagnosis of WFS2, previously misdiagnosed with type 1 diabetes mellitus and diabetic retinopathy-related blindness. We report possible additional clinical and laboratory findings that have not been pre-viously reported, such as asymptomatic hypoparathyroidism, osteomalacia, growth hormone (GH) deficiency and hepatomegaly. Even though not a requirement for the diagnosis of WFS2 currently, our case series confirm hypogonadotropic hypogonadism to be also a feature of this syndrome, as reported before. © Polish Society for Pediatric Endocrinology and Diabetology.

  11. Feature Binding and the Hebb Repetition Effect

    OpenAIRE

    Barrett, Maeve

    2008-01-01

    Previous studies have found no evidence that long-term learning of integrated objects and individual features benefit visual short term memory tasks (Logie, Brockmole, & Vandenbroucke, in press; Olson & Jiang, 2004; Treisman, 2006). These findings may have been due to stimulus interference as a restricted number of features were utilised in these studies to form objects in the stimulus arrays. In these studies, participants would have needed to break apart the features of several objects in a...

  12. Implementing a Psychotherapy Service for Medically Unexplained Symptoms in a Primary Care Setting

    Directory of Open Access Journals (Sweden)

    Angela Cooper

    2017-11-01

    Full Text Available Medically unexplained symptoms (MUS are known to be costly, complex to manage and inadequately addressed in primary care settings. In many cases, there are unresolved psychological and emotional processes underlying these symptoms, leaving traditional medical approaches insufficient. This paper details the implementation of an evidence-based, emotion-focused psychotherapy service for MUS across two family medicine clinics. The theory and evidence-base for using Intensive Short-Term Dynamic Psychotherapy (ISTDP with MUS is presented along with the key service components of assessment, treatment, education and research. Preliminary outcome indicators showed diverse benefits. Patients reported significantly decreased somatic symptoms in the Patient Health Questionnaire-15 (d = 0.4. A statistically significant (23% decrease in family physicians’ visits was found in the 6 months after attending the MUS service compared to the 6 months prior. Both patients and primary care clinicians reported a high degree of satisfaction with the service. Whilst further research is needed, these findings suggest that a direct psychology service maintained within the family practice clinic may assist patient and clinician function while reducing healthcare utilization. Challenges and further service developments are discussed, including the potential benefits of re-branding the service to become a ‘Primary Care Psychological Consultation and Treatment Service’.

  13. Implementing a Psychotherapy Service for Medically Unexplained Symptoms in a Primary Care Setting.

    Science.gov (United States)

    Cooper, Angela; Abbass, Allan; Town, Joel

    2017-11-29

    Medically unexplained symptoms (MUS) are known to be costly, complex to manage and inadequately addressed in primary care settings. In many cases, there are unresolved psychological and emotional processes underlying these symptoms, leaving traditional medical approaches insufficient. This paper details the implementation of an evidence-based, emotion-focused psychotherapy service for MUS across two family medicine clinics. The theory and evidence-base for using Intensive Short-Term Dynamic Psychotherapy (ISTDP) with MUS is presented along with the key service components of assessment, treatment, education and research. Preliminary outcome indicators showed diverse benefits. Patients reported significantly decreased somatic symptoms in the Patient Health Questionnaire-15 ( d = 0.4). A statistically significant (23%) decrease in family physicians' visits was found in the 6 months after attending the MUS service compared to the 6 months prior. Both patients and primary care clinicians reported a high degree of satisfaction with the service. Whilst further research is needed, these findings suggest that a direct psychology service maintained within the family practice clinic may assist patient and clinician function while reducing healthcare utilization. Challenges and further service developments are discussed, including the potential benefits of re-branding the service to become a 'Primary Care Psychological Consultation and Treatment Service'.

  14. The role of Coxsackievirus A16 in a case of sudden unexplained death in an infant

    DEFF Research Database (Denmark)

    Astrup, B. S.; Johnsen, I. B. G.; Engsbro, Anne Line

    2016-01-01

    The Coxsackievirus A16 (CV-A16) is one of the main pathogens causing hand-foot-and-mouth disease in young children. It is a low-virulence virus rarely involved in serious illness. It is seen sporadically or in outbreaks all over the world. We report a case of sudden unexplained death in infancy......, SUDI, in a 3 and 1/2 months old infant, in which a thorough post mortem investigation pointed at a fatal infection with CV-A16 as the most likely cause of death. Only five cases of fatal CV-A16 infection have been published and none of these presented as sudden death. The fatal cases involved two...... infants, two young children and an elderly man. Post mortem, pre-autopsy CT-scan and C-reactive protein analysis allowed for an autopsy procedure targeted at a microbiological cause of death. The case illustrates the usefulness of supplementary testing during autopsy. © 2015 Elsevier Ireland Ltd....

  15. Analysis of 40 sporadic or familial neonatal and pediatric cases with severe unexplained respiratory distress: relationship to SFTPB.

    Science.gov (United States)

    Tredano, Mohammed; Griese, Matthias; de Blic, Jacques; Lorant, Tifenn; Houdayer, Claude; Schumacher, Silja; Cartault, François; Capron, Frédérique; Boccon-Gibod, Liliane; Lacaze-Masmonteil, Thierry; Renolleau, Sylvain; Delaisi, Bertrand; Elion, Jacques; Couderc, Rémy; Bahuau, Michel

    2003-06-15

    We have analyzed surfactant protein B (SP-B) and its encoding gene (SFTPB, MIM 178640) in 40 unrelated pediatric patients with unexplained respiratory distress (URD). There was high consanguinity (eight kindreds) and an underlying autosomal recessive trait could be inferred in most cases, with overall high sex ratio (32/17) suggesting proband's gender to impact on penetrance. The clinical/biological presentations fitted into three major nosologic frameworks. I: SP-B deficiency (nine probands), complete or incomplete, with homozygous/compoundly heterozygous mutations identified (six probands), including one from the population isolate of Réunion Island (496delG). In addition, there was a consanguineous kindred in which incomplete deficiency was unambiguously unlinked to SFTPB. II: pulmonary alveolar proteinosis (PAP, 19 probands), with typical storage of PAS-positive material within the alveoli with foamy macrophages and variable interstitial reaction, which was diagnosed in most patients from Réunion Island. In contrast to previously published findings, mutation and/or segregation analyses excluded SFTPB as a disease locus, although slight metabolic derangement related to SP-B and/or mild SFTPB changes could somehow contribute to disease. III: URD without evidence for SP-B deficiency or PAP (12 probands), equally unlinked to SFTPB, although a single patient had a possibly causal, maternally-derived, heterozygous genetic change (G4521A). The population frequency of five known and four novel SNPs was studied, providing as many potential markers for pulmonary disease related to SFTPB. Overall, URD was found to be heterogeneous, both phenotypically and genetically, even in population isolates where a founder effect might have been expected. When disease loci are identified, patient genotyping will be crucial as a diagnostic aid, for devising proper treatment, and as a basis for genetic counseling. Copyright 2003 Wiley-Liss, Inc.

  16. Seasonal Timing of Infant Bronchiolitis, Apnea and Sudden Unexplained Infant Death.

    Directory of Open Access Journals (Sweden)

    Chantel D Sloan

    Full Text Available Rates of Sudden Unexplained Infant Death (SUID, bronchiolitis, and central apnea increase in winter in temperate climates. Though associations between these three conditions are suggested, more work is required to establish if there is a causal pathway linking bronchiolitis to SUID through inducing central apnea. Utilizing a large population-based cohort of infants studied over a 20-year period (n = 834,595, from birth years 1989-2009, we analyzed ecological associations between timing of SUID cases, bronchiolitis, and apnea healthcare visits. Data were analyzed between 2013 and 2015. We used a Cox Proportional Hazards model to analyze possible interactions between maternal smoking and maternal asthma with infant bronchiolitis on time to SUID. SUID and bronchiolitis both occurred more frequently in winter. An increase in bronchiolitis clinical visits occurred within a few days prior to apnea visits. We found a temporal relationship between infant bronchiolitis and apnea. In contrast, no peak in SUID cases was seen during peaks of bronchiolitis. Among those without any bronchiolitis visits, maternal smoking was associated with an increased risk of SUID: Hazard Ratio (HR of 2.38 (95% CI: 2.11, 2.67, p-value <0.001. Maternal asthma was associated with an increased risk of SUID among infants with at least one bronchiolitis visit: HR of 2.40 (95% CI: 1.04, 5.54, p-value = 0.04. Consistent trends between bronchiolitis, apnea, and SUID were not established due to small numbers of SUID cases. However, interaction analysis revealed potential differential associations of bronchiolitis and SUID by maternal smoking, maternal asthma status.

  17. An Angiopoietin-2 gene polymorphism in unexplained intrauterine fetal death: a multi-center study.

    Science.gov (United States)

    Huber, Ambros; Grimm, Christoph; Pietrowski, Detlef; Zeillinger, Robert; Bettendorf, Hertha; Husslein, Peter; Hefler, Lukas

    2005-02-01

    Angiopoietin-2 (Ang-2) is a potent regulator of angiogenesis and vascular tone. As vascular processes have been proposed to be involved in the pathogenesis of pregnancy associated complications such as late unexplained intrauterine fetal death (IUFD), we determined whether a common G/A polymorphism of the Ang-2 gene (ANGPT2) is associated with this condition. In a multicenter case-control study, we evaluated the common G/A polymorphism within exon 4 of the ANGPT2 gene using PCR in 90 women with IUFD and 90 healthy women with at least one uncomplicated full term pregnancy and no history of IUFD. Genotype (p=0.2; OR=1.4 [0.8-2.6]) and allele frequencies (p=0.1; OR=1.4 [0.9-2.1]) of the ANGPT2 polymorphism did not differ between women with IUFD and healthy women. A multivariate regression analysis with smoking habits and preexisting diabetes as covariates did not change the results. We are the first to report on a common polymorphism of the ANGPT2 gene in patients with late IUFD. The investigated ANGPT2 poylmorphism does not seem to be a candidate gene for IUFD in Caucasian women.

  18. Particle swarm optimization based feature enhancement and feature selection for improved emotion recognition in speech and glottal signals.

    Science.gov (United States)

    Muthusamy, Hariharan; Polat, Kemal; Yaacob, Sazali

    2015-01-01

    In the recent years, many research works have been published using speech related features for speech emotion recognition, however, recent studies show that there is a strong correlation between emotional states and glottal features. In this work, Mel-frequency cepstralcoefficients (MFCCs), linear predictive cepstral coefficients (LPCCs), perceptual linear predictive (PLP) features, gammatone filter outputs, timbral texture features, stationary wavelet transform based timbral texture features and relative wavelet packet energy and entropy features were extracted from the emotional speech (ES) signals and its glottal waveforms(GW). Particle swarm optimization based clustering (PSOC) and wrapper based particle swarm optimization (WPSO) were proposed to enhance the discerning ability of the features and to select the discriminating features respectively. Three different emotional speech databases were utilized to gauge the proposed method. Extreme learning machine (ELM) was employed to classify the different types of emotions. Different experiments were conducted and the results show that the proposed method significantly improves the speech emotion recognition performance compared to previous works published in the literature.

  19. Calmodulin 2 Mutation N98S Is Associated with Unexplained Cardiac Arrest in Infants Due to Low Clinical Penetrance Electrical Disorders.

    Directory of Open Access Journals (Sweden)

    Juan Jiménez-Jáimez

    Full Text Available Calmodulin 1, 2 and 3 (CALM mutations have been found to cause cardiac arrest in children at a very early age. The underlying aetiology described is long QT syndrome (LQTS, catecholaminergic polymorphic ventricular tachycardia (CPVT and idiopathic ventricular fibrillation (IVF. Little phenotypical data about CALM2 mutations is available.The aim of this paper is to describe the clinical manifestations of the Asn98Ser mutation in CALM2 in two unrelated children in southern Spain with apparently unexplained cardiac arrest/death.Two unrelated children aged 4 and 7, who were born to healthy parents, were studied. Both presented with sudden cardiac arrest. The first was resuscitated after a VF episode, and the second died suddenly. In both cases the baseline QTc interval was within normal limits. Peripheral blood DNA was available to perform targeted gene sequencing.The surviving 4-year-old girl had a positive epinephrine test for LQTS, and polymorphic ventricular ectopic beats were seen on a previous 24-hour Holter recording from the deceased 7-year-old boy, suggestive of a possible underlying CPVT phenotype. A p.Asn98Ser mutation in CALM2 was detected in both cases. This affected a highly conserved across species residue, and the location in the protein was adjacent to critical calcium binding loops in the calmodulin carboxyl-terminal domain, predicting a high pathogenic effect.Human calmodulin 2 mutation p.Asn98Ser is associated with sudden cardiac death in childhood with a variable clinical penetrance. Our results provide new phenotypical information about clinical behaviour of this mutation.

  20. Construction of Individual Morphological Brain Networks with Multiple Morphometric Features

    Directory of Open Access Journals (Sweden)

    Chunlan Yang

    2017-04-01

    Full Text Available In recent years, researchers have increased attentions to the morphological brain network, which is generally constructed by measuring the mathematical correlation across regions using a certain morphometric feature, such as regional cortical thickness and voxel intensity. However, cerebral structure can be characterized by various factors, such as regional volume, surface area, and curvature. Moreover, most of the morphological brain networks are population-based, which has limitations in the investigations of individual difference and clinical applications. Hence, we have extended previous studies by proposing a novel method for realizing the construction of an individual-based morphological brain network through a combination of multiple morphometric features. In particular, interregional connections are estimated using our newly introduced feature vectors, namely, the Pearson correlation coefficient of the concatenation of seven morphometric features. Experiments were performed on a healthy cohort of 55 subjects (24 males aged from 20 to 29 and 31 females aged from 20 to 28 each scanned twice, and reproducibility was evaluated through test–retest reliability. The robustness of morphometric features was measured firstly to select the more reproducible features to form the connectomes. Then the topological properties were analyzed and compared with previous reports of different modalities. Small-worldness was observed in all the subjects at the range of the entire network sparsity (20–40%, and configurations were comparable with previous findings at the sparsity of 23%. The spatial distributions of the hub were found to be significantly influenced by the individual variances, and the hubs obtained by averaging across subjects and sparsities showed correspondence with previous reports. The intraclass coefficient of graphic properties (clustering coefficient = 0.83, characteristic path length = 0.81, betweenness centrality = 0.78 indicates

  1. Defining a Therapeutic Program for Recurrent Acute Pancreatitis Patients with Unknown Etiology

    Directory of Open Access Journals (Sweden)

    Vincenzo Neri

    2014-07-01

    Full Text Available Aim To define a therapeutic program for mild-moderate acute pancreatitis (AP, often recurrent, which at the end of the diagnostic process remains of undefined etiology. Material and Methods In the period 2011-2012, we observed 64 cases of AP: 52 mild-moderate, 12 severe; biliary 39, biliary in alcoholic chronic pancreatitis 5, unexplained recurrent 20. The clinical and instrumental evaluation of the 20 cases of unexplained AP showed 6 patients with biliary sludge, 4 microlithiasis, 4 sphincter of Oddi dysfunction, and 6 cases that remained undefined. Results Among 20 patients with recurrent, unexplained AP at initial etiological assessment, we performed 10 video laparo cholecystectomies (VLCs, 2 open cholecystectomies and 4 endoscopic retrograde cholangiopancreatography/endoscopic sphincterotomies (ERCP/ES in patients who had undergone previous cholecystectomy; 4 patients refused surgery. Among these 20 patients, 6 had AP that remained unexplained after second-level imaging investigations. For these patients, 4 VLCs and 2 ERCP/ES were performed. Follow-up after six months was negative for further recurrence. Conclusion The recurrence of unexplained acute pancreatitis could be treated with empirical cholecystectomy and/or ERCP/ES in cases of previous cholecystectomy.

  2. Feature Scaling via Second-Order Cone Programming

    Directory of Open Access Journals (Sweden)

    Zhizheng Liang

    2016-01-01

    Full Text Available Feature scaling has attracted considerable attention during the past several decades because of its important role in feature selection. In this paper, a novel algorithm for learning scaling factors of features is proposed. It first assigns a nonnegative scaling factor to each feature of data and then adopts a generalized performance measure to learn the optimal scaling factors. It is of interest to note that the proposed model can be transformed into a convex optimization problem: second-order cone programming (SOCP. Thus the scaling factors of features in our method are globally optimal in some sense. Several experiments on simulated data, UCI data sets, and the gene data set are conducted to demonstrate that the proposed method is more effective than previous methods.

  3. Poly-epiphyseal overgrowth: description of a previously unreported skeletal dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Pazzaglia, Ugo E.; Bonaspetti, Giovanni [University of Brescia, Orthopaedic Clinic, Brescia (Italy); Beluffi, Giampiero [Fondazione IRCCS Policlinico San Matteo, Department of Paediatric Radiology, Pavia (Italy); Marchi, Antonietta; Bozzola, Mauro; Savasta, Salvatore [Fondazione IRCCS Policlinico San Matteo, Paediatric Clinic, University of Pavia, Pavia (Italy)

    2007-10-15

    A skeletal dysplasia with previously unreported features is presented. Its evolution was characterized by growth abnormalities of bones without involvement of other organs. Advanced bone age, increased stature and irregular epiphyseal ossification with stippling of the main long bones were documented. Physeal overgrowth was massive in the left proximal humerus and femur. Furthermore, the hip joint appeared fused with an abundant mass of pathological calcific tissue extending from the femur to the ilium. Pathological epiphyses were characterized by anarchic cartilaginous proliferation with multiple ossification centres, while lamellar bone apposition and remodelling were normal. The observed bone changes were different from those in any previously reported syndrome, metabolic defect or bone dysplasia. However, they clearly indicated a defect of endochondral ossification with some resemblance to phenotypes observed in dysplasia epiphysealis hemimelica. (orig.)

  4. Poly-epiphyseal overgrowth: description of a previously unreported skeletal dysplasia

    International Nuclear Information System (INIS)

    Pazzaglia, Ugo E.; Bonaspetti, Giovanni; Beluffi, Giampiero; Marchi, Antonietta; Bozzola, Mauro; Savasta, Salvatore

    2007-01-01

    A skeletal dysplasia with previously unreported features is presented. Its evolution was characterized by growth abnormalities of bones without involvement of other organs. Advanced bone age, increased stature and irregular epiphyseal ossification with stippling of the main long bones were documented. Physeal overgrowth was massive in the left proximal humerus and femur. Furthermore, the hip joint appeared fused with an abundant mass of pathological calcific tissue extending from the femur to the ilium. Pathological epiphyses were characterized by anarchic cartilaginous proliferation with multiple ossification centres, while lamellar bone apposition and remodelling were normal. The observed bone changes were different from those in any previously reported syndrome, metabolic defect or bone dysplasia. However, they clearly indicated a defect of endochondral ossification with some resemblance to phenotypes observed in dysplasia epiphysealis hemimelica. (orig.)

  5. Comparison of the Number of Peripheral Blood CD4+CD25+ T Cells in Unexplained Recurrent Spontaneous Abortion Patients with Normal Pregnant Women

    Directory of Open Access Journals (Sweden)

    M Eslami

    2011-05-01

    Full Text Available Introduction: Undoubtedly, reproduction is a necessity for survival and successful pregnancy is an immunological paradox. In the present study, we investigated the proportional changes of CD4+CD25bright T cells, CD4+CD25dim T cells in peripheral blood in unexplained recurrent spontaneous abortions (URSA and compared it with normal pregnant women by antibody monoclonal method. Methods: The study group comprised of women with miscarriages of unexplained etiology who had normal karyotypes, anticardiolipin antibodies, prolactin levels and normal spousal spermograms. They did not have polycystic ovaries and also did not receive any drugs at the time of the study. PBLs lymphocytes were isolated, then FITC-conjugated and anti-CD4 and PE-conjugated anti-CD25 antibody levels were measured. Then results of the study and control group were analyzed and compared. Results: The absolute number of CD25 bright cells in the CD4‏+T cells in peripheral blood was statistically significantly lower in the study group as compared to the control group(P=0.000. The absolute number of CD4+CD25dimT cells in peripheral blood was statistically significantly higher in the study group as compared to the control group (P=0.000. Conclusion: As decrease in the number of CD4+CD25+Tcells or their functional deficiency may be linked with miscarriage, CD4+CD25+‏ Tells could serve as a novel biomarker for monitoring in URSA patients, but more studies are needed in this field.

  6. Clinical and Immunological Features of Common Variable Immunodeficiency in China

    Directory of Open Access Journals (Sweden)

    Lian-Jun Lin

    2015-01-01

    Full Text Available Background: Common variable immunodeficiency (CVID is one of the most common symptomatic primary immunodeficiency syndromes. The purpose of this article was to broaden our knowledge about CVID for better diagnosis and treatment. Methods: Clinical and immunological features of 40 Chinese patients with CVID were analyzed retrospectively. Results: The median age at onset was 11-year-old (range 4-51 years. The median age at diagnosis was 14.5-year-old (range 5-66 years. The average time of delay in diagnosis was 5.3 years (range 1-41 years. The most common main complaint was fever due to infections (35 cases, 87.5%. Pneumonia (28 cases, 70% was the most common type of infections. Bronchiectasis was present in 6 patients (15%. Autoimmune disease was detected in 6 cases of CVID, and malignancy in 2 cases. The median total serum levels of IgG, IgA, and IgM at diagnosis were 1.07 g/L, 0.07 g/L, and 0.28 g/L, respectively. The percentages of CD3− /CD19 + B-cells were 1%-3.14%. Conclusions: Infection is the most frequent presentation of CVID. Patients with unexplainable infections should receive further examination including serum immunoglobulin (Ig and lymphocyte subset analysis. Regular and sufficient substitution with Ig is recommended.

  7. Face Alignment via Regressing Local Binary Features.

    Science.gov (United States)

    Ren, Shaoqing; Cao, Xudong; Wei, Yichen; Sun, Jian

    2016-03-01

    This paper presents a highly efficient and accurate regression approach for face alignment. Our approach has two novel components: 1) a set of local binary features and 2) a locality principle for learning those features. The locality principle guides us to learn a set of highly discriminative local binary features for each facial landmark independently. The obtained local binary features are used to jointly learn a linear regression for the final output. This approach achieves the state-of-the-art results when tested on the most challenging benchmarks to date. Furthermore, because extracting and regressing local binary features are computationally very cheap, our system is much faster than previous methods. It achieves over 3000 frames per second (FPS) on a desktop or 300 FPS on a mobile phone for locating a few dozens of landmarks. We also study a key issue that is important but has received little attention in the previous research, which is the face detector used to initialize alignment. We investigate several face detectors and perform quantitative evaluation on how they affect alignment accuracy. We find that an alignment friendly detector can further greatly boost the accuracy of our alignment method, reducing the error up to 16% relatively. To facilitate practical usage of face detection/alignment methods, we also propose a convenient metric to measure how good a detector is for alignment initialization.

  8. Sensitivity to feature displacement in familiar and unfamiliar faces: beyond the internal/external feature distinction.

    Science.gov (United States)

    Brooks, Kevin R; Kemp, Richard I

    2007-01-01

    Previous studies of face recognition and of face matching have shown a general improvement for the processing of internal features as a face becomes more familiar to the participant. In this study, we used a psychophysical two-alternative forced-choice paradigm to investigate thresholds for the detection of a displacement of the eyes, nose, mouth, or ears for familiar and unfamiliar faces. No clear division between internal and external features was observed. Rather, for familiar (compared to unfamiliar) faces participants were more sensitive to displacements of internal features such as the eyes or the nose; yet, for our third internal feature-the mouth no such difference was observed. Despite large displacements, many subjects were unable to perform above chance when stimuli involved shifts in the position of the ears. These results are consistent with the proposal that familiarity effects may be mediated by the construction of a robust representation of a face, although the involvement of attention in the encoding of face stimuli cannot be ruled out. Furthermore, these effects are mediated by information from a spatial configuration of features, rather than by purely feature-based information.

  9. Turkish Music Genre Classification using Audio and Lyrics Features

    Directory of Open Access Journals (Sweden)

    Önder ÇOBAN

    2017-05-01

    Full Text Available Music Information Retrieval (MIR has become a popular research area in recent years. In this context, researchers have developed music information systems to find solutions for such major problems as automatic playlist creation, hit song detection, and music genre or mood classification. Meta-data information, lyrics, or melodic content of music are used as feature resource in previous works. However, lyrics do not often used in MIR systems and the number of works in this field is not enough especially for Turkish. In this paper, firstly, we have extended our previously created Turkish MIR (TMIR dataset, which comprises of Turkish lyrics, by including the audio file of each song. Secondly, we have investigated the effect of using audio and textual features together or separately on automatic Music Genre Classification (MGC. We have extracted textual features from lyrics using different feature extraction models such as word2vec and traditional Bag of Words. We have conducted our experiments on Support Vector Machine (SVM algorithm and analysed the impact of feature selection and different feature groups on MGC. We have considered lyrics based MGC as a text classification task and also investigated the effect of term weighting method. Experimental results show that textual features can also be effective as well as audio features for Turkish MGC, especially when a supervised term weighting method is employed. We have achieved the highest success rate as 99,12\\% by using both audio and textual features together.

  10. Long-term effects of previous oxandrolone treatment in adult women with Turner syndrome

    NARCIS (Netherlands)

    K. Freriks (Kim); T.C.J. Sas (Theo); T. Traas (Theo); R.T. Netea-Maier (Romana ); M. den Heijer (Martin); A.R.M.M. Hermus (Ad); J.M. Wit (Jan); J.A.E.M. Van Alfen-van Der Velden (Janiëlle A. E.); B.J. Otten (Barto); S.M.P.F. de Muinck Keizer-Schrama (Sabine); M. Gotthardt (Martin); P.H. Dejonckere (Philippe); G.R.J. Zandwijken (Gladys); L.A. Menke (Leonie); H.J.L.M. Timmers

    2013-01-01

    textabstractObjective: Short stature is a prominent feature of Turner syndrome (TS), which is partially overcome by GH treatment. We have previously reported the results of a trial on the effect of oxandrolone (Ox) in girls with TS. Ox in a dose of 0.03 mg/kg per day (Ox 0.03) significantly

  11. Permanent pacemaker implantation in octogenarians with unexplained syncope and positive electrophysiologic testing.

    Science.gov (United States)

    Giannopoulos, Georgios; Kossyvakis, Charalampos; Panagopoulou, Vasiliki; Tsiachris, Dimitrios; Doudoumis, Konstantinos; Mavri, Maria; Vrachatis, Dimitrios; Letsas, Konstantinos; Efremidis, Michael; Katsivas, Apostolos; Lekakis, John; Deftereos, Spyridon

    2017-05-01

    Syncope is a common problem in the elderly, and a permanent pacemaker is a therapeutic option when a bradycardic etiology is revealed. However, the benefit of pacing when no association of symptoms to bradycardia has been shown is not clear, especially in the elderly. The aim of this study was to evaluate the effect of pacing on syncope-free mortality in patients aged 80 years or older with unexplained syncope and "positive" invasive electrophysiologic testing (EPT). This was an observational study. A positive EPT for the purposes of this study was defined by at least 1 of the following: a corrected sinus node recovery time of >525 ms, a basic HV interval of >55 ms, detection of infra-Hisian block, or appearance of second-degree atrioventricular block on atrial decremental pacing at a paced cycle length of >400 ms. Among the 2435 screened patients, 228 eligible patients were identified, 145 of whom were implanted with a pacemaker. Kaplan-Meier analysis determined that time to event (syncope or death) was 50.1 months (95% confidence interval 45.4-54.8 months) with a pacemaker vs 37.8 months (95% confidence interval 31.3-44.4 months) without a pacemaker (log-rank test, P = .001). The 4-year time-dependent estimate of the rate of syncope was 12% vs 44% (P pacemaker implantation was independently associated with longer syncope-free survival. Significant differences were also shown in the individual components of the primary outcome measure (syncope and death from any cause). Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  12. Mediastinal involvement in lymphangiomatosis: a previously unreported MRI sign

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Vikas; Shah, Sachit; Barnacle, Alex; McHugh, Kieran [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); Sebire, Neil J. [Great Ormond Street Hospital for Children, Department of Histopathology, London (United Kingdom); Brock, Penelope [Great Ormond Street Hospital for Children, Department of Oncology, London (United Kingdom); Harper, John I. [Great Ormond Street Hospital for Children, Department of Dermatology, London (United Kingdom)

    2011-08-15

    Multifocal lymphangiomatosis is a rare systemic disorder affecting children. Due to its rarity and wide spectrum of clinical, histological and imaging features, establishing the diagnosis of multifocal lymphangiomatosis can be challenging. The purpose of this study was to describe a new imaging sign in this disorder: paraspinal soft tissue and signal abnormality at MRI. We retrospectively reviewed the imaging, clinical and histopathological findings in a cohort of eight children with thoracic involvement from this condition. Evidence of paraspinal chest disease was identified at MRI and CT in all eight of these children. The changes comprise heterogeneous intermediate-to-high signal parallel to the thoracic vertebrae on T2-weighted sequences at MRI, with abnormal paraspinal soft tissue at CT and plain radiography. Multifocal lymphangiomatosis is a rare disorder with a broad range of clinicopathological and imaging features. MRI allows complete evaluation of disease extent without the use of ionising radiation and has allowed us to describe a previously unreported imaging sign in this disorder, namely, heterogeneous hyperintense signal in abnormal paraspinal tissue on T2-weighted images. (orig.)

  13. Long-term effects of previous oxandrolone treatment in adult women with Turner syndrome

    NARCIS (Netherlands)

    Freriks, K.; Sas, T.C.J.; Traas, M.A.F.; Netea-Maier, R.T.; Heijer, M. den; Hermus, A.R.M.M.; Wit, J.M.; Alfen-van der Velden, J. van; Otten, B.J.; Muinck Keizer-Schrama, S.M.P.F. de; Gotthardt, M.; Dejonckere, P.H.; Zandwijken, G.R.; Menke, L.A.; Timmers, H.J.L.M.

    2013-01-01

    OBJECTIVE: Short stature is a prominent feature of Turner syndrome (TS), which is partially overcome by GH treatment. We have previously reported the results of a trial on the effect of oxandrolone (Ox) in girls with TS. Ox in a dose of 0.03 mg/kg per day (Ox 0.03) significantly increased adult

  14. Medically Unexplained Symptoms and the risk of loss of labor market participation - A prospective study in the Danish population

    DEFF Research Database (Denmark)

    Løngaard, Katja; Bjorner, Jacob Bue; Fink, Per

    2015-01-01

    follow-up. MUS participants also showed an elevated RR with regard to risk of disability pensioning, however this association was not statistically significant (RR = 2.06, 95% CI = 0.77-5.52). CONCLUSION: MUS seem to have a negative effect on labor market participation defined by LTSA and unemployment......BACKGROUND: Medically Unexplained Symptoms (MUS) are frequently encountered in general practice. However, little is known whether MUS affects labor market participation. We investigated the prospective association between MUS at baseline and risk of long-term sickness absence (LTSA), unemployment...... treatment. Participants were classified with MUS if they: a) had reported three or more symptoms during the last month, and b) did not have a chronic condition, neither in the self-reported nor the register data. We assessed LTSA, unemployment, and disability pensioning by linking our data with National...

  15. Learning to Recognize Features of Valid Textual Entailments

    National Research Council Canada - National Science Library

    MacCartney, Bill; Grenager, Trond; Marneffe, Marie-Catherine de; Cer, Daniel; Manning, Christopher D

    2006-01-01

    .... Instead we propose a pipelined approach where alignment is followed by a classification step, in which we extract features representing high-level characteristics of the entailment problem, and pass the resulting feature vector to a statistical classifier trained on development data. We report results on data from the 2005 Pascal RTE Challenge which surpass previously reported results for alignment-based systems.

  16. The treatment of patients with medically unexplained physical symptoms in China: a study comparing expectations and treatment satisfaction in psychosomatic medicine, biomedicine, and traditional Chinese medicine.

    Science.gov (United States)

    Fritzsche, Kurt; Xudong, Zhao; Anselm, Kathrin; Kern, Stephanie; Wirsching, Michael; Schaefert, Rainer

    2011-01-01

    Little is known about treatment for patients with medically unexplained symptoms (MUS) in China. This study investigates the treatment expectations and treatment satisfaction of patients with MUS in psychosomatic medicine, biomedicine, and Traditional Chinese Medicine (TCM). In a cross-sectional survey, n = 96 (10.3%) out of 931 participating patients were screened positive for multiple somatoform symptoms. These patients answered questionnaires concerning symptom duration, number of doctor visits, functional impairment, emotional distress, treatment expectations, treatment satisfaction, and empathy in the consultation. The physicians filled in a questionnaire about applied or recommended treatment. Most of the patients from psychosomatic medicine wanted psychotherapy. In TCM, 55% of the patients had already received TCM treatment and most of them wanted to continue TCM treatment. Patients in biomedicine did not express clear expectations; most of them had had no previous treatment. A combination of treatment methods was most prevalent in biomedicine in comparison to psychosomatic medicine and TCM. The outcome from the patients' point of view was significantly better in TCM than in psychosomatic medicine and biomedicine. Psychosomatic medicine's strength was the empathetic physician-patient interaction. From a biopsychosocial perspective, these results suggest that various treatment approaches with various emphases can be effective depending on the patient's complaints, his illness beliefs, and what the physician offers. The results will be verified in a larger multicenter longitudinal study.

  17. The medico-legal investigation of sudden, unexpected and/or unexplained infant deaths in South Africa: where are we--and where are we going?

    Science.gov (United States)

    du Toit-Prinsloo, L; Dempers, J J; Wadee, S A; Saayman, G

    2011-03-01

    Sudden Infant Death Syndrome (SIDS) has been reported to be the leading cause of death in infants under 1 year of age in many countries. Unfortunately, a paucity of published research data exists in South Africa, with regard to the incidence of and investigation into the circumstances surrounding Sudden Unexplained Deaths in Infants (SUDI) and/or SIDS. Currently, even though most academic centers conform to a protocol consistent with internationally accepted standards, there exists no nationally accepted infant death investigation protocol in South Africa. It is the aim of this study to review the current practice of infant death investigation in two representative but geographically and demographically distinct centers. Retrospective case audit over a five-year period (2000-2004) was conducted at two large medico-legal mortuaries in Pretoria (Gauteng) and Tygerberg (Cape Town). Case files on all infants younger than 1 year of age were reviewed. The outcome measures included number of deaths, demographic details and the nature and final outcome of the post mortem examinations. A total of 512 cases were identified as possible SIDS cases and of these, 171 was classified as SIDS. The study showed marked inter-case and inter-divisional variation in terms of the investigation of infant deaths at the two institutions. It is envisaged that this study will focus attention on the current lack of usable data regarding sudden/unexplained/unexpected infant deaths in South Africa, and aid in the formulation and implementation of a practical (yet internationally accountable) infant death investigation protocol, which could facilitate comparisons with other countries and initiate further structured research in this field.

  18. Previously unknown species of Aspergillus.

    Science.gov (United States)

    Gautier, M; Normand, A-C; Ranque, S

    2016-08-01

    The use of multi-locus DNA sequence analysis has led to the description of previously unknown 'cryptic' Aspergillus species, whereas classical morphology-based identification of Aspergillus remains limited to the section or species-complex level. The current literature highlights two main features concerning these 'cryptic' Aspergillus species. First, the prevalence of such species in clinical samples is relatively high compared with emergent filamentous fungal taxa such as Mucorales, Scedosporium or Fusarium. Second, it is clearly important to identify these species in the clinical laboratory because of the high frequency of antifungal drug-resistant isolates of such Aspergillus species. Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) has recently been shown to enable the identification of filamentous fungi with an accuracy similar to that of DNA sequence-based methods. As MALDI-TOF MS is well suited to the routine clinical laboratory workflow, it facilitates the identification of these 'cryptic' Aspergillus species at the routine mycology bench. The rapid establishment of enhanced filamentous fungi identification facilities will lead to a better understanding of the epidemiology and clinical importance of these emerging Aspergillus species. Based on routine MALDI-TOF MS-based identification results, we provide original insights into the key interpretation issues of a positive Aspergillus culture from a clinical sample. Which ubiquitous species that are frequently isolated from air samples are rarely involved in human invasive disease? Can both the species and the type of biological sample indicate Aspergillus carriage, colonization or infection in a patient? Highly accurate routine filamentous fungi identification is central to enhance the understanding of these previously unknown Aspergillus species, with a vital impact on further improved patient care. Copyright © 2016 European Society of Clinical Microbiology and

  19. The assessment of ovulation by a combination of ultrasound and detailed serial hormone profiles in 35 women with long-standing unexplained infertility.

    Science.gov (United States)

    Petsos, P; Chandler, C; Oak, M; Ratcliffe, W A; Wood, R; Anderson, D C

    1985-06-01

    We have examined for the presence of subtle hormonal abnormalities in women with long-standing unexplained infertility. For a full cycle serum LH, FSH, progesterone and oestradiol levels were measured about three times a week, and serial ultrasound scans of the ovaries made until the time of apparent ovulation. The results on 45 cycles in 35 women with unexplained infertility and in three normal volunteers are presented. Normal ovulatory cycles were defined by a length of 26-32 d, and progressive follicular maturation followed by disappearance or abrupt reduction in size of a follicle within 48 h of the recorded LH peak, followed by progressive and sustained rise in serum progesterone levels to more than 25 nmol/l and a luteal phase length of greater than or equal to 13 d. Thirty spontaneous cycles (28 women) were clearly normal while 15 spontaneous cycles (12 women) were abnormal. Abnormalities included luteinization of an unruptured follicle (eight cycles), absence of follicular development (two cycles), poor follicular development (two cycles), persistence of a large ovarian cyst from the preceeding cycle (two cycles) and one aluteal cycle. Six of the abnormal cycles were characterized hormonally by inappropriate elevation of serum LH levels throughout. If this study had been based only on serial ultrasound scans, all results on abnormal cycles might have been misinterpreted. If it had been conducted only with (multiple) progesterone determinations and the level of greater than 25 nmol/l had been taken as indicative of ovulation nine clearly abnormal cycles would have been considered as normal. We conclude that the combination of the hormonal and ultrasound assessment of ovulation increases our confidence for confirmation of normality and reveals various ovulatory disorders which are possibly due to an endocrinological defect or defects.

  20. Feature-Based versus Category-Based Induction with Uncertain Categories

    Science.gov (United States)

    Griffiths, Oren; Hayes, Brett K.; Newell, Ben R.

    2012-01-01

    Previous research has suggested that when feature inferences have to be made about an instance whose category membership is uncertain, feature-based inductive reasoning is used to the exclusion of category-based induction. These results contrast with the observation that people can and do use category-based induction when category membership is…

  1. Illness explanations among patients with medically unexplained symptoms: different idioms for different contexts.

    Science.gov (United States)

    Risør, Mette Bech

    2009-09-01

    Patients with medically unexplained symptoms (MUS) are often considered to be strictly confined to thinking about their symptoms as having only a physical etiology. However, several studies have shown, that the patients also apply other explanations for their sufferings. The aim of this study is to analyse the social construction of illness explanations among patients with MUS, and to illustrate the use of explanatory idioms as being dependent on space, time and setting, legitimizing each idiom. The study is based on repeated, semi-structured, qualitative interviews with nine informants during a period of 1.5 years. A thematic content analysis was performed on a pragmatic and phenomenological basis. We found, that patients with MUS employ at least four different explanatory idioms defined as: (1) the symptomatic idiom; (2) the personal idiom; (3) the social idiom; and (4) the moral idiom. All idioms play an important role in the process of creating meaning in the patients' everyday life. The symptomatic idiom is mainly used at clinical consultations in primary care, but it is not the only idiom of significance for the patients. Simultaneously other idioms exist and gradually become important for especially patients with MUS due to the lack of valid diagnoses and treatment opportunities. Clinical settings, however, call for the employment of the symptomatic idiom and a discrepancy is found between the general practitioners' notion of the bio-psycho-social model and the patients' everyday life idioms.

  2. Designing attractive gamification features for collaborative storytelling websites.

    Science.gov (United States)

    Hsu, Shang Hwa; Chang, Jen-Wei; Lee, Chun-Chia

    2013-06-01

    Gamification design is considered as the predictor of collaborative storytelling websites' success. Although aforementioned studies have mentioned a broad range of factors that may influence gamification, they neither depicted the actual design features nor relative attractiveness among them. This study aims to identify attractive gamification features for collaborative storytelling websites. We first constructed a hierarchical system structure of gamification design of collaborative storytelling websites and conducted a focus group interview with eighteen frequent users to identify 35gamification features. After that, this study determined the relative attractiveness of these gamification features by administrating an online survey to 6333 collaborative storytelling websites users. The results indicated that the top 10 most attractive gamification features could account for more than 50% of attractiveness among these 35 gamification features. The feature of unpredictable time pressure is important to website users, yet not revealed in previous relevant studies. Implications of the findings were discussed.

  3. Health care costs before and after diagnosis of depression in patients with unexplained pain: a retrospective cohort study using the United Kingdom General Practice Research Database

    Directory of Open Access Journals (Sweden)

    Reed C

    2013-01-01

    Full Text Available Catherine Reed,1 Jihyung Hong,2 Diego Novick,1 Alan Lenox-Smith,3 Michael Happich41Global Health Outcomes, Eli Lilly and Company, Windlesham, Surrey, UK; 2Personal Social Services Research Unit, London School of Economics and Political Science, London, UK; 3Eli Lilly UK, Basingstoke, UK; 4Eli Lilly and Company, Bad Homburg, GermanyPurpose: To assess the impact of pain severity and time to diagnosis of depression on health care costs for primary care patients with pre-existing unexplained pain symptoms who subsequently received a diagnosis of depression.Patients and methods: This retrospective cohort study analyzed 4000 adults with unexplained pain (defined as painful physical symptoms [PPS] without any probable organic cause and a subsequent diagnosis of depression, identified from the UK General Practice Research Database using diagnostic codes. Patients were categorized into four groups based on pain severity (milder or more severe; based on number of pain-relief medications and use of opioids and time to diagnosis of depression (≤1 year or >1 year from PPS index date. Annual health care costs were calculated (2009 values and included general practitioner (GP consultations, secondary care referrals, and prescriptions for pain-relief medications for the 12 months before depression diagnosis and in the subsequent 2 years. Multivariate models of cost included time period as a main independent variable, and adjusted for age, gender, and comorbidities.Results: Total annual health care costs before and after depression diagnosis for the four patient groups were higher for the groups with more severe pain (£819–£988 versus £565–£628; P < 0.001 for all pairwise comparisons and highest for the group with more severe pain and longer time to depression diagnosis in the subsequent 2 years (P < 0.05. Total GP costs were highest in the group with more severe pain and longer time to depression diagnosis both before and after depression diagnosis (P

  4. BAD knockout provides metabolic seizure resistance in a genetic model of epilepsy with sudden unexplained death in epilepsy.

    Science.gov (United States)

    Foley, Jeannine; Burnham, Veronica; Tedoldi, Meghan; Danial, Nika N; Yellen, Gary

    2018-01-01

    Metabolic alteration, either through the ketogenic diet (KD) or by genetic alteration of the BAD protein, can produce seizure protection in acute chemoconvulsant models of epilepsy. To assess the seizure-protective role of knocking out (KO) the Bad gene in a chronic epilepsy model, we used the Kcna1 -/- model of epilepsy, which displays progressively increased seizure severity and recapitulates the early death seen in sudden unexplained death in epilepsy (SUDEP). Beginning on postnatal day 24 (P24), we continuously video monitored Kcna1 -/- and Kcna1 -/- Bad -/- double knockout mice to assess survival and seizure severity. We found that Kcna1 -/- Bad -/- mice outlived Kcna1 -/- mice by approximately 2 weeks. Kcna1 -/- Bad -/- mice also spent significantly less time in seizure than Kcna1 -/- mice on P24 and the day of death, showing that BadKO provides seizure resistance in a genetic model of chronic epilepsy. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  5. Patterns of Dysmorphic Features in Schizophrenia

    Science.gov (United States)

    Scutt, L.E.; Chow, E.W.C.; Weksberg, R.; Honer, W.G.; Bassett, Anne S.

    2011-01-01

    Congenital dysmorphic features are prevalent in schizophrenia and may reflect underlying neurodevelopmental abnormalities. A cluster analysis approach delineating patterns of dysmorphic features has been used in genetics to classify individuals into more etiologically homogeneous subgroups. In the present study, this approach was applied to schizophrenia, using a sample with a suspected genetic syndrome as a testable model. Subjects (n = 159) with schizophrenia or schizoaffective disorder were ascertained from chronic patient populations (random, n=123) or referred with possible 22q11 deletion syndrome (referred, n = 36). All subjects were evaluated for presence or absence of 70 reliably assessed dysmorphic features, which were used in a three-step cluster analysis. The analysis produced four major clusters with different patterns of dysmorphic features. Significant between-cluster differences were found for rates of 37 dysmorphic features (P dysmorphic features (P = 0.0001), and validating features not used in the cluster analysis: mild mental retardation (P = 0.001) and congenital heart defects (P = 0.002). Two clusters (1 and 4) appeared to represent more developmental subgroups of schizophrenia with elevated rates of dysmorphic features and validating features. Cluster 1 (n = 27) comprised mostly referred subjects. Cluster 4 (n= 18) had a different pattern of dysmorphic features; one subject had a mosaic Turner syndrome variant. Two other clusters had lower rates and patterns of features consistent with those found in previous studies of schizophrenia. Delineating patterns of dysmorphic features may help identify subgroups that could represent neurodevelopmental forms of schizophrenia with more homogeneous origins. PMID:11803519

  6. Visual Search for Feature and Conjunction Targets with an Attention Deficit

    OpenAIRE

    Arguin, Martin; Joanette, Yves; Cavanagh, Patrick

    1993-01-01

    Brain-damaged subjects who had previously been identified as suffering from a visual attention deficit for contralesional stimulation were tested on a series of visual search tasks. The experiments examined the hypothesis that the processing of single features is preattentive but that feature integration, necessary for the correct perception of conjunctions of features, requires attention (Treisman & Gelade, 1980 Treisman & Sato, 1990). Subjects searched for a feature target (orientation or c...

  7. Progress for Women in Academe, Yet Inequities Persist: Evidence from NSOPF:99

    Science.gov (United States)

    Toutkoushian, Robert K.; Conley, Valerie Martin

    2005-01-01

    In this study, we use data from the 1999 National Study of Postsecondary Faculty (NSOPF:99) to measure the unexplained wage gap between men and women in academe. We pay particular attention to how these unexplained wage gaps have changed over time by comparing the results from the 1999 survey to published results from previous national surveys and…

  8. A developmental, body-oriented intervention for children and adolescents with medically unexplained chronic pain.

    Science.gov (United States)

    Kozlowska, Kasia; Khan, Rubina

    2011-10-01

    The regulation of pain and other emotions is a developmental process that takes place in the context of attachment relationships. Children with chronic, medically unexplained pain struggle to accurately identify, communicate and regulate negative body states, and to connect these body states to their day-to-day experience. This article describes an individual intervention - one component of a multimodal treatment programme - whose aim is to help children find skills to manage their pain. The intervention incorporates ideas and practices from several theoretical models - the dynamic-maturational model of attachment, cognitive-behavioural theories, narrative therapy, art therapy, sensorimotor approaches -pragmatically selected and adapted to help children presenting to our Chronic Pain Service achieve good clinical outcomes. At the outset we assess the child's capacity to identify, regulate and communicate positive and negative body states, and tailor our individual intervention so as to extend each child's proximal level of development. We initially focus on the body in an effort to equip the child with a non-verbal, image-based language for identifying and communicating pain and other negative body states. Once the child has developed a non-verbal way of knowing her body, a range of cognitive-behavioural, narrative and other strategies are introduced. The intervention aims to increase the child's emotional functioning: her skill in identifying, symbolically representing, communicating and managing pain and other negative body states.

  9. Unexplained neurological events during bathing in young people: Possible association with the use of gas geysers

    Directory of Open Access Journals (Sweden)

    Singh Prabhjeet

    2008-01-01

    Full Text Available Here, we report sudden, unexplained neurological collapse in 14 young people while bathing with hot water associated with the use of liquefied petroleum gas (LPG-based water heaters (gas geysers in ill-ventilated bathrooms. None of the patients reported any circumstantial evidence of seizures or prior epilepsy. One patient developed cortical blindness and demonstrated posterior leucoencephalopathy on imaging studies. The remaining patients made rapid and excellent recovery without any residual neurological sequelae. In these cases, the results of all routine investigations, i.e., serum chemistry, brain imaging (computed tomography in 2 and magnetic resonance imaging in 10 and electroencephalography were normal. The clinical clustering of these cases in winter months with similar presentations of reversible encephalopathy probably indicates an inhalational toxin exposure. Therefore, we postulate a hypothesis that harmful emissions consisting of carbon monoxide (CO, hydrocarbon gases (HC and nitrogen oxides (NOx, produced by incomplete combustion of LPG might be responsible for the cellular injury and subsequent transient neurological deficits. Physicians should be aware of this entity in order to avoid misdiagnosis of this condition as seizures, and a public awareness should also be created regarding the proper use of these devices.

  10. Learning Motion Features for Example-Based Finger Motion Estimation for Virtual Characters

    Science.gov (United States)

    Mousas, Christos; Anagnostopoulos, Christos-Nikolaos

    2017-09-01

    This paper presents a methodology for estimating the motion of a character's fingers based on the use of motion features provided by a virtual character's hand. In the presented methodology, firstly, the motion data is segmented into discrete phases. Then, a number of motion features are computed for each motion segment of a character's hand. The motion features are pre-processed using restricted Boltzmann machines, and by using the different variations of semantically similar finger gestures in a support vector machine learning mechanism, the optimal weights for each feature assigned to a metric are computed. The advantages of the presented methodology in comparison to previous solutions are the following: First, we automate the computation of optimal weights that are assigned to each motion feature counted in our metric. Second, the presented methodology achieves an increase (about 17%) in correctly estimated finger gestures in comparison to a previous method.

  11. Feature singletons attract spatial attention independently of feature priming.

    Science.gov (United States)

    Yashar, Amit; White, Alex L; Fang, Wanghaoming; Carrasco, Marisa

    2017-08-01

    People perform better in visual search when the target feature repeats across trials (intertrial feature priming [IFP]). Here, we investigated whether repetition of a feature singleton's color modulates stimulus-driven shifts of spatial attention by presenting a probe stimulus immediately after each singleton display. The task alternated every two trials between a probe discrimination task and a singleton search task. We measured both stimulus-driven spatial attention (via the distance between the probe and singleton) and IFP (via repetition of the singleton's color). Color repetition facilitated search performance (IFP effect) when the set size was small. When the probe appeared at the singleton's location, performance was better than at the opposite location (stimulus-driven attention effect). The magnitude of this attention effect increased with the singleton's set size (which increases its saliency) but did not depend on whether the singleton's color repeated across trials, even when the previous singleton had been attended as a search target. Thus, our findings show that repetition of a salient singleton's color affects performance when the singleton is task relevant and voluntarily attended (as in search trials). However, color repetition does not affect performance when the singleton becomes irrelevant to the current task, even though the singleton does capture attention (as in probe trials). Therefore, color repetition per se does not make a singleton more salient for stimulus-driven attention. Rather, we suggest that IFP requires voluntary selection of color singletons in each consecutive trial.

  12. Linear Regression on Sparse Features for Single-Channel Speech Separation

    DEFF Research Database (Denmark)

    Schmidt, Mikkel N.; Olsson, Rasmus Kongsgaard

    2007-01-01

    In this work we address the problem of separating multiple speakers from a single microphone recording. We formulate a linear regression model for estimating each speaker based on features derived from the mixture. The employed feature representation is a sparse, non-negative encoding of the speech...... mixture in terms of pre-learned speaker-dependent dictionaries. Previous work has shown that this feature representation by itself provides some degree of separation. We show that the performance is significantly improved when regression analysis is performed on the sparse, non-negative features, both...

  13. Light field morphing using 2D features.

    Science.gov (United States)

    Wang, Lifeng; Lin, Stephen; Lee, Seungyong; Guo, Baining; Shum, Heung-Yeung

    2005-01-01

    We present a 2D feature-based technique for morphing 3D objects represented by light fields. Existing light field morphing methods require the user to specify corresponding 3D feature elements to guide morph computation. Since slight errors in 3D specification can lead to significant morphing artifacts, we propose a scheme based on 2D feature elements that is less sensitive to imprecise marking of features. First, 2D features are specified by the user in a number of key views in the source and target light fields. Then the two light fields are warped view by view as guided by the corresponding 2D features. Finally, the two warped light fields are blended together to yield the desired light field morph. Two key issues in light field morphing are feature specification and warping of light field rays. For feature specification, we introduce a user interface for delineating 2D features in key views of a light field, which are automatically interpolated to other views. For ray warping, we describe a 2D technique that accounts for visibility changes and present a comparison to the ideal morphing of light fields. Light field morphing based on 2D features makes it simple to incorporate previous image morphing techniques such as nonuniform blending, as well as to morph between an image and a light field.

  14. AIDS, individual behaviour and the unexplained remaining variation.

    Science.gov (United States)

    Katz, Alison

    2002-01-01

    From the start of the AIDS pandemic, individual behaviour has been put forward, implicitly or explicitly, as the main explanatory concept for understanding the epidemiology of HIV infection and in particular for the rapid spread and high prevalence in sub-Saharan Africa. This has had enormous implications for the international response to AIDS and has heavily influenced public health policy and strategy and the design of prevention and care interventions at national, community and individual level. It is argued that individual behaviour alone cannot possibly account for the enormous variation in HIV prevalence between population groups, countries and regions and that the unexplained remaining variation has been neglected by the international AIDS community. Biological vulnerability to HIV due to seriously deficient immune systems has been ignored as a determinant of the high levels of infection in certain populations. This is in sharp contrast to well proven public health approaches to other infectious diseases. In particular, it is argued that poor nutrition and co-infection with the myriad of other diseases of poverty including tuberculosis, malaria, leishmaniasis and parasitic infections, have been neglected as root causes of susceptibility, infectiousness and high rates of transmission of HIV at the level of populations. Vulnerability in terms of non-biological factors such as labour migration, prostitution, exchange of sex for survival, population movements due to war and violence, has received some attention but the solutions proposed to these problems are also inappropriately focused on individual behaviour and suffer from the same neglect of economic and political root causes. As the foundation for the international community's response to the AIDS pandemic, explanations of HIV/AIDS epidemiology in terms of individual behaviour are not only grossly inadequate, they are highly stigmatising and may in some cases, be racist. They have diverted attention from

  15. Feature-aware natural texture synthesis

    KAUST Repository

    Wu, Fuzhang

    2014-12-04

    This article presents a framework for natural texture synthesis and processing. This framework is motivated by the observation that given examples captured in natural scene, texture synthesis addresses a critical problem, namely, that synthesis quality can be affected adversely if the texture elements in an example display spatially varied patterns, such as perspective distortion, the composition of different sub-textures, and variations in global color pattern as a result of complex illumination. This issue is common in natural textures and is a fundamental challenge for previously developed methods. Thus, we address it from a feature point of view and propose a feature-aware approach to synthesize natural textures. The synthesis process is guided by a feature map that represents the visual characteristics of the input texture. Moreover, we present a novel adaptive initialization algorithm that can effectively avoid the repeat and verbatim copying artifacts. Our approach improves texture synthesis in many images that cannot be handled effectively with traditional technologies.

  16. Audiovisual laughter detection based on temporal features

    NARCIS (Netherlands)

    Petridis, Stavros; Nijholt, Antinus; Nijholt, A.; Pantic, M.; Pantic, Maja; Poel, Mannes; Poel, M.; Hondorp, G.H.W.

    2008-01-01

    Previous research on automatic laughter detection has mainly been focused on audio-based detection. In this study we present an audiovisual approach to distinguishing laughter from speech based on temporal features and we show that the integration of audio and visual information leads to improved

  17. Higher TSH Levels Within the Normal Range Are Associated With Unexplained Infertility.

    Science.gov (United States)

    Orouji Jokar, Tahereh; Fourman, Lindsay T; Lee, Hang; Mentzinger, Katherine; Fazeli, Pouneh K

    2018-02-01

    Unexplained infertility (UI), defined as the inability to conceive after 12 months of unprotected intercourse with no diagnosed cause, affects 10% to 30% of infertile couples. An improved understanding of the mechanisms underlying UI could lead to less invasive and less costly treatment strategies. Abnormalities in thyroid function and hyperprolactinemia are well-known causes of infertility, but whether thyrotropin (TSH) and prolactin levels within the normal range are associated with UI is unknown. To compare TSH and prolactin levels in women with UI and women with a normal fertility evaluation except for an azoospermic or severely oligospermic male partner. Cross-sectional study including women evaluated at a large academic health system between 1 January 2000 and 31 December 2012 with normal TSH (levels within the normal range of the assay and ≤5 mIU/L) and normal prolactin levels (≤20 ng/mL) and either UI (n = 187) or no other cause of infertility other than an azoospermic or severely oligospermic partner (n = 52). TSH and prolactin. Women with UI had significantly higher TSH levels than controls [UI: TSH 1.95 mIU/L, interquartile range: (1.54, 2.61); severe male factor: TSH 1.66 mIU/L, interquartile range: (1.25, 2.17); P = 0.003]. This finding remained significant after we controlled for age, body mass index, and smoking status. Nearly twice as many women with UI (26.9%) had a TSH ≥2.5 mIU/L compared with controls (13.5%; P < 0.05). Prolactin levels did not differ between the groups. Women with UI have higher TSH levels compared with a control population. More studies are necessary to determine whether treatment of high-normal TSH levels decreases time to conception in couples with UI. Copyright © 2017 Endocrine Society

  18. Feature Optimization for Long-Range Visual Homing in Changing Environments

    Directory of Open Access Journals (Sweden)

    Qidan Zhu

    2014-02-01

    Full Text Available This paper introduces a feature optimization method for robot long-range feature-based visual homing in changing environments. To cope with the changing environmental appearance, the optimization procedure is introduced to distinguish the most relevant features for feature-based visual homing, including the spatial distribution, selection and updating. In the previous research on feature-based visual homing, less effort has been spent on the way to improve the feature distribution to get uniformly distributed features, which are closely related to homing performance. This paper presents a modified feature extraction algorithm to decrease the influence of anisotropic feature distribution. In addition, the feature selection and updating mechanisms, which have hardly drawn any attention in the domain of feature-based visual homing, are crucial in improving homing accuracy and in maintaining the representation of changing environments. To verify the feasibility of the proposal, several comprehensive evaluations are conducted. The results indicate that the feature optimization method can find optimal feature sets for feature-based visual homing, and adapt the appearance representation to the changing environments as well.

  19. The INeS study: prevention of multiple pregnancies: a randomised controlled trial comparing IUI COH versus IVF e SET versus MNC IVF in couples with unexplained or mild male subfertility.

    Science.gov (United States)

    Bensdorp, Alexandra J; Slappendel, Els; Koks, Carolien; Oosterhuis, Jur; Hoek, Annemieke; Hompes, Peter; Broekmans, Frank; Verhoeve, Harold; de Bruin, Jan Peter; van Weert, Janne Meije; Traas, Maaike; Maas, Jacques; Beckers, Nicole; Repping, Sjoerd; Mol, Ben W; van der Veen, Fulco; van Wely, Madelon

    2009-12-18

    Multiple pregnancies are high risk pregnancies with higher chances of maternal and neonatal mortality and morbidity. In the past decades the number of multiple pregnancies has increased. This trend is partly due to the fact that women start family planning at an increased age, but also due to the increased use of ART.Couples with unexplained or mild male subfertility generally receive intrauterine insemination IUI with controlled hormonal stimulation (IUI COH). The cumulative pregnancy rate is 40%, with a 10% multiple pregnancy rate.This study aims to reveal whether alternative treatments such as IVF elective Single Embryo Transfer (IVF e SET) or Modified Natural Cycle IVF (MNC IVF) can reduce the number of multiple pregnancy rates, but uphold similar pregnancy rates as IUI COH in couples with mild male or unexplained subfertility. Secondly, the aim is to perform a cost effective analyses and assess treatment preference of these couples. We plan a multicentre randomised controlled clinical trial in the Netherlands comparing six cycles of intra-uterine insemination with controlled ovarian hyperstimulation or six cycles of Modified Natural Cycle (MNC) IVF or three cycles with IVF-elective Single Embryo Transfer (eSET) plus cryo-cycles within a time frame of 12 months.Couples with unexplained subfertility or mild male subfertility and a poor prognosis for treatment independent pregnancy will be included. Women with anovulatory cycles, severe endometriosis, double sided tubal pathology or serious endocrine illness will be excluded.Our primary outcome is the birth of a healthy singleton. Secondary outcomes are multiple pregnancy, treatment costs, and patient experiences in each treatment arm. The analysis will be performed according tot the intention to treat principle. We will test for non-inferiority of the three arms with respect to live birth. As we accept a 12.5% loss in pregnancy rate in one of the two IVF arms to prevent multiple pregnancies, we need 200 couples

  20. Detection of Fraudulent Emails by Employing Advanced Feature Abundance

    DEFF Research Database (Denmark)

    Nizamani, Sarwat; Memon, Nasrullah; Glasdam, Mathies

    2014-01-01

    In this paper, we present a fraudulent email detection model using advanced feature choice. We extracted various kinds of features and compared the performance of each category of features with the others in terms of the fraudulent email detection rate. The different types of features...... are incorporated step by step. The detection of fraudulent email has been considered as a classification problem and it is evaluated using various state-of-the art algorithms and on CCM [1] which is authors' previous cluster based classification model. The experiments have been performed on diverse feature sets...... and the different classification methods. The comparison of the results is also presented and the evaluations shows that for the fraudulent email detection tasks, the feature set is more important regardless of classification method. The results of the study suggest that the task of fraudulent emails detection...

  1. Attention in the processing of complex visual displays: detecting features and their combinations.

    Science.gov (United States)

    Farell, B

    1984-02-01

    The distinction between operations in visual processing that are parallel and preattentive and those that are serial and attentional receives both theoretical and empirical support. According to Treisman's feature-integration theory, independent features are available preattentively, but attention is required to veridically combine features into objects. Certain evidence supporting this theory is consistent with a different interpretation, which was tested in four experiments. The first experiment compared the detection of features and feature combinations while eliminating a factor that confounded earlier comparisons. The resulting priority of access to combinatorial information suggests that features and nonlocal combinations of features are not connected solely by a bottom-up hierarchical convergence. Causes of the disparity between the results of Experiment 1 and the results of previous research were investigated in three subsequent experiments. The results showed that of the two confounded factors, it was the difference in the mapping of alternatives onto responses, not the differing attentional demands of features and objects, that underlaid the results of the previous research. The present results are thus counterexamples to the feature-integration theory. Aspects of this theory are shown to be subsumed by more general principles, which are discussed in terms of attentional processes in the detection of features, objects, and stimulus alternatives.

  2. Lipomatosis of the sciatic nerve: typical and atypical MRI features

    International Nuclear Information System (INIS)

    Wong, Bernadette Zhi Ying; Amrami, Kimberly K.; Wenger, Doris E.; Dyck, P. James B.; Scheithauer, Bernd W.; Spinner, Robert J.

    2006-01-01

    Lipomatosis of nerve, also known as fibrolipomatous hamartoma, is a rare condition of nerve, usually affecting the median nerve. The MRI appearance is characteristic. We describe two cases of lipomatosis of nerve involving the sciatic nerve, an extremely unusual location for this lesion, in patients with sciatic neuropathy. These cases share the typical features previously described in the literature for other nerves, but also contain atypical features not previously highlighted, relating to the variability in distribution and extent of the fatty deposition. Recognition of the MRI appearance of this entity is important in order to avoid unnecessary attempts at surgical resection of this lesion. (orig.)

  3. Online feature selection with streaming features.

    Science.gov (United States)

    Wu, Xindong; Yu, Kui; Ding, Wei; Wang, Hao; Zhu, Xingquan

    2013-05-01

    We propose a new online feature selection framework for applications with streaming features where the knowledge of the full feature space is unknown in advance. We define streaming features as features that flow in one by one over time whereas the number of training examples remains fixed. This is in contrast with traditional online learning methods that only deal with sequentially added observations, with little attention being paid to streaming features. The critical challenges for Online Streaming Feature Selection (OSFS) include 1) the continuous growth of feature volumes over time, 2) a large feature space, possibly of unknown or infinite size, and 3) the unavailability of the entire feature set before learning starts. In the paper, we present a novel Online Streaming Feature Selection method to select strongly relevant and nonredundant features on the fly. An efficient Fast-OSFS algorithm is proposed to improve feature selection performance. The proposed algorithms are evaluated extensively on high-dimensional datasets and also with a real-world case study on impact crater detection. Experimental results demonstrate that the algorithms achieve better compactness and higher prediction accuracy than existing streaming feature selection algorithms.

  4. [A description of children and adolescents with somatic unexplained physical symptoms in a Dutch mental health care institution].

    Science.gov (United States)

    Kouijzer, M E J; Loman, F; van der Feltz-Cornelis, C M

    2013-01-01

    Medically unexplained symptoms (MUS) occur frequently in children and adolescents. Treatment of MUS in children and adolescents takes place mainly in mental health care (MHC) institutions, as does the treatment of adults with MUS. However, there is hardly any literature about the prevalence of MUS in children and adolescents in MHC. To study the prevalence of MUS in children and adolescents in Dutch MHC. Comparisons were drawn between children and adolescents with MUS and those without MUS who had been referred to a Dutch MHC institution. Children and adolescents with MUS had more anxiety and depression and more introvert personality characteristics than children and adolescents without MUS. However, the quality of life of children and adolescents with MUS was similar to that of children and adolescents without MUS. One in five children and adolescents in Dutch MHC had MUS. These children and adolescents had introverted personality characteristics and showed anxious and depressed behavior, withdrawn-depressed behavior, and thought problems. The quality of life of children and adolescents with MUS and those without MUS was below average.

  5. Understanding Legacy Features with Featureous

    DEFF Research Database (Denmark)

    Olszak, Andrzej; Jørgensen, Bo Nørregaard

    2011-01-01

    Java programs called Featureous that addresses this issue. Featureous allows a programmer to easily establish feature-code traceability links and to analyze their characteristics using a number of visualizations. Featureous is an extension to the NetBeans IDE, and can itself be extended by third...

  6. Detection of fraudulent emails by employing advanced feature abundance

    Directory of Open Access Journals (Sweden)

    Sarwat Nizamani

    2014-11-01

    Full Text Available In this paper, we present a fraudulent email detection model using advanced feature choice. We extracted various kinds of features and compared the performance of each category of features with the others in terms of the fraudulent email detection rate. The different types of features are incorporated step by step. The detection of fraudulent email has been considered as a classification problem and it is evaluated using various state-of-the art algorithms and on CCM (Nizamani et al., 2011 [1] which is authors’ previous cluster based classification model. The experiments have been performed on diverse feature sets and the different classification methods. The comparison of the results is also presented and the evaluation show that for the fraudulent email detection tasks, the feature set is more important regardless of classification method. The results of the study suggest that the task of fraudulent emails detection requires the better choice of feature set; while the choice of classification method is of less importance.

  7. Navigation and Comprehension of Digital Expository Texts: Hypertext Structure, Previous Domain Knowledge, and Working Memory Capacity

    Science.gov (United States)

    Burin, Debora I.; Barreyro, Juan P.; Saux, Gastón; Irrazábal, Natalia C.

    2015-01-01

    Introduction: In contemporary information societies, reading digital text has become pervasive. One of the most distinctive features of digital texts is their internal connections via hyperlinks, resulting in non-linear hypertexts. Hypertext structure and previous knowledge affect navigation and comprehension of digital expository texts. From the…

  8. The Speed of Feature-Based Attention: Attentional Advantage Is Slow, but Selection Is Fast

    Science.gov (United States)

    Huang, Liqiang

    2010-01-01

    When paying attention to a feature (e.g., red), no attentional advantage is gained in perceiving items with this feature in very brief displays. Therefore, feature-based attention seems to be slow. In previous feature-based attention studies, attention has often been measured as the difference in performance in a secondary task. In our recent work…

  9. 11. Prevalence of psychiatric symptoms among patients with recurrent vasovagal and unexplained syncope

    Directory of Open Access Journals (Sweden)

    A.W. Al-Johar

    2016-07-01

    Full Text Available Syncope is defined as a transient loss of consciousness and absence of postural tone followed by spontaneous recovery. Neurally mediated syncope (vasovagal and idiopathic unexplained syncope (US are the most common causes of syncope. Syncope is a very limiting disease that, if recurrent, affects the patients’ physical and psychological health. Our objective from this study is to measure the prevalence of psychiatric symptoms among patients with US. All patients (>12 years with vasovagal or US who were evaluated in King Khalid University Hospital were identified. Echocardiography and table tilt test reports were reviewed and patients who had cardiac syncope (due to arrhythmia or structural heart disease were excluded (N = 18. Ninety-four patients were included for further psychiatric assessment. The patients were contacted to fill the Symptoms Checklist-90-Revised (SCL-90-R, which is a self-reporting questionnaire used to evaluate traits of depression, anxiety, somatization disorder and phobia. SCL-90-R scale has been translated to Arabic and validated in previous studies. Of the included cohort, 43 responded to fill the assessment scale, and 51 were excluded due to failure of communication (N = 41 or refusal to participate (N = 10. A control group was recruited with a case: control ratio of 1:3 matching for age, gender, and chronic illnesses.There were 43 patients and 129 control subjects, with predominance of females (67.4% and an average age of 33.8 (SD = 16. There was no difference in average scores of depression (13 vs. 14.53, P = 0.31, anxiety (11.3 vs. 10.4, P = 0.51, or phobia (5.4 vs. 5.2, P = 0.88. However, the syncope group had a higher average score for somatization disorder (18.53 vs. 13.66, P = 0.002. Binary logistic regression model was measured after grouping the cohort into above and below median scores. After adjusting for age, gender, and chronic illnesses, the association between syncope and somatization

  10. Discriminative semi-supervised feature selection via manifold regularization.

    Science.gov (United States)

    Xu, Zenglin; King, Irwin; Lyu, Michael Rung-Tsong; Jin, Rong

    2010-07-01

    Feature selection has attracted a huge amount of interest in both research and application communities of data mining. We consider the problem of semi-supervised feature selection, where we are given a small amount of labeled examples and a large amount of unlabeled examples. Since a small number of labeled samples are usually insufficient for identifying the relevant features, the critical problem arising from semi-supervised feature selection is how to take advantage of the information underneath the unlabeled data. To address this problem, we propose a novel discriminative semi-supervised feature selection method based on the idea of manifold regularization. The proposed approach selects features through maximizing the classification margin between different classes and simultaneously exploiting the geometry of the probability distribution that generates both labeled and unlabeled data. In comparison with previous semi-supervised feature selection algorithms, our proposed semi-supervised feature selection method is an embedded feature selection method and is able to find more discriminative features. We formulate the proposed feature selection method into a convex-concave optimization problem, where the saddle point corresponds to the optimal solution. To find the optimal solution, the level method, a fairly recent optimization method, is employed. We also present a theoretic proof of the convergence rate for the application of the level method to our problem. Empirical evaluation on several benchmark data sets demonstrates the effectiveness of the proposed semi-supervised feature selection method.

  11. Medically unexplained illness and the diagnosis of hysterical conversion reaction (HCR in women’s medicine wards of Bangladeshi hospitals: a record review and qualitative study

    Directory of Open Access Journals (Sweden)

    Kendall Emily A

    2012-10-01

    Full Text Available Abstract Background Frequent reporting of cases of hysterical conversion reaction (HCR among hospitalized female medical patients in Bangladesh’s public hospital system led us to explore the prevalence of “HCR” diagnoses within hospitals and the manner in which physicians identify, manage, and perceive patients whom they diagnose with HCR. Methods We reviewed admission records from women’s general medicine wards in two public hospitals to determine how often and at what point during hospitalization patients received diagnoses of HCR. We also interviewed 13 physicians about their practices and perceptions related to HCR. Results Of 2520 women admitted to the selected wards in 2008, 6% received diagnoses of HCR. HCR patients had wide-ranging symptoms including respiratory distress, headaches, chest pain, convulsions, and abdominal complaints. Most doctors diagnosed HCR in patients who had any medically-unexplained physical symptom. According to physician reports, women admitted to medical wards for HCR received brief diagnostic evaluations and initial treatment with short-acting tranquilizers or placebo agents. Some were referred to outpatient psychiatric treatment. Physicians reported that repeated admissions for HCR were common. Physicians noted various social factors associated with HCR, and they described failures of the current system to meet psychosocial needs of HCR patients. Conclusions In these hospital settings, physicians assign HCR diagnoses frequently and based on vague criteria. We recommend providing education to increase general physicians’ awareness, skill, and comfort level when encountering somatization and other common psychiatric issues. Given limited diagnostic capacity for all patients, we raise concern that when HCR is used as a "wastebasket" diagnosis for unexplained symptoms, patients with treatable medical conditions may go unrecognized. We also advocate introducing non-physician hospital personnel to address

  12. [Clinical and histopathological features of myositis associated with anti-mitochondrial antibodies].

    Science.gov (United States)

    Shimizu, Jun

    2013-01-01

    Anti-mitochondrial antibodies (AMA) are known to be characteristic markers of primary biliary cirrhosis (PBC). The association of PBC with myositis has been reported mainly as case reports, and comprehensive studies of the clinical and histopathological features of patients with myositis and AMAs or PBC have not been conducted thus far. We retrospectively reviewed 212 patients with inflammatory myopathies in our laboratory and found 24 patients with AMA-positive myositis (11%) (seven patients with PBC and 17 patients without PBC). The analysis of clinical and histopathological features revealed that myositis associated with AMAs frequently include patients with a clinically chronic disease course, muscle atrophy, cardiopulmonary involvement and granulomatous inflammation, regardless of the presence or absence of PBC. We also reviewed and analyzed the clinical features of previously reported patients. The analysis of 75 patients, which have been described in previous case reports including the ones of meeting abstracts, also showed the similar results about clinical features of myositis associated with AMAs and supported our findings. Our study suggests that myositis associated with AMAs form a characteristic subgroup.

  13. Onychomatricoma with misleading features.

    Science.gov (United States)

    Fayol, J; Baran, R; Perrin, C; Labrousse, F

    2000-01-01

    Onychomatricoma is a rare tumour of the nail matrix with peculiar clinical and histological features and electron microscopic findings. We report on 5 cases with appearances which were misleading. Three presented as longitudinal melanonychia, a previously unreported observation. One case had the appearance of a cutaneous horn. In 3 of the 5 cases the tumour was associated with an onychomycosis and this may thus have been a predisposing factor in the secondary fungal infestation. Onychomatricoma appears as a multi-faceted tumour which can be mimicked by longitudinal melanonychia and/or onychomycosis.

  14. Patients with persistent medically unexplained physical symptoms: a descriptive study from Norwegian general practice.

    Science.gov (United States)

    Aamland, Aase; Malterud, Kirsti; Werner, Erik L

    2014-05-29

    Further research on effective interventions for patients with peristent Medically Unexplained Physical Symptoms (MUPS) in general practice is needed. Prevalence estimates of such patients are conflicting, and other descriptive knowledge is needed for development and evaluation of effective future interventions. In this study, we aimed to estimate the consultation prevalence of patients with persistent MUPS in general practice, including patients' characteristics and symptom pattern, employment status and use of social benefits, and the general practitioners' (GPs) management strategy. During a four-week period the participating Norwegian GPs (n=84) registered all consultations with patients who met a strict definition of MUPS (>3 months duration and function loss), using a questionnaire with simple tick-off questions. Analyses were performed with descriptive statistics for all variables and split analysis on gender and age. The GPs registered 526 patients among their total of 17 688 consultations, giving a consultation prevalence of persistent MUPS of 3%. The mean age of patients was 46 years, and 399 (76%) were women. The most frequent group of symptoms was musculoskeletal problems, followed by asthenia/fatigue. There was no significant gender difference in symptom pattern. Almost half of the patients were currently working (45%), significantly more men. The major GP management strategy was supportive counseling. A consultation prevalence rate of 3% implies that patients with persistent MUPS are common in general practice. Our study disclosed heterogeneity among the patients such as differences in employment status, which emphasizes the importance of personalized focus rather than unsubstantiated stereotyping of "MUPS patients" as a group.

  15. Somatoform disorders and rheumatic diseases: from DSM-IV to DSM-V.

    Science.gov (United States)

    Alciati, A; Atzeni, F; Sgiarovello, P; Sarzi-Puttini, P

    2014-06-06

    Medically unexplained symptoms are considered 'somatoform disorders' in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The introduction of this nosographic category has been helpful in drawing attention to a previously neglected area, but has not been successful in promoting an understanding of the disorders' biological basis and treatment implications, probably because of a series of diagnostic shortcomings. The newly proposed DSM-V diagnostic criteria try to overcome the limitations of the DSM-IV definition, which was organised centrally around the concept of medically unexplained symptoms, by emphasising the extent to which a patient's thoughts, feelings and behaviours concerning their somatic symptoms are disproportionate or excessive. This change is supported by a growing body of evidence showing that psychological and behavioural features play a major role in causing patient disability and maintaining high level of health care use. Pain disorders is the sub-category of DSM-IV somatoform disorders that most closely resembles fibromyalgia. Regardless of the diagnostic changes recently brought about by DSM-V, neuroimaging studies have identified important components of the mental processes associated with a DSM- IV diagnosis of pain disorder.

  16. Quadrilateral mesh fitting that preserves sharp features based on multi-normals for Laplacian energy

    Directory of Open Access Journals (Sweden)

    Yusuke Imai

    2014-04-01

    Full Text Available Because the cost of performance testing using actual products is expensive, manufacturers use lower-cost computer-aided design simulations for this function. In this paper, we propose using hexahedral meshes, which are more accurate than tetrahedral meshes, for finite element analysis. We propose automatic hexahedral mesh generation with sharp features to precisely represent the corresponding features of a target shape. Our hexahedral mesh is generated using a voxel-based algorithm. In our previous works, we fit the surface of the voxels to the target surface using Laplacian energy minimization. We used normal vectors in the fitting to preserve sharp features. However, this method could not represent concave sharp features precisely. In this proposal, we improve our previous Laplacian energy minimization by adding a term that depends on multi-normal vectors instead of using normal vectors. Furthermore, we accentuate a convex/concave surface subset to represent concave sharp features.

  17. Prospective Analysis on the Effect of Botanical Medicine (Tribulus terrestris) on Serum Testosterone Level and Semen Parameters in Males with Unexplained Infertility.

    Science.gov (United States)

    Roaiah, Mohamed Farid; Elkhayat, Yasser Ibrahim; Saleh, Sameh Fayek GamalEl Din; Abd El Salam, Mohamed Ahmed

    2016-06-23

    We evaluated the role of Tribulus terrestris in males with unexplained infertility and its effect on serum testosterone and semen parameters. Thirty randomized male patients presenting to Andrology outpatient clinic complaining of idiopathic infertility were selected. They were given Tribulus terrestris (750 mg) in three divided doses for three months. The effect of Tribulus terrestris on serum testosterone (total and free) and luteinizing hormone (LH), as well as its impact on semen parameters in those patients, was studied. No statistically significant difference was observed in the levels of testosterone (total and free) and LH and semen parameters (sperm concentration or motility, or abnormal forms) before and after the treatment. In addition, no statistically significant correlations were observed between testosterone (free and total) and LH and semen parameters before and after the treatment. Tribulus terrestris was ineffective in the treatment of idiopathic infertility.

  18. Hybrid feature selection for supporting lightweight intrusion detection systems

    Science.gov (United States)

    Song, Jianglong; Zhao, Wentao; Liu, Qiang; Wang, Xin

    2017-08-01

    Redundant and irrelevant features not only cause high resource consumption but also degrade the performance of Intrusion Detection Systems (IDS), especially when coping with big data. These features slow down the process of training and testing in network traffic classification. Therefore, a hybrid feature selection approach in combination with wrapper and filter selection is designed in this paper to build a lightweight intrusion detection system. Two main phases are involved in this method. The first phase conducts a preliminary search for an optimal subset of features, in which the chi-square feature selection is utilized. The selected set of features from the previous phase is further refined in the second phase in a wrapper manner, in which the Random Forest(RF) is used to guide the selection process and retain an optimized set of features. After that, we build an RF-based detection model and make a fair comparison with other approaches. The experimental results on NSL-KDD datasets show that our approach results are in higher detection accuracy as well as faster training and testing processes.

  19. The Effects of Total Motile Sperm Count on Spontaneous Pregnancy Rate and Pregnancy After IUI Treatment in Couples with Male Factor and Unexplained Infertility.

    Science.gov (United States)

    Hajder, Mithad; Hajder, Elmira; Husic, Amela

    2016-02-01

    Male infertility factor is defined if the total number of motile spermatozoa (TMSC) 3,10(6) / ejaculate and a spontaneous pregnancy, group (B) with TMSCl 3 x 10(6) / ejaculate and couples who have not achieved pregnancy. From a total of 98 pairs of men's and unexplained infertility, 42 of them (42.8%) achieved spontaneous pregnancy, while 56 (57.2%) pairs did not achieve spontaneous pregnancy. TMSC was significantly higher (42.4 ± 28.4 vs. 26.2 ± 24, p 20 x 10(6) / ejaculate (RR = 1.7, 95% CI: 1.56-1.82, 5 x 10(6) / ejaculate are indicated for treatment with IUI. TMSC can be used as the method of choice for diagnosis and treatment of male infertility.

  20. INTERNATIONAL TRADE AND UNEXPLAINED GENDER WAGE GAPS: EVIDENCE FOR AGRICULTURAL SECTOR IN BOLIVIA

    Directory of Open Access Journals (Sweden)

    Oscar Jorge Molina Tejerina

    2017-01-01

    Full Text Available The present investigation has the objective of showing evidence that there would be a reduction on wage differences between men and women in agriculture if they participate in international trade. The methodology that will be used is based on Molina[Mol10], who used Becker [Bec71] as a knowledge base for his study. This methodology consists on showing that wage difference occurs because of a taste for discrimination. This means that companies are willing to pay a higher salary to men just because they want to. But because international trade brings new competence to the markets, local companies need to be more competitive to survive. Therefore they wouldn’t be able to pay higher wages to men; this would reduce the wage difference by gender. Agriculture shows a different behavior from other sectors due to the strong agricultural subsidies governments give, De la Dehesa[Del03]. Using the Oaxaca-Blinder decomposition an estimate wage can be found for both men and women in tradable and non-tradable sectors of agriculture. At the same time two components will be found, one of them shows the difference produced by factors that affect the productivity of an individual. The second component shows the difference that cannot be explained, this is where discrimination is shown. Once these results are found they will be compared to find out if they are different in tradable and non-tradable sectors. The results that have been found show consistency with Molina’s study for the year 2002. Agriculture shows a behavioral difference from other economic sectors and different from Becker’s idea. As there is no unexplained wage difference by gender between tradable and non-tradable sectors. The results show that the difference is that these two sectors are the same. Thus international trade doesn’t result in a reduction of inequality in agriculture.

  1. The INeS study: prevention of multiple pregnancies: a randomised controlled trial comparing IUI COH versus IVF e SET versus MNC IVF in couples with unexplained or mild male subfertility

    Directory of Open Access Journals (Sweden)

    Beckers Nicole

    2009-12-01

    Full Text Available Abstract Background Multiple pregnancies are high risk pregnancies with higher chances of maternal and neonatal mortality and morbidity. In the past decades the number of multiple pregnancies has increased. This trend is partly due to the fact that women start family planning at an increased age, but also due to the increased use of ART. Couples with unexplained or mild male subfertility generally receive intrauterine insemination IUI with controlled hormonal stimulation (IUI COH. The cumulative pregnancy rate is 40%, with a 10% multiple pregnancy rate. This study aims to reveal whether alternative treatments such as IVF elective Single Embryo Transfer (IVF e SET or Modified Natural Cycle IVF (MNC IVF can reduce the number of multiple pregnancy rates, but uphold similar pregnancy rates as IUI COH in couples with mild male or unexplained subfertility. Secondly, the aim is to perform a cost effective analyses and assess treatment preference of these couples. Methods/Design We plan a multicentre randomised controlled clinical trial in the Netherlands comparing six cycles of intra-uterine insemination with controlled ovarian hyperstimulation or six cycles of Modified Natural Cycle (MNC IVF or three cycles with IVF-elective Single Embryo Transfer (eSET plus cryo-cycles within a time frame of 12 months. Couples with unexplained subfertility or mild male subfertility and a poor prognosis for treatment independent pregnancy will be included. Women with anovulatory cycles, severe endometriosis, double sided tubal pathology or serious endocrine illness will be excluded. Our primary outcome is the birth of a healthy singleton. Secondary outcomes are multiple pregnancy, treatment costs, and patient experiences in each treatment arm. The analysis will be performed according tot the intention to treat principle. We will test for non-inferiority of the three arms with respect to live birth. As we accept a 12.5% loss in pregnancy rate in one of the two IVF arms

  2. Predictors of pregnancy and live birth after insemination in couples with unexplained or male-factor infertility.

    Science.gov (United States)

    Huang, Hao; Hansen, Karl R; Factor-Litvak, Pamela; Carson, Sandra A; Guzick, David S; Santoro, Nanette; Diamond, Michael P; Eisenberg, Esther; Zhang, Heping

    2012-04-01

    To identify risk factors for pregnancy outcomes in couples treated with intracervical or intrauterine insemination, with or without superovulation for unexplained or male-factor infertility. Secondary analysis of data from a randomized superovulation and intrauterine insemination trial. Academic medical centers. Treatment continued for four cycles unless pregnancy was achieved. Out of 932 couples randomized to four treatment groups, 664 couples who had completed the lifestyle questionnaires were assessed for occurrence of pregnancy and live birth. Pregnancy and live birth. The pregnancy and live birth rates were significantly higher in couples in which the female partners reported that they had consumed coffee or tea in the past or drank alcoholic beverages in the past (past users) compared with those who had never consumed coffee, tea, or alcoholic beverages. Past users also had significantly higher pregnancy and live birth rates than those currently consuming coffee or tea or alcoholic beverages. Demographic, occupational exposure, and other lifestyle factors were not significant. Couples in which the female partners drank coffee, tea, or alcoholic beverages in the past had higher pregnancy and live birth rates compared with never or current users. When discontinuing these habits, they might have made other lifestyle changes to improve the pregnancy outcome. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Screening for primary creatine deficiencies in French patients with unexplained neurological symptoms

    Directory of Open Access Journals (Sweden)

    Cheillan David

    2012-12-01

    Full Text Available Abstract A population of patients with unexplained neurological symptoms from six major French university hospitals was screened over a 28-month period for primary creatine disorder (PCD. Urine guanidinoacetate (GAA and creatine:creatinine ratios were measured in a cohort of 6,353 subjects to identify PCD patients and compile their clinical, 1H-MRS, biochemical and molecular data. Six GAMT [N-guanidinoacetatemethyltransferase (EC 2.1.1.2] and 10 X-linked creatine transporter (SLC6A8 but no AGAT (GATM [L-arginine/glycine amidinotransferase (EC 2.1.4.1] deficient patients were identified in this manner. Three additional affected sibs were further identified after familial inquiry (1 brother with GAMT deficiency and 2 brothers with SLC6A8 deficiency in two different families. The prevalence of PCD in this population was 0.25% (0.09% and 0.16% for GAMT and SLC6A8 deficiencies, respectively. Seven new PCD-causing mutations were discovered (2 nonsense [c.577C > T and c.289C > T] and 1 splicing [c.391 + 15G > T] mutations for the GAMT gene and, 2 missense [c.1208C > A and c.926C > A], 1 frameshift [c.930delG] and 1 splicing [c.1393-1G > A] mutations for the SLC6A8 gene. No hot spot mutations were observed in these genes, as all the mutations were distributed throughout the entire gene sequences and were essentially patient/family specific. Approximately one fifth of the mutations of SLC6A8, but not GAMT, were attributed to neo-mutation, germinal or somatic mosaicism events. The only SLC6A8-deficient female patient in our series presented with the severe phenotype usually characterizing affected male patients, an observation in agreement with recent evidence that is in support of the fact that this X-linked disorder might be more frequent than expected in the female population with intellectual disability.

  4. Screening for primary creatine deficiencies in French patients with unexplained neurological symptoms

    Science.gov (United States)

    2012-01-01

    A population of patients with unexplained neurological symptoms from six major French university hospitals was screened over a 28-month period for primary creatine disorder (PCD). Urine guanidinoacetate (GAA) and creatine:creatinine ratios were measured in a cohort of 6,353 subjects to identify PCD patients and compile their clinical, 1H-MRS, biochemical and molecular data. Six GAMT [N-guanidinoacetatemethyltransferase (EC 2.1.1.2)] and 10 X-linked creatine transporter (SLC6A8) but no AGAT (GATM) [L-arginine/glycine amidinotransferase (EC 2.1.4.1)] deficient patients were identified in this manner. Three additional affected sibs were further identified after familial inquiry (1 brother with GAMT deficiency and 2 brothers with SLC6A8 deficiency in two different families). The prevalence of PCD in this population was 0.25% (0.09% and 0.16% for GAMT and SLC6A8 deficiencies, respectively). Seven new PCD-causing mutations were discovered (2 nonsense [c.577C > T and c.289C > T] and 1 splicing [c.391 + 15G > T] mutations for the GAMT gene and, 2 missense [c.1208C > A and c.926C > A], 1 frameshift [c.930delG] and 1 splicing [c.1393-1G > A] mutations for the SLC6A8 gene). No hot spot mutations were observed in these genes, as all the mutations were distributed throughout the entire gene sequences and were essentially patient/family specific. Approximately one fifth of the mutations of SLC6A8, but not GAMT, were attributed to neo-mutation, germinal or somatic mosaicism events. The only SLC6A8-deficient female patient in our series presented with the severe phenotype usually characterizing affected male patients, an observation in agreement with recent evidence that is in support of the fact that this X-linked disorder might be more frequent than expected in the female population with intellectual disability. PMID:23234264

  5. Association between hyperflexibility of the thumb and an unexplained bleeding tendency: is it a rule of thumb?

    Science.gov (United States)

    Kaplinsky, C; Kenet, G; Seligsohn, U; Rechavi, G

    1998-05-01

    A bleeding tendency manifested by petechiae and ecchymoses is one of the most common causes for referral of patients to haematology clinics. Vessel wall pathology is not usually considered to be a cause for deranged haemostasis, although coexistence of increased capillary fragility and joint hypermobility have been reported. We determined the frequency of thumb hyperextensibility and scored the findings in a series of 44 patients referred because of ecchymoses and petechiae, as well as 261 control children and their mothers. All 44 patients had normal coagulation studies. Thumb flexibility score was +4 in 30 patients, +3 in eight patients, +2 in five patients and +1 in one of the index patients. In the control group, only one of 261 had a +4, and three had a +3 score, and two of 260 mothers had a +4 score. Ecchymoses were not observed in any of these subjects, nor in the +1 patients. Based on clinical presentation and normal coagulation studies, we suggest that our patients had an underlying subtype of Ehlers-Danlos syndrome. In view of the dramatically high occurrence of thumb hyperextensibility in patients with unexplained mild bleeding tendency, costly haemostatic and coagulation studies on such patients may not be necessary.

  6. Histological image classification using biologically interpretable shape-based features

    International Nuclear Information System (INIS)

    Kothari, Sonal; Phan, John H; Young, Andrew N; Wang, May D

    2013-01-01

    Automatic cancer diagnostic systems based on histological image classification are important for improving therapeutic decisions. Previous studies propose textural and morphological features for such systems. These features capture patterns in histological images that are useful for both cancer grading and subtyping. However, because many of these features lack a clear biological interpretation, pathologists may be reluctant to adopt these features for clinical diagnosis. We examine the utility of biologically interpretable shape-based features for classification of histological renal tumor images. Using Fourier shape descriptors, we extract shape-based features that capture the distribution of stain-enhanced cellular and tissue structures in each image and evaluate these features using a multi-class prediction model. We compare the predictive performance of the shape-based diagnostic model to that of traditional models, i.e., using textural, morphological and topological features. The shape-based model, with an average accuracy of 77%, outperforms or complements traditional models. We identify the most informative shapes for each renal tumor subtype from the top-selected features. Results suggest that these shapes are not only accurate diagnostic features, but also correlate with known biological characteristics of renal tumors. Shape-based analysis of histological renal tumor images accurately classifies disease subtypes and reveals biologically insightful discriminatory features. This method for shape-based analysis can be extended to other histological datasets to aid pathologists in diagnostic and therapeutic decisions

  7. Sequence features responsible for intron retention in human

    Directory of Open Access Journals (Sweden)

    Sakabe Noboru

    2007-02-01

    Full Text Available Abstract Background One of the least common types of alternative splicing is the complete retention of an intron in a mature transcript. Intron retention (IR is believed to be the result of intron, rather than exon, definition associated with failure of the recognition of weak splice sites flanking short introns. Although studies on individual retained introns have been published, few systematic surveys of large amounts of data have been conducted on the mechanisms that lead to IR. Results TTo understand how sequence features are associated with or control IR, and to produce a generalized model that could reveal previously unknown signals that regulate this type of alternative splicing, we partitioned intron retention events observed in human cDNAs into two groups based on the relative abundance of both isoforms and compared relevant features. We found that a higher frequency of IR in human is associated with individual introns that have weaker splice sites, genes with shorter intron lengths, higher expression levels and lower density of both a set of exon splicing silencers (ESSs and the intronic splicing enhancer GGG. Both groups of retained introns presented events conserved in mouse, in which the retained introns were also short and presented weaker splice sites. Conclusion Although our results confirmed that weaker splice sites are associated with IR, they showed that this feature alone cannot explain a non-negligible fraction of events. Our analysis suggests that cis-regulatory elements are likely to play a crucial role in regulating IR and also reveals previously unknown features that seem to influence its occurrence. These results highlight the importance of considering the interplay among these features in the regulation of the relative frequency of IR.

  8. Evaluation of clinical and sonographic features in 55 children with tularemia.

    Science.gov (United States)

    Oz, Fatma; Eksioglu, Ayse; Tanır, Gonul; Bayhan, Gulsum; Metin, Özge; Teke, Turkan Aydın

    2014-08-01

    The aim of this study was to determine the clinical characteristics and sonographic features of lymphadenopathy (LAP) and to evaluate the treatment modalities and treatment outcomes in children with tularemia. Demographic characteristics, ultrasonographic and physical examination findings, and treatment outcomes in 55 tularemia patients (24 male and 31 female) with a mean age of 10.8 ± 4.0 years were analyzed retrospectively. Lymph node necrosis was classified in three stages based on ultrasound findings-stage 1, cortical microabscesses; stage 2, cortical and medullar abscesses; stage 3, total necrosis of the lymph node. In total, 50 (90%) of the patients had oropharyngeal, four (8%) had glandular, and one (2%) had oculoglandular tularemia. The most common symptoms were sore throat (67%) and fever (64%). LAP was the most frequently (100%) observed sign. Abscess formation was noted in 36 (65%) patients, of which seven (19%) were sonographically classified as stage 1, 20 (55%) as stage 2, and nine (26%) as stage 3. There was a statistically significant correlation between delayed treatment and stage of abscess formation in lymph nodes (p0.05). In all, nine (16%) of the patients did not respond to medical treatment, and surgical intervention was required. Tularemia should be considered in the differential diagnosis of children presenting with unexplained fever, sore throat, and cervical LAP in endemic areas. Sonographic findings may be useful in the evaluation and staging of this infection.

  9. SVM-based glioma grading. Optimization by feature reduction analysis

    International Nuclear Information System (INIS)

    Zoellner, Frank G.; Schad, Lothar R.; Emblem, Kyrre E.; Harvard Medical School, Boston, MA; Oslo Univ. Hospital

    2012-01-01

    We investigated the predictive power of feature reduction analysis approaches in support vector machine (SVM)-based classification of glioma grade. In 101 untreated glioma patients, three analytic approaches were evaluated to derive an optimal reduction in features; (i) Pearson's correlation coefficients (PCC), (ii) principal component analysis (PCA) and (iii) independent component analysis (ICA). Tumor grading was performed using a previously reported SVM approach including whole-tumor cerebral blood volume (CBV) histograms and patient age. Best classification accuracy was found using PCA at 85% (sensitivity = 89%, specificity = 84%) when reducing the feature vector from 101 (100-bins rCBV histogram + age) to 3 principal components. In comparison, classification accuracy by PCC was 82% (89%, 77%, 2 dimensions) and 79% by ICA (87%, 75%, 9 dimensions). For improved speed (up to 30%) and simplicity, feature reduction by all three methods provided similar classification accuracy to literature values (∝87%) while reducing the number of features by up to 98%. (orig.)

  10. SVM-based glioma grading. Optimization by feature reduction analysis

    Energy Technology Data Exchange (ETDEWEB)

    Zoellner, Frank G.; Schad, Lothar R. [University Medical Center Mannheim, Heidelberg Univ., Mannheim (Germany). Computer Assisted Clinical Medicine; Emblem, Kyrre E. [Massachusetts General Hospital, Charlestown, A.A. Martinos Center for Biomedical Imaging, Boston MA (United States). Dept. of Radiology; Harvard Medical School, Boston, MA (United States); Oslo Univ. Hospital (Norway). The Intervention Center

    2012-11-01

    We investigated the predictive power of feature reduction analysis approaches in support vector machine (SVM)-based classification of glioma grade. In 101 untreated glioma patients, three analytic approaches were evaluated to derive an optimal reduction in features; (i) Pearson's correlation coefficients (PCC), (ii) principal component analysis (PCA) and (iii) independent component analysis (ICA). Tumor grading was performed using a previously reported SVM approach including whole-tumor cerebral blood volume (CBV) histograms and patient age. Best classification accuracy was found using PCA at 85% (sensitivity = 89%, specificity = 84%) when reducing the feature vector from 101 (100-bins rCBV histogram + age) to 3 principal components. In comparison, classification accuracy by PCC was 82% (89%, 77%, 2 dimensions) and 79% by ICA (87%, 75%, 9 dimensions). For improved speed (up to 30%) and simplicity, feature reduction by all three methods provided similar classification accuracy to literature values ({proportional_to}87%) while reducing the number of features by up to 98%. (orig.)

  11. Origins of the 3.28 μm dust emission feature

    International Nuclear Information System (INIS)

    Gatley, I.

    1984-01-01

    Some practical problems encountered in making spectroscopic observations in the 3 - 4 μm wavelength range are discussed. Emphasis is placed on the interpretation of observations of the Galactic center, and their implications for the origins of the 3.28 μm dust emission feature. These observations suggest, in contrast to some previous analyses, that the carrier of the 3.28 μm feature may be a common, non-volatile component of interstellar grains. (author)

  12. Maternal homozygocity for a 14 basepair insertion in exon 8 of the HLA-G gene and carriage of HLA class II alleles restricting HY immunity predispose to unexplained secondary recurrent miscarriage and low birth weight in children born to these patients

    DEFF Research Database (Denmark)

    Christiansen, Ole B; Kolte, Astrid Marie; Dahl, Mette

    2012-01-01

    Homozygous carriage of a 14 base pair (bp) insertion in exon 8 of the HLA-G gene may be associated with low levels of soluble HLA-G and recurrent miscarriage (RM). We investigated the G14bp insertion(ins)/deletion(del) polymorphism in 339 women with unexplained RM and 125 control women. In all...

  13. Sonographic features of lethal multiple pterygium syndrome at 14 weeks.

    Science.gov (United States)

    Chen, Min; Chan, Gavin Shueng Wai; Lee, Chin Peng; Tang, Mary Hoi Yin

    2005-06-01

    Lethal multiple pterygium syndrome is a rare inherited disorder. Previous reports suggest that the diagnosis may be based on prenatal sonographic demonstration of severe limb flexion, absence of fetal motion, and a large cystic hygroma in the second and third trimesters. We present the sonographic features and postmortem features of a fetus with lethal multiple pterygium syndrome at 13 weeks of gestation, which shows that the condition can possibly be diagnosed in the first trimester of pregnancy.

  14. Effect of Pertubation on Pregnancy Rates before Intrauterine Insemination Treatment in Patients with Unexplained Infertility

    Directory of Open Access Journals (Sweden)

    Funda Yildiz

    2014-03-01

    Full Text Available Background: The aim of this study was to determine the relationship between marital violence and distress level among women with a diagnosis of infertility. Materials and Methods: In this prospective randomized study, a total of 180 patients were included in the study. Amongst these, pertubation of the uterine cavity was carried out in 79 patients prior to insemination. One patient in the pertubation group was later excluded because insemination could not be performed due to cycle cancellation. Results: There were no significant differences in demographic characteristics between the study and control groups. When the pregnancy rates of both groups were evaluated, 14(17.8% patients in the study group achieved pregancy. Three (3.8% had a biochemical pregnancy, 1(1.3% miscarried and 10(12.7% had live births. In the control group, a total of 24(23.8% pregnancies were achieved, amongst which one (1% had a biochemical pregnancy, 3(3% miscarried and 20(19.8% resulted in live births. There was no significant difference between groups in terms of total pregnancy and live birth rates (p>0.05. There was a 21% total pregnancy loss rate. There was no significant difference between the control and study groups in terms of pregnancy loss rates (p>0.05. Conclusion: This study on a homogenous group of unexplained infertile patients determined that the addition of pertubation to a controlled ovarian hyperstimulation plus intrauterine insemination (COH+IUI treatment protocol did not affect pregnancy rates (Registration Number: NCT01999959.

  15. The management of uterine fibroids in women with otherwise unexplained infertility.

    Science.gov (United States)

    Carranza-Mamane, Belina; Havelock, Jon; Hemmings, Robert

    2015-03-01

    addition to an assessment of fibroid size and location within the uterine cavity, evaluation of the degree of invasion of the cavity and thickness of residual myometrium to the serosa. A combination of hysteroscopy and transvaginal ultrasound or hysterosonography are the modalities of choice. (III-B) 3. Submucosal fibroids are managed hysteroscopically. The fibroid size should be women with otherwise unexplained infertility, submucosal fibroids should be removed in order to improve conception and pregnancy rates. (II-2A) 6. Removal of subserosal fibroids is not recommended. (III-D) 7. There is fair evidence to recommend against myomectomy in women with intramural fibroids (hysteroscopically confirmed intact endometrium) and otherwise unexplained infertility, regardless of their size. (II-2D) If the patient has no other options, the benefits of myomectomy should be weighed against the risks, and management of intramural fibroids should be individualized. (III-C) 8. If fibroids are removed abdominally, efforts should be made to use an anterior uterine incision to minimize the formation of postoperative adhesions. (II-2A) 9. Widespread use of the laparoscopic approach to myomectomy may be limited by the technical difficulty of this procedure. Patient selection should be individualized based on the number, size, and location of uterine fibroids and the skill of the surgeon. (III-A) 10. Women, fertile or infertile, seeking future pregnancy should not generally be offered uterine artery embolization as a treatment option for uterine fibroids. (II-3E).

  16. Oversampling the Minority Class in the Feature Space.

    Science.gov (United States)

    Perez-Ortiz, Maria; Gutierrez, Pedro Antonio; Tino, Peter; Hervas-Martinez, Cesar

    2016-09-01

    The imbalanced nature of some real-world data is one of the current challenges for machine learning researchers. One common approach oversamples the minority class through convex combination of its patterns. We explore the general idea of synthetic oversampling in the feature space induced by a kernel function (as opposed to input space). If the kernel function matches the underlying problem, the classes will be linearly separable and synthetically generated patterns will lie on the minority class region. Since the feature space is not directly accessible, we use the empirical feature space (EFS) (a Euclidean space isomorphic to the feature space) for oversampling purposes. The proposed method is framed in the context of support vector machines, where the imbalanced data sets can pose a serious hindrance. The idea is investigated in three scenarios: 1) oversampling in the full and reduced-rank EFSs; 2) a kernel learning technique maximizing the data class separation to study the influence of the feature space structure (implicitly defined by the kernel function); and 3) a unified framework for preferential oversampling that spans some of the previous approaches in the literature. We support our investigation with extensive experiments over 50 imbalanced data sets.

  17. Traumatic glaucoma with features of unilateral pigment dispersion.

    Science.gov (United States)

    Bowler, Gordon; Ellul, Antony; Gouws, Pieter

    2014-01-01

    We report a patient with traumatic glaucoma with features of unilateral pigment dispersion. This rare form of secondary glaucoma has only been reported twice previously, with both patients demonstrating angle recession, indicating associated damage to the trabecular meshwork. To our knowledge, this is the first such case reported in which angle recession was absent.

  18. A case-control study of sudden unexplained nocturnal death syndrome in the southern Chinese Han population.

    Science.gov (United States)

    Zheng, Jinxiang; Huang, Erwen; Tang, Shuangbo; Wu, Qiuping; Huang, Lei; Zhang, Dongchuan; Quan, Li; Liu, Chao; Cheng, Jianding

    2015-03-01

    To study the epidemiological characteristics of sudden unexplained nocturnal death syndrome (SUNDS) in the southern Chinese Han population during 2007 to 2013, we gathered 879 SUNDS victims from Dongguan City and in the Longgang District in Shenzhen City as the case group then selected 879 all-cause death cases, adopting a 1:1 pair method, as the control group I and collected 8142 all-cause death cases from the Bao'an District in Shenzhen City as the control group II, simultaneously. Case information collected was statistically analyzed. The annual incidence of SUNDS is 1.02 and 2.23 per 100,000 person-years for Dongguan City and in the Longgang District, respectively. The number of male and female victims is drastically different, with a ratio of 13.92:1, whereas the incidence between the 2 sexes is significantly different (χ2 = 78.734, P population is significant (χ2 = 767.12, P China, but the difference between the SUNDS victims and the all-cause death population is not significant (χ2 = 27.273, P > 0.05). The monthly incidence of SUNDS is relatively higher from March to June, whereas the difference of monthly distribution between SUNDS victims and all-cause death population is significant (χ2 = 9.869, P China and implicated that risk factors of this fatal disease still exist. The efficient strategy of early identification such as molecular diagnosis for SUNDS is extremely urgently required.

  19. Attention to internal face features in unfamiliar face matching.

    Science.gov (United States)

    Fletcher, Kingsley I; Butavicius, Marcus A; Lee, Michael D

    2008-08-01

    Accurate matching of unfamiliar faces is vital in security and forensic applications, yet previous research has suggested that humans often perform poorly when matching unfamiliar faces. Hairstyle and facial hair can strongly influence unfamiliar face matching but are potentially unreliable cues. This study investigated whether increased attention to the more stable internal face features of eyes, nose, and mouth was associated with more accurate face-matching performance. Forty-three first-year psychology students decided whether two simultaneously presented faces were of the same person or not. The faces were displayed for either 2 or 6 seconds, and had either similar or dissimilar hairstyles. The level of attention to internal features was measured by the proportion of fixation time spent on the internal face features and the sensitivity of discrimination to changes in external feature similarity. Increased attention to internal features was associated with increased discrimination in the 2-second display-time condition, but no significant relationship was found in the 6-second condition. Individual differences in eye-movements were highly stable across the experimental conditions.

  20. PyEEG: an open source Python module for EEG/MEG feature extraction.

    Science.gov (United States)

    Bao, Forrest Sheng; Liu, Xin; Zhang, Christina

    2011-01-01

    Computer-aided diagnosis of neural diseases from EEG signals (or other physiological signals that can be treated as time series, e.g., MEG) is an emerging field that has gained much attention in past years. Extracting features is a key component in the analysis of EEG signals. In our previous works, we have implemented many EEG feature extraction functions in the Python programming language. As Python is gaining more ground in scientific computing, an open source Python module for extracting EEG features has the potential to save much time for computational neuroscientists. In this paper, we introduce PyEEG, an open source Python module for EEG feature extraction.

  1. East Chestnut Ridge hydrogeologic characterization: A geophysical study of two karst features

    International Nuclear Information System (INIS)

    1991-01-01

    Permitting and site selection activities for the proposed East Chestnut Ridge landfill, located on the Oak Ridge Reservation, have required additional hydrogeologic studies of two karst features. Geophysical testing methods were utilized for investigating these karst features. The objectives of the geophysical testing was to determine the feasibility of geophysical techniques for locating subsurface karst features and to determine if subsurface anomalies exist at the proposed landfill site. Two karst features, one lacking surface expression (sinkhole) but with a known solution cavity at depth (from previous hydrologic studies), and the other with surface expression were tested with surface geophysical methods. Four geophysical profiles, two crossing and centered over each karst feature were collected using both gravimetric and electrical resistivity techniques

  2. Measuring Biometric Sample Quality in terms of Biometric Feature Information in Iris Images

    Directory of Open Access Journals (Sweden)

    R. Youmaran

    2012-01-01

    Full Text Available This paper develops an approach to measure the information content in a biometric feature representation of iris images. In this context, the biometric feature information is calculated using the relative entropy between the intraclass and interclass feature distributions. The collected data is regularized using a Gaussian model of the feature covariances in order to practically measure the biometric information with limited data samples. An example of this method is shown for iris templates processed using Principal-Component Analysis- (PCA- and Independent-Component Analysis- (ICA- based feature decomposition schemes. From this, the biometric feature information is calculated to be approximately 278 bits for PCA and 288 bits for ICA iris features using Masek's iris recognition scheme. This value approximately matches previous estimates of iris information content.

  3. Cardiovascular function in women with recurrent miscarriage, pre-eclampsia and/or intrauterine growth restriction.

    Science.gov (United States)

    Mahendru, Amita A; Everett, Thomas R; McEniery, Carmel M; Wilkinson, Ian B; Lees, Christoph C

    2013-03-01

    To investigate prepregnancy cardiovascular function and risk factors in women with previous pregnancy complications. Thirty-four women with previous normal pregnancy (controls), 26 with unexplained recurrent miscarriage (RM) and 14 with pre-eclampsia (PE) and/or intrauterine growth restriction (IUGR), planning to conceive were recruited. Brachial and central blood pressures (BP), cardiac output (CO), peripheral vascular resistance (PVR), aortic stiffness, blood biochemistry and platelet aggregation were assessed. Women with previous PE/IUGR had higher brachial diastolic BP (78 ± 9 vs 71 ± 7 mmHg; p = 0.03), central systolic BP (107 ± 10 vs 99 ± 8 mmHg; p = 0.03), mean arterial pressure (92 ± 10 vs 84 ± 8 mmHg; p = 0.01) and PVR (1499 ± 300 vs 1250 ± 220 dynes.s(-1) cm(-5); p = 0.005), than the controls. No differences were observed in either cardiovascular function or blood biochemistry in women with unexplained RM compared with the controls. Women with previous PE/IUGR though not with RM had a stronger family history of cardiovascular disease (CVD) than controls. Women with previous PE and/or IUGR had higher BP and PVR compared with controls, which may predispose them to CVD later in life. However, in the absence of underlying vascular pathology, women with unexplained RM did not have abnormal cardiovascular function. Prepregnancy period provides an opportunity to identify cardiovascular risks in relation to previous obstetric history.

  4. Multi-frequency direct sampling method in inverse scattering problem

    Science.gov (United States)

    Kang, Sangwoo; Lambert, Marc; Park, Won-Kwang

    2017-10-01

    We consider the direct sampling method (DSM) for the two-dimensional inverse scattering problem. Although DSM is fast, stable, and effective, some phenomena remain unexplained by the existing results. We show that the imaging function of the direct sampling method can be expressed by a Bessel function of order zero. We also clarify the previously unexplained imaging phenomena and suggest multi-frequency DSM to overcome traditional DSM. Our method is evaluated in simulation studies using both single and multiple frequencies.

  5. Efficient Topological Localization Using Global and Local Feature Matching

    Directory of Open Access Journals (Sweden)

    Junqiu Wang

    2013-03-01

    Full Text Available We present an efficient vision-based global topological localization approach in which different image features are used in a coarse-to-fine matching framework. Orientation Adjacency Coherence Histogram (OACH, a novel image feature, is proposed to improve the coarse localization. The coarse localization results are taken as inputs for the fine localization which is carried out by matching Harris-Laplace interest points characterized by the SIFT descriptor. The computation of OACHs and interest points is efficient due to the fact that these features are computed in an integrated process. The matching of local features is improved by using approximate nearest neighbor searching technique. We have implemented and tested the localization system in real environments. The experimental results demonstrate that our approach is efficient and reliable in both indoor and outdoor environments. This work has also been compared with previous works. The comparison results show that our approach has better performance with higher correct ratio and lower computational complexity.

  6. Junior doctors' experiences of managing patients with medically unexplained symptoms: a qualitative study.

    Science.gov (United States)

    Yon, Katherine; Nettleton, Sarah; Walters, Kate; Lamahewa, Kethakie; Buszewicz, Marta

    2015-12-01

    To explore junior doctors' knowledge about and experiences of managing patients with medically unexplained symptoms (MUS) and to seek their recommendations for improved future training on this important topic about which they currently receive little education. Qualitative study using in-depth interviews analysed using the framework method. Participants were recruited from three North Thames London hospitals within the UK. Twenty-two junior doctors undertaking the UK foundation two-year training programme (FY1/FY2). The junior doctors interviewed identified a significant gap in their training on the topic of MUS, particularly in relation to their awareness of the topic, the appropriate level of investigations, possible psychological comorbidities, the formulation of suitable explanations for patients' symptoms and longer term management strategies. Many junior doctors expressed feelings of anxiety, frustration and a self-perceived lack of competency in this area, and spoke of over-investigating patients or avoiding patient contact altogether due to the challenging nature of MUS and a difficulty in managing the accompanying uncertainty. They also identified the negative attitudes of some senior clinicians and potential role models towards patients with MUS as a factor contributing to their own attitudes and management choices. Most reported a need for more training during the foundation years, and recommended interactive case-based group discussions with a focus on providing meaningful explanations to patients for their symptoms. There is an urgent need to improve postgraduate training about the topics of MUS and avoiding over-investigation, as current training does not equip junior doctors with the necessary knowledge and skills to effectively and confidently manage patients in these areas. Training needs to focus on practical skill development to increase clinical knowledge in areas such as delivering suitable explanations, and to incorporate individual management

  7. Features of MCNP6

    International Nuclear Information System (INIS)

    Goorley, T.; James, M.; Booth, T.; Brown, F.; Bull, J.; Cox, L.J.; Durkee, J.; Elson, J.; Fensin, M.; Forster, R.A.; Hendricks, J.; Hughes, H.G.; Johns, R.; Kiedrowski, B.; Martz, R.; Mashnik, S.; McKinney, G.; Pelowitz, D.; Prael, R.; Sweezy, J.

    2016-01-01

    Highlights: • MCNP6 is simply and accurately described as the merger of MCNP5 and MCNPX capabilities, but it is much more than the sum of these two computer codes. • MCNP6 is the result of six years of effort by the MCNP5 and MCNPX code development teams. • These groups of people, residing in Los Alamos National Laboratory’s X Computational Physics Division, Monte Carlo Codes Group (XCP-3) and Nuclear Engineering and Nonproliferation Division, Radiation Transport Modeling Team (NEN-5) respectively, have combined their code development efforts to produce the next evolution of MCNP. • While maintenance and major bug fixes will continue for MCNP5 1.60 and MCNPX 2.7.0 for upcoming years, new code development capabilities only will be developed and released in MCNP6. • In fact, the initial release of MCNP6 contains numerous new features not previously found in either code. • These new features are summarized in this document. • Packaged with MCNP6 is also the new production release of the ENDF/B-VII.1 nuclear data files usable by MCNP. • The high quality of the overall merged code, usefulness of these new features, along with the desire in the user community to start using the merged code, have led us to make the first MCNP6 production release: MCNP6 version 1. • High confidence in the MCNP6 code is based on its performance with the verification and validation test suites, comparisons to its predecessor codes, our automated nightly software debugger tests, the underlying high quality nuclear and atomic databases, and significant testing by many beta testers. - Abstract: MCNP6 can be described as the merger of MCNP5 and MCNPX capabilities, but it is much more than the sum of these two computer codes. MCNP6 is the result of six years of effort by the MCNP5 and MCNPX code development teams. These groups of people, residing in Los Alamos National Laboratory’s X Computational Physics Division, Monte Carlo Codes Group (XCP-3) and Nuclear Engineering and

  8. Adaptive Feature Based Control of Compact Disk Players

    DEFF Research Database (Denmark)

    Odgaard, Peter Fogh; Stoustrup, Jakob; Vidal, Enrique Sanchez

    2005-01-01

    Many have experienced the problem that their Compact Disc players have difficulties playing Compact Discs with surface faults like scratches and fingerprints. The cause of this is due to the two servo control loops used to keep the Optical Pick-up Unit focused and radially on the information track...... of the Compact Disc. The problem is to design servo controllers which are well suited for handling surface faults which disturb the position measurement and still react sufficiently against normal disturbances like mechanical shocks. In previous work of the same authors a feature based control scheme for CD......-players playing CDs with surface fault is derived and described. This feature based control scheme uses precomputed base to remove the surface fault influence from the position measurements. In this paper an adaptive version of the feature based control scheme is proposed and described. This adaptive scheme can...

  9. High Prevalence of Exercise-Induced Laryngeal Obstruction in Athletes

    DEFF Research Database (Denmark)

    Walsted Nielsen, Emil; Hull, James H; Backer, Vibeke

    2013-01-01

    INTRODUCTION: Unexplained respiratory symptoms reported by athletes are often incorrectly considered secondary to exercise-induced asthma. We hypothesised that this may be related to exercise induced laryngeal obstruction (EILO). This study evaluates the prevalence of EILO in an unselected cohort......-one percent of athletes with EILO and negative bronchoprovocation and bronchodilator reversibility tests used regular asthma medication at referral. CONCLUSION: In athletes with unexplained respiratory symptoms, EILO is an important differential diagnosis not discerned from other aetiologies by clinical...... features. These findings have important implications for the assessment and management of athletes presenting with persistent respiratory symptoms despite asthma therapy....

  10. Role of Importance and Distinctiveness of Semantic Features in People with Aphasia: A Replication Study

    Science.gov (United States)

    Mason-Baughman, Mary Beth; Wallace, Sarah E.

    2014-01-01

    Previous studies suggest that people with aphasia have incomplete lexical-semantic representations with decreased low-importance distinctive (LID) feature knowledge. In addition, decreased LID feature knowledge correlates with ability to discriminate among semantically related words. The current study seeks to replicate and extend previous…

  11. MindDigger: Feature Identification and Opinion Association for Chinese Movie Reviews

    Science.gov (United States)

    Zhao, Lili; Li, Chunping

    In this paper, we present a prototype system called MindDigger, which can be used to analyze the opinions in Chinese movie reviews. Different from previous research that employed techniques on product reviews, we focus on Chinese movie reviews, in which opinions are expressed in subtle and varied ways. The system designed in this work aims to extract the opinion expressions and assign them to the corresponding features. The core tasks include feature and opinion extraction, and feature-opinion association. To deal with Chinese effectively, several novel approaches based on syntactic analysis are proposed in this paper. Running results show the performance is satisfactory.

  12. Understanding Quality Factor Degradation in Superconducting Niobium Cavities at Low Microwave Field Amplitudes

    Science.gov (United States)

    Romanenko, A.; Schuster, D. I.

    2017-12-01

    In niobium superconducting radio frequency (SRF) cavities for particle acceleration, a decrease of the quality factor at lower fields—a so-called low field Q slope or LFQS—has been a long-standing unexplained effect. By extending the high Q measurement techniques to ultralow fields, we discover two previously unknown features of the effect: (i) saturation at rf fields lower than Eacc˜0.1 MV /m ; (ii) strong degradation enhancement by growing thicker niobium pentoxide. Our findings suggest that the LFQS may be caused by the two level systems in the natural niobium oxide on the inner cavity surface, thereby identifying a new source of residual resistance and providing guidance for potential nonaccelerator low-field applications of SRF cavities.

  13. Prostate cancer detection: Fusion of cytological and textural features.

    Science.gov (United States)

    Nguyen, Kien; Jain, Anil K; Sabata, Bikash

    2011-01-01

    A computer-assisted system for histological prostate cancer diagnosis can assist pathologists in two stages: (i) to locate cancer regions in a large digitized tissue biopsy, and (ii) to assign Gleason grades to the regions detected in stage 1. Most previous studies on this topic have primarily addressed the second stage by classifying the preselected tissue regions. In this paper, we address the first stage by presenting a cancer detection approach for the whole slide tissue image. We propose a novel method to extract a cytological feature, namely the presence of cancer nuclei (nuclei with prominent nucleoli) in the tissue, and apply this feature to detect the cancer regions. Additionally, conventional image texture features which have been widely used in the literature are also considered. The performance comparison among the proposed cytological textural feature combination method, the texture-based method and the cytological feature-based method demonstrates the robustness of the extracted cytological feature. At a false positive rate of 6%, the proposed method is able to achieve a sensitivity of 78% on a dataset including six training images (each of which has approximately 4,000×7,000 pixels) and 1 1 whole-slide test images (each of which has approximately 5,000×23,000 pixels). All images are at 20X magnification.

  14. [Dermatological features of auto-inflammatory recurrent fevers].

    Science.gov (United States)

    Escudier, A; Mauvais, F-X; Bastard, P; Boussard, C; Jaoui, A; Koskas, V; Lecoq, E; Michel, A; Orcel, M-C; Truelle, P-E; Wohrer, D; Piram, M

    2018-02-01

    Auto-inflammatory diseases are characterized by unexplained and recurrent attacks of systemic inflammation often involving the skin, joints, or serosal membranes. They are due to a dysfunction or dysregulation of the innate immunity, which is the first line of defense against pathogens. Early recognition of these diseases by the clinician, especially by pediatricians encountering such pathologies in pediatric patients, is primordial to avoid complications. Skin manifestations, common in most auto-inflammatory diseases, are helpful for prompt diagnosis. After a brief physiopathological review, we will describe auto-inflammatory recurrent fevers by their main dermatological presentations: urticarial lesions, neutrophilic dermatoses, panniculitis, other maculopapular eruptions, dyskeratosis, skin vasculitis, and oral aphthous. We finally suggest a decision tree to help clinicians better target genetic exams in patients with recurrent fevers and dermatological manifestations. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  15. Prevalence and Characteristics of Infant's Unexplained Breast Preference for Nursing One Breast: A Self-Administered Survey.

    Science.gov (United States)

    Al-Abdi, Sameer Yaseen; Al Omran, Sadek Abdullah; Al-Aamri, Maryam Ali; Al Nasser, Mohammad Hasan; Al Omran, Abbas Moosa

    2015-12-01

    Breastfeeding is recommended by international bodies as the only source of infant nutrition during the first 6 months of life. Sometimes infants prefer to nurse on one breast for no obvious reason (hereafter called infant's unexplained breast preference [IUBP]). IUBP might reduce the rate of exclusive breastfeeding. The prevalence of IUBP is unknown because most of the literature on IUBP so far has been anecdotal. This study's objective was to investigate the prevalence and characteristics of IUBP among healthy infants in Al-Ahsa, Saudi Arabia. We conducted a population-based, cross-sectional study between March and August 2013 in the Al-Ahsa area, Eastern Province, Saudi Arabia. Healthy infants who had been born at full term (≥37 weeks of gestation) and were 2-24 months of age were included. We distributed 600 self-administered surveys to mothers who attended vaccination clinics in nine primary healthcare centers. Of 478 mothers who responded to the survey, 121 (25.3%) reported unilateral breastfeeding. IUBP was the most common reason for unilateral breastfeeding, with a prevalence of 13.6% (65/478). IUBP developed at a median age of 1 month (range, 1 day-9 months) and was familial in 42.9% of cases. It was the only reason for formula feeding during the first 6 months of life in 18.5% of cases. IUBP is common, develops very early in life, and can be familial and a reason for formula feeding. However, these findings need to be confirmed in other studies of other populations.

  16. What's 'difficult'? A multi-stage qualitative analysis of secondary care specialists' experiences with medically unexplained symptoms.

    Science.gov (United States)

    Maatz, Anke; Wainwright, Megan; Russell, Andrew J; Macnaughton, Jane; Yiannakou, Yan

    2016-11-01

    The term 'difficult' is pervasively used in relation to medically unexplained symptoms (MUS) and patients with MUS. This article scrutinises the use of the term by analysing interview data from a study of secondary care specialists' experiences with and attitudes towards patients suffering from MUS. Qualitative design employing semi-structured open-ended interviews systematically analysed in three stages: first, data were analysed according to the principles of content analysis. The analysis subsequently focused on the use of the term 'difficult'. Iterations of the term were extracted by summative analysis and thematic coding revealed its different meanings. Finally, alternative expressions were explored. Three NHS trust secondary care hospitals in North-East England. 17 senior clinicians from seven medical and two surgical specialities. Unsolicited use of the term 'difficult' was common. 'Difficult' was rarely used as a patient characteristic or to describe the therapeutic relationship. Participants used 'difficult' to describe their experience of diagnosing, explaining, communicating and managing these conditions and their own emotional reactions. Health care system deficits and the conceptual basis for MUS were other facets of 'difficult'. Participants also reported experiences that were rewarding and positive. This study shows that blanket statements such as 'difficult patients' mask the complexity of doctors' experiences in the context of MUS. Our nuanced analysis of the use of 'difficult' challenges preconceived attitudes. This can help counter the unreflexive perpetuation of negative evaluations that stigmatize patients with MUS, encourage greater acknowledgement of doctors' emotions, and lead to more appropriate conceptualizations and management of MUS. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Feature generation and representations for protein-protein interaction classification.

    Science.gov (United States)

    Lan, Man; Tan, Chew Lim; Su, Jian

    2009-10-01

    Automatic detecting protein-protein interaction (PPI) relevant articles is a crucial step for large-scale biological database curation. The previous work adopted POS tagging, shallow parsing and sentence splitting techniques, but they achieved worse performance than the simple bag-of-words representation. In this paper, we generated and investigated multiple types of feature representations in order to further improve the performance of PPI text classification task. Besides the traditional domain-independent bag-of-words approach and the term weighting methods, we also explored other domain-dependent features, i.e. protein-protein interaction trigger keywords, protein named entities and the advanced ways of incorporating Natural Language Processing (NLP) output. The integration of these multiple features has been evaluated on the BioCreAtIvE II corpus. The experimental results showed that both the advanced way of using NLP output and the integration of bag-of-words and NLP output improved the performance of text classification. Specifically, in comparison with the best performance achieved in the BioCreAtIvE II IAS, the feature-level and classifier-level integration of multiple features improved the performance of classification 2.71% and 3.95%, respectively.

  18. Neurological features of epilepsy, ataxia, sensorineural deafness, tubulopathy syndrome.

    OpenAIRE

    Cross, J. H.; Arora, R.; Heckemann, R. A.; Gunny, R.; Chong, K.; Carr, L.; Baldeweg, T.; Differ, A. M.; Lench, N.; Varadkar, S.; Sirimanna, T.; Wassmer, E.; Hulton, S. A.; Ognjanovic, M.; Ramesh, V.

    2013-01-01

    Recently, we reported a previously unrecognized symptom constellation comprising epilepsy, ataxia, sensorineural deafness, and tubulopathy (EAST syndrome) associated with recessive mutations in the KCNJ10 gene. Here, we provide a detailed characterization of the clinical features of the syndrome to aid patient management with respect to diagnosis, prognostic counselling, and identification of best treatment modalities.

  19. A prototype feature system for feature retrieval using relationships

    Science.gov (United States)

    Choi, J.; Usery, E.L.

    2009-01-01

    Using a feature data model, geographic phenomena can be represented effectively by integrating space, theme, and time. This paper extends and implements a feature data model that supports query and visualization of geographic features using their non-spatial and temporal relationships. A prototype feature-oriented geographic information system (FOGIS) is then developed and storage of features named Feature Database is designed. Buildings from the U.S. Marine Corps Base, Camp Lejeune, North Carolina and subways in Chicago, Illinois are used to test the developed system. The results of the applications show the strength of the feature data model and the developed system 'FOGIS' when they utilize non-spatial and temporal relationships in order to retrieve and visualize individual features.

  20. Clinical Features of Fatal Asthma

    Directory of Open Access Journals (Sweden)

    Chiung-Zuei Chen

    2006-05-01

    Full Text Available To characterize the clinical features of fatal asthma, we retrospectively analyzed the clinical characteristics of patients who died of an acute asthma attack in our hospital during a 15-year period from 1989 to 2003. Twelve patients had fatal asthma during this period, including eight who were dead on arrival in the emergency room (ER and three who died within 1 hour of admission to the ER. Patients were categorized into three groups according to the clinical presentations during the fatal attack: (1 rapid (< 3 hours decompensation in four patients; (2 gradual development of respiratory failure over several days in two patients; and (3 acute deterioration after unstable asthma lasting several days in six patients. All patients in groups 1 and 2 had reported previous near-fatal attacks. The proportion of young patients was highest in group 3, with half of them (3/6 younger than 35 years of age. Only one patient in group 3 had had a previous near-fatal attack. Five of the seven patients, with previous near-fatal attacks, had a pattern of decompensation during their fatal attack that was similar to their previous attacks. In conclusion, nearly all patients with fatal asthma in this study died outside of the hospital or within 1 hour after admission to the ER. Patients had patterns of decompensation during the fatal attack that were similar to those of their previous attacks. Early detection of warning signs, early admission to the ER, adequate treatment, and extremely close observation of patients, especially within 1 hour after ER arrival, may prevent or decrease the incidence of fatal asthmatic attack.

  1. Combining Deep and Handcrafted Image Features for Presentation Attack Detection in Face Recognition Systems Using Visible-Light Camera Sensors

    Directory of Open Access Journals (Sweden)

    Dat Tien Nguyen

    2018-02-01

    Full Text Available Although face recognition systems have wide application, they are vulnerable to presentation attack samples (fake samples. Therefore, a presentation attack detection (PAD method is required to enhance the security level of face recognition systems. Most of the previously proposed PAD methods for face recognition systems have focused on using handcrafted image features, which are designed by expert knowledge of designers, such as Gabor filter, local binary pattern (LBP, local ternary pattern (LTP, and histogram of oriented gradients (HOG. As a result, the extracted features reflect limited aspects of the problem, yielding a detection accuracy that is low and varies with the characteristics of presentation attack face images. The deep learning method has been developed in the computer vision research community, which is proven to be suitable for automatically training a feature extractor that can be used to enhance the ability of handcrafted features. To overcome the limitations of previously proposed PAD methods, we propose a new PAD method that uses a combination of deep and handcrafted features extracted from the images by visible-light camera sensor. Our proposed method uses the convolutional neural network (CNN method to extract deep image features and the multi-level local binary pattern (MLBP method to extract skin detail features from face images to discriminate the real and presentation attack face images. By combining the two types of image features, we form a new type of image features, called hybrid features, which has stronger discrimination ability than single image features. Finally, we use the support vector machine (SVM method to classify the image features into real or presentation attack class. Our experimental results indicate that our proposed method outperforms previous PAD methods by yielding the smallest error rates on the same image databases.

  2. Combining Deep and Handcrafted Image Features for Presentation Attack Detection in Face Recognition Systems Using Visible-Light Camera Sensors.

    Science.gov (United States)

    Nguyen, Dat Tien; Pham, Tuyen Danh; Baek, Na Rae; Park, Kang Ryoung

    2018-02-26

    Although face recognition systems have wide application, they are vulnerable to presentation attack samples (fake samples). Therefore, a presentation attack detection (PAD) method is required to enhance the security level of face recognition systems. Most of the previously proposed PAD methods for face recognition systems have focused on using handcrafted image features, which are designed by expert knowledge of designers, such as Gabor filter, local binary pattern (LBP), local ternary pattern (LTP), and histogram of oriented gradients (HOG). As a result, the extracted features reflect limited aspects of the problem, yielding a detection accuracy that is low and varies with the characteristics of presentation attack face images. The deep learning method has been developed in the computer vision research community, which is proven to be suitable for automatically training a feature extractor that can be used to enhance the ability of handcrafted features. To overcome the limitations of previously proposed PAD methods, we propose a new PAD method that uses a combination of deep and handcrafted features extracted from the images by visible-light camera sensor. Our proposed method uses the convolutional neural network (CNN) method to extract deep image features and the multi-level local binary pattern (MLBP) method to extract skin detail features from face images to discriminate the real and presentation attack face images. By combining the two types of image features, we form a new type of image features, called hybrid features, which has stronger discrimination ability than single image features. Finally, we use the support vector machine (SVM) method to classify the image features into real or presentation attack class. Our experimental results indicate that our proposed method outperforms previous PAD methods by yielding the smallest error rates on the same image databases.

  3. Combining Deep and Handcrafted Image Features for Presentation Attack Detection in Face Recognition Systems Using Visible-Light Camera Sensors

    Science.gov (United States)

    Nguyen, Dat Tien; Pham, Tuyen Danh; Baek, Na Rae; Park, Kang Ryoung

    2018-01-01

    Although face recognition systems have wide application, they are vulnerable to presentation attack samples (fake samples). Therefore, a presentation attack detection (PAD) method is required to enhance the security level of face recognition systems. Most of the previously proposed PAD methods for face recognition systems have focused on using handcrafted image features, which are designed by expert knowledge of designers, such as Gabor filter, local binary pattern (LBP), local ternary pattern (LTP), and histogram of oriented gradients (HOG). As a result, the extracted features reflect limited aspects of the problem, yielding a detection accuracy that is low and varies with the characteristics of presentation attack face images. The deep learning method has been developed in the computer vision research community, which is proven to be suitable for automatically training a feature extractor that can be used to enhance the ability of handcrafted features. To overcome the limitations of previously proposed PAD methods, we propose a new PAD method that uses a combination of deep and handcrafted features extracted from the images by visible-light camera sensor. Our proposed method uses the convolutional neural network (CNN) method to extract deep image features and the multi-level local binary pattern (MLBP) method to extract skin detail features from face images to discriminate the real and presentation attack face images. By combining the two types of image features, we form a new type of image features, called hybrid features, which has stronger discrimination ability than single image features. Finally, we use the support vector machine (SVM) method to classify the image features into real or presentation attack class. Our experimental results indicate that our proposed method outperforms previous PAD methods by yielding the smallest error rates on the same image databases. PMID:29495417

  4. Laparoscopy After Previous Laparotomy

    Directory of Open Access Journals (Sweden)

    Zulfo Godinjak

    2006-11-01

    Full Text Available Following the abdominal surgery, extensive adhesions often occur and they can cause difficulties during laparoscopic operations. However, previous laparotomy is not considered to be a contraindication for laparoscopy. The aim of this study is to present that an insertion of Veres needle in the region of umbilicus is a safe method for creating a pneumoperitoneum for laparoscopic operations after previous laparotomy. In the last three years, we have performed 144 laparoscopic operations in patients that previously underwent one or two laparotomies. Pathology of digestive system, genital organs, Cesarean Section or abdominal war injuries were the most common causes of previouslaparotomy. During those operations or during entering into abdominal cavity we have not experienced any complications, while in 7 patients we performed conversion to laparotomy following the diagnostic laparoscopy. In all patients an insertion of Veres needle and trocar insertion in the umbilical region was performed, namely a technique of closed laparoscopy. Not even in one patient adhesions in the region of umbilicus were found, and no abdominal organs were injured.

  5. Brain activity patterns uniquely supporting visual feature integration after traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Anjali eRaja Beharelle

    2011-12-01

    Full Text Available Traumatic brain injury (TBI patients typically respond more slowly and with more variability than controls during tasks of attention requiring speeded reaction time. These behavioral changes are attributable, at least in part, to diffuse axonal injury (DAI, which affects integrated processing in distributed systems. Here we use a multivariate method sensitive to distributed neural activity to compare brain activity patterns of patients with chronic phase moderate-to-severe TBI to those of controls during performance on a visual feature-integration task assessing complex attentional processes that has previously shown sensitivity to TBI. The TBI patients were carefully screened to be free of large focal lesions that can affect performance and brain activation independently of DAI. The task required subjects to hold either one or three features of a target in mind while suppressing responses to distracting information. In controls, the multi-feature condition activated a distributed network including limbic, prefrontal, and medial temporal structures. TBI patients engaged this same network in the single-feature and baseline conditions. In multi-feature presentations, TBI patients alone activated additional frontal, parietal, and occipital regions. These results are consistent with neuroimaging studies using tasks assessing different cognitive domains, where increased spread of brain activity changes was associated with TBI. Our results also extend previous findings that brain activity for relatively moderate task demands in TBI patients is similar to that associated with of high task demands in controls.

  6. Toward a Comprehensive Framework for Evaluating the Core Integration Features of Enterprise Integration Middleware Technologies

    Directory of Open Access Journals (Sweden)

    Hossein Moradi

    2013-01-01

    Full Text Available To achieve greater automation of their business processes, organizations face the challenge of integrating disparate systems. In attempting to overcome this problem, organizations are turning to different kinds of enterprise integration. Implementing enterprise integration is a complex task involving both technological and business challenges and requires appropriate middleware technologies. Different enterprise integration solutions provide various functions and features which lead to the complexity of their evaluation process. To overcome this complexity, appropriate tools for evaluating the core integration features of enterprise integration solutions is required. This paper proposes a new comprehensive framework for evaluating the core integration features of both intra-enterprise and inter-enterprise Integration's enabling technologies, which simplify the process of evaluating the requirements met by enterprise integration middleware technologies.The proposed framework for evaluating the core integration features of enterprise integration middleware technologies was enhanced using the structural and conceptual aspects of previous frameworks. It offers a new schema for which various enterprise integration middleware technologies are categorized in different classifications and are evaluated based on their supporting level for the core integration features' criteria. These criteria include the functional and supporting features. The proposed framework, which is a revised version of our previous framework in this area, has developed the scope, structure and content of the mentioned framework.

  7. Feature and Pose Constrained Visual Aided Inertial Navigation for Computationally Constrained Aerial Vehicles

    Science.gov (United States)

    Williams, Brian; Hudson, Nicolas; Tweddle, Brent; Brockers, Roland; Matthies, Larry

    2011-01-01

    A Feature and Pose Constrained Extended Kalman Filter (FPC-EKF) is developed for highly dynamic computationally constrained micro aerial vehicles. Vehicle localization is achieved using only a low performance inertial measurement unit and a single camera. The FPC-EKF framework augments the vehicle's state with both previous vehicle poses and critical environmental features, including vertical edges. This filter framework efficiently incorporates measurements from hundreds of opportunistic visual features to constrain the motion estimate, while allowing navigating and sustained tracking with respect to a few persistent features. In addition, vertical features in the environment are opportunistically used to provide global attitude references. Accurate pose estimation is demonstrated on a sequence including fast traversing, where visual features enter and exit the field-of-view quickly, as well as hover and ingress maneuvers where drift free navigation is achieved with respect to the environment.

  8. Feature-guided analysis for reduction of false positives in CAD of polyps for computed tomographic colonography

    International Nuclear Information System (INIS)

    Naeppi, Janne; Yoshida, Hiroyuki

    2003-01-01

    We evaluated the effect of our novel technique of feature-guided analysis of polyps on the reduction of false-positive (FP) findings generated by our computer-aided diagnosis (CAD) scheme for the detection of polyps from computed tomography colonographic data sets. The detection performance obtained by use of feature-guided analysis in the segmentation and feature analysis of polyp candidates was compared with that obtained by use of our previously employed fuzzy clustering technique. We also evaluated the effect of a feature called modified gradient concentration (MGC) on the detection performance. A total of 144 data sets, representing prone and supine views of 72 patients that included 14 patients with 21 colorectal polyps 5-25 mm in diameter, were used in the evaluation. At a 100% by-patient (95% by-polyp) detection sensitivity, the FP rate of our CAD scheme with feature-guided analysis based on round-robin evaluation was 1.3 (1.5) FP detections per patient. This corresponds to a 70-75 % reduction in the number of FPs obtained by use of fuzzy clustering at the same sensitivity levels. Application of the MGC feature instead of our previously used gradient concentration feature did not improve the detection result. The results indicate that feature-guided analysis is useful for achieving high sensitivity and a low FP rate in our CAD scheme

  9. Female Infertility Caused by Mutations in the Oocyte-Specific Translational Repressor PATL2

    KAUST Repository

    Maddirevula, Sateesh; Coskun, Serdar; Alhassan, Saad; Elnour, Atif; Alsaif, Hessa S.; Ibrahim, Niema; Abdulwahab, Firdous; Arold, Stefan T.; Alkuraya, Fowzan S.

    2017-01-01

    Infertility is a relatively common disorder of the reproductive system and remains unexplained in many cases. In vitro fertilization techniques have uncovered previously unrecognized infertility phenotypes, including oocyte maturation arrest

  10. Features of spatial and functional segregation and integration of the primate connectome revealed by trade-off between wiring cost and efficiency.

    Science.gov (United States)

    Chen, Yuhan; Wang, Shengjun; Hilgetag, Claus C; Zhou, Changsong

    2017-09-01

    The primate connectome, possessing a characteristic global topology and specific regional connectivity profiles, is well organized to support both segregated and integrated brain function. However, the organization mechanisms shaping the characteristic connectivity and its relationship to functional requirements remain unclear. The primate brain connectome is shaped by metabolic economy as well as functional values. Here, we explored the influence of two competing factors and additional advanced functional requirements on the primate connectome employing an optimal trade-off model between neural wiring cost and the representative functional requirement of processing efficiency. Moreover, we compared this model with a generative model combining spatial distance and topological similarity, with the objective of statistically reproducing multiple topological features of the network. The primate connectome indeed displays a cost-efficiency trade-off and that up to 67% of the connections were recovered by optimal combination of the two basic factors of wiring economy and processing efficiency, clearly higher than the proportion of connections (56%) explained by the generative model. While not explicitly aimed for, the trade-off model captured several key topological features of the real connectome as the generative model, yet better explained the connectivity of most regions. The majority of the remaining 33% of connections unexplained by the best trade-off model were long-distance links, which are concentrated on few cortical areas, termed long-distance connectors (LDCs). The LDCs are mainly non-hubs, but form a densely connected group overlapping on spatially segregated functional modalities. LDCs are crucial for both functional segregation and integration across different scales. These organization features revealed by the optimization analysis provide evidence that the demands of advanced functional segregation and integration among spatially distributed regions may

  11. MR, CT, and myelographic features of epidural lipomatosis

    International Nuclear Information System (INIS)

    Quint, D.J.; Boulos, R.S.; Patel, S.C.; Sanders, W.P.; Tiel, R.L.; Washington, J.M.

    1987-01-01

    Central deposition of fat is a well-known clinical feature of chronically elevated corticosteroid levels. Rarely described is increased extradural fat causing compression of the spinal cord and neurologic deficits. Twelve previously reported and five new cases of epidural lipomatosis are presented. Representative examples of the common myelographic and CT findings in this disorder are shown. In addition, previously undescribed examples of epidural lipomatosis demonstrating (1) the MR findings, (2) no associated myelographic block, (3) lipomatosis in both the thoracic and lumbar regions, and (4) a case in a nonobese patient without known steroid use are presented. The importance of considering this entity in the appropriate clinical setting (chronic exogenous steroid use) even with a normal myelogram is stressed

  12. Right-hemispheric processing of non-linguistic word features

    DEFF Research Database (Denmark)

    Baumgaertner, Annette; Hartwigsen, Gesa; Roman Siebner, Hartwig

    2013-01-01

    -hemispheric homologues of classic left-hemispheric language areas may partly be due to processing nonlinguistic perceptual features of verbal stimuli. We used functional MRI (fMRI) to clarify the role of the right hemisphere in the perception of nonlinguistic word features in healthy individuals. Participants made...... perceptual, semantic, or phonological decisions on the same set of auditorily and visually presented word stimuli. Perceptual decisions required judgements about stimulus-inherent changes in font size (visual modality) or fundamental frequency contour (auditory modality). The semantic judgement required......, the right inferior frontal gyrus (IFG), an area previously suggested to support language recovery after left-hemispheric stroke, displayed modality-independent activation during perceptual processing of word stimuli. Our findings indicate that activation of the right hemisphere during language tasks may...

  13. Non--Local Approach to the Analysis of the Stress Distribution in Granular Systems.

    Science.gov (United States)

    Scott, J. E.; Kenkre, V. M.; Hurd, A. J.

    1998-03-01

    A continuum mechanical theory of the stress distribution in granular materials is presented, where the transformation of the vertical spatial coordinate into a formal time variable converts the study of the static stress distribution into a generally non--Markoffian, i.e., memory-possessing (non-local) propagation analysis. Previous treatments (J. -P). Bouchaud, M. E. Cates, and P. Claudin, J. Phys. I France 5, 639 (1995). (C. -h). Liu, S. R. Nagel, D. A. Schecter, S. N. Coppersmith, S. Majumdar, O. Narayan, and T. A. Witten, Science 269, 513 (1995). are shown to be particular cases of our theory corresponding to, respectively, wave-like and dif fusive limits of the general evolution. Calculations are presented for the example of ceramic or metal powder compaction in dies, with emphasis on the understanding of previously unexplained features as seen in experimental data found in the literature o ver the past 50 years. Specific proposals for new experimental investigations are presented.

  14. Guanidinoacetate methyltransferase (GAMT) deficiency: late onset of movement disorder and preserved expressive language.

    Science.gov (United States)

    O'Rourke, Declan J; Ryan, Stephanie; Salomons, Gajja; Jakobs, Cornelis; Monavari, Ahmad; King, Mary D

    2009-05-01

    Guanidinoacetate methyltransferase (GAMT) deficiency is a disorder of creatine biosynthesis, characterized by early-onset learning disability and epilepsy in most affected children. Severe expressive language delay is a constant feature even in the mildest clinical phenotypes.We report the clinical, biochemical, imaging, and treatment data of two female siblings (18y and 13y) with an unusual phenotype of GAMT deficiency. The oldest sibling had subacute onset of a movement disorder at age 17 years, later than has been previously reported. The younger sibling had better language skills than previously described in this disorder. After treatment with creatine, arginine restriction and ornithine-supplemented diet, seizure severity and movement disorder were reduced but cognition did not improve. This report confirms that GAMT deficiency, a heterogeneous, potentially treatable disorder, detected by increased levels of guanidinoacetate in body fluids (e.g. plasma or urine) or by an abnormal creatine peak on magnetic resonance spectroscopy, should be considered in patients of any age with unexplained, apparently static learning disability and epilepsy.

  15. Sequence-based classification using discriminatory motif feature selection.

    Directory of Open Access Journals (Sweden)

    Hao Xiong

    Full Text Available Most existing methods for sequence-based classification use exhaustive feature generation, employing, for example, all k-mer patterns. The motivation behind such (enumerative approaches is to minimize the potential for overlooking important features. However, there are shortcomings to this strategy. First, practical constraints limit the scope of exhaustive feature generation to patterns of length ≤ k, such that potentially important, longer (> k predictors are not considered. Second, features so generated exhibit strong dependencies, which can complicate understanding of derived classification rules. Third, and most importantly, numerous irrelevant features are created. These concerns can compromise prediction and interpretation. While remedies have been proposed, they tend to be problem-specific and not broadly applicable. Here, we develop a generally applicable methodology, and an attendant software pipeline, that is predicated on discriminatory motif finding. In addition to the traditional training and validation partitions, our framework entails a third level of data partitioning, a discovery partition. A discriminatory motif finder is used on sequences and associated class labels in the discovery partition to yield a (small set of features. These features are then used as inputs to a classifier in the training partition. Finally, performance assessment occurs on the validation partition. Important attributes of our approach are its modularity (any discriminatory motif finder and any classifier can be deployed and its universality (all data, including sequences that are unaligned and/or of unequal length, can be accommodated. We illustrate our approach on two nucleosome occupancy datasets and a protein solubility dataset, previously analyzed using enumerative feature generation. Our method achieves excellent performance results, with and without optimization of classifier tuning parameters. A Python pipeline implementing the approach is

  16. Preoperative screening: value of previous tests.

    Science.gov (United States)

    Macpherson, D S; Snow, R; Lofgren, R P

    1990-12-15

    To determine the frequency of tests done in the year before elective surgery that might substitute for preoperative screening tests and to determine the frequency of test results that change from a normal value to a value likely to alter perioperative management. Retrospective cohort analysis of computerized laboratory data (complete blood count, sodium, potassium, and creatinine levels, prothrombin time, and partial thromboplastin time). Urban tertiary care Veterans Affairs Hospital. Consecutive sample of 1109 patients who had elective surgery in 1988. At admission, 7549 preoperative tests were done, 47% of which duplicated tests performed in the previous year. Of 3096 previous results that were normal as defined by hospital reference range and done closest to the time of but before admission (median interval, 2 months), 13 (0.4%; 95% CI, 0.2% to 0.7%), repeat values were outside a range considered acceptable for surgery. Most of the abnormalities were predictable from the patient's history, and most were not noted in the medical record. Of 461 previous tests that were abnormal, 78 (17%; CI, 13% to 20%) repeat values at admission were outside a range considered acceptable for surgery (P less than 0.001, frequency of clinically important abnormalities of patients with normal previous results with those with abnormal previous results). Physicians evaluating patients preoperatively could safely substitute the previous test results analyzed in this study for preoperative screening tests if the previous tests are normal and no obvious indication for retesting is present.

  17. Prostate cancer detection: Fusion of cytological and textural features

    Directory of Open Access Journals (Sweden)

    Kien Nguyen

    2011-01-01

    Full Text Available A computer-assisted system for histological prostate cancer diagnosis can assist pathologists in two stages: (i to locate cancer regions in a large digitized tissue biopsy, and (ii to assign Gleason grades to the regions detected in stage 1. Most previous studies on this topic have primarily addressed the second stage by classifying the preselected tissue regions. In this paper, we address the first stage by presenting a cancer detection approach for the whole slide tissue image. We propose a novel method to extract a cytological feature, namely the presence of cancer nuclei (nuclei with prominent nucleoli in the tissue, and apply this feature to detect the cancer regions. Additionally, conventional image texture features which have been widely used in the literature are also considered. The performance comparison among the proposed cytological textural feature combination method, the texture-based method and the cytological feature-based method demonstrates the robustness of the extracted cytological feature. At a false positive rate of 6%, the proposed method is able to achieve a sensitivity of 78% on a dataset including six training images (each of which has approximately 4,000x7,000 pixels and 1 1 whole-slide test images (each of which has approximately 5,000x23,000 pixels. All images are at 20X magnification.

  18. Enhancing facial features by using clear facial features

    Science.gov (United States)

    Rofoo, Fanar Fareed Hanna

    2017-09-01

    The similarity of features between individuals of same ethnicity motivated the idea of this project. The idea of this project is to extract features of clear facial image and impose them on blurred facial image of same ethnic origin as an approach to enhance a blurred facial image. A database of clear images containing 30 individuals equally divided to five different ethnicities which were Arab, African, Chines, European and Indian. Software was built to perform pre-processing on images in order to align the features of clear and blurred images. And the idea was to extract features of clear facial image or template built from clear facial images using wavelet transformation to impose them on blurred image by using reverse wavelet. The results of this approach did not come well as all the features did not align together as in most cases the eyes were aligned but the nose or mouth were not aligned. Then we decided in the next approach to deal with features separately but in the result in some cases a blocky effect was present on features due to not having close matching features. In general the available small database did not help to achieve the goal results, because of the number of available individuals. The color information and features similarity could be more investigated to achieve better results by having larger database as well as improving the process of enhancement by the availability of closer matches in each ethnicity.

  19. Spatial features register: toward standardization of spatial features

    Science.gov (United States)

    Cascio, Janette

    1994-01-01

    As the need to share spatial data increases, more than agreement on a common format is needed to ensure that the data is meaningful to both the importer and the exporter. Effective data transfer also requires common definitions of spatial features. To achieve this, part 2 of the Spatial Data Transfer Standard (SDTS) provides a model for a spatial features data content specification and a glossary of features and attributes that fit this model. The model provides a foundation for standardizing spatial features. The glossary now contains only a limited subset of hydrographic and topographic features. For it to be useful, terms and definitions must be included for other categories, such as base cartographic, bathymetric, cadastral, cultural and demographic, geodetic, geologic, ground transportation, international boundaries, soils, vegetation, water, and wetlands, and the set of hydrographic and topographic features must be expanded. This paper will review the philosophy of the SDTS part 2 and the current plans for creating a national spatial features register as one mechanism for maintaining part 2.

  20. More than one kind of inference: re-examining what's learned in feature inference and classification.

    Science.gov (United States)

    Sweller, Naomi; Hayes, Brett K

    2010-08-01

    Three studies examined how task demands that impact on attention to typical or atypical category features shape the category representations formed through classification learning and inference learning. During training categories were learned via exemplar classification or by inferring missing exemplar features. In the latter condition inferences were made about missing typical features alone (typical feature inference) or about both missing typical and atypical features (mixed feature inference). Classification and mixed feature inference led to the incorporation of typical and atypical features into category representations, with both kinds of features influencing inferences about familiar (Experiments 1 and 2) and novel (Experiment 3) test items. Those in the typical inference condition focused primarily on typical features. Together with formal modelling, these results challenge previous accounts that have characterized inference learning as producing a focus on typical category features. The results show that two different kinds of inference learning are possible and that these are subserved by different kinds of category representations.

  1. Feature selection based on SVM significance maps for classification of dementia

    NARCIS (Netherlands)

    E.E. Bron (Esther); M. Smits (Marion); J.C. van Swieten (John); W.J. Niessen (Wiro); S. Klein (Stefan)

    2014-01-01

    textabstractSupport vector machine significance maps (SVM p-maps) previously showed clusters of significantly different voxels in dementiarelated brain regions. We propose a novel feature selection method for classification of dementia based on these p-maps. In our approach, the SVM p-maps are

  2. Antiphospholipid syndrome in northwest Italy (APS Piedmont Cohort): demographic features, risk factors, clinical and laboratory profile.

    Science.gov (United States)

    Bertero, M T; Bazzan, M; Carignola, R; Montaruli, B; Silvestro, E; Sciascia, S; Vaccarino, A; Baldovino, S; Roccatello, D

    2012-06-01

    We report the experience from the Antiphospholipid Antibodies (aPL) Regional Consortium in northwest Italy, meant to support clinical research and foster collaboration among health professionals regarding the diagnosis and management of antiphospholipid syndrome (APS) patients. This cohort-study (APS Piedmont Cohort) was designed to register the clinical characteristics at inception and associated immunological manifestations at diagnosis (if any) of patients who strictly fulfilled the current criteria for APS, all recruited at the Piedmont and Valle d'Aosta regions. Clinical and laboratory data from 217 APS patients (171 with vascular events, 33 with pregnancy morbidity and 13 with both), from 16 centres within the geographical area were collected. Venous thrombosis was recorded in 45.6% of patients, arterial thrombosis in 35%, small-vessel thrombosis in 1.12% and mixed arterial and venous thrombosis in the remaining 19.4% of the cases. Pregnancy morbidity included 19 patients with unexplained fetal death beyond the 10th week of pregnancy, 17 with premature birth before the 34th week and 10 with three or more unexplained spontaneous abortions before the 10th week of gestation. This consortium represents an instrument by which to audit clinical practice, to provide counselling to local centres and to sustain future basic and clinical APS research.

  3. Predictors of Pregnancy and Live Birth in Couples with Unexplained or Male-factor Infertility after Insemination

    Science.gov (United States)

    Huang, Hao; Hansen, Karl R.; Factor-Litvak, Pamela; Carson, Sandra A.; Guzick, David S.; Santoro, Nanette; Diamond, Michael P.; Eisenberg, Esther; Zhang, Heping

    2012-01-01

    Objective To identify risk factors for pregnancy outcomes in couples treated with intracervical or intrauterine insemination, with or without superovulation for unexplained or male-factor infertility. The treatment continued for four cycles unless pregnancy was achieved. Design Secondary analysis of data from a randomized superovulation and intrauterine insemination trial. Setting Academic medical centers. Intervention(s) None. Patients Out of 932 couples randomized to four treatment groups, 664 couples who had completed the lifestyle questionnaires were assessed for occurrence of pregnancy and live birth. Main outcome measure(s) pregnancy and live birth. Results The pregnancy and live birth rates were significantly higher in couples in which the female partners reported that they had consumed coffee or tea in the past or drank alcoholic beverages in the past (past users) when compared to those who had never consumed coffee or tea (4.0, 1.6–10.2 for pregnancy; 3.1, 1.2–8.1 for live birth) or alcoholic beverages (1.9, 1.1–3.3 for pregnancy; 2.1, 1.2–3.7 for live birth) (data are adjusted odds ratio and 95% confidence interval). Past users also had significantly higher pregnancy and live birth rates than those who were currently consuming coffee or tea or alcoholic beverages. Demographic, occupational exposures and other lifestyle factors were not significant. Conclusion(s) Couples in which the female partners drank coffee, tea, or alcoholic beverages in the past had higher pregnancy and live birth rates when compared to never or current users. When discontinuing these habits, they might have made other lifestyle changes to improve the pregnancy outcome. PMID:22270557

  4. Atypical findings on computed tomography in tuberous sclerosis

    International Nuclear Information System (INIS)

    Glass, R.B.J.; Mendelsohn, D.B.; Hertzanu, Y.

    1984-01-01

    In 3 patients with tuberous sclerosis computed tomography showed numerous low-density areas suggestive of brain demyelination. In addition, solitary small subependymal calcifications were noted. These features in an infant or child with unexplained seizures should alert one to the diagnosis of tuberous sclerosis

  5. FEATURE SELECTION METHODS BASED ON MUTUAL INFORMATION FOR CLASSIFYING HETEROGENEOUS FEATURES

    Directory of Open Access Journals (Sweden)

    Ratri Enggar Pawening

    2016-06-01

    Full Text Available Datasets with heterogeneous features can affect feature selection results that are not appropriate because it is difficult to evaluate heterogeneous features concurrently. Feature transformation (FT is another way to handle heterogeneous features subset selection. The results of transformation from non-numerical into numerical features may produce redundancy to the original numerical features. In this paper, we propose a method to select feature subset based on mutual information (MI for classifying heterogeneous features. We use unsupervised feature transformation (UFT methods and joint mutual information maximation (JMIM methods. UFT methods is used to transform non-numerical features into numerical features. JMIM methods is used to select feature subset with a consideration of the class label. The transformed and the original features are combined entirely, then determine features subset by using JMIM methods, and classify them using support vector machine (SVM algorithm. The classification accuracy are measured for any number of selected feature subset and compared between UFT-JMIM methods and Dummy-JMIM methods. The average classification accuracy for all experiments in this study that can be achieved by UFT-JMIM methods is about 84.47% and Dummy-JMIM methods is about 84.24%. This result shows that UFT-JMIM methods can minimize information loss between transformed and original features, and select feature subset to avoid redundant and irrelevant features.

  6. A feature-based approach to modeling protein-protein interaction hot spots.

    Science.gov (United States)

    Cho, Kyu-il; Kim, Dongsup; Lee, Doheon

    2009-05-01

    Identifying features that effectively represent the energetic contribution of an individual interface residue to the interactions between proteins remains problematic. Here, we present several new features and show that they are more effective than conventional features. By combining the proposed features with conventional features, we develop a predictive model for interaction hot spots. Initially, 54 multifaceted features, composed of different levels of information including structure, sequence and molecular interaction information, are quantified. Then, to identify the best subset of features for predicting hot spots, feature selection is performed using a decision tree. Based on the selected features, a predictive model for hot spots is created using support vector machine (SVM) and tested on an independent test set. Our model shows better overall predictive accuracy than previous methods such as the alanine scanning methods Robetta and FOLDEF, and the knowledge-based method KFC. Subsequent analysis yields several findings about hot spots. As expected, hot spots have a larger relative surface area burial and are more hydrophobic than other residues. Unexpectedly, however, residue conservation displays a rather complicated tendency depending on the types of protein complexes, indicating that this feature is not good for identifying hot spots. Of the selected features, the weighted atomic packing density, relative surface area burial and weighted hydrophobicity are the top 3, with the weighted atomic packing density proving to be the most effective feature for predicting hot spots. Notably, we find that hot spots are closely related to pi-related interactions, especially pi . . . pi interactions.

  7. A feature-based approach to modeling protein–protein interaction hot spots

    Science.gov (United States)

    Cho, Kyu-il; Kim, Dongsup; Lee, Doheon

    2009-01-01

    Identifying features that effectively represent the energetic contribution of an individual interface residue to the interactions between proteins remains problematic. Here, we present several new features and show that they are more effective than conventional features. By combining the proposed features with conventional features, we develop a predictive model for interaction hot spots. Initially, 54 multifaceted features, composed of different levels of information including structure, sequence and molecular interaction information, are quantified. Then, to identify the best subset of features for predicting hot spots, feature selection is performed using a decision tree. Based on the selected features, a predictive model for hot spots is created using support vector machine (SVM) and tested on an independent test set. Our model shows better overall predictive accuracy than previous methods such as the alanine scanning methods Robetta and FOLDEF, and the knowledge-based method KFC. Subsequent analysis yields several findings about hot spots. As expected, hot spots have a larger relative surface area burial and are more hydrophobic than other residues. Unexpectedly, however, residue conservation displays a rather complicated tendency depending on the types of protein complexes, indicating that this feature is not good for identifying hot spots. Of the selected features, the weighted atomic packing density, relative surface area burial and weighted hydrophobicity are the top 3, with the weighted atomic packing density proving to be the most effective feature for predicting hot spots. Notably, we find that hot spots are closely related to π–related interactions, especially π · · · π interactions. PMID:19273533

  8. Feature Selection Has a Large Impact on One-Class Classification Accuracy for MicroRNAs in Plants.

    Science.gov (United States)

    Yousef, Malik; Saçar Demirci, Müşerref Duygu; Khalifa, Waleed; Allmer, Jens

    2016-01-01

    MicroRNAs (miRNAs) are short RNA sequences involved in posttranscriptional gene regulation. Their experimental analysis is complicated and, therefore, needs to be supplemented with computational miRNA detection. Currently computational miRNA detection is mainly performed using machine learning and in particular two-class classification. For machine learning, the miRNAs need to be parametrized and more than 700 features have been described. Positive training examples for machine learning are readily available, but negative data is hard to come by. Therefore, it seems prerogative to use one-class classification instead of two-class classification. Previously, we were able to almost reach two-class classification accuracy using one-class classifiers. In this work, we employ feature selection procedures in conjunction with one-class classification and show that there is up to 36% difference in accuracy among these feature selection methods. The best feature set allowed the training of a one-class classifier which achieved an average accuracy of ~95.6% thereby outperforming previous two-class-based plant miRNA detection approaches by about 0.5%. We believe that this can be improved upon in the future by rigorous filtering of the positive training examples and by improving current feature clustering algorithms to better target pre-miRNA feature selection.

  9. PyEEG: An Open Source Python Module for EEG/MEG Feature Extraction

    OpenAIRE

    Bao, Forrest Sheng; Liu, Xin; Zhang, Christina

    2011-01-01

    Computer-aided diagnosis of neural diseases from EEG signals (or other physiological signals that can be treated as time series, e.g., MEG) is an emerging field that has gained much attention in past years. Extracting features is a key component in the analysis of EEG signals. In our previous works, we have implemented many EEG feature extraction functions in the Python programming language. As Python is gaining more ground in scientific computing, an open source Python module for extracting ...

  10. Learning about the internal structure of categories through classification and feature inference.

    Science.gov (United States)

    Jee, Benjamin D; Wiley, Jennifer

    2014-01-01

    Previous research on category learning has found that classification tasks produce representations that are skewed toward diagnostic feature dimensions, whereas feature inference tasks lead to richer representations of within-category structure. Yet, prior studies often measure category knowledge through tasks that involve identifying only the typical features of a category. This neglects an important aspect of a category's internal structure: how typical and atypical features are distributed within a category. The present experiments tested the hypothesis that inference learning results in richer knowledge of internal category structure than classification learning. We introduced several new measures to probe learners' representations of within-category structure. Experiment 1 found that participants in the inference condition learned and used a wider range of feature dimensions than classification learners. Classification learners, however, were more sensitive to the presence of atypical features within categories. Experiment 2 provided converging evidence that classification learners were more likely to incorporate atypical features into their representations. Inference learners were less likely to encode atypical category features, even in a "partial inference" condition that focused learners' attention on the feature dimensions relevant to classification. Overall, these results are contrary to the hypothesis that inference learning produces superior knowledge of within-category structure. Although inference learning promoted representations that included a broad range of category-typical features, classification learning promoted greater sensitivity to the distribution of typical and atypical features within categories.

  11. Predicting protein amidation sites by orchestrating amino acid sequence features

    Science.gov (United States)

    Zhao, Shuqiu; Yu, Hua; Gong, Xiujun

    2017-08-01

    Amidation is the fourth major category of post-translational modifications, which plays an important role in physiological and pathological processes. Identifying amidation sites can help us understanding the amidation and recognizing the original reason of many kinds of diseases. But the traditional experimental methods for predicting amidation sites are often time-consuming and expensive. In this study, we propose a computational method for predicting amidation sites by orchestrating amino acid sequence features. Three kinds of feature extraction methods are used to build a feature vector enabling to capture not only the physicochemical properties but also position related information of the amino acids. An extremely randomized trees algorithm is applied to choose the optimal features to remove redundancy and dependence among components of the feature vector by a supervised fashion. Finally the support vector machine classifier is used to label the amidation sites. When tested on an independent data set, it shows that the proposed method performs better than all the previous ones with the prediction accuracy of 0.962 at the Matthew's correlation coefficient of 0.89 and area under curve of 0.964.

  12. Training tomorrow's doctors to explain 'medically unexplained' physical symptoms: An examination of UK medical educators' views of barriers and solutions.

    Science.gov (United States)

    Joyce, Emmeline; Cowing, Jennifer; Lazarus, Candice; Smith, Charlotte; Zenzuck, Victoria; Peters, Sarah

    2018-05-01

    Co-occuring physical symptoms, unexplained by organic pathology (known as Functional Syndromes, FS), are common and disabling presentations. However, FS is absent or inconsistently taught within undergraduate medical training. This study investigates the reasons for this and identifies potential solutions to improved implementation. Twenty-eight medical educators from thirteen different UK medical schools participated in semi-structured interviews. Thematic analysis proceeded iteratively, and in parallel with data production. Barriers to implementing FS training are beliefs about the complexity of FS, tutors' negative attitudes towards FS, and FS being perceived as a low priority for the curriculum. In parallel participants recognised FS as ubiquitous within medical practice and erroneously assumed it must be taught by someone. They recommended that students should learn about FS through managed exposure, but only if tutors' negative attitudes and behaviour are also addressed. Negative attitudes towards FS by educators prevents designing and delivering effective education on this common medical presentation. Whilst there is recognition of the need to implement FS training, recommendations are multifaceted. Increased liaison between students, patients and educators is necessary to develop more informed and effective teaching methods for trainee doctors about FS and in order to minimise the impact of the hidden curriculum. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  13. The interpretation of low mood and worry by high users of secondary care with medically unexplained symptoms

    Directory of Open Access Journals (Sweden)

    Weller David

    2011-10-01

    Full Text Available Abstract Background Around 1% of adults are repeatedly referred from primary to secondary care with medically unexplained symptoms (MUS; many of these patients have depression and anxiety disorders which are unrecognized or inadequately treated. We aimed to investigate the ways patients with MUS and their General Practitioners (GPs interpret low mood and worry, whether they regard them as depressive or anxiety disorders and how they relate them causally to symptoms. Methods We carried out semi-structured interviews with 27 patients who had been repeatedly referred to specialists for MUS and their GPs and analysed transcripts by qualitative comparison. The analysis examined themes relating to low mood and worry, and their influence on symptoms. It drew on the concept of "otherness", whereby mental phenomena can be located either within the self or as separate entities. Results Both patients and GPs acknowledged the presence of low mood and worry. They viewed low mood as either an individual's personal response to circumstances (including their physical symptoms or as the illness called "depression"; only the latter was amenable to medical intervention. Worry was seen as a trait rather than as a symptom of an anxiety disorder. While low mood and worry were acknowledged to influence physical symptoms, they were considered insufficient to be the main cause by either the patients or their doctors. Conclusions Patients with MUS who are high users of secondary care services interpret low mood and worry in ways which allow them to be discussed with professionals, but not as the cause of their physical symptoms.

  14. PHACES syndrome: a review of eight previously unreported cases with late arterial occlusions

    International Nuclear Information System (INIS)

    Bhattacharya, J.J.; Luo, C.B.; Alvarez, H.; Rodesch, G.; Lasjaunias, P.L.; Pongpech, S.

    2004-01-01

    PHACE and PHACES are acronyms for a syndrome of variable expression comprising posterior cranial fossa malformations, facial haemangiomas, arterial anomalies, aortic coarctation and other cardiac disorders, ocular abnormalities and stenotic arterial disease. We review five girls and three boys aged 1 month-14 years with disorders from this spectrum. Six had large facial haemangiomas but recent reports suggest that small haemangiomas may occur; hence our inclusion of two possible cases. We also focus on the recently recognised feature of progressive intracranial arterial occlusions, present in four of our patients, later than previously recognised, from 4 to 14 years of age. We suggest that many elements of this disorder could reflect an abnormality of cell proliferation and apoptosis. (orig.)

  15. Learning probabilistic features for robotic navigation using laser sensors.

    Directory of Open Access Journals (Sweden)

    Fidel Aznar

    Full Text Available SLAM is a popular task used by robots and autonomous vehicles to build a map of an unknown environment and, at the same time, to determine their location within the map. This paper describes a SLAM-based, probabilistic robotic system able to learn the essential features of different parts of its environment. Some previous SLAM implementations had computational complexities ranging from O(Nlog(N to O(N(2, where N is the number of map features. Unlike these methods, our approach reduces the computational complexity to O(N by using a model to fuse the information from the sensors after applying the Bayesian paradigm. Once the training process is completed, the robot identifies and locates those areas that potentially match the sections that have been previously learned. After the training, the robot navigates and extracts a three-dimensional map of the environment using a single laser sensor. Thus, it perceives different sections of its world. In addition, in order to make our system able to be used in a low-cost robot, low-complexity algorithms that can be easily implemented on embedded processors or microcontrollers are used.

  16. Learning probabilistic features for robotic navigation using laser sensors.

    Science.gov (United States)

    Aznar, Fidel; Pujol, Francisco A; Pujol, Mar; Rizo, Ramón; Pujol, María-José

    2014-01-01

    SLAM is a popular task used by robots and autonomous vehicles to build a map of an unknown environment and, at the same time, to determine their location within the map. This paper describes a SLAM-based, probabilistic robotic system able to learn the essential features of different parts of its environment. Some previous SLAM implementations had computational complexities ranging from O(Nlog(N)) to O(N(2)), where N is the number of map features. Unlike these methods, our approach reduces the computational complexity to O(N) by using a model to fuse the information from the sensors after applying the Bayesian paradigm. Once the training process is completed, the robot identifies and locates those areas that potentially match the sections that have been previously learned. After the training, the robot navigates and extracts a three-dimensional map of the environment using a single laser sensor. Thus, it perceives different sections of its world. In addition, in order to make our system able to be used in a low-cost robot, low-complexity algorithms that can be easily implemented on embedded processors or microcontrollers are used.

  17. IDENTIFICATION OF BURSTING WATER MASER FEATURES IN ORION KL

    International Nuclear Information System (INIS)

    Hirota, Tomoya; Honma, Mareki; Kim, Mi Kyoung; Kobayashi, Hideyuki; Shibata, Katsunori M.; Tsuboi, Masato; Fujisawa, Kenta; Kawaguchi, Noriyuki; Imai, Hiroshi; Omodaka, Toshihiro; Shimoikura, Tomomi; Yonekura, Yoshinori

    2011-01-01

    In 2011 February, a burst event of the H 2 O maser in Orion KL (Kleinmann-Low object) has started after a 13 year silence. This is the third time such phenomena has been detected in Orion KL, followed by the events in 1979-1985 and 1998. We have carried out astrometric observations of the bursting H 2 O maser features in Orion KL with the VLBI Exploration of Radio Astrometry (VERA), a Japanese very long baseline interferometry network dedicated for astrometry. The total flux of the bursting feature at the local standard of rest (LSR) velocity of 7.58 km s -1 reaches 4.4 x 10 4 Jy in 2011 March. The intensity of the bursting feature is three orders of magnitude larger than that of the same velocity feature in the quiescent phase in 2006. Two months later, another new feature appears at the LSR velocity of 6.95 km s -1 in 2011 May, separated by 12 mas north of the 7.58 km s -1 feature. Thus, the current burst occurs at two spatially different features. The bursting masers are elongated along the northwest-southeast direction as reported in the previous burst in 1998. We determine the absolute positions of the bursting features for the first time ever with a submilliarcsecond (mas) accuracy. Their positions are coincident with the shocked molecular gas called the Orion Compact Ridge. We tentatively detect the absolute proper motions of the bursting features toward the southwest direction. It is most likely that the outflow from the radio source I or another young stellar object interacting with the Compact Ridge is a possible origin of the H 2 O maser burst.

  18. On the use of INS to improve Feature Matching

    Science.gov (United States)

    Masiero, A.; Guarnieri, A.; Vettore, A.; Pirotti, F.

    2014-11-01

    The continuous technological improvement of mobile devices opens the frontiers of Mobile Mapping systems to very compact systems, i.e. a smartphone or a tablet. This motivates the development of efficient 3D reconstruction techniques based on the sensors typically embedded in such devices, i.e. imaging sensors, GPS and Inertial Navigation System (INS). Such methods usually exploits photogrammetry techniques (structure from motion) to provide an estimation of the geometry of the scene. Actually, 3D reconstruction techniques (e.g. structure from motion) rely on use of features properly matched in different images to compute the 3D positions of objects by means of triangulation. Hence, correct feature matching is of fundamental importance to ensure good quality 3D reconstructions. Matching methods are based on the appearance of features, that can change as a consequence of variations of camera position and orientation, and environment illumination. For this reason, several methods have been developed in recent years in order to provide feature descriptors robust (ideally invariant) to such variations, e.g. Scale-Invariant Feature Transform (SIFT), Affine SIFT, Hessian affine and Harris affine detectors, Maximally Stable Extremal Regions (MSER). This work deals with the integration of information provided by the INS in the feature matching procedure: a previously developed navigation algorithm is used to constantly estimate the device position and orientation. Then, such information is exploited to estimate the transformation of feature regions between two camera views. This allows to compare regions from different images but associated to the same feature as seen by the same point of view, hence significantly easing the comparison of feature characteristics and, consequently, improving matching. SIFT-like descriptors are used in order to ensure good matching results in presence of illumination variations and to compensate the approximations related to the estimation

  19. Statistical evolution of quiet-Sun small-scale magnetic features using Sunrise observations

    Science.gov (United States)

    Anusha, L. S.; Solanki, S. K.; Hirzberger, J.; Feller, A.

    2017-02-01

    The evolution of small magnetic features in quiet regions of the Sun provides a unique window for probing solar magneto-convection. Here we analyze small-scale magnetic features in the quiet Sun, using the high resolution, seeing-free observations from the Sunrise balloon borne solar observatory. Our aim is to understand the contribution of different physical processes, such as splitting, merging, emergence and cancellation of magnetic fields to the rearrangement, addition and removal of magnetic flux in the photosphere. We have employed a statistical approach for the analysis and the evolution studies are carried out using a feature-tracking technique. In this paper we provide a detailed description of the feature-tracking algorithm that we have newly developed and we present the results of a statistical study of several physical quantities. The results on the fractions of the flux in the emergence, appearance, splitting, merging, disappearance and cancellation qualitatively agrees with other recent studies. To summarize, the total flux gained in unipolar appearance is an order of magnitude larger than the total flux gained in emergence. On the other hand, the bipolar cancellation contributes nearly an equal amount to the loss of magnetic flux as unipolar disappearance. The total flux lost in cancellation is nearly six to eight times larger than the total flux gained in emergence. One big difference between our study and previous similar studies is that, thanks to the higher spatial resolution of Sunrise, we can track features with fluxes as low as 9 × 1014 Mx. This flux is nearly an order of magnitude lower than the smallest fluxes of the features tracked in the highest resolution previous studies based on Hinode data. The area and flux of the magnetic features follow power-law type distribution, while the lifetimes show either power-law or exponential type distribution depending on the exact definitions used to define various birth and death events. We have

  20. Neural Tuning to Low-Level Features of Speech throughout the Perisylvian Cortex.

    Science.gov (United States)

    Berezutskaya, Julia; Freudenburg, Zachary V; Güçlü, Umut; van Gerven, Marcel A J; Ramsey, Nick F

    2017-08-16

    Despite a large body of research, we continue to lack a detailed account of how auditory processing of continuous speech unfolds in the human brain. Previous research showed the propagation of low-level acoustic features of speech from posterior superior temporal gyrus toward anterior superior temporal gyrus in the human brain (Hullett et al., 2016). In this study, we investigate what happens to these neural representations past the superior temporal gyrus and how they engage higher-level language processing areas such as inferior frontal gyrus. We used low-level sound features to model neural responses to speech outside of the primary auditory cortex. Two complementary imaging techniques were used with human participants (both males and females): electrocorticography (ECoG) and fMRI. Both imaging techniques showed tuning of the perisylvian cortex to low-level speech features. With ECoG, we found evidence of propagation of the temporal features of speech sounds along the ventral pathway of language processing in the brain toward inferior frontal gyrus. Increasingly coarse temporal features of speech spreading from posterior superior temporal cortex toward inferior frontal gyrus were associated with linguistic features such as voice onset time, duration of the formant transitions, and phoneme, syllable, and word boundaries. The present findings provide the groundwork for a comprehensive bottom-up account of speech comprehension in the human brain. SIGNIFICANCE STATEMENT We know that, during natural speech comprehension, a broad network of perisylvian cortical regions is involved in sound and language processing. Here, we investigated the tuning to low-level sound features within these regions using neural responses to a short feature film. We also looked at whether the tuning organization along these brain regions showed any parallel to the hierarchy of language structures in continuous speech. Our results show that low-level speech features propagate throughout the

  1. Features generated for computational splice-site prediction correspond to functional elements

    Directory of Open Access Journals (Sweden)

    Wilbur W John

    2007-10-01

    Full Text Available Abstract Background Accurate selection of splice sites during the splicing of precursors to messenger RNA requires both relatively well-characterized signals at the splice sites and auxiliary signals in the adjacent exons and introns. We previously described a feature generation algorithm (FGA that is capable of achieving high classification accuracy on human 3' splice sites. In this paper, we extend the splice-site prediction to 5' splice sites and explore the generated features for biologically meaningful splicing signals. Results We present examples from the observed features that correspond to known signals, both core signals (including the branch site and pyrimidine tract and auxiliary signals (including GGG triplets and exon splicing enhancers. We present evidence that features identified by FGA include splicing signals not found by other methods. Conclusion Our generated features capture known biological signals in the expected sequence interval flanking splice sites. The method can be easily applied to other species and to similar classification problems, such as tissue-specific regulatory elements, polyadenylation sites, promoters, etc.

  2. Exploring point-cloud features from partial body views for gender classification

    Science.gov (United States)

    Fouts, Aaron; McCoppin, Ryan; Rizki, Mateen; Tamburino, Louis; Mendoza-Schrock, Olga

    2012-06-01

    In this paper we extend a previous exploration of histogram features extracted from 3D point cloud images of human subjects for gender discrimination. Feature extraction used a collection of concentric cylinders to define volumes for counting 3D points. The histogram features are characterized by a rotational axis and a selected set of volumes derived from the concentric cylinders. The point cloud images are drawn from the CAESAR anthropometric database provided by the Air Force Research Laboratory (AFRL) Human Effectiveness Directorate and SAE International. This database contains approximately 4400 high resolution LIDAR whole body scans of carefully posed human subjects. Success from our previous investigation was based on extracting features from full body coverage which required integration of multiple camera images. With the full body coverage, the central vertical body axis and orientation are readily obtainable; however, this is not the case with a one camera view providing less than one half body coverage. Assuming that the subjects are upright, we need to determine or estimate the position of the vertical axis and the orientation of the body about this axis relative to the camera. In past experiments the vertical axis was located through the center of mass of torso points projected on the ground plane and the body orientation derived using principle component analysis. In a natural extension of our previous work to partial body views, the absence of rotational invariance about the cylindrical axis greatly increases the difficulty for gender classification. Even the problem of estimating the axis is no longer simple. We describe some simple feasibility experiments that use partial image histograms. Here, the cylindrical axis is assumed to be known. We also discuss experiments with full body images that explore the sensitivity of classification accuracy relative to displacements of the cylindrical axis. Our initial results provide the basis for further

  3. Improved features of MARS 1.4 and verification

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Jae; Chung, Bub Don; Jeong, Jae Jun; Ha, Kwi Seok [Korea Atomic Energy Research Institute, Taejon (Korea)

    1999-09-01

    MARS 1.4 code has been developed as a basic code frame for multi-dimensional thermal-hydraulic analysis of light water reactor transients. This report describes the newly improved features of MARS 1.4 and their verification results. The new features of MARS 1.4 include the implementation of point kinetics model in the 3D module, the coupled heat structure model, the extension of control functions and input check functions in the 3D module, the implementation of new features of RELAP5/MOD3.2.2 -version, the addition of automatic initialization function for fuel 3-D analysis and the unification of material properties and forcing functions, etc. These features have been implemented in the code in order to extend the code modeling capability and to enhance the user friendliness. Among these features, this report describes the implementation of new features of RELAP5/MOD3.3.3-version such as reflood model and critical heat flux models, etc., the automatic initialization function, the unification of material properties and forcing functions and the other code improvements and error corrections, which were not reported in the previous report. Through the verification calculations, the new features of MARS 1.4 have been verified well implemented in the code. In conclusion, MARS 1.4 code has been developed and verified as implemented in the code. In conclusion, MARS 1.4 code has been developed and verified as a multi-dimensional system thermal-hydraulic analysis tool. And, it can play its role as a basic code frame for the future development of a multi-purpose consolidated code, MARS 2.x, for coupled analysis of multi-dimensional system thermal hydraulics, 3D core kinetics, core CHF and containment as well as for further improvement of thermal-hydraulic and numerical models. 4 refs., 10 figs. (Author)

  4. Automatically measuring the effect of strategy drawing features on pupils' handwriting and gender

    Science.gov (United States)

    Tabatabaey-Mashadi, Narges; Sudirman, Rubita; Guest, Richard M.; Khalid, Puspa Inayat

    2013-12-01

    Children's dynamic drawing strategies have been recently recognized as indicators of handwriting ability. However the influence of each feature in predicting handwriting is unknown due to lack of a measuring system. An automated measuring algorithm suitable for psychological assessment and non-subjective scoring is presented here. Using the weight vector and classification rate of a machine learning algorithm, an overall feature's effect is calculated which is comparable in different groupings. In this study thirteen previously detected drawing strategy features are measured for their influence on handwriting and gender. Features are extracted from drawing a triangle, Beery VMI and Bender Gestalt tangent patterns. Samples are related to 203 pupils (77 below average writers, and 101 female). The results show that the number of strokes in drawing the triangle pattern plays a major role in both groupings; however Left Tendency flag feature is affected by children's handwriting about 2.5 times greater than their gender. Experiments indicate that different forms of a feature sometimes show different influences.

  5. Identifying significant environmental features using feature recognition.

    Science.gov (United States)

    2015-10-01

    The Department of Environmental Analysis at the Kentucky Transportation Cabinet has expressed an interest in feature-recognition capability because it may help analysts identify environmentally sensitive features in the landscape, : including those r...

  6. Feature-based attention: it is all bottom-up priming.

    Science.gov (United States)

    Theeuwes, Jan

    2013-10-19

    Feature-based attention (FBA) enhances the representation of image characteristics throughout the visual field, a mechanism that is particularly useful when searching for a specific stimulus feature. Even though most theories of visual search implicitly or explicitly assume that FBA is under top-down control, we argue that the role of top-down processing in FBA may be limited. Our review of the literature indicates that all behavioural and neuro-imaging studies investigating FBA suffer from the shortcoming that they cannot rule out an effect of priming. The mere attending to a feature enhances the mandatory processing of that feature across the visual field, an effect that is likely to occur in an automatic, bottom-up way. Studies that have investigated the feasibility of FBA by means of cueing paradigms suggest that the role of top-down processing in FBA is limited (e.g. prepare for red). Instead, the actual processing of the stimulus is needed to cause the mandatory tuning of responses throughout the visual field. We conclude that it is likely that all FBA effects reported previously are the result of bottom-up priming.

  7. HEART TRANSPLANTATION IN PATIENTS WITH PREVIOUS OPEN HEART SURGERY

    Directory of Open Access Journals (Sweden)

    R. Sh. Saitgareev

    2016-01-01

    Full Text Available Heart Transplantation (HTx to date remains the most effective and radical method of treatment of patients with end-stage heart failure. The defi cit of donor hearts is forcing to resort increasingly to the use of different longterm mechanical circulatory support systems, including as a «bridge» to the follow-up HTx. According to the ISHLT Registry the number of recipients underwent cardiopulmonary bypass surgery increased from 40% in the period from 2004 to 2008 to 49.6% for the period from 2009 to 2015. HTx performed in repeated patients, on the one hand, involves considerable technical diffi culties and high risks; on the other hand, there is often no alternative medical intervention to HTx, and if not dictated by absolute contradictions the denial of the surgery is equivalent to 100% mortality. This review summarizes the results of a number of published studies aimed at understanding the immediate and late results of HTx in patients, previously underwent open heart surgery. The effect of resternotomy during HTx and that of the specifi c features associated with its implementation in recipients previously operated on open heart, and its effects on the immediate and long-term survival were considered in this review. Results of studies analyzing the risk factors for perioperative complications in repeated recipients were also demonstrated. Separately, HTx risks after implantation of prolonged mechanical circulatory support systems were examined. The literature does not allow to clearly defi ning the impact factor of earlier performed open heart surgery on the course of perioperative period and on the prognosis of survival in recipients who underwent HTx. On the other hand, subject to the regular fl ow of HTx and the perioperative period the risks in this clinical situation are justifi ed as a long-term prognosis of recipients previously conducted open heart surgery and are comparable to those of patients who underwent primary HTx. Studies

  8. Learning deep features with adaptive triplet loss for person reidentification

    Science.gov (United States)

    Li, Zhiqiang; Sang, Nong; Chen, Kezhou; Gao, Changxin; Wang, Ruolin

    2018-03-01

    Person reidentification (re-id) aims to match a specified person across non-overlapping cameras, which remains a very challenging problem. While previous methods mostly focus on feature extraction or metric learning, this paper makes the attempt in jointly learning both the global full-body and local body-parts features of the input persons with a multichannel convolutional neural network (CNN) model, which is trained by an adaptive triplet loss function that serves to minimize the distance between the same person and maximize the distance between different persons. The experimental results show that our approach achieves very promising results on the large-scale Market-1501 and DukeMTMC-reID datasets.

  9. Clinical features in patients with long-lasting macrophagic myofasciitis

    OpenAIRE

    Muriel eRIGOLET; Jessie eAOUIZERATE; Jessie eAOUIZERATE; Maryline eCOUETTE; Nilusha eTHANGARAJAH; Nilusha eTHANGARAJAH; Mehdi eAOUN-SEBAITI; Romain Kroum GHERARDI; Romain Kroum GHERARDI; Romain Kroum GHERARDI; Josette eCADUSSEAU; Josette eCADUSSEAU; Francois Jerome eAUTHIER; Francois Jerome eAUTHIER; Francois Jerome eAUTHIER

    2014-01-01

    Macrophagic myofasciitis (MMF) is an emerging condition characterized by specific muscle lesions assessing abnormal long-term persistence of aluminium hydroxide within macrophages at the site of previous immunization. Affected patients usually are middle-aged adults, mainly presenting with diffuse arthromyalgias, chronic fatigue, and marked cognitive deficits, not related to pain, fatigue or depression. Clinical features usually correspond to that observed in chronic fatigue syndrome/myalgic ...

  10. Clinical Features in Patients with Long-Lasting Macrophagic Myofasciitis

    OpenAIRE

    Rigolet, Muriel; Aouizerate, Jessie; Couette, Maryline; Ragunathan-Thangarajah, Nilusha; Aoun-Sebaiti, Mehdi; Gherardi, Romain Kroum; Cadusseau, Josette; Authier, François Jérôme

    2014-01-01

    Macrophagic myofasciitis (MMF) is an emerging condition characterized by specific muscle lesions assessing abnormal long-term persistence of aluminum hydroxide within macrophages at the site of previous immunization. Affected patients usually are middle-aged adults, mainly presenting with diffuse arthromyalgias, chronic fatigue, and marked cognitive deficits, not related to pain, fatigue, or depression. Clinical features usually correspond to that observed in chronic fatigue syndrome/myalgic ...

  11. A case of splenomegaly in CBL syndrome

    NARCIS (Netherlands)

    Coe, Rachel R.; McKinnon, Margaret L.; Tarailo-Graovac, Maja; Ross, Colin J.; Wasserman, Wyeth W.; Friedman, Jan M.; Rogers, Paul C.; van Karnebeek, Clara D. M.

    2017-01-01

    We present a child with unexplained splenomegaly to highlight this feature as a presenting sign of the RASopathy CBL syndrome and to draw attention to the power and utility of next generation genomic sequencing for providing rapid diagnosis and critical information to guide care in the pediatric

  12. A previously unreported association between Nance-Horan syndrome and spontaneous dental abscesses.

    Science.gov (United States)

    Hibbert, Sally

    2005-02-01

    Atypical dentofacial structures may be the first indicator of other anomalies linked to a syndrome. This case describes the management of a 9-year-old girl referred for the routine management of supernumerary teeth. The anomalous form of her teeth, together with multiple supernumerary units and a history of congenital cataracts, were suggestive of a diagnosis of Nance-Horan syndrome. This is an X-linked disorder, in which females usually demonstrate mild expression; this case was unusual in respect to the marked phenotype expressed. Unusually, the girl developed 2 spontaneous abscesses of her noncarious upper incisor teeth; a feature never previously described in this syndrome. This report details the patient's dental management and discusses the possible pathogenesis of the dental abscesses, together with the genetic implications of this syndrome.

  13. Whole Exome Sequencing for a Patient with Rubinstein-Taybi Syndrome Reveals de Novo Variants besides an Overt CREBBP Mutation

    Directory of Open Access Journals (Sweden)

    Hee Jeong Yoo

    2015-03-01

    Full Text Available Rubinstein-Taybi syndrome (RSTS is a rare condition with a prevalence of 1 in 125,000–720,000 births and characterized by clinical features that include facial, dental, and limb dysmorphology and growth retardation. Most cases of RSTS occur sporadically and are caused by de novo mutations. Cytogenetic or molecular abnormalities are detected in only 55% of RSTS cases. Previous genetic studies have yielded inconsistent results due to the variety of methods used for genetic analysis. The purpose of this study was to use whole exome sequencing (WES to evaluate the genetic causes of RSTS in a young girl presenting with an Autism phenotype. We used the Autism diagnostic observation schedule (ADOS and Autism diagnostic interview revised (ADI-R to confirm her diagnosis of Autism. In addition, various questionnaires were used to evaluate other psychiatric features. We used WES to analyze the DNA sequences of the patient and her parents and to search for de novo variants. The patient showed all the typical features of Autism, WES revealed a de novo frameshift mutation in CREBBP and de novo sequence variants in TNC and IGFALS genes. Mutations in the CREBBP gene have been extensively reported in RSTS patients, while potential missense mutations in TNC and IGFALS genes have not previously been associated with RSTS. The TNC and IGFALS genes are involved in central nervous system development and growth. It is possible for patients with RSTS to have additional de novo variants that could account for previously unexplained phenotypes.

  14. Spectroscopy of the 4.6 - 4.7 micron interstellar absorption features

    International Nuclear Information System (INIS)

    Geballe, T.R.

    1984-01-01

    Perhaps the most successful application of spectroscopy to the study of interstellar solid state infrared absorption features has been in the case of the previously unidentified feature near 4.6 μm first seen in absorption toward the protostar W33A. Whereas the original spectrum of this object, obtained at a resolving power of 70, revealed only a single deep absorption feature, a later spectrum, using a single channel grating spectrometer at ten times the resolving power, indicates that it is made up of three separate components. The central narrow absorption feature at 2140 cm -1 (4.67 μm) coincides in wavelength precisely with that of solid CO. It and its unresolved shoulder at just lower frequency have now been seen quite commonly in absorption toward other protostars. The broad absorption seen in W33A at 2165 cm -1 (4.62 μm) is apparently much less common. (author)

  15. Risk of peptic ulcer, oesophagitis, pancreatitis or gallstone in patients with unexplained chest/epigastric pain and normal upper endoscopy: a 10-year Danish cohort study

    DEFF Research Database (Denmark)

    Munk, E M; Drewes, A M; Gorst-Rasmussen, Anders

    2007-01-01

    BACKGROUND: No studies have examined the risk of upper gastrointestinal diseases among patients with unexplained chest/epigastric pain (UCEP) and a normal upper endoscopy. AIM: To examine the relative risk of peptic ulcer, oesophagitis, pancreatitis or gallstone in UCEP patients. METHODS...... for peptic ulcer, oesophagitis, pancreatitis or gallstone. RESULTS: Compared with controls, the adjusted relative risks among UCEP patients or = 1 year after upper endoscopy were for peptic ulcer 2.0 [95% confidence interval (CI) 0.2-18.4] and 1.7 (95% CI 0.9-3.4), for oesophagitis 8.2 (95% CI 1.......2-59.2) and 1.9 (95% CI 0.7-5.0), for pancreatitis 9.2 (95% CI 2.0-41.8) and 3.9 (95% CI 1.4-10.5), and for gallstone 14.1 (95% CI 5.4-37.2) and 3.3 (95% CI 1.9-5.8). CONCLUSIONS: UCEP is positively associated with all study outcomes especially in the first year after upper endoscopy, indicating that peptic...

  16. Spatial-temporal features of thermal images for Carpal Tunnel Syndrome detection

    Science.gov (United States)

    Estupinan Roldan, Kevin; Ortega Piedrahita, Marco A.; Benitez, Hernan D.

    2014-02-01

    Disorders associated with repeated trauma account for about 60% of all occupational illnesses, Carpal Tunnel Syndrome (CTS) being the most consulted today. Infrared Thermography (IT) has come to play an important role in the field of medicine. IT is non-invasive and detects diseases based on measuring temperature variations. IT represents a possible alternative to prevalent methods for diagnosis of CTS (i.e. nerve conduction studies and electromiography). This work presents a set of spatial-temporal features extracted from thermal images taken in healthy and ill patients. Support Vector Machine (SVM) classifiers test this feature space with Leave One Out (LOO) validation error. The results of the proposed approach show linear separability and lower validation errors when compared to features used in previous works that do not account for temperature spatial variability.

  17. Systemic connective tissue features in women with fibromuscular dysplasia.

    Science.gov (United States)

    O'Connor, Sarah; Kim, Esther Sh; Brinza, Ellen; Moran, Rocio; Fendrikova-Mahlay, Natalia; Wolski, Kathy; Gornik, Heather L

    2015-10-01

    Fibromuscular dysplasia (FMD) is a non-atherosclerotic disease associated with hypertension, headache, dissection, stroke, and aneurysm. The etiology is unknown but hypothesized to involve genetic and environmental components. Previous studies suggest a possible overlap of FMD with other connective tissue diseases that present with dissections and aneurysms. The aim of this study was to investigate the prevalence of connective tissue physical features in FMD. A total of 142 FMD patients were consecutively enrolled at a single referral center (97.9% female, 92.1% of whom had multifocal FMD). Data are reported for 139 female patients. Moderately severe myopia (29.1%), high palate (33.1%), dental crowding (29.7%), and early-onset arthritis (15.6%) were prevalent features. Classic connective features such as hypertelorism, cleft palate, and hypermobility were uncommon. The frequency of systemic connective tissue features was compared between FMD patients with a high vascular risk profile (having had ⩾1 dissection and/or ⩾2 aneurysms) and those with a standard vascular risk profile. A history of spontaneous pneumothorax (5.9% high risk vs 0% standard risk) and atrophic scarring (17.6% high risk vs 6.8% standard risk) were significantly more prevalent in the high risk group, pconnective tissue features such as high palate and pneumothorax were more prominent among FMD patients with a high vascular risk profile. © The Author(s) 2015.

  18. Vaginal Masses: Magnetic Resonance Imaging Features with Pathologic Correlation

    International Nuclear Information System (INIS)

    Elsayes, K.M.; Narra, V.R.; Dillman, J.R.; Velcheti, V.; Hameed, O.; Tongdee, R.; Menias, C.O.

    2007-01-01

    The detection of vaginal lesions has increased with the expanding use of cross-sectional imaging. Magnetic resonance imaging (MRI) - with its high-contrast resolution and multiplanar capabilities - is often useful for characterizing vaginal masses. Vaginal masses can be classified as congenital, inflammatory, cystic (benign), and neoplastic (benign or malignant) in etiology. Recognition of the typical MR imaging features of such lesions is important because it often determines the treatment approach and may obviate surgery. Finally, vaginal MR imaging can be used to evaluate post-treatment changes related to previous surgery and radiation therapy. In this article, we will review pertinent vaginal anatomy, vaginal and pelvic MRI technique, and the MRI features of a variety of vaginal lesions with pathological correlation

  19. Predicting hot spots in protein interfaces based on protrusion index, pseudo hydrophobicity and electron-ion interaction pseudopotential features

    Science.gov (United States)

    Xia, Junfeng; Yue, Zhenyu; Di, Yunqiang; Zhu, Xiaolei; Zheng, Chun-Hou

    2016-01-01

    The identification of hot spots, a small subset of protein interfaces that accounts for the majority of binding free energy, is becoming more important for the research of drug design and cancer development. Based on our previous methods (APIS and KFC2), here we proposed a novel hot spot prediction method. For each hot spot residue, we firstly constructed a wide variety of 108 sequence, structural, and neighborhood features to characterize potential hot spot residues, including conventional ones and new one (pseudo hydrophobicity) exploited in this study. We then selected 3 top-ranking features that contribute the most in the classification by a two-step feature selection process consisting of minimal-redundancy-maximal-relevance algorithm and an exhaustive search method. We used support vector machines to build our final prediction model. When testing our model on an independent test set, our method showed the highest F1-score of 0.70 and MCC of 0.46 comparing with the existing state-of-the-art hot spot prediction methods. Our results indicate that these features are more effective than the conventional features considered previously, and that the combination of our and traditional features may support the creation of a discriminative feature set for efficient prediction of hot spots in protein interfaces. PMID:26934646

  20. On application of kernel PCA for generating stimulus features for fMRI during continuous music listening.

    Science.gov (United States)

    Tsatsishvili, Valeri; Burunat, Iballa; Cong, Fengyu; Toiviainen, Petri; Alluri, Vinoo; Ristaniemi, Tapani

    2018-06-01

    There has been growing interest towards naturalistic neuroimaging experiments, which deepen our understanding of how human brain processes and integrates incoming streams of multifaceted sensory information, as commonly occurs in real world. Music is a good example of such complex continuous phenomenon. In a few recent fMRI studies examining neural correlates of music in continuous listening settings, multiple perceptual attributes of music stimulus were represented by a set of high-level features, produced as the linear combination of the acoustic descriptors computationally extracted from the stimulus audio. NEW METHOD: fMRI data from naturalistic music listening experiment were employed here. Kernel principal component analysis (KPCA) was applied to acoustic descriptors extracted from the stimulus audio to generate a set of nonlinear stimulus features. Subsequently, perceptual and neural correlates of the generated high-level features were examined. The generated features captured musical percepts that were hidden from the linear PCA features, namely Rhythmic Complexity and Event Synchronicity. Neural correlates of the new features revealed activations associated to processing of complex rhythms, including auditory, motor, and frontal areas. Results were compared with the findings in the previously published study, which analyzed the same fMRI data but applied linear PCA for generating stimulus features. To enable comparison of the results, methodology for finding stimulus-driven functional maps was adopted from the previous study. Exploiting nonlinear relationships among acoustic descriptors can lead to the novel high-level stimulus features, which can in turn reveal new brain structures involved in music processing. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Neural tuning to low-level features of speech throughout the perisylvian cortex

    NARCIS (Netherlands)

    Berezutskaya, Y.; Freudenburg, Z.V.; Güçlü, U.; Gerven, M.A.J. van; Ramsey, N.F.

    2017-01-01

    Despite a large body of research, we continue to lack a detailed account of how auditory processing of continuous speech unfolds in the human brain. Previous research showed the propagation of low-level acoustic features of speech from posterior superior temporal gyrus towards anterior superior

  2. Neural tuning to low-level features of speech throughout the perisylvian cortex

    NARCIS (Netherlands)

    Berezutskaya, Julia; Freudenburg, Zachary V.; Güçlü, Umut; van Gerven, Marcel A.J.; Ramsey, Nick F.

    2017-01-01

    Despite a large body of research, we continue to lack a detailed account of how auditory processing of continuous speech unfolds in the human brain. Previous research showed the propagation of low-level acoustic features of speech from posterior superior temporal gyrus toward anterior superior

  3. Evaluation of EEG Features in Decoding Individual Finger Movements from One Hand

    Directory of Open Access Journals (Sweden)

    Ran Xiao

    2013-01-01

    Full Text Available With the advancements in modern signal processing techniques, the field of brain-computer interface (BCI is progressing fast towards noninvasiveness. One challenge still impeding these developments is the limited number of features, especially movement-related features, available to generate control signals for noninvasive BCIs. A few recent studies investigated several movement-related features, such as spectral features in electrocorticography (ECoG data obtained through a spectral principal component analysis (PCA and direct use of EEG temporal data, and demonstrated the decoding of individual fingers. The present paper evaluated multiple movement-related features under the same task, that is, discriminating individual fingers from one hand using noninvasive EEG. The present results demonstrate the existence of a broadband feature in EEG to discriminate individual fingers, which has only been identified previously in ECoG. It further shows that multiple spectral features obtained from the spectral PCA yield an average decoding accuracy of 45.2%, which is significantly higher than the guess level (P<0.05 and other features investigated (P<0.05, including EEG spectral power changes in alpha and beta bands and EEG temporal data. The decoding of individual fingers using noninvasive EEG is promising to improve number of features for control, which can facilitate the development of noninvasive BCI applications with rich complexity.

  4. Featureous: infrastructure for feature-centric analysis of object-oriented software

    DEFF Research Database (Denmark)

    Olszak, Andrzej; Jørgensen, Bo Nørregaard

    2010-01-01

    The decentralized nature of collaborations between objects in object-oriented software makes it difficult to understand how user-observable program features are implemented and how their implementations relate to each other. It is worthwhile to improve this situation, since feature-centric program...... understanding and modification are essential during software evolution and maintenance. In this paper, we present an infrastructure built on top of the NetBeans IDE called Featureous that allows for rapid construction of tools for feature-centric analysis of object-oriented software. Our infrastructure...... encompasses a lightweight feature location mechanism, a number of analytical views and an API allowing for addition of third-party extensions. To form a common conceptual framework for future feature-centric extensions, we propose to structure feature centric analysis along three dimensions: perspective...

  5. Early response in cognitive-behavior therapy for syndromes of medically unexplained symptoms.

    Science.gov (United States)

    Kleinstäuber, Maria; Lambert, Michael J; Hiller, Wolfgang

    2017-05-25

    Early dramatic treatment response suggests a subset of patients who respond to treatment before most of it has been offered. These early responders tend to be over represented among those who are well at termination and at follow-up. Early response patterns in psychotherapy have been investigated only for a few of mental disorders so far. The main aim of the current study was to examine early response after five therapy-preparing sessions of a cognitive behavior therapy (CBT) for syndromes of medically unexplained symptoms (MUS). In the context of a randomized, waiting-list controlled trial 48 patients who suffered from ≥3 MUS over ≥6 months received 5 therapy-preparing sessions and 20 sessions of CBT for somatoform disorders. They completed self-report scales of somatic symptom severity (SOMS-7 T), depression (BDI-II), anxiety (BSI), illness anxiety and behavior (IAS) at pre-treatment, after 5 therapy-preparing sessions (FU-5P) and at therapy termination (FU-20 T). The current analyses are based on data from the treatment arm only. Repeated measure ANOVAs revealed a significant decrease of depression (d = 0.34), anxiety (d = 0.60), illness anxiety (d = 0.38) and illness behavior (d = 0.42), but no change of somatic symptom severity (d = -0.03) between pre-treatment and FU-5P. Hierarchical linear multiple regression analyses showed that symptom improvements between pre-treatment and FU-5P predict a better outcome at therapy termination for depression and illness anxiety, after controlling for pre-treatment scores. Mixed-effect ANOVAs revealed significant group*time interaction effects indicating differences in the course of symptom improvement over the therapy between patients who fulfilled a reliable change (i.e., early response) during the 5 therapy-preparing sessions and patients who did not reach an early reliable change. Demographic or clinical variables at pre-treatment were not significantly correlated with differential scores between pre

  6. Generic features of Einstein-Aether black holes

    International Nuclear Information System (INIS)

    Tamaki, Takashi; Miyamoto, Umpei

    2008-01-01

    We reconsider spherically symmetric black hole solutions in Einstein-Aether theory with the condition that this theory has identical parametrized post-Newtonian parameters as those for general relativity, which is the main difference from the previous research. In contrast with previous study, we allow superluminal propagation of a spin-0 Aether-gravity wave mode. As a result, we obtain black holes having a spin-0 'horizon' inside an event horizon. We allow a singularity at a spin-0 horizon since it is concealed by the event horizon. If we allow such a configuration, the kinetic term of the Aether field can be large enough for black holes to be significantly different from Schwarzschild black holes with respect to Arnowitt-Deser-Misner mass, innermost stable circular orbit, Hawking temperature, and so on. We also discuss whether or not the above features can be seen in more generic vector-tensor theories

  7. Clinical features of measles pneumonia in adults

    International Nuclear Information System (INIS)

    Tanaka, Hiroshi; Honma, Shin-ichi; Yamagishi, Masahiko; Honda, Yasuhito; Abe, Shosaku; Igarashi, Tomofumi; Sekine, Kyuichiro.

    1993-01-01

    The clinical features, chest radiographs and computed tomographic (CT) images were evaluated in 11 cases of serologically proved adult measles complicated with pneumonia (10 were previously healthy and one had sarcoidosis). Pneumonia appeared during the rash period in all cases. Respiratory symptoms were cough (9/11), dyspnea (3/11), and hypoxemia (10/11). Pneumonia manifestations were detected in only 4 cases by chest radiograph; on the other hand, they were seen in all cases by CT scan and consisted of ground-glass opacities (73%), nodular opacities (64%) and consolidation (27%). CT seems to be useful method to detect measles pneumonia if it is suspected. Measles pneumonia in previously healthy patients had a good prognosis, as the hypoxemia disappeared within 6 days in all cases. The sarcoidosis patient showed prolonged pneumonic shadows and period of hypoxemia. Measles pneumonia occurring in a host with cellular immunodeficiency may have a severe clinical course. (author)

  8. Mobile Augmented Reality Support for Architects Based on Feature Tracking Techniques

    DEFF Research Database (Denmark)

    Bang Nielsen, Michael; Kramp, Gunnar; Grønbæk, Kaj

    2004-01-01

    on the horizon view from an office building, while working on a courtyard garden proposal. The SitePack applies a novel combination of GPS tracking and vision based feature tracking in its support for architects. The SitePack requires no preparation of the site and combines and extends the strengths of previous...

  9. Shape adaptive, robust iris feature extraction from noisy iris images.

    Science.gov (United States)

    Ghodrati, Hamed; Dehghani, Mohammad Javad; Danyali, Habibolah

    2013-10-01

    In the current iris recognition systems, noise removing step is only used to detect noisy parts of the iris region and features extracted from there will be excluded in matching step. Whereas depending on the filter structure used in feature extraction, the noisy parts may influence relevant features. To the best of our knowledge, the effect of noise factors on feature extraction has not been considered in the previous works. This paper investigates the effect of shape adaptive wavelet transform and shape adaptive Gabor-wavelet for feature extraction on the iris recognition performance. In addition, an effective noise-removing approach is proposed in this paper. The contribution is to detect eyelashes and reflections by calculating appropriate thresholds by a procedure called statistical decision making. The eyelids are segmented by parabolic Hough transform in normalized iris image to decrease computational burden through omitting rotation term. The iris is localized by an accurate and fast algorithm based on coarse-to-fine strategy. The principle of mask code generation is to assign the noisy bits in an iris code in order to exclude them in matching step is presented in details. An experimental result shows that by using the shape adaptive Gabor-wavelet technique there is an improvement on the accuracy of recognition rate.

  10. Combining Semantic and Acoustic Features for Valence and Arousal Recognition in Speech

    DEFF Research Database (Denmark)

    Karadogan, Seliz; Larsen, Jan

    2012-01-01

    The recognition of affect in speech has attracted a lot of interest recently; especially in the area of cognitive and computer sciences. Most of the previous studies focused on the recognition of basic emotions (such as happiness, sadness and anger) using categorical approach. Recently, the focus...... has been shifting towards dimensional affect recognition based on the idea that emotional states are not independent from one another but related in a systematic manner. In this paper, we design a continuous dimensional speech affect recognition model that combines acoustic and semantic features. We...... show that combining semantic and acoustic information for dimensional speech recognition improves the results. Moreover, we show that valence is better estimated using semantic features while arousal is better estimated using acoustic features....

  11. Failure to thrive as primary feature in two patients with subtle chromosomal aneuploidy: Interstitial deletion 2q33

    Energy Technology Data Exchange (ETDEWEB)

    Grace, K.; Mulla, W.; Stump, T. [Children`s Hospital of Philadelpha, PA (United States)] [and others

    1994-09-01

    It is well known that patients with chromosomal aneuploidy present with multiple congenital anomalies and dysmorphia, and that they may have associated failure to thrive. However, rarely is failure to thrive the predominant presenting feature. We report two such patients. Patient 1 had a marked history of failure to thrive, (weight 50% for 5 1/2 months at 20 months, length 50% for 15 months at 20 months). Patient 2 was noted to be growth retarded at 2 months upon presenting to the hospital with respiratory symptoms (weight 50% for a newborn, length 50% for 36 weeks gestation). There was relative head sparing in both patients. Chromosome analysis in patient 1, prompted by a negative work-up for the failure to thrive, and emerging evidence of developmental delay, revealed a 46,XY,del(2)(q32.2q33) karyotype. Chromosome analysis in patient 2, done as part of a complete workup for the failure to thrive, revealed a 46,XX,del(2)(q33.2q33.2 or q33.2q33.3) karyotype. On careful examination, subtle dysmorphic features were seen. In both patients these included a long flat philtrum, thin upper lip and high arched palate. Patient 1 also had a small posterior cleft of the palate. These patients have the smallest interstitial deletions of chromosome 2 so far reported. Their deletions overlap within 2q33 although they are not identical. Review of the literature reveals 15 patients with interstitial deletions which include 2q33. Marked growth retardation is reported in 14 of these cases. Cleft palate/abnormal uvula were frequently associated. These cases illustrate the need to include high resolution chromosomal studies as part of a complete work-up for unexplained failure to thrive.

  12. A modular CUDA-based framework for scale-space feature detection in video streams

    International Nuclear Information System (INIS)

    Kinsner, M; Capson, D; Spence, A

    2010-01-01

    Multi-scale image processing techniques enable extraction of features where the size of a feature is either unknown or changing, but the requirement to process image data at multiple scale levels imposes a substantial computational load. This paper describes the architecture and emerging results from the implementation of a GPGPU-accelerated scale-space feature detection framework for video processing. A discrete scale-space representation is generated for image frames within a video stream, and multi-scale feature detection metrics are applied to detect ridges and Gaussian blobs at video frame rates. A modular structure is adopted, in which common feature extraction tasks such as non-maximum suppression and local extrema search may be reused across a variety of feature detectors. Extraction of ridge and blob features is achieved at faster than 15 frames per second on video sequences from a machine vision system, utilizing an NVIDIA GTX 480 graphics card. By design, the framework is easily extended to additional feature classes through the inclusion of feature metrics to be applied to the scale-space representation, and using common post-processing modules to reduce the required CPU workload. The framework is scalable across multiple and more capable GPUs, and enables previously intractable image processing at video frame rates using commodity computational hardware.

  13. The acoustic features of human laughter

    Science.gov (United States)

    Bachorowski, Jo-Anne; Owren, Michael J.

    2002-05-01

    Remarkably little is known about the acoustic features of laughter, despite laughter's ubiquitous role in human vocal communication. Outcomes are described for 1024 naturally produced laugh bouts recorded from 97 young adults. Acoustic analysis focused on temporal characteristics, production modes, source- and filter-related effects, and indexical cues to laugher sex and individual identity. The results indicate that laughter is a remarkably complex vocal signal, with evident diversity in both production modes and fundamental frequency characteristics. Also of interest was finding a consistent lack of articulation effects in supralaryngeal filtering. Outcomes are compared to previously advanced hypotheses and conjectures about this species-typical vocal signal.

  14. Feature Article

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education. Feature Article. Articles in Resonance – Journal of Science Education. Volume 1 Issue 1 January 1996 pp 80-85 Feature Article. What's New in Computers Windows 95 · Vijnan Shastri · More Details Fulltext PDF. Volume 1 Issue 1 January 1996 pp 86-89 Feature ...

  15. Pacman dysplasia: a lethal skeletal dysplasia with variable radiographic features

    Energy Technology Data Exchange (ETDEWEB)

    Miller, S.F. [Dept. of Radiology, Children' s Hospital of the King' s Daughters, Norfolk (United States); Proud, V.K. [Dept. of Genetics, Children' s Hospital of the King' s Daughters, Norfolk (United States); Werner, A.L. [Dept. of Pathology, Children' s Hospital of the King' s Daughters, Norfolk (United States); Field, F.M.; Wilcox, W.F.; Lachman, R.S.; Rimoin, D.L. [International Skeletal Dysplasia Registry, Cedars-Sinai Medical Center, Los Angeles (United States)

    2003-04-01

    Background: Punctate or stippled cartilaginous calcifications are associated with many conditions, including chromosomal, infectious, endocrine, and teratogenic etiologies. Some of these conditions are clinically mild, while others are lethal. Accurate diagnosis can prove instrumental in clinical management and in genetic counseling. Objective: To describe the diagnostic radiographic features seen in Pacman dysplasia, a distinct autosomal recessive, lethal skeletal dysplasia. Materials and methods: We present the fourth reported case of Pacman dysplasia and compare the findings seen in our patient with the three previously described patients. Results: Invariable and variable radiographic findings were seen in all four cases of histologically proven Pacman dysplasia. Conclusion: Pacman dysplasia presents both constant and variable diagnostic radiographic features. (orig.)

  16. Featureous: A Tool for Feature-Centric Analysis of Java Software

    DEFF Research Database (Denmark)

    Olszak, Andrzej; Jørgensen, Bo Nørregaard

    2010-01-01

    Feature-centric comprehension of source code is necessary for incorporating user-requested modifications during software evolution and maintenance. However, such comprehension is difficult to achieve in case of large object-oriented programs due to the size, complexity, and implicit character...... of mappings between features and source code. To support programmers in overcoming these difficulties, we present a feature-centric analysis tool, Featureous. Our tool extends the NetBeans IDE with mechanisms for efficient location of feature implementations in legacy source code, and an extensive analysis...

  17. Unexplained Variation for Hospitals' Use of Inpatient Rehabilitation and Skilled Nursing Facilities After an Acute Ischemic Stroke.

    Science.gov (United States)

    Xian, Ying; Thomas, Laine; Liang, Li; Federspiel, Jerome J; Webb, Laura E; Bushnell, Cheryl D; Duncan, Pamela W; Schwamm, Lee H; Stein, Joel; Fonarow, Gregg C; Hoenig, Helen; Montalvo, Cris; George, Mary G; Lutz, Barbara J; Peterson, Eric D; Bettger, Janet Prvu

    2017-10-01

    Rehabilitation is recommended after a stroke to enhance recovery and improve outcomes, but hospital's use of inpatient rehabilitation facilities (IRFs) or skilled nursing facility (SNF) and the factors associated with referral are unknown. We analyzed clinical registry and claims data for 31 775 Medicare beneficiaries presenting with acute ischemic stroke from 918 Get With The Guidelines-Stroke hospitals who were discharged to either IRF or SNF between 2006 and 2008. Using a multilevel logistic regression model, we evaluated patient and hospital characteristics, as well as geographic availability, in relation to discharge to either IRF or SNF. After accounting for observed factors, the median odds ratio was reported to quantify hospital-level variation in the use of IRF versus SNF. Of 31 775 patients, 17 662 (55.6%) were discharged to IRF and 14 113 (44.4%) were discharged to SNF. Compared with SNF patients, IRF patients were younger, more were men, had less health-service use 6 months prestroke, and had fewer comorbid conditions and in-hospital complications. Use of IRF or SNF varied significantly across hospitals (median IRF use, 55.8%; interquartile range, 34.8%-75.0%; unadjusted median odds ratio, 2.59; 95% confidence interval, 2.44-2.77). Hospital-level variation in discharge rates to IRF or SNF persisted after adjustment for patient, clinical, and geographic variables (adjusted median odds ratio, 2.87; 95% confidence interval, 2.68-3.11). There is marked unexplained variation among hospitals in their use of IRF versus SNF poststroke even after accounting for clinical characteristics and geographic availability. URL: https://clinicaltrials.gov. Unique identifier: NCT02284165. © 2017 American Heart Association, Inc.

  18. Endometrial Scratch Injury Induces Higher Pregnancy Rate for Women With Unexplained Infertility Undergoing IUI With Ovarian Stimulation: A Randomized Controlled Trial.

    Science.gov (United States)

    Maged, Ahmed M; Al-Inany, Hesham; Salama, Khaled M; Souidan, Ibrahim I; Abo Ragab, Hesham M; Elnassery, Noura

    2016-02-01

    To explore the impact of endometrial scratch injury (ESI) on intrauterine insemination (IUI) success. One hundred and fifty four infertile women received 100 mg of oral clomiphene citrate for 5 days starting on day 3 of the menstrual cycle. Patients were randomized to 2 equal groups: Group C received IUI without ESI and group S had ESI. Successful pregnancy was confirmed by ultrasound. 13, 21, and 10 women got pregnant after the first, second, and third IUI trials, respectively, with 28.6% cumulative pregnancy rate (PR). The cumulative PR was significantly higher in group S (39%) compared to group C (18.2%). The PR in group S was significantly higher compared to that in group C at the second and third trials. The PR was significantly higher in group S at the second trial compared to that reported in the same group at the first trial but nonsignificantly higher compared to that reported during the third trial, while in group C, the difference was nonsignificant. Eight pregnant women had first trimester abortion with 18.2% total abortion rate with nonsignificant difference between studied groups. The ESI significantly improves the outcome of IUI in women with unexplained infertility especially when conducted 1 month prior to IUI. © The Author(s) 2015.

  19. Identification of informative features for predicting proinflammatory potentials of engine exhausts.

    Science.gov (United States)

    Wang, Chia-Chi; Lin, Ying-Chi; Lin, Yuan-Chung; Jhang, Syu-Ruei; Tung, Chun-Wei

    2017-08-18

    The immunotoxicity of engine exhausts is of high concern to human health due to the increasing prevalence of immune-related diseases. However, the evaluation of immunotoxicity of engine exhausts is currently based on expensive and time-consuming experiments. It is desirable to develop efficient methods for immunotoxicity assessment. To accelerate the development of safe alternative fuels, this study proposed a computational method for identifying informative features for predicting proinflammatory potentials of engine exhausts. A principal component regression (PCR) algorithm was applied to develop prediction models. The informative features were identified by a sequential backward feature elimination (SBFE) algorithm. A total of 19 informative chemical and biological features were successfully identified by SBFE algorithm. The informative features were utilized to develop a computational method named FS-CBM for predicting proinflammatory potentials of engine exhausts. FS-CBM model achieved a high performance with correlation coefficient values of 0.997 and 0.943 obtained from training and independent test sets, respectively. The FS-CBM model was developed for predicting proinflammatory potentials of engine exhausts with a large improvement on prediction performance compared with our previous CBM model. The proposed method could be further applied to construct models for bioactivities of mixtures.

  20. Fenómenos de somatización en la población penitenciaria: diagnóstico y tratamiento Unexplained phsyical complaints amongst prison inmates: diagnois and treatment

    Directory of Open Access Journals (Sweden)

    J. García Campayo

    2007-02-01

    Full Text Available Los procesos fisiológicos diarios, el exceso de fatiga física, infecciones víricas subclínicas o determinadas circunstancias ambientales, son capaces de producir algún tipo de dolor o malestar físico en el 75% de los adultos en el plazo de una semana. Cuando, en contra de la opinión de su médico, el individuo atribuye estas molestias a una enfermedad orgánica y busca un diagnóstico y un tratamiento de forma persistente, hablamos de somatización. Trastornos depresivos y de ansiedad o incluso una verdadera alteración de la personalidad, están detrás de la mayoría de este tipo de trastornos. La falta de estudios de prevalencia de este tipo de trastornos en prisión impide valorar adecuadamente la importancia de este fenómeno en las consultas de atención primaria de las prisiones, si bien cabe esperar un volumen similar de estos trastornos, sino mayor al encontrado en la población general, en torno al 15%. El manejo de este tipo de paciente es siempre conflictivo, complejo y emocionalmente muy exigente para el profesional sanitario.Daily physiological processes, excess physical fatigue, subclinical viral infections and certain environmental situations can all cause some kind of physical pain or malaise in 75% of adults in a typical week. When the individual refuses to accept medical opinion and attributes the pain to a physical illness and persistently seeks diagnosis and treatment, then there is a possibility of an unexplained somatic problem. Depression, anxiety or even a personality disorder may be causative factors. The lack of studies of this type of disorder in the prison environment makes it difficult to fully evaluate the importance of this phenomenon for primary health care consultation in prison, despite the fact that the number of presented unexplained somatic complaints may well be the same as in the community (around 15%. Management of this type of patient is always difficult, complex and emotionally demanding for the

  1. Case Report: Congenital Erythroleukemia in a Premature Infant with Dysmorphic Features.

    Science.gov (United States)

    Helin, Heidi; van der Walt, Jon; Holder, Muriel; George, Simi

    2016-01-01

    We present a case of pure erythroleukemia, diagnosed at autopsy, in a dysmorphic premature infant who died of multiorgan failure within 24 hours of birth. Dysmorphic features included facial and limb abnormalities with long philtrum, microagnathia, downturned mouth, short neck as well as abnormal and missing nails, missing distal phalanx from the second toe, and overlapping toes. Internal findings included gross hepatomegaly and patchy hemorrhages in the liver, splenomegaly, and cardiomegaly; and subdural, intracerebral, and intraventricular hemorrhages. Histology revealed infiltration of bone marrow, kidney, heart, liver, adrenal, lung, spleen, pancreas, thyroid, testis, thymus, and placenta by pure erythroleukemia. Only 6 cases of congenital erythroleukemia have been previously reported with autopsy findings similar to those of this case. The dysmorphic features, although not fitting any specific syndrome, make this case unique. Congenital erythroleukemia and possible syndromes suggested by the dysmorphic features are discussed.

  2. Pregnancy-associated breast disease: radiologic features and diagnostic dilemmas.

    Science.gov (United States)

    Son, Eun Ju; Oh, Ki Keun; Kim, Eun Kyung

    2006-02-28

    In this paper, we evaluate the radiological features of pregnancy-associated breast lesions and discuss the difficulties in diagnosis by imaging. We selected patients who were diagnosed with pregnancy-associated breast lesions during the previous 5 years. All patients complained of palpable lesions in the breast and underwent ultrasonographic (US) examination, the first choice for examination of pregnancy-related breast lesions. Any suspicious lesions found by the US were recommended for a US-guided core biopsy, US-guided fine needle aspiration (FNA), or surgery. Various breast lesions were detected during pregnancy and lactation, including breast cancer, mastitis and abscesses, lactating adenoma, galactoceles, lobular hyperplasia, and fibroadenomas. The imaging features of pregnancy-associated breast lesions did not differ from the features of non-pregnancy-associated breast lesions; however, some pregnancy-associated benign lesions had suspicious sonographic features. A US-guided core biopsy was necessary for differentiating benign from malignant. In patients with breast cancer, the cancer was often advanced at the time of diagnosis. In conclusion, various pregnancy-related breast lesions were detected and the imaging of these lesions had variable findings. Breast ultrasound could be an excellent imaging modality for diagnosis and differentiation between benign and malignant lesions. However, when the imaging results are suspicious, a biopsy should be performed to obtain a pathologic diagnosis.

  3. RELAP5-3D Code Includes ATHENA Features and Models

    International Nuclear Information System (INIS)

    Riemke, Richard A.; Davis, Cliff B.; Schultz, Richard R.

    2006-01-01

    Version 2.3 of the RELAP5-3D computer program includes all features and models previously available only in the ATHENA version of the code. These include the addition of new working fluids (i.e., ammonia, blood, carbon dioxide, glycerol, helium, hydrogen, lead-bismuth, lithium, lithium-lead, nitrogen, potassium, sodium, and sodium-potassium) and a magnetohydrodynamic model that expands the capability of the code to model many more thermal-hydraulic systems. In addition to the new working fluids along with the standard working fluid water, one or more noncondensable gases (e.g., air, argon, carbon dioxide, carbon monoxide, helium, hydrogen, krypton, nitrogen, oxygen, SF 6 , xenon) can be specified as part of the vapor/gas phase of the working fluid. These noncondensable gases were in previous versions of RELAP5-3D. Recently four molten salts have been added as working fluids to RELAP5-3D Version 2.4, which has had limited release. These molten salts will be in RELAP5-3D Version 2.5, which will have a general release like RELAP5-3D Version 2.3. Applications that use these new features and models are discussed in this paper. (authors)

  4. Feature diagnosticity and task context shape activity in human scene-selective cortex.

    Science.gov (United States)

    Lowe, Matthew X; Gallivan, Jason P; Ferber, Susanne; Cant, Jonathan S

    2016-01-15

    Scenes are constructed from multiple visual features, yet previous research investigating scene processing has often focused on the contributions of single features in isolation. In the real world, features rarely exist independently of one another and likely converge to inform scene identity in unique ways. Here, we utilize fMRI and pattern classification techniques to examine the interactions between task context (i.e., attend to diagnostic global scene features; texture or layout) and high-level scene attributes (content and spatial boundary) to test the novel hypothesis that scene-selective cortex represents multiple visual features, the importance of which varies according to their diagnostic relevance across scene categories and task demands. Our results show for the first time that scene representations are driven by interactions between multiple visual features and high-level scene attributes. Specifically, univariate analysis of scene-selective cortex revealed that task context and feature diagnosticity shape activity differentially across scene categories. Examination using multivariate decoding methods revealed results consistent with univariate findings, but also evidence for an interaction between high-level scene attributes and diagnostic visual features within scene categories. Critically, these findings suggest visual feature representations are not distributed uniformly across scene categories but are shaped by task context and feature diagnosticity. Thus, we propose that scene-selective cortex constructs a flexible representation of the environment by integrating multiple diagnostically relevant visual features, the nature of which varies according to the particular scene being perceived and the goals of the observer. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. [Association of polymorphisms in signal transducer and activator of transcription 4 gene and the susceptibility to unexplained recurrent spontaneous abortions].

    Science.gov (United States)

    Li, Yin-Guang; You, Ze-Shan; Wu, Zai-Gui; Li, Zhu-Yu; Li, Jie; Zhang, Xiu-Ming; Fang, Li-Yuan; Jiang, Li

    2013-09-01

    To investigate the association between the polymorphisms of signal transducer and activator of transcription 4 (STAT4) gene and the susceptibility to unexplained recurrent spontaneous abortion(URSA). PCR-restriction fragment length polymorphism (PCR-RFLP) was used to detect genotype 3 loca (rs7574865 G/T, rs10181656 C/G and rs16833431 C/T) polymorphism of STAT4 in 246 URSA cases (URSA group) and 183 normal controls (control group) . (1)The frequencies of rs7574865 were genotype G/G of 36.2% (89/246) in URSA group and 46.4% (85/183) in control group, genotype G/T of 47.2% (116/246) in URSA group and 45.4% (83/183) in control group, and genotype T/T of 16.7% (41/246) in URSA group and 8.2% (15/183) in control group, which reached statistical difference (P rs7574865 T allele and rs10181656 G allele increased the risk of URSA (OR = 1.51, 1.44, all P rs7574865 G/T and rs10181656 C/G showed haplotype G-T conferring the susceptibility to URSA (OR = 1.49, P < 0.01), but haplotype C-G could provide protection on URSA (OR = 0.68, P < 0.01). Polymorphisms of STAT4 gene might confer the susceptibility to URSA by altering STAT4 function and (or) its expression.

  6. Automatic segmentation of closed-contour features in ophthalmic images using graph theory and dynamic programming

    Science.gov (United States)

    Chiu, Stephanie J.; Toth, Cynthia A.; Bowes Rickman, Catherine; Izatt, Joseph A.; Farsiu, Sina

    2012-01-01

    This paper presents a generalized framework for segmenting closed-contour anatomical and pathological features using graph theory and dynamic programming (GTDP). More specifically, the GTDP method previously developed for quantifying retinal and corneal layer thicknesses is extended to segment objects such as cells and cysts. The presented technique relies on a transform that maps closed-contour features in the Cartesian domain into lines in the quasi-polar domain. The features of interest are then segmented as layers via GTDP. Application of this method to segment closed-contour features in several ophthalmic image types is shown. Quantitative validation experiments for retinal pigmented epithelium cell segmentation in confocal fluorescence microscopy images attests to the accuracy of the presented technique. PMID:22567602

  7. Archeomagnetic Intensity Spikes: Global or Regional Geomagnetic Field Features?

    Directory of Open Access Journals (Sweden)

    Monika Korte

    2018-03-01

    Full Text Available Variations of the geomagnetic field prior to direct observations are inferred from archeo- and paleomagnetic experiments. Seemingly unusual variations not seen in the present-day and historical field are of particular interest to constrain the full range of core dynamics. Recently, archeomagnetic intensity spikes, characterized by very high field values that appear to be associated with rapid secular variation rates, have been reported from several parts of the world. They were first noted in data from the Levant at around 900 BCE. A recent re-assessment of previous and new Levantine data, involving a rigorous quality assessment, interprets the observations as an extreme local geomagnetic high with at least two intensity spikes between the 11th and 8th centuries BCE. Subsequent reports of similar features from Asia, the Canary Islands and Texas raise the question of whether such features might be common occurrences, or whether they might even be part of a global magnetic field feature. Here we use spherical harmonic modeling to test two hypotheses: firstly, whether the Levantine and other potential spikes might be associated with higher dipole field intensity than shown by existing global field models around 1,000 BCE, and secondly, whether the observations from different parts of the world are compatible with a westward drifting intense flux patch. Our results suggest that the spikes originate from intense flux patches growing and decaying mostly in situ, combined with stronger and more variable dipole moment than shown by previous global field models. Axial dipole variations no more than 60% higher than observed in the present field, probably within the range of normal geodynamo behavior, seem sufficient to explain the observations.

  8. Medically unexplained symptoms and the risk of loss of labor market participation--a prospective study in the Danish population.

    Science.gov (United States)

    Loengaard, Katja; Bjorner, Jakob Bue; Fink, Per Klausen; Burr, Hermann; Rugulies, Reiner

    2015-09-02

    Medically Unexplained Symptoms (MUS) are frequently encountered in general practice. However, little is known whether MUS affects labor market participation. We investigated the prospective association between MUS at baseline and risk of long-term sickness absence (LTSA), unemployment, and disability pensioning in a 5-year-follow-up study. In the Danish Work Environment Cohort Study 2005, 8187 randomly selected employees from the Danish general population answered a questionnaire on work and health. Responses were linked with national registers on prescribed medication and hospital treatment. Participants were classified with MUS if they: a) had reported three or more symptoms during the last month, and b) did not have a chronic condition, neither in the self-reported nor the register data. We assessed LTSA, unemployment, and disability pensioning by linking our data with National registers of social transfer payments. Of the 8187 participants, 272 (3.3%) were categorized with MUS. Compared to healthy participants, participants with MUS had an increased risk of LTSA (Rate ratio (RR) = 1.76, 95% CI = 1.28-2.42), and of unemployment (RR = 1.48, 95% CI = 1.02-2.15) during follow-up. MUS participants also showed an elevated RR with regard to risk of disability pensioning, however this association was not statistically significant (RR = 2.06, 95% CI = 0.77-5.52). MUS seem to have a negative effect on labor market participation defined by LTSA and unemployment, whereas it is more uncertain whether MUS affects risk of disability pensioning.

  9. Automatic Target Recognition in Synthetic Aperture Sonar Images Based on Geometrical Feature Extraction

    Directory of Open Access Journals (Sweden)

    J. Del Rio Vera

    2009-01-01

    Full Text Available This paper presents a new supervised classification approach for automated target recognition (ATR in SAS images. The recognition procedure starts with a novel segmentation stage based on the Hilbert transform. A number of geometrical features are then extracted and used to classify observed objects against a previously compiled database of target and non-target features. The proposed approach has been tested on a set of 1528 simulated images created by the NURC SIGMAS sonar model, achieving up to 95% classification accuracy.

  10. DNABP: Identification of DNA-Binding Proteins Based on Feature Selection Using a Random Forest and Predicting Binding Residues.

    Science.gov (United States)

    Ma, Xin; Guo, Jing; Sun, Xiao

    2016-01-01

    DNA-binding proteins are fundamentally important in cellular processes. Several computational-based methods have been developed to improve the prediction of DNA-binding proteins in previous years. However, insufficient work has been done on the prediction of DNA-binding proteins from protein sequence information. In this paper, a novel predictor, DNABP (DNA-binding proteins), was designed to predict DNA-binding proteins using the random forest (RF) classifier with a hybrid feature. The hybrid feature contains two types of novel sequence features, which reflect information about the conservation of physicochemical properties of the amino acids, and the binding propensity of DNA-binding residues and non-binding propensities of non-binding residues. The comparisons with each feature demonstrated that these two novel features contributed most to the improvement in predictive ability. Furthermore, to improve the prediction performance of the DNABP model, feature selection using the minimum redundancy maximum relevance (mRMR) method combined with incremental feature selection (IFS) was carried out during the model construction. The results showed that the DNABP model could achieve 86.90% accuracy, 83.76% sensitivity, 90.03% specificity and a Matthews correlation coefficient of 0.727. High prediction accuracy and performance comparisons with previous research suggested that DNABP could be a useful approach to identify DNA-binding proteins from sequence information. The DNABP web server system is freely available at http://www.cbi.seu.edu.cn/DNABP/.

  11. Delayed diaphragmatic herniation masquerading as a complicated parapneumonic effusion.

    Science.gov (United States)

    Tsang, J; Ryan, F

    1999-01-01

    Injury to the diaphragm following blunt or penetrating thoracoabdominal trauma is not uncommon. Recognition of this important complication of trauma continues to be a challenge because of the lack of specific clinical and plain radiographic features, the frequent presence of other serious injuries and the potential for delayed presentation. Delayed diaphragmatic herniation often presents with catastrophic bowel obstruction or strangulation. Early recognition of diaphragmatic injury is required to avoid this potentially lethal complication. The case of a 35-year-old man with a history of a knife wound to the left flank 15 years previously, who presented with unexplained acute hypoxemic respiratory failure and a unilateral exudative pleural effusion that was refractory to tube thoracostomy drainage, is reported. After admission to hospital, he developed gross dilation of his colon; emergency laparotomy revealed an incarcerated colonic herniation into the left hemithorax. Interesting clinical features of this patient's case included the patient's hobby of weightlifting, a persistently deviated mediastinum despite drainage of the pleural effusion and deceptive pleural fluid biochemical indices.

  12. Delayed Diaphragmatic Herniation Masquerading as a Complicated Parapneumonic Effusion

    Directory of Open Access Journals (Sweden)

    John Tsang

    1999-01-01

    Full Text Available Injury to the diaphragm following blunt or penetrating thoraco-abdominal trauma is not uncommon. Recognition of this important complication of trauma continues to be a challenge because of the lack of specific clinical and plain radiographic features, the frequent presence of other serious injuries and the potential for delayed presentation. Delayed diaphragmatic herniation often presents with catastrophic bowel obstruction or strangulation. Early recognition of diaphragmatic injury is required to avoid this potentially lethal complication. The case of a 35-year-old man with a history of a knife wound to the left flank 15 years previously, who presented with unexplained acute hypoxemic respiratory failure and a unilateral exudative pleural effusion that was refractory to tube thoracostomy drainage, is reported. After admission to hospital, he developed gross dilation of his colon; emergency laparotomy revealed an incarcerated colonic herniation into the left hemithorax. Interesting clinical features of this patient's case included the patient's hobby of weightlifting, a persistently deviated mediastinum despite drainage of the pleural effusion and deceptive pleural fluid biochemical indices.

  13. A feature point identification method for positron emission particle tracking with multiple tracers

    Energy Technology Data Exchange (ETDEWEB)

    Wiggins, Cody, E-mail: cwiggin2@vols.utk.edu [University of Tennessee-Knoxville, Department of Physics and Astronomy, 1408 Circle Drive, Knoxville, TN 37996 (United States); Santos, Roque [University of Tennessee-Knoxville, Department of Nuclear Engineering (United States); Escuela Politécnica Nacional, Departamento de Ciencias Nucleares (Ecuador); Ruggles, Arthur [University of Tennessee-Knoxville, Department of Nuclear Engineering (United States)

    2017-01-21

    A novel detection algorithm for Positron Emission Particle Tracking (PEPT) with multiple tracers based on optical feature point identification (FPI) methods is presented. This new method, the FPI method, is compared to a previous multiple PEPT method via analyses of experimental and simulated data. The FPI method outperforms the older method in cases of large particle numbers and fine time resolution. Simulated data show the FPI method to be capable of identifying 100 particles at 0.5 mm average spatial error. Detection error is seen to vary with the inverse square root of the number of lines of response (LORs) used for detection and increases as particle separation decreases. - Highlights: • A new approach to positron emission particle tracking is presented. • Using optical feature point identification analogs, multiple particle tracking is achieved. • Method is compared to previous multiple particle method. • Accuracy and applicability of method is explored.

  14. Appearance-based human gesture recognition using multimodal features for human computer interaction

    Science.gov (United States)

    Luo, Dan; Gao, Hua; Ekenel, Hazim Kemal; Ohya, Jun

    2011-03-01

    The use of gesture as a natural interface plays an utmost important role for achieving intelligent Human Computer Interaction (HCI). Human gestures include different components of visual actions such as motion of hands, facial expression, and torso, to convey meaning. So far, in the field of gesture recognition, most previous works have focused on the manual component of gestures. In this paper, we present an appearance-based multimodal gesture recognition framework, which combines the different groups of features such as facial expression features and hand motion features which are extracted from image frames captured by a single web camera. We refer 12 classes of human gestures with facial expression including neutral, negative and positive meanings from American Sign Languages (ASL). We combine the features in two levels by employing two fusion strategies. At the feature level, an early feature combination can be performed by concatenating and weighting different feature groups, and LDA is used to choose the most discriminative elements by projecting the feature on a discriminative expression space. The second strategy is applied on decision level. Weighted decisions from single modalities are fused in a later stage. A condensation-based algorithm is adopted for classification. We collected a data set with three to seven recording sessions and conducted experiments with the combination techniques. Experimental results showed that facial analysis improve hand gesture recognition, decision level fusion performs better than feature level fusion.

  15. Feature-Selective Attention Adaptively Shifts Noise Correlations in Primary Auditory Cortex.

    Science.gov (United States)

    Downer, Joshua D; Rapone, Brittany; Verhein, Jessica; O'Connor, Kevin N; Sutter, Mitchell L

    2017-05-24

    Sensory environments often contain an overwhelming amount of information, with both relevant and irrelevant information competing for neural resources. Feature attention mediates this competition by selecting the sensory features needed to form a coherent percept. How attention affects the activity of populations of neurons to support this process is poorly understood because population coding is typically studied through simulations in which one sensory feature is encoded without competition. Therefore, to study the effects of feature attention on population-based neural coding, investigations must be extended to include stimuli with both relevant and irrelevant features. We measured noise correlations ( r noise ) within small neural populations in primary auditory cortex while rhesus macaques performed a novel feature-selective attention task. We found that the effect of feature-selective attention on r noise depended not only on the population tuning to the attended feature, but also on the tuning to the distractor feature. To attempt to explain how these observed effects might support enhanced perceptual performance, we propose an extension of a simple and influential model in which shifts in r noise can simultaneously enhance the representation of the attended feature while suppressing the distractor. These findings present a novel mechanism by which attention modulates neural populations to support sensory processing in cluttered environments. SIGNIFICANCE STATEMENT Although feature-selective attention constitutes one of the building blocks of listening in natural environments, its neural bases remain obscure. To address this, we developed a novel auditory feature-selective attention task and measured noise correlations ( r noise ) in rhesus macaque A1 during task performance. Unlike previous studies showing that the effect of attention on r noise depends on population tuning to the attended feature, we show that the effect of attention depends on the tuning

  16. Intelligent fault diagnosis of rolling bearing based on kernel neighborhood rough sets and statistical features

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Xiao Ran; Zhang, You Yun; Zhu, Yong Sheng [Xi' an Jiaotong Univ., Xi' an (China)

    2012-09-15

    Intelligent fault diagnosis benefits from efficient feature selection. Neighborhood rough sets are effective in feature selection. However, determining the neighborhood value accurately remains a challenge. The wrapper feature selection algorithm is designed by combining the kernel method and neighborhood rough sets to self-adaptively select sensitive features. The combination effectively solves the shortcomings in selecting the neighborhood value in the previous application process. The statistical features of time and frequency domains are used to describe the characteristic of the rolling bearing to make the intelligent fault diagnosis approach work. Three classification algorithms, namely, classification and regression tree (CART), commercial version 4.5 (C4.5), and radial basis function support vector machines (RBFSVM), are used to test UCI datasets and 10 fault datasets of rolling bearing. The results indicate that the diagnostic approach presented could effectively select the sensitive fault features and simultaneously identify the type and degree of the fault.

  17. Intelligent fault diagnosis of rolling bearing based on kernel neighborhood rough sets and statistical features

    International Nuclear Information System (INIS)

    Zhu, Xiao Ran; Zhang, You Yun; Zhu, Yong Sheng

    2012-01-01

    Intelligent fault diagnosis benefits from efficient feature selection. Neighborhood rough sets are effective in feature selection. However, determining the neighborhood value accurately remains a challenge. The wrapper feature selection algorithm is designed by combining the kernel method and neighborhood rough sets to self-adaptively select sensitive features. The combination effectively solves the shortcomings in selecting the neighborhood value in the previous application process. The statistical features of time and frequency domains are used to describe the characteristic of the rolling bearing to make the intelligent fault diagnosis approach work. Three classification algorithms, namely, classification and regression tree (CART), commercial version 4.5 (C4.5), and radial basis function support vector machines (RBFSVM), are used to test UCI datasets and 10 fault datasets of rolling bearing. The results indicate that the diagnostic approach presented could effectively select the sensitive fault features and simultaneously identify the type and degree of the fault

  18. Comparing the Lexical Features of EAP Students' Essays by Prompt and Rating

    Science.gov (United States)

    Lavallée, Maxime; McDonough, Kim

    2015-01-01

    Previous research has shown that high frequency lexical items, such as AWL words and formulaic expressions, may differentiate between texts written by expert and novice writers (Chen & Baker, 2010; Hancioglu, 2009), and that lexical features related to breadth, depth, and accessibility differentiate among texts from L2 writers of different…

  19. Trephine Transverse Colostomy Is Effective for Patients Who Have Previously Undergone Rectal Surgery

    Science.gov (United States)

    Yeom, Seung-Seop; Jung, Sung Woo; Oh, Se Heon; Lee, Jong Lyul; Yoon, Yong Sik; Park, In Ja; Lim, Seok-Byung; Yu, Chang Sik; Kim, Jin Cheon

    2018-01-01

    Purpose Colostomy creation is an essential procedure for colorectal surgeons, but the preferred method of colostomy varies by surgeon. We compared the outcomes of trephine colostomy creation with open those for the (laparotomy) and laparoscopic methods and evaluated appropriate indications for a trephine colostomy and the advantages of the technique. Methods We retrospectively evaluated 263 patients who had undergone colostomy creation by trephine, open and laparoscopic approaches between April 2006 and March 2016. We compared the clinical features and the operative and postoperative outcomes according to the approach used for stoma creation. Results One hundred sixty-three patients (62%) underwent colostomy surgery for obstructive causes and 100 (38%) for fistulous problems. The mean operative time was significantly shorter with the trephine approach (trephine, 46.0 ± 1.9 minutes; open, 78.7 ± 3.9 minutes; laparoscopic, 63.5 ± 5.0 minutes; P colostomy was feasible for a diversion colostomy (P colostomy is safe and can be implemented quickly in various situations, and compared to other colostomy procedures, the patient’s recovery is faster. Previous laparotomy history was not a contraindication for a trephine colostomy, and a trephine transverse colostomy is feasible for patients who have undergone previous rectal surgery. PMID:29742862

  20. Featured Image: A New Dark Vortex on Neptune

    Science.gov (United States)

    Kohler, Susanna

    2018-03-01

    This remarkable series of images by the Hubble Space Telescope (click for the full view) track a dark vortex only the fifth ever observed on Neptune as it evolves in Neptunes atmosphere. These Hubble images, presented in a recent study led by Michael Wong (University of California, Berkeley), were taken in 2015 September, 2016 May, 2016 October, and 2017 October; the observations have monitored the evolution of the vortex as it has gradually weakened and drifted polewards. Confirmation of the vortex solved a puzzle that arose in 2015, when astronomers spotted an unexplained outburst of cloud activity on Neptune. This outburst was likely a group of bright companion clouds that form as air flows over high-pressure dark vortices, causing gases to freeze into methane ice crystals. To learn more about what the authors have since learned by studying this vortex, check out the paper below.CitationMichael H. Wong et al 2018 AJ 155 117. doi:10.3847/1538-3881/aaa6d6

  1. Image Feature Types and Their Predictions of Aesthetic Preference and Naturalness

    Directory of Open Access Journals (Sweden)

    Marc G. Berman

    2017-04-01

    Full Text Available Previous research has investigated ways to quantify visual information of a scene in terms of a visual processing hierarchy, i.e., making sense of visual environment by segmentation and integration of elementary sensory input. Guided by this research, studies have developed categories for low-level visual features (e.g., edges, colors, high-level visual features (scene-level entities that convey semantic information such as objects, and how models of those features predict aesthetic preference and naturalness. For example, in Kardan et al. (2015a, 52 participants provided aesthetic preference and naturalness ratings, which are used in the current study, for 307 images of mixed natural and urban content. Kardan et al. (2015a then developed a model using low-level features to predict aesthetic preference and naturalness and could do so with high accuracy. What has yet to be explored is the ability of higher-level visual features (e.g., horizon line position relative to viewer, geometry of building distribution relative to visual access to predict aesthetic preference and naturalness of scenes, and whether higher-level features mediate some of the association between the low-level features and aesthetic preference or naturalness. In this study we investigated these relationships and found that low- and high- level features explain 68.4% of the variance in aesthetic preference ratings and 88.7% of the variance in naturalness ratings. Additionally, several high-level features mediated the relationship between the low-level visual features and aaesthetic preference. In a multiple mediation analysis, the high-level feature mediators accounted for over 50% of the variance in predicting aesthetic preference. These results show that high-level visual features play a prominent role predicting aesthetic preference, but do not completely eliminate the predictive power of the low-level visual features. These strong predictors provide powerful insights for

  2. Discrete-Feature Model Implementation of SDM-Site Forsmark

    Energy Technology Data Exchange (ETDEWEB)

    Geier, Joel (Clearwater Hardrock Consulting, Corvallis, OR (United States))

    2010-03-15

    A discrete-feature model (DFM) was implemented for the Forsmark repository site based on the final site descriptive model from surface based investigations. The discrete-feature conceptual model represents deformation zones, individual fractures, and other water-conducting features around a repository as discrete conductors surrounded by a rock matrix which, in the present study, is treated as impermeable. This approximation is reasonable for sites in crystalline rock which has very low permeability, apart from that which results from macroscopic fracturing. Models are constructed based on the geological and hydrogeological description of the sites and engineering designs. Hydraulic heads and flows through the network of water-conducting features are calculated by the finite-element method, and are used in turn to simulate migration of non-reacting solute by a particle-tracking method, in order to estimate the properties of pathways by which radionuclides could be released to the biosphere. Stochastic simulation is used to evaluate portions of the model that can only be characterized in statistical terms, since many water-conducting features within the model volume cannot be characterized deterministically. Chapter 2 describes the methodology by which discrete features are derived to represent water-conducting features around the hypothetical repository at Forsmark (including both natural features and features that result from the disturbance of excavation), and then assembled to produce a discrete-feature network model for numerical simulation of flow and transport. Chapter 3 describes how site-specific data and repository design are adapted to produce the discrete-feature model. Chapter 4 presents results of the calculations. These include utilization factors for deposition tunnels based on the emplacement criteria that have been set forth by the implementers, flow distributions to the deposition holes, and calculated properties of discharge paths as well as

  3. Discrete-Feature Model Implementation of SDM-Site Forsmark

    International Nuclear Information System (INIS)

    Geier, Joel

    2010-03-01

    A discrete-feature model (DFM) was implemented for the Forsmark repository site based on the final site descriptive model from surface based investigations. The discrete-feature conceptual model represents deformation zones, individual fractures, and other water-conducting features around a repository as discrete conductors surrounded by a rock matrix which, in the present study, is treated as impermeable. This approximation is reasonable for sites in crystalline rock which has very low permeability, apart from that which results from macroscopic fracturing. Models are constructed based on the geological and hydrogeological description of the sites and engineering designs. Hydraulic heads and flows through the network of water-conducting features are calculated by the finite-element method, and are used in turn to simulate migration of non-reacting solute by a particle-tracking method, in order to estimate the properties of pathways by which radionuclides could be released to the biosphere. Stochastic simulation is used to evaluate portions of the model that can only be characterized in statistical terms, since many water-conducting features within the model volume cannot be characterized deterministically. Chapter 2 describes the methodology by which discrete features are derived to represent water-conducting features around the hypothetical repository at Forsmark (including both natural features and features that result from the disturbance of excavation), and then assembled to produce a discrete-feature network model for numerical simulation of flow and transport. Chapter 3 describes how site-specific data and repository design are adapted to produce the discrete-feature model. Chapter 4 presents results of the calculations. These include utilization factors for deposition tunnels based on the emplacement criteria that have been set forth by the implementers, flow distributions to the deposition holes, and calculated properties of discharge paths as well as

  4. Combining morphometric features and convolutional networks fusion for glaucoma diagnosis

    Science.gov (United States)

    Perdomo, Oscar; Arevalo, John; González, Fabio A.

    2017-11-01

    Glaucoma is an eye condition that leads to loss of vision and blindness. Ophthalmoscopy exam evaluates the shape, color and proportion between the optic disc and physiologic cup, but the lack of agreement among experts is still the main diagnosis problem. The application of deep convolutional neural networks combined with automatic extraction of features such as: the cup-to-disc distance in the four quadrants, the perimeter, area, eccentricity, the major radio, the minor radio in optic disc and cup, in addition to all the ratios among the previous parameters may help with a better automatic grading of glaucoma. This paper presents a strategy to merge morphological features and deep convolutional neural networks as a novel methodology to support the glaucoma diagnosis in eye fundus images.

  5. A blur-invariant local feature for motion blurred image matching

    Science.gov (United States)

    Tong, Qiang; Aoki, Terumasa

    2017-07-01

    Image matching between a blurred (caused by camera motion, out of focus, etc.) image and a non-blurred image is a critical task for many image/video applications. However, most of the existing local feature schemes fail to achieve this work. This paper presents a blur-invariant descriptor and a novel local feature scheme including the descriptor and the interest point detector based on moment symmetry - the authors' previous work. The descriptor is based on a new concept - center peak moment-like element (CPME) which is robust to blur and boundary effect. Then by constructing CPMEs, the descriptor is also distinctive and suitable for image matching. Experimental results show our scheme outperforms state of the art methods for blurred image matching

  6. Definitions of engineered safety features and related features for nuclear power plants

    International Nuclear Information System (INIS)

    1986-01-01

    In light water moderated, light water cooled nuclear power plants, definitions are given of engineered safety features which are designed to suppress or prevent dispersion of radioactive materials due to damage etc. of fuel at the times of power plant failures, and of related features which are designed to actuate or operate the engineered safety features. Contents are the following: scope of engineered safety features and of related features; classification of engineered safety features (direct systems and indirect systems) and of related features (auxiliaries, emergency power supply, and protective means). (Mori, K.)

  7. Features of spatial and functional segregation and integration of the primate connectome revealed by trade-off between wiring cost and efficiency.

    Directory of Open Access Journals (Sweden)

    Yuhan Chen

    2017-09-01

    Full Text Available The primate connectome, possessing a characteristic global topology and specific regional connectivity profiles, is well organized to support both segregated and integrated brain function. However, the organization mechanisms shaping the characteristic connectivity and its relationship to functional requirements remain unclear. The primate brain connectome is shaped by metabolic economy as well as functional values. Here, we explored the influence of two competing factors and additional advanced functional requirements on the primate connectome employing an optimal trade-off model between neural wiring cost and the representative functional requirement of processing efficiency. Moreover, we compared this model with a generative model combining spatial distance and topological similarity, with the objective of statistically reproducing multiple topological features of the network. The primate connectome indeed displays a cost-efficiency trade-off and that up to 67% of the connections were recovered by optimal combination of the two basic factors of wiring economy and processing efficiency, clearly higher than the proportion of connections (56% explained by the generative model. While not explicitly aimed for, the trade-off model captured several key topological features of the real connectome as the generative model, yet better explained the connectivity of most regions. The majority of the remaining 33% of connections unexplained by the best trade-off model were long-distance links, which are concentrated on few cortical areas, termed long-distance connectors (LDCs. The LDCs are mainly non-hubs, but form a densely connected group overlapping on spatially segregated functional modalities. LDCs are crucial for both functional segregation and integration across different scales. These organization features revealed by the optimization analysis provide evidence that the demands of advanced functional segregation and integration among spatially

  8. Neonatal screening for absolute lymphopenia | El-Sayed | Egyptian ...

    African Journals Online (AJOL)

    Three neonates had congenital anomalies, one only experienced dysmorphic features and 8 (1.6%) had family history of unexplained death but these data could not be linked to the presence of lymphopenia in the studied sample. APGAR scores at 1 and 5 minutes were significantly lower in neonates with lymphopenia (p ...

  9. Feature-Specific Event-Related Potential Effects to Action- and Sound-Related Verbs during Visual Word Recognition.

    Science.gov (United States)

    Popp, Margot; Trumpp, Natalie M; Kiefer, Markus

    2016-01-01

    Grounded cognition theories suggest that conceptual representations essentially depend on modality-specific sensory and motor systems. Feature-specific brain activation across different feature types such as action or audition has been intensively investigated in nouns, while feature-specific conceptual category differences in verbs mainly focused on body part specific effects. The present work aimed at assessing whether feature-specific event-related potential (ERP) differences between action and sound concepts, as previously observed in nouns, can also be found within the word class of verbs. In Experiment 1, participants were visually presented with carefully matched sound and action verbs within a lexical decision task, which provides implicit access to word meaning and minimizes strategic access to semantic word features. Experiment 2 tested whether pre-activating the verb concept in a context phase, in which the verb is presented with a related context noun, modulates subsequent feature-specific action vs. sound verb processing within the lexical decision task. In Experiment 1, ERP analyses revealed a differential ERP polarity pattern for action and sound verbs at parietal and central electrodes similar to previous results in nouns. Pre-activation of the meaning of verbs in the preceding context phase in Experiment 2 resulted in a polarity-reversal of feature-specific ERP effects in the lexical decision task compared with Experiment 1. This parallels analogous earlier findings for primed action and sound related nouns. In line with grounded cognitions theories, our ERP study provides evidence for a differential processing of action and sound verbs similar to earlier observation for concrete nouns. Although the localizational value of ERPs must be viewed with caution, our results indicate that the meaning of verbs is linked to different neural circuits depending on conceptual feature relevance.

  10. Mutations in HIVEP2 are associated with developmental delay, intellectual disability, and dysmorphic features

    NARCIS (Netherlands)

    Steinfeld, Hallie; Cho, Megan T.; Retterer, Kyle; Person, Rick; Schaefer, G. Bradley; Danylchuk, Noelle; Malik, Saleem; Wechsler, Stephanie Burns; Wheeler, Patricia G.; van Gassen, Koen L I; Terhal, P. A.; Verhoeven, Virginie J M; van Slegtenhorst, Marjon A.; Monaghan, Kristin G.; Henderson, Lindsay B.; Chung, Wendy K.

    Human immunodeficiency virus type I enhancer binding protein 2 (HIVEP2) has been previously associated with intellectual disability and developmental delay in three patients. Here, we describe six patients with developmental delay, intellectual disability, and dysmorphic features with de novo likely

  11. Language Recognition Using Latent Dynamic Conditional Random Field Model with Phonological Features

    Directory of Open Access Journals (Sweden)

    Sirinoot Boonsuk

    2014-01-01

    Full Text Available Spoken language recognition (SLR has been of increasing interest in multilingual speech recognition for identifying the languages of speech utterances. Most existing SLR approaches apply statistical modeling techniques with acoustic and phonotactic features. Among the popular approaches, the acoustic approach has become of greater interest than others because it does not require any prior language-specific knowledge. Previous research on the acoustic approach has shown less interest in applying linguistic knowledge; it was only used as supplementary features, while the current state-of-the-art system assumes independency among features. This paper proposes an SLR system based on the latent-dynamic conditional random field (LDCRF model using phonological features (PFs. We use PFs to represent acoustic characteristics and linguistic knowledge. The LDCRF model was employed to capture the dynamics of the PFs sequences for language classification. Baseline systems were conducted to evaluate the features and methods including Gaussian mixture model (GMM based systems using PFs, GMM using cepstral features, and the CRF model using PFs. Evaluated on the NIST LRE 2007 corpus, the proposed method showed an improvement over the baseline systems. Additionally, it showed comparable result with the acoustic system based on i-vector. This research demonstrates that utilizing PFs can enhance the performance.

  12. A Common Representation of Spatial Features Drives Action and Perception

    DEFF Research Database (Denmark)

    Christiansen, Jens H; Christensen, Jeppe Høy; Grünbaum, Thor

    2014-01-01

    Spatial features of an object can be specified using two different response types: either by use of symbols or motorically by directly acting upon the object. Is this response dichotomy reflected in a dual representation of the visual world: one for perception and one for action? Previously, symb...... of matching object-processing characteristics is also in agreement with the idea of a common representation driving both response types....

  13. The Impact Of Website Design Features On Behavioral Intentions

    Directory of Open Access Journals (Sweden)

    Chun-Chin Chiu

    2015-08-01

    Full Text Available The design of a website interface plays an important role in online purchasing and customers are more likely to visit and buy from better-designed websites. However previous studies have not provided consistent information about the features a website should provide. Based on Hausman and Siekpes 2009 comprehensive model this study aims to empirically verify whether the model can be applied in e-service markets to predict and explain website users behavioral intentions trade intentions and revisit intentions. Based on the data from a survey of 303 Internet users the results indicate that computer factors and human factors the key website design features are significantly related to website users experiences perceived usefulness perceived entertainment value and perceived informativeness in turn significantly affect the intermediary outcomes of attitude toward the site and ultimately influence users behavioral intentions.

  14. Investigation of fatigue by Australian general practice registrars: a cross-sectional study.

    Science.gov (United States)

    Morgan, Simon; Henderson, Kim M; Tapley, Amanda; Thomson, Allison; Wilson, Jessica; Scott, John; Spike, Neil A; McArthur, Lawrie; van Driel, Mieke L; Magin, Parker J

    2015-06-01

    Fatigue is the most common undifferentiated problem presenting in general practice. Previous studies have shown that this presentation leads to multiple investigations. There is no published literature describing the management of patients with fatigue by general practice (GP) registrars. To document the investigation-ordering behaviour of GP registrars in managing patients with a new diagnosis of unexplained fatigue. This was a cross-sectional analysis of data from Registrar Clinical Encounters in Training (ReCEnT), an ongoing cohort study of GP registrars' consultations. We established the prevalence of new diagnoses of unexplained fatigue and associations with that diagnosis, the rate of test ordering and the number and types of investigations ordered. 644 registrars contributed data from 68 986 encounters. In 0.78% of patient encounters, a new diagnosis of unexplained fatigue was made. Pathology was ordered in 78.4% of these problems (versus 18.1% in non-fatigue problems), at a rate of 488 tests per 100 new fatigue problems. Our study suggests that unexplained fatigue elicits a non-rational approach to test ordering by registrars. These findings contribute to the understanding of GP registrar management of fatigue, and undifferentiated presentations more broadly, and suggest educational approaches to improve practice, including dealing with uncertainty.

  15. Features of annual and semiannual variations derived from the global ionospheric maps of total electron content

    Directory of Open Access Journals (Sweden)

    B. Zhao

    2008-01-01

    Full Text Available In the present work we use the NASA-JPL global ionospheric maps of total electron content (TEC, firstly to construct TEC maps (TEC vs. magnetic local time MLT, and magnetic latitude MLAT in the interval from 1999 to 2005. These TEC maps were, in turn, used to estimate the annual-to-mean amplitude ratio, A1, and the semiannual-to-mean amplitude ratio, A2, as well as the latitudinal symmetrical and asymmetrical parts, A' and A" of A1. Thus, we investigated in detail the TEC climatology from maps of these indices, with an emphasis on the quantitative presentation for local time and latitudinal changes in the seasonal, annual and semiannual anomalies of the ionospheric TEC. Then we took the TEC value at 14:00 LT to examine various anomalies at a global scale following the same procedure. Results reveal similar features appearing in NmF2, such as that the seasonal anomaly is more significant in the near-pole regions than in the far-pole regions and the reverse is true for the semiannual anomaly; the winter anomaly has least a chance to be observed at the South America and South Pacific areas. The most impressive feature is that the equinoctial asymmetry is most prominent at the East Asian and South Australian areas. Through the analysis of the TIMED GUVI columnar [O/N2] data, we have investigated to what extent the seasonal, annual and semiannual variations can be explained by their counterparts in [O/N2]. Results revealed that the [O/N2] variation is a major contributor to the daytime winter anomaly of TEC, and it also contributes to some of the semiannual and annual anomalies. The contribution to the anomalies unexplained by the [O/N2] data could possibly be due to the dynamics associated with thermospheric winds and electric fields.

  16. Music Genre Classification Using MIDI and Audio Features

    Science.gov (United States)

    Cataltepe, Zehra; Yaslan, Yusuf; Sonmez, Abdullah

    2007-12-01

    We report our findings on using MIDI files and audio features from MIDI, separately and combined together, for MIDI music genre classification. We use McKay and Fujinaga's 3-root and 9-leaf genre data set. In order to compute distances between MIDI pieces, we use normalized compression distance (NCD). NCD uses the compressed length of a string as an approximation to its Kolmogorov complexity and has previously been used for music genre and composer clustering. We convert the MIDI pieces to audio and then use the audio features to train different classifiers. MIDI and audio from MIDI classifiers alone achieve much smaller accuracies than those reported by McKay and Fujinaga who used not NCD but a number of domain-based MIDI features for their classification. Combining MIDI and audio from MIDI classifiers improves accuracy and gets closer to, but still worse, accuracies than McKay and Fujinaga's. The best root genre accuracies achieved using MIDI, audio, and combination of them are 0.75, 0.86, and 0.93, respectively, compared to 0.98 of McKay and Fujinaga. Successful classifier combination requires diversity of the base classifiers. We achieve diversity through using certain number of seconds of the MIDI file, different sample rates and sizes for the audio file, and different classification algorithms.

  17. Mouse epileptic seizure detection with multiple EEG features and simple thresholding technique

    Science.gov (United States)

    Tieng, Quang M.; Anbazhagan, Ashwin; Chen, Min; Reutens, David C.

    2017-12-01

    Objective. Epilepsy is a common neurological disorder characterized by recurrent, unprovoked seizures. The search for new treatments for seizures and epilepsy relies upon studies in animal models of epilepsy. To capture data on seizures, many applications require prolonged electroencephalography (EEG) with recordings that generate voluminous data. The desire for efficient evaluation of these recordings motivates the development of automated seizure detection algorithms. Approach. A new seizure detection method is proposed, based on multiple features and a simple thresholding technique. The features are derived from chaos theory, information theory and the power spectrum of EEG recordings and optimally exploit both linear and nonlinear characteristics of EEG data. Main result. The proposed method was tested with real EEG data from an experimental mouse model of epilepsy and distinguished seizures from other patterns with high sensitivity and specificity. Significance. The proposed approach introduces two new features: negative logarithm of adaptive correlation integral and power spectral coherence ratio. The combination of these new features with two previously described features, entropy and phase coherence, improved seizure detection accuracy significantly. Negative logarithm of adaptive correlation integral can also be used to compute the duration of automatically detected seizures.

  18. An unusual mixed tumor of the pancreas: sonographic and MDCT features.

    Science.gov (United States)

    Mortelé, Koenraad J; Peters, Hope E; Odze, Robert D; Glickman, Jonathan N; Jajoo, Kunal; Banks, Peter A

    2009-03-09

    Mixed tumors of the pancreas are exceedingly rare. We herein report on a 54-year-old female who presented with an enlarging cystic lesion in the head of the pancreas. Right upper quadrant ultrasound and multidetector-row CT scan showed a well-defined unilocular cystic tumor located in the head of the pancreas and surrounded, in part, by a hypervascular solid mass. Although mixed exocrine/endocrine pancreatic tumors have been described previously, to the best of our knowledge, this is the first case of a pancreatic mixed intraductal papillary mucinous neoplasm/endocrine tumor with illustration of its ultrasound and CT features. Moreover, the importance of preoperative analysis of imaging features in the assessment of pancreatic neoplasms is discussed.

  19. JCE Feature Columns

    Science.gov (United States)

    Holmes, Jon L.

    1999-05-01

    The Features area of JCE Online is now readily accessible through a single click from our home page. In the Features area each column is linked to its own home page. These column home pages also have links to them from the online Journal Table of Contents pages or from any article published as part of that feature column. Using these links you can easily find abstracts of additional articles that are related by topic. Of course, JCE Online+ subscribers are then just one click away from the entire article. Finding related articles is easy because each feature column "site" contains links to the online abstracts of all the articles that have appeared in the column. In addition, you can find the mission statement for the column and the email link to the column editor that I mentioned above. At the discretion of its editor, a feature column site may contain additional resources. As an example, the Chemical Information Instructor column edited by Arleen Somerville will have a periodically updated bibliography of resources for teaching and using chemical information. Due to the increase in the number of these resources available on the WWW, it only makes sense to publish this information online so that you can get to these resources with a simple click of the mouse. We expect that there will soon be additional information and resources at several other feature column sites. Following in the footsteps of the Chemical Information Instructor, up-to-date bibliographies and links to related online resources can be made available. We hope to extend the online component of our feature columns with moderated online discussion forums. If you have a suggestion for an online resource you would like to see included, let the feature editor or JCE Online (jceonline@chem.wisc.edu) know about it. JCE Internet Features JCE Internet also has several feature columns: Chemical Education Resource Shelf, Conceptual Questions and Challenge Problems, Equipment Buyers Guide, Hal's Picks, Mathcad

  20. Behavioural cues surpass habitat factors in explaining prebreeding resource selection by a migratory diving duck

    Science.gov (United States)

    O'Neil, Shawn T.; Warren, Jeffrey M.; Takekawa, John Y.; De La Cruz, Susan E. W.; Cutting, Kyle A.; Parker, Michael W.; Yee, Julie L.

    2014-01-01

    Prebreeding habitat selection in birds can often be explained in part by habitat characteristics. However, females may also select habitats on the basis of fidelity to areas of previous reproductive success or use by conspecifics. The relative influences of sociobehavioural attributes versus habitat characteristics in habitat selection has been primarily investigated in songbirds, while less is known about how these factors affect habitat selection processes in migratory waterfowl. Animal resource selection models often exhibit much unexplained variation; spatial patterns driven by social and behavioural characteristics may account for some of this. We radiomarked female lesser scaup, Aythya affinis, in the southwestern extent of their breeding range to explore hypotheses regarding relative roles of habitat quality, site fidelity and conspecific density in prebreeding habitat selection. We used linear mixed-effects models to relate intensity of use within female home ranges to habitat features, distance to areas of reproductive success during the previous breeding season and conspecific density. Home range habitats included shallow water (≤118 cm), moderate to high densities of flooded emergent vegetation/open water edge and open water areas with submerged aquatic vegetation. Compared with habitat features, conspecific female density and proximity to successful nesting habitats from the previous breeding season had greater influences on habitat use within home ranges. Fidelity and conspecific attraction are behavioural characteristics in some waterfowl species that may exert a greater influence than habitat features in influencing prebreeding space use and habitat selection within home ranges, particularly where quality habitat is abundant. These processes may be of critical importance to a better understanding of habitat selection in breeding birds.

  1. Principal Feature Analysis: A Multivariate Feature Selection Method for fMRI Data

    Directory of Open Access Journals (Sweden)

    Lijun Wang

    2013-01-01

    Full Text Available Brain decoding with functional magnetic resonance imaging (fMRI requires analysis of complex, multivariate data. Multivoxel pattern analysis (MVPA has been widely used in recent years. MVPA treats the activation of multiple voxels from fMRI data as a pattern and decodes brain states using pattern classification methods. Feature selection is a critical procedure of MVPA because it decides which features will be included in the classification analysis of fMRI data, thereby improving the performance of the classifier. Features can be selected by limiting the analysis to specific anatomical regions or by computing univariate (voxel-wise or multivariate statistics. However, these methods either discard some informative features or select features with redundant information. This paper introduces the principal feature analysis as a novel multivariate feature selection method for fMRI data processing. This multivariate approach aims to remove features with redundant information, thereby selecting fewer features, while retaining the most information.

  2. Planck intermediate results: XLVI. Reduction of large-scale systematic effects in HFI polarization maps and estimation of the reionization optical depth

    DEFF Research Database (Denmark)

    Aghanim, N.; Ashdown, M.; Aumont, J.

    2016-01-01

    This paper describes the identification, modelling, and removal of previously unexplained systematic effects in the polarization data of the Planck High Frequency Instrument (HFI) on large angular scales, including new mapmaking and calibration procedures, new and more complete end-to-end simulat...

  3. On the connective tissue regulator Follistatin-like 1

    NARCIS (Netherlands)

    Sylva, M.

    2014-01-01

    Even though for many years the molecular mechanisms underlying cardiac development have been studied, the majority of cardiac defects remain unexplained. Defects in the cardiac connective tissue component result in a large proportion of heart defects such as valve and septal defects. Previous

  4. Gender Differences in Figural Matrices: The Moderating Role of Item Design Features

    Science.gov (United States)

    Arendasy, Martin E.; Sommer, Markus

    2012-01-01

    There is a heated debate on whether observed gender differences in some figural matrices in adults can be attributed to gender differences in inductive reasoning/G[subscript f] or differential item functioning and/or test bias. Based on previous studies we hypothesized that three specific item design features moderate the effect size of the gender…

  5. Financial impact of adopting implantable loop recorder diagnostic for unexplained syncope compared with conventional diagnostic pathway in Portugal.

    Science.gov (United States)

    Providência, Rui; Candeias, Rui; Morais, Carlos; Reis, Hipólito; Elvas, Luís; Sanfins, Vitor; Farinha, Sara; Eggington, Simon; Tsintzos, Stelios

    2014-05-06

    To estimate the short- and long-term financial impact of early referral for implantable loop recorder diagnostic (ILR) versus conventional diagnostic pathway (CDP) in the management of unexplained syncope (US) in the Portuguese National Health Service (PNHS). A Markov model was developed to estimate the expected number of hospital admissions due to US and its respective financial impact in patients implanted with ILR versus CDP. The average cost of a syncope episode admission was estimated based on Portuguese cost data and landmark papers. The financial impact of ILR adoption was estimated for a total of 197 patients with US, based on the number of syncope admissions per year in the PNHS. Sensitivity analysis was performed to take into account the effect of uncertainty in the input parameters (hazard ratio of death; number of syncope events per year; probabilities and unit costs of each diagnostic test; probability of trauma and yield of diagnosis) over three-year and lifetime horizons. The average cost of a syncope event was estimated to be between 1,760€ and 2,800€. Over a lifetime horizon, the total discounted costs of hospital admissions and syncope diagnosis for the entire cohort were 23% lower amongst patients in the ILR group compared with the CDP group (1,204,621€ for ILR, versus 1,571,332€ for CDP). The utilization of ILR leads to an earlier diagnosis and lower number of syncope hospital admissions and investigations, thus allowing significant cost offsets in the Portuguese setting. The result is robust to changes in the input parameter values, and cost savings become more pronounced over time.

  6. The effect of an educational intervention in family phisicians on self-rated quality of life in patients with medically unexplained symptoms.

    Science.gov (United States)

    Ivetić, Vojislav; Pašić, Klemen; Selič, Polona

    2017-06-01

    Medically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to evaluate the effect of an educational intervention (EI) on self-rated quality of life, treatment satisfaction, and the family physician-patient relationship in patients with MUS. In a multi-centre longitudinal intervention study, which was performed between 2012 and 2014, patients were asked to rate their quality of life, assess their depression, anxiety, stress and somatisation, complete the Hypochondriasis Index, the Medical Interview Satisfaction Scale and the Patient Enablement Instrument for assessing the physician-patient relationship, before and after the EI. The mean values before and after the intervention showed that after the EI, patients with MUS gave a lower (total) mean rating of their health issues and a higher rating of their quality of life, and they also had a more positive opinion of their relationship with the physician (p<0.05). However, there were no differences in the (total) rating of treatment satisfaction before and after the EI (p=0.423). Significant differences in the symptoms in patients with MUS before and after the intervention were confirmed for stress, somatisation and hypochondriasis (p<0.05). It could be beneficial to equip family physicians with the knowledge, skills and tools to reduce hypochondriasis and somatisation in MUS patients, which would improve patients' self-rated health status.

  7. Computer-aided mass detection in mammography: False positive reduction via gray-scale invariant ranklet texture features

    International Nuclear Information System (INIS)

    Masotti, Matteo; Lanconelli, Nico; Campanini, Renato

    2009-01-01

    In this work, gray-scale invariant ranklet texture features are proposed for false positive reduction (FPR) in computer-aided detection (CAD) of breast masses. Two main considerations are at the basis of this proposal. First, false positive (FP) marks surviving our previous CAD system seem to be characterized by specific texture properties that can be used to discriminate them from masses. Second, our previous CAD system achieves invariance to linear/nonlinear monotonic gray-scale transformations by encoding regions of interest into ranklet images through the ranklet transform, an image transformation similar to the wavelet transform, yet dealing with pixels' ranks rather than with their gray-scale values. Therefore, the new FPR approach proposed herein defines a set of texture features which are calculated directly from the ranklet images corresponding to the regions of interest surviving our previous CAD system, hence, ranklet texture features; then, a support vector machine (SVM) classifier is used for discrimination. As a result of this approach, texture-based information is used to discriminate FP marks surviving our previous CAD system; at the same time, invariance to linear/nonlinear monotonic gray-scale transformations of the new CAD system is guaranteed, as ranklet texture features are calculated from ranklet images that have this property themselves by construction. To emphasize the gray-scale invariance of both the previous and new CAD systems, training and testing are carried out without any in-between parameters' adjustment on mammograms having different gray-scale dynamics; in particular, training is carried out on analog digitized mammograms taken from a publicly available digital database, whereas testing is performed on full-field digital mammograms taken from an in-house database. Free-response receiver operating characteristic (FROC) curve analysis of the two CAD systems demonstrates that the new approach achieves a higher reduction of FP marks

  8. Forged Signature Distinction Using Convolutional Neural Network for Feature Extraction

    Directory of Open Access Journals (Sweden)

    Seungsoo Nam

    2018-01-01

    Full Text Available This paper proposes a dynamic verification scheme for finger-drawn signatures in smartphones. As a dynamic feature, the movement of a smartphone is recorded with accelerometer sensors in the smartphone, in addition to the moving coordinates of the signature. To extract high-level longitudinal and topological features, the proposed scheme uses a convolution neural network (CNN for feature extraction, and not as a conventional classifier. We assume that a CNN trained with forged signatures can extract effective features (called S-vector, which are common in forging activities such as hesitation and delay before drawing the complicated part. The proposed scheme also exploits an autoencoder (AE as a classifier, and the S-vector is used as the input vector to the AE. An AE has high accuracy for the one-class distinction problem such as signature verification, and is also greatly dependent on the accuracy of input data. S-vector is valuable as the input of AE, and, consequently, could lead to improved verification accuracy especially for distinguishing forged signatures. Compared to the previous work, i.e., the MLP-based finger-drawn signature verification scheme, the proposed scheme decreases the equal error rate by 13.7%, specifically, from 18.1% to 4.4%, for discriminating forged signatures.

  9. A Transform-Based Feature Extraction Approach for Motor Imagery Tasks Classification

    Science.gov (United States)

    Khorshidtalab, Aida; Mesbah, Mostefa; Salami, Momoh J. E.

    2015-01-01

    In this paper, we present a new motor imagery classification method in the context of electroencephalography (EEG)-based brain–computer interface (BCI). This method uses a signal-dependent orthogonal transform, referred to as linear prediction singular value decomposition (LP-SVD), for feature extraction. The transform defines the mapping as the left singular vectors of the LP coefficient filter impulse response matrix. Using a logistic tree-based model classifier; the extracted features are classified into one of four motor imagery movements. The proposed approach was first benchmarked against two related state-of-the-art feature extraction approaches, namely, discrete cosine transform (DCT) and adaptive autoregressive (AAR)-based methods. By achieving an accuracy of 67.35%, the LP-SVD approach outperformed the other approaches by large margins (25% compared with DCT and 6 % compared with AAR-based methods). To further improve the discriminatory capability of the extracted features and reduce the computational complexity, we enlarged the extracted feature subset by incorporating two extra features, namely, Q- and the Hotelling’s \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$T^{2}$ \\end{document} statistics of the transformed EEG and introduced a new EEG channel selection method. The performance of the EEG classification based on the expanded feature set and channel selection method was compared with that of a number of the state-of-the-art classification methods previously reported with the BCI IIIa competition data set. Our method came second with an average accuracy of 81.38%. PMID:27170898

  10. Swallowing sound detection using hidden markov modeling of recurrence plot features

    International Nuclear Information System (INIS)

    Aboofazeli, Mohammad; Moussavi, Zahra

    2009-01-01

    Automated detection of swallowing sounds in swallowing and breath sound recordings is of importance for monitoring purposes in which the recording durations are long. This paper presents a novel method for swallowing sound detection using hidden Markov modeling of recurrence plot features. Tracheal sound recordings of 15 healthy and nine dysphagic subjects were studied. The multidimensional state space trajectory of each signal was reconstructed using the Taken method of delays. The sequences of three recurrence plot features of the reconstructed trajectories (which have shown discriminating capability between swallowing and breath sounds) were modeled by three hidden Markov models. The Viterbi algorithm was used for swallowing sound detection. The results were validated manually by inspection of the simultaneously recorded airflow signal and spectrogram of the sounds, and also by auditory means. The experimental results suggested that the performance of the proposed method using hidden Markov modeling of recurrence plot features was superior to the previous swallowing sound detection methods.

  11. Swallowing sound detection using hidden markov modeling of recurrence plot features

    Energy Technology Data Exchange (ETDEWEB)

    Aboofazeli, Mohammad [Faculty of Engineering, Department of Electrical and Computer Engineering, University of Manitoba, Winnipeg, Manitoba, R3T 5V6 (Canada)], E-mail: umaboofa@cc.umanitoba.ca; Moussavi, Zahra [Faculty of Engineering, Department of Electrical and Computer Engineering, University of Manitoba, Winnipeg, Manitoba, R3T 5V6 (Canada)], E-mail: mousavi@ee.umanitoba.ca

    2009-01-30

    Automated detection of swallowing sounds in swallowing and breath sound recordings is of importance for monitoring purposes in which the recording durations are long. This paper presents a novel method for swallowing sound detection using hidden Markov modeling of recurrence plot features. Tracheal sound recordings of 15 healthy and nine dysphagic subjects were studied. The multidimensional state space trajectory of each signal was reconstructed using the Taken method of delays. The sequences of three recurrence plot features of the reconstructed trajectories (which have shown discriminating capability between swallowing and breath sounds) were modeled by three hidden Markov models. The Viterbi algorithm was used for swallowing sound detection. The results were validated manually by inspection of the simultaneously recorded airflow signal and spectrogram of the sounds, and also by auditory means. The experimental results suggested that the performance of the proposed method using hidden Markov modeling of recurrence plot features was superior to the previous swallowing sound detection methods.

  12. The optimal extraction of feature algorithm based on KAZE

    Science.gov (United States)

    Yao, Zheyi; Gu, Guohua; Qian, Weixian; Wang, Pengcheng

    2015-10-01

    As a novel method of 2D features extraction algorithm over the nonlinear scale space, KAZE provide a special method. However, the computation of nonlinear scale space and the construction of KAZE feature vectors are more expensive than the SIFT and SURF significantly. In this paper, the given image is used to build the nonlinear space up to a maximum evolution time through the efficient Additive Operator Splitting (AOS) techniques and the variable conductance diffusion. Changing the parameter can improve the construction of nonlinear scale space and simplify the image conductivities for each dimension space, with the predigest computation. Then, the detection for points of interest can exhibit a maxima of the scale-normalized determinant with the Hessian response in the nonlinear scale space. At the same time, the detection of feature vectors is optimized by the Wavelet Transform method, which can avoid the second Gaussian smoothing in the KAZE Features and cut down the complexity of the algorithm distinctly in the building and describing vectors steps. In this way, the dominant orientation is obtained, similar to SURF, by summing the responses within a sliding circle segment covering an angle of π/3 in the circular area of radius 6σ with a sampling step of size σ one by one. Finally, the extraction in the multidimensional patch at the given scale, centered over the points of interest and rotated to align its dominant orientation to a canonical direction, is able to simplify the description of feature by reducing the description dimensions, just as the PCA-SIFT method. Even though the features are somewhat more expensive to compute than SIFT due to the construction of nonlinear scale space, but compared to SURF, the result revels a step forward in performance in detection, description and application against the previous ways by the following contrast experiments.

  13. Automated identification of protein-ligand interaction features using Inductive Logic Programming: a hexose binding case study.

    Science.gov (United States)

    A Santos, Jose C; Nassif, Houssam; Page, David; Muggleton, Stephen H; E Sternberg, Michael J

    2012-07-11

    There is a need for automated methods to learn general features of the interactions of a ligand class with its diverse set of protein receptors. An appropriate machine learning approach is Inductive Logic Programming (ILP), which automatically generates comprehensible rules in addition to prediction. The development of ILP systems which can learn rules of the complexity required for studies on protein structure remains a challenge. In this work we use a new ILP system, ProGolem, and demonstrate its performance on learning features of hexose-protein interactions. The rules induced by ProGolem detect interactions mediated by aromatics and by planar-polar residues, in addition to less common features such as the aromatic sandwich. The rules also reveal a previously unreported dependency for residues cys and leu. They also specify interactions involving aromatic and hydrogen bonding residues. This paper shows that Inductive Logic Programming implemented in ProGolem can derive rules giving structural features of protein/ligand interactions. Several of these rules are consistent with descriptions in the literature. In addition to confirming literature results, ProGolem's model has a 10-fold cross-validated predictive accuracy that is superior, at the 95% confidence level, to another ILP system previously used to study protein/hexose interactions and is comparable with state-of-the-art statistical learners.

  14. 49 CFR 173.23 - Previously authorized packaging.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Previously authorized packaging. 173.23 Section... REQUIREMENTS FOR SHIPMENTS AND PACKAGINGS Preparation of Hazardous Materials for Transportation § 173.23 Previously authorized packaging. (a) When the regulations specify a packaging with a specification marking...

  15. The Effect of Resolution on Detecting Visually Salient Preattentive Features

    Science.gov (United States)

    2015-06-01

    resolutions in descending order (a–e). The plot compiles the areas of interest displayed in the images and each symbol represents 1 of the images. Data...to particular regions in a scene by highly salient 2 features, for example, the color of the flower discussed in the previous example. These...descending order (a–e). The plot compiles the areas of interest displayed in the images and each symbol represents 1 of the images. Data clusters

  16. An ontology design pattern for surface water features

    Science.gov (United States)

    Sinha, Gaurav; Mark, David; Kolas, Dave; Varanka, Dalia; Romero, Boleslo E.; Feng, Chen-Chieh; Usery, E. Lynn; Liebermann, Joshua; Sorokine, Alexandre

    2014-01-01

    Surface water is a primary concept of human experience but concepts are captured in cultures and languages in many different ways. Still, many commonalities exist due to the physical basis of many of the properties and categories. An abstract ontology of surface water features based only on those physical properties of landscape features has the best potential for serving as a foundational domain ontology for other more context-dependent ontologies. The Surface Water ontology design pattern was developed both for domain knowledge distillation and to serve as a conceptual building-block for more complex or specialized surface water ontologies. A fundamental distinction is made in this ontology between landscape features that act as containers (e.g., stream channels, basins) and the bodies of water (e.g., rivers, lakes) that occupy those containers. Concave (container) landforms semantics are specified in a Dry module and the semantics of contained bodies of water in a Wet module. The pattern is implemented in OWL, but Description Logic axioms and a detailed explanation is provided in this paper. The OWL ontology will be an important contribution to Semantic Web vocabulary for annotating surface water feature datasets. Also provided is a discussion of why there is a need to complement the pattern with other ontologies, especially the previously developed Surface Network pattern. Finally, the practical value of the pattern in semantic querying of surface water datasets is illustrated through an annotated geospatial dataset and sample queries using the classes of the Surface Water pattern.

  17. An Ontology Design Pattern for Surface Water Features

    Energy Technology Data Exchange (ETDEWEB)

    Sinha, Gaurav [Ohio University; Mark, David [University at Buffalo (SUNY); Kolas, Dave [Raytheon BBN Technologies; Varanka, Dalia [U.S. Geological Survey, Rolla, MO; Romero, Boleslo E [University of California, Santa Barbara; Feng, Chen-Chieh [National University of Singapore; Usery, Lynn [U.S. Geological Survey, Rolla, MO; Liebermann, Joshua [Tumbling Walls, LLC; Sorokine, Alexandre [ORNL

    2014-01-01

    Surface water is a primary concept of human experience but concepts are captured in cultures and languages in many different ways. Still, many commonalities can be found due to the physical basis of many of the properties and categories. An abstract ontology of surface water features based only on those physical properties of landscape features has the best potential for serving as a foundational domain ontology. It can then be used to systematically incor-porate concepts that are specific to a culture, language, or scientific domain. The Surface Water ontology design pattern was developed both for domain knowledge distillation and to serve as a conceptual building-block for more complex surface water ontologies. A fundamental distinction is made in this on-tology between landscape features that act as containers (e.g., stream channels, basins) and the bodies of water (e.g., rivers, lakes) that occupy those containers. Concave (container) landforms semantics are specified in a Dry module and the semantics of contained bodies of water in a Wet module. The pattern is imple-mented in OWL, but Description Logic axioms and a detailed explanation is provided. The OWL ontology will be an important contribution to Semantic Web vocabulary for annotating surface water feature datasets. A discussion about why there is a need to complement the pattern with other ontologies, es-pecially the previously developed Surface Network pattern is also provided. Fi-nally, the practical value of the pattern in semantic querying of surface water datasets is illustrated through a few queries and annotated geospatial datasets.

  18. An optimal set of features for predicting type IV secretion system effector proteins for a subset of species based on a multi-level feature selection approach.

    Directory of Open Access Journals (Sweden)

    Zhila Esna Ashari

    Full Text Available Type IV secretion systems (T4SS are multi-protein complexes in a number of bacterial pathogens that can translocate proteins and DNA to the host. Most T4SSs function in conjugation and translocate DNA; however, approximately 13% function to secrete proteins, delivering effector proteins into the cytosol of eukaryotic host cells. Upon entry, these effectors manipulate the host cell's machinery for their own benefit, which can result in serious illness or death of the host. For this reason recognition of T4SS effectors has become an important subject. Much previous work has focused on verifying effectors experimentally, a costly endeavor in terms of money, time, and effort. Having good predictions for effectors will help to focus experimental validations and decrease testing costs. In recent years, several scoring and machine learning-based methods have been suggested for the purpose of predicting T4SS effector proteins. These methods have used different sets of features for prediction, and their predictions have been inconsistent. In this paper, an optimal set of features is presented for predicting T4SS effector proteins using a statistical approach. A thorough literature search was performed to find features that have been proposed. Feature values were calculated for datasets of known effectors and non-effectors for T4SS-containing pathogens for four genera with a sufficient number of known effectors, Legionella pneumophila, Coxiella burnetii, Brucella spp, and Bartonella spp. The features were ranked, and less important features were filtered out. Correlations between remaining features were removed, and dimensional reduction was accomplished using principal component analysis and factor analysis. Finally, the optimal features for each pathogen were chosen by building logistic regression models and evaluating each model. The results based on evaluation of our logistic regression models confirm the effectiveness of our four optimal sets of

  19. 22 CFR 40.91 - Certain aliens previously removed.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a result...

  20. Subsurface mapping of Rustenburg Layered Suite (RLS), Bushveld Complex, South Africa: Inferred structural features using borehole data and spatial analysis

    Science.gov (United States)

    Bamisaiye, O. A.; Eriksson, P. G.; Van Rooy, J. L.; Brynard, H. M.; Foya, S.; Billay, A. Y.; Nxumalo, V.

    2017-08-01

    Faults and other structural features within the mafic-ultramafic layers of the Bushveld Complex have been a major issue mainly for exploration and mine planning. This study employed a new approach in detecting faults with both regional and meter scale offsets, which was not possible with the usually applied structure contour mapping. Interpretations of faults from structural and isopach maps were previously based on geological experience, while meter-scale faults were virtually impossible to detect from such maps. Spatial analysis was performed using borehole data primarily. This resulted in the identification of previously known structures and other hitherto unsuspected structural features. Consequently, the location, trends, and geometry of faults and some regional features within the Rustenburg Layered Suite (RLS) that might not be easy to detect through field mapping are adequately described in this study.

  1. Classification of visual and linguistic tasks using eye-movement features.

    Science.gov (United States)

    Coco, Moreno I; Keller, Frank

    2014-03-07

    The role of the task has received special attention in visual-cognition research because it can provide causal explanations of goal-directed eye-movement responses. The dependency between visual attention and task suggests that eye movements can be used to classify the task being performed. A recent study by Greene, Liu, and Wolfe (2012), however, fails to achieve accurate classification of visual tasks based on eye-movement features. In the present study, we hypothesize that tasks can be successfully classified when they differ with respect to the involvement of other cognitive domains, such as language processing. We extract the eye-movement features used by Greene et al. as well as additional features from the data of three different tasks: visual search, object naming, and scene description. First, we demonstrated that eye-movement responses make it possible to characterize the goals of these tasks. Then, we trained three different types of classifiers and predicted the task participants performed with an accuracy well above chance (a maximum of 88% for visual search). An analysis of the relative importance of features for classification accuracy reveals that just one feature, i.e., initiation time, is sufficient for above-chance performance (a maximum of 79% accuracy in object naming). Crucially, this feature is independent of task duration, which differs systematically across the three tasks we investigated. Overall, the best task classification performance was obtained with a set of seven features that included both spatial information (e.g., entropy of attention allocation) and temporal components (e.g., total fixation on objects) of the eye-movement record. This result confirms the task-dependent allocation of visual attention and extends previous work by showing that task classification is possible when tasks differ in the cognitive processes involved (purely visual tasks such as search vs. communicative tasks such as scene description).

  2. Double trisomy (48,XXX,+18) with features of Roberts syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Descartes, M.; Longshore, J.W.; Crawford, E. [Univ. of Alabama, Birmingham, AL (United States)] [and others

    1994-09-01

    We report an infant with double trisomy 48,XXX,+18, who also displayed features of Roberts syndrome. All previously published cases with similar double trisomy have presented with features of trisomy 18 syndrome. The chromosome analysis done at birth revealed the double trisomy; parental chromosomes were normal. The proband presented with microbrachycephaly, unilateral cleft lip and palate, choanal atresia, midfacial capillary hemanioma, thin nares, shallow orbits, malformed ears, sparse hair, hypomelia of the upper limbs, rocker-bottom feet, auricular septal defect and agenesis of the corpus callosum. Characteristic features of Roberts syndrome included hypomelia, midfacial defects, and severe growth deficiency. Among the many different features reported in the literature for patients with trisomy 18 syndrome, the most consistent were growth deficiency, clenched fingers and congenital heart defects (e.g. VSD, ASD, PDA). Although some of our patient`s features such as cleft lip and cleft palate, low-set malformed ears, ASD, defects of the corpus callosum, choanal atresia, radial aplasia could also be seen in trisomy 18 syndrome (in 10-50% of the cases), her phenotype was more typical of Roberts syndrome because of symmetrical hypomelia and midfacial defects. Our patient`s chromosomes did not show premature separation of centromeric heterochromatin, a feature reported to occur in approximately one-half of individuals with Roberts syndrome. Sporadic aneuploidy involving different chromosomes has been found in lymphocyte cultures from some Roberts syndrome patients and is considered by some authors as a mitotic mutant. This aneuploidy is most likely to be chromosome gain. The simultaneous occurrence of trisomy X and 18 is extremely rare with only 11 cases having been reported in the literature. Our patient is unique since she has the double trisomy in addition to the characteristic features of Roberts syndrome.

  3. Classification Influence of Features on Given Emotions and Its Application in Feature Selection

    Science.gov (United States)

    Xing, Yin; Chen, Chuang; Liu, Li-Long

    2018-04-01

    In order to solve the problem that there is a large amount of redundant data in high-dimensional speech emotion features, we analyze deeply the extracted speech emotion features and select better features. Firstly, a given emotion is classified by each feature. Secondly, the recognition rate is ranked in descending order. Then, the optimal threshold of features is determined by rate criterion. Finally, the better features are obtained. When applied in Berlin and Chinese emotional data set, the experimental results show that the feature selection method outperforms the other traditional methods.

  4. Electrolyte composition of retro-oil fluid and silicone oil-related visual loss

    NARCIS (Netherlands)

    Scheerlinck, Laura M E; Kuiper, Jonas J W; Liem, Albert T A; Schellekens, Peter A W J F; van Leeuwen, Redmer

    2016-01-01

    PURPOSE: Up to one-third of patients with intra-ocular silicone oil (SO) tamponade for complex macula-on retinal detachment may experience an unexplained visual loss during or after SO tamponade. Although the underlying mechanism is unknown, previous studies suggested that accumulation of retinal

  5. Feature- and Face-Exchange illusions: new insights and applications for the study of the binding problem.

    Science.gov (United States)

    Shapiro, Arthur G; Caplovitz, Gideon P; Dixon, Erica L

    2014-01-01

    i.e., how are humans able to maintain a relatively stable representation of objects and features even though the visual system processes many aspects of the world separately and in parallel? We previously investigated this issue with a variant of the bounce-pass paradigm, which consists of two rectangular bars moving in opposite directions; if the bars are identical and never overlap, the motion could equally be interpreted as bouncing or passing. Although bars of different colors should be seen as passing each other (since the colors provide more information about the bars' paths), we found "Feature Exchange": observers reported the paradoxical perception that the bars appear to bounce off of each other and exchange colors. Here we extend our previous findings with three demonstrations. "Peripheral Feature-Exchange" consists of two colored bars that physically bounce (they continually meet in the middle of the monitor and return to the sides). When viewed in the periphery, the bars appear to stream past each other even though this percept relies on the exchange of features and contradicts the information provided by the color of the bars. In "Face-Exchange" two different faces physically pass each other. When fixating centrally, observers typically report the perception of bouncing faces that swap features, indicating that the Feature Exchange effect can occur even with complex objects. In "Face-Go-Round," one face repeatedly moves from left to right on the top of the monitor, and the other from right to left at the bottom of the monitor. Observers typically perceive the faces moving in a circle-a percept that contradicts information provided by the identity of the faces. We suggest that Feature Exchange and the paradigms used to elicit it can be useful for the investigation of the binding problem as well as other contemporary issues of interest to vision science.

  6. An age-related deficit in spatial-feature reference memory in homing pigeons (Columba livia).

    Science.gov (United States)

    Coppola, Vincent J; Flaim, Mary E; Carney, Samantha N; Bingman, Verner P

    2015-03-01

    Age-related memory decline in mammals has been well documented. By contrast, very little is known about memory decline in birds as they age. In the current study we trained younger and older homing pigeons on a reference memory task in which a goal location could be encoded by spatial and feature cues. Consistent with a previous working memory study, the results revealed impaired acquisition of combined spatial-feature reference memory in older compared to younger pigeons. Following memory acquisition, we used cue-conflict probe trials to provide an initial assessment of possible age-related differences in cue preference. Both younger and older pigeons displayed a similarly modest preference for feature over spatial cues. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. A Novel Approach for Automatic Machining Feature Recognition with Edge Blend Feature

    OpenAIRE

    Keong Chen Wong; Yusof Yusri

    2017-01-01

    This paper presents an algorithm for efficiently recognizing and determining the convexity of an edge blend feature. The algorithm first recognizes all of the edge blend features from the Boundary Representation of a part; then a series of convexity test have been run on the recognized edge blend features. The novelty of the presented algorithm lies in, instead of each recognized blend feature is suppressed as most of researchers did, the recognized blend features of this research are gone th...

  8. Endometrial cancer in postmenopausal women with and without previous estrogen replacement treatment: comparison of clinical and histopathological characteristics

    DEFF Research Database (Denmark)

    Nyholm, H C; Nielsen, Anette Lynge; Norup, P

    1993-01-01

    Clinical and histopathological features of postmenopausal endometrial cancer were studied in 63 patients who had received exogenous estrogens previously and in 76 patients who had never been exposed to estrogens. All treatments were primarily surgical. Estrogen users were younger than nonusers (P...... metaplasia and "foam" cells were not related to tumor grade or use of estrogens. The receptor content correlated inversely with grade but was not related to estrogen use. Duration of estrogen treatment was not associated with tumor stage and grade. Our findings support the theory that endometrial cancer...

  9. Effect of Quantitative Nuclear Image Features on Recurrence of Ductal Carcinoma In Situ (DCIS of the Breast

    Directory of Open Access Journals (Sweden)

    Judith-Anne W. Chapman

    2008-01-01

    Full Text Available Background: Nuclear grade has been associated with breast DCIS recurrence and progression to invasive carcinoma; however, our previous study of a cohort of patients with breast DCIS did not find such an association with outcome. Fifty percent of patients had heterogeneous DCIS with more than one nuclear grade. The aim of the current study was to investigate the effect of quantitative nuclear features assessed with digital image analysis on ipsilateral DCIS recurrence.Methods: Hematoxylin and eosin stained slides for a cohort of 80 patients with primary breast DCIS were reviewed and two fields with representative grade (or grades were identified by a Pathologist and simultaneously used for acquisition of digital images for each field. Van Nuys worst nuclear grade was assigned, as was predominant grade, and heterogeneous grading when present. Patients were grouped by heterogeneity of their nuclear grade: Group A: nuclear grade 1 only, nuclear grades 1 and 2, or nuclear grade 2 only (32 patients, Group B: nuclear grades 1, 2 and 3, or nuclear grades 2 and 3 (31 patients, Group 3: nuclear grade 3 only (17 patients. Nuclear fi ne structure was assessed by software which captured thirty-nine nuclear feature values describing nuclear morphometry, densitometry, and texture. Step-wise forward Cox regressions were performed with previous clinical and pathologic factors, and the new image analysis features.Results: Duplicate measurements were similar for 89.7% to 97.4% of assessed image features. The rate of correct classification of nuclear grading with digital image analysis features was similar in the two fields, and pooled assessment across both fields. In the pooled assessment, a discriminant function with one nuclear morphometric and one texture feature was significantly (p = 0.001 associated with nuclear grading, and provided correct jackknifed classification of a patient’s nuclear grade for Group A (78.1%, Group B (48.4%, and Group C (70.6%. The

  10. Object-based attention underlies the rehearsal of feature binding in visual working memory.

    Science.gov (United States)

    Shen, Mowei; Huang, Xiang; Gao, Zaifeng

    2015-04-01

    Feature binding is a core concept in many research fields, including the study of working memory (WM). Over the past decade, it has been debated whether keeping the feature binding in visual WM consumes more visual attention than the constituent single features. Previous studies have only explored the contribution of domain-general attention or space-based attention in the binding process; no study so far has explored the role of object-based attention in retaining binding in visual WM. We hypothesized that object-based attention underlay the mechanism of rehearsing feature binding in visual WM. Therefore, during the maintenance phase of a visual WM task, we inserted a secondary mental rotation (Experiments 1-3), transparent motion (Experiment 4), or an object-based feature report task (Experiment 5) to consume the object-based attention available for binding. In line with the prediction of the object-based attention hypothesis, Experiments 1-5 revealed a more significant impairment for binding than for constituent single features. However, this selective binding impairment was not observed when inserting a space-based visual search task (Experiment 6). We conclude that object-based attention underlies the rehearsal of binding representation in visual WM. (c) 2015 APA, all rights reserved.

  11. Music Genre Classification Using MIDI and Audio Features

    Directory of Open Access Journals (Sweden)

    Abdullah Sonmez

    2007-01-01

    Full Text Available We report our findings on using MIDI files and audio features from MIDI, separately and combined together, for MIDI music genre classification. We use McKay and Fujinaga's 3-root and 9-leaf genre data set. In order to compute distances between MIDI pieces, we use normalized compression distance (NCD. NCD uses the compressed length of a string as an approximation to its Kolmogorov complexity and has previously been used for music genre and composer clustering. We convert the MIDI pieces to audio and then use the audio features to train different classifiers. MIDI and audio from MIDI classifiers alone achieve much smaller accuracies than those reported by McKay and Fujinaga who used not NCD but a number of domain-based MIDI features for their classification. Combining MIDI and audio from MIDI classifiers improves accuracy and gets closer to, but still worse, accuracies than McKay and Fujinaga's. The best root genre accuracies achieved using MIDI, audio, and combination of them are 0.75, 0.86, and 0.93, respectively, compared to 0.98 of McKay and Fujinaga. Successful classifier combination requires diversity of the base classifiers. We achieve diversity through using certain number of seconds of the MIDI file, different sample rates and sizes for the audio file, and different classification algorithms.

  12. Unsupervised Feature Subset Selection

    DEFF Research Database (Denmark)

    Søndberg-Madsen, Nicolaj; Thomsen, C.; Pena, Jose

    2003-01-01

    This paper studies filter and hybrid filter-wrapper feature subset selection for unsupervised learning (data clustering). We constrain the search for the best feature subset by scoring the dependence of every feature on the rest of the features, conjecturing that these scores discriminate some ir...... irrelevant features. We report experimental results on artificial and real data for unsupervised learning of naive Bayes models. Both the filter and hybrid approaches perform satisfactorily....

  13. Systems-Level Annotation of a Metabolomics Data Set Reduces 25 000 Features to Fewer than 1000 Unique Metabolites.

    Science.gov (United States)

    Mahieu, Nathaniel G; Patti, Gary J

    2017-10-03

    When using liquid chromatography/mass spectrometry (LC/MS) to perform untargeted metabolomics, it is now routine to detect tens of thousands of features from biological samples. Poor understanding of the data, however, has complicated interpretation and masked the number of unique metabolites actually being measured in an experiment. Here we place an upper bound on the number of unique metabolites detected in Escherichia coli samples analyzed with one untargeted metabolomics method. We first group multiple features arising from the same analyte, which we call "degenerate features", using a context-driven annotation approach. Surprisingly, this analysis revealed thousands of previously unreported degeneracies that reduced the number of unique analytes to ∼2961. We then applied an orthogonal approach to remove nonbiological features from the data using the 13 C-based credentialing technology. This further reduced the number of unique analytes to less than 1000. Our 90% reduction in data is 5-fold greater than previously published studies. On the basis of the results, we propose an alternative approach to untargeted metabolomics that relies on thoroughly annotated reference data sets. To this end, we introduce the creDBle database ( http://creDBle.wustl.edu ), which contains accurate mass, retention time, and MS/MS fragmentation data as well as annotations of all credentialed features.

  14. Brief Report: Major Depressive Disorder with Psychotic Features in Williams Syndrome--A Case Series

    Science.gov (United States)

    Valdes, Francisca; Keary, Christopher J.; Mullett, Jennifer E.; Palumbo, Michelle L.; Waxler, Jessica L.; Pober, Barbara R.; McDougle, Christopher J.

    2018-01-01

    Descriptions of individuals with Williams syndrome (WS) and co-morbid major depressive disorder (MDD) with psychotic features have not appeared in the literature. In addition to reviewing previous reports of psychotic symptoms in persons with WS, this paper introduces clinical histories and therapeutic management strategies for three previously…

  15. Complete Genome Sequence of a Porcine Polyomavirus from Nasal Swabs of Pigs with Respiratory Disease.

    Science.gov (United States)

    Hause, Ben M; Smith, Catherine; Bishop, Brian; Stewart, Chelsea; Simonson, Randy

    2018-04-26

    Metagenomic sequencing of pooled nasal swabs from pigs with unexplained respiratory disease identified a large number of reads mapping to a previously uncharacterized porcine polyomavirus. Sus scrofa polyomavirus 2 was most closely related to betapolyomaviruses frequently detected in mammalian respiratory samples. Copyright © 2018 Hause et al.

  16. Specific collaborative group intervention for patients with medically unexplained symptoms in general practice: a cluster randomized controlled trial.

    Science.gov (United States)

    Schaefert, R; Kaufmann, C; Wild, B; Schellberg, D; Boelter, R; Faber, R; Szecsenyi, J; Sauer, N; Guthrie, E; Herzog, W

    2013-01-01

    Patients with medically unexplained symptoms (MUS) are frequent in primary care and substantially impaired in their quality of life (QoL). Specific training of general practitioners (GPs) alone did not demonstrate sustained improvement at later follow-up in current reviews. We evaluated a collaborative group intervention. We conducted a cluster randomized controlled trial. Thirty-five GPs recruited 304 MUS patients (intervention group: 170; control group: 134). All GPs were trained in diagnosis and management of MUS (control condition). Eighteen randomly selected intervention GPs participated in training for a specific collaborative group intervention. They conducted 10 weekly group sessions and 2 booster meetings in their practices, together with a psychosomatic specialist. Six and 12 months after baseline, QoL was assessed with the Short-Form 36. The primary outcome was the physical composite score (PCS), and the secondary outcome was the mental composite score (MCS). At 12 months, intention-to-treat analyses showed a significant between-group effect for the MCS (p = 0.023) but not for the PCS (p = 0.674). This effect was preceded by a significant reduction of somatic symptom severity (15-item somatic symptom severity scale of the Patient Health Questionnaire, PHQ-15) at 6 months (p = 0.008) that lacked significance at 12 months (p = 0.078). As additional between-group effects at 12 months, per-protocol analyses showed less health anxiety (Whiteley-7; p = 0.038) and less psychosocial distress (PHQ; p = 0.024); GP visits were significantly (p = 0.042) reduced in the intervention group. Compared to pure GP training, collaborative group intervention achieved a progressive, clinically meaningful improvement in mental but not physical QoL. It could bridge gaps between general practice and mental health care. Copyright © 2012 S. Karger AG, Basel.

  17. When do letter features migrate? A boundary condition for feature-integration theory.

    Science.gov (United States)

    Butler, B E; Mewhort, D J; Browse, R A

    1991-01-01

    Feature-integration theory postulates that a lapse of attention will allow letter features to change position and to recombine as illusory conjunctions (Treisman & Paterson, 1984). To study such errors, we used a set of uppercase letters known to yield illusory conjunctions in each of three tasks. The first, a bar-probe task, showed whole-character mislocations but not errors based on feature migration and recombination. The second, a two-alternative forced-choice detection task, allowed subjects to focus on the presence or absence of subletter features and showed illusory conjunctions based on feature migration and recombination. The third was also a two-alternative forced-choice detection task, but we manipulated the subjects' knowledge of the shape of the stimuli: In the case-certain condition, the stimuli were always in uppercase, but in the case-uncertain condition, the stimuli could appear in either upper- or lowercase. Subjects in the case-certain condition produced illusory conjunctions based on feature recombination, whereas subjects in the case-uncertain condition did not. The results suggest that when subjects can view the stimuli as feature groups, letter features regroup as illusory conjunctions; when subjects encode the stimuli as letters, whole items may be mislocated, but subletter features are not. Thus, illusory conjunctions reflect the subject's processing strategy, rather than the architecture of the visual system.

  18. Featureous: an Integrated Approach to Location, Analysis and Modularization of Features in Java Applications

    DEFF Research Database (Denmark)

    Olszak, Andrzej

    , it is essential that features are properly modularized within the structural organization of software systems. Nevertheless, in many object-oriented applications, features are not represented explicitly. Consequently, features typically end up scattered and tangled over multiple source code units......, such as architectural layers, packages and classes. This lack of modularization is known to make application features difficult to locate, to comprehend and to modify in isolation from one another. To overcome these problems, this thesis proposes Featureous, a novel approach to location, analysis and modularization...... quantitative and qualitative results suggest that Featureous succeeds at efficiently locating features in unfamiliar codebases, at aiding feature-oriented comprehension and modification, and at improving modularization of features using Java packages....

  19. GAPO syndrome : a new case of this rare syndrome and a review of the relative importance of different phenotypic features in diagnosis

    NARCIS (Netherlands)

    Bacon, W; Hall, RK; Roset, JP; Boukari, A; Tenenbaum, H; Walter, B

    1999-01-01

    The case of GAPO syndrome reported here is the 24th recorded case, 23 cases having been published previously. The 29-year-old male under discussion presents all the typical features of the syndrome, having short stature, dysmorphic craniofacial features. total alopecia and pseudoanodontia. Orally,

  20. Robust Feature Selection from Microarray Data Based on Cooperative Game Theory and Qualitative Mutual Information

    Directory of Open Access Journals (Sweden)

    Atiyeh Mortazavi

    2016-01-01

    Full Text Available High dimensionality of microarray data sets may lead to low efficiency and overfitting. In this paper, a multiphase cooperative game theoretic feature selection approach is proposed for microarray data classification. In the first phase, due to high dimension of microarray data sets, the features are reduced using one of the two filter-based feature selection methods, namely, mutual information and Fisher ratio. In the second phase, Shapley index is used to evaluate the power of each feature. The main innovation of the proposed approach is to employ Qualitative Mutual Information (QMI for this purpose. The idea of Qualitative Mutual Information causes the selected features to have more stability and this stability helps to deal with the problem of data imbalance and scarcity. In the third phase, a forward selection scheme is applied which uses a scoring function to weight each feature. The performance of the proposed method is compared with other popular feature selection algorithms such as Fisher ratio, minimum redundancy maximum relevance, and previous works on cooperative game based feature selection. The average classification accuracy on eleven microarray data sets shows that the proposed method improves both average accuracy and average stability compared to other approaches.

  1. Sparse Matrix for ECG Identification with Two-Lead Features

    Directory of Open Access Journals (Sweden)

    Kuo-Kun Tseng

    2015-01-01

    Full Text Available Electrocardiograph (ECG human identification has the potential to improve biometric security. However, improvements in ECG identification and feature extraction are required. Previous work has focused on single lead ECG signals. Our work proposes a new algorithm for human identification by mapping two-lead ECG signals onto a two-dimensional matrix then employing a sparse matrix method to process the matrix. And that is the first application of sparse matrix techniques for ECG identification. Moreover, the results of our experiments demonstrate the benefits of our approach over existing methods.

  2. Somatostatinoma: collision with neurofibroma and ultrastructural features.

    Science.gov (United States)

    Varikatt, W; Yong, J L C; Killingsworth, M C

    2006-11-01

    The clinical presentation, histopathology and immunoelectron microscopic features of two cases of duodenal somatostatinoma are described, one of which is a hitherto unreported example of a collision tumour with a neurofibroma. Ultrastructural morphometric immunoelectron microscopy studies revealed the presence of four types of cells in both tumours, but there was no difference in the proportions of these cells between the collision tumour and the non-collision tumour. Neurosecretory granules ranging in size from 255-815 nm were generally larger than those previously reported for somatostatinomas and somatostatin was identified in granules of all sizes across this range. Neither tumour was associated with the somatostatinoma syndrome comprising associated diabetes mellitis, steatorrhoea and cholelithiasis.

  3. Automated identification of protein-ligand interaction features using Inductive Logic Programming: a hexose binding case study

    Directory of Open Access Journals (Sweden)

    A Santos Jose C

    2012-07-01

    Full Text Available Abstract Background There is a need for automated methods to learn general features of the interactions of a ligand class with its diverse set of protein receptors. An appropriate machine learning approach is Inductive Logic Programming (ILP, which automatically generates comprehensible rules in addition to prediction. The development of ILP systems which can learn rules of the complexity required for studies on protein structure remains a challenge. In this work we use a new ILP system, ProGolem, and demonstrate its performance on learning features of hexose-protein interactions. Results The rules induced by ProGolem detect interactions mediated by aromatics and by planar-polar residues, in addition to less common features such as the aromatic sandwich. The rules also reveal a previously unreported dependency for residues cys and leu. They also specify interactions involving aromatic and hydrogen bonding residues. This paper shows that Inductive Logic Programming implemented in ProGolem can derive rules giving structural features of protein/ligand interactions. Several of these rules are consistent with descriptions in the literature. Conclusions In addition to confirming literature results, ProGolem’s model has a 10-fold cross-validated predictive accuracy that is superior, at the 95% confidence level, to another ILP system previously used to study protein/hexose interactions and is comparable with state-of-the-art statistical learners.

  4. A configural effect in visual short-term memory for features from different parts of an object.

    Science.gov (United States)

    Delvenne, Jean-François; Bruyer, Raymond

    2006-09-01

    Previous studies have shown that change detection performance is improved when the visual display holds features (e.g., a colour and an orientation) that are grouped into different parts of the same object compared to when they are all spatially separated (Xu, 2002a, 2002b). These findings indicate that visual short-term memory (VSTM) encoding can be "object based". Recently, however, it has been demonstrated that changing the orientation of an item could affect the spatial configuration of the display (Jiang, Chun, & Olson, 2004), which may have an important influence on change detection. The perceptual grouping of features into an object obviously reduces the amount of distinct spatial relations in a display and hence the complexity of the spatial configuration. In the present study, we ask whether the object-based encoding benefit observed in previous studies may reflect the use of configural coding rather than the outcome of a true object-based effect. The results show that when configural cues are removed, the object-based encoding benefit remains for features (i.e., colour and orientation) from different parts of an object, but is significantly reduced. These findings support the view that memory for features from different parts of an object can benefit from object-based encoding, but the use of configural coding significantly helps enlarge this effect.

  5. An efficient heuristic method for active feature acquisition and its application to protein-protein interaction prediction

    Directory of Open Access Journals (Sweden)

    Thahir Mohamed

    2012-11-01

    belief of the classification model induced by the acquisition of the feature under consideration. As compared to random selection of proteins on which the experiments are performed and the type of experiment that is performed, the heuristic method reduces the number of experiments to as few as 40%. Most notable characteristic of this method is that it does not require re-training of the classification model on every possible combination of instance, feature and feature-value tuples. For this reason, our method is far less computationally expensive as compared with previous AFA strategies. Conclusions The results show that our heuristic method for AFA creates an optimal training set with far less features acquired as compared to random acquisition. This shows the value of active feature acquisition to aid in protein-protein interaction prediction where feature acquisition is costly. Compared to previous methods, the proposed method reduces computational cost while also achieving a better F-score. The proposed method is valuable as it presents a direction to AFA with a far lesser computational expense by removing the need for the first time, of training a classifier for every combination of instance, feature and feature-value tuples which would be impractical for several domains.

  6. Selective screening of 650 high risk Iranian patients for detection of inborn error of metabolism

    Directory of Open Access Journals (Sweden)

    Narges Pishva

    2015-02-01

    Full Text Available Objective: Although metabolic diseases individually are rare ,but overall have an incidence of 1/2000 and can cause devastating and irreversible effect if not diagnosed early and treated promptly. selective screening is an acceptable method for detection of these multi presentation diseases.Method: using panel neonatal screening for detection of metabolic diseases in 650 high risk Iranian patients in Fars province. The following clinical features were used as inclusion criteria for investigation of the patients.Lethargy, poor feeding ,persistent vomiting, cholestasis, intractable seizure ,decreased level of consciousness ,persistent hypoglycemia, unexplained acid base disturbance and unexplained neonatal death.Result: Organic acidemia with 40 cases (42% was the most frequent disorder diagnosed in our high risk populations, followed by disorder of galactose metabolism(30%, 15 patient had classic galactosemia(GALT

  7. Selective screening of 650 high risk Iranian patients for detection of inborn error of metabolism

    Directory of Open Access Journals (Sweden)

    Narges Pishva

    2015-02-01

    Full Text Available Objective: Although metabolic diseases individually are rare ,but overall have an incidence of 1/2000 and can cause devastating and irreversible effect if not diagnosed early and treated promptly. selective screening is an acceptable method for detection of these multi presentation diseases. Method: using panel neonatal screening for detection of metabolic diseases in 650 high risk Iranian patients in Fars province. The following clinical features were used as inclusion criteria for investigation of the patients. Lethargy, poor feeding ,persistent vomiting, cholestasis, intractable seizure ,decreased level of consciousness ,persistent hypoglycemia, unexplained acid base disturbance and unexplained neonatal death. Result: Organic acidemia with 40 cases (42% was the most frequent disorder diagnosed in our high risk populations, followed by disorder of galactose metabolism(30%, 15 patient had classic galactosemia(GALT

  8. Innovations in individual feature history management - The significance of feature-based temporal model

    Science.gov (United States)

    Choi, J.; Seong, J.C.; Kim, B.; Usery, E.L.

    2008-01-01

    A feature relies on three dimensions (space, theme, and time) for its representation. Even though spatiotemporal models have been proposed, they have principally focused on the spatial changes of a feature. In this paper, a feature-based temporal model is proposed to represent the changes of both space and theme independently. The proposed model modifies the ISO's temporal schema and adds new explicit temporal relationship structure that stores temporal topological relationship with the ISO's temporal primitives of a feature in order to keep track feature history. The explicit temporal relationship can enhance query performance on feature history by removing topological comparison during query process. Further, a prototype system has been developed to test a proposed feature-based temporal model by querying land parcel history in Athens, Georgia. The result of temporal query on individual feature history shows the efficiency of the explicit temporal relationship structure. ?? Springer Science+Business Media, LLC 2007.

  9. Automatic feature extraction in large fusion databases by using deep learning approach

    Energy Technology Data Exchange (ETDEWEB)

    Farias, Gonzalo, E-mail: gonzalo.farias@ucv.cl [Pontificia Universidad Católica de Valparaíso, Valparaíso (Chile); Dormido-Canto, Sebastián [Departamento de Informática y Automática, UNED, Madrid (Spain); Vega, Jesús; Rattá, Giuseppe [Asociación EURATOM/CIEMAT Para Fusión, CIEMAT, Madrid (Spain); Vargas, Héctor; Hermosilla, Gabriel; Alfaro, Luis; Valencia, Agustín [Pontificia Universidad Católica de Valparaíso, Valparaíso (Chile)

    2016-11-15

    Highlights: • Feature extraction is a very critical stage in any machine learning algorithm. • The problem dimensionality can be reduced enormously when selecting suitable attributes. • Despite the importance of feature extraction, the process is commonly done manually by trial and error. • Fortunately, recent advances in deep learning approach have proposed an encouraging way to find a good feature representation automatically. • In this article, deep learning is applied to the TJ-II fusion database to get more robust and accurate classifiers in comparison to previous work. - Abstract: Feature extraction is one of the most important machine learning issues. Finding suitable attributes of datasets can enormously reduce the dimensionality of the input space, and from a computational point of view can help all of the following steps of pattern recognition problems, such as classification or information retrieval. However, the feature extraction step is usually performed manually. Moreover, depending on the type of data, we can face a wide range of methods to extract features. In this sense, the process to select appropriate techniques normally takes a long time. This work describes the use of recent advances in deep learning approach in order to find a good feature representation automatically. The implementation of a special neural network called sparse autoencoder and its application to two classification problems of the TJ-II fusion database is shown in detail. Results have shown that it is possible to get robust classifiers with a high successful rate, in spite of the fact that the feature space is reduced to less than 0.02% from the original one.

  10. Automatic feature extraction in large fusion databases by using deep learning approach

    International Nuclear Information System (INIS)

    Farias, Gonzalo; Dormido-Canto, Sebastián; Vega, Jesús; Rattá, Giuseppe; Vargas, Héctor; Hermosilla, Gabriel; Alfaro, Luis; Valencia, Agustín

    2016-01-01

    Highlights: • Feature extraction is a very critical stage in any machine learning algorithm. • The problem dimensionality can be reduced enormously when selecting suitable attributes. • Despite the importance of feature extraction, the process is commonly done manually by trial and error. • Fortunately, recent advances in deep learning approach have proposed an encouraging way to find a good feature representation automatically. • In this article, deep learning is applied to the TJ-II fusion database to get more robust and accurate classifiers in comparison to previous work. - Abstract: Feature extraction is one of the most important machine learning issues. Finding suitable attributes of datasets can enormously reduce the dimensionality of the input space, and from a computational point of view can help all of the following steps of pattern recognition problems, such as classification or information retrieval. However, the feature extraction step is usually performed manually. Moreover, depending on the type of data, we can face a wide range of methods to extract features. In this sense, the process to select appropriate techniques normally takes a long time. This work describes the use of recent advances in deep learning approach in order to find a good feature representation automatically. The implementation of a special neural network called sparse autoencoder and its application to two classification problems of the TJ-II fusion database is shown in detail. Results have shown that it is possible to get robust classifiers with a high successful rate, in spite of the fact that the feature space is reduced to less than 0.02% from the original one.

  11. Acinar Cell Cyst adenoma (Acinar Cystic Transformation) of the Pancreas: the Radiologic-Pathologic Features

    Energy Technology Data Exchange (ETDEWEB)

    Gumus, Mehmet; Algin, Oktay; Gundogdu, Haldun [Ataturk Training and Research Hospital, Ankara (Turkmenistan); Ugras, Serdar [Selcuk University, Selcuklu Medical Faculty, Konya (Turkmenistan)

    2011-02-15

    Acinar cystic transformation of the pancreas is also known as acinar cell cystadenoma (ACC), and this is an extremely rare benign lesion that was first described in April 2002. We report here on a case of a previously asymptomatic patient with pancreatic ACC and this was diagnosed by computed tomography (CT) and magnetic resonance imaging (MRI). To the best of our knowledge, there is no previous report concerning the CT or MRI features of ACC in the medical literature. We present here the CT, MRI and pathological findings of pancreatic ACC

  12. Acinar Cell Cyst adenoma (Acinar Cystic Transformation) of the Pancreas: the Radiologic-Pathologic Features

    International Nuclear Information System (INIS)

    Gumus, Mehmet; Algin, Oktay; Gundogdu, Haldun; Ugras, Serdar

    2011-01-01

    Acinar cystic transformation of the pancreas is also known as acinar cell cystadenoma (ACC), and this is an extremely rare benign lesion that was first described in April 2002. We report here on a case of a previously asymptomatic patient with pancreatic ACC and this was diagnosed by computed tomography (CT) and magnetic resonance imaging (MRI). To the best of our knowledge, there is no previous report concerning the CT or MRI features of ACC in the medical literature. We present here the CT, MRI and pathological findings of pancreatic ACC

  13. A Labeling Model Based on the Region of Movability for Point-Feature Label Placement

    Directory of Open Access Journals (Sweden)

    Lin Li

    2016-09-01

    Full Text Available Automatic point-feature label placement (PFLP is a fundamental task for map visualization. As the dominant solutions to the PFLP problem, fixed-position and slider models have been widely studied in previous research. However, the candidate labels generated with these models are set to certain fixed positions or a specified track line for sliding. Thus, the whole surrounding space of a point feature is not sufficiently used for labeling. Hence, this paper proposes a novel label model based on the region of movability, which comes from plane collision detection theory. The model defines a complete conflict-free search space for label placement. On the premise of no conflict with the point, line, and area features, the proposed model utilizes the surrounding zone of the point feature to generate candidate label positions. By combining with heuristic search method, the model achieves high-quality label placement. In addition, the flexibility of the proposed model enables placing arbitrarily shaped labels.

  14. Visual Localization across Seasons Using Sequence Matching Based on Multi-Feature Combination.

    Science.gov (United States)

    Qiao, Yongliang

    2017-10-25

    Visual localization is widely used in autonomous navigation system and Advanced Driver Assistance Systems (ADAS). However, visual-based localization in seasonal changing situations is one of the most challenging topics in computer vision and the intelligent vehicle community. The difficulty of this task is related to the strong appearance changes that occur in scenes due to weather or season changes. In this paper, a place recognition based visual localization method is proposed, which realizes the localization by identifying previously visited places using the sequence matching method. It operates by matching query image sequences to an image database acquired previously (video acquired during traveling period). In this method, in order to improve matching accuracy, multi-feature is constructed by combining a global GIST descriptor and local binary feature CSLBP (Center-symmetric local binary patterns) to represent image sequence. Then, similarity measurement according to Chi-square distance is used for effective sequences matching. For experimental evaluation, the relationship between image sequence length and sequences matching performance is studied. To show its effectiveness, the proposed method is tested and evaluated in four seasons outdoor environments. The results have shown improved precision-recall performance against the state-of-the-art SeqSLAM algorithm.

  15. Dependency Parsing with Transformed Feature

    Directory of Open Access Journals (Sweden)

    Fuxiang Wu

    2017-01-01

    Full Text Available Dependency parsing is an important subtask of natural language processing. In this paper, we propose an embedding feature transforming method for graph-based parsing, transform-based parsing, which directly utilizes the inner similarity of the features to extract information from all feature strings including the un-indexed strings and alleviate the feature sparse problem. The model transforms the extracted features to transformed features via applying a feature weight matrix, which consists of similarities between the feature strings. Since the matrix is usually rank-deficient because of similar feature strings, it would influence the strength of constraints. However, it is proven that the duplicate transformed features do not degrade the optimization algorithm: the margin infused relaxed algorithm. Moreover, this problem can be alleviated by reducing the number of the nearest transformed features of a feature. In addition, to further improve the parsing accuracy, a fusion parser is introduced to integrate transformed and original features. Our experiments verify that both transform-based and fusion parser improve the parsing accuracy compared to the corresponding feature-based parser.

  16. Developing and Integrating Advanced Movement Features Improves Automated Classification of Ciliate Species.

    Science.gov (United States)

    Soleymani, Ali; Pennekamp, Frank; Petchey, Owen L; Weibel, Robert

    2015-01-01

    Recent advances in tracking technologies such as GPS or video tracking systems describe the movement paths of individuals in unprecedented details and are increasingly used in different fields, including ecology. However, extracting information from raw movement data requires advanced analysis techniques, for instance to infer behaviors expressed during a certain period of the recorded trajectory, or gender or species identity in case data is obtained from remote tracking. In this paper, we address how different movement features affect the ability to automatically classify the species identity, using a dataset of unicellular microbes (i.e., ciliates). Previously, morphological attributes and simple movement metrics, such as speed, were used for classifying ciliate species. Here, we demonstrate that adding advanced movement features, in particular such based on discrete wavelet transform, to morphological features can improve classification. These results may have practical applications in automated monitoring of waste water facilities as well as environmental monitoring of aquatic systems.

  17. Ependymal alterations in sudden intrauterine unexplained death and sudden infant death syndrome: possible primary consequence of prenatal exposure to cigarette smoking

    Directory of Open Access Journals (Sweden)

    Matturri Luigi

    2010-07-01

    Full Text Available Abstract Background The ependyma, the lining providing a protective barrier and filtration system separating brain parenchyma from cerebrospinal fluid, is still inadequately understood in humans. In this study we aimed to define, by morphological and immunohistochemical methods, the sequence of developmental steps of the human ependyma in the brainstem (ventricular ependyma and thoracic spinal cord (central canal ependyma of a large sample of fetal and infant death victims, aged from 17 gestational weeks to 8 postnatal months. Additionally, we investigated a possible link between alterations of this structure, sudden unexplained fetal and infant death and maternal smoking. Results Our results demonstrate that in early fetal life the human ependyma shows a pseudostratified cytoarchitecture including many tanycytes and ciliated cells together with numerous apoptotic and reactive astrocytes in the subependymal layer. The ependyma is fully differentiated, with a monolayer of uniform cells, after 32 to 34 gestational weeks. We observed a wide spectrum of ependymal pathological changes in sudden death victims, such as desquamation, clusters of ependymal cells in the subventricular zone, radial glial cells, and the unusual presence of neurons within and over the ependymal lining. These alterations were significantly related to maternal smoking in pregnancy. Conclusions We conclude that in smoking mothers, nicotine and its derivatives easily reach the cerebrospinal fluid in the fetus, immediately causing ependymal damage. Consequently, we suggest that the ependyma should be examined in-depth first in victims of sudden fetal or infant death with mothers who smoke.

  18. Too good to be true: the role of online reviews’ features in probability to buy

    NARCIS (Netherlands)

    Maslowska, E.; Malthouse, E.C.; Bernritter, S.F.

    2017-01-01

    Online consumer reviews are broadly believed to be a necessary and powerful marketing tool, and as such they have attracted considerable attention from both marketers and academics. However, previous research has not sufficiently focused on the effects of various review features on sales but rather

  19. Chromosome 12q24.31-q24.33 deletion causes multiple dysmorphic features and developmental delay: First mosaic patient and overview of the phenotype related to 12q24qter defects

    Directory of Open Access Journals (Sweden)

    Sakati Nadia

    2011-04-01

    Full Text Available Abstract Background Genomic imbalances of the 12q telomere are rare; only a few patients having 12q24.31-q24.33 deletions were reported. Interestingly none of these were mosaic. Although some attempts have been made to establish phenotype/genotype interaction for the deletions in this region, no clear relationship has been established to date. Results We have clinically screened more than 100 patients with dysmorphic features, mental retardation and normal karyotype using high density oligo array-CGH (aCGH and identified a ~9.2 Mb hemizygous interstitial deletion at the 12q telomere (Chromosome 12: 46,XY,del(12(q24.31q24.33 in a severely developmentally retarded patient having dysmorphic features such as low set ears, microcephaly, undescended testicles, bent elbow, kyphoscoliosis, and micropenis. Parents were found to be not carriers. MLPA experiments confirmed the aCGH result. Interphase FISH revealed mosaicism in cultured peripheral blood lymphocytes. Conclusions Since conventional G-Banding technique missed the abnormality; this work re-confirms that any child with unexplained developmental delay and systemic involvement should be studied by aCGH techniques. The FISH technique, however, would still be useful to further delineate the research work and identify such rare mosaicism. Among the 52 deleted genes, P2RX2, ULK1, FZD10, RAN, NCOR2 STX2, TESC, FBXW8, and TBX3 are noteworthy since they may have a role in observed phenotype.

  20. Hypersensitivity pneumonitis: an immunopathology review.

    Science.gov (United States)

    Woda, Bruce A

    2008-02-01

    Hypersensitivity pneumonitis (HSP) is an immunologically mediated alveolar and interstitial lung disease caused by repeated inhalation of organic dusts and some occupational agents. The pathogenesis of HSP is uncertain. A number of unexplained features of HSP remain, namely (1) why do so few exposed individuals develop clinical HSP, (2) what triggers an acute episode after prolonged periods of previous sensitization, and (3) what leads to disease progression. This article considers these issues and aims to discuss and clarify current concepts in pathogenesis. Pertinent literature review in conjunction with the author's personal interpretive opinion. Current data suggest that individuals with a T(H)1 dominant response are likely to develop clinical disease. There is also some evidence that genetic factors such as polymorphisms in the major histocompatibility complex, tumor necrosis factor alpha, and tissue inhibitor of metalloproteinase 3 are associated with the development of or resistance to the disease.

  1. GFVO: the Genomic Feature and Variation Ontology

    KAUST Repository

    Baran, Joachim

    2015-05-05

    Falling costs in genomic laboratory experiments have led to a steady increase of genomic feature and variation data. Multiple genomic data formats exist for sharing these data, and whilst they are similar, they are addressing slightly different data viewpoints and are consequently not fully compatible with each other. The fragmentation of data format specifications makes it hard to integrate and interpret data for further analysis with information from multiple data providers. As a solution, a new ontology is presented here for annotating and representing genomic feature and variation dataset contents. The Genomic Feature and Variation Ontology (GFVO) specifically addresses genomic data as it is regularly shared using the GFF3 (incl. FASTA), GTF, GVF and VCF file formats. GFVO simplifies data integration and enables linking of genomic annotations across datasets through common semantics of genomic types and relations. Availability and implementation. The latest stable release of the ontology is available via its base URI; previous and development versions are available at the ontology’s GitHub repository: https://github.com/BioInterchange/Ontologies; versions of the ontology are indexed through BioPortal (without external class-/property-equivalences due to BioPortal release 4.10 limitations); examples and reference documentation is provided on a separate web-page: http://www.biointerchange.org/ontologies.html. GFVO version 1.0.2 is licensed under the CC0 1.0 Universal license (https://creativecommons.org/publicdomain/zero/1.0) and therefore de facto within the public domain; the ontology can be appropriated without attribution for commercial and non-commercial use.

  2. Managing the consultation with patients with medically unexplained symptoms: a grounded theory study of supervisors and registrars in general practice.

    Science.gov (United States)

    Stone, Louise

    2014-12-05

    Patients with medically unexplained symptoms (MUS) commonly present in general practice. They often experience significant disability and have difficulty accessing appropriate care. Many feel frustrated and helpless. Doctors also describe feeling frustrated and helpless when managing these patients. These shared negative feelings can have a detrimental effect on the therapeutic relationship and on clinical outcomes. The aim of this study was to explore how novice and experienced GPs manage patients with MUS and how these skills are taught and learned in GP training. A constructivist grounded theory study with 24 general practice registrars and supervisors in GP training practices across Australia. Registrars lacked a framework for managing patients with MUS. Some described negative feelings towards patients that were uncomfortable and confronting. Registrars also were uncertain about their clinical role: where their professional responsibilities began and ended. Supervisors utilised a range of strategies to address the practical, interpersonal and therapeutic challenges associated with the care of these patients. Negative feelings and a lack of diagnostic language and frameworks may prevent registrars from managing these patients effectively. Some of these negative feelings, such as frustration, shame and helplessness, are shared between doctors and patients. Registrars need assistance to identify and manage these difficult feelings so that consultations are more effective. The care of these patients also raises issues of professional identity, roles and responsibilities. Supervisors can assist their registrars by proactively sharing models of the consultation, strategies for managing their own feelings and frustrations, and ways of understanding and managing the therapeutic relationship in this difficult area of practice.

  3. [Celiac crisis with quadriplegia due to potassium depletion as presenting feature of celiac disease].

    Science.gov (United States)

    Atikou, A; Rabhi, M; Hidani, H; El Alaoui Faris, M; Toloune, F

    2009-06-01

    Adult coeliac disease revealed by coeliac crisis and quadriplegia due to potassium depletion is an extremely rare situation. A 26-year-old woman presented with a suddenly developed weakness of all four limbs and a severe diarrhea. Authors emphasize coeliac crisis, which is a presenting feature of coeliac disease, characterized by acute diarrhea with life-threatening acid base and electrolyte abnormalities. The patient improved with correction of hypokalemia and gluten-free diet. A severe acute diarrhea with metabolic and systemic complications, the so-called coeliac crisis, is a possible presenting clinical feature of a previously undiagnosed adult celiac disease.

  4. Upper Tract Urothelial Carcinomas Accompanied by Previous or Synchronous Nonmuscle-Invasive Bladder Cancer and Preoperative Hydronephrosis Might Have Worse Oncologic Outcomes After Radical Nephroureterectomy.

    Science.gov (United States)

    Liang, Chengcai; Chi, Runmin; Huang, Liqun; Wang, Jinliang; Liu, Hailong; Xu, Ding; Qian, Subo; Qian, Xiaoqiang; Qi, Jun

    2016-10-01

    The purpose of the study was to identify predictors of clinicopathologic features and oncologic outcomes in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy (RNU). The medical records of 172 patients treated with RNU from January 2001 to September 2014 were retrospectively reviewed. Logistic regression and survival analysis methodology were respectively used to evaluate predictors of clinicopathologic features and oncologic outcomes. Of the enrolled 172 patients, 80 (46.5%) had renal pelvic tumors, 67 (39%) had ureteral tumors, and the remaining 25 (14.5%) patients had multifocal tumors. Compared with patients with renal pelvic tumors, those with ureteral and multifocal tumors were more likely to have previous or synchronous nonmuscle-invasive bladder cancer (NMIBC) and severe hydronephrosis (P = .001 and P hydronephrosis independently predicted worse renal function and positive lymph node or lymphovascular invasion status (P = .001 and P = .007, respectively). Moreover, severe hydronephrosis was an independent risk factor for overall survival and cancer-specific survival in multivariate analysis (P = .025 and P = .045, respectively). Multifocality and previous or synchronous NMIBC were significantly associated with bladder-recurrence-free survival (P = .023 and P = .001, respectively). Upper tract urothelial carcinoma accompanied by previous or synchronous NMIBC and preoperative severe hydronephrosis could have worse oncologic outcomes after RNU. These common accompanied diagnoses could be valuable for guiding preoperative planning and postoperative adjuvant therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Biological adaptations for functional features of language in the face of cultural evolution.

    Science.gov (United States)

    Christiansen, Morten H; Reali, Florencia; Chater, Nick

    2011-04-01

    Although there may be no true language universals, it is nonetheless possible to discern several family resemblance patterns across the languages of the world. Recent work on the cultural evolution of language indicates the source of these patterns is unlikely to be an innate universal grammar evolved through biological adaptations for arbitrary linguistic features. Instead, it has been suggested that the patterns of resemblance emerge because language has been shaped by the brain, with individual languages representing different but partially overlapping solutions to the same set of nonlinguistic constraints. Here, we use computational simulations to investigate whether biological adaptation for functional features of language, deriving from cognitive and communicative constraints, may nonetheless be possible alongside rapid cultural evolution. Specifically, we focus on the Baldwin effect as an evolutionary mechanism by which previously learned linguistic features might become innate through natural selection across many generations of language users. The results indicate that cultural evolution of language does not necessarily prevent functional features of language from becoming genetically fixed, thus potentially providing a particularly informative source of constraints on cross-linguistic resemblance patterns.

  6. Perception Of "Features" And "Objects": Applications To The Design Of Instrument Panel Displays

    Science.gov (United States)

    Poynter, Douglas; Czarnomski, Alan J.

    1988-10-01

    An experiment was conducted to determine whether socalled feature displays allow for faster and more accurate processing compared to object displays. Previous psychological studies indicate that features can be processed in parallel across the visual field, whereas objects must be processed one at a time with the aid of attentional focus. Numbers and letters are examples of objects; line orientation and color are examples of features. In this experiment, subjects were asked to search displays composed of up to 16 elements for the presence of specific elements. The ability to detect, localize, and identify targets was influenced by display format. Digital errors increased with the number of elements, the number of targets, and the distance of the target from the fixation point. Line orientation errors increased only with the number of targets. Several other display types were evaluated, and each produced a pattern of errors similar to either digital or line orientation format. Results of the study were discussed in terms of Feature Integration Theory, which distinguishes between elements that are processed with parallel versus serial mechanisms.

  7. THE 6 μ m FEATURE AS A TRACER OF ALIPHATIC COMPONENTS OF INTERSTELLAR CARBONACEOUS GRAINS

    Energy Technology Data Exchange (ETDEWEB)

    Hsia Chih-Hao; Sadjadi, Seyedabdolreza; Zhang Yong; Kwok Sun, E-mail: chhsia@must.edu.mo, E-mail: ssadjadi@hku.hk, E-mail: zhangy96@hku.hk, E-mail: sunkwok@hku.hk [Laboratory for Space Research, Faculty of Science, The University of Hong Kong, Pokfulam Road, Hong Kong (China)

    2016-12-01

    An unidentified infrared emission (UIE) feature at 6.0 μ m is detected in a number of astronomical sources showing the UIE bands. In contrast to the previous suggestion that this band is due to C=O vibrational modes, we suggest that the 6.0 μ m feature arises from olefinic double-bond functional groups. These groups are likely to be attached to aromatic rings, which are responsible for the major UIE bands. The possibility that the formation of these functional groups is related to the hydrogenation process is discussed.

  8. Clinical and laboratory features of 48 feline hyperthyroidism cases in Japan

    Directory of Open Access Journals (Sweden)

    Shinichi Namba

    2014-02-01

    Full Text Available Feline hyperthyroidism (HT is a common endocrine disorder worldwide, but clinical and laboratory features might vary geographically. The aim of this retrospective study was to evaluate feline HT in Japan, and compare results to those of previous study for feline HT. We evaluated 48 feline HT cases clinical and laboratory features. Surprisingly, the youngest patient was 32 months of age (2 year 9 months. There was no significant difference among the study subjects in sex, but frequency of spayed/castrated cats was high (85.4%. Median age was 186 months (32-272 months. 91.3% (n=42 of subjects were over 10 years of age, and 8.7% (n=4 were under 10 years of age. Clinical symptoms included vomiting, 56.3% (n=27; diarrhea, 2.1% (n=1; hyperactivity, 12.5% (n=6; emaciation, 41.7% (n=20; polyuria and polydipsia, 22.9% (n=11; chronic weight loss, 60.4% (n=29; and palpated enlarged thyroid, 2.1% (n=1. Concurrent findings included chronic kidney disease, 20.8% (n=10; congestive heart failure, 20.8% (n=10; tachycardia (over 240 beats/min, 18.8% (n=9; gallop rhythm, 31.3% (n=15; neurological disorders such as hind-limb paralysis, 14.6% (n=7; cystitis, 8.7% (n=4; gingivitis, 4.2% (n=2; diabetes mellitus, 4.2% (n=2; and arterial thromboembolism, 6.3% (n=3. In addition, laboratory features (complete blood counts and biochemistry differed from those of previous reports in certain respects. Our results show that it might be important for practitioners to comprehend epidemiologic differences regarding feline HT worldwide.

  9. The feature-weighted receptive field: an interpretable encoding model for complex feature spaces.

    Science.gov (United States)

    St-Yves, Ghislain; Naselaris, Thomas

    2017-06-20

    We introduce the feature-weighted receptive field (fwRF), an encoding model designed to balance expressiveness, interpretability and scalability. The fwRF is organized around the notion of a feature map-a transformation of visual stimuli into visual features that preserves the topology of visual space (but not necessarily the native resolution of the stimulus). The key assumption of the fwRF model is that activity in each voxel encodes variation in a spatially localized region across multiple feature maps. This region is fixed for all feature maps; however, the contribution of each feature map to voxel activity is weighted. Thus, the model has two separable sets of parameters: "where" parameters that characterize the location and extent of pooling over visual features, and "what" parameters that characterize tuning to visual features. The "where" parameters are analogous to classical receptive fields, while "what" parameters are analogous to classical tuning functions. By treating these as separable parameters, the fwRF model complexity is independent of the resolution of the underlying feature maps. This makes it possible to estimate models with thousands of high-resolution feature maps from relatively small amounts of data. Once a fwRF model has been estimated from data, spatial pooling and feature tuning can be read-off directly with no (or very little) additional post-processing or in-silico experimentation. We describe an optimization algorithm for estimating fwRF models from data acquired during standard visual neuroimaging experiments. We then demonstrate the model's application to two distinct sets of features: Gabor wavelets and features supplied by a deep convolutional neural network. We show that when Gabor feature maps are used, the fwRF model recovers receptive fields and spatial frequency tuning functions consistent with known organizational principles of the visual cortex. We also show that a fwRF model can be used to regress entire deep

  10. Impact of previously disadvantaged land-users on sustainable ...

    African Journals Online (AJOL)

    Impact of previously disadvantaged land-users on sustainable agricultural ... about previously disadvantaged land users involved in communal farming systems ... of input, capital, marketing, information and land use planning, with effect on ...

  11. Magnetic resonance imaging features of esthesioneuroblastoma in three dogs and one cat.

    Science.gov (United States)

    Söffler, Charlotte; Hartmann, Antje; Gorgas, Daniela; Ludewig, Eberhard; von Pückler, Kerstin; Kramer, Martin; Schmidt, Martin J

    2016-10-12

    Esthesioneuroblastoma is a rare malignant intranasal tumor that originates from the olfactory neuroepithelium of the upper nasal cavity, and can destroy the cribriform plate and expand into the neurocranium. Descriptions of the magnetic resonance features of esthesioneuroblastomas in animals are scarce. The objectives of this study were to report the magnetic resonance imaging features of esthesioneuroblastomas in order to determine distinct imaging characteristics that may help distinguish it from other intracranial tumor types. Magnetic resonance images of four patients with confirmed esthesioneuroblastomas were reviewed and compared with previously reported cases. The esthesioneuroblastomas appeared as oval-shaped, solitary lesions in the caudal nasal cavity that caused osteolysis of the cribriform plate and extended into the brain in all cases. Signal intensity was variable. Contrast enhancement was mild and varied from homogeneous to heterogeneous. A peripheral cystic component was found in two patients and was reported in only one previous case. Mass effect and white matter edema were marked to severe. Osteolysis of facial bones and extension into the facial soft tissues or retrobulbar space were not present in any of the cases, although this has been reported in the literature. A definitive diagnosis of esthesioneuroblastoma based on signal intensity or contrast behavior was not possible. Nevertheless, the presence of a mass in the caudal nasal cavity with extension into the neurocranium seems to be a feature highly suspicious of esthesioneuroblastoma. In contrast to other extra-cranial lesions, the extra-cranial mass was relatively small and destruction of facial bones seems to be rare.

  12. Determining root correspondence between previously and newly detected objects

    Science.gov (United States)

    Paglieroni, David W.; Beer, N Reginald

    2014-06-17

    A system that applies attribute and topology based change detection to networks of objects that were detected on previous scans of a structure, roadway, or area of interest. The attributes capture properties or characteristics of the previously detected objects, such as location, time of detection, size, elongation, orientation, etc. The topology of the network of previously detected objects is maintained in a constellation database that stores attributes of previously detected objects and implicitly captures the geometrical structure of the network. A change detection system detects change by comparing the attributes and topology of new objects detected on the latest scan to the constellation database of previously detected objects.

  13. Language Features and Culture Features on Short Message

    Institute of Scientific and Technical Information of China (English)

    王佳

    2013-01-01

    Mobile phone is regarded as“the fifth media”after newspaper,radio,TV and the Internet.The mobile phone short message further highlights the importance of written signs in communication.“The thumb revolution”is eagerly anticipating one kind of trend by the hand replace of mouth,sound substitute for the quiet around us. My paper will analyze the language features and the culture features of mobile phone short messages which are written in Chinese and English.

  14. A Feingold syndrome case with previously undescribed features and a new mutation.

    NARCIS (Netherlands)

    Kocak, H.; Ozaydin, E.; Kose, G.; Marcelis, C.L.M.; Kamsteeg, E.J.; Ceylaner, S.

    2009-01-01

    Feingold syndrome (FS) is a dominantly inherited combination of microcephaly with or without learning disabilities, hand and foot abnormalities, short palpebral fissures and esophageal/duodenal atresia. The syndrome has autosomal dominant inheritance with full penetrance, and variable expressivity.

  15. New Science in Plain Sight: Optical Manifestations of Coupled Subauroral Features Documented by Citizen Scientists

    Science.gov (United States)

    MacDonald, E.; Heavner, M.; Kosar, B.; Case, N.; Donovan, E.; Spanswick, E.; Nishimura, Y.; Gallardo-Lacourt, B.

    2017-12-01

    Aurora has been observed and recorded by people for thousands of years. Recently, citizen scientists captured features of aurora-like arc events not previously described in the literature at subauroral latitudes. Amateur photo sequences show unusual flow, unstable composition changes, and field aligned structures. Observations from the Swarm satellite crossing the arc reveals thermal enhancement, density depletion, and strong westward ion flow. These signatures resemble features previously described from in situ observation however the optical manifestation is surprising and contains rich, unstable signatures as well. The relevant observations have presented important implications on a variety of open questions, including the fundamental definition of aurora, and limitations of jargon and subfield distinctions. This paper covers the discovery, its context, and the significant implications for the application of public participation measurement modes to the natural sciences whereby they can form a disruptive gap to expose new observing perspectives. Photo Credit: Notanee Bourassa, Alberta Aurora Chasers

  16. Oriented Edge-Based Feature Descriptor for Multi-Sensor Image Alignment and Enhancement

    Directory of Open Access Journals (Sweden)

    Myung-Ho Ju

    2013-10-01

    Full Text Available In this paper, we present an efficient image alignment and enhancement method for multi-sensor images. The shape of the object captured in a multi-sensor images can be determined by comparing variability of contrast using corresponding edges across multi-sensor image. Using this cue, we construct a robust feature descriptor based on the magnitudes of the oriented edges. Our proposed method enables fast image alignment by identifying matching features in multi-sensor images. We enhance the aligned multi-sensor images through the fusion of the salient regions from each image. The results of stitching the multi-sensor images and their enhancement demonstrate that our proposed method can align and enhance multi-sensor images more efficiently than previous methods.

  17. Secondary Rayleigh-Taylor Instabilities in the Reconnection Exhaust Jet: A Mechanism for Supra-Arcade Downflows in the Solar Corona

    Science.gov (United States)

    Guo, L.; Bhattacharjee, A.; Huang, Y. M.; Innes, D.

    2014-12-01

    Supra-arcade downflows (hereafter referred to as SADs) are low-emission, elongated, finger-like features usually observed in active-region coronae above post-eruption flare arcades. Observations exhibit downward moving SADs intertwined with bright, upward moving spikes. Whereas SADs are dark voids, spikes are brighter, denser structures. Although SADs have been observed for decades, the mechanism for formation of SADs remains an open issue. Using high-Lundquist-number three-dimensional resistive MHD simulations, we demonstrate that secondary Rayleigh-Taylor type instabilities develop in the downstream region of a reconnecting current sheet. The instability results in the formation of low-density coherent structures that resemble SADs, intertwined with high-density structures that appear to be spike-like. Using SDO/AIA images, we highlight features that have been previously unexplained, such as the splitting of SADs at their heads, but are a natural consequence of instabilities above the arcade. Comparison with siumlations suggest that secondary Rayleigh-Taylor type instabilities in the exhaust of reconnecting current sheets provide a plausible mechanism for observed SADs and spikes. Although the plasma conditions are vastly different, analogous phenomena also occur in the Earth's magnetotail during reconnection.

  18. Feature- and Face-Exchange illusions: New insights and applications for the study of the binding problem

    Directory of Open Access Journals (Sweden)

    Arthur Gilman Shapiro

    2014-10-01

    Full Text Available The binding problem is a longstanding issue in vision science: i.e., how are humans able to maintain a relatively stable representation of objects and features even though the visual system processes many aspects of the world separately and in parallel? We previously investigated this issue with a variant of the bounce-pass paradigm, which consists of two rectangular bars moving in opposite directions; if the bars are identical and never overlap, the motion could equally be interpreted as bouncing or passing. Although bars of different colors should be seen as passing each other (since the colors provide more information about the bars’ paths, we found Feature Exchange: observers reported the paradoxical perception that the bars appear to bounce off of each other and exchange colors. Here we extend our previous findings with three demonstrations. Peripheral Feature-Exchange consists of two colored bars that physically bounce (they continually meet in the middle of the monitor and return to the sides. When viewed in the periphery, the bars appear to stream past each other even though this percept relies on the exchange of features and contradicts the information provided by the color of the bars. In Face-Exchange two different faces physically pass each other. When fixating centrally, observers typically report the perception of bouncing faces that swap features, indicating that the Feature Exchange effect can occur even with complex objects. In Face-Go-Round, one face repeatedly moves from left to right on the top of the monitor, and the other from right to left at the bottom of the monitor. Observers typically perceive the faces moving in a circle--a percept that contradicts information provided by the identity of the faces. We suggest that Feature Exchange and the paradigms used to elicit it can be useful for the investigation of the binding problem as well as other contemporary issues of interest to vision science.

  19. Comparison of image features calculated in different dimensions for computer-aided diagnosis of lung nodules

    Science.gov (United States)

    Xu, Ye; Lee, Michael C.; Boroczky, Lilla; Cann, Aaron D.; Borczuk, Alain C.; Kawut, Steven M.; Powell, Charles A.

    2009-02-01

    Features calculated from different dimensions of images capture quantitative information of the lung nodules through one or multiple image slices. Previously published computer-aided diagnosis (CADx) systems have used either twodimensional (2D) or three-dimensional (3D) features, though there has been little systematic analysis of the relevance of the different dimensions and of the impact of combining different dimensions. The aim of this study is to determine the importance of combining features calculated in different dimensions. We have performed CADx experiments on 125 pulmonary nodules imaged using multi-detector row CT (MDCT). The CADx system computed 192 2D, 2.5D, and 3D image features of the lesions. Leave-one-out experiments were performed using five different combinations of features from different dimensions: 2D, 3D, 2.5D, 2D+3D, and 2D+3D+2.5D. The experiments were performed ten times for each group. Accuracy, sensitivity and specificity were used to evaluate the performance. Wilcoxon signed-rank tests were applied to compare the classification results from these five different combinations of features. Our results showed that 3D image features generate the best result compared with other combinations of features. This suggests one approach to potentially reducing the dimensionality of the CADx data space and the computational complexity of the system while maintaining diagnostic accuracy.

  20. Borderline Personality Features and Implicit Shame-Prone Self-Concept in Middle Childhood and Early Adolescence

    Science.gov (United States)

    Hawes, David J.; Helyer, Rebekah; Herlianto, Eugene C.; Willing, Jonah

    2013-01-01

    This study tested if children and adolescents with high levels of borderline personality features (BPF) exhibit the same shame-prone self-concept previously found to characterize adults with borderline personality disorder (Rusch et al., 2007). Self-concept was indexed using the Implicit Association Test, in a community sample of…