WorldWideScience

Sample records for unknown presented multiple

  1. Celiac Disease Presenting as Fever of Unknown Origin

    Megan J. Cooney

    2013-01-01

    Full Text Available Celiac disease (CD is a common autoimmune enteropathy that occurs, in affected individuals, with exposure to gluten in the diet and improves with removal of dietary gluten. Although CD is readily considered in patients with classical presentations of the disease, atypical manifestations may be the only presenting symptoms. We present a case of CD in a 16-year-old female presenting as fever of unknown origin, which has not been reported previously. The postulated mechanism for fever in CD and the importance of clinicians having a low threshold for considering CD in the differential diagnosis of fever of unknown origin and other enigmatic clinical presentations is discussed.

  2. Metastatic Carcinoma of Unknown Primary Presenting as Jugular Venous Thrombosis

    Prince Cheriyan Modayil

    2009-01-01

    Full Text Available Jugular venous thrombosis is unusual and is associated with central venous catheterisation, intravenous drug abuse and head and neck sepsis. It is rarely associated with malignancy. We report a case of metastatic carcinoma of unknown primary in a forty year old female which presented with jugular venous thrombosis. The discussion includes investigation and treatment options for this condition.

  3. Metastatic meningioma presenting as cancer of unknown primary

    Vinay Gupta

    2013-12-01

    Full Text Available We describe a case of anaplastic meningioma presenting in an extracranial osseous location, initially diagnosed as cancer of unknown primary. Although anaplastic meningioma comprise 3% of all meningiomas, this subtype is more likely to be associated with metastases. The increased degree of dedifferentiation in anaplastic meningioma makes diagnosis difficult, especially if characteristic imaging findings of meningioma are not identified. Adequate tissue for diagnostic purposes and appropriate imaging studies may help in establishing a definitive diagnosis.

  4. Multiple analysis of an unknown optical multilayer coating

    Dobrowolski, J.A.; Ho, F.C.; Waldorf, A.

    1985-01-01

    Results are given of the analysis at five different laboratories of an unknown optical multilayer coating. In all, eleven different analytical and laboratory techniques were applied to the problem. The multilayer nominally consisted of three dielectric and two metallic layers. It was demonstrated convincingly that with present day techniques it is possible to determine the basic structure of such a coating

  5. Graves' disease presenting as pyrexia of unknown origin.

    Shaked, Y.; Samra, Y.; Zwas, S. T.

    1988-01-01

    Fever is a common clinical manifestation of inflammatory processes of the thyroid and thyroid crisis. On the other hand, fever alone as a presenting symptom of thyrotoxicosis, without other manifestations, is extremely rare. A female patient is described in whom fever persisted for two months prior to hospitalization, but without clinical symptoms or signs to lead to suspicion of thyroid disease. After exhaustive investigation it was found that the patient was suffering from hyperthyroidism. ...

  6. Chaos Synchronization Based on Unknown Input Proportional Multiple-Integral Fuzzy Observer

    T. Youssef

    2013-01-01

    Full Text Available This paper presents an unknown input Proportional Multiple-Integral Observer (PIO for synchronization of chaotic systems based on Takagi-Sugeno (TS fuzzy chaotic models subject to unmeasurable decision variables and unknown input. In a secure communication configuration, this unknown input is regarded as a message encoded in the chaotic system and recovered by the proposed PIO. Both states and outputs of the fuzzy chaotic models are subject to polynomial unknown input with kth derivative zero. Using Lyapunov stability theory, sufficient design conditions for synchronization are proposed. The PIO gains matrices are obtained by resolving linear matrix inequalities (LMIs constraints. Simulation results show through two TS fuzzy chaotic models the validity of the proposed method.

  7. Multiple aneurysm of unknown aetiology in childhood: Complications and diagnostic possibilities

    Lanfermann, H.; Benz-Bohm, G.; Schaper, J.; Gross-Fengels, W.

    1990-01-01

    A 6,5-year old boy with already known multiple aneurysm of all major arteries presented with acute abdominal pain. As demonstrated by ultrasound a big aneurysm of the left renal artery thrombosed in the course of three days. As a result, the left kidney developed severe ischaemia. Although computed tomography and scintigraphy were applied, a plan for a definitive therapeutic procedere could be established only by arterial angiography. Both Ehlers-Danlos' syndrome and Kawasaki's syndrome were excluded. There were no facts suggesting an infective aetiology. Four other cases with multiple aneurysms of unknown aetiology in childhood have so far been described in literature. (orig.) [de

  8. Magnetic resonance appearance of monoclonal gammopathies of unknown significance and multiple myeloma. The GRI Study Group.

    Bellaïche, L; Laredo, J D; Lioté, F; Koeger, A C; Hamze, B; Ziza, J M; Pertuiset, E; Bardin, T; Tubiana, J M

    1997-11-01

    A prospective multicenter study. To evaluate the use of magnetic resonance imaging, in the differentiation between monoclonal gammopathies of unknown significance and multiple myeloma. Although multiple myeloma has been studied extensively with magnetic resonance imaging, to the authors' knowledge, no study has evaluated the clinical interest of magnetic resonance imaging in the differentiation between monoclonal gammopathies of unknown significance and multiple myeloma. The magnetic resonance examinations of the thoracolumbar spine in 24 patients with newly diagnosed monoclonal gammopathies of unknown significance were compared with those performed in 44 patients with newly diagnosed nontreated multiple myeloma. All findings on magnetic resonance examination performed in patients with monoclonal gammopathies of unknown significance were normal, whereas findings on 38 (86%) of the 44 magnetic resonance examinations performed in patients with multiple myeloma were abnormal. Magnetic resonance imaging can be considered as an additional diagnostic tool in differentiating between monoclonal gammopathies of unknown significance and multiple myeloma, which may be helpful when routine criteria are not sufficient. An abnormal finding on magnetic resonance examination in a patient with monoclonal gammopathies of unknown significance should suggest the diagnosis of multiple myeloma after other causes of marrow signal abnormalities are excluded. Magnetic resonance imaging also may be proposed in the long-term follow-up of monoclonal gammopathies of unknown significance when a new biologic or clinical event suggests the diagnosis of malignant monoclonal gammopathy.

  9. Disseminated hydatid disease presenting as fever of unknown origin: A case report and review of literature

    Nikhil Gupta

    2015-01-01

    Full Text Available Human hydatid disease occurs due to infection with larval form of Echinococcus granulosus. The disseminated hydatid disease is a very rare finding. Disseminated hydatid disease presenting as a cause of fever of unknown origin is a rare phenomenon. We present to you such a rare case.

  10. Hemophagocytic Lymphohistiocytosis Secondary to Unknown Underlying Hodgkin Lymphoma Presenting with a Cholestatic Pattern of Liver Injury

    A.L. Booth

    2018-04-01

    Full Text Available Hemophagocytic lymphohistiocytosis (HLH is an uncommon disease that often presents with nonspecific findings. A high index of suspicion is necessary to make a prompt diagnosis and prevent fatal disease. A 45-year-old man presented with fever, hypotension, abdominal pain, nausea, and vomiting. Imaging showed hepatosplenomegaly and laboratory tests revealed pancytopenia, increased ferritin, and a cholestatic pattern of injury with elevated alkaline phosphatase and total bilirubin. Due to a history of Crohn disease, systemic lupus erythematous, and rheumatoid arthritis, the patient was on immunosuppressants, including infliximab. After multiple negative cultures, persistent fever, and days of empiric broad spectrum antibiotics, our differential shifted to fever of unknown origin. A liver wedge biopsy revealed areas of sinusoidal dilatation with enlarged, activated macrophages containing erythrocytes and intracytoplasmic iron, consistent with hemophagocytosis due to HLH. The portal tracts showed mixed lymphoplasmacytic inflammation, a prominent bile ductular reaction, periportal fibrosis, and scattered large cells with occasional binucleation and prominent nucleoli. These cells stained positive for Epstein-Barr virus encoding region in situ hybridization, PAX5, CD15, and CD30, and hepatic involvement by classic Hodgkin lymphoma was diagnosed and determined to be the cause of the HLH and cholestatic pattern of injury. Simultaneously, a bone marrow biopsy showed diffuse involvement by Hodgkin lymphoma with a similar staining pattern. Aggressive treatment failed and the patient succumbed to multiorgan failure. HLH is a rare, potentially fatal disease, with nonspecific signs and symptoms, and should be considered in any patient presenting with fever and pancytopenia, especially if they are immune compromised.

  11. Squamous cell carcinoma presenting with trigeminal anesthesia: An uncommon presentation of head & neck cancer with unknown primary.

    Shah, Ameer T; Dagher, Walid I; O'Leary, Miriam A; Wein, Richard O

    The differential diagnosis of facial anesthesia is vast. This may be secondary to trauma, neoplasm, both intracranial and extracranial, infection, and neurologic disease. When evaluating a patient with isolated facial anesthesia, the head and neck surgeon often thinks of adenoid cystic carcinoma, which has a propensity for perineural invasion and spread. When one thinks of head and neck squamous cell carcinoma with or without unknown primary, the typical presentation involves dysphagia, odynophagia, weight loss, hoarseness, or more commonly, a neck mass. Squamous cell carcinoma presenting as facial anesthesia and perineural spread, with no primary site is quite rare. Case presentations and review of the literature. Trigeminal anesthesia is an uncommon presentation of head and neck squamous cell carcinoma with unknown primary. We present two interesting cases of invasive squamous cell carcinoma of the trigeminal nerve, with no primary site identified. We will also review the literature of head and neck malignancies with perineural spread and the management techniques for the two different cases presented. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Multiple Eccrine Spiradenoma- An Unusual Clinical Presentation

    Anita P. Javalgi

    2017-04-01

    Full Text Available Eccrine spiradenoma is an uncommon benign adnexal tumour of apocrine differentiation. It is commonly seen in young adults with no sex predilection on upper ventral aspect of body as a solitary papule or nodule. Here we are reporting a rare case of Multiple Eccrine Spiradenoma (MES in a 29 year male patient, who presented with multiple nodules on the anterior chest wall.

  13. Impulsive synchronization of Markovian jumping randomly coupled neural networks with partly unknown transition probabilities via multiple integral approach.

    Chandrasekar, A; Rakkiyappan, R; Cao, Jinde

    2015-10-01

    This paper studies the impulsive synchronization of Markovian jumping randomly coupled neural networks with partly unknown transition probabilities via multiple integral approach. The array of neural networks are coupled in a random fashion which is governed by Bernoulli random variable. The aim of this paper is to obtain the synchronization criteria, which is suitable for both exactly known and partly unknown transition probabilities such that the coupled neural network is synchronized with mixed time-delay. The considered impulsive effects can be synchronized at partly unknown transition probabilities. Besides, a multiple integral approach is also proposed to strengthen the Markovian jumping randomly coupled neural networks with partly unknown transition probabilities. By making use of Kronecker product and some useful integral inequalities, a novel Lyapunov-Krasovskii functional was designed for handling the coupled neural network with mixed delay and then impulsive synchronization criteria are solvable in a set of linear matrix inequalities. Finally, numerical examples are presented to illustrate the effectiveness and advantages of the theoretical results. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Neuroendocrine Cell Carcinoma of Unknown Primary Arising in Long Standing History of Multiple Sclerosis

    Stergios Boussios

    2015-01-01

    Full Text Available Multiple sclerosis (MS is a chronic autoimmune disease that targets myelinated axons in the central nervous system (CNS. Cancer of unknown primary site (CUP is a well-recognised clinical disorder, accounting for 3–5% of all malignant epithelial tumors. CUP is clinically characterised as an aggressive disease with early dissemination. Studies of cancer risk in MS patients have shown inconsistent findings. An increased risk of malignancy in patients with MS has been suggested, but recently serious questions have been raised regarding this association. Use of disease-modifying therapies might contribute to an increased cancer risk in selected MS patients. The concurrence of MS and CUP is exceptionally rare. Here we describe the case of a neuroendocrine carcinoma of unknown primary diagnosed in a male patient with a nine-year history of MS. The discussion includes data from all available population-based register studies with estimates of certain malignancies in patients with MS.

  15. Gestational Tubal Choriocarcinoma Presenting as a Pregnancy of Unknown Location following Ovarian Induction

    Lawrence Hsu Lin

    2018-01-01

    Full Text Available The management of pregnancy of unknown location (PUL can be a challenging situation, since it can present as several different conditions. Here we describe a rare case of gestational choriocarcinoma arising in the fallopian tube after ovarian induction in an infertile patient. The patient received clomiphene for ovarian induction and had rising levels of human chorionic gonadotropin (hCG over nine months without sign of pregnancy. After referral to our center, the patient was diagnosed with a paraovarian tumor, which revealed a gestational choriocarcinoma arising in the fallopian tube; the final diagnosis was supported by pathological and cytogenomic analysis. Malignancies, such as gestational trophoblastic disease, should be in the differential diagnosis of PUL; the early recognition of these conditions is key for the proper treatment and favorable outcome.

  16. An Unusual Presentation of Isolated Leptomeningeal Disease in Carcinoma of Unknown Primary With Pancreatic Features

    Madhurima Anne MD

    2013-06-01

    Full Text Available Leptomeningeal disease (LMD can occur in a small percentage of patients with active metastatic cancer. However, we report a case of LMD occurring during disease remission in a patient with carcinoma of unknown primary with panreaticobiliary features. A 45-year-old woman was found with mediastinal and abdominal lymphadenopathy with lymph node biopsy consistent with adenocarcinoma, expressing immunomarkers CK7, CK20, and Ca19-9 along with markedly elevated serum Ca19-9 level. The patient was started on a pancreatic cancer directed chemotherapy regimen of Folfirinox (5-fluorouracil, leucovorin, oxaliplatin, irinotecan and achieved complete response. She was then noted to have slowly rising Ca19-9 level that did not correlate with her lack of evidence of systemic disease progression. Eventually, she presented with neurologic symptoms and was found on imaging to have isolated LMD.

  17. Distributed Containment Control for Multiple Unknown Second-Order Nonlinear Systems With Application to Networked Lagrangian Systems.

    Mei, Jie; Ren, Wei; Li, Bing; Ma, Guangfu

    2015-09-01

    In this paper, we consider the distributed containment control problem for multiagent systems with unknown nonlinear dynamics. More specifically, we focus on multiple second-order nonlinear systems and networked Lagrangian systems. We first study the distributed containment control problem for multiple second-order nonlinear systems with multiple dynamic leaders in the presence of unknown nonlinearities and external disturbances under a general directed graph that characterizes the interaction among the leaders and the followers. A distributed adaptive control algorithm with an adaptive gain design based on the approximation capability of neural networks is proposed. We present a necessary and sufficient condition on the directed graph such that the containment error can be reduced as small as desired. As a byproduct, the leaderless consensus problem is solved with asymptotical convergence. Because relative velocity measurements between neighbors are generally more difficult to obtain than relative position measurements, we then propose a distributed containment control algorithm without using neighbors' velocity information. A two-step Lyapunov-based method is used to study the convergence of the closed-loop system. Next, we apply the ideas to deal with the containment control problem for networked unknown Lagrangian systems under a general directed graph. All the proposed algorithms are distributed and can be implemented using only local measurements in the absence of communication. Finally, simulation examples are provided to show the effectiveness of the proposed control algorithms.

  18. Systemic amyloidosis due to unknown multiple myeloma in small bowel pseudo-obstruction: case report

    Giuseppe Caparrotti

    2016-03-01

    Full Text Available Amyloidosis is a pathologic diagnosis characterized by extracellular deposition of insoluble protein fibrils in various organs and tissues. There are two main forms of amyloidosis, primary amyloidosis, and secondary amyloidosis. Gastrointestinal involvement is common in both amyloidosis forms. We describe the case of a 78-year-old woman taken to the operating room for small bowel obstruction, found to have pseudo-obstruction and enteritis. Exploratory laparotomy revealed gastric mass and histological examen showed extensive amyloid deposition consistent with amyloidosis. Hematological evaluation revealed unknown multiple myeloma. This case report and literature data suggest to perform a hematological examination in patients with amyloidosis diagnosis to exclude a multiple myeloma or other plasma cell disorders

  19. Multiple myeloma presenting as mandibular pain

    Crowley, Miriam

    2016-10-01

    Introduction: Multiple myeloma (MM) is a systemic malignancy of plasma cells defined by monoclonal production of circulating immunoglobulins. Bone pain is a presenting feature in the majority of cases. Treatment may involve intravenous use of bisphosphonates, chemotherapy or haematopoietic stem cell transplantation. Here, we illustrate a first presentation of MM in a patient with mandibular pain and discuss radiographic, diagnostic and treatment challenges of orofacial issues in patients with MM.\\r\

  20. Multiple ureterolithiasis resembling steinstrasse: An unusual presentation

    Praveen Kumar Pandey

    2014-12-01

    Full Text Available Steinstrasse or “stone street” is an expected complication after extracorporeal shock wave lithotripsy in patients with high stone burden. However, there are published reports of multiple ureterolithiasis resembling steinstrasse in patients with distal renal tubular acidosis. Here we report an uncommon case of a 60-year-old woman who presented with right renal calculi. Her right ureter was studded with multiple calculi up to the vesicoureteric junction. The affected right kidney was nonfunctional and was managed by nephroureterectomy.

  1. Remote multiple intracranial hemorrhage in multiple metastatic lung adenocarcinoma following decompression of posterior fossa lesion: Unknown cause

    Subhas Konar

    2015-01-01

    Full Text Available Cerebral metastasis can present with hemorrhage. However, multiple hemorrhages in metastatic lesions following surgical decompression of a single lesion are never reported. We report a case of cerebral metastasis from lung cancer that developed multiple hemorrhages in supratentorial metastatic lesions following surgical resection of an infratentorial lesion.

  2. Tracking Control Based on Recurrent Neural Networks for Nonlinear Systems with Multiple Inputs and Unknown Deadzone

    J. Humberto Pérez-Cruz

    2012-01-01

    Full Text Available This paper deals with the problem of trajectory tracking for a broad class of uncertain nonlinear systems with multiple inputs each one subject to an unknown symmetric deadzone. On the basis of a model of the deadzone as a combination of a linear term and a disturbance-like term, a continuous-time recurrent neural network is directly employed in order to identify the uncertain dynamics. By using a Lyapunov analysis, the exponential convergence of the identification error to a bounded zone is demonstrated. Subsequently, by a proper control law, the state of the neural network is compelled to follow a bounded reference trajectory. This control law is designed in such a way that the singularity problem is conveniently avoided and the exponential convergence to a bounded zone of the difference between the state of the neural identifier and the reference trajectory can be proven. Thus, the exponential convergence of the tracking error to a bounded zone and the boundedness of all closed-loop signals can be guaranteed. One of the main advantages of the proposed strategy is that the controller can work satisfactorily without any specific knowledge of an upper bound for the unmodeled dynamics and/or the disturbance term.

  3. A case of hemophagocytic lymphohistiocytosis presenting as pyrexia of unknown origin

    Indira Madhavan

    2015-01-01

    Full Text Available Hemophagocytic lymphohistiocytosis (HLH is a potentially fatal hyper inflammatory condition, which occurs as either primary (genetic or secondary (acquired due to impaired or absent function of natural killer cells and cytotoxic cells. Common secondary causes include viral and bacterial infections, autoimmune diseases, and hematological malignancies. Extensive phagocytosis of blood cells by histiocytes in bone marrow, spleen, liver and lymphnodes result in peripheral blood cytopenias, hepatosplenomegaly, and lymphadenopathy. We evaluated a case of pyrexia of unknown origin and found out that he fulfilled the criteria for diagnosing HLH. He was started on immunochemotherapy with etoposide, cyclosporine and steroids, but he succumbed to illness within 2 weeks of treatment. High index of suspicion is needed to diagnose HLH and prompt treatment on diagnosis can be lifesaving.

  4. musculoskeletal presentation of multiple myeloma at general

    2014-09-01

    Sep 1, 2014 ... Results: A total of 62 patients were diagnosed with multiple myeloma, 63% were female. ... Conclusion: Presence of bone pain and anaemia should alert the clinician to investigate along the ... not found to fall among the ten most common cancers ..... Dugan LO, Dugan DA, Dugan WM Jr. Back pain: the.

  5. Primary hyperparathyroidism presenting with multiple pathological ...

    The diagnosis of primary hyperparathyroidism (PHPT) is a rarity in developing countries. We report a 30-year old Nigerian farmer seen at the Usmanu Danfodiyo University Teaching Hospital, Sokoto with multiple pathological fractures. The diagnosis of PHPT was made based on these bone changes and the elevated ...

  6. Fever of unknown origin as a presenting manifestation of craniopharyngioma in a child

    NANDI, Madhumita; MONDAL, Rakesh

    2010-01-01

    An unusual case of cranio-pharyngioma which presented with prolonged fever described here. Investigation revealed that the child was suffering from leaking craniopharyngioma with hypo-pituitarism Fever was due to chemical meningitis following cranio-pharyngioma as evident from the CSF findings. Craniopharyngioma can cause prolonged or recurrent fever due to various reasons [1]. Prolonged fever as the sole manifestation of cranio-pharyngioma has been rarely reported in literature and this is p...

  7. Fever of unknown origin as a presenting manifestation of craniopharyngioma in a child

    Madhumita Nandi and Rakesh Kumar Mondal

    2010-01-01

    Full Text Available An unusual case of cranio-pharyngioma which presented with prolonged fever described here. Investigation revealed that the child was suffering from leaking craniopharyngioma with hypo-pituitarism Fever was due to chemical meningitis following cranio-pharyngioma as evident from the CSF findings. Craniopharyngioma can cause prolonged or recurrent fever due to various reasons. Prolonged fever as the sole manifestation of cranio-pharyngioma has been rarely reported in literature and this is probably first such report in Indian children.

  8. Bone metastases from initially unknown origin as unusual presentation of thyroid cancer

    Sabate, M.I.; Guerra, J.; Parizzia, W.; Venditti, J.; Negueruela, M.C.; Etchegoyen, F.; Quiros, M.C.; Zarlenga, C.; Martinez, J.

    2006-01-01

    The insular carcinoma of thyroid gland is a poorly frequent neoplasm, slightly differentiated and of clinical aggressive course. The bone metastasis unique as a form of presentation in absence of regional ganglions compromise or another metastasis localization is very unusual. The local invasion, regional ganglions and metastases at a distance (lung and bone) are the usual conduct. It is of interesting to highlight the importance of the immunoreactivity for Tg (thyroglobulin) to tackle the diagnosis, like also the considerable absorption with Tc 99m -MDP, I 131 and Tc 99m -MIBI by the tissue of the metastasis [es

  9. Using multiple criteria for fingerprinting unknown oil samples having very similar chemical composition

    Wang, Z.; Fingas, M.F.; Sigouin, L.

    2002-01-01

    A study was conducted in which 3 mystery oil samples from Quebec were fingerprinted using a multi-criterion approach. The three objectives of the study were to determine the nature and the type of product, to obtain the detailed hydrocarbon composition of the samples, and to determine if the samples came from the same source. The product type was first determined by identifying the hydrocarbon distribution patterns. Polycyclic aromatic hydrocarbon (PAH) profiles were then compared and then the conclusions were verified by quantifying biomarkers and by determining several diagnostic ratios of source-specific marker compounds. Additives in the oil were also identified. The samples were analyzed using gas chromatography combined with flame ionization detection (GC-FID), and by gas chromatography-mass spectrometry (GC-MS). It was determined that the 3 oils were probably hydraulic-fluid type oil. They were very pure, and composed mostly of saturated hydrocarbons with the total aromatics being 4 to 10 per cent of the total petroleum hydrocarbon. Although it was determined that the oils were mixtures of 2 different hydraulic fluids, there was no clear indication if they had been weathered. The PAH concentration was very low, while the biomarker concentration was very high. Three unknown compounds (antioxidants) were positively identified. Two of the samples came from the same source. One of the samples had similar group hydrocarbon composition but it was not identical in chemical composition and did not come from the same source. 34 refs., 3 tabs., 6 figs

  10. Pattern of Presentation of Multiple Organ Dysfunction Syndrome in ...

    Background: Multiple organ dysfunction syndrome is the sequential failure of several organ systems after a trigger event, like sepsis, massive transfusions, burns, trauma and cardiogenic shock. Aim and Objectives- The pattern of presentation of multiple organ dysfunction and the risk factors associated with multiple organ ...

  11. Nausea, Vomiting and Diarrhea: An Unusual Presentation of Multiple Sclerosis

    Andrew Szilagyi

    1997-01-01

    Full Text Available The case of a young woman who presented with nausea, vomiting and diarrhea is outlined; the etiology turned out to be a first attack of multiple sclerosis. Plausible mechanisms are discussed.

  12. A case of multiple myeloma presenting as a bullous dermatosis

    Gul Ulker

    2008-01-01

    Full Text Available Multiple myeloma is a malignant plasma cell proliferative disorder that produces a monoclonal immunoglobulin protein. The skin involvement and the development of bullous disease are rarely seen features in multiple myeloma. We present a 55-year-old man with a longstanding, large, tense bullous eruption and hypertrophic scars over his body accompanied recently with weight loss and fatique. He had no response to the previous treatments, which included oral glucocorticoids and dapsone. Histologic examination of the lesions revealed subepidermal bullae, while no immunoflourescence staining was observed. In a further detailed labarotory examination, multiple myeloma was detected. After the treatment of multiple myeloma with chemotherapy, the lesions regressed. Patients with longstanding, recurrent, unusual bullous eruption should be investigated for the development of multiple myeloma.

  13. Hypophosphatemic osteomalacia: an unusual clinical presentation of multiple myeloma.

    Reyskens, M; Sleurs, K; Verresen, L; Janssen, M; van den Bergh, J; van den Berg, J; Geusens, P

    2015-07-01

    An unusual case of a 75-year-old man is presented who had multiple stress fractures due to adult onset hypophosphatemic osteomalacia, which was the result of Fanconi syndrome, with light chain cast proximal tubulopathy due to multiple myeloma. A 75-year-old man presented with diffuse pain and muscle weakness. He had multiple stress fractures, low serum phosphate, decreased renal tubular reabsorption of phosphate, and normal PTH and FGF23, indicating adult onset hypophosphatemic osteomalacia. Phosphate supplements with calcitriol resulted in clinical recovery and healing of stress fractures. Because of proteinuria, a renal biopsy was performed that revealed Fanconi syndrome with light chain cast proximal tubulopathy and light kappa chains were found in serum and urine. A bone biopsy confirmed the diagnosis of multiple myeloma, and treatment with chemotherapy resulted in cytological and clinical recovery.

  14. A case of multiple tuberculomas in brain presenting as hemiparesis

    Amit Gupta

    2011-03-01

    Full Text Available Tuberculosis of central nervous system can be present in many different clinical and radiological patterns with disseminated or miliary brain tuberculomas as a rare presentation. Multiple central nervous system tuberculoma is commonly associated with human immunodeficiency virus (HIV infection. Tuberculomas develop following haematogenous dissemination of bacilli from an infection elsewhere in the body, usually lung. Here we describe a case of immunocompetent host with a past history of pulmonary tuberculosis, presenting with headache and generalised weakness, and later was diagnosed as a case of multiple tuberculoma brain.

  15. Primary hyperparathyroidism with rare presentation as multiple brown tumours

    Smit Doshi

    2012-04-01

    Full Text Available We present a case of primary hyperparathyroidism with an uncommon presentation as multiple brown tumours, which may easily be mistaken for a primary bone neoplasm. A brief literature review and its clinical and surgical management are also discussed here.

  16. Localized cutaneous mucinosis associated with multiple myeloma: A rare presentation

    Parvaiz Anwar Rather

    2014-01-01

    Full Text Available Lichen myxoedematosus (LM, a form of primary cutaneous mucinosis, may present either as localized less severe form called papular mucinosis or diffuse more severe form called scleromyxoedema. The diffuse form is almost always associated with monoclonal gammopathy, whereas localized form is not. We report an atypical case of localized form of LM associated with multiple myeloma in a 66-year-old male, who presented with asymptomatic waxy papular eruption on extremities, which on histopathological examination confirmed the diagnosis of cutaneous mucinosis. After initially being put on steroids and hydroxychloroquine with minimal improvement, patient subsequently presented with encephalopathy and on evaluation revealed hypernatremia, hypercalcemia, hypergammaglobulinemia, reversal of albumin-globulin (A/G ratio, azotemia, and lytic lesions in skull X-ray. Bone marrow aspiration and biopsy confirmed multiple myeloma. Patient was successfully treated with standard treatment regimen for multiple myeloma with bortezumib and dexamethasone and his skin lesions subsided completely.

  17. Multiple Autoimmune Syndromes Associated with Psoriasis: A Rare Clinical Presentation

    Sadia Masood

    2014-03-01

    Full Text Available Autoimmune diseases are known to have association with each other but it is very rare to see multiple autoimmune diseases in one patient. The combination of at least three autoimmune diseases in the same patient is referred to as multiple autoimmune syndrome. The case we are reporting features multiple autoimmune syndrome with five different conditions. The patient had type 1 diabetes mellitus, autoimmune hemolytic anemia, systemic lupus erythematosus, vitiligo, and psoriasis. Psoriasis has rarely been reported previously under the spectrum of autoimmune syndrome. Although the relationship of autoimmune conditions with each other has been explored in the past, this case adds yet another dimension to the unique evolution of autoimmune pathologies. The patient presented with a combination of five autoimmune diseases, which makes it consistent type three multiple autoimmune syndromes with the addition of psoriasis. The current case is unique in this aspect that the combination of these five autoimmune disorders has never been reported in the past.

  18. Multiple myeloma presenting as CEA-producing rectal cancer.

    Talamo, Giampaolo; Barochia, Amitkumar; Zangari, Maurizio; Loughran, Thomas P

    2010-03-31

    We report the case of a 57-year-old patient with multiple myeloma, characterized by extramedullary involvement of the rectum at presentation. Malignant plasma cells were found to produce carcinoembryonic antigen (CEA), a tumor antigen more commonly associated with rectal adenocarcinomas.

  19. Multiple myeloma presenting as CEA-producing rectal cancer

    Giampaolo Talamo

    2010-03-01

    Full Text Available We report the case of a 57-year old patient with multiple myeloma, characterized by extramedullary involvement of the rectum at presentation. Malignant plasma cells were found to produce carcinoembryonic antigen (CEA, a tumor antigen more commonly associated with rectal adenocarcinomas.

  20. Multiple Cutaneous Metastases as Initial Presentation in Advanced Colon Cancer

    Sudheer Nambiar

    2018-01-01

    Full Text Available Skin metastases from advanced colorectal cancer are relatively rare and occur most often when the cancer is advanced, following the spread to other organs. Cutaneous metastases occur in about 3% of advanced colorectal cancers. We present an extremely rare case of a 68-year-old woman with advanced ascending colon adenocarcinoma that presented with multiple rapidly progressing painless cutaneous metastatic lesions with no other distant metastases. Of all the tumors, breast cancer most commonly spreads as cutaneous metastasis is followed by lung, colorectal, renal, ovarian, and bladder cancers. Cutaneous metastases can present in a variety of clinical manifestations, such as a rapidly growing painless dermal or subcutaneous nodule with intact overlying epidermis or as ulcers. In cases where the cutaneous deposit is isolated, as in visceral metastasis, there is a role for radical management such as wide local excision and reconstruction. In our patient, since she had multiple cutaneous metastases she began treatment with palliative systemic combination chemotherapy.

  1. A Very Rare Presentation of Multiple Myeloma: Unilateral Raccoon Eye

    Ceyhun Varım

    2015-08-01

    Two thirds of patients complain of bone pain, especially lower back pain. MM could be diagnosed after a pathologic fracture occurs in one third of patients. Presentation with symptoms related to hyperviscosity, hypercalcemia and bleeding tendency could also be observed. A rare presentation of MM is peri-orbital ecchymotic lesion (raccoon eye. Here, we report a 64 years old, male patient presented with unilateral raccoon eye and high erythrocyte sedimentation rate (ESR to internal medicine outpatient. The patient was referred to hematology outpatient and was diagnosed with multiple myeloma.

  2. Rheumatic polymyalgia like presentation of multiple myeloma and amyloidosis

    Medina, Yimy F; Martinez, Jose Bernardo; Restrepo, Jose Felix; Rondon, Federico; Iglesias Gamarra, Antonio

    2005-01-01

    Polymyalgia rheumatica is a disorder with defined clinical characteristics and may be the initial expression or to be associated to other diseases. Although it is not associated to neoplastic diseases, may be their initial manifestation. We report a patient who presented the initial complaining of polymyalgia rheumatica as a manifestation of another illness, amyloidosis associated to multiple myeloma. We also discuss the clinical characteristics of these entities and revised the available literature with regard to this association

  3. Nephrogenic Diabetes Insipidus: A Rare Presentation in Multiple Myeloma

    Mehdi Dehghani

    2012-04-01

    Full Text Available We report a case of multiple myeloma that presented with anorexia, fatigue, high erythrocyte sedimentation rate, bone marrow plasmacytosis of more than 30%, polyuria,and low urine specific gravity. This unusual presentation was diagnosed as nephrogenic diabetes insipidus secondary to a proximal tubular dysfunction. The tubular functional disturbance appeared to be related to thepresence of lambda-type light chains. The patient was treated withdesmopressine without response. After one month of treatment with thalidomide and dexamethasone for myeloma there was a dramatic response with decreased urine output.

  4. Multidrug-resistant Nocardia pseudobrasiliensis presenting as multiple muscle abscesses.

    Veerappan Kandasamy, Vimalkumar; Nagabandi, Arun; Horowitz, Edward A; Vivekanandan, Renuga

    2015-05-06

    A 79-year-old Caucasian man presented with multiple leg abscesses due to Nocardia pseudobrasiliensis. He was on chronic steroid therapy for myasthenia gravis. We present the difficulties in diagnosis and treatment of this rare organism. N. pseudobrasiliensis is a new emerging species that was previously thought to belong to the N. brasiliensis species. The distinction between the two species is extremely important given the different antibiotic susceptibility pattern and association of N. pseudobrasiliensis with more invasive and disseminated disease. 2015 BMJ Publishing Group Ltd.

  5. Novel figurative phrases and idioms: phrase characteristics over multiple presentations.

    Schweigert, Wendy A; Cintron, Jennifer; Sullivan, Karin; Ilic, Emily; Ellis, Shannon; Dobrowits, Carrie; Roberts, Crystal

    2003-07-01

    In a series of three studies, characteristics of novel figurative phrases were compared with those of established idioms. Studies 1 and 2 found that certain correlations were found to be strong and in one direction for familiar idioms and comparably strong but in the opposite direction for novel figurative phrases, with the correlations for less familiar idioms usually falling partway between these extremes. Study 2 also noted that written or auditory presentation had minimal effects on characteristic ratings. In Study 3 the correlations among characteristics stayed relatively constant for familiar idioms after one, three, or six presentations, but for the novel figurative phrases, after multiple presentations the correlations changed in the direction of the established idioms.

  6. Atypical presentation of multiple evanescent white dot syndrome (MEWDS).

    Yenerel, Nursal Melda; Kucumen, Beril; Gorgun, Ebru; Dinc, Umut Asli

    2008-01-01

    To present fundus autofluorescence (FAF), indocyanine green angiography (ICGA), and microperimetry (MP) findings of a patient with multiple evanescent white dot syndrome (MEWDS). Observational case report. A 30-year-old woman with blurry vision was referred for evaluation. Fundus examination revealed only foveal granularity. FAF showed hyperautofluorescent spots, although they were not visible clinically. On ICGA, matching areas were hypofluorescent. Microperimetry revealed mean sensitivity decrease. The resolution of the symptoms was followed by disappearance of these spots in FAF and ICGA and increase of mean macular sensitivity in MP. FAF is a noninvasive imaging technique that might help in the differential diagnosis of chorioretinal pathologies.

  7. Self-presentational persona: simultaneous management of multiple impressions.

    Leary, Mark R; Allen, Ashley Batts

    2011-11-01

    Most research on self-presentation has examined how people convey images of themselves on only 1 or 2 dimensions at a time. In everyday interactions, however, people often manage their impressions on several image-relevant dimensions simultaneously. By examining people's self-presentations to several targets across multiple dimensions, these 2 studies offer new insights into the nature of self-presentation and provide a novel paradigm for studying impression management. Results showed that most people rely on a relatively small number of basic self-presentational personas in which they convey particular profiles of impressions as a set and that these personas reflect both normative influences to project images that are appropriate to a particular target and distinctive influences by which people put an idiosyncratic spin on these normative images. Furthermore, although people's self-presentational profiles correlate moderately with their self-views, they tailor their public images to specific targets. The degree to which participants' self-presentations were normative and distinctive, as well as the extent to which they reflected their own self-views, were moderated by individual differences in agreeableness, self-esteem, authenticity, and Machiavellianism.

  8. Mucoid impaction presenting as multiple pulmonary nodules in cystic fibrosis

    Carpenter, L.D.; Lambie, N.K.; Wilsher, M.L.

    1996-01-01

    Mucoid impaction has been described as a complication of asthma and more commonly in patients with allergic bronchopulmonary aspergillosis. In such cases, the impacted pools of mucus may present as discrete nodules on chest X-ray and hence simulate the appearance of metastatic malignancy. A case of mucoid impaction presenting as multiple pulmonary nodules in a patient with cystic fibrosis is described. The chest X-ray showed hyperinfiltration and scattered changes consistent with bronchiectasis. Computed tomography scan confirmed these and additional intra-pulmonary nodular densities. This report illustrates that mucus impaction as a cause of pulmonary nodules should be considered in any patient with chronic lung disease characterised by excess mucus production. 6 refs., 3 figs

  9. Multiple sclerosis exceptionally presenting as parkinsonism responds to intravenous methylprednisolone.

    Saidha, S

    2012-01-31

    Parkinsonism due to multiple sclerosis (MS) is rare. In previously reported patients with MS-induced parkinsonism, MS manifested first, followed a typical clinical course, and parkinsonism developed later in the course of the illness. We report a 52-year-old male presenting with parkinsonism as the initial manifestation of MS, in whom a subsequent MS relapse consisted of marked deterioration in parkinsonism, a clinical pattern not previously described in MS. A brain MRI demonstrated involvement of the substantia nigra and basal ganglia. This patient illustrates that the clinical presentation and progression of MS may rarely be characterised by predominating parkinsonian features which are reversible by treatment with intravenous methylprednisolone and interferon beta1a.

  10. Multiple sclerosis exceptionally presenting as parkinsonism responds to intravenous methylprednisolone.

    Saidha, S

    2010-05-01

    Parkinsonism due to multiple sclerosis (MS) is rare. In previously reported patients with MS-induced parkinsonism, MS manifested first, followed a typical clinical course, and parkinsonism developed later in the course of the illness. We report a 52-year-old male presenting with parkinsonism as the initial manifestation of MS, in whom a subsequent MS relapse consisted of marked deterioration in parkinsonism, a clinical pattern not previously described in MS. A brain MRI demonstrated involvement of the substantia nigra and basal ganglia. This patient illustrates that the clinical presentation and progression of MS may rarely be characterised by predominating parkinsonian features which are reversible by treatment with intravenous methylprednisolone and interferon beta1a.

  11. Integrated presentation of ecological risk from multiple stressors

    Goussen, Benoit; Price, Oliver R.; Rendal, Cecilie; Ashauer, Roman

    2016-10-01

    Current environmental risk assessments (ERA) do not account explicitly for ecological factors (e.g. species composition, temperature or food availability) and multiple stressors. Assessing mixtures of chemical and ecological stressors is needed as well as accounting for variability in environmental conditions and uncertainty of data and models. Here we propose a novel probabilistic ERA framework to overcome these limitations, which focusses on visualising assessment outcomes by construct-ing and interpreting prevalence plots as a quantitative prediction of risk. Key components include environmental scenarios that integrate exposure and ecology, and ecological modelling of relevant endpoints to assess the effect of a combination of stressors. Our illustrative results demonstrate the importance of regional differences in environmental conditions and the confounding interactions of stressors. Using this framework and prevalence plots provides a risk-based approach that combines risk assessment and risk management in a meaningful way and presents a truly mechanistic alternative to the threshold approach. Even whilst research continues to improve the underlying models and data, regulators and decision makers can already use the framework and prevalence plots. The integration of multiple stressors, environmental conditions and variability makes ERA more relevant and realistic.

  12. Integrated presentation of ecological risk from multiple stressors.

    Goussen, Benoit; Price, Oliver R; Rendal, Cecilie; Ashauer, Roman

    2016-10-26

    Current environmental risk assessments (ERA) do not account explicitly for ecological factors (e.g. species composition, temperature or food availability) and multiple stressors. Assessing mixtures of chemical and ecological stressors is needed as well as accounting for variability in environmental conditions and uncertainty of data and models. Here we propose a novel probabilistic ERA framework to overcome these limitations, which focusses on visualising assessment outcomes by construct-ing and interpreting prevalence plots as a quantitative prediction of risk. Key components include environmental scenarios that integrate exposure and ecology, and ecological modelling of relevant endpoints to assess the effect of a combination of stressors. Our illustrative results demonstrate the importance of regional differences in environmental conditions and the confounding interactions of stressors. Using this framework and prevalence plots provides a risk-based approach that combines risk assessment and risk management in a meaningful way and presents a truly mechanistic alternative to the threshold approach. Even whilst research continues to improve the underlying models and data, regulators and decision makers can already use the framework and prevalence plots. The integration of multiple stressors, environmental conditions and variability makes ERA more relevant and realistic.

  13. Singularity-Free Neural Control for the Exponential Trajectory Tracking in Multiple-Input Uncertain Systems with Unknown Deadzone Nonlinearities

    J. Humberto Pérez-Cruz

    2014-01-01

    Full Text Available The trajectory tracking for a class of uncertain nonlinear systems in which the number of possible states is equal to the number of inputs and each input is preceded by an unknown symmetric deadzone is considered. The unknown dynamics is identified by means of a continuous time recurrent neural network in which the control singularity is conveniently avoided by guaranteeing the invertibility of the coupling matrix. Given this neural network-based mathematical model of the uncertain system, a singularity-free feedback linearization control law is developed in order to compel the system state to follow a reference trajectory. By means of Lyapunov-like analysis, the exponential convergence of the tracking error to a bounded zone can be proven. Likewise, the boundedness of all closed-loop signals can be guaranteed.

  14. Multiple aspects of climate change - Summary of presentations

    Andre, Jean-Claude; Bauer, Pierre; Le Treut, Herve; Woeppelmann, Guy; Kouraev, Alexei; Remy, Frederique; Berthier, Etienne; Lehodey, Patrick; Lebourgeois, Francois; Chuine, Isabelle; Vennetier, Michel; Duchene, Eric; Lafaye, Murielle

    2011-01-01

    The French Meteorological Society (SMF) organized its annual scientific day on March 23, 2011 on the topic of the multiple aspects of climate change. The aim was to take stock of the lessons learnt from the different meteorological markers in several domains (agriculture, forests, ecosystems, rise of sea level, changes in marine biodiversity, health, snow and ice caps..). This paper summarizes the seven presentations given at this meeting: 1 - climate change today and tomorrow (H. Le Treut); 2 - rise of oceans level: estimations and regional variability (G. Woeppelmann); 3 - polar caps and continental cryo-sphere as seen from space (A. Kouraev, F. Remy and E. Berthier); 4 - impact of climate change on exploited marine populations: projections and uncertainties (P. Lehodey); 5 - stakes of climate change on agricultural and winery activities in France (E. Duchene); 6 - impact of climate change on forest trees phenology and consequence on their survival and operation (F. Lebourgeois, I. Chuine and M. Vennetier); 7 - 'tele-epidemiology': a health-aid in a climate change context. (J.S.)

  15. Multiple cavernous malformations presenting in a patient with Poland syndrome: A case report

    De Salles Antonio AF

    2011-09-01

    Full Text Available Abstract Introduction Poland syndrome is a congenital disorder related to chest and hand anomalies on one side of the body. Its etiology remains unclear, with an ipsilateral vascular alteration (of unknown origin to the subclavian artery in early embryogenesis being the currently accepted theory. Cavernous malformations are vascular hamartomas, which have been linked to a genetic etiology, particularly in familial cases, which commonly present with multiple lesions. Our case report is the first to describe multiple cavernous malformations associated with Poland syndrome, further supporting the vascular etiology theory, but pointing to a genetic rather than a mechanistic factor disrupting blood flow in the corresponding vessels. Case presentation A 41-year-old Caucasian man with Poland syndrome on the right side of his body presented to our hospital with a secondary generalized seizure and was found to have multiple cavernous malformations distributed in his brain, cerebellum, and brain stem, with a predominance of lesions in the left hemisphere. Conclusion The distribution of cavernous malformations in the left hemisphere and the right-sided Poland syndrome in our patient could not be explained by a mechanistic disruption of one of the subclavian arteries. A genetic alteration, as in familial cavernous malformations, would be a more appropriate etiologic diagnosis of Poland syndrome in our patient. Further genetic and pathological studies of the involved blood vessels in patients with Poland syndrome could lead to a better understanding of the disease.

  16. Multiple aspects of climate change - Summary of presentations; Les multiples facettes du changement climatique - Resume des presentations

    Andre, Jean-Claude; Bauer, Pierre; Le Treut, Herve [Institut Pierre Simon Laplace, 78280 Guyancourt Cedex (France); Woeppelmann, Guy [Universite de la Rochelle, 17000 La Rochelle (France); Kouraev, Alexei; Remy, Frederique; Berthier, Etienne [Legos, 31401 Toulouse cedex 9 (France); Lehodey, Patrick [CLS, 31520 Ramonville St Agne (France); Lebourgeois, Francois [ENGREF, AgroParisTech, 54042 Nancy Cedex (France); Chuine, Isabelle [CEFE, CNRS, Montpellier (France); Vennetier, Michel [CEMAGREF, 13182 Aix en Provence cedex 5 (France); Duchene, Eric [INRA-Universite de Strasbourg, 68021 Colmar Cedex (France); Lafaye, Murielle [CNES, 31401 Toulouse cedex 9 (France)

    2011-08-15

    The French Meteorological Society (SMF) organized its annual scientific day on March 23, 2011 on the topic of the multiple aspects of climate change. The aim was to take stock of the lessons learnt from the different meteorological markers in several domains (agriculture, forests, ecosystems, rise of sea level, changes in marine biodiversity, health, snow and ice caps..). This paper summarizes the seven presentations given at this meeting: 1 - climate change today and tomorrow (H. Le Treut); 2 - rise of oceans level: estimations and regional variability (G. Woeppelmann); 3 - polar caps and continental cryo-sphere as seen from space (A. Kouraev, F. Remy and E. Berthier); 4 - impact of climate change on exploited marine populations: projections and uncertainties (P. Lehodey); 5 - stakes of climate change on agricultural and winery activities in France (E. Duchene); 6 - impact of climate change on forest trees phenology and consequence on their survival and operation (F. Lebourgeois, I. Chuine and M. Vennetier); 7 - 'tele-epidemiology': a health-aid in a climate change context. (J.S.)

  17. Sarcoidosis and multiple myeloma: Concurrent presentation of an unusual association

    Vidya Nair

    2016-01-01

    Full Text Available Literature on concurrent association of sarcoidosis with lymphoproliferative malignancies other than lymphoma e.g. multiple myeloma is meager. The rarity of the situation prompted us to report this patient who was a 51-year-old woman with a 2-years history of breathlessness, cough with expectoration, chest pain and backache. Initial evaluation revealed mild anemia, increased alkaline phosphatase with chest skiagram showing both lower zone non homogenous opacities with calcified hilar lymph nodes. CECT chest showed mediastinal with bilateral hilar lymphadenopathy, parenchymal fibrosis, traction bronchiectasis, ground glass opacities, septal and peribronchovascular thickening affecting mid and lower lung zones bilaterally. MRI Dorsolumbar spine was suggestive of marrow infiltrative disorder. EBUS FNA of intrathoracic nodes, EBB and TBLB confirmed sarcoidosis. PET CT revealed hyper metabolic activity in lung, multiple lymph nodes and lytic bone lesions. Serum protein electrophoresis and immunofixation revealed a monoclonal paraprotein, immunoglobulin IgG kappa type. Bone marrow biopsy revealed an increase in plasma cells (15%, but no granulomas. Diagnosis of Indolent or multiple myeloma with sarcoidosis was established. 12 cases of sarcoidosis and multiple myeloma have been reported in literature, and mostly preceding the onset of multiple myeloma by many years, in our case both were diagnosed concurrently.

  18. Integrated presentation of ecological risk from multiple stressors

    Goussen, Benoit Regis Marc; Price, Oliver R.; Rendal, Cecilie; Ashauer, Roman

    2016-01-01

    Current environmental risk assessments (ERA) do not account explicitly for ecological factors (e.g. species composition, temperature or food availability) and multiple stressors. Assessing mixtures of chemical and ecological stressors is needed as well as accounting for variability in environmental conditions and uncertainty of data and models. Here we propose a novel probabilistic ERA framework to overcome these limitations, which focusses on visualising assessment outcomes by construct-ing ...

  19. Cat-scratch disease presenting as multiple hepatic lesions: case report and literature review.

    Baptista, Mariana Andrade; Lo, Denise Swei; Hein, Noely; Hirose, Maki; Yoshioka, Cristina Ryoka Miyao; Ragazzi, Selma Lopes Betta; Gilio, Alfredo Elias; Ferronato, Angela Esposito

    2014-01-01

    Although infectious diseases are the most prevalent cause of fevers of unknown origin (FUO), this diagnosis remains challenging in some pediatric patients. Imaging exams, such as computed tomography (CT) are frequently required during the diagnostic processes. The presence of multiple hypoattenuating scattered images throughout the liver associated with the history of cohabitation with cats should raise the suspicion of the diagnosis of cat-scratch disease (CSD), although the main etiologic agent of liver abscesses in childhood is S taphylococcus aureus . Differential diagnosis by clinical and epidemiological data with Bartonella henselae is often advisable. The authors report the case of a boy aged 2 years and 9 months with 16-day history of daily fever accompanied by intermittent abdominal pain. Physical examination was unremarkable. Abdominal ultrasound performed in the initial work up was unrevealing, but an abdominal CT that was performed afterwards disclosed multiple hypoattenuating hepatic images compatible with the diagnosis of micro abscesses. Initial antibiotic regimen included cefotaxime, metronidazole, and oxacillin. Due to the epidemiology of close contact with kittens, diagnosis of CSD was considered and confirmed by serologic tests. Therefore, the initial antibiotics were replaced by clarithromycin orally for 14 days followed by fever defervescence and clinical improvement. The authors call attention to this uncommon diagnosis in a child presenting with FUO and multiple hepatic images suggestive of micro abscesses.

  20. Cat-scratch disease presenting as multiple hepatic lesions: case report and literature review

    Mariana Andrade Baptista

    2014-06-01

    Full Text Available Although infectious diseases are the most prevalent cause of fevers of unknown origin (FUO, this diagnosis remains challenging in some pediatric patients. Imaging exams, such as computed tomography (CT are frequently required during the diagnostic processes. The presence of multiple hypoattenuating scattered images throughout the liver associated with the history of cohabitation with cats should raise the suspicion of the diagnosis of cat-scratch disease (CSD, although the main etiologic agent of liver abscesses in childhood is Staphylococcus aureus. Differential diagnosis by clinical and epidemiological data with Bartonella henselae is often advisable. The authors report the case of a boy aged 2 years and 9 months with 16-day history of daily fever accompanied by intermittent abdominal pain. Physical examination was unremarkable. Abdominal ultrasound performed in the initial work up was unrevealing, but an abdominal CT that was performed afterwards disclosed multiple hypoattenuating hepatic images compatible with the diagnosis of micro abscesses. Initial antibiotic regimen included cefotaxime, metronidazole, and oxacillin. Due to the epidemiology of close contact with kittens, diagnosis of CSD was considered and confirmed by serologic tests. Therefore, the initial antibiotics were replaced by clarithromycin orally for 14 days followed by fever defervescence and clinical improvement. The authors call attention to this uncommon diagnosis in a child presenting with FUO and multiple hepatic images suggestive of micro abscesses.

  1. [A review of multiple sclerosis (1). Presentation of a case].

    Martinez-Altarriba, M C; Ramos-Campoy, O; Luna-Calcaño, I M; Arrieta-Antón, E

    2015-01-01

    Multiple sclerosis is a major demyelinating disease of the central nervous system. It has a significant economic and social impact. Its etiology is unclear, although there are several hypotheses, such as infections or genetics. In its pathophysiology, it seems that immune activation attacks the myelin sheath, causing a progressive and irreversible axonal degeneration. The disease produces a variety of symptoms, and diagnosis requires fulfilling a number of criteria and the exclusion of other possible causes. The role of neuroimaging, especially MRI, is very important. Despite the availability of disease-modifying drugs, none of them are able to halt its progress, and the most useful drugs are those designed to alleviate the symptoms of outbreaks. Overall, multiple sclerosis requires a significant effort in research to clarify not only why and how it occurs, but also to develop of new measures to improve the life of affected patients. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Bilateral lateral ventricular subependymoma with extensive multiplicity presenting with hemorrhage.

    Moinuddin, F M; Ikbar Khairunnisa, Novita; Hirano, Hirofumi; Hanada, Tomoko; Hiraki, Tsubasa; Kirishima, Mari; Kamimura, Kiyohisa; Arita, Kazunori

    2018-02-01

    This 48-year-old-man who had undergone right thyroid lobectomy for undifferentiated thyroid carcinoma nine years earlier developed generalized seizures. His cerebrospinal fluid was xanthochromic with elevation of total protein. Computed tomography (CT) showed mixed-density bilateral ventricular masses. Magnetic resonance imaging (MRI) revealed multiple nodules in both lateral ventricles; they were heterogeneously enhanced by gadolinium. Diffuse hyperintensity in the right medial temporal lobe and bilateral subependymal area was noted on fluid-attenuated inversion recovery images. Susceptibility-weighted imaging showed low intensity in the masses and cerebellar sulci suggesting hemorrhage and hemosiderin deposition. The preoperative diagnosis was disseminated malignant tumor with recurring hemorrhage. Histological examination of biopsy specimens showed clusters of cells with small uniform nuclei embedded in a dense fibrillary matrix of glial cells and microcystic degeneration. Pseudo-rosettes indicating ependymoma were absent. Microhemorrhages and hemosiderin deposits were noted. Immunohistochemically, the background fibrillary matrix and neoplastic cells were positive for glial fibrillary acidic protein. Mutated isocitrate dehydrogenase-1 was negative. The MIB-1 index was 1.5%. The tumor was pathologically diagnosed as subependymoma containing microhemorrhages and hemosiderin deposits. The extensive multiplicity and hemorrhage encountered in this case have rarely been reported in patients with subependymoma.

  3. Multiple ciguatoxins present in Indian Ocean reef fish.

    Hamilton, Brett; Hurbungs, Mira; Jones, Alun; Lewis, Richard J

    2002-09-01

    Optimised gradient reversed-phase high-performance liquid chromatography electrospray ionisation mass spectrometry (LC/MS) methods, in combination with a [3H]-brevetoxin binding assay (RLB), revealed multiple ciguatoxins in a partially purified extract of a highly toxic Lutjanus sebae (red emperor) from the Indian Ocean. Two major ciguatoxins of 1140.6 Da (I-CTX-1 and -2) and two minor ciguatoxins of 1156.6 Da (I-CTX-3 and -4) were identified. Accurate mass analysis revealed that I-CTX-1 and -2 and Caribbean C-CTX-1 had indistinguishable masses (1140.6316 Da, at 0.44 ppm resolution). Toxicity estimated from LC/MS/RLB responses indicated that I-CTX-1 and -2 were both approximately 60% the potency of Pacific ciguatoxin-1 (P-CTX-1). In contrast to ciguatoxins of the Pacific where the more oxidised ciguatoxins are more potent, I-CTX-3 and -4 were approximately 20% of P-CTX-1 potency. Interconversion in dilute acid or on storage, typical of spiroketal and hemiketal functionality found in P-CTXs and C-CTXs, respectively, was not observed to occur between I-CTX-1 and -2. The ratio of CTX-1 and -2 varied depending on the fish extract being analysed. These results suggest that I-CTX-1 and -2 may arise from separate dinoflagellate precursors that may be oxidatively biotransformed to I-CTX-3 and -4 in fish.

  4. Multiple Presents: How Search Engines Re-write the Past

    Hellsten, I; Leydesdorff, L.; Wouters, P.

    2006-01-01

    Internet search engines function in a present which changes continuously. The search engines update their indices regularly, overwriting webpages with newer ones, adding new pages to the index and losing older ones. Some search engines can be used to search for information on the internet for

  5. Fiebre de origen desconocido, una forma de presentarse la tuberculosis Fever of unknown origin as a form of presentation of tuberculosis

    Lázaro Arturo Vidal Tallet

    2012-12-01

    Full Text Available La tuberculosis es una causa importante de fiebre de origen desconocido. Dentro de los factores de riesgo para estar infectado por el bacilo tuberculoso se encuentra la edad, la presencia de comorbilidades, la competencia inmunológica y la alta prevalencia de la enfermedad en el área geográfica. Los hallazgos clínicos, radiológicos, epidemiológicos y la respuesta a la terapéutica antimicrobiana, pueden orientar en el diagnóstico de esta enfermedad infecciosa. Se presenta un caso en el que los elementos clínicos y epidemiológicos (padre con diagnóstico de tuberculosis llevaron finalmente a la sospecha diagnóstica de tuberculosis extra pulmonar, que no pudo ser demostrada por cultivo, pero la respuesta terapéutica resultó concluyente, ya que, una vez iniciada esta, hubo total remisión del cuadro clínico y recuperación nutricional. La terapia antituberculosa con carácter terapéutico y diagnóstico debe ser considerada en todo paciente con fiebre de origen desconocido, que, además, presente elementos clínicos y epidemiológicos que justifiquen la posibilidad de infección por el bacilo.Tuberculosis is an important cause of fever of unknown origin. Among the risk factors of getting infected by the tuberculosis bacillus are age, presence of comorbidities, immunological competence and high prevalence of the disease in a geographical area. The clinical, radiological and epidemiological findings along with the response to antimicrobial treatment can guide the physician to the correct diagnosis of this infectious disease. Here is a case in which the clinical and epidemiological elements (the father of the patient diagnosed with tuberculosis led to diagnostic suspicion of extrapulmonary tuberculosis. It was not possible to demonstrate it by culturing, but the response to therapy was conclusive, since once the treatment began, there were total remission of the clinical picture and nutritional recovery. The therapeutically and

  6. Early Mycoplasma pneumoniae infection presenting as multiple pulmonary masses: an unusual presentation in a child

    Yang, Edward; Altes, Talissa; Anupindi, Sudha A. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2008-04-15

    Mycoplasma pneumoniae is a major cause of community-acquired pneumonia. Because most children are not imaged prior to onset of clinical symptoms, the appearance of early Mycoplasma infection has not been extensively studied. We present the case of an 11-year-old boy with large pulmonary masses incidentally detected during spine MRI evaluation for scoliosis. Eight days later, the patient developed acute respiratory symptoms, and the masses seen previously had evolved into a diffuse bronchiolitis. Diagnostic testing identified Mycoplasma pneumoniae as the likely etiology. We briefly review chest CT findings of infection by Mycoplasma and compare them to this unusual presentation of Mycoplasma pneumonia with subclinical imaging findings. (orig.)

  7. Early Mycoplasma pneumoniae infection presenting as multiple pulmonary masses: an unusual presentation in a child

    Yang, Edward; Altes, Talissa; Anupindi, Sudha A.

    2008-01-01

    Mycoplasma pneumoniae is a major cause of community-acquired pneumonia. Because most children are not imaged prior to onset of clinical symptoms, the appearance of early Mycoplasma infection has not been extensively studied. We present the case of an 11-year-old boy with large pulmonary masses incidentally detected during spine MRI evaluation for scoliosis. Eight days later, the patient developed acute respiratory symptoms, and the masses seen previously had evolved into a diffuse bronchiolitis. Diagnostic testing identified Mycoplasma pneumoniae as the likely etiology. We briefly review chest CT findings of infection by Mycoplasma and compare them to this unusual presentation of Mycoplasma pneumonia with subclinical imaging findings. (orig.)

  8. Geometry-based multiplication correction for passive neutron coincidence assay of materials with variable and unknown (α,n) neutron rates

    Langner, D.G.; Russo, P.A.

    1993-02-01

    We have studied the problem of assaying impure plutonium-bearing materials using passive neutron coincidence counting. We have developed a technique to analyze neutron coincidence data from impure plutonium samples that uses the bulk geometry of the sample to correct for multiplication in samples for which the (α,n) neutron production rate is unknown. This technique can be applied to any impure plutonium-bearing material whose matrix constituents are approximately constant, whose self-multiplication is low to moderate, whose plutonium isotopic composition is known and not substantially varying, and whose bulk geometry is measurable or can be derived. This technique requires a set of reference materials that have well-characterized plutonium contents. These reference materials are measured once to derive a calibration that is specific to the neutron detector and the material. The technique has been applied to molten salt extraction residues, PuF 4 samples that have a variable salt matrix, and impure plutonium oxide samples. It is also applied to pure plutonium oxide samples for comparison. Assays accurate to 4% (1 σ) were obtained for impure samples measured in a High-Level Neutron Coincidence Counter II. The effects on the technique of variations in neutron detector efficiency with energy and the effects of neutron capture in the sample are discussed

  9. Known knowns, known unknowns and unknown unknowns in prokaryotic transposition.

    Siguier, Patricia; Gourbeyre, Edith; Chandler, Michael

    2017-08-01

    Although the phenomenon of transposition has been known for over 60 years, its overarching importance in modifying and streamlining genomes took some time to recognize. In spite of a robust understanding of transposition of some TE, there remain a number of important TE groups with potential high genome impact and unknown transposition mechanisms and yet others, only recently identified by bioinformatics, yet to be formally confirmed as mobile. Here, we point to some areas of limited understanding concerning well established important TE groups with DDE Tpases, to address central gaps in our knowledge of characterised Tn with other types of Tpases and finally, to highlight new potentially mobile DNA species. It is not exhaustive. Examples have been chosen to provide encouragement in the continued exploration of the considerable prokaryotic mobilome especially in light of the current threat to public health posed by the spread of multiple Ab R . Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Negotiating Discourses: Sixth-Grade Students' Use of Multiple Science Discourses during a Science Fair Presentation

    Gomez, Kimberley

    2007-01-01

    This study offers important insights into the coexistence of multiple discourses and the link between these discourses and science understanding. It offers concrete examples of students' movement between multiple discourses in sixth-grade science fair presentations, and shows how those multiple discourses in science practices illuminate students'…

  11. Histogram Analysis of Apparent Diffusion Coefficients for Occult Tonsil Cancer in Patients with Cervical Nodal Metastasis from an Unknown Primary Site at Presentation.

    Choi, Young Jun; Lee, Jeong Hyun; Kim, Hye Ok; Kim, Dae Yoon; Yoon, Ra Gyoung; Cho, So Hyun; Koh, Myeong Ju; Kim, Namkug; Kim, Sang Yoon; Baek, Jung Hwan

    2016-01-01

    To explore the added value of histogram analysis of apparent diffusion coefficient (ADC) values over magnetic resonance (MR) imaging and fluorine 18 ((18)F) fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) for the detection of occult palatine tonsil squamous cell carcinoma (SCC) in patients with cervical nodal metastasis from a cancer of an unknown primary site. The institutional review board approved this retrospective study, and the requirement for informed consent was waived. Differences in the bimodal histogram parameters of the ADC values were assessed among occult palatine tonsil SCC (n = 19), overt palatine tonsil SCC (n = 20), and normal palatine tonsils (n = 20). One-way analysis of variance was used to analyze differences among the three groups. Receiver operating characteristic curve analysis was used to determine the best differentiating parameters. The increased sensitivity of histogram analysis over MR imaging and (18)F-FDG PET/CT for the detection of occult palatine tonsil SCC was evaluated as added value. Histogram analysis showed statistically significant differences in the mean, standard deviation, and 50th and 90th percentile ADC values among the three groups (P histogram analysis was 52.6% over MR imaging alone and 15.8% over combined conventional MR imaging and (18)F-FDG PET/CT. Adding ADC histogram analysis to conventional MR imaging can improve the detection sensitivity for occult palatine tonsil SCC in patients with a cervical nodal metastasis originating from a cancer of an unknown primary site. © RSNA, 2015.

  12. Part 2. Development of Enhanced Statistical Methods for Assessing Health Effects Associated with an Unknown Number of Major Sources of Multiple Air Pollutants.

    Park, Eun Sug; Symanski, Elaine; Han, Daikwon; Spiegelman, Clifford

    2015-06-01

    A major difficulty with assessing source-specific health effects is that source-specific exposures cannot be measured directly; rather, they need to be estimated by a source-apportionment method such as multivariate receptor modeling. The uncertainty in source apportionment (uncertainty in source-specific exposure estimates and model uncertainty due to the unknown number of sources and identifiability conditions) has been largely ignored in previous studies. Also, spatial dependence of multipollutant data collected from multiple monitoring sites has not yet been incorporated into multivariate receptor modeling. The objectives of this project are (1) to develop a multipollutant approach that incorporates both sources of uncertainty in source-apportionment into the assessment of source-specific health effects and (2) to develop enhanced multivariate receptor models that can account for spatial correlations in the multipollutant data collected from multiple sites. We employed a Bayesian hierarchical modeling framework consisting of multivariate receptor models, health-effects models, and a hierarchical model on latent source contributions. For the health model, we focused on the time-series design in this project. Each combination of number of sources and identifiability conditions (additional constraints on model parameters) defines a different model. We built a set of plausible models with extensive exploratory data analyses and with information from previous studies, and then computed posterior model probability to estimate model uncertainty. Parameter estimation and model uncertainty estimation were implemented simultaneously by Markov chain Monte Carlo (MCMC*) methods. We validated the methods using simulated data. We illustrated the methods using PM2.5 (particulate matter ≤ 2.5 μm in aerodynamic diameter) speciation data and mortality data from Phoenix, Arizona, and Houston, Texas. The Phoenix data included counts of cardiovascular deaths and daily PM2

  13. Designing towards the unknown

    Wilde, Danielle; Underwood, Jenny

    2018-01-01

    the research potential to far-ranging possibilities. In this article we unpack the motivations driving the PKI project. We present our mixed-methodology, which entangles textile crafts, design interactions and materiality to shape an embodied enquiry. Our research outcomes are procedural and methodological......New materials with new capabilities demand new ways of approaching design. Destabilising existing methods is crucial to develop new methods. Yet, radical destabilisation—where outcomes remain unknown long enough that new discoveries become possible—is not easy in technology design where complex......, to design towards unknown outcomes, using unknown materials. The impossibility of this task is proving as useful as it is disruptive. At its most potent, it is destabilising expectations, aesthetics and processes. Keeping the researchers, collaborators and participants in a state of unknowing, is opening...

  14. Evaluation of a Multiple-Stimulus Presentation Format for Assessing Reinforcer Preferences.

    DeLeon, Iser G.; Iwata, Brian A.

    1996-01-01

    A study of seven adults with profound developmental disabilities compared methods for presenting stimuli during reinforcer-preference assessments. It found that a multiple-stimulus format in which selections were made without replacement may share the advantages of a paired-stimulus format and a multiple-stimulus format with replacement, while…

  15. Current status of multiple antigen-presenting peptide vaccine systems: Application of organic and inorganic nanoparticles

    Taguchi Hiroaki

    2011-08-01

    Full Text Available Abstract Many studies are currently investigating the development of safe and effective vaccines to prevent various infectious diseases. Multiple antigen-presenting peptide vaccine systems have been developed to avoid the adverse effects associated with conventional vaccines (i.e., live-attenuated, killed or inactivated pathogens, carrier proteins and cytotoxic adjuvants. Recently, two main approaches have been used to develop multiple antigen-presenting peptide vaccine systems: (1 the addition of functional components, e.g., T-cell epitopes, cell-penetrating peptides, and lipophilic moieties; and (2 synthetic approaches using size-defined nanomaterials, e.g., self-assembling peptides, non-peptidic dendrimers, and gold nanoparticles, as antigen-displaying platforms. This review summarizes the recent experimental studies directed to the development of multiple antigen-presenting peptide vaccine systems.

  16. Variable Reporting by Authors Presenting Arthroplasty Research at Multiple Annual Conferences.

    Choo, Kevin J; Yi, Paul H; Burns, Robert; Mohan, Rohith; Wong, Kevin

    2017-01-01

    Prior studies have demonstrated discrepancies in financial conflict of interest (COI) disclosure among authors presenting research at multiple spine and sports medicine conferences. The purpose of this study was to quantify the variability of self-reported financial disclosures of individual authors presenting at multiple arthroplasty conferences during the same year. The author disclosure information published for the 2012 annual meetings of the American Academy of Orthopaedic Surgeons (AAOS), American Association of Hip and Knee Surgeons, the Hip Society, and the Knee Society were compiled. We tabulated the author disclosures, the number of companies/entities represented, and the types of disclosures reported. The disclosures made by authors presenting at more than one meeting were then compared for discrepancies. Of the 209 authors who presented at both the AAOS and American Association of Hip and Knee Surgeons meetings, 79 (37.79%) demonstrated discrepancies in their disclosures with 7 (8.8%) reporting no disclosures to the AAOS. Of the 84 authors who presented at both the AAOS and Hip Society meetings, 1 (1.19%) had discrepancies in their disclosures. Of the 52 authors who presented at both the AAOS and Knee Society meetings, 2 (3.84%) had discrepancies in their disclosures. There is variability in reported financial COIs by authors presenting at multiple arthroplasty conferences within the same year. Further work is warranted to improve transparency of COI disclosures among arthroplasty surgeons presenting research at national meetings. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. A rare presentation of multiple endocrine neoplasia (MEN type 2A syndrome

    Elroy Patrick Weledji

    2016-02-01

    Full Text Available Peptic ulcer disease may be a manifestation of symptomatic primary hyperparathyroidism. A case of an intractable complicated peptic ulcer disease secondary to hypercalcaemia from multiple endocrine neoplasia type 2A is presented. Hypercalcaemia should always be excluded as a cause of recurrent, or complicated peptic ulcer disease.

  18. Unsuspected multiples myeloma presenting as bilateral pleural effusion – a cytological diagnosis

    Dhingra Kajal

    2007-01-01

    Full Text Available Abstract Background Multiple Myeloma presenting as a pleural effusion is extremely rare. It is usually a late complication and is associated with a poor prognosis. Case Presentation A 40-year-old male presented with dyspnea and fever of six months duration. Clinical diagnosis of pulmonary tuberculosis was considered. X-ray chest showed bilateral pleural effusion. Pleural cytology revealed numerous plasma cells, some of which were binucleated and atypical. Cytological differential diagnosis included: Myelomatous effusion and Non-Hodgkin's Lymphoma deposit (Immunoblastic type. Bone marrow biopsy, serum protein electrophoresis and bone scan confirmed the diagnosis of multiple myeloma (Plasmablastic type. Conclusion Myelomatous pleural effusion as an initial presentation although extremely rare, should always be considered in presence of atypical plasma cells irrespective of age.

  19. Localized pulmonary crystal-storing histiocytosis complicating pulmonary mucosa-associated lymphoid tissue lymphoma presenting with multiple mass lesions.

    Kokuho, Nariaki; Terasaki, Yasuhiro; Kunugi, Shinobu; Onda, Naomi; Urushiyama, Hirokazu; Terasaki, Mika; Hino, Mitsunori; Gemma, Akihiko; Hatori, Tsutomu; Shimizu, Akira

    2017-07-01

    Crystal-storing histiocytosis (CSH) is an uncommon finding in lymphoplasmacytic disorders that presents histiocytes with abnormal intralysosomal accumulations of immunoglobulin light chains as crystals of unknown etiology. A 38-year-old woman with antiphospholipid syndrome had a surgical lung biopsy because of multiple lung mass lesions. In a right middle lobe lesion, lymphoplasmacytic cells had a monocytoid appearance, destructive lymphoepithelial lesions, and positive immunoglobulin heavy chain (IGH) gene rearrangements. A right upper lobe lesion manifested proliferating rounded histiocytes with abundant, deeply eosinophilic cytoplasm and negative IGH gene rearrangements. Electron microscopy and mass spectrometry revealed a case of pulmonary CSH: abnormal proliferation of the immunoglobulin κ chain of a variable region that may be crystallized within plasma cells and histiocytes. We report a rare case of localized pulmonary CSH complicating pulmonary mucosa-associated lymphoid tissue lymphoma with multiple mass lesions. We demonstrate advances in the understanding of the pathogenesis of CSH by various analyses of these lesions. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Multiple myeloma presenting with a maxillary lesion as the first sign

    Ramaiah, Kiran Kumar Kotagudda; Joshi, Vajendra; Thayi, Shilpa Ravishankar; Sathyanarayana, Pathalapate; Patil, Prashant [Dept. of Oral Medicine and Radiology, Navodaya Dental College and Hospital, Raichur (Korea, Republic of); Ahmed, Zaheer [Dept. of Public Health Dentistry, Navodaya Dental College and Hospital, Raichur (Korea, Republic of)

    2015-03-15

    Multiple myeloma is a clonal neoplastic proliferation of terminally differentiated B-lymphocytes involving the skeletal system in a multifocal fashion. Its oral manifestations are less common in the maxilla than in the mandible due to the lower amount of hemopoietic bone marrow in the maxilla. We report the case of a 50-year-old man who presented with a mass in the left maxillary alveolar region with tooth mobility. The mass had become enlarged after the teeth were extracted 15 days previously. Radiographs demonstrated multiple punched-out radiolucent lesions in the skull and pelvic region. Computed tomography images showed a soft tissue density mass in the left maxilla, eroding the floor and walls of the maxillary sinus. Although several analytical techniques were used to characterize the lesion, it was finally confirmed as multiple myeloma through immunohistochemistry.

  1. Papulonodular Secondary Syphilis Presenting as Multiple Distinct Cutaneous Lesions in an HIV-Positive Transgender Woman

    Kristina Navrazhina

    2017-03-01

    Full Text Available We present the first reported case of papulonodular secondary syphilis in an HIV-positive transgender female. Syphilis is classified into primary, secondary, latent, and tertiary stages, with secondary syphilis having notably diverse cutaneous manifestations. Our patient presented with diverse lesions throughout her body, all pathologically consistent with papulonodular secondary syphilis. Proper identification of the multiple presentations of syphilis is crucial to early diagnosis and treatment. This report seeks to broaden the scope of dermatological manifestations that arise secondary to papulonodular syphilis in HIV-positive patients.

  2. Paraneoplastic addisonian pigmentation and acquired ichthyosis as presenting features of multiple myeloma

    Dar, N.R.; Raza, N.

    2010-01-01

    Black brown hyperpigmentation of the mucosae, sun exposed skin, palmar creases and frictional sites (Addisonian pigmentation) is characteristic of Addison disease. However, it can also occur as a para neoplastic manifestation of tumours like bronchogenic carcinoma. Acquired ichthyosis starts later in life and can also be a para neoplastic presentation.We report a unique combination of para neoplastic Addisonian pigmentation and acquired ichthyosis as presenting features in a patient with undiagnosed multiple myeloma. To the best of our knowledge this combination of para neoplastic dermatosis has not been documented before in multiple myeloma. It is concluded that the presence of more than one suspicious dermatosis may be an indicator of being para neoplastic requiring necessary work-up. (author)

  3. Diffuse arachnoid ossification and multiple arachnoid cysts presenting with progressive thoracic myelopathy

    Sakai, Toshinori; Sairyo, Koichi; Kashima, Masahiro; Kosaka, Hirofumi; Katoh, Shinsuke; Yasui, Natsuo [The University of Tokushima Graduate School, Department of Orthopedics, Institute of Health Biosciences, Tokushima (Japan)

    2010-03-15

    An ossified arachnoid membrane combined with cystic formation is rarely reported as a cause of spinal cord compression. We report the case of a 60-year-old man who presented with diffuse ossification of the arachnoid membrane (arachnoid ossification) and multiple cystic changes (arachnoid cyst) at the thoracic and lumbar spine. The lesions were surgically removed and progressive deterioration was prevented, although no marked improvement of neurological symptoms was attained. (orig.)

  4. MULTIPLE MYELOMA PRESENTED AS AN ANTERIOR CHEST WALL MASS DIAGNOSED BY CYTOLOGICAL EXAMINATION : A CASE REPORT

    Parvathi

    2015-02-01

    Full Text Available Myeloma is a malignancy of terminally differentiated B cells (plasma cells that produce a complete and / or partial monoclonal immunoglobulin protein. Myeloma accounts for approximately 1% of all malignancies and 10% of haematological tumors. It becomes difficult to arrive at early diagnosis because myeloma manifests itself in different forms. The disease usually presents as bone pains, pathological fractures and anemia but can also present as swelling in jaw, orbit, rib, sternoclavicular area, scalp, paraspinal region and tonsil. We present a case of multiple myeloma in 63 year old male which presented as a soft tissue mass on anterior chest wall and diagnosed by FNAC . This case is presented because diagnosis was made on cytology and not many cases have been reported in literature where FNAC helped in making the diagnosis. This increases the hope of early diagnosis so that treatment can be advocated

  5. Spastic paretic hemifacial contracture as a presenting feature of multiple sclerosis.

    Koutsis, Georgios; Breza, Marianthi; Evangelopoulos, Maria-Eleftheria; Anagnostouli, Maria; Andreadou, Elisavet; Karagiorgis, Georgios; Kokotis, Panagiotis; Kilidireas, Costas; Karandreas, Nikolaos

    2017-04-01

    Spastic paretic hemifacial contracture (SPHC) is characterized by sustained unilateral contraction of the facial muscles associated with mild ipsilateral facial paresis. Rarely described in the context of multiple sclerosis (MS), it has never been reported as presenting symptom of MS. Two patients developed SPHC within the context of a clinically isolated syndrome suggestive of MS. EMG revealed continuous resting activity of irregularly firing motor unit potentials, associated with impaired recruitment upon voluntary contraction. SPHC remitted fully in both patients. SPHC, a rare but distinct clinical and EMG entity, can occasionally be the presenting feature of MS. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Multiple Primary Merkel Cell Carcinomas Presenting as Pruritic, Painful Lower Leg Tumors

    Laura Blumenthal

    2015-10-01

    Full Text Available Merkel cell carcinoma (MCC is a rare and highly aggressive neuroendocrine tumor of the skin which almost exclusively presents as a solitary tumor. It is most often seen on sun-exposed regions, historically almost exclusively on the head and neck, with only rare case reports on the extremities. Although recent studies have shown increased incidence with up to 20% on the extremities, here we present one of these rare emerging presentations, with the addition of a unique treatment option. Our patient is an 80-year-old male with a 3-month history of multiple raised, rapidly enlarging tumors on the right ankle. Two separate biopsies were performed and demonstrated sheets and clusters of small blue cells filling the dermis with scant cytoplasm, dusty chromatin, and nuclear molding. Subsequent immunohistochemical stains confirmed the diagnosis of multiple primary MCC. Despite the characteristic immunohistochemical profile of primary MCC, the possibility of a metastatic neuroendocrine carcinoma from an alternate primary site was entertained, given his unusual clinical presentation. A complete clinical workup including CT scans of the chest, abdomen, and pelvis showed no evidence of disease elsewhere. Instead of amputation, the patient opted for nonsurgical treatment with radiation therapy alone, resulting in a rapid and complete response. This case represents an unusual presentation of primary MCC and demonstrates further evidence that radiation as monotherapy is an effective local treatment option for inoperable MCC.

  7. Multiple Primary Merkel Cell Carcinomas Presenting as Pruritic, Painful Lower Leg Tumors

    Blumenthal, Laura; VandenBoom, Timothy; Melian, Edward; Peterson, Anthony; Hutchens, Kelli A.

    2015-01-01

    Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroendocrine tumor of the skin which almost exclusively presents as a solitary tumor. It is most often seen on sun-exposed regions, historically almost exclusively on the head and neck, with only rare case reports on the extremities. Although recent studies have shown increased incidence with up to 20% on the extremities, here we present one of these rare emerging presentations, with the addition of a unique treatment option. Our patient is an 80-year-old male with a 3-month history of multiple raised, rapidly enlarging tumors on the right ankle. Two separate biopsies were performed and demonstrated sheets and clusters of small blue cells filling the dermis with scant cytoplasm, dusty chromatin, and nuclear molding. Subsequent immunohistochemical stains confirmed the diagnosis of multiple primary MCC. Despite the characteristic immunohistochemical profile of primary MCC, the possibility of a metastatic neuroendocrine carcinoma from an alternate primary site was entertained, given his unusual clinical presentation. A complete clinical workup including CT scans of the chest, abdomen, and pelvis showed no evidence of disease elsewhere. Instead of amputation, the patient opted for nonsurgical treatment with radiation therapy alone, resulting in a rapid and complete response. This case represents an unusual presentation of primary MCC and demonstrates further evidence that radiation as monotherapy is an effective local treatment option for inoperable MCC. PMID:26594171

  8. Synchronous Bone Metastasis From Multiple Myeloma and Prostate Adenocarcinoma as Initial Presentation of Coexistent Malignancies

    Diego Andres Adrianzen Herrera

    2018-04-01

    Full Text Available The radiographic appearance of bone metastases is usually determined by tumor histology and can be osteolytic, osteoblastic, or mixed. We present a patient with coexistent bone metastasis from multiple myeloma and prostate adenocarcinoma who exhibited synchronous bone involvement of both histologies within the same bone lesion, a rare phenomenon that has not been previously reported and led to atypical radiographic findings. The radiograph of a 71-year-old man with thigh swelling and pain demonstrated a lytic femoral lesion. Magnetic resonance imaging (MRI confirmed a destructive process, but showed coexistent metaphyseal sclerosis. Multiple myeloma was suspected by demonstration of monoclonal gammopathy and confirmed by computed tomography (CT-guided biopsy. Incidentally, CT demonstrated areas of sclerosis corresponding to T2 hypointensity on MRI. Further studies revealed osteoblastic spinal metastasis, prostate enhancement on CT and prostate-specific antigen (PSA level of 90 ng/mL, concerning for concomitant prostate neoplasm. After endoprosthetic reconstruction, pathology of the femur identified both plasma cell neoplasm and metastatic prostate adenocarcinoma. An association between prostate cancer and multiple myeloma is hypothesized due to tumor microenvironment similarities and possible common genetic variations, however, coexisting bone metastases have never been reported. This unusual finding explains the discrepant imaging features in our patient and is evidenced that certain clinical situations merit contemplation of atypical presentations of common malignancies even if this leads to additional testing.

  9. [Badminton--unknown sport].

    Zekan-Petrinović, Lidija

    2007-01-01

    For a long time, badminton was considered to be only a slow and light game for children, a game that is played outdoors and is structurally undemanding.Today, it is not an unknown and unrecognised sport, especially after it was included into the Olympics Games in 1992. Badminton is one of the oldest sports in the world. It is suitable for all ages (for children and elderly equally), women and men and even handicapped persons. Beginners can start playing badminton matches early because the basics are learned quickly. As a recreational activity, badminton is very popular in Zagreb. In the last 10 years, a number of halls specialized for badminton or offering badminton as one of available sports activities have been opened in Zagreb. At present, there are over 70 professional playgrounds for training of top contestants but also for the citizens who can play recreational badminton.

  10. A multiple-dimension liquid chromatography coupled with mass spectrometry data strategy for the rapid discovery and identification of unknown compounds from a Chinese herbal formula (Er-xian decoction).

    Wang, Caihong; Zhang, Jinlan; Wu, Caisheng; Wang, Zhe

    2017-10-06

    It is very important to rapidly discover and identify the multiple components of traditional Chinese medicine (TCM) formula. High performance liquid chromatography with high resolution tandem mass spectrometry (HPLC-HRMS/MS) has been widely used to analyze TCM formula and contains multiple-dimension data including retention time (RT), high resolution mass (HRMS), multiple-stage mass spectrometric (MS n ), and isotope intensity distribution (IID) data. So it is very necessary to exploit a useful strategy to utilize multiple-dimension data to rapidly probe structural information and identify chemical compounds. In this study, a new strategy to initiatively use the multiple-dimension LC-MS data has been developed to discover and identify unknown compounds of TCM in many styles. The strategy guarantees the fast discovery of candidate structural information and provides efficient structure clues for identification. The strategy contains four steps in sequence: (1) to discover potential compounds and obtain sub-structure information by the mass spectral tree similarity filter (MTSF) technique, based on HRMS and MS n data; (2) to classify potential compounds into known chemical classes by discriminant analysis (DA) on the basis of RT and HRMS data; (3) to hit the candidate structural information of compounds by intersection sub-structure between MTSF and DA (M,D-INSS); (4) to annotate and confirm candidate structures by IID data. This strategy allowed for the high exclusion efficiency (greater than 41%) of irrelevant ions in er-xian decoction (EXD) while providing accurate structural information of 553 potential compounds and identifying 66 candidates, therefore accelerating and simplifying the discovery and identification of unknown compounds in TCM formula. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. A rare presentation of atypical demyelination: tumefactive multiple sclerosis causing Gerstmann’s syndrome

    2014-01-01

    Background Tumefactive demyelinating lesions are a rare manifestation of multiple sclerosis (MS). Differential diagnosis of such space occupying lesions may not be straightforward and sometimes necessitate brain biopsy. Impaired cognition is the second most common clinical manifestation of tumefactive MS; however complex cognitive syndromes are unusual. Case presentation We report the case of a 30 year old woman who presented with Gerstmann’s syndrome. MRI revealed a large heterogeneous contrast enhancing lesion in the left cerebral hemisphere. Intravenous corticosteroids did not stop disease progression. A tumour or cerebral lymphoma was suspected, however brain biopsy confirmed inflammatory demyelination. Following diagnosis of tumefactive MS treatment with natalizumab effectively suppressed disease activity. Conclusions The case highlights the need for clinicians, radiologists and surgeons to appreciate the heterogeneous presentation of tumefactive MS. Early brain biopsy facilitates rapid diagnosis and management. Treatment with natalizumab may be useful in cases of tumefactive demyelination where additional evidence supports a diagnosis of relapsing MS. PMID:24694183

  12. Adult T-cell leukemia/lymphoma presenting multiple lymphomatous polyposis

    Akira Hokama; Nobuyuki Takasu; Jiro Fujita; Takeaki Tomoyose; Yu-ichi Yamamoto; Takako Watanabe; Tetsuo Hirata; Fukunori Kinjo; Seiya Kato; Koichi Ohshima; Hiroshi Uezato

    2008-01-01

    Multiple lymphomatous polyposis (HLP) is an unusual form of non-Hodgkin's lymphoma characterized by polyps throughout the gastrointestinal tract. It has been reported that most MLP are observed in cases with mantle cell lymphoma of B-cell type. We herein present a case of a 66-year-old man with adult T-cell leukemia/lymphoma (ATLL). Colonoscopy revealed MLP throughout the colon and histopathological findings of ATLL cell infiltration. The patient died despite combination of chemotherapy. The literature of manifestations of colonic involvement of ATLL is reviewed and the importance of endoscopic evaluation to differentiate ATLL intestinal lesions from opportunistic infectious enterocolitis is discussed.

  13. Long-term survival of patients with multiple myeloma and acute renal failure at presentation.

    Lazarus, H M; Adelstein, D J; Herzig, R H; Smith, M C

    1983-03-01

    Eight patients presented with simultaneous multiple myeloma and acute renal failure requiring hemodialysis. Patients had no known pre-existing renal disease nor exposure to nephrotoxic agents or x-ray contrast dye. Renal failure was attributed to light chain nephropathy in all cases. In 4 of these patients the diagnosis of myeloma was initially unsuspected. Renal biopsies in 3 of these patients, and post-mortem material in a fourth revealed the changes of "myeloma kidney." No patient regained renal function and all required chronic hemodialysis. Among these eight patients, three survived for periods greater than 21 months.

  14. Beyond the CRAB symptoms: a study of presenting clinical manifestations of multiple myeloma.

    Talamo, Giampaolo; Farooq, Umar; Zangari, Maurizio; Liao, Jason; Dolloff, Nathan G; Loughran, Thomas P; Epner, Elliot

    2010-12-01

    Although the typical clinical manifestations of multiple myeloma (MM) are summarized by the CRAB symptoms (hypercalcemia, renal insufficiency, anemia, and bone lesions), a significant proportion of patients with MM present with a variety of other clinical manifestations. We conducted a study evaluating the presenting symptoms that led to the diagnosis of MM. We conducted a retrospective review of 170 consecutive patients with MM seen at the Penn State Hershey Cancer Institute. Among patients with symptomatic MM, 74% presented with CRAB symptoms, 20% presented with non-CRAB manifestations, and 6% had both clinical features. Ten categories of non-CRAB manifestations were found, in order of decreasing frequency: neuropathy (because of spinal cord compression, nerve root compression, or peripheral neuropathy), extramedullary involvement, hyperviscosity syndrome, concomitant amyloidosis (eg, nephrotic syndrome or cardiopathy), hemorrhage/coagulopathy, systemic symptoms (eg, fever or weight loss), primary plasma cell leukemia, infections, cryoglobulinemia, and secondary gout. Kaplan-Meier estimates of survival in patients with non-CRAB manifestations did not show a significant difference from the survival of patients presenting with CRAB symptoms. Presenting symptoms of MM may be grouped in a total of 14 categories, 4 for the CRAB and 10 for the less common non-CRAB features. Grouped together, non-CRAB manifestations do not appear to confer a negative effect on the prognosis of patients with MM.

  15. Presentations

    2007-01-01

    The presented materials consist of presentations of international workshop which held in Warsaw from 4 to 5 October 2007. Main subject of the meeting was progress in manufacturing as well as research program development for neutron detector which is planned to be placed at GANIL laboratory and will be used in nuclear spectroscopy research

  16. Multiple sclerosis presented as clinically isolated syndrome: the need for early diagnosis and treatment

    Sigliti-Henrietta Pelidou

    2008-06-01

    Full Text Available Sigliti-Henrietta Pelidou, Sotirios Giannopoulos, Sotiria Tzavidi, Georgios Lagos, Athanassios P KyritsisDepartment of Neurology, University of Ioannina School of Medicine, GreeceObjective: To aid in the timely diagnosis of patients who present with clinically isolated syndrome (CIS.Patients and methods: We studied 25 patients (18 women, 7 men, originally presented in our clinic with a CIS suggestive of multiple sclerosis (MS. All patients underwent the full investigation procedure including routine tests, serology, cerebrospinal fluid (CSF examinations, evoked potentials (EPs, and magnetic resonance imaging (MRI of brain and cervical spinal cord. Patients were imaged at baseline, and every three months thereafter up to a year.Results: The CIS was consisted of optic neuritis in 12 cases, incomplete transverse myelitis (ITM in 7 cases, Lhermitte sign in 2 cases, internuclear ophthalmoplegia (INO in 2 cases, mild brainstem syndrome in 1 case, and tonic-clonic seizures in 1 case. Using the baseline and three-month scans 18/25 (72% patients developed definite MS in one year of follow up while 7 (28% had no further findings during this observation period. Immunomodulatory treatments were applied to all definite MS patients.Conclusion: In light of new treatments available, MRIs at 3 month intervals are helpful to obtain the definite diagnosis of MS as early as possible.Keywords: multiple sclerosis, clinically isolated syndrome, optic neuritis, transverse myelitis

  17. An unusual presentation of multiple cavitated lung metastases from colon carcinoma

    Iannace Alessandro

    2011-05-01

    Full Text Available Abstract Background Consolidation with or without ground-glass opacity is the typical radiologic finding of lung metastases of adenocarcinoma from the gastrointestinal tract. Lung excavated metastases from gastrointestinal carcinoma are very rare. Case presentation The authors describe an unusual presentation of multiple cavitated lung metastases from colon adenocarcinoma and discuss the outcome of a patient. The absence both of symptoms and other disease localizations, the investigations related to different diagnostic hypotheses and the empirical treatments caused a delay in correct diagnosis. Only a transparietal biopsy revealed the neoplastic origin of nodules. Conclusions This report demonstrates that although lung excavated metastases are described in literature, initial failure to reach a diagnosis is common. We would like to alert clinicians and radiologists to the possibility of unusual atypical features of pulmonary metastases from colon adenocarcinoma.

  18. Incidence of tonic spasms as the initial presentation of pediatric multiple sclerosis in Slovenia.

    Bizjak, Neli; Osredkar, Damjan; Meglič, Nuška Pečarič; Benedik, Mirjana Perković

    2017-07-01

    Tonic spasms (TS) are involuntary movement patterns that can present in patients with multiple sclerosis (MS). They have been first described decades ago, but are frequently missed and misdiagnosed, particularly in the pediatric MS patients and if appearing ahead of hallmark neurological signs and symptoms of MS. Slovenia is a country with the population of about 2 million people. In the years from 1992 to 2016, we have treated 57 sequential pediatric patients with MS at our hospital, which is the only tertiary medical institution for treating children with MS in the country. We present the only two MS patients, a 17-year-old girl and a 14-year-old boy, whose first manifestation of MS were TS. This allowed us to estimate the incidence of TS in pediatric MS patients in Slovenia. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. First-episode psychosis as the initial presentation of multiple sclerosis: a case report

    Enderami A

    2018-04-01

    Full Text Available Athena Enderami,1 Rose Fouladi,2 Seyed Hamzeh Hosseini3 1Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Sari, Iran; 2Sport Injuries and Corrective Exercise, University of Mazandaran, Mazandaran, Babolsar, Iran; 3Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran Background: Multiple sclerosis (MS is an inflammatory disease that affects the central nervous system (CNS. MS with episode of psychosis is a rare entity, and to the best of our knowledge, no case has been reported from Iran till date. Case presentation: We report a case of MS with first-episode psychosis in a 27-year-old single man with no history of psychiatric disorder or drug abuse. The patient developed neurological symptoms after 3 months and was finally diagnosed as a case of MS. His symptoms started with behavioral dysfunctions and progressively resulted in depression. Subsequently, treatment was performed with citalopram 20 mg daily, risperidone 2 mg three times a day, and biperiden 2 mg three times a day; however, no improvements in the symptoms were observed. T2-weighted magnetic resonance imaging has demonstrated periventricular and white matter multiple sclerotic plugs with lesions. Eventually, MS was diagnosed after the appearance of paresthesia, upper and lower limb muscle weakness, ataxia, and urinary incontinency as typical signs. Then, the medications were changed to methylprednisolone and interferon therapy, which resulted in improvements in the clinical conditions of the patient. Conclusion: Based on the fact that organic disorders such as MS may sometimes appear with initial pure psychiatric symptoms without any neurological signs and symptoms, examinations for symptoms linked to CNS dysfunction, cognitive changes, atypical symptoms, detailed neurological examination, and limited response to conventional antipsychotic drugs are highly

  20. Impression of multiple implants using photogrammetry: description of technique and case presentation.

    Peñarrocha-Oltra, David; Agustín-Panadero, Rubén; Bagán, Leticia; Giménez, Beatriz; Peñarrocha, María

    2014-07-01

    To describe a technique for registering the positions of multiple dental implants using a system based on photogrammetry. A case is presented in which a prosthetic treatment was performed using this technique. Three Euroteknika® dental implants were placed to rehabilitate a 55-year-old male patient with right posterior maxillary edentulism. Three months later, the positions of the implants were registered using a photogrammetry-based stereo-camera (PICcamera®). After processing patient and implant data, special abutments (PICabutment®) were screwed onto each implant. The PICcamera® was then used to capture images of the implant positions, automatically taking 150 images in less than 60 seconds. From this information a file was obtained describing the relative positions - angles and distances - of each implant in vector form. Information regarding the soft tissues was obtained from an alginate impression that was cast in plaster and scanned. A Cr-Co structure was obtained using CAD/CAM, and its passive fit was verified in the patient's mouth using the Sheffield test and the screw resistance test. Twelve months after loading, peri-implant tissues were healthy and no marginal bone loss was observed. The clinical application of this new system using photogrammetry to record the position of multiple dental implants facilitated the rehabilitation of a patient with posterior maxillary edentulism by means of a prosthesis with optimal fit. The prosthetic process was accurate, fast, simple to apply and comfortable for the patient.

  1. A Patient with Multiple Keratinocytic Cancers (MKC: Uncommon Presentation in a Bulgarian Patient

    Georgi Tchernev

    2018-01-01

    Full Text Available Keratinocyte skin cancers, including basal cell carcinoma (BCC and squamous cell carcinoma (SCC, are the most common cancer occurring in people with fair skin, worldwide. Despite all known triggers, several suggested contributors are still investigated. We will focus our attention on the personal history of previous cancers and radiation exposure as occupational risk factors, as in the presented case. We report a patient, with multiple BCCs, and subsequent occurrence of a SCC on photo-exposed area of the face, as we want to emphasize the importance of strict following up of these patients, regarding the risk for developing new tumors in short periods of time, no matter if the triggering exposure factor is known from the history, or not.  Although keratinocytes tumours are associated with the low mortality rate, we focus the attention on the fact, that the history of non-melanoma skin cancer is associated with increased mortality.

  2. A Patient with Multiple Keratinocytic Cancers (MKC): Uncommon Presentation in a Bulgarian Patient.

    Tchernev, Georgi; Philipov, Stanislav; Chokoeva, Anastasiya Atanasova; Wollina, Uwe; Lotti, Torello; Lozev, Ilia; Yungareva, Irina; Maximov, Georgi Konstantinov

    2018-01-25

    Keratinocyte skin cancers, including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are the most common cancer occurring in people with fair skin, worldwide. Despite all known triggers, several suggested contributors are still investigated. We will focus our attention on the personal history of previous cancers and radiation exposure as occupational risk factors, as in the presented case. We report a patient, with multiple BCCs, and subsequent occurrence of a SCC on photo-exposed area of the face, as we want to emphasize the importance of strict following up of these patients, regarding the risk for developing new tumors in short periods of time, no matter if the triggering exposure factor is known from the history, or not. Although keratinocytes tumours are associated with the low mortality rate, we focus the attention on the fact, that the history of non-melanoma skin cancer is associated with increased mortality.

  3. ANCA-Negative Churg-Strauss Syndrome Presenting as Acute Multiple Cerebral Infarcts: A Case Report.

    Psychogios, Klearchos; Evmorfiadis, Ilias; Dragomanovits, Spyros; Stavridis, Athanasios; Takis, Konstantinos; Kaklamanis, Loukas; Stathis, Pantelis

    2017-03-01

    Eosinophilic granulomatosis with polyangiitis (EGPA, previously named Churg-Strauss syndrome) is a form of necrotizing vasculitis occurring in patients with asthma and eosinophilia. Ischemic stroke is a relatively rare complication of the disease. We report a case of a 63-year-old woman with multiple embolic infarcts, hypereosinophilia (for >7 years), and skin rash. Elevated cardiac enzymes and cardiac magnetic resonance imaging were consistent with endomyocarditis. The simultaneous presence of history of asthma, sinusitis, hypereosinophilia, and vasculitis led to the diagnosis of EGPA. This case contributes to the recent debate of the 2 possible presentations of the disease according to the ANCA (antineutrophil cytoplasmic antibodies) status. We furthermore underscore the need for careful differential diagnosis of the "ANCA negative" cases with persistent hypereosinophilia from the idiopathic hypereosinophilic syndrome. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  4. Presentations

    2007-01-01

    The PARIS meeting held in Cracow, Poland from 14 to 15 May 2007. The main subjects discussed during this meeting were the status of international project dedicated to gamma spectroscopy research. The scientific research program includes investigations of giant dipole resonance, probe of hot nuclei induced in heavy reactions, Jacobi shape transitions, isospin mixing and nuclear multifragmentation. The mentioned programme needs Rand D development such as new scintillations materials as lanthanum chlorides and bromides as well as new photo detection sensors as avalanche photodiodes - such subjects are also subjects of discussion. Additionally results of computerized simulations of scintillation detectors properties by means of GEANT- 4 code are presented

  5. A splenic artery aneurysm presenting with multiple episodes of upper gastrointestinal bleeding: a case report.

    De Silva, W S L; Gamlaksha, D S; Jayasekara, D P; Rajamanthri, S D

    2017-05-03

    Splenic artery aneurysm is rare and its diagnosis is challenging due to the nonspecific nature of the clinical presentation. We report a case of a splenic artery aneurysm in which the patient presented with chronic dyspepsia and multiple episodes of minor intragastric bleeding. A 60-year-old, previously healthy Sri Lankan man presented with four episodes of hematemesis and severe dyspeptic symptoms over a period of 6 months. The results of two initial upper gastrointestinal endoscopies and an abdominal ultrasound scan were unremarkable. A third upper gastrointestinal endoscopy detected a pulsatile bulge at the posterior wall of the gastric antrum. A contrast-enhanced computed tomogram of his abdomen detected a splenic artery aneurysm measuring 3 × 3 × 2.5 cm. While awaiting routine surgery, he developed a torrential upper gastrointestinal bleeding and shock, leading to emergency laparotomy. Splenectomy and en bloc resection of the aneurysm with the posterior stomach wall were performed. Histology revealed evidence for a true aneurysm without overt, acute, or chronic inflammation of the surrounding gastric mucosa. He became completely asymptomatic 2 weeks after the surgery. Splenic artery aneurysms can result in recurrent upper gastrointestinal bleeding. The possibility of impending catastrophic bleeding should be remembered when managing patients with splenic artery aneurysms after a minor bleeding. Negative endoscopy and ultrasonography should require contrast-enhanced computed tomography to look for the cause of recurrent upper gastrointestinal bleeding.

  6. An unusual presentation of brucellosis, involving multiple organ systems, with low agglutinating titers: a case report

    Khorvash Farzin

    2007-07-01

    Full Text Available Abstract Background Brucellosis is a multi-system disease that may present with a broad spectrum of clinical manifestations. While hepatic involvement in brucellosis is not rare, it may rarely involve the kidney or display with cardiac manifestations. Central nervous system involvement in brucellosis sometimes can cause demyelinating syndromes. Here we present a case of brucella hepatitis, myocarditis, acute disseminated encephalomyelitis, and renal failure. Case presentation A 26-year-old man presented with fever, ataxia, and dysarthria. He was a shepherd and gave a history of low grade fever, chilly sensation, cold sweating, loss of appetite, arthralgia and 10 Kg weight loss during the previous 3 months. He had a body temperature of 39°C at the time of admission. On laboratory tests he had elevated level of liver enzymes, blood urea nitrogen, Creatinine, Creatine phosphokinase (MB, and moderate proteinuria. He also had abnormal echocardiography and brain MRI. Enzyme-linked immunosorbent assay for IgG and IgM was negative. Standard tube agglutination test (STAT and 2-mercaptoethanol (2-ME titers were 1:80 and 1:40 respectively. Finally he was diagnosed with brucellosis by positive blood culture and the polymerase chain reaction for Brucella mellitensis. Conclusion In endemic areas clinicians should consider brucellosis in any unusual presentation involving multiple organ systems, even if serology is inconclusive. In endemic areas low STAT and 2-ME titers should be considered as an indication of brucellosis and in these cases additional testing is recommended to rule out brucellosis.

  7. Presentation

    Eduardo Vicente

    2013-06-01

    Full Text Available In the present edition of Significação – Scientific Journal for Audiovisual Culture and in the others to follow something new is brought: the presence of thematic dossiers which are to be organized by invited scholars. The appointed subject for the very first one of them was Radio and the invited scholar, Eduardo Vicente, professor at the Graduate Course in Audiovisual and at the Postgraduate Program in Audiovisual Media and Processes of the School of Communication and Arts of the University of São Paulo (ECA-USP. Entitled Radio Beyond Borders the dossier gathers six articles and the intention of reuniting works on the perspectives of usage of such media as much as on the new possibilities of aesthetical experimenting being build up for it, especially considering the new digital technologies and technological convergences. It also intends to present works with original theoretical approach and original reflections able to reset the way we look at what is today already a centennial media. Having broadened the meaning of “beyond borders”, four foreign authors were invited to join the dossier. This is the first time they are being published in this country and so, in all cases, the articles where either written or translated into Portuguese.The dossier begins with “Radio is dead…Long live to the sound”, which is the transcription of a thought provoking lecture given by Armand Balsebre (Autonomous University of Barcelona – one of the most influential authors in the world on the Radio study field. It addresses the challenges such media is to face so that it can become “a new sound media, in the context of a new soundscape or sound-sphere, for the new listeners”. Andrew Dubber (Birmingham City University regarding the challenges posed by a Digital Era argues for a theoretical approach in radio studies which can consider a Media Ecology. The author understands the form and discourse of radio as a negotiation of affordances and

  8. Benign metastasizing leiomyoma presenting as multiple cystic pulmonary nodules: a case report.

    Choe, Yeong Hun; Jeon, So Yeon; Lee, Yoon Chae; Chung, Myung Ja; Park, Seung Yong; Lee, Yong Chul; Kim, So Ri

    2017-09-12

    Benign metastatic leiomyoma (BML) is an extremely rare disease. Although uterine leiomyomas are benign histologically, they can metastasize to distant sites. While the incidence is very low, the lung is the organ most frequently affected by BML. Pulmonary BML usually presents as numerous well-defined nodules of various sizes, while the cavitary or cystic features in the nodules are rarely observed on radiologic images. A 52-year-old woman complained of cough and dyspnea for one month. She had been previously diagnosed with uterine leiomyoma and had undergone total hysterectomy about 14 years prior. High-resolution computed tomography (CT) images showed that there were multiple cystic nodules of various sizes in both lungs. Pathologic examination revealed that the pulmonary nodule had complex branching glandular structures lined by a single layer of simple cuboidal to columnar epithelium that was surrounded by abundant spindle cells. Additional immunohistochemistry data suggested that pulmonary nodule diagnosis was BML-associated uterine leiomyoma. In this report, we introduce an interesting case of pulmonary BML that presented as a combination of various kinds of nodules including simple round nodules, simple cysts, and cysts with a solid portion, which are very rare radiologic features of BML in lung. In addition, when the patient is a woman of reproductive age, physicians should meticulously review the gynecological history and suspect BML when there are various cystic pulmonary lesions.

  9. A Case of Brucellosis Presenting with Multiple Hypodense Splenic Lesions and Bilateral Pleural Effusions

    Emine Dilek Eruz

    2011-01-01

    Full Text Available Brucellosis is a zoonotic infectious disease, which mainly present with lymphoreticular system invovement. However any organ system can be attacked by the microorganism. In this paper we present a 52-year-old female patient who was admitted to the Infectious Diseases Department with complaints of fatigue, arthralgias, fever, and weight loss. In the medical examination and radiological analysis bilateral pleural effusions and hepatosplenomegaly were detected. Serum transaminase levels were two times higher than the upper limits of normal. Abdominal ultrasound revealed sludge in the gallbladder and multiple hypodense splenic lesions (the largest was 1 cm in diameter. Brucella melitensis was isolated from the blood culture of the patient. Rifampicin (600 mg/day and doxycycline (200 mg/day therapy was started. Follow-up chest radiography and ultrasonography revealed the absence of pleural effusion. Splenic lesions and hepatosplenomegaly were totally regressed. The patient has been followed for 3 months after 6 week antibiotic regimen without recurrence. Brucellosis was expected to be the cause of all pathological signs.

  10. A conjugative 38 kB plasmid is present in multiple subspecies of Xylella fastidiosa.

    Rogers, Elizabeth E; Stenger, Drake C

    2012-01-01

    A ≈ 38kB plasmid (pXF-RIV5) was present in the Riv5 strain of Xylella fastidiosa subsp. multiplex isolated from ornamental plum in southern California. The complete nucleotide sequence of pXF-RIV5 is almost identical to that of pXFAS01 from X. fastidiosa subsp. fastidiosa strain M23; the two plasmids vary at only 6 nucleotide positions. BLAST searches and phylogenetic analyses indicate pXF-RIV5 and pXFAS01 share some similarity to chromosomal and plasmid (pXF51) sequences of X. fastidiosa subsp. pauca strain 9a5c and more distant similarity to plasmids from a wide variety of bacteria. Both pXF-RIV5 and pXFAS01 encode homologues of a complete Type IV secretion system involved in conjugation and DNA transfer among bacteria. Mating pair formation proteins (Trb) from Yersinia pseudotuberculosis IP31758 are the mostly closely related non-X. fastidiosa proteins to most of the Trb proteins encoded by pXF-RIV5 and pXFAS01. Unlike many bacterial conjugative plasmids, pXF-RIV5 and pXFAS01 do not carry homologues of known accessory modules that confer selective advantage on host bacteria. However, both plasmids encode seven hypothetical proteins of unknown function and possess a small transposon-associated region encoding a putative transposase and associated factor. Vegetative replication of pXF-RIV5 and pXFAS01 appears to be under control of RepA protein and both plasmids have an origin of DNA replication (oriV) similar to that of pRP4 and pR751 from Escherichia coli. In contrast, conjugative plasmids commonly encode TrfA and have an oriV similar to those found in IncP-1 incompatibility group plasmids. The presence of nearly identical plasmids in single strains from two distinct subspecies of X. fastidiosa is indicative of recent horizontal transfer, probably subsequent to the introduction of subspecies fastidiosa to the United States in the late 19(th) century.

  11. A conjugative 38 kB plasmid is present in multiple subspecies of Xylella fastidiosa.

    Elizabeth E Rogers

    Full Text Available A ≈ 38kB plasmid (pXF-RIV5 was present in the Riv5 strain of Xylella fastidiosa subsp. multiplex isolated from ornamental plum in southern California. The complete nucleotide sequence of pXF-RIV5 is almost identical to that of pXFAS01 from X. fastidiosa subsp. fastidiosa strain M23; the two plasmids vary at only 6 nucleotide positions. BLAST searches and phylogenetic analyses indicate pXF-RIV5 and pXFAS01 share some similarity to chromosomal and plasmid (pXF51 sequences of X. fastidiosa subsp. pauca strain 9a5c and more distant similarity to plasmids from a wide variety of bacteria. Both pXF-RIV5 and pXFAS01 encode homologues of a complete Type IV secretion system involved in conjugation and DNA transfer among bacteria. Mating pair formation proteins (Trb from Yersinia pseudotuberculosis IP31758 are the mostly closely related non-X. fastidiosa proteins to most of the Trb proteins encoded by pXF-RIV5 and pXFAS01. Unlike many bacterial conjugative plasmids, pXF-RIV5 and pXFAS01 do not carry homologues of known accessory modules that confer selective advantage on host bacteria. However, both plasmids encode seven hypothetical proteins of unknown function and possess a small transposon-associated region encoding a putative transposase and associated factor. Vegetative replication of pXF-RIV5 and pXFAS01 appears to be under control of RepA protein and both plasmids have an origin of DNA replication (oriV similar to that of pRP4 and pR751 from Escherichia coli. In contrast, conjugative plasmids commonly encode TrfA and have an oriV similar to those found in IncP-1 incompatibility group plasmids. The presence of nearly identical plasmids in single strains from two distinct subspecies of X. fastidiosa is indicative of recent horizontal transfer, probably subsequent to the introduction of subspecies fastidiosa to the United States in the late 19(th century.

  12. A new parameter to simultaneously assess antioxidant activity for multiple phenolic compounds present in food products.

    Yang, Hong; Xue, Xuejia; Li, Huan; Tay-Chan, Su Chin; Ong, Seng Poon; Tian, Edmund Feng

    2017-08-15

    In this work, we established a new methodology to simultaneously assess the relative reaction rates of multiple antioxidant compounds in one experimental set-up. This new methodology hypothesizes that the competition among antioxidant compounds towards limiting amount of free radical (in this article, DPPH) would reflect their relative reaction rates. In contrast with the conventional detection of DPPH decrease at 515nm on a spectrophotometer, depletion of antioxidant compounds treated by a series of DPPH concentrations was monitored instead using liquid chromatography coupled with quadrupole time-of-flight (LC-QTOF). A new parameter, namely relative antioxidant activity (RAA), has been proposed to rank these antioxidants according to their reaction rate constants. We have investigated the applicability of RAA using pre-mixed standard phenolic compounds, and also extended this application to two food products, i.e. red wine and green tea. It has been found that RAA correlates well with the reported k values. This new parameter, RAA, provides a new perspective in evaluating antioxidant compounds present in food and herbal matrices. It not only realistically reflects the antioxidant activity of compounds when co-existing with competitive constituents; and it could also quicken up the discovery process in the search for potent yet rare antioxidants from many herbs of food/medicinal origins. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Evaluation of biases present in the cohort multiple randomised controlled trial design: a simulation study

    Jane Candlish

    2017-01-01

    Full Text Available Abstract Background The cohort multiple randomised controlled trial (cmRCT design provides an opportunity to incorporate the benefits of randomisation within clinical practice; thus reducing costs, integrating electronic healthcare records, and improving external validity. This study aims to address a key concern of the cmRCT design: refusal to treatment is only present in the intervention arm, and this may lead to bias and reduce statistical power. Methods We used simulation studies to assess the effect of this refusal, both random and related to event risk, on bias of the effect estimator and statistical power. A series of simulations were undertaken that represent a cmRCT trial with time-to-event endpoint. Intention-to-treat (ITT, per protocol (PP, and instrumental variable (IV analysis methods, two stage predictor substitution and two stage residual inclusion, were compared for various refusal scenarios. Results We found the IV methods provide a less biased estimator for the causal effect when refusal is present in the intervention arm, with the two stage residual inclusion method performing best with regards to minimum bias and sufficient power. We demonstrate that sample sizes should be adapted based on expected and actual refusal rates in order to be sufficiently powered for IV analysis. Conclusion We recommend running both an IV and ITT analyses in an individually randomised cmRCT as it is expected that the effect size of interest, or the effect we would observe in clinical practice, would lie somewhere between that estimated with ITT and IV analyses. The optimum (in terms of bias and power instrumental variable method was the two stage residual inclusion method. We recommend using adaptive power calculations, updating them as refusal rates are collected in the trial recruitment phase in order to be sufficiently powered for IV analysis.

  14. Unusual CT findings of a benign metastasizing leiomyoma presenting with multiple cavitary nodules: a case report

    Ahn, Ji Eun; Do, Kyung Hyun; Chae, Eun Jin; Seo, Joon Beom; Lee, Jin Seong; Song, Koun Sik; Song, Jae Wo; Kim, Kyu Rae; Lim, Tae Hwan

    2007-01-01

    A benign metastasizing leiomyoma is a rare condition that affects women with a history of uterine leiomyoma, usually after a myomectomy or hysterectomy. Typical radiographic findings include well-circumscribed solitary or multiple pulmonary nodules ranging from a few millimeters to several centimeters in diameter and scattered among the normal interstitium. We report a case of a benign metastasizing leiomyoma that manifested with multiple cavitary nodules in a 46-year-old woman with no previous history of a myomectomy or hysterectomy

  15. Unusual CT findings of a benign metastasizing leiomyoma presenting with multiple cavitary nodules: a case report

    Ahn, Ji Eun; Do, Kyung Hyun; Chae, Eun Jin; Seo, Joon Beom; Lee, Jin Seong; Song, Koun Sik; Song, Jae Wo; Kim, Kyu Rae; Lim, Tae Hwan [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2007-09-15

    A benign metastasizing leiomyoma is a rare condition that affects women with a history of uterine leiomyoma, usually after a myomectomy or hysterectomy. Typical radiographic findings include well-circumscribed solitary or multiple pulmonary nodules ranging from a few millimeters to several centimeters in diameter and scattered among the normal interstitium. We report a case of a benign metastasizing leiomyoma that manifested with multiple cavitary nodules in a 46-year-old woman with no previous history of a myomectomy or hysterectomy.

  16. Carcinomatous Meningitis from Unknown Primary Carcinoma

    L. Favier

    2009-10-01

    Full Text Available Carcinomatous meningitis (CM occurs in 3 to 8% of cancer patients. Patients present with a focal symptom, and multifocal signs are often found following neurological examination. The gold standard for diagnosis remains the demonstration of carcinomatous cells in the cerebrospinal fluid on cytopathological examination. Despite the poor prognosis, palliative treatment could improve quality of life and, in some cases, overall survival. We report on a patient who presented with vertigo, tinnitus and left-sided hearing loss followed by progressive diffuse facial nerve paralysis. Lumbar cerebrospinal fluid confirmed the diagnosis of CM. However, no primary tumor was discovered, even after multiple invasive investigations. This is the first reported case in the English-language medical literature of CM resulting from a carcinoma of unknown primary origin.

  17. Evaluation of biases present in the cohort multiple randomised controlled trial design : a simulation study

    Candlish, Jane; Pate, Alexander; Sperrin, Matthew; Staa, Tjeerd P van

    2017-01-01

    BACKGROUND: The cohort multiple randomised controlled trial (cmRCT) design provides an opportunity to incorporate the benefits of randomisation within clinical practice; thus reducing costs, integrating electronic healthcare records, and improving external validity. This study aims to address a key

  18. Fever of unknown origin

    Misaki, Takashi; Matsui, Akira; Tanaka, Fumiko; Okuno, Yoshishige; Mitsumori, Michihide; Torizuka, Tatsurou; Dokoh, Shigeharu; Hayakawa, Katsumi; Shimbo, Shin-ichirou

    1990-01-01

    Gallium-67 scintigraphy is a commonly performed imaging modality in deteting pyrogenic lesions in cases of long-standing inexplainable fever. To re-evaluate the significance of gallium imaging in such cases, a retrospective review was made of 56 scans performed in febrile patients in whom sufficient clinical and laboratory findings were obtained. Gallium scans were true positive in 30 patients, false positive in 3, true negative in 19, and false negative in 4. In the group of true positive, local inflammatory lesions were detected in 23 patients with a final diagnosis of lung tuberculosis, urinary tract infection, and inflammatory joint disease. Abnormal gallium accumulation, as shown in the other 7 patients, provided clues to the diagnosis of generalized disorders, such as hematological malignancies (n=3), systemic autoimmune diseases (n=3), and severe infectious mononucleosis (n=one). In the group of false positive, gallium imaging revealed intestinal excretion of gallium in 2 patients and physiological pulmonary hilar accumulation in one. In the true negative group of 19 patients, fever of unknown origin was resolved spontaneously in 12 patients, and with antibiotics and corticosteroids in 2 and 5 patients, respectively. Four patients having false negative scans were finally diagnosed as having urinary tract infection (n=2), bacterial meningitis (n=one), and polyarteritis (n=one). Gallium imaging would remain the technique of choice in searching for origin of unknown fever. It may also be useful for early diagnosis of systemic disease, as well as focal inflammation. (N.K.)

  19. Multiple prismatic calcium phosphate layers in the jaws of present-day sharks (Chondrichthyes; Selachii).

    Dingerkus, G; Séret, B; Guilbert, E

    1991-01-15

    Jaws of large individuals, over 2 m in total length, of the shark species Carcharodon carcharias (great white shark) and Isurus oxyrinchus (mako shark) of the family Lamnidae, and Galeocerdo cuvieri (tiger shark) and Carcharhinus leucas (bull shark) of the family Carcharhinidae were found to have multiple, up to five, layers of prismatic calcium phosphate surrounding the cartilages. Smaller individuals of these species and other known species of living chondrichthyans have only one layer of prismatic calcium phosphate surrounding the cartilages, as also do most species of fossil chondrichthyans. Two exceptions are the fossil shark genera Xenacanthus and Tamiobatis. Where it is found in living forms, this multiple layered calcification does not appear to be phylogenetic, as it appears to be lacking in other lamnid and carcharhinid genera and species. Rather it appears to be functional, only appearing in larger individuals and species of these two groups, and hence may be necessary to strengthen the jaw cartilages of such individuals for biting.

  20. Function analysis of unknown genes

    Rogowska-Wrzesinska, A.

    2002-01-01

      This thesis entitled "Function analysis of unknown genes" presents the use of proteome analysis for the characterisation of yeast (Saccharomyces cerevisiae) genes and their products (proteins especially those of unknown function). This study illustrates that proteome analysis can be used...... to describe different aspects of molecular biology of the cell, to study changes that occur in the cell due to overexpression or deletion of a gene and to identify various protein modifications. The biological questions and the results of the described studies show the diversity of the information that can...... genes and proteins. It reports the first global proteome database collecting 36 yeast single gene deletion mutants and selecting over 650 differences between analysed mutants and the wild type strain. The obtained results show that two-dimensional gel electrophoresis and mass spectrometry based proteome...

  1. Lupus erythematosus, thyroiditis, alopecia areata and vitiligo – A multiple autoimmune syndrome type 3 case presentation

    Alin Laurentiu Tatu

    2017-04-01

    Full Text Available The combination of at least three autoimmune diseases in the same patient has defined as multiple autoimmune syndrome (MAS. Abnormalities of T cell-mediated immunity and humoral immunity have been described previously in the literature. Aims of work were to investigate the 22 years old patient with lupus erythematosus for three years and autoimune thyroiditis for one year, regardind other possible autoimmune conditions and to establish a treatment to control the diseases. The clinical exam revealed some circular hairless patches on the beard appeared about three months ago and white depigmented disseminated areas started one month ago and the laboratory investigations were performed. The modified laboratory findings were total IgE 530 UI/mL, Anti-SSA (anti-RO antibodies> 200 IU/mL, SSB negative, Antinuclear antibodies (ANA positive and fine speckled, Lupus anticoagulant testing positive, Anti-thyroid peroxidase antibodies 951 UI/ml, TSH 4,7 µUI/mL. The diagnosis of multiple autoimmune syndrome(MAS type 3 including Lupus erythematosus, autoimune Thyroiditis, Alopecia Areata and Vitiligo was established. Endocrine autoimmunities are associated with autoantibodies that react to specific antigens, whereas patients with collagen diseases synthesize immunoglobulins that recognize nonorgan-specific cellular targets, such as nucleoproteins and nucleic acids. Cellular autoimmunity is important in the pathogenesis MAS. The existence of one autoimmune disorder helps lead to the discovery of other autoimmune conditions.

  2. First-episode psychosis as the initial presentation of multiple sclerosis: a case report.

    Enderami, Athena; Fouladi, Rose; Hosseini, Seyed Hamzeh

    2018-01-01

    Multiple sclerosis (MS) is an inflammatory disease that affects the central nervous system (CNS). MS with episode of psychosis is a rare entity, and to the best of our knowledge, no case has been reported from Iran till date. We report a case of MS with first-episode psychosis in a 27-year-old single man with no history of psychiatric disorder or drug abuse. The patient developed neurological symptoms after 3 months and was finally diagnosed as a case of MS. His symptoms started with behavioral dysfunctions and progressively resulted in depression. Subsequently, treatment was performed with citalopram 20 mg daily, risperidone 2 mg three times a day, and biperiden 2 mg three times a day; however, no improvements in the symptoms were observed. T2-weighted magnetic resonance imaging has demonstrated periventricular and white matter multiple sclerotic plugs with lesions. Eventually, MS was diagnosed after the appearance of paresthesia, upper and lower limb muscle weakness, ataxia, and urinary incontinency as typical signs. Then, the medications were changed to methylprednisolone and interferon therapy, which resulted in improvements in the clinical conditions of the patient. Based on the fact that organic disorders such as MS may sometimes appear with initial pure psychiatric symptoms without any neurological signs and symptoms, examinations for symptoms linked to CNS dysfunction, cognitive changes, atypical symptoms, detailed neurological examination, and limited response to conventional antipsychotic drugs are highly recommended to be carried out for patients with first-episode psychosis and even in the followup period.

  3. Multiple Primary Merkel Cell Carcinomas Presenting as Pruritic, Painful Lower Leg Tumors

    Laura Blumenthal; Timothy VandenBoom; Edward Melian; Anthony Peterson; Kelli A. Hutchens

    2015-01-01

    Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroendocrine tumor of the skin which almost exclusively presents as a solitary tumor. It is most often seen on sun-exposed regions, historically almost exclusively on the head and neck, with only rare case reports on the extremities. Although recent studies have shown increased incidence with up to 20% on the extremities, here we present one of these rare emerging presentations, with the addition of a unique treatment option. Our p...

  4. Canine Choroid Plexus Tumor with Intracranial Dissemination Presenting as Multiple Cystic Lesions

    Trisha J. Oura

    2013-01-01

    Full Text Available A Miniature Pinscher developed acute blindness and behavioral changes. On magnetic resonance imaging (MRI, there were multiple small intra-axial cystic lesions, and primary differential diagnoses included primary or metastatic neoplasia and neurocysticercosis. These cystic lesions were subsequently diagnosed histopathologically as disseminated choroid plexus carcinoma. This is only the second documented description of this diagnosis in a dog, but both patients had very similar MRI findings. This patient adds to the literature about the MRI characteristics of choroid plexus tumors and indicates that choroid plexus tumor should be considered as a possible cause of small multifocal intra-axial cystic brain lesions in dogs, regardless of whether a primary intraventricular lesion is visible.

  5. Extraskeletal multiple myeloma presenting with an atrial mass: a case report and a review of the literature

    Vigo, Federica; Ciammella, Patrizia; Valli, Riccardo; Cagni, Elisabetta; Iotti, Cinzia

    2012-01-01

    Abstract Introduction Extraskeletal presentation at diagnosis or during the course of multiple myeloma is a rare event. The prognosis is usually very poor. At the moment there is no agreed gold standard for the treatment of this presentation. Case presentation A 79-year-old Caucasian woman was treated at our hospital for right atrial myeloma localization. Our patient showed the following signs and symptoms of congestive heart failure: dyspnea, hypotension, cyanosis and facial edema. Surgery w...

  6. [Cognitive rehabilitation in multiple sclerosis: preliminary results and presentation of a new program, PROCOG-SEP].

    Brissart, H; Leroy, M; Debouverie, M

    2010-04-01

    Although cognitive disorders are well-known in multiple sclerosis (MS), even in earlier stages of the disease, their management may be overlooked. Our objective was to elaborate and evaluate the efficiency of a remedial program (PROCOG-SEP) designed for MS patients. The evidence-based program proposes exercises to both stimulate preserved functions and develop new abilities compensating for cognitive disabilities. Twenty-four patients with MS participated in 10/2-hour PROCOG-SEP sessions over a 6-month period. A neuropsychologist recorded BCcog-SEP performances before and after the PROCOG-SEP program. In addition, the same neuropsychologist conducted psychoclinical interviews to complete the before and after cognitive evaluations. The statistical analysis used the t-test performed with Excel. Compared with the initial levels, subtests of BCcog-SEP showing improvement after PROCOG-SEP were: verbal memory (SRT), visuospatial memory (10/36), verbal fluency (animal categories) and response to conflicting orders. Also, individual psychological interviews tended to be in favor of a general improvement in quality of life (more social interactions for instance). To our knowledge, the management program we have elaborated is the first designed to improve cognitive deficits in MS. These encouraging results suggest possibilities for improving cognition and thus quality-of-life in MS patients. 2009 Elsevier Masson SAS. All rights reserved.

  7. Rehabilitation-triggered cortical plasticity after stroke: in vivo imaging at multiple scales (Conference Presentation)

    Allegra Mascaro, Anna Letizia; Conti, Emilia; Lai, Stefano; Spalletti, Cristina; Di Giovanna, Antonino Paolo; Alia, Claudia; Panarese, Alessandro; Sacconi, Leonardo; Micera, Silvestro; Caleo, Matteo; Pavone, Francesco S.

    2017-02-01

    Neurorehabilitation protocols based on the use of robotic devices provide a highly repeatable therapy and have recently shown promising clinical results. Little is known about how rehabilitation molds the brain to promote motor recovery of the affected limb. We used a custom-made robotic platform that provides quantitative assessment of forelimb function in a retraction test. Complementary imaging techniques allowed us to access to the multiple facets of robotic rehabilitation-induced cortical plasticity after unilateral photothrombotic stroke in mice Primary Motor Cortex (Caudal Forelimb Area - CFA). First, we analyzed structural features of vasculature and dendritic reshaping in the peri-infarct area with two-photon fluorescence microscopy. Longitudinal analysis of dendritic branches and spines of pyramidal neurons suggests that robotic rehabilitation promotes the stabilization of peri-infarct cortical excitatory circuits, which is not accompanied by consistent vascular reorganization towards pre-stroke conditions. To investigate if this structural stabilization was linked to functional remapping, we performed mesoscale wide-field imaging on GCaMP6 mice while performing the motor task on the robotic platform. We revealed temporal and spatial features of the motor-triggered cortical activation, shining new light on rehabilitation-induced functional remapping of the ipsilesional cortex. Finally, by using an all-optical approach that combines optogenetic activation of the contralesional hemisphere and wide-field functional imaging of peri-infarct area, we dissected the effect of robotic rehabilitation on inter-hemispheric cortico-cortical connectivity.

  8. Oxidative Stress Is Differentially Present in Multiple Sclerosis Courses, Early Evident, and Unrelated to Treatment

    Maira Gironi

    2014-01-01

    Full Text Available Background. Oxidative stress is well documented in multiple sclerosis (MS lesions, but its correspondence at peripheral level is still controversial. Objective. To evaluate peripheral oxidative stress markers in MS patients. Methods. We studied total blood levels of Coenzyme Q10 (CoQ10, oxidized and reduced forms of glutathione, malondialdehyde, reactive oxygen species (ROS, anti-oxidized-low-density lipoproteins (anti-oxLDL antibodies, and antioxidant power (PAO in 87 patients with different MS clinical phenotypes and in 77 controls. Results. CoQ10 was lower whereas anti-oxLDL antibodies titer was higher in MS patients than in controls. The benign variant of MS displayed both higher CoQ10 and higher anti-oxLDL than other MS clinical variants. Female patients had lower CoQ10 and PAO and higher ROS than male patients. Differences were greater in younger patients with shorter disease duration. Surprisingly, there was no difference for these markers between treated and untreated patients. Conclusion. We found lower antioxidant agents and higher anti-oxLDL antibodies in MS, and the highest antibody titers occurred in the benign form. We suggest that natural anti-oxLDL antibodies can be protective against MS, saving blood brain barrier integrity. Our findings also suggest that milder MS is associated with a distinct oxidative stress pattern, which may provide a useful biomarker of disease prognosis.

  9. Incidence, clinical features, laboratory findings and outcome of patients with multiple myeloma presenting with extramedullary relapse.

    Papanikolaou, Xenofon; Repousis, Panagiotis; Tzenou, Tatiana; Maltezas, Dimitris; Kotsopoulou, Maria; Megalakaki, Katerina; Angelopoulou, Maria; Dimitrakoloulou, Elektra; Koulieris, Efstathios; Bartzis, Vassiliki; Pangalis, Gerasimos; Panayotidis, Panagiotis; Kyrtsonis, Marie-Christine

    2013-07-01

    Extramedullary plasmacytomas constitute a rare and not well studied subset of multiple myeloma (MM) relapses. We report the incidence, clinical-laboratory features and outcome of patients with MM and extramedullary relapse (ExMeR). A total of 303 patients with symptomatic MM were recorded in a 13-year period in two institutions. Twenty-eight cases of ExMeR (9%) were recorded. There was an increased frequency of elevated lactate dehydrogenase (LDH) (p = 0.026), bone plasmacytomas (p = 0.001) and fractures (p = 0.002) at diagnosis, in patients with ExMeR compared to the others. ExMeR was associated with an ominous outcome, high LDH, constitutional symptoms and a statistically significant decrease of monoclonal paraprotein compared to levels at diagnosis (p = 0.009). Prior treatment with bortezomib was associated with a decreased hazard of ExMeR (p = 0.041). Overall survival (OS) was decreased in patients with ExMeR compared to the others (38 vs. 59 months, p = 0.006). Patients with MM with ExMeR have a lower OS and their clinical and laboratory features differ from those without.

  10. Natalizumab Modifies Catecholamines Levels Present in Patients with Relapsing- Remitting Multiple Sclerosis.

    Escribano, Begona M; Aguilar-Luque, Macarena; Bahamonde, Carmen; Conde, Cristina; Lillo, Rafael; Sanchez-Lopez, Fernando; Giraldo, Ana I; Cruz, Antonio H; Luque, Evelio; Gascon, Felix; Aguera, Eduardo; Tunez, Isaac

    2016-01-01

    The main aim of this study was to verify the effect of natalizumab on the levels of circulating catecholamines and indolamine and their possible relation with MS. For this purpose, 12 healthy individuals (control group) and 12 relapsing-remitting multiple sclerosis patients (RR-MS) were selected. The patients were treated with 300 mg of natalizumab during 56 weeks (1 dose/4 weeks) (MS-56). This selection was based on the McDonalds revision criterion and scheduled to star treatment with natalizumab. Blood samples were taken before treatment (basal level) and after 56 weeks of using natalizumab. Melatonin was measured in serum and in plasma, catecholamines (dopamine, epinephrine, and norepinephrine), carbonylated proteins, 8-hydroxy-2'deoxyguanosine (8OH-dG) and the ratio reduced glutathione/oxidised glutathione (GSH/GSSG). The epinephrine and dopamine levels diminished in the basal group with respect to the control and did not recover normal levels with the treatment. The melatonin was decreased in RR-MS patients and went back to its normal levels with natalizumab. Norepinephrine was increased in RR-MS and decreased in MS-56 until it equalled the control group. Natalizumab normalizes altered melatonin and norepinephrine levels in MS.

  11. Mantle cell lymphoma of the gastrointestinal tract presenting with multiple intussusceptions – case report and review of literature

    Abo Stephen M

    2009-07-01

    Full Text Available Abstract Background Mantle cell lymphoma (MCL is an aggressive type of B-cell non-Hodgkin's lymphoma that originates from small to medium sized lymphocytes located in the mantle zone of the lymph node. Extra nodal involvement is present in the majority of cases, with a peculiar tendency to invade the gastro-intestinal tract in the form of multiple lymphomatous polyposis. MCL can be accurately diagnosed with the use of the highly specific marker Cyclin D1. Few cases of mantle cell lymphoma presenting with intussuception have been reported. Here we present a rare case of multiple intussusceptions caused by mantle cell lymphoma and review the literature of this disease. Case presentation A 68-year-old male presented with pain, tenderness in the right lower abdomen, associated with nausea and non-bilious vomiting. CT scan of abdomen revealed ileo-colic intussusception. Laparoscopy confirmed multiple intussusceptions involving ileo-colic and ileo-ileal segments of gastrointestinal tract. A laparoscopically assisted right hemicolectomy and extended ileal resection was performed. Postoperative recovery was uneventful. The histology and immuno-histochemistry of the excised small and large bowel revealed mantle cell lymphoma with multiple lymphomatous polyposis and positivity to Cyclin D1 marker. The patient was successfully treated with Rituximab-CHOP chemotherapy and remains in complete remission at one-year follow-up. Conclusion This is a rare case of intestinal lymphomatous polyposis due to mantle cell lymphoma presenting with multiple small bowel intussusceptions. Our case highlights laparoscopic-assisted bowel resection as a potential and feasible option in the multi-disciplinary treatment of mantle cell lymphoma.

  12. Can Reliability of Multiple Component Measuring Instruments Depend on Response Option Presentation Mode?

    Menold, Natalja; Raykov, Tenko

    2016-01-01

    This article examines the possible dependency of composite reliability on presentation format of the elements of a multi-item measuring instrument. Using empirical data and a recent method for interval estimation of group differences in reliability, we demonstrate that the reliability of an instrument need not be the same when polarity of the…

  13. Hydatid disease presenting as multiple cystic swelling in the right supraclavicular region

    Manab Nandy

    2012-12-01

    Full Text Available Hydatid disease (Echinococcus granulosus is endemic in the Middle East as well as other parts of the world including India. Even though hydatid cysts can occur in any organ, infestation by hydatid disease in humans most commonly occurs in the liver because it acts as the first filter followed by the lung, which forms a second filter. The two organs can be affected simultaneously. After entering the systemic circulation it may be distributed in various organs including brain, orbit, parotid gland, vertebrae, bones and even palm and sole. Some other organs may also be rarely affected, but presentation as lymph node swelling in the supraclavicular region is very rare. The purpose of this paper is to emphasize the fact that supra clavicular lymph node swelling may be a presenting feature of hydatid disease, especially in endemic areas of the world.

  14. Unilateral facial palsy in an infant: an unusual presentation of familial multiple cerebral cavernous malformation.

    Zakaria, Zaitun

    2012-01-01

    Cerebral cavernous malformation (CCM) in infants tends to have genetic predisposition. These cavernomas have a progressive course of events and associated neurological symptoms with increase in age. They most commonly present with seizure and syndrome of increased intracranial pressure comprising of headache, vomiting and focal neurological signs. We describe a case of a 7-month-old infant who presented with an acute onset of right facial paralysis with a background of familial CCM. The CT and MRI scan revealed fresh haemorrhage in the right cerebellar and pontine cavernomas with surrounding oedema and no evidence of obstructive hydrocephalus. These two cavernomas re-bled in a week duration causing episodes of incessant crying and irritability. After discussing the pros and cons of treatment, owing to stable clinical status, the patient is currently been managed conservatively.

  15. Extraskeletal multiple myeloma presenting with an atrial mass: a case report and a review of the literature

    Vigo Federica

    2012-08-01

    Full Text Available Abstract Introduction Extraskeletal presentation at diagnosis or during the course of multiple myeloma is a rare event. The prognosis is usually very poor. At the moment there is no agreed gold standard for the treatment of this presentation. Case presentation A 79-year-old Caucasian woman was treated at our hospital for right atrial myeloma localization. Our patient showed the following signs and symptoms of congestive heart failure: dyspnea, hypotension, cyanosis and facial edema. Surgery was not considered feasible due to the extent of the disease. Our patient underwent external-beam radiation therapy using an intensity modulated technique, thus obtaining a persistent complete remission. Our patient has been in continuous complete local remission for 25 months since the end of radiotherapy. Conclusion The role of radiotherapy is not defined in multiple myeloma with extraskeletal presentation. Our regimen seems to be effective in controlling the disease in this patient. This case report adds to the existing literature as it describes an unusual presentation of the disease and a new therapeutic approach to this rare presentation of multiple myeloma.

  16. Aleukemic granulocytic sarcoma presenting at multiple sites: ovary, breast and soft tissue

    Jitendra Singh Nigam

    2012-06-01

    Full Text Available An 18 year old female presented with the history of pain in abdomen, breast engorgement, swelling over both legs and breathlessness for three month. On clinical examination diagnosis of fibroadenoma breast was made. Ultrasonography of abdomen showed bilateral ovarian mass. Bilateral salpingo-ophrectomy was done and specimen was sent for histological examination. Two lobulated solid masses of tissues the larger one measuring 13x8x5 cm and smaller one measuring 10x7x5 cm in size received. Microscopic examination showed monomorphic population of discohesive, hyperchromatic small round cells had high N:C ratio, coarse chromatin, conspicuous nucleoli and scant to moderate amount of basophilic cytoplasm, lying in sheets and separated by fibrous strands and diffusely infiltrating the ovarian stroma. Fine needle aspiration from breast lump and leg swelling showed predominant population of blast cells. Myeloperoxidase was strongly positive and diagnosis of granulocytic sarcoma was confirmed.

  17. Intraabdominal abscessus of unknown etiology

    Čolović Radoje

    2012-01-01

    Full Text Available Introduction. Intraabdominal abscesses are in 98-99% cases the result of secondary and only in 1-2% of primary peritonitis. They are easy and successfully diagnosed. Abdominal abscesses of unknown cause are extremely rare. Case Outline. The authors present a 68-year-old man, without significant data in past history, who suddenly developed epigastric pain, nausea, vomiting and leukocytosis which was treated with antibiotics resulting in the alleviation of complaints and reduction of white blood cells count. After five days ultrasonography showed incapsulated collection of dense fluid in the epigastrium confirmed by CT scan two days later. Upper endoscopy excluded ulcer and/or perforation of the stomach and duodenum. Under local anesthesia, through the upper part of the left rectal muscle, puncture followed by incision was done, and about 50 ml of dense pus was removed. Finger exploration of the cavity showed no foreign body within the cavity. Using drainage, the recovery was quick and uneventful. By preoperative and postoperative abdominal investigations no cause of the abscess was found. Two and a half years after surgery the patient remained symptom-free with normal clinical, laboratory and ultrasonographic findings. Conclusion. The authors presented an intraabdominal abscess of unknown cause that was successfully treated with antibiotics, percutaneous puncture and drainage under local anaesthesia. In spite of all diagnostic methods the cause of the abscess could not be found. Thus, such a possibility, although being rare, should be taken into account.

  18. Recension: Mao - The Unknown Story

    Clausen, Søren

    2005-01-01

    Anmeldelse - kritisk! - til Sveriges førende Kinatidsskrift af Jung Chang & Jon Halliday's sensationelle "Mao - the Unknown Story".......Anmeldelse - kritisk! - til Sveriges førende Kinatidsskrift af Jung Chang & Jon Halliday's sensationelle "Mao - the Unknown Story"....

  19. Extraskeletal multiple myeloma presenting with an atrial mass: a case report and a review of the literature.

    Vigo, Federica; Ciammella, Patrizia; Valli, Riccardo; Cagni, Elisabetta; Iotti, Cinzia

    2012-08-10

    Extraskeletal presentation at diagnosis or during the course of multiple myeloma is a rare event. The prognosis is usually very poor. At the moment there is no agreed gold standard for the treatment of this presentation. A 79-year-old Caucasian woman was treated at our hospital for right atrial myeloma localization. Our patient showed the following signs and symptoms of congestive heart failure: dyspnea, hypotension, cyanosis and facial edema. Surgery was not considered feasible due to the extent of the disease. Our patient underwent external-beam radiation therapy using an intensity modulated technique, thus obtaining a persistent complete remission. Our patient has been in continuous complete local remission for 25 months since the end of radiotherapy. The role of radiotherapy is not defined in multiple myeloma with extraskeletal presentation. Our regimen seems to be effective in controlling the disease in this patient.This case report adds to the existing literature as it describes an unusual presentation of the disease and a new therapeutic approach to this rare presentation of multiple myeloma.

  20. MULTIPLE MYELOMA-LIKE SPINAL MRI FINDINGS IN SKELETAL FLUOROSIS: AN UNUSUAL PRESENTATION OF FLUORIDE TOXICITY IN HUMAN

    Javed Ahsan Quadri

    2016-11-01

    Full Text Available Endemic fluorosis is a worldwide environmental problem due to excessive fluoride, commonly due to increased drinking water fluoride levels but sometimes due to other sources such food with high fluoride content. In India, 21 of the 35 states are known to have health problems associated with fluoride toxicity. The present report is a case of a 50-year-old female who was seen with progressive spinal complications and a MRI of the spine suggestive of multiple myeloma. The MRI of the lumbo-sacral spine showed a diffuse and heterogeneous marrow signal of the lower dorsal and lumbo-sacral vertebrae. The MRI was also suggestive of coarse trabeculation and appeared predominantly hypointanse on the T1W image and had mixed signal intensity on the T2W image. These findings were suggestive of neoplastic bone marrow infiltration and the presence of a proliferative disorder, with multiple myeloma being the most likely. During the patient workup, it was found that other family members were also having similar complications and, after investigation of these family members, it was found that they are suffering from systemic fluorosis. The patient was then evaluated for skeletal fluorosis and this condition was found to be present. Multiple myeloma was ruled out by the finding of a negative serum protein electrophoresis. The spinal complications appeared to be mainly due to the compression of the spinal cord and nerve roots by protruding osteophytes, thickening of the posterior longitudinal ligament, and thickening of the ligamentum flavum resulting in a compressive myeloradiculopathy and compressive myelopathy. The finding of multiple myeloma- like findings on the spinal MRI in association with skeletal fluorosis was considered to be a very rare event. This case report underlines the need to consider the presence of spinal skeletal fluorosis when evaluating spinal complications with unusual pseudo-multiple myeloma-like changes on the spinal MRI.

  1. Unknown Russian giant

    Ross, Priscilla.

    1996-01-01

    The present position and future potential of the Russian oil company Tatneft are assessed. Tatneft, the eighteenth largest oil company in the world, has 85 oil fields and over 20,700 production wells. In 1995, it increased its production by 6% to 504,000bpd and its crude oil exports outside Russia were 213,000bpd. The company forms the basis of the oil industry in the semi-autonomous republic of Tatarstan. Tafneft became a joint stock company in May 1994 with the government of Tatarstan as the largest shareholder with a 46% stake. Although Tafneft produces far more crude than Conoco or YPF, its market capitalisation per barrel of production is only 5% of these companies. Its long-term future lies in successfully increasing production and enhancing financial performance. The former is being addressed through enhanced oil recovery methods and various joint ventures are being entered into with western partners in order to tap foreign expertise and to finance modern equipment. The achievement of the latter requires an improvement towards world prices of the price for Russian domestic crude and a reduction in the tax burden away from revenue towards a profits basis. (UK)

  2. The human homolog of S. cerevisiae CDC27, CDC27 Hs, is encoded by a highly conserved intronless gene present in multiple copies in the human genome

    Devor, E.J.; Dill-Devor, R.M. [Univ. of Iowa College of Medicine, Iowa City (United States)

    1994-09-01

    We have obtained a number of unique sequences via PCR amplification of human genomic DNA using degenerate primers under low stringency (42{degrees}C). One of these, an 853 bp product, has been identified as a partial genomic sequence of the human homolog of the S. cerevisiae CDC27 gene, CDC27Hs (GenBank No. U00001). This gene, reported by Turgendreich et al. is also designated EST00556 from Adams et al. We have undertaken a more detailed examination of our sequence, MCP34N, and have found that: 1. the genomic sequence is nearly identical to CDC27Hs over its entire 853 bp length; 2. an MCP34N-specific PCR assay of several non-human primate species reveals amplification products in chimpanzee and gorilla genomes having greater than 90% sequence identity with CDC27Hs; and 3. an MCP34N-specific PCR assay of the BIOS hybrid cell line panel gives a discordancy pattern suggesting multiple loci. Based upon these data, we present the following initial characterization: 1. the complete MCP34N sequence identity with CDC27Hs indicates that the latter is encoded by an intronless gene; 2. CDC27Hs is highly conserved among higher primates; and 3. CDC27Hs is present in multiple copies in the human genome. These characteristics, taken together with those initially reported for CDC27Hs, suggest that this is an old gene that carries out an important but, as yet, unknown function in the human brain.

  3. Pleural effusion in 11:14 translocation q1 multiple myeloma in the setting of proteasome inhibitor presents therapeutic complexity.

    Ghannam, Malik; Bryan, Maria; Kuross, Erik; Berry, Brent

    2018-01-01

    Primary malignant pleural effusion has been reported in about 134 cases of multiple myeloma (MM). Associated pleural effusions in cases of MM portend a poor prognosis and identifying them is highly relevant. Reported is the case of a man diagnosed with MM who developed primary myelomatous pleural effusion in the setting of multiple relapses and subsequent mortality within 2 months of the pleural effusion diagnosis. A 61-year-old African American man was diagnosed with MM in 2011. He received induction therapy of lenalidomide and dexamethasone and an autologous stem cell transplant in 2012. Over the next 5 years, the patient went through alternating periods of remission and relapse that were treated with two rounds of thoracic spine radiation therapy and chemotherapeutic agents. In September 2017, the patient presented with worsening dyspnea and was found to have pleural effusion. Fluid analysis showed plasma cell dyscrasia. Fluid drainage was performed, then the patient was discharged after 1 week which was followed by rapid re-accumulation of fluid and rehospitalization about 10 days after discharge. The patient passed away a few weeks after the second admission. Pleural effusion carries a differential diagnosis which may include malignancy but is commonly thought to be less specific to multiple myeloma but should still remain in the differential diagnosis. To our knowledge, this is the first case of myelomatous pleural effusion (MPE) that was reported after multiple relapses of MM. MPE is a very rare complication of MM, and its presence is a strong indicator of imminent mortality and need for comfort care in case of multiple relapses. End-stage pleural effusion in MM in the setting of proteasome inhibitor adds more therapeutic and diagnostic challenges.

  4. Urinary tract infection as a single presenting sign of multiple vaginal foreign bodies: case report and review of the literature.

    Neulander, Endre Z; Tiktinsky, Alex; Romanowsky, Igor; Kaneti, Jacob

    2010-02-01

    Vaginal foreign bodies in children usually present with foul-smelling discharge and/or vaginal bleeding. Rarely, these basic clinical diagnostic signs are not present. We report on a 5(1/2)-year-old girl with recurrent lower urinary tract infection as the sole presentation of multiple vaginal foreign bodies. Ultrasound of the lower urinary tract was inconclusive, and cystography indicated for recurrent urinary tract infections was declined by the patient in an outpatient setting. Cystography under general anesthesia raised the suspicion of foreign vaginal objects, and the definitive diagnosis was made by vaginoscopy. The relevant literature covering this subject is reviewed. High level of suspicion and strict basic diagnostic protocol are the most important steps for a timely diagnosis of this condition. Copyright 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  5. Delayed ethylene glycol poisoning presenting with abdominal pain and multiple cranial and peripheral neuropathies: a case report

    Sran Hersharan

    2010-07-01

    Full Text Available Abstract Introduction Ethylene glycol poisoning may pose diagnostic difficulties if the history of ingestion is not volunteered, or if the presentation is delayed. This is because the biochemical features of high anion-gap metabolic acidosis and an osmolar gap resolve within 24 to 72 hours as the ethylene glycol is metabolized to toxic metabolites. This case illustrates the less well-known clinical features of delayed ethylene glycol poisoning, including multiple cranial and peripheral neuropathies, and the clinical findings which may point towards this diagnosis in the absence of a history of ingestion. Case presentation A 53-year-old Afro-Caribbean man presented with vomiting, abdominal pain and oliguria, and was found to have acute renal failure requiring emergency hemofiltration, and raised inflammatory markers. Computed tomography imaging of the abdomen revealed the appearance of bilateral pyelonephritis, however he failed to improve with broad-spectrum antibiotics, and subsequently developed multiple cranial neuropathies and increasing obtundation, necessitating intubation and ventilation. Computed tomography of the brain showed no focal lesions, and a lumbar puncture revealed a raised cerebrospinal fluid opening pressure and cyto-albuminological dissociation. Nerve conduction studies revealed a sensorimotor radiculoneuropathy mimicking a Guillain-Barre type lesion with an atypical distribution. It was only about two weeks after presentation that the history of ethylene glycol ingestion one week before presentation was confirmed. He had a slow recovery on the intensive care unit, requiring renal replacement therapy for eight weeks, and complicated by acute respiratory distress syndrome, neuropathic pain and a slow neurological recovery requiring prolonged rehabilitation. Conclusions Although neuropathy as a result of ethylene glycol poisoning has been described in a few case reports, all of these were in the context of a known history of

  6. A rare case of multiple pituitary adenomas in an adolescent Cushing disease presenting as a vertebral compression fracture

    Ji-Yeon Song

    2017-09-01

    Full Text Available Cushing disease in children and adolescents, especially with multiple pituitary adenomas (MPAs, is very rare. We report 17-year-old boy with MPAs. He presented with a vertebral compression fracture, weight gain, short stature, headache, and hypertension. On magnetic resonance imaging (MRI, only a left pituitary microadenoma was found. After surgery, transient clinical improvement was observed but headache and hypertension were observed again after 3 months later. Follow-up MRI showed a newly developed right pituitary microadenoma 6 months after the surgery. The need for careful clinical and radiographic follow-up should be emphasized in the search for potential MPAs in patients with persistent Cushing disease.

  7. A rare case of multiple pituitary adenomas in an adolescent Cushing disease presenting as a vertebral compression fracture.

    Song, Ji-Yeon; Mun, Sue-Jean; Sung, Soon-Ki; Hwang, Jae-Yeon; Baik, Seung-Kug; Kim, Jee Yeon; Cheon, Chong-Kun; Kim, Su-Young; Kim, Yoo-Mi

    2017-09-01

    Cushing disease in children and adolescents, especially with multiple pituitary adenomas (MPAs), is very rare. We report 17-year-old boy with MPAs. He presented with a vertebral compression fracture, weight gain, short stature, headache, and hypertension. On magnetic resonance imaging (MRI), only a left pituitary microadenoma was found. After surgery, transient clinical improvement was observed but headache and hypertension were observed again after 3 months later. Follow-up MRI showed a newly developed right pituitary microadenoma 6 months after the surgery. The need for careful clinical and radiographic follow-up should be emphasized in the search for potential MPAs in patients with persistent Cushing disease.

  8. Value of Bone marrow Examination in Pyrexia of unknown origin

    A Jha

    2013-10-01

    Full Text Available Background: Pyrexia of unknown origin is a common diagnostic dilemma. Series of diagnostic modalities are required to arrive at diagnosis. Bone marrow examination is one of the common tests implicated in the diagnosis in combination with other diagnostic modalities. Present study has attempted to explore the causes of pyrexia of unknown origin based on bone marrow morphological study. Materials and Methods: In a one year prospective study conducted at Manipal Teaching Hospital, Pokhara, Nepal; bone marrow aspiration and biopsy was performed and evaluated morphologically, in 57 patients fulfilling the criteria of classic pyrexia of unknown origin. Results: In 42% cases; specific diagnosis could be made and hematological neoplasm was the most common finding followed by megaloblastic anemia, hypoplastic anemia and one case each of hemophagocytosis, malaria and tuberculosis. Acute leukemia was the most frequently encountered hematological malignancy followed by multiple myeloma, chronic myeloid leukemia, essential thrombocythemia and myelodysplastic syndrome. Conclusion: Morphological examination of bone marrow has important role in diagnosis of pyrexia of unknown origin. However, yield of diagnosis can be increased if it is combined with other diagnostic modalities including radiological, microbiological and serological tests. DOI: http://dx.doi.org/10.3126/jpn.v3i6.8991 Journal of Pathology of Nepal (2013 Vol. 3, 447-451

  9. The ALICE TPC, a high resolution device for ultra-high particle multiplicities. Past, present and future

    Ivanov, Marian [GSI Helmholtzzentrum fuer Schwerionenforschung GmbH (Germany); Collaboration: ALICE-Collaboration

    2015-07-01

    The Time Projection Chamber (TPC) of the ALICE apparatus is a large 3-dimensional tracking and particle identification device for ultra-high multiplicity collision events. It has been operated successfully at the Large Hadron Collider (LHC) at CERN, recording data from pp, p-Pb, and Pb-Pb collisions. Presently, LHC is in its first long shutdown (LS1), the next round of data taking will start in summer 2015 at or close to the LHC design energy and luminosity. During the second long shutdown (LS2), LHC will undergo a further increase in the Pb-Pb luminosity together with a major upgrade of ALICE. After the upgrade, the ALICE TPC will operate with Pb-Pb collisions at an interaction rate of 50 kHz. We present the performance in operation, calibration and reconstruction with the ALICE TPC together with ongoing work and plans for the near future and the coming 10 years.

  10. Abnormal uterine bleeding as a presenting symptom is related to multiple uterine leiomyoma: an ultrasound-based study

    Fonseca-Moutinho JA

    2013-10-01

    Full Text Available José Alberto Fonseca-Moutinho,1,2 Lígia Silva Barbosa,1 Daniel Gonçalves Torres,1 Sara Morgado Nunes31Faculty of Health Sciences, School of Medicine, Beira Interior University, Covilhã, Portugal; 2Child and Women Department, Cova da Beira Academic Medical Center, Covilhã, Portugal; 3Polytechnic Institute of Castelo Branco, Castelo Branco, PortugalPurpose: To determine the prevalence of uterine leiomyomas, diagnosed by ultrasound, in a private health care setting located in the central eastern region of Portugal, and to explore the demographic and clinical factors related to diagnosis and symptomatology.Patients and methods: The files of 624 patients attending a private clinic in Covilhã, Portugal, from January 2 to December 31, 2010 were retrieved for evaluation. Pelvic ultrasound record, age, weight, height, age at menarche, number of pregnancies and deliveries, marital status, menstrual cycles characteristic, and contraceptive method at consultation were included in the analysis.Results: Uterine leiomyoma (UL was diagnosed by ultrasonography in 161 (25.8% patients. A single UL was diagnosed in 80 (49.7% patients. In 79 (49.1% patients, the largest leiomyoma had a dimension <20 mm. Prevalence of UL was age dependent: at 11.0% for women 20–39 years old; 45.4% for those aged 40–59 years; and 19.5% for women 60 years or older. Metrorrhagia was the most distressing presenting symptom. When menorrhagia was the presenting symptom, the probability of having an ultrasound diagnosis of UL was 73.3%. Metrorrhagia or menorrhagia, as presenting symptom, was significantly related to the ultrasound diagnosis of multiple ULs.Conclusion: UL was especially prevalent in women aged between 40 and 59 years. Patients with multiple ULs had significantly more abnormal uterine bleeding. In patients with menorrhagia or metrorrhagia, special attention should be taken in searching for the presence of multiple ULs during ultrasound.Keywords: fibroid, leiomyoma

  11. Neonatal Acute Megakaryoblastic Leukemia Presenting with Leukemia Cutis and Multiple Intracranial Lesions Successfully Treated with Unrelated Cord Blood Transplantation

    Hiroshi Tsujimoto

    2015-01-01

    Full Text Available Neonatal acute megakaryoblastic leukemia (AMKL without Down syndrome (DS is an extremely rare disorder. We report of a one-day-old male infant without DS who developed AMKL with leukemia cutis and right facial nerve palsy. Magnetic resonance imaging of the patient’s brain revealed multiple intracranial tumors. A biopsy specimen of the skin lesion was suggestive of AMKL, but the bone marrow leukemic cells were less than 5% of the marrow nucleated cells. The skin and intracranial lesions had spontaneously regressed within one and a half months, but the patient’s anemia and thrombocytopenia gradually worsened and the leukemic cells in the bone marrow gradually increased to more than 20% of the nucleated cells. In addition, multiple intracranial lesions reappeared at 72 days of life. We diagnosed the patient with AMKL, and chemotherapy followed by unrelated cord blood transplantation after a reduced-intensity conditioning regimen resulted in sustained complete remission. At present, the patient is well, and he has demonstrated normal development for five years.

  12. Unknown foundation determination for scour.

    2012-04-01

    Unknown foundations affect about 9,000 bridges in Texas. For bridges over rivers, this creates a problem : regarding scour decisions as the calculated scour depth cannot be compared to the foundation depth, and a : very conservative costly approach m...

  13. Presenting evidence-based health information for people with multiple sclerosis: the IN-DEEP project protocol.

    Hill, Sophie; Filippini, Graziella; Synnot, Anneliese; Summers, Michael; Beecher, Deirdre; Colombo, Cinzia; Mosconi, Paola; Battaglia, Mario A; Shapland, Sue; Osborne, Richard H; Hawkins, Melanie

    2012-03-16

    Increasingly, evidence-based health information, in particular evidence from systematic reviews, is being made available to lay audiences, in addition to health professionals. Research efforts have focused on different formats for the lay presentation of health information. However, there is a paucity of data on how patients integrate evidence-based health information with other factors such as their preferences for information and experiences with information-seeking. The aim of this project is to explore how people with multiple sclerosis (MS) integrate health information with their needs, experiences, preferences and values and how these factors can be incorporated into an online resource of evidence-based health information provision for people with MS and their families. This project is an Australian-Italian collaboration between researchers, MS societies and people with MS. Using a four-stage mixed methods design, a model will be developed for presenting evidence-based health information on the Internet for people with MS and their families. This evidence-based health information will draw upon systematic reviews of MS interventions from The Cochrane Library. Each stage of the project will build on the last. After conducting focus groups with people with MS and their family members (Stage 1), we will develop a model for summarising and presenting Cochrane MS reviews that is integrated with supporting information to aid understanding and decision making. This will be reviewed and finalised with people with MS, family members, health professionals and MS Society staff (Stage 2), before being uploaded to the Internet and evaluated (Stages 3 and 4). This project aims to produce accessible and meaningful evidence-based health information about MS for use in the varied decision making and management situations people encounter in everyday life. It is expected that the findings will be relevant to broader efforts to provide evidence-based health information for

  14. Multifocal chronic osteomyelitis of unknown etiology

    Kozlowski, K.; Masel, J.; Harbison, S.; Yu, J.; Royal Brisbane Children Hospital; Regional Hospital Bowral

    1983-01-01

    Five cases of chronic, inflammatory, multifocal bone lesions of unknown etiology are reported. Although bone biopsy confirmed osteomyelitis in each case in none of them were organisms found inspite of an extensive work up. Different clinical course of the disease reflects different aetiology in respective cases. These cases present changing aspects of osteomyelitis emerging since introduction of antibiotics. (orig.)

  15. Navigating the Complexity of Socio-scientific Controversies—How Students Make Multiple Voices Present in Discourse

    Solli, Anne; Hillman, Thomas; Mäkitalo, Åsa

    2017-10-01

    In this article, we argue that students' unfolding discourse on socio-scientific issues (SSI) can be fruitfully analyzed by using dialogical theories of language and communication (Bakhtin 1986; Linell 2009). While research in science education often reports on how individual reasoning changes when bringing SSI into the classroom, we argue for the relevance of analyzing how the individual is "in dialogue" with present as well as remote interlocutors and contexts on the internet. We suggest that the analytical approach is particularly sensitized to illuminate how students' handle multiple perspectives. A dialogical perspective takes as its premise that SSI are part of society, where politicians, interest groups, and scientists engage in debates and offer perspectives that are often in conflict. Rather than assuming that the individual student is the primary unit for analysis, a dialogical approach is premised on an analysis that incorporates several perspectives and voices—a multivocality that also resides with the individual. Arguing for the relevance of this analytical approach to studies of SSI in the classroom, we analyze a group of students in upper secondary school as they discuss hydraulic fracturing after having worked with online data. The results illuminate how students discursively manage multivocality and multimodality inherent in the following SSI online. We describe a set of discursive means that the students use to handle the many perspectives involved when communicating about the issue. In addition, we describe and articulate what kind of communicative competences that are involved and, hence, could be cultivated through education, when engaging in public debates.

  16. PROLONGED MULTIPLE SPASMS OF SMOOTH CORONARY ARTERIES PRESENTING AS ACUTE MIOCARDIAL INFARCTION, COMPLETE AV BLOCK AND SYNCOPE

    Franci Cesar

    2004-11-01

    Full Text Available Background. A variant form of angina pectoris (VAP is caused by coronary vessel spasm and occures in patients with and without varying degrees of obstructive coronary artery disease. Although the prognosis of VAP without significant organic stenosis is generally good, multivessel spasm is associated with a high risk of life-threatening abnormalities of rhythm and conduction.Patient and methods. We describe a patient who presented with prolonged chest pain, associated with hypotension, lost of consciousness, complete AV block and widespread ST segment elevations consistent with inferoanterior acute myocardial infarction. Urgent selective coronary angiography revealed spasms in right coronary artery and in left circumflex artery that were relieved by intracoronary injection of nitroglycerin. All coronary arteries were otherwise patient, without signs of atherosclerosis. The patient was treated with diltiazem and nitrates. She made a complete recovery and resumed her normal activities.Conclusions. Simultaneous multiple spasms of native coronary arteries represent a rare syndrome characterized by significantly higher incidence of potentially life-threatening arrhythmia. Less commonly, prolonged coronary spasm may mimic acute myocardial infarction. Modern management of acute coronary syndromes, including urgent coronarography, enables a prompt differentiation between prolonged coronary spasm and atherosclerotic coronary disease, warranting different treatment strategies. Medical treatment with nitrates and calcium channel blockers in most cases prevents recurrence of vasospasms and arrhythmias.

  17. Soil-Transmitted Helminth Eggs Are Present in Soil at Multiple Locations within Households in Rural Kenya.

    Lauren Steinbaum

    Full Text Available Almost one-quarter of the world's population is infected with soil-transmitted helminths (STH. We conducted a study to determine the prevalence and location of STH-Ascaris, Trichuris, and hookworm spp.-egg contamination in soil within rural household plots in Kenya. Field staff collected soil samples from July to September 2014 from the house entrance and the latrine entrance of households in Kakamega County; additional spatial sampling was conducted at a subset of households (N = 22 samples from 3 households. We analyzed soil samples using a modified version of the US Environmental Protection Agency (EPA method for enumerating Ascaris in biosolids. We found 26.8% of households had one or more species of STH eggs present in the soil in at least one household location (n = 18 out of 67 households, and Ascaris was the most commonly detected STH (19.4%, n = 13 out of 67 households. Prevalence of STH eggs in soil was equally likely at the house entrance (19.4%, N = 67 as at the latrine entrance (11.3%, N = 62 (p = 0.41. We also detected STH eggs at bathing and food preparation areas in the three houses revisited for additional spatial sampling, indicating STH exposure can occur at multiple sites within a household plot, not just near the latrine. The highest concentration of eggs in one house occurred in the child's play area. Our findings suggest interventions to limit child exposure to household soil could complement other STH control strategies.

  18. Clinical presentation of multiple cerebral emboli and central retinal artery occlusion (CRAO as signs of cardiac myxoma

    Alberto Galvez-Ruiz

    2018-04-01

    Full Text Available Cardiac myxomas are benign tumors of endocardial origin that usually occur in the left atrium. Trans-thoracic echocardiography is the diagnostic method of choice, and early surgical removal is the preferred method of treatment.We present a patient whose history of cerebral emboli and central retinal artery occlusion (CRAO led to a diagnosis of cardiac myxoma.Neuroimaging studies showed multiple infarcts in the region of the left middle and anterior cerebral arteries. Ophthalmic examination showed gross retinal pallor compatible with left central retinal artery occlusion (CRAO.The etiology of stroke was investigated by performing trans-thoracic echocardiography, which showed a mass in the left atrium compatible with cardiac myxoma. Complete removal of the cardiac tumor was performed by open-heart surgery.Fortunately, after a period of rehabilitation, the patient’s hemiparesis almost completely resolved, but the loss of vision OS remained unchanged.Many cases of myxoma are accompanied by constitutional symptoms, such as anemia, fever and weight loss, which allow for a diagnosis to made before serious complications such as embolism occur. Unfortunately, in some patients, such as ours, the absence of signs and symptoms allows the myxoma to pass completely unnoticed until the first embolic event occurs. Keywords: Cardiac myxoma, Central retinal artery occlusion, Cerebral emboli, Amaurosis

  19. Allocating monitoring effort in the face of unknown unknowns

    Wintle, B.A.; Runge, M.C.; Bekessy, S.A.

    2010-01-01

    There is a growing view that to make efficient use of resources, ecological monitoring should be hypothesis-driven and targeted to address specific management questions. 'Targeted' monitoring has been contrasted with other approaches in which a range of quantities are monitored in case they exhibit an alarming trend or provide ad hoc ecological insights. The second form of monitoring, described as surveillance, has been criticized because it does not usually aim to discern between competing hypotheses, and its benefits are harder to identify a priori. The alternative view is that the existence of surveillance data may enable rapid corroboration of emerging hypotheses or help to detect important 'unknown unknowns' that, if undetected, could lead to catastrophic outcomes or missed opportunities. We derive a model to evaluate and compare the efficiency of investments in surveillance and targeted monitoring. We find that a decision to invest in surveillance monitoring may be defensible if: (1) the surveillance design is more likely to discover or corroborate previously unknown phenomena than a targeted design and (2) the expected benefits (or avoided costs) arising from discovery are substantially higher than those arising from a well-planned targeted design. Our examination highlights the importance of being explicit about the objectives, costs and expected benefits of monitoring in a decision analytic framework. ?? 2010 Blackwell Publishing Ltd/CNRS.

  20. Presenting evidence-based health information for people with multiple sclerosis: the IN-DEEP project protocol

    Hill Sophie

    2012-03-01

    Full Text Available Abstract Background Increasingly, evidence-based health information, in particular evidence from systematic reviews, is being made available to lay audiences, in addition to health professionals. Research efforts have focused on different formats for the lay presentation of health information. However, there is a paucity of data on how patients integrate evidence-based health information with other factors such as their preferences for information and experiences with information-seeking. The aim of this project is to explore how people with multiple sclerosis (MS integrate health information with their needs, experiences, preferences and values and how these factors can be incorporated into an online resource of evidence-based health information provision for people with MS and their families. Methods This project is an Australian-Italian collaboration between researchers, MS societies and people with MS. Using a four-stage mixed methods design, a model will be developed for presenting evidence-based health information on the Internet for people with MS and their families. This evidence-based health information will draw upon systematic reviews of MS interventions from The Cochrane Library. Each stage of the project will build on the last. After conducting focus groups with people with MS and their family members (Stage 1, we will develop a model for summarising and presenting Cochrane MS reviews that is integrated with supporting information to aid understanding and decision making. This will be reviewed and finalised with people with MS, family members, health professionals and MS Society staff (Stage 2, before being uploaded to the Internet and evaluated (Stages 3 and 4. Discussion This project aims to produce accessible and meaningful evidence-based health information about MS for use in the varied decision making and management situations people encounter in everyday life. It is expected that the findings will be relevant to broader

  1. Contrast-enhanced ultrasound and computed tomography findings of granulomatosis with polyangiitis presenting with multiple intrarenal microaneurysms: A case report.

    Kim, Youe Ree; Lee, Young Hwan; Lee, Jong-Ho; Yoon, Kwon-Ha

    Granulomatosis with polyangiitis (GPA) is a systemic disorder that affects small- and medium- sized vessels in many organs. Although the kidneys are the second most commonly involved organ in patients with GPA, its manifestation as multiple intrarenal aneurysms is rare. We report an unusual manifestation of GPA with multiple intrarenal microaneurysms, as demonstrated by contrast-enhanced ultrasound and computed tomography. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Financial Development and Economic Growth: Known Knowns, Known Unknowns, and Unknown Unknowns

    Ugo Panizza

    2014-01-01

    This paper summarizes the main findings of the literature on the relationship between financial and economic development (the known knowns), points to directions for future research (the known unknowns), and then speculates on the third Rumsfeldian category. The known knowns section organizes the empirical literature on finance and growth into three strands: (i) the traditional literature which established the link between finance and growth; (ii) the new literature which qualified some of th...

  3. Epstein-Barr virus is present in the brain of most cases of multiple sclerosis and may engage more than just B cells

    Hassani, Asma; Corboy, John R.; Al-Salam, Suhail

    2018-01-01

    Multiple sclerosis (MS) is a chronic neuroinflammatory condition of the central nervous system (CNS). It is a major cause of neurological disability in young adults, particularly women. What triggers the destruction of myelin sheaths covering nerve fibres is unknown. Both genetic and infectious agents have been implicated. Of the infectious agents, Epstein-Barr virus (EBV), a common herpesvirus, has the strongest epidemiological and serological evidence. However, the presence of EBV in the CNS and demonstration of the underlying mechanism(s) linking EBV to the pathogenesis of MS remain to be elucidated. We aimed at understanding the contribution of EBV infection in the pathology of MS. We examined 1055 specimens (440 DNA samples and 615 brain tissues) from 101 MS and 21 non-MS cases for the presence of EBV using PCR and EBER-in situ hybridization (EBER-ISH). EBV was detected by PCR and/or EBER-ISH in 91/101 (90%) of MS cases compared to only 5/21 (24%) of non-MS cases with other neuropathologies. None of the samples were PCR positive for other common herpesviruses (HSV-1, CMV, HHV-6). By quantitative PCR, EBV viral load in MS brain was mainly low to moderate in most cases. However, in 18/101 (18%) of MS cases, widespread but scattered presence of EBV infected cells was noted in the affected tissues by EBER-ISH. Immunohistochemical analysis of EBV gene expression in the 18 heavily infected cases, revealed that the EBV latent protein EBNA1, and to a lesser extent the early lytic protein BZLF1 were expressed. Furthermore, using double-staining we show for the first time that astrocytes and microglia, in addition to B-cells can also be infected. To the best of our knowledge, this is the most comprehensive study demonstrating that EBV is present and transcriptionally active in the brain of most cases of MS and supports a role for the virus in MS pathogenesis. Further studies are required to address the mechanism of EBV involvement in MS pathology. PMID:29394264

  4. Multiple Salivary Cortisol Measurements Are a Useful Tool to Optimize Metyrapone Treatment in Patients with Cushing's Syndromes Treatment: Case Presentations.

    Yoshida, Kenichi; Fukuoka, Hidenori; Odake, Yukiko; Nakajima, Shinsuke; Tachibana, Mariko; Ito, Jun; Hosokawa, Yusei; Yamada, Tomoko; Miura, Hiroshi; Suematsu, Natsu; Matsumoto, Ryusaku; Bando, Hironori; Suda, Kentaro; Nishizawa, Hitoshi; Iguchi, Genzo; Ogawa, Wataru; Takahashi, Yutaka

    2017-01-01

    Measuring salivary cortisol is both convenient and non-invasive for patients; however, its usefulness as a marker for monitoring medical therapy has not yet been established. The aim of this study was to assess the utility of multiple salivary cortisol measurements in patients with Cushing's syndrome (CS) during medical therapy. Six patients with CS (three with cortisol-secreting adrenocortical adenoma and three with ACTH-secreting pituitary adenoma) were recruited. Samples for morning serum cortisol, urinary free cortisol (UFC), and multiple salivary cortisol levels were collected before and during metyrapone treatment. The area under the curve (AUC) and mean value (MV) of daily salivary cortisol levels were calculated. In five out of six patients, UFC were normalized; however, multiple salivary cortisol measurements revealed an impaired diurnal cortisol rhythm in these patients. To verify the usefulness of multiple salivary cortisol measurements, we performed a prospective case study of a patient in whom the excess secretion of cortisol was not controlled (UFC 211 μg/day) with 2,250 mg/day in four divided doses of metyrapone. Multiple measurements of salivary cortisol revealed that cortisol levels elevated before the next administration. Accordingly, we shortened the interval by increasing the number of administration from four to five times per day, with a slight increment of daily dose of 2,500 mg. These optimizations resulted in a drastic improvement of diurnal pattern as well as UFC level (101 μg/day). Changes in both the MV and AUC of salivary cortisol levels were more correlated with those in UFC levels (Correlation coefficient 0.75, p  = 0.007, and 0.70, p  = 0.017) than those in the morning serum cortisol levels (0.42, p  = 0.200), indicating that multiple salivary cortisol measurements reflect more precisely the excess secretion of cortisol. Our preliminary data suggest that multiple salivary cortisol measurements can be a useful

  5. Autonomous Flight in Unknown Indoor Environments

    Bachrach, Abraham Galton; He, Ruijie; Roy, Nicholas

    2009-01-01

    This paper presents our solution for enabling a quadrotor helicopter, equipped with a laser rangefinder sensor, to autonomously explore and map unstructured and unknown indoor environments. While these capabilities are already commodities on ground vehicles, air vehicles seeking the same performance face unique challenges. In this paper, we describe the difficulties in achieving fully autonomous helicopter flight, highlighting the differences between ground and helicopter robots that make it ...

  6. Neurological autoantibodies in drug-resistant epilepsy of unknown cause.

    Tecellioglu, Mehmet; Kamisli, Ozden; Kamisli, Suat; Yucel, Fatma Ebru; Ozcan, Cemal

    2018-03-09

    Autoimmune epilepsy is a rarely diagnosed condition. Recognition of the underlying autoimmune condition is important, as these patients can be resistant to antiepileptic drugs. To determine the autoimmune and oncological antibodies in adult drug-resistant epilepsy of unknown cause and identify the clinical, radiological, and EEG findings associated with these antibodies according to data in the literature. Eighty-two patients with drug-resistant epilepsy of unknown cause were prospectively identified. Clinical features were recorded. The levels of anti-voltage-gated potassium channel complex (anti-VGKCc), anti-thyroid peroxidase (anti-TPO), anti-nuclear antibody (ANA), anti-glutamic acid decarboxylase (anti-GAD), anti-phospholipid IgG and IgM, anti-cardiolipin IgG and IgM, and onconeural antibodies were determined. Serum antibody positivity suggesting the potential role of autoimmunity in the aetiology was present in 17 patients with resistant epilepsy (22.0%). Multiple antibodies were found in two patients (2.6%). One of these patients (1.3%) had anti-VGKCc and ANA, whereas another (1.3%) had anti-VGKCc and anti-TPO. A single antibody was present in 15 patients (19.5%). Of the 77 patients finally included in the study, 4 had anti-TPO (5.2%), 1 had anti-GAD (1.3%), 4 had anti-VGKCc (5.2%) 8 had ANA (10.3%), and 2 had onconeural antibodies (2.6%) (1 patient had anti-Yo and 1 had anti-MA2/TA). The other antibodies investigated were not detected. EEG abnormality (focal), focal seizure incidence, and frequent seizures were more common in antibody-positive patients. Autoimmune factors may be aetiologically relevant in patients with drug-resistant epilepsy of unknown cause, especially if focal seizures are present together with focal EEG abnormality and frequent seizures.

  7. [Focal myositis: An unknown disease].

    Gallay, L; Streichenberger, N; Benveniste, O; Allenbach, Y

    2017-10-01

    Focal myositis are inflammatory muscle diseases of unknown origin. At the opposite from the other idiopathic inflammatory myopathies, they are restricted to a single muscle or to a muscle group. They are not associated with extramuscular manifestations, and they have a good prognosis without any treatment. They are characterized by a localized swelling affecting mostly lower limbs. The pseudo-tumor can be painful, but is not associated with a muscle weakness. Creatine kinase level is normal. Muscle MRI shows an inflammation restricted to a muscle or a muscle group. Muscle biopsy and pathological analysis remain necessary for the diagnosis, showing inflammatory infiltrates composed by macrophages and lymphocytes without any specific distribution within the muscle. Focal overexpression of HLA-1 by the muscle fibers is frequently observed. The muscle biopsy permits to rule out differential diagnosis such a malignancy (sarcoma). Spontaneous remission occurs within weeks or months after the first symptoms, relapse is unusual. Copyright © 2017. Published by Elsevier SAS.

  8. Previously unknown species of Aspergillus.

    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

  9. Non-marfan idiopathic medionecrosis (cystic medial necrosis) presenting with multiple visceral artery aneurysms and diffuse connective tissue fragility: Two brothers

    Kubota, Jun [Gunma University School of Medicine, Department of Nuclear Medicine (Japan); Tsunemura, Mami [Gunma University School of Medicine, Department of Diagnostic Radiology (Japan); Amano, Shigeko [Gunma University School of Medicine, Department of Nuclear Medicine (Japan); Tokizawa, Shigemi [Gunma University School of Medicine, Department of Hygiene and Virology (Japan); Oowada, Susumu [Gunma University School of Medicine, Department of Second Surgery (Japan); Shinkai, Hiroko [Gunma Health Foundation (Japan); Maehara, Yasunobu [Gunma University School of Medicine, Department of Diagnostic Radiology (Japan); Endo, Keigo [Gunma University School of Medicine, Department of Nuclear Medicine (Japan)

    1997-05-15

    Two brothers with multiple visceral artery aneurysms or dilatations and diffuse connective tissue fragility who did not have clinical features of Marfan syndrome are reported. One presented with retroperitoneal hemorrhage during angiography, and idiopathic medionecrosis was proved by resection of the aneurysms. These cases belong to the heterogeneous group of Marfan syndrome. The angiographical features (multiple dilation of visceral arteries) suggests fragility of connective tissue and is predictive of hazards during and after a catheterization and operation.

  10. Non-marfan idiopathic medionecrosis (cystic medial necrosis) presenting with multiple visceral artery aneurysms and diffuse connective tissue fragility: Two brothers

    Kubota, Jun; Tsunemura, Mami; Amano, Shigeko; Tokizawa, Shigemi; Oowada, Susumu; Shinkai, Hiroko; Maehara, Yasunobu; Endo, Keigo

    1997-01-01

    Two brothers with multiple visceral artery aneurysms or dilatations and diffuse connective tissue fragility who did not have clinical features of Marfan syndrome are reported. One presented with retroperitoneal hemorrhage during angiography, and idiopathic medionecrosis was proved by resection of the aneurysms. These cases belong to the heterogeneous group of Marfan syndrome. The angiographical features (multiple dilation of visceral arteries) suggests fragility of connective tissue and is predictive of hazards during and after a catheterization and operation

  11. Effects of using presentation formats that accommodate the learner's multiple intelligences on the learning of freshman college chemistry concepts

    Brown Wright, Gloria Aileen

    Howard Gardner's Theory of Multiple Intelligences identifies linguistic, spatial and logical-mathematical intelligences as necessary for learning in the physical sciences. He has identified nine intelligences which all persons possess to varying degrees, and says that learning is most effective when learners receive information in formats that correspond to their intelligence strengths. This research investigated the importance of the multiple intelligences of students in first-year college chemistry to the learning of chemistry concepts. At three pre-selected intervals during the first-semester course each participant received a tutorial on a chemistry topic, each time in a format corresponding to a different one of the three intelligences, just before the concept was introduced by the class lecturer. At the end of the experiment all subjects had experienced each of the three topics once and each format once, after which they were administered a validated instrument to measure their relative strengths in these three intelligences. The difference between a pre- and post-tutorial quiz administered on each occasion was used as a measure of learning. Most subjects were found to have similar strengths in the three intelligences and to benefit from the tutorials regardless of format. Where a difference in the extent of benefit occurred the difference was related to the chemistry concept. Data which indicate that students' preferences support these findings are also included and recommendations for extending this research to other intelligences are made.

  12. Natural Attenuation of Chlorinated Solvents Performance and Cost Results from Multiple Air Force Demonstration Sites, Technology Demonstration Slide Presentation

    Wiedemeier, Todd

    1999-01-01

    This slide presentation summarizes the results of natural attenuation treatability studies at 14 Air Force sites contaminated with chlorinated solvents and their associated biodegradation daughter products...

  13. Cerebriform intradermal nevus presenting as cutis verticis gyrata with multiple cellular blue nevus over the body: A rare occurrence

    Somenath Sarkar

    2014-01-01

    Full Text Available Cutis verticis gyrata is a rare skin condition characterized by swelling of scalp resembling the surface of the brain. Various conditions, like cerebriform intradermal nevus (CIN, may give rise to this clinical entity. Moreover, its association with cellular blue nevus is extremely rare and has not been reported so far. Here, we report a 28-year-old male with a huge cerebriform swelling covering the occipital lobe along with multiple nodules all over the body. Histology of the scalp swelling showed solitary or clusters of nevus cells in the dermis and from the body lesions showed features of cellular blue nevus. The diagnosis of CIN with cellular blue nevus was confirmed

  14. Determination of the origin of unknown irradiated nuclear fuel.

    Nicolaou, G

    2006-01-01

    An isotopic fingerprinting method is presented to determine the origin of unknown nuclear material with forensic importance. Spent nuclear fuel of known origin has been considered as the 'unknown' nuclear material in order to demonstrate the method and verify its prediction capabilities. The method compares, using factor analysis, the measured U, Pu isotopic compositions of the 'unknown' material with U, Pu isotopic compositions simulating well known spent fuels from a range of commercial nuclear power stations. Then, the 'unknown' fuel has the same origin as the commercial fuel with which it exhibits the highest similarity in U, Pu compositions.

  15. Determination of the origin of unknown irradiated nuclear fuel

    Nicolaou, G.

    2006-01-01

    An isotopic fingerprinting method is presented to determine the origin of unknown nuclear material with forensic importance. Spent nuclear fuel of known origin has been considered as the 'unknown' nuclear material in order to demonstrate the method and verify its prediction capabilities. The method compares, using factor analysis, the measured U, Pu isotopic compositions of the 'unknown' material with U, Pu isotopic compositions simulating well known spent fuels from a range of commercial nuclear power stations. Then, the 'unknown' fuel has the same origin as the commercial fuel with which it exhibits the highest similarity in U, Pu compositions

  16. Case study of conservation and community concerns for present and future multiple use of the Great Australian Bight

    Flaherty, T. [Marine and Coastal Community Network, Henley Beach, SA (Australia)

    1996-12-31

    As part of the Australian National Strategy for ecologically sustainable development, State and Federal Governments have agreed to cooperate on action under the Ocean Rescue 2000 Program to develop a national representative system of Marine Protected Areas. As a component of this program an area of the Great Australian Bight has been the focus of a proposal for a large area multiple use marine park. Within the context of this workshop, however, the conservation and community considerations extend beyond this proposed area. There is a need for resolution of apparent and real conflict with conservation, fishing, tourism and mining objectives in the development of equitable policies in establishing a marine protected area for the significant region. In this paper current activities in the Great Australian Bight, conservation values and concerns, fisheries and conservation, and fisheries and potential conflict with future petroleum exploitation, are discussed. The marine animals of the area are outlined, and community conservation concerns are detailed. It is concluded that there is an increasing need for States to develop a strategic approach to marine management. The adoption of marine bio-regionalisation methodology to define areas of significant biodiversity, representative marine protected areas and the development of a marine conservation and management strategy can be seen as essential components in the management of the marine environment. (author). refs.

  17. A Rare Bilateral Presentation of Multiple Dens Invaginatus, Shovel-Shaped Incisor and Talon Cusp With Mesiodens.

    Hegde, S; Jain, M; Shubha, A B

    2014-01-01

    The aim of this paper is to describe a unique and unusual case of concomitant appearance of morphological dental anomalies in the maxillary anterior region, along with its management in a patient with no systemic abnormality. This case report describes the clinical and radiographic features of talon cusp, dens invaginatus, shovel-shaped incisors and a supernumerary tooth occurring in a single patient, which is a rare presentation. All 4 permanent maxillary incisors had dens invaginatus, the permanent maxillary canines showed the presence of talon cusps, the permanent maxillary central incisors were shovel-shaped and an erupted mesiodens was also observed. Treatment included restorative, surgical and orthodontic approaches.

  18. The many facets of climate change - Conference proceedings; Les multiples facettes du changement climatique - Recueil des presentations

    NONE

    2011-03-15

    This conference day on climate change was organized by the French meteorological society (SMF) at the Ecole Normale Superieure of Paris. This document brings together the available presentations given at the conference. Eight presentations (slides) are compiled in this document and deal with: 1 - Climate change today and tomorrow, the research stakes (Herve Le Treut, IPSL); 2 - Rise of sea levels: estimations and regional variability (Guy Woeppelmann, La Rochelle Univ.); 3 - Polar ice caps and continental cryo-sphere as seen from space (A. Kouraev, F. Remy, E. Berthier, LEGOS); 4 - Impacts of climate change on exploited marine populations: projections and uncertainties (Patrick Lehodey, CLS); 5 - Climate change stakes on agricultural and winery activities in France (Eric Duchene, INRA); 6 - Impacts of climate change on forest trees phenology and their consequences on trees life and survival (Francois Lebourgeois, ENGREF); 7 - Remote-epidemiology: a health-aid in a climate change context (Murielle Lafaye, CNES); 8 - Socio-economic aspects and adaptation: a climate history, for what? (Emmanuel Garnier, Caen Univ.)

  19. Quantifying the variability of financial disclosure information reported by authors presenting research at multiple sports medicine conferences.

    Jegede, Kolawole A; Ju, Brian; Miller, Christopher P; Whang, Peter; Grauer, Jonathan N

    2011-11-01

    In the study reported here, we compared self-reported industry relationships of authors who attended 3 major orthopedic sports medicine conferences during a single calendar year. Our goal was to calculate the variability between disclosure information over time. A significant percentage of authors who attended these meetings were inconsistent in submitting their disclosure information. In addition, most authors with irregularities had more than 1 discrepancy. We believe that the vast majority of the observed discrepancies did not result from intentional deception on the part of the authors but instead from ongoing confusion regarding which industry relationships should be acknowledged for particular meetings (some specialty societies require that all relationships be divulged, whereas others require only those affiliations directly applicable to research being presented). In the absence of a uniform disclosure policy that is widely adopted by many specialty societies, these findings suggest that the disclosure process will continue to be plagued by inconsistent reporting of financial conflicts of interest.

  20. [Energy drinks: an unknown risk].

    Petit, Aymeric; Levy, Fanny; Lejoyeux, Michel; Reynaud, Michel; Karila, Laurent

    2012-05-01

    The term "energy drink" designates "any product in the form of a drink or concentrated liquid, which claims to contain a mixture of ingredients having the property to raise the level of energy and vivacity". The main brands, Red Bull, Dark Dog, Rockstar, Burn, and Monster, are present in food stores, sports venues, and bars among other soft drinks and fruit juices. Their introduction into the French market raised many reluctances, because of the presence of taurine, caffeine and glucuronolactone. These components present in high concentrations, could be responsible for adverse effects on health. The association of energy drinks and spirits is widely found among adolescents and adults who justify drinking these mixed drinks by their desire to drink more alcohol while delaying drunkenness. Given the importance of the number of incidents reported among the energy drinks consumers, it seemed appropriate to make a synthesis of available data and to establish causal links between the use of these products and the development of health complications. For a literature review, we selected scientific articles both in English and French published between 2001 and 2011 by consulting the databases Medline, Embase, PsycINFO and Google Scholar. The words used alone or in combination are "energy dinks", "caffeine", "taurine", "toxicity", "dependence". An occasional to a moderate consumption of these drinks seems to present little risk for healthy adults. However, excessive consumption associated with the use of alcohol or drugs in amounts that far exceed the manufacturers recommended amount, could be responsible for negative consequences on health, particularly among subjects with cardiovascular disease.

  1. The unknowns in particles physics

    Spiro, M.

    1996-01-01

    The author presents the historical quest of particles since Democrite's time. Some particles are very difficult to identify as for instance neutrinos and antiparticles. Nine anti-hydrogen atoms have just being manufactured in the CERN. This successful result is the last episode of a long history. This achievement is the first step in the elaboration of antimatter too. The enigma of the antimatter created at the universe dawn is perennial. Why is the universe made of matter and not of antimatter? Is there any slight difference in the physical law of antimatter and matter? That's why the study of antimatter is so important. The question of the missing mass of our galaxy leads to another quest: the Higgs's particles. The graviton is another target. That could lead to the unification theory, may be another proof of the unreasonable efficiency of mathematics. (O.M.). 2 figs

  2. Greenhouse effect: doubts and unknowns

    Tabarelli, D.

    1992-01-01

    There are few doubts today in the scientific world that atmospheric carbon dioxide traps in heat and therefore contributes to global warming; however, it is yet uncertain as to whether the presence of this gas in the upper atmosphere is the only cause of the greenhouse effect, and the scientific theories defining the effect and its causes present a few obvious and significant gaps. This paper cites the fact that most greenhouse effect models only marginally, if at all, consider the mechanisms governing the formation and absorption of carbon dioxide by the earth's oceans; yet oceanic CO 2 concentration levels are about 60 times greater than those found in the atmosphere, and they depend on complex interactions, in seawater, among such factors as currents, carbon oxygenation, and vegetative activity. Another area of weakness in greenhouse effect modelling stems from the complexity and uncertainty introduced by the fact that, in addition to trapping heat, clouds reflect it, thus giving rise to an opposite cooling effect. In addition, it is pointed out that the current models are limited to predicting global and not regional or local effects

  3. The Unknown Component Problem Theory and Applications

    Villa, Tiziano; Brayton, Robert K; Mishchenko, Alan; Petrenko, Alexandre; Sangiovanni-Vincentelli, Alberto

    2012-01-01

    The Problem of the Unknown Component: Theory and Applications addresses the issue of designing a component that, combined with a known part of a system, conforms to an overall specification. The authors tackle this problem by solving abstract equations over a language. The most general solutions are studied when both synchronous and parallel composition operators are used. The abstract equations are specialized to languages associated with important classes of automata used for modeling systems. The book is a blend of theory and practice, which includes a description of a software package with applications to sequential synthesis of finite state machines. Specific topologies interconnecting the components, exact and heuristic techniques, and optimization scenarios are studied. Finally the scope is enlarged to domains like testing, supervisory control, game theory and synthesis for special omega languages. The authors present original results of the authors along with an overview of existing ones.

  4. The rank-heat plot is a novel way to present the results from a network meta-analysis including multiple outcomes.

    Veroniki, Areti Angeliki; Straus, Sharon E; Fyraridis, Alexandros; Tricco, Andrea C

    2016-08-01

    To present a novel and simple graphical approach to improve the presentation of the treatment ranking in a network meta-analysis (NMA) including multiple outcomes. NMA simultaneously compares many relevant interventions for a clinical condition from a network of trials, and allows ranking of the effectiveness and/or safety of each intervention. There are numerous ways to present the NMA results, which can challenge their interpretation by research users. The rank-heat plot is a novel graph that can be used to quickly recognize which interventions are most likely the best or worst interventions with respect to their effectiveness and/or safety for a single or multiple outcome(s) and may increase interpretability. Using empirical NMAs, we show that the need for a concise and informative presentation of results is imperative, particularly as the number of competing treatments and outcomes in an NMA increases. The rank-heat plot is an efficient way to present the results of ranking statistics, particularly when a large amount of data is available, and it is targeted to users from various backgrounds. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Twelve previously unknown phage genera are ubiquitous in global oceans.

    Holmfeldt, Karin; Solonenko, Natalie; Shah, Manesh; Corrier, Kristen; Riemann, Lasse; Verberkmoes, Nathan C; Sullivan, Matthew B

    2013-07-30

    Viruses are fundamental to ecosystems ranging from oceans to humans, yet our ability to study them is bottlenecked by the lack of ecologically relevant isolates, resulting in "unknowns" dominating culture-independent surveys. Here we present genomes from 31 phages infecting multiple strains of the aquatic bacterium Cellulophaga baltica (Bacteroidetes) to provide data for an underrepresented and environmentally abundant bacterial lineage. Comparative genomics delineated 12 phage groups that (i) each represent a new genus, and (ii) represent one novel and four well-known viral families. This diversity contrasts the few well-studied marine phage systems, but parallels the diversity of phages infecting human-associated bacteria. Although all 12 Cellulophaga phages represent new genera, the podoviruses and icosahedral, nontailed ssDNA phages were exceptional, with genomes up to twice as large as those previously observed for each phage type. Structural novelty was also substantial, requiring experimental phage proteomics to identify 83% of the structural proteins. The presence of uncommon nucleotide metabolism genes in four genera likely underscores the importance of scavenging nutrient-rich molecules as previously seen for phages in marine environments. Metagenomic recruitment analyses suggest that these particular Cellulophaga phages are rare and may represent a first glimpse into the phage side of the rare biosphere. However, these analyses also revealed that these phage genera are widespread, occurring in 94% of 137 investigated metagenomes. Together, this diverse and novel collection of phages identifies a small but ubiquitous fraction of unknown marine viral diversity and provides numerous environmentally relevant phage-host systems for experimental hypothesis testing.

  6. The unknown-unknowns: Revealing the hidden insights in massive biomedical data using combined artificial intelligence and knowledge networks

    Chris Yoo

    2017-12-01

    Full Text Available Genomic data is estimated to be doubling every seven months with over 2 trillion bases from whole genome sequence studies deposited in Genbank in just the last 15 years alone. Recent advances in compute and storage have enabled the use of artificial intelligence techniques in areas such as feature recognition in digital pathology and chemical synthesis for drug development. To apply A.I. productively to multidimensional data such as cellular processes and their dysregulation, the data must be transformed into a structured format, using prior knowledge to create contextual relationships and hierarchies upon which computational analysis can be performed. Here we present the organization of complex data into hypergraphs that facilitate the application of A.I. We provide an example use case of a hypergraph containing hundreds of biological data values and the results of several classes of A.I. algorithms applied in a popular compute cloud. While multiple, biologically insightful correlations between disease states, behavior, and molecular features were identified, the insights of scientific import were revealed only when exploration of the data included visualization of subgraphs of represented knowledge. The results suggest that while machine learning can identify known correlations and suggest testable ones, the greater probability of discovering unexpected relationships between seemingly independent variables (unknown-unknowns requires a context-aware system – hypergraphs that impart biological meaning in nodes and edges. We discuss the implications of a combined hypergraph-A.I. analysis approach to multidimensional data and the pre-processing requirements for such a system.

  7. Multiple Myeloma Presenting as Massive Amyloid Deposition in a Parathyroid Gland Associated with Amyloid Goiter: A Medullary Thyroid Carcinoma Mimic on Intra-operative Frozen Section.

    Hill, Kirk; Diaz, Jason; Hagemann, Ian S; Chernock, Rebecca D

    2018-06-01

    Clinical examples of amyloid deposition in parathyroid glands are exceedingly rare and usually present as an incidental finding in a patient with amyloid goiter. Here, we present the first histologically documented case of parathyroid amyloid deposition that presented as a mass. The patient did not have hyperparathyroidism. The parathyroid gland was submitted for intra-operative frozen section and concern for medullary thyroid carcinoma was raised. An important histologic clue arguing against medullary thyroid carcinoma was the evenly dispersed nature of the amyloid. Histologic perinuclear clearing and parathyroid hormone immunohistochemistry confirmed parathyroid origin on permanent sections. The patient was also found to have associated amyloid goiter. Mass spectrometry of the amyloid showed it to be composed of kappa light chains. On further work-up, the patient was diagnosed with multiple myeloma. Awareness of parathyroid amyloid deposition is important as it is a histologic mimic of medullary thyroid carcinoma, especially on frozen section. Amyloid typing with evaluation for multiple myeloma in any patient with kappa or lambda light chain restriction is also important.

  8. A personalized, intense physical rehabilitation program improves walking in people with multiple sclerosis presenting with different levels of disability: a retrospective cohort.

    Kalron, Alon; Nitzani, Dalia; Magalashvili, David; Dolev, Mark; Menascu, Shay; Stern, Yael; Rosenblum, Uri; Pasitselsky, Diana; Frid, Lior; Zeilig, Gabi; Barmatz, Caroline; Givon, Uri; Achiron, Anat

    2015-03-04

    People with multiple sclerosis (PwMS) endure walking limitations. To address this restriction, various physical rehabilitation programs have been implemented with no consensus regarding their efficacy. Our objective was to report on the efficacy of an integrated tailored physical rehabilitation program on walking in people with multiple sclerosis categorized according to their level of neurological disability. Retrospective data were examined and analyzed. Specifically, data obtained from all patients who participated in the Multiple Sclerosis Center's 3 week rehabilitation program were extracted for in depth exploration. The personalized rehabilitation program included three major components modified according to the patient's specific impairments and functional needs: (a) goal directed physical therapy (b) moderately intense aerobic exercise training on a bicycle ergometer and (c) aquatic therapy chiefly oriented to body structures appropriate to movement. Gait outcome measurements included the 10 meter, 20 meter, Timed up and go and 2 minute walking tests measured pre and post the rehabilitation program. Three hundred and twelve people with relapsing-remitting multiple sclerosis were included in the final analysis. Patients were categorized into mild (n = 87), moderate (n = 104) and severely (n = 121) disabled groups. All clinical walking outcome measurements demonstrated statistically significant improvements, however, only an increase in the 2 minute walking test was above the minimal clinical difference value. The moderate and severe groups considerably improved compared to the mild gait disability group. Mean change scores (%) of the pre-post intervention period of the 2 minute walking test were 19.0 (S.E. = 3.4) in the moderate group, 16.2 (S.E. = 5.4) in the severe group and 10.9 (S.E. = 2.3) in the mild gait disability group. We presented comprehensive evidence verifying the effects of an intense goal-directed physical

  9. PMS2 monoallelic mutation carriers: the known unknown.

    Goodenberger, McKinsey L; Thomas, Brittany C; Riegert-Johnson, Douglas; Boland, C Richard; Plon, Sharon E; Clendenning, Mark; Win, Aung Ko; Senter, Leigha; Lipkin, Steven M; Stadler, Zsofia K; Macrae, Finlay A; Lynch, Henry T; Weitzel, Jeffrey N; de la Chapelle, Albert; Syngal, Sapna; Lynch, Patrick; Parry, Susan; Jenkins, Mark A; Gallinger, Steven; Holter, Spring; Aronson, Melyssa; Newcomb, Polly A; Burnett, Terrilea; Le Marchand, Loïc; Pichurin, Pavel; Hampel, Heather; Terdiman, Jonathan P; Lu, Karen H; Thibodeau, Stephen; Lindor, Noralane M

    2016-01-01

    Germ-line mutations in MLH1, MSH2, MSH6, and PMS2 have been shown to cause Lynch syndrome. The penetrance of the cancer and tumor spectrum has been repeatedly studied, and multiple professional societies have proposed clinical management guidelines for affected individuals. Several studies have demonstrated a reduced penetrance for monoallelic carriers of PMS2 mutations compared with the other mismatch repair (MMR) genes, but clinical management guidelines have largely proposed the same screening recommendations for all MMR gene carriers. The authors considered whether enough evidence existed to propose new screening guidelines specific to PMS2 mutation carriers with regard to age at onset and frequency of colonic screening. Published reports of PMS2 germ-line mutations were combined with unpublished cases from the authors' research registries and clinical practices, and a discussion of potential modification of cancer screening guidelines was pursued. A total of 234 monoallelic PMS2 mutation carriers from 170 families were included. Approximately 8% of those with colorectal cancer (CRC) were diagnosed before age 30, and each of these tumors presented on the left side of the colon. As it is currently unknown what causes the early onset of CRC in some families with monoallelic PMS2 germline mutations, the authors recommend against reducing cancer surveillance guidelines in families found having monoallelic PMS2 mutations in spite of the reduced penetrance.Genet Med 18 1, 13-19.

  10. Autologous hematopoietic progenitor cell mobilization and collection in adult patients presenting with multiple myeloma and lymphoma: A position-statement from the Turkish Society of Apheresis (TSA).

    Tekgündüz, Emre; Arat, Mutlu; Göker, Hakan; Özdoğu, Hakan; Kaynar, Leylagül; Çağırgan, Seçkin; Erkurt, Mehmet Ali; Vural, Filiz; Kiki, İlhami; Altuntaş, Fevzi; Demirkan, Fatih

    2017-12-01

    Autologous hematopoietic cell transplantation (AHCT) is a routinely used procedure in the treatment of adult patients presenting with multiple myeloma (MM), Hodgkin lymphoma (HL) and various subtypes of non-Hodgkin lymphoma (NHL) in upfront and relapsed/refractory settings. Successful hematopoietic progenitor cell mobilization (HPCM) and collection are the rate limiting first steps for application of AHCT. In 2015, almost 1700 AHCT procedures have been performed for MM, HL and NHL in Turkey. Although there are recently published consensus guidelines addressing critical issues regarding autologous HPCM, there is a tremendous heterogeneity in terms of mobilization strategies of transplant centers across the world. In order to pave the way to a more standardized HPCM approach in Turkey, Turkish Society of Apheresis (TSA) assembled a working group consisting of experts in the field. Here we report the position statement of TSA regarding autologous HPCM mobilization strategies in adult patients presenting with MM and lymphoma. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. [The application of high-frequency and iTBS transcranial magnetic stimulation for the treatment of spasticity in the patients presenting with secondary progressive multiple sclerosis].

    Korzhova, J E; Chervyakov, A V; Poydasheva, A G; Kochergin, I A; Peresedova, A V; Zakharova, M N; Suponeva, N A; Chernikova, L A; Piradov, M A

    Spasticity is considered to be a common manifestation of multiple sclerosis. Muscle relaxants are not sufficiently effective; more than that, some of them often cause a variety of adverse reactions. Transcranial magnetic stimulation (TMS) can be a promising new tool for the treatment of spasticity. The objective of the present study was to compare the effectiveness of the two TMS protocols: rhythmic (high-frequency) TMS (rTMS) and stimulation with the theta bursts (iTBS) in terms of their ability to reduce spasticity in the patients presenting with multiple sclerosis. Twenty two patients with secondary-progressive multiple sclerosis were pseudo-randomized into two groups: those in the first (high-frequency) group received the treatment with the use of rTMS therapy at a frequency of 10 Hz; the patients of the second group, underwent stimulation with the theta bursts (iTBS). All the patients received 10 sessions of either stimulation applied to the primary motor area (M1) of both legs. The effectiveness of TMS protocols was evaluated before therapy and after 10 sessions of stimulation based on the Modified Ashworth scale (MAS), the expanded disability status scale (EDSS), and the Kurtzke functional scale (Kfs). In addition, the patients were interviewed before treatment, after 10 rTMS sessions, immediately after and within 2 and 12 weeks after the completion of the treatment using questionnaires for the evaluation of spasticity (SESS) , fatigue, and dysfunction of the pelvic organs (severity of defecation and urination disorders), fatigue. The study has demonstrated a significant reduction in spasticity in the patients of both groups at the end of the TMS protocol based on the MAS scale. There was no significant difference between the outcomes of the two protocols. Both had positive effect on the concomitant «non-motor» symptoms (fatigue, dysfunction of the pelvic organs). High-frequency transcranial magnetic stimulation (10 sessions of rTMS therapy at a frequency

  12. Quantum circuits cannot control unknown operations

    Araújo, Mateus; Feix, Adrien; Costa, Fabio; Brukner, Časlav

    2014-01-01

    One of the essential building blocks of classical computer programs is the ‘if’ clause, which executes a subroutine depending on the value of a control variable. Similarly, several quantum algorithms rely on applying a unitary operation conditioned on the state of a control system. Here we show that this control cannot be performed by a quantum circuit if the unitary is completely unknown. The task remains impossible even if we allow the control to be done modulo a global phase. However, this no-go theorem does not prevent implementing quantum control of unknown unitaries in practice, as any physical implementation of an unknown unitary provides additional information that makes the control possible. We then argue that one should extend the quantum circuit formalism to capture this possibility in a straightforward way. This is done by allowing unknown unitaries to be applied to subspaces and not only to subsystems. (paper)

  13. Multifocal, chronic osteomyelitis of unknown etiology

    Kozlowski, K.; Beluffi, G.; Feltham, C.; James, M.; Nespoli, L.; Tamaela, L.; Pavia Univ.; Municipal Hospital, Nelson; Medical School, Jakarta

    1985-01-01

    Four cases of multifocal osteomyelitis of unknown origin in childhood are reported. The variable clinical and radiographic appearances of the disease are illustrated and the diagnostic difficulties in the early stages of the disease are stressed. (orig.) [de

  14. Known Unknowns in Judgment and Choice

    Walters, Daniel

    2017-01-01

    This dissertation investigates how people make inferences about missing information. Whereas most prior literature focuses on how people process known information, I show that the extent to which people make inferences about missing information impacts judgments and choices. Specifically, I investigate how (1) awareness of known unknowns affects overconfidence in judgment in Chapter 1, (2) beliefs about the knowability of unknowns impacts investment strategies in Chapter 2, and (3) inferences...

  15. Mobile assistant for unknown caller identification

    Hribernik, Andraž

    2012-01-01

    The main motivation of this diploma thesis is a development of Android application, which helps user of application to find out who is the owner of unknown phone number. Data source for finding unknown phone number are free available web sources. Through the development of prototype, data from different web sources were integrated. Result of this integration is shown in Android application. Data integration includes access to semi-structured data on web portal of Phone Directory of Slovenia, ...

  16. Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET/CT) Findings in an Unusual Case of Multiple Myeloma Presenting with a Large Extra-Axial Intracranial Mass.

    Ayaz, Sevin; Ayaz, Ümit Yaşar

    2016-01-01

    We aimed to present unusual cranial FDG PET/CT findings of a 56-year-old female with multiple myeloma (MM). Plain CT images revealed a lytic lesion in the right parietal bone, filled with an oval-shaped, large, extra-axial, extradural, intracranial mass which measured 75×75×40 mm and had smooth borders. The right parietal lobe was compressed by the mass. The maximum standardized uptake value (SUV max ) of the mass lesion was 8.94 on FDG PET/CT images. Multiple lytic lesions with an increased uptake were also detected in other calvarial bones, in several vertebras and in the proximal left femur. After seven months, a control FDG PET/CT following radiotherapy and chemotherapy revealed almost complete regression of the right parietal extra-axial mass lesion. The number, size and metabolism of lytic lesions in other bones also decreased. FDG PET/CT was useful for an initial evaluation of MM lesions and was effective in monitoring the response of these lesions to therapy.

  17. Grasping Unknown Objects in an Early Cognitive Vision System

    Popovic, Mila

    2011-01-01

    Grasping of unknown objects presents an important and challenging part of robot manipulation. The growing area of service robotics depends upon the ability of robots to autonomously grasp and manipulate a wide range of objects in everyday environments. Simple, non task-specific grasps of unknown ...... and comparing vision-based grasping methods, and the creation of algorithms for bootstrapping a process of acquiring world understanding for artificial cognitive agents....... presents a system for robotic grasping of unknown objects us- ing stereo vision. Grasps are defined based on contour and surface information provided by the Early Cognitive Vision System, that organizes visual informa- tion into a biologically motivated hierarchical representation. The contributions...... of the thesis are: the extension of the Early Cognitive Vision representation with a new type of feature hierarchy in the texture domain, the definition and evaluation of contour based grasping methods, the definition and evaluation of surface based grasping methods, the definition of a benchmark for testing...

  18. Imaging in smoldering (asymptomatic) multiple myeloma. Past, present and future; Bildgebung bei ''smoldering'' (asymptomatischem) multiplem Myelom. Vergangenheit, Gegenwart und Zukunft

    Bhutani, M.; Landgren, O. [Center for Cancer Research, National Cancer Institute, National Institutes of Health, Multiple Myeloma Section, Lymphoid Malignancies Branch, Bethesda, MD (United States)

    2014-06-15

    Emerging clinical trial data support treatment of high-risk smoldering multiple myeloma (SMM) upon diagnosis, and not only at the time of progression to symptomatic complications (multiple myeloma). Early detection of bone and/or bone marrow involvement by sensitive imaging modalities may help define SMM patients at a high risk of progression. Current (2011) consensus guidelines recognize skeletal survey as a cornerstone modality for assessment of bone involvement at initial diagnosis and during follow-up of SMM. Skeletal survey has severe limitations related to underdetection of bone lesions and also provides no information on bone marrow abnormalities. Modern imaging strategies such as fluorodeoxyglucose positron-emission tomography/CT (FDG PET/CT) and MRI, in conjunction with functional innovations, provide improved estimates of global abnormalities in the bone marrow and bone compartments. These methods have the potential to objectively quantify early transformation from SMM to multiple myeloma. Although frequently used for staging and risk prognostication in multiple myeloma, modern imaging techniques have only been evaluated to a limited extent in SMM. Scant data in SMM indicate the prognostic value of two or more MRI-detected focal bone marrow abnormalities, which, if present, predict rapid progression to multiple myeloma. Data evaluating the role of FDG PET/CT in detecting early bone marrow abnormalities as an aid to predicting risk or directing treatment in SMM is currently lacking. The superior specificity and sensitivity of modern imaging techniques compared to skeletal survey suggest that these should have a place in standard practice management of patients at a high risk of SMM progression. The model imaging of the future should be an all-in-one strategy offering high diagnostic performance for bone marrow abnormalities and low-volume bone lesions, as well as allowing monitoring by minimizing radiation exposure and the need for contrast agents. Newer

  19. Protocol for counterfactually transporting an unknown qubit

    Hatim eSalih

    2016-01-01

    Full Text Available Quantum teleportation circumvents the uncertainty principle using dual channels: a quantum one consisting of previously-shared entanglement, and a classical one, together allowing the disembodied transport of an unknown quantum state over distance. It has recently been shown that a classical bit can be counterfactually communicated between two parties in empty space, Alice and Bob. Here, by using our dual version of the chained quantum Zeno effect to achieve a counterfactual CNOT gate, we propose a protocol for transporting an unknown qubit counterfactually, that is without any physical particles travelling between Alice and Bob—no classical channel and no previously-shared entanglement.

  20. Fault tolerant control of wind turbines using unknown input observers

    Odgaard, Peter Fogh; Stoustrup, Jakob

    2012-01-01

    This paper presents a scheme for accommodating faults in the rotor and generator speed sensors in a wind turbine. These measured values are important both for the wind turbine controller as well as the supervisory control of the wind turbine. The scheme is based on unknown input observers, which...

  1. Severe scratcher-reaction: an unknown health hazard?

    Carsten Sauer Mikkelsen

    2015-03-01

    Full Text Available Tattoos are well known to cause skin problems and the number of reported adverse reactions after tattooing has increased. Illegally imported tattoo ink is unrestrained and can contain unknown ingredients and contamination thereby posing a serious health hazard. We present a case illustrating the risk of pronounced phototoxic allergic reaction and other severe complications after using home kit tattoo ink.

  2. Scheme for teleportation of unknown states of trapped ion

    Chen Mei-Feng; Ma Song-She

    2008-01-01

    A scheme is presented for teleporting an unknown state in a trapped ion system.The scheme only requires a single laser beam.It allows the trap to be in any state with a few phonons,e.g.a thermal motion.Furthermore,it works in the regime,where the Rabi frequency of the laser is on the order of the trap frequency.Thus,the teleportation speed is greatly increased,which is important for decreasing the decoherence effect.This idea can also be used to teleport an unknown ionic entangled state.

  3. Prognostic value of high-field proton magnetic resonance spectroscopy in patients presenting with clinically isolated syndromes suggestive of multiple sclerosis

    Wattjes, Mike P. [University of Bonn, Department of Radiology/Neuroradiology, Bonn (Germany); VU University Medical Center, MS Center Amsterdam, Department of Radiology, Amsterdam (Netherlands); Harzheim, Michael; Schmidt, Stephan [University of Bonn, Department of Neurology, Bonn (Germany); Lutterbey, Goetz G.; Schild, Hans H.; Traeber, Frank [University of Bonn, Department of Radiology/Neuroradiology, Bonn (Germany); Bogdanow, Manuela [University of Bonn, Department of Medical Biometrics, Informatics and Epidemiology, Bonn (Germany)

    2008-02-15

    The aim of this study was to determine the prognostic value of metabolic alterations in the normal-appearing white matter (NAWM) of patients presenting with clinically isolated syndromes (CIS) suggestive of multiple sclerosis (MS) with special regard to the prediction of conversion to definite MS. Using a 3T whole-body MR system, a multisequence conventional MRI protocol and single-voxel proton MR spectroscopy (PRESS, repetition time 2000 ms, echo times 38 ms and 140 ms) of the parietal NAWM were performed in 25 patients presenting with CIS at baseline and in 20 controls. Absolute concentrations of N-acetyl-aspartate (tNAA), myo-inositol (Ins), choline (Cho) and creatine (tCr) as well as metabolite ratios were determined. Follow-up including neurological assessment and conventional MRI was performed 3-4 and 6-7 months after the initial event. Nine patients converted to definite MS during the follow-up period. Compared to controls, those patients who converted to MS also showed significantly lower tNAA concentrations in the NAWM (-13.4%, P = 0.002) whereas nonconverters (-6.5%, P = 0.052) did not. The Ins concentration was 20.2% higher in the converter group and 1.9% higher in the nonconverter group, but these differences did not reach significance. No significant differences could be observed for tCr and Cho in either patient group. Axonal damage at baseline in patients presenting with CIS was more prominent in those who subsequently converted to definite MS in the short term follow-up, indicating that tNAA might be a sufficient prognostic marker for patients with a higher risk of conversion to early definite MS. (orig.)

  4. Prognostic value of high-field proton magnetic resonance spectroscopy in patients presenting with clinically isolated syndromes suggestive of multiple sclerosis

    Wattjes, Mike P.; Harzheim, Michael; Schmidt, Stephan; Lutterbey, Goetz G.; Schild, Hans H.; Traeber, Frank; Bogdanow, Manuela

    2008-01-01

    The aim of this study was to determine the prognostic value of metabolic alterations in the normal-appearing white matter (NAWM) of patients presenting with clinically isolated syndromes (CIS) suggestive of multiple sclerosis (MS) with special regard to the prediction of conversion to definite MS. Using a 3T whole-body MR system, a multisequence conventional MRI protocol and single-voxel proton MR spectroscopy (PRESS, repetition time 2000 ms, echo times 38 ms and 140 ms) of the parietal NAWM were performed in 25 patients presenting with CIS at baseline and in 20 controls. Absolute concentrations of N-acetyl-aspartate (tNAA), myo-inositol (Ins), choline (Cho) and creatine (tCr) as well as metabolite ratios were determined. Follow-up including neurological assessment and conventional MRI was performed 3-4 and 6-7 months after the initial event. Nine patients converted to definite MS during the follow-up period. Compared to controls, those patients who converted to MS also showed significantly lower tNAA concentrations in the NAWM (-13.4%, P = 0.002) whereas nonconverters (-6.5%, P = 0.052) did not. The Ins concentration was 20.2% higher in the converter group and 1.9% higher in the nonconverter group, but these differences did not reach significance. No significant differences could be observed for tCr and Cho in either patient group. Axonal damage at baseline in patients presenting with CIS was more prominent in those who subsequently converted to definite MS in the short term follow-up, indicating that tNAA might be a sufficient prognostic marker for patients with a higher risk of conversion to early definite MS. (orig.)

  5. MoCha: Molecular Characterization of Unknown Pathways.

    Lobo, Daniel; Hammelman, Jennifer; Levin, Michael

    2016-04-01

    Automated methods for the reverse-engineering of complex regulatory networks are paving the way for the inference of mechanistic comprehensive models directly from experimental data. These novel methods can infer not only the relations and parameters of the known molecules defined in their input datasets, but also unknown components and pathways identified as necessary by the automated algorithms. Identifying the molecular nature of these unknown components is a crucial step for making testable predictions and experimentally validating the models, yet no specific and efficient tools exist to aid in this process. To this end, we present here MoCha (Molecular Characterization), a tool optimized for the search of unknown proteins and their pathways from a given set of known interacting proteins. MoCha uses the comprehensive dataset of protein-protein interactions provided by the STRING database, which currently includes more than a billion interactions from over 2,000 organisms. MoCha is highly optimized, performing typical searches within seconds. We demonstrate the use of MoCha with the characterization of unknown components from reverse-engineered models from the literature. MoCha is useful for working on network models by hand or as a downstream step of a model inference engine workflow and represents a valuable and efficient tool for the characterization of unknown pathways using known data from thousands of organisms. MoCha and its source code are freely available online under the GPLv3 license.

  6. [A case of an anti-Ma2 antibody-positive patient presenting with variable CNS symptoms mimicking multiple system atrophy with a partial response to immunotherapy].

    Shiraishi, Wataru; Iwanaga, Yasutaka; Yamamoto, Akifumi

    2015-01-01

    A 70-year-old man with a 5-month history of progressive bradykinesia of the bilateral lower extremities was admitted to our hospital. At the age of 64, he underwent proximal gastrectomy for gastric cancer. He also had a history of subacute combined degeneration of the spinal cord since the age of 67, which was successfully treated with vitamin B12 therapy. Four weeks before admission to our hospital, he admitted himself to his former hospital complaining of walking difficulty. Two weeks later, however, his symptoms progressed rapidly; he was immobilized for two weeks and did not respond to the vitamin therapy. On admission to our hospital, he showed moderate paralysis of the lower extremities, cog-wheel rigidity of the four extremities, and dystonic posture of his left hand. He also showed orthostatic hypotension and vesicorectal disorders. Blood examination and cerebrospinal fluid analysis revealed no remarkable abnormalities. Electroencephalography showed frontal dominant, high voltage, sharp waves. His brain and spinal MRI revealed no notable abnormalities. We suspected autoimmune disease and commenced one course of intravenous methylprednisolone therapy, resulting in improvement of the parkinsonism and orthostatic hypotension. Based on these results, we investigated possible neural antigens and detected anti-Ma2 antibody. In addition to limbic encephalitis, anti-Ma2 antibody-positive neural disorders are characterized by rapid eye movement sleep behavior disorders or parkinsonism. Here, we report an anti-Ma2 antibody positive patient presenting variable CNS symptoms mimicking multiple system atrophy, who responded to immunotherapy.

  7. Multisite EPR oximetry from multiple quadrature harmonics.

    Ahmad, R; Som, S; Johnson, D H; Zweier, J L; Kuppusamy, P; Potter, L C

    2012-01-01

    Multisite continuous wave (CW) electron paramagnetic resonance (EPR) oximetry using multiple quadrature field modulation harmonics is presented. First, a recently developed digital receiver is used to extract multiple harmonics of field modulated projection data. Second, a forward model is presented that relates the projection data to unknown parameters, including linewidth at each site. Third, a maximum likelihood estimator of unknown parameters is reported using an iterative algorithm capable of jointly processing multiple quadrature harmonics. The data modeling and processing are applicable for parametric lineshapes under nonsaturating conditions. Joint processing of multiple harmonics leads to 2-3-fold acceleration of EPR data acquisition. For demonstration in two spatial dimensions, both simulations and phantom studies on an L-band system are reported. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Melanoma of unknown origin: a case series.

    Kelly, J

    2010-12-01

    The natural history of metastatic melanoma involving lymph nodes, in the absence of a known primary site (cutaneous, ocular or mucosal) has, to date, been poorly defined; and the optimal management of this rare subtype of disease is therefore unclear. Melanomas of unknown primary site (MUP) are estimated to comprise between 3.7 and 6% of all melanomas (Anbari et al. in Cancer 79:1861-1821, 1997).

  9. Multidimensional procurement auctions with unknown weights

    Greve, Thomas

    This paper studies the consequences of holding a procurement auction when the principal chooses not to show its preferences. My paper extends the procurement auction model of Che (1993) to a situation where both the principal and the agents have private information. Thus, unknown parameters of bo...... gives rise to an analysis of a principal that can not fully commit to the outcome induced by the scoring rule. Therefore, my result apply to contract theory and it’s problems with imperfect commitment....

  10. Designing towards the Unknown: Engaging with Material and Aesthetic Uncertainty

    Danielle Wilde

    2017-12-01

    Full Text Available New materials with new capabilities demand new ways of approaching design. Destabilising existing methods is crucial to develop new methods. Yet, radical destabilisation—where outcomes remain unknown long enough that new discoveries become possible—is not easy in technology design where complex interdisciplinary teams with time and resource constraints need to deliver concrete outcomes on schedule. The Poetic Kinaesthetic Interface project (PKI engages with this problematic directly. In PKI we use unfolding processes—informed by participatory, speculative and critical design—in emergent actions, to design towards unknown outcomes, using unknown materials. The impossibility of this task is proving as useful as it is disruptive. At its most potent, it is destabilising expectations, aesthetics and processes. Keeping the researchers, collaborators and participants in a state of unknowing, is opening the research potential to far-ranging possibilities. In this article we unpack the motivations driving the PKI project. We present our mixed-methodology, which entangles textile crafts, design interactions and materiality to shape an embodied enquiry. Our research outcomes are procedural and methodological. PKI brings together diverse human, non-human, known and unknown actors to discover where the emergent assemblages might lead. Our approach is re-invigorating—as it demands re-envisioning of—the design process.

  11. Direct Position Determination of Unknown Signals in the Presence of Multipath Propagation.

    Du, Jianping; Wang, Ding; Yu, Wanting; Yu, Hongyi

    2018-03-17

    A novel geolocation architecture, termed "Multiple Transponders and Multiple Receivers for Multiple Emitters Positioning System (MTRE)" is proposed in this paper. Existing Direct Position Determination (DPD) methods take advantage of a rather simple channel assumption (line of sight channels with complex path attenuations) and a simplified MUltiple SIgnal Classification (MUSIC) algorithm cost function to avoid the high dimension searching. We point out that the simplified assumption and cost function reduce the positioning accuracy because of the singularity of the array manifold in a multi-path environment. We present a DPD model for unknown signals in the presence of Multi-path Propagation (MP-DPD) in this paper. MP-DPD adds non-negative real path attenuation constraints to avoid the mistake caused by the singularity of the array manifold. The Multi-path Propagation MUSIC (MP-MUSIC) method and the Active Set Algorithm (ASA) are designed to reduce the dimension of searching. A Multi-path Propagation Maximum Likelihood (MP-ML) method is proposed in addition to overcome the limitation of MP-MUSIC in the sense of a time-sensitive application. An iterative algorithm and an approach of initial value setting are given to make the MP-ML time consumption acceptable. Numerical results validate the performances improvement of MP-MUSIC and MP-ML. A closed form of the Cramér-Rao Lower Bound (CRLB) is derived as a benchmark to evaluate the performances of MP-MUSIC and MP-ML.

  12. Quadrotor Control in the Presence of Unknown Mass Properties

    Duivenvoorden, Rikky Ricardo Petrus Rufino

    Quadrotor UAVs are popular due to their mechanical simplicity, as well as their capability to hover and vertically take-off and land. As applications diversify, quadrotors are increasingly required to operate under unknown mass properties, for example as a multirole sensor platform or for package delivery operations. The work presented here consists of the derivation of a generalized quadrotor dynamic model without the typical simplifying assumptions on the first and second moments of mass. The maximum payload capacity of a quadrotor in hover, and the observability of the unknown mass properties are discussed. A brief introduction of L1 adaptive control is provided, and three different L 1 adaptive controllers were designed for the Parrot AR.Drone quadrotor. Their tracking and disturbance rejection performance was compared to the baseline nonlinear controller in experiments. Finally, the results of the combination of L1 adaptive control with iterative learning control are presented, showing high performance trajectory tracking under uncertainty.

  13. The three unknown data of climate

    Noblet-Ducoudre, N.; Dupouey, J.L.; Levy, M.; Bopp, L.; Boucher, O.; Dahan Dalmedico, A.; Baruch, J.O.

    2007-01-01

    Even if the relation between global warming and the increase of greenhouse gases of anthropic origin in the atmosphere is now well established, several questions remain unanswered. The climate machine is so complex that the multiple actions and retroactions can hardly be modelled and the uncertainties of carbon and water cycles are numerous. This press-kit presents in five parts the complex problem of the understanding of climatic change: 1 - the ambiguous role of forests: making a status of the effects of forests on climate is a difficult task involving the biosphere, the leaf respiration, the migration of vegetable species and their reaction with respect to climate change. 2 - the turbulences in the ocean: according to measurements performed since 15 years, the ocean traps more than a quarter of anthropic carbon emissions. But, will the oceanic CO 2 pump be capable of following up the permanent increase of emissions? 3 - the double game of aerosols: some aerosols contribute to the cooling down of the Earth's surface while others influence the formation of clouds and contribute to the greenhouse effect. The role of aerosols remains a puzzling problem for climatologists. 4 - a world of uncertainties: according to the last estimates of the Intergovernmental Panel on Climatic Change, the average world temperature should rise from 1.1 to 6.4 deg. C from now to the end of the century. This wide range reflects the uncertainties in the modelling of the Earth system. 5 - the necessary blend of economics and climate or the impact of climate models and of their uncertainties on political-economical decisions and on international negotiations. (J.S.)

  14. TOURISM PROMOTION FOR UNKNOWN AREAS IN ROMANIA

    Fotache Lacramioara

    2013-12-01

    Full Text Available The paper is an effort to unknown areas identity affirmation, through collaborative development of advertising mix, with an emphasis on virtual platforms as admissible solution for increasing visibility. Based upon comparative effective analysis of categories of communication particularities, it is suggested a positioning strategic solution, via virtual advertising platform as unique, integrated, complex and very attractive tourism product promotion, fitted for the internal and international tourism circuit. The active promotion of the specified territorial identity will launch a brand with an impact among tourists by using marketing techniques and innovating technical means and prioritizing tourism as a principal vector of local and regional development.

  15. Metastasis to neck from unknown primary tumor

    Jose, B.; Bosch, A.; Caldwell, W.L.; Frias, Z.

    1979-01-01

    The records of 54 consecutive patients who were irradiated for metastatic disease in the neck from an unknown primary tumor were reviewed. The overall survival results are comparable to those of other reported series. Patients with high or posterior cervical lymph node involvement were irradiated with fields including the nasopharynx and oropharynx. Patients with high neck nodes had a better survival rate than those with low neck nodes. The size of the neck tumors and the local control after treatment also have prognostic significance. (Auth.)

  16. Diagnosis of the cancer of unknown primary origin

    Jurisova, S.; Poersoek, S.

    2013-01-01

    Cancer of unknown primary origin (CUP) is one of the ten most frequent cancers worldwide. It constitutes of 3-5% of all human malignancies. At time of diagnosis patients with CUP present with disseminated metastases without established primary origin. CUP manifests as heterogenous group of mainly epithelial cancers recognised by distinct clinico pathological entities. The diagnostic work-up includes extensive histopathology investigations and modern imaging technology. Nevertheless, the primary tumour remains undetected most of the time. (author)

  17. Transfer of an unknown quantum state, quantum networks, and memory

    Biswas, Asoka; Agarwal, G.S.

    2004-01-01

    We present a protocol for transfer of an unknown quantum state. The protocol is based on a two-mode cavity interacting dispersively in a sequential manner with three-level atoms in the Λ configuration. We propose a scheme for quantum networking using an atomic channel. We investigate the effect of cavity decoherence in the entire process. Further, we demonstrate the possibility of an efficient quantum memory for arbitrary superposition of two modes of a cavity containing one photon

  18. Overall survival patterns in patients with multiple myeloma in the era of novel agents and the role of initial clinical presentation and comorbidities: A population-based study

    Oortgiesen, Berdien; Van Roon, Eric N.; Joosten, Peter; Kibbelaar, Robby; Storm, Huib; Hovenga, Sjoerd; Van Rees, Bas P.; Woolthuis, Gerhard; Veeger, Nic J. G. M.; Hoogendoorn, Mels

    2014-01-01

    Introduction Clinical trials have shown improved response rates, progression-free survival and overall survival (OS) in patients with multiple myeloma (MM) when using the novel agents thalidomide, lenalidomide and bortezomib. However, outcome data provided by population-based registries, reflecting

  19. Assessing the impact of groundwater contamination on stream water quality by multiple approaches at the groundwater-surface water interface (Invited Presentation)

    Bjerg, Poul Løgstrup; Rønde, Vinni Kampman; Balbarini, Nicola

    Contaminants such as chlorinated solvents and pesticides, as well as new classes of compounds or emerging micropollutants are extensively produced, utilized and then discarded in society and subsequently released to streams from multiple point and diffuse sources. Sustainable management of water...

  20. Multiple Salivary Cortisol Measurements Are a Useful Tool to Optimize Metyrapone Treatment in Patients with Cushing’s Syndromes Treatment: Case Presentations

    Kenichi Yoshida

    2018-01-01

    Full Text Available Measuring salivary cortisol is both convenient and non-invasive for patients; however, its usefulness as a marker for monitoring medical therapy has not yet been established. The aim of this study was to assess the utility of multiple salivary cortisol measurements in patients with Cushing’s syndrome (CS during medical therapy. Six patients with CS (three with cortisol-secreting adrenocortical adenoma and three with ACTH-secreting pituitary adenoma were recruited. Samples for morning serum cortisol, urinary free cortisol (UFC, and multiple salivary cortisol levels were collected before and during metyrapone treatment. The area under the curve (AUC and mean value (MV of daily salivary cortisol levels were calculated. In five out of six patients, UFC were normalized; however, multiple salivary cortisol measurements revealed an impaired diurnal cortisol rhythm in these patients. To verify the usefulness of multiple salivary cortisol measurements, we performed a prospective case study of a patient in whom the excess secretion of cortisol was not controlled (UFC 211 μg/day with 2,250 mg/day in four divided doses of metyrapone. Multiple measurements of salivary cortisol revealed that cortisol levels elevated before the next administration. Accordingly, we shortened the interval by increasing the number of administration from four to five times per day, with a slight increment of daily dose of 2,500 mg. These optimizations resulted in a drastic improvement of diurnal pattern as well as UFC level (101 μg/day. Changes in both the MV and AUC of salivary cortisol levels were more correlated with those in UFC levels (Correlation coefficient 0.75, p = 0.007, and 0.70, p = 0.017 than those in the morning serum cortisol levels (0.42, p = 0.200, indicating that multiple salivary cortisol measurements reflect more precisely the excess secretion of cortisol. Our preliminary data suggest that multiple salivary cortisol measurements can be a

  1. Multiple giant succular and fusiform right and left coronary artery aneurysms after early and adequate treatment of atypical kawasaki disease with unusual presentation.

    Mostafa Behjati-Ardakani

    2014-06-01

    Full Text Available The major complication of Kawasaki disease is coronary artery dilatation and aneurysm. It occurs in approximately 15-25% of untreated children with Kawasaki Disease. Early diagnosis and treatment with Intravenous immune globulin (IVIG and aspirin (ASA can reduce the incidence of coronary artery abnormality to 2%-5%. We report one case of Atypical Kawasaki Disease with Multiple giant coronary artery aneurysms despite early adequate treatment with IVIG and ASA.

  2. Management of Gene Variants of Unknown Significance

    Alosi, Daniela; Bisgaard, Marie Luise; Hemmingsen, Sophie Nowak

    2017-01-01

    by germline mutations in the VHL gene, which predispose to the development of multiple tumors such as central nervous system hemangioblastomas and renal cell carcinoma (RCC). Objective: We propose a method for the evaluation of VUS pathogenicity through our experience with the VHL missense mutation c.241C...... (IHC); 3) Assessment of the variant’s impact on protein structure and function, using multiple databases, in silico algorithms, and reports of functional studies. Results: Only one family member had clinical signs of vHL with early-onset RCC. IHC analysis showed no VHL protein expressed in the tumor...

  3. Numerical method of identification of an unknown source term in a heat equation

    Fatullayev Afet Golayo?lu

    2002-01-01

    Full Text Available A numerical procedure for an inverse problem of identification of an unknown source in a heat equation is presented. Approach of proposed method is to approximate unknown function by polygons linear pieces which are determined consecutively from the solution of minimization problem based on the overspecified data. Numerical examples are presented.

  4. Renal disease masquerading as pyrexia of unknown origin

    D Korivi

    2013-01-01

    Full Text Available Pyrexia of unknown origin is a challenging clinical problem. Infections, malignancies, and connective tissue diseases form the major etiologies for this condition. We report a case of a 57-year-old diabetic male who presented with fever of unknown origin for several months. The course of investigations led to a kidney biopsy which clinched the cause of his fever as well as the underlying diagnosis. The light microscopy findings of expansile storiform fibrosis with a dense inflammatory infiltrate suggested the diagnosis which was confirmed by positive staining of Immunoglobulin G4, the dense lympho-plasmacytic infiltrate and elevated serum IgG4 concentrations. A course of steroids followed by mycophenolate mofetil as maintenance immunosuppression rendered the patient afebrile with improvement of renal function.

  5. Learning Unknown Structure in CRFs via Adaptive Gradient Projection Method

    Wei Xue

    2016-08-01

    Full Text Available We study the problem of fitting probabilistic graphical models to the given data when the structure is not known. More specifically, we focus on learning unknown structure in conditional random fields, especially learning both the structure and parameters of a conditional random field model simultaneously. To do this, we first formulate the learning problem as a convex minimization problem by adding an l_2-regularization to the node parameters and a group l_1-regularization to the edge parameters, and then a gradient-based projection method is proposed to solve it which combines an adaptive stepsize selection strategy with a nonmonotone line search. Extensive simulation experiments are presented to show the performance of our approach in solving unknown structure learning problems.

  6. Adresse inconnue / Address unknown / Suchwiin Bulmyeong

    Serge Gruzinski

    2005-03-01

    Full Text Available Tous les films asiatiques parlent de métissage, même ceux qui se présentent comme de vastes fresques historiques perdues dans le temps. Les emprunts aux traditions hollywoodiennes et européennes n'ont cessé d'enrichir une cinématographie aussi ancienne que celle du monde occidental. Dans Adresse inconnue (Address unknown le cinéaste coréen Kim Ki-duk explore l'expérience du métissage et le corps du métis à la frontière entre Corée du Nord et Corée du sud. Fils d'un GI américain et noir et d...

  7. Adresse inconnue / Address unknown / Suchwiin Bulmyeong

    Serge Gruzinski

    2005-01-01

    Tous les films asiatiques parlent de métissage, même ceux qui se présentent comme de vastes fresques historiques perdues dans le temps. Les emprunts aux traditions hollywoodiennes et européennes n'ont cessé d'enrichir une cinématographie aussi ancienne que celle du monde occidental. Dans Adresse inconnue (Address unknown) le cinéaste coréen Kim Ki-duk explore l'expérience du métissage et le corps du métis à la frontière entre Corée du Nord et Corée du sud. Fils d'un GI américain et noir et d'...

  8. Education Through Exploration: Evaluating the Unknown

    Anbar, A. D.

    2015-12-01

    Mastery of the peculiar and powerful practices of science is increasingly important for the average citizen. With the rise of the Internet, most of human knowledge is at our fingertips. As content becomes a commodity, success and survival aren't about who knows the most, but who is better able to explore the unknown, actively applying and extending knowledge through critical thinking and hypothesis-driven problem-solving. This applies to the economic livelihoods of individuals and to society at large as we grapple with climate change and other science-infused challenges. Unfortunately, science is too often taught as an encyclopedic collection of settled facts to be mastered rather than as a process of exploration that embraces curiosity, inquiry, testing, and communication to reduce uncertainty about the unknown. This problem is exacerbated by the continued prevalence of teacher-centric pedagogy, which promotes learning-from-authority and passive learning. The initial wave of massively open online courses (MOOCs) generally mimic this teaching style in virtual form. It is hypothesized that emerging digital teaching technologies can help address this challenge at Internet scale in "next generation" MOOCs and flipped classroom experiences. Interactive simulations, immersive virtual field trips, gamified elements, rapid adaptive feedback, intelligent tutoring systems, and personalized pathways, should motivate and enhance learning. Through lab-like projects and tutorials, students should be able to construct knowledge from interactive experiences, modeling the authentic practice of science while mastering complex concepts. Freed from lecturing, teaching staff should be available for direct and intense student-teacher interactions. These claims are difficult to evaluate with traditional assessment instruments, but digital technologies provide powerful new ways to evaluate student learning and learn from student behaviors. We will describe ongoing experiences with such

  9. Students' Distributive Reasoning with Fractions and Unknowns

    Hackenberg, Amy J.; Lee, Mi Yeon

    2016-01-01

    To understand relationships between students' quantitative reasoning with fractions and their algebraic reasoning, a clinical interview study was conducted with 18 middle and high school students. The study included six students with each of three different multiplicative concepts, which are based on how students create and coordinate composite…

  10. Estimation of the false discovery proportion with unknown dependence.

    Fan, Jianqing; Han, Xu

    2017-09-01

    Large-scale multiple testing with correlated test statistics arises frequently in many scientific research. Incorporating correlation information in approximating false discovery proportion has attracted increasing attention in recent years. When the covariance matrix of test statistics is known, Fan, Han & Gu (2012) provided an accurate approximation of False Discovery Proportion (FDP) under arbitrary dependence structure and some sparsity assumption. However, the covariance matrix is often unknown in many applications and such dependence information has to be estimated before approximating FDP. The estimation accuracy can greatly affect FDP approximation. In the current paper, we aim to theoretically study the impact of unknown dependence on the testing procedure and establish a general framework such that FDP can be well approximated. The impacts of unknown dependence on approximating FDP are in the following two major aspects: through estimating eigenvalues/eigenvectors and through estimating marginal variances. To address the challenges in these two aspects, we firstly develop general requirements on estimates of eigenvalues and eigenvectors for a good approximation of FDP. We then give conditions on the structures of covariance matrices that satisfy such requirements. Such dependence structures include banded/sparse covariance matrices and (conditional) sparse precision matrices. Within this framework, we also consider a special example to illustrate our method where data are sampled from an approximate factor model, which encompasses most practical situations. We provide a good approximation of FDP via exploiting this specific dependence structure. The results are further generalized to the situation where the multivariate normality assumption is relaxed. Our results are demonstrated by simulation studies and some real data applications.

  11. Clinical and genetic spectrum of Birt–Hogg–Dubé syndrome patients in whom pneumothorax and/or multiple lung cysts are the presenting feature

    Kunogi, Makiko; Kurihara, Masatoshi; Ikegami, Takako Shigihara; Kobayashi, Toshiyuki; Shindo, Noriko; Kumasaka, Toshio; Gunji, Yoko; Kikkawa, Mika; Iwakami, Shin-ichiro; Hino, Okio; Takahashi, Kazuhisa

    2010-01-01

    Background Birt–Hogg–Dubé syndrome (BHDS) is an inherited autosomal genodermatosis characterised by fibrofolliculomas of the skin, renal tumours and multiple lung cysts. Genetic studies have disclosed that the clinical picture as well as responsible germline FLCN mutations are diverse. Objectives BHDS may be caused by a germline deletion which cannot be detected by a conventional genetic approach. Real-time quantitative polymerase chain reaction (qPCR) may be able to identify such a mutation and thus provide us with a more accurate clinical picture of BHDS. Methods This study analysed 36 patients with multiple lung cysts of undetermined causes. Denaturing high performance liquid chromatography (DHPLC) was applied for mutation screening. If no abnormality was detected by DHPLC, the amount of each FLCN exon in genome was quantified by qPCR. Results An FLCN germline mutation was found in 23 (63.9%) of the 36 patients by DHPLC and direct sequencing (13 unique small nucleotide alterations which included 11 novel mutations). A large genomic deletion was identified in two of the remaining 13 patients by qPCR (one patient with exon 14 deletion and one patient with a deletion encompassing exons 9 to 14). Mutations including genomic deletions were most frequently identified in the 3′-end of the FLCN gene including exons 12 and 13 (13/25=52.0%). The BHDS patients whose multiple cysts prompted the diagnosis in this study showed a very low incidence of skin and renal involvement. Conclusions BHDS is due to large deletions as well as small nucleotide alterations. Racial differences may occur between Japanese and patients of European decent in terms of FLCN mutations and clinical manifestations. PMID:20413710

  12. Group prioritisation with unknown expert weights in incomplete linguistic context

    Cheng, Dong; Cheng, Faxin; Zhou, Zhili; Wang, Juan

    2017-09-01

    In this paper, we study a group prioritisation problem in situations when the expert weights are completely unknown and their judgement preferences are linguistic and incomplete. Starting from the theory of relative entropy (RE) and multiplicative consistency, an optimisation model is provided for deriving an individual priority vector without estimating the missing value(s) of an incomplete linguistic preference relation. In order to address the unknown expert weights in the group aggregating process, we define two new kinds of expert weight indicators based on RE: proximity entropy weight and similarity entropy weight. Furthermore, a dynamic-adjusting algorithm (DAA) is proposed to obtain an objective expert weight vector and capture the dynamic properties involved in it. Unlike the extant literature of group prioritisation, the proposed RE approach does not require pre-allocation of expert weights and can solve incomplete preference relations. An interesting finding is that once all the experts express their preference relations, the final expert weight vector derived from the DAA is fixed irrespective of the initial settings of expert weights. Finally, an application example is conducted to validate the effectiveness and robustness of the RE approach.

  13. Chronic kidney disease of unknown etiology in agricultural communities.

    Almaguer, Miguel; Herrera, Raúl; Orantes, Carlos M

    2014-04-01

    In recent years, Central America, Egypt, India and Sri Lanka have reported a high prevalence of chronic kidney disease of unknown etiology in agricultural communities, predominantly among male farmworkers. This essay examines the disease's case definitions, epidemiology (disease burden, demographics, associated risk factors) and causal hypotheses, by reviewing published findings from El Salvador, Nicaragua, Costa Rica, Sri Lanka, Egypt and India. The range of confirmed chronic kidney disease prevalence was 17.9%-21.1%. Prevalence of reduced glomerular filtration (homemade alcohol use and family history of chronic kidney disease. There is no strong evidence for a single cause, and multiple environmental, occupational and social factors are probably involved. Further etiological research is needed, plus interventions to reduce preventable risk factors.

  14. Quantum key distribution with an unknown and untrusted source

    Zhao, Yi; Qi, Bing; Lo, Hoi-Kwong

    2009-03-01

    The security of a standard bi-directional ``plug & play'' quantum key distribution (QKD) system has been an open question for a long time. This is mainly because its source is equivalently controlled by an eavesdropper, which means the source is unknown and untrusted. Qualitative discussion on this subject has been made previously. In this paper, we present the first quantitative security analysis on a general class of QKD protocols whose sources are unknown and untrusted. The securities of standard BB84 protocol, weak+vacuum decoy state protocol, and one-decoy decoy state protocol, with unknown and untrusted sources are rigorously proved. We derive rigorous lower bounds to the secure key generation rates of the above three protocols. Our numerical simulation results show that QKD with an untrusted source gives a key generation rate that is close to that with a trusted source. Our work is published in [1]. [4pt] [1] Y. Zhao, B. Qi, and H.-K. Lo, Phys. Rev. A, 77:052327 (2008).

  15. Navigation through unknown and dynamic open spaces using topological notions

    Miguel-Tomé, Sergio

    2018-04-01

    Until now, most algorithms used for navigation have had the purpose of directing system towards one point in space. However, humans communicate tasks by specifying spatial relations among elements or places. In addition, the environments in which humans develop their activities are extremely dynamic. The only option that allows for successful navigation in dynamic and unknown environments is making real-time decisions. Therefore, robots capable of collaborating closely with human beings must be able to make decisions based on the local information registered by the sensors and interpret and express spatial relations. Furthermore, when one person is asked to perform a task in an environment, this task is communicated given a category of goals so the person does not need to be supervised. Thus, two problems appear when one wants to create multifunctional robots: how to navigate in dynamic and unknown environments using spatial relations and how to accomplish this without supervision. In this article, a new architecture to address the two cited problems is presented, called the topological qualitative navigation architecture. In previous works, a qualitative heuristic called the heuristic of topological qualitative semantics (HTQS) has been developed to establish and identify spatial relations. However, that heuristic only allows for establishing one spatial relation with a specific object. In contrast, navigation requires a temporal sequence of goals with different objects. The new architecture attains continuous generation of goals and resolves them using HTQS. Thus, the new architecture achieves autonomous navigation in dynamic or unknown open environments.

  16. High Valence, Normal Valence and Unknown Valence

    Morsing, Thorbjørn Juul

    the serendipitous synthesis of the nitrido-bridged [Rh(en)3]2- [(CN)5MnNMn(CN)5]. The complex anion have previously been studied in the form of the mixed Rb4Na2-salt. In this earlier study, the nitrido-bridge was found to be asymmetrical with the axial ligands in an eclipsed formation. The complex was described...... the [Rh(en)3]2-salt is best described as Mn3.5/Mn3.5. This means that the [(CN)5MnNMn(CN)5]6􀀀 ion displays crystal packing induced oxidation state isomerism, a rare phenomenon. Chapter 4 details the synthesis and characterisation of group 9 dithiolene complexes with focus on the hitherto unknown...... homoleptic iridium dithiolene complexes. When the complexes [M(mnt)3]3􀀀, M = Rh and Co are chemically oxidized, they decompose to yield dinuclear complexes with the metal still in oxidation state III. This is not the case for the corresponding Ir complex which can be oxidized and the oxidation...

  17. Lung Lesions During Fever of Unknown Origin.

    Krupa, Renata; Zielonka, Tadeusz M; Hadzik-Blaszczyk, Malgorzata; Wardyn, Kazimierz A; Zycinska, Katarzyna

    2017-01-01

    Fever of unknown origin (FUO) remains one of the most difficult diagnostic challenges. The causes of FUO can be various diseases located in different organs. The aim of the study was to determine the prevalence and nature of pulmonary lesions during FUO. One hundred and sixty one patients with FUO participated in this prospective study. We performed a detailed comprehensive history, physical examination, and a wide spectrum of tests. The most common causes of FUO were infections (39%), autoimmune conditions (28%), and neoplasms (17%). Lung lesions were found in 30% of patients. In this group 35% were infections, 30% autoimmune diseases, and 4% cancer. Among patients with respiratory infections, there were cases of tuberculosis, atypical pneumonia, lung abscess, and bronchiectases. Autoimmune pulmonary lesions were observed during vasculitis and systemic lupus. The causes of FUO in the group of patients with lung lesions were also pulmonary embolism, sarcoidosis, and pulmonary fibrosis. Chest CT played an important role in the diagnosis of the causes of FUO with pulmonary manifestations. Pulmonary lesions are a common cause of FUO. Most FUO with pulmonary lesions are recognized during infections and autoimmune diseases. An important part of diagnosing FUO is a detailed evaluation of the respiratory system.

  18. Unknown Risks: Parental Hesitation about Vaccination.

    Blaisdell, Laura L; Gutheil, Caitlin; Hootsmans, Norbert A M; Han, Paul K J

    2016-05-01

    This qualitative study of a select sample of vaccine-hesitant parents (VHPs) explores perceived and constructed personal judgments about the risks and uncertainties associated with vaccines and vaccine-preventable diseases (VPDs) and how these subjective risk judgments influence parents' decisions about childhood vaccination. The study employed semistructured focus group interviews with 42 VHPs to elicit parents' perceptions and thought processes regarding the risks associated with vaccination and nonvaccination, the sources of these perceptions, and their approach to decision making about vaccination for their children. VHPs engage in various reasoning processes and tend to perceive risks of vaccination as greater than the risks of VPDs. At the same time, VHPs engage in other reasoning processes that lead them to perceive ambiguity in information about the harms of vaccination-citing concerns about the missing, conflicting, changing, or otherwise unreliable nature of information. VHPs' refusal of vaccination may reflect their aversion to both the risk and ambiguity they perceive to be associated with vaccination. Mitigating this vaccine hesitancy likely requires reconstructing the risks and ambiguities associated with vaccination-a challenging task that requires providing parents with meaningful evidence-based information on the known risks of vaccination versus VPDs and explicitly acknowledging the risks that remain truly unknown. © The Author(s) 2015.

  19. The energy equation with three unknowns

    Schifano, Fabio; Moriconi, Daniele

    2008-01-01

    This article discusses the alarming situation of energy in Italy as this country depends at 82 per cent on its imports (oil, natural gas and electricity), a dependence which could even increase. The authors first propose overviews of the situation regarding oil, natural gas and electric power (origins of imports, role of Italian companies, status of infrastructures), and also briefly of renewable energies. They recall the history of the use of nuclear energy: Italy has been one of the first country to use nuclear energy to produce electric power, but a referendum organised after Chernobyl resulted in phasing out nuclear. Then, the authors discuss perspectives associated with three main strategic unknowns: an increase of energy dependence with respect to hydrocarbons and to foreign nuclear power, a supply insecurity due to a dependence concentrated on a small number of countries (notably as far as natural gas is concerned), and an increasing interdependence between economic growth and sustainable development (the reduction of greenhouse emissions is a prevailing parameter for future energetic choices)

  20. Genetic Analysis of Multiple Endocrine Neoplasia Type 1 ( Leads to Misdiagnosis of an Extremely Rare Presentation of Intrasellar Cavernous Hemangioma as MEN1

    Dong Min Lee

    2014-06-01

    Full Text Available BackgroundMultiple endocrine neoplasia type 1 (MEN1 is a rare inherited disorder characterized by the simultaneous occurrence of endocrine tumors in target tissues (mainly the pituitary, endocrine pancreas, and parathyroid glands. MEN1 is caused by mutations in the MEN1 gene, which functions as a tumor suppressor and consists of one untranslated exon and nine exons encoding the menin protein. This condition is usually suspected when we encounter patients diagnosed with tumors in multiple endocrine organs, as mentioned above.MethodsA 65-year-old woman who underwent surgery for a pancreatic tumor (serous cystadenoma 5 years previously was referred to our hospital due to neurologic symptoms of diplopia and left ptosis. Brain magnetic resonance imaging revealed a 3.4-cm lesion originating from the cavernous sinus wall and extending into the sellar region. It was thought to be a nonfunctioning tumor from the results of the combined pituitary function test. Incidentally, we found that she also had a pancreatic tumor, indicating the necessity of genetic analysis for MEN1.ResultsGenomic analysis using peripheral leukocytes revealed a heterozygous c.1621G>A mutation in the MEN1 gene that was previously reported to be either a pathogenic mutation or a simple polymorphism. We pursued a stereotactic approach to the pituitary lesion, and microscopic findings of the tumor revealed it to be an intrasellar cavernous hemangioma, a rare finding in the sellar region and even rarer in relation to oculomotor palsy. The patient recovered well from surgery, but refused further evaluation for the pancreatic lesion.ConclusionThere is great emphasis placed on genetic testing in the diagnosis of MEN1, but herein we report a case where it did not assist in diagnosis, hence, further discussion on the role of genetic testing in this disease is needed. Also, in cases of pituitary tumor with cranial nerve palsy, despite its low prevalence, intrasellar cavernous hemangioma

  1. Off-Policy Actor-Critic Structure for Optimal Control of Unknown Systems With Disturbances.

    Song, Ruizhuo; Lewis, Frank L; Wei, Qinglai; Zhang, Huaguang

    2016-05-01

    An optimal control method is developed for unknown continuous-time systems with unknown disturbances in this paper. The integral reinforcement learning (IRL) algorithm is presented to obtain the iterative control. Off-policy learning is used to allow the dynamics to be completely unknown. Neural networks are used to construct critic and action networks. It is shown that if there are unknown disturbances, off-policy IRL may not converge or may be biased. For reducing the influence of unknown disturbances, a disturbances compensation controller is added. It is proven that the weight errors are uniformly ultimately bounded based on Lyapunov techniques. Convergence of the Hamiltonian function is also proven. The simulation study demonstrates the effectiveness of the proposed optimal control method for unknown systems with disturbances.

  2. Uric Acid: The Unknown Uremic Toxin.

    Treviño-Becerra, Alejandro

    2018-01-01

    This review brings together concepts of uric acid metabolism affecting renal parenchyma and its function and the current therapies to reduce hyperuricemia (HyU) and avoid renal disease progression. High uric acid plays an important role in several chronic diseases including kidney diseases such as lithiasis, gout nephropathy, and preeclampsia. In the last 30 years, it has been shown that reducing HyU with low protein and low purine diets in addition to allopurinol creates physiopathological conditions that produce a slight increase in the glomerular filtration rate (GFR). In recent years, in a new era of research in clinical, genetics, pharmacological, and epidemiologic fields, they have been moving forward to support the idea that reduction in HyU could benefit the chronic renal failure (CRF) patients (stage III-IV), thereby avoiding the drop of GFR for undefined mechanisms. There are several clinical trials in progress that show the HyU reducing to very low values and an increased GFR. In a young population, when treating HyU there is a reduction in high blood pressure. There are some reports showing that HyU could play a role in the diabetic nephropathy. Therefore, there have been some speculations that HyU treatment could stop the progression of CRF modifying the natural history of the diseases. So there will be new clinical trials with old and new medication and metabolic procedure to maintain a very low blood levels in the unknown uremic toxin know as uric acid which seems to be the toxin to the damage kidney. © 2018 S. Karger AG, Basel.

  3. Direct Position Determination of Unknown Signals in the Presence of Multipath Propagation

    Yu, Hongyi

    2018-01-01

    A novel geolocation architecture, termed “Multiple Transponders and Multiple Receivers for Multiple Emitters Positioning System (MTRE)” is proposed in this paper. Existing Direct Position Determination (DPD) methods take advantage of a rather simple channel assumption (line of sight channels with complex path attenuations) and a simplified MUltiple SIgnal Classification (MUSIC) algorithm cost function to avoid the high dimension searching. We point out that the simplified assumption and cost function reduce the positioning accuracy because of the singularity of the array manifold in a multi-path environment. We present a DPD model for unknown signals in the presence of Multi-path Propagation (MP-DPD) in this paper. MP-DPD adds non-negative real path attenuation constraints to avoid the mistake caused by the singularity of the array manifold. The Multi-path Propagation MUSIC (MP-MUSIC) method and the Active Set Algorithm (ASA) are designed to reduce the dimension of searching. A Multi-path Propagation Maximum Likelihood (MP-ML) method is proposed in addition to overcome the limitation of MP-MUSIC in the sense of a time-sensitive application. An iterative algorithm and an approach of initial value setting are given to make the MP-ML time consumption acceptable. Numerical results validate the performances improvement of MP-MUSIC and MP-ML. A closed form of the Cramér–Rao Lower Bound (CRLB) is derived as a benchmark to evaluate the performances of MP-MUSIC and MP-ML. PMID:29562601

  4. Direct Position Determination of Unknown Signals in the Presence of Multipath Propagation

    Jianping Du

    2018-03-01

    Full Text Available A novel geolocation architecture, termed “Multiple Transponders and Multiple Receivers for Multiple Emitters Positioning System (MTRE” is proposed in this paper. Existing Direct Position Determination (DPD methods take advantage of a rather simple channel assumption (line of sight channels with complex path attenuations and a simplified MUltiple SIgnal Classification (MUSIC algorithm cost function to avoid the high dimension searching. We point out that the simplified assumption and cost function reduce the positioning accuracy because of the singularity of the array manifold in a multi-path environment. We present a DPD model for unknown signals in the presence of Multi-path Propagation (MP-DPD in this paper. MP-DPD adds non-negative real path attenuation constraints to avoid the mistake caused by the singularity of the array manifold. The Multi-path Propagation MUSIC (MP-MUSIC method and the Active Set Algorithm (ASA are designed to reduce the dimension of searching. A Multi-path Propagation Maximum Likelihood (MP-ML method is proposed in addition to overcome the limitation of MP-MUSIC in the sense of a time-sensitive application. An iterative algorithm and an approach of initial value setting are given to make the MP-ML time consumption acceptable. Numerical results validate the performances improvement of MP-MUSIC and MP-ML. A closed form of the Cramér–Rao Lower Bound (CRLB is derived as a benchmark to evaluate the performances of MP-MUSIC and MP-ML.

  5. Fever of unknown origin in the elderly.

    Wakefield, K M; Henderson, S T; Streit, J G

    1989-06-01

    Fever is a prominent sign of an acute-phase response induced by microbial invasion, tissue injury, immunologic reactions, or inflammatory processes. This generalized host response is produced by a multiplicity of localized or systemic diseases and characterized by acute, subacute, or chronic changes in metabolic, endocrinologic, neurologic, and immunologic functions. The fundamental event is an initiation of the acute-phase response by the production of a mediated molecule called IL-1. This polypeptide is produced primarily from phagocytic cells such as blood monocytes, phagocytic lining cells of the liver and spleen, and other tissue macrophages. IL-1 produces a local reaction but also enters the circulation, acting as a hormone to mediate distant organ system responses to infection, immunologic reaction, and inflammatory processes. Fever is the result when IL-1 initiates the synthesis of prostaglandins, notably prostaglandin E2 in the thermoregulatory center located in the anterior hypothalamus. The thermostatic set point is then raised and mechanisms to conserve heat (vasoconstriction) and to produce heat (shivering) are initiated. The result is a sudden rise in body temperature. The same basic mechanisms are involved in FUO. Many of the biologic and biochemical changes that are seen in FUO are also evidence of an acute-phase response. The elevated erythrocyte sedimentation rate is partly due to increased synthesis of hepatic proteins, including compliment components, ceruloplasmin, fibrinogen, and C-reactive protein. IL-1 acts directly on the bone marrow to increase absolute numbers and immaturity of circulating neutrophils. Anemia is produced by many mechanisms, including the reduction of circulating serum iron. Although fever production in the elderly maybe delayed or of less intensity, it is still a marker of significant disease.(ABSTRACT TRUNCATED AT 400 WORDS)

  6. Virtual Charter Schools: Realities and Unknowns

    Torre, Daniela

    2013-01-01

    Virtual charter schools have emerged over the last decade as an increasingly popular alternative to traditional public schooling. Unlike their face-to-face counterparts, virtual charter schools educate students through blended or entirely online curricula. They present a host of new policy issues that should be scrutinized in order to ensure that…

  7. A Case of Multiple Cardiovascular and Tracheal Anomalies Presented with Wolff-Parkinson-White Syndrome in a Middle-aged Adult.

    Shi, Hyejin; Sohn, Sungmin; Wang, SungHo; Park, Sungrock; Lee, SangKi; Kim, Song Yi; Jeong, Sun Young; Kim, Changhwan

    2017-12-01

    Congenital cardiovascular anomalies, such as dextrocardia, persistent left superior vena cava (SVC), and pulmonary artery (PA) sling, are rare disorders. These congenital anomalies can occur alone, or coincide with other congenital malformations. In the majority of cases, congenital anomalies are detected early in life by certain signs and symptoms. A 56-year-old man with no previous medical history was admitted due to recurrent wide QRS complex tachycardia with hemodynamic collapse. A chest radiograph showed dextrocardia. After synchronized cardioversion, an electrocardiogram revealed Wolff-Parkinson-White (WPW) syndrome. Persistent left SVC, PA sling, and right tracheal bronchus were also detected by a chest computed tomography (CT) scan. He was diagnosed with paroxysmal supraventricular tachycardia (PSVT) associated with WPW syndrome, and underwent radiofrequency ablation. We reported the first case of situs solitus dextrocardia coexisting with persistent left SVC, PA sling and right tracheal bronchus presented with WPW and PSVT in a middle-aged adult. In patients with a cardiovascular anomaly, clinicians should consider thorough evaluation of possibly combined cardiovascular and airway malformations and cardiac dysrhythmia. © 2017 The Korean Academy of Medical Sciences.

  8. Mobile robot navigation in unknown static environments using ANFIS controller

    Anish Pandey

    2016-09-01

    Full Text Available Navigation and obstacle avoidance are the most important task for any mobile robots. This article presents the Adaptive Neuro-Fuzzy Inference System (ANFIS controller for mobile robot navigation and obstacle avoidance in the unknown static environments. The different sensors such as ultrasonic range finder sensor and sharp infrared range sensor are used to detect the forward obstacles in the environments. The inputs of the ANFIS controller are obstacle distances obtained from the sensors, and the controller output is a robot steering angle. The primary objective of the present work is to use ANFIS controller to guide the mobile robot in the given environments. Computer simulations are conducted through MATLAB software and implemented in real time by using C/C++ language running Arduino microcontroller based mobile robot. Moreover, the successful experimental results on the actual mobile robot demonstrate the effectiveness and efficiency of the proposed controller.

  9. Chronic traumatic encephalopathy: The unknown disease.

    Martínez-Pérez, R; Paredes, I; Munarriz, P M; Paredes, B; Alén, J F

    2017-04-01

    Chronic traumatic encephalopathy is a neurodegenerative disease produced by accumulated minor traumatic brain injuries; no definitive premortem diagnosis and no treatments are available for chronic traumatic encephalopathy. Risk factors associated with chronic traumatic encephalopathy include playing contact sports, presence of the apolipoprotein E4, and old age. Although it shares certain histopathological findings with Alzheimer disease, chronic traumatic encephalopathy has a more specific presentation (hyperphosphorylated tau protein deposited as neurofibrillary tangles, associated with neuropil threads and sometimes with beta-amyloid plaques). Its clinical presentation is insidious; patients show mild cognitive and emotional symptoms before progressing to parkinsonian motor signs and finally dementia. Results from new experimental diagnostic tools are promising, but these tools are not yet available. The mainstay of managing this disease is prevention and early detection of its first symptoms. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Anterior spinal cord syndrome of unknown etiology

    Klakeel, Merrine; Thompson, Justin; Srinivasan, Rajashree; McDonald, Frank

    2015-01-01

    A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery. We present the cases of two 13-year-old boys with anterior spinal cord syndrome, along with a review of the anatomy and vasculature of the spinal cord and an explanation of how a lesion in the cord corresponds to anterior spinal cord syndrome.

  11. Unknown quantum states: The quantum de Finetti representation

    Caves, Carlton M.; Fuchs, Christopher A.; Schack, Ruediger

    2002-01-01

    We present an elementary proof of the quantum de Finetti representation theorem, a quantum analog of de Finetti's classical theorem on exchangeable probability assignments. This contrasts with the original proof of Hudson and Moody [Z. Wahrschein. verw. Geb. 33, 343 (1976)], which relies on advanced mathematics and does not share the same potential for generalization. The classical de Finetti theorem provides an operational definition of the concept of an unknown probability in Bayesian probability theory, where probabilities are taken to be degrees of belief instead of objective states of nature. The quantum de Finetti theorem, in a closely analogous fashion, deals with exchangeable density-operator assignments and provides an operational definition of the concept of an ''unknown quantum state'' in quantum-state tomography. This result is especially important for information-based interpretations of quantum mechanics, where quantum states, like probabilities, are taken to be states of knowledge rather than states of nature. We further demonstrate that the theorem fails for real Hilbert spaces and discuss the significance of this point

  12. Reactive Path Planning Approach for Docking Robots in Unknown Environment

    Peng Cui

    2017-01-01

    Full Text Available Autonomous robots need to be recharged and exchange information with the host through docking in the long-distance tasks. Therefore, feasible path is required in the docking process to guide the robot and adjust its pose. However, when there are unknown obstacles in the work area, it becomes difficult to determine the feasible path for docking. This paper presents a reactive path planning approach named Dubins-APF (DAPF to solve the path planning problem for docking in unknown environment with obstacles. In this proposed approach the Dubins curves are combined with the designed obstacle avoidance potential field to plan the feasible path. Firstly, an initial path is planned and followed according to the configurations of the robot and the docking station. Then when the followed path is evaluated to be infeasible, the intermediate configuration is calculated as well as the replanned path based on the obstacle avoidance potential field. The robot will be navigated to the docking station with proper pose eventually via the DAPF approach. The proposed DAPF approach is efficient and does not require the prior knowledge about the environment. Simulation results are given to validate the effectiveness and feasibility of the proposed approach.

  13. Bidirectional ventricular tachycardia of unknown etiology

    Ali, M.; Khan, J.A.; Masood, T.; Shamsi, F.; Dero, M.H.; Khan, S.

    2013-01-01

    A 45 years old male presented to the emergency department with palpitations, headache and apprehension. His electrocardiogram revealed bidirectional ventricular tachycardia. He remained vitally stable and responded to intravenous beta-blocker. Initially digitalis toxicity was suspected but history was negative for digitalis intake. The cause remained unidentified in patient despite detailed investigations. During a short follow-up (of 6 months) he remained asymptomatic and no cause was further identified during this period. Some other unseen causes of bidirectional ventricular tachycardia need to be explored. (author)

  14. Ionizing radiation sources: very diversified means, multiple applications and a changing regulatory environment. Conference proceedings; Les sources de rayonnements ionisants: des moyens tres diversifies, des applications multiples et une reglementation en evolution. Recueil des presentations

    NONE

    2011-11-15

    This document brings together the available presentations given at the conference organised by the French society of radiation protection about ionizing radiation source means, applications and regulatory environment. Twenty eight presentations (slides) are compiled in this document and deal with: 1 - Overview of sources - some quantitative data from the national inventory of ionizing radiation sources (Yann Billarand, IRSN); 2 - Overview of sources (Jerome Fradin, ASN); 3 - Regulatory framework (Sylvie Rodde, ASN); 4 - Alternatives to Iridium radiography - the case of pressure devices at the manufacturing stage (Henri Walaszek, Cetim; Bruno Kowalski, Welding Institute); 5 - Dosimetric stakes of medical scanner examinations (Jean-Louis Greffe, Charleroi hospital of Medical University); 6 - The removal of ionic smoke detectors (Bruno Charpentier, ASN); 7 - Joint-activity and reciprocal liabilities - Organisation of labour risk prevention in case of companies joint-activity (Paulo Pinto, DGT); 8 - Consideration of gamma-graphic testing in the organization of a unit outage activities (Jean-Gabriel Leonard, EDF); 9 - Radiological risk control at a closed and independent work field (Stephane Sartelet, Areva); 10 - Incidents and accidents status and typology (Pascale Scanff, IRSN); 11 - Regional overview of radiation protection significant events (Philippe Menechal, ASN); 12 - Incident leading to a tritium contamination in and urban area - consequences and experience feedback (Laurence Fusil, CEA); 13 - Experience feedback - loss of sealing of a calibration source (Philippe Mougnard, Areva); 14 - Blocking incident of a {sup 60}Co source (Bruno Delille, Salvarem); 15 - Triggering of gantry's alarm: status of findings (Philippe Prat, Syctom); 16 - Non-medical electric devices: regulatory changes (Sophie Dagois, IRSN; Jerome Fradin, ASN); 17 - Evaluation of the dose equivalent rate in pulsed fields: method proposed by the IRSN and implementation test (Laurent Donadille

  15. Challenges of the Unknown: Clinical Application of Microbial Metagenomics

    Graham Rose

    2015-01-01

    Full Text Available Availability of fast, high throughput and low cost whole genome sequencing holds great promise within public health microbiology, with applications ranging from outbreak detection and tracking transmission events to understanding the role played by microbial communities in health and disease. Within clinical metagenomics, identifying microorganisms from a complex and host enriched background remains a central computational challenge. As proof of principle, we sequenced two metagenomic samples, a known viral mixture of 25 human pathogens and an unknown complex biological model using benchtop technology. The datasets were then analysed using a bioinformatic pipeline developed around recent fast classification methods. A targeted approach was able to detect 20 of the viruses against a background of host contamination from multiple sources and bacterial contamination. An alternative untargeted identification method was highly correlated with these classifications, and over 1,600 species were identified when applied to the complex biological model, including several species captured at over 50% genome coverage. In summary, this study demonstrates the great potential of applying metagenomics within the clinical laboratory setting and that this can be achieved using infrastructure available to nondedicated sequencing centres.

  16. Adaptively locating unknown steady states: Formalism and basin of attraction

    Wu, Yu; Lin, Wei

    2011-01-01

    The adaptive technique, which includes both dynamical estimators and coupling gains, has been recently verified to be practical for locating the unknown steady states numerically. This Letter, in the light of the center manifold theory for dynamical systems and the matrix spectrum principle, establishes an analytical formalism of this adaptive technique and reveals a connection between this technique and the original adaptive controller which includes only the dynamical estimator. More interestingly, in study of the well-known Lorenz system, the selections of the estimator parameters and initial values are found to be crucial to the successful application of the adaptive technique. Some Milnor-like basins of attraction with fractal structures are found quantitatively. All the results obtained in the Letter can be further extended to more general dynamical systems of higher dimensions. -- Highlights: → Establishing a new and rigorous formalism for the adaptive stabilization technique. → Showing a close connection between the adaptive technique and the original controller. → Providing feasible algorithms for simultaneous stabilization of multiple steady states. → Finding Milnor-like basins of attraction with fractal structures in adaptive control.

  17. MUSIC-type imaging of small perfectly conducting cracks with an unknown frequency

    Park, Won-Kwang

    2015-01-01

    MUltiple SIgnal Classification (MUSIC) is a famous non-iterative detection algorithm in inverse scattering problems. However, when the applied frequency is unknown, inaccurate locations are identified via MUSIC. This fact has been confirmed through numerical simulations. However, the reason behind this phenomenon has not been investigated theoretically. Motivated by this fact, we identify the structure of MUSIC-type imaging functionals with unknown frequency, by establishing a relationship with Bessel functions of order zero of the first kind. Through this, we can explain why inaccurate results appear. (paper)

  18. MUSIC-type imaging of small perfectly conducting cracks with an unknown frequency

    Park, Won-Kwang

    2015-09-01

    MUltiple SIgnal Classification (MUSIC) is a famous non-iterative detection algorithm in inverse scattering problems. However, when the applied frequency is unknown, inaccurate locations are identified via MUSIC. This fact has been confirmed through numerical simulations. However, the reason behind this phenomenon has not been investigated theoretically. Motivated by this fact, we identify the structure of MUSIC-type imaging functionals with unknown frequency, by establishing a relationship with Bessel functions of order zero of the first kind. Through this, we can explain why inaccurate results appear.

  19. Fever of unknown origin (FUO): CMV infectious mononucleosis or lymphoma?

    Cunha, Burke A; Chawla, Karishma

    2018-04-20

    Fever of unknown origin (FUO) refers to fevers of > 101 °F that persist for > 3 weeks and remain undiagnosed after a focused inpatient or outpatient workup. FUO may be due to infectious, malignant/neoplastic, rheumatic/inflammatory, or miscellaneous disorders. The FUO category determines the focus of the diagnostic workup. In the case presented of an FUO in a young woman, there were clinical findings of both CMV infectious mononucleosis or a lymphoma, e.g., highly elevated ESR, elevated ferritin levels, and elevated ACE level, β-2 microglobulins. The indium scan showed intense splenic uptake. Lymph node biopsy, PET scan, and flow cytometry were negative for lymphoma. CMV infectious mononucleosis was the diagnosis, and she made a slow recovery.

  20. Autonomous Underwater Navigation and Optical Mapping in Unknown Natural Environments

    Juan David Hernández

    2016-07-01

    Full Text Available We present an approach for navigating in unknown environments while, simultaneously, gathering information for inspecting underwater structures using an autonomous underwater vehicle (AUV. To accomplish this, we first use our pipeline for mapping and planning collision-free paths online, which endows an AUV with the capability to autonomously acquire optical data in close proximity. With that information, we then propose a reconstruction pipeline to create a photo-realistic textured 3D model of the inspected area. These 3D models are also of particular interest to other fields of study in marine sciences, since they can serve as base maps for environmental monitoring, thus allowing change detection of biological communities and their environment over time. Finally, we evaluate our approach using the Sparus II, a torpedo-shaped AUV, conducting inspection missions in a challenging, real-world and natural scenario.

  1. Analysing Trust Transitivity and The Effects of Unknown Dependence

    Touhid Bhuiyan

    2010-03-01

    Full Text Available Trust can be used to improve online automated recommendation within a given domain. Trust transitivity is used to make it successful. But trust transitivity has different interpretations. Trust and trust transitivity; both are the human mental phenomenon and for this reason, there is no such thing as objective transitivity. Trust transitivity and trust fusion both are important elements in computational trust. This paper analyses the parameter dependence problem in trust transitivity and proposes some definitions considering the effects of base rate. In addition, it also proposes belief functions based on subjective logic to analyse trust transitivity of three specified cases with sensitive and insensitive based rate. Then it presents a quantitative analysis of the effects of unknown dependence problem in an interconnected network environment; such Internet.

  2. Neurological Autoantibody Prevalence in Epilepsy of Unknown Etiology.

    Dubey, Divyanshu; Alqallaf, Abdulradha; Hays, Ryan; Freeman, Matthew; Chen, Kevin; Ding, Kan; Agostini, Mark; Vernino, Steven

    2017-04-01

    Autoimmune epilepsy is an underrecognized condition, and its true incidence is unknown. Identifying patients with an underlying autoimmune origin is critical because these patients' condition may remain refractory to conventional antiseizure medications but may respond to immunotherapy. To determine the prevalence of neurological autoantibodies (Abs) among adult patients with epilepsy of unknown etiology. Consecutive patients presenting to neurology services with new-onset epilepsy or established epilepsy of unknown etiology were identified. Serum samples were tested for autoimmune encephalitis Abs as well as thyroperoxidase (TPO) and glutamic acid decarboxylase 65 (GAD65) Abs. An antibody prevalence in epilepsy (APE) score based on clinical characteristics was assigned prospectively. Data were collected from June 1, 2015, to June 1, 2016. Presence of neurological Abs. A score based on clinical characteristics was assigned to estimate the probability of seropositivity prior to antibody test results. Good seizure outcome was estimated on the basis of significant reduction of seizure frequency at the first follow-up or seizure freedom. Of the 127 patients (68 males and 59 females) enrolled in the study, 15 were subsequently excluded after identification of an alternative diagnosis. Serum Abs suggesting a potential autoimmune etiology were detected in 39 (34.8%) cases. More than 1 Ab was detected in 7 patients (6.3%): 3 (2.7%) had TPO-Ab and voltage-gated potassium channel complex (VGKCc) Ab, 2 (1.8%) had GAD65-Ab and VGKCc-Ab, 1 had TPO-Ab and GAD65-Ab, and 1 had anti-Hu Ab and GAD65-Ab. Thirty-two patients (28.6%) had a single Ab marker. Among 112 patients included in the study, 15 (13.4%) had TPO-Ab, 14 (12.5%) had GAD65-Ab, 12 (10.7%) had VGKCc (4 of whom were positive for leucine-rich glioma-inactivated protein 1 [LGI1] Ab), and 4 (3.6%) had N-methyl-D-aspartate receptor (NMDAR) Ab. Even after excluding TPO-Ab and low-titer GAD65-Ab, Abs strongly suggesting an

  3. Defining active progressive multiple sclerosis

    Sellebjerg, Finn; Börnsen, Lars; Ammitzbøll, Cecilie

    2017-01-01

    BACKGROUND: It is unknown whether disease activity according to consensus criteria (magnetic resonance imaging activity or clinical relapses) associate with cerebrospinal fluid (CSF) changes in progressive multiple sclerosis (MS). OBJECTIVE: To compare CSF biomarkers in active and inactive...

  4. IgG,kappa monoclonal gammopathy of unknown significance with AL amyloidosis simulating giant cell arteritis

    Pompilian Valer Mihai

    2017-09-01

    Full Text Available Monoclonal gammopathies complicated by AL amyloidosis can mimic giant cell arteritis (GCA. We hereby present the case of a 63 year old woman in whom symptoms consistent with GCA were the first manifestations of a monoclonal gammopathy of unknown significance (MGUS associated with amyloidosis. A 63 year old woman was admitted for temporal headache, maseterine claudication, neck and shoulder stiffness. She was recently diagnosed with carpal tunnel syndrome. On physical examination she had prominent temporal arteries, macroglosia and orthostatic hypotension. Muscular strength was normal. She had high ESR and CRP; in this clinical context, GCA was suspected. A gamma spike on serum protein electrophoresis raised the suspicion of monoclonal gammopathy (MG. Immunoelectrophoresis revealed monoclonal bands for IgG and kappa chains. Massive deposits of amyloid and no inflammation were found on temporal artery biopsy. Multiple myeloma and lymphoma were ruled out. A diagnosis of AL amyloidosis complicating MGUS was formulated. She did well on therapy with bortezomib, cyclophosphamide and dexamethasone. Cases published in medical literature reveal amyloidosis mimicking GCA in the setting of established MGUS. As far as we know, this is the first case of MGUS with IgG and kappa chains in which a GCA-like picture induced by amyloidosis was present from the very onset.

  5. Building a RAPPOR with the Unknown: Privacy-Preserving Learning of Associations and Data Dictionaries

    Fanti Giulia

    2016-07-01

    Full Text Available Techniques based on randomized response enable the collection of potentially sensitive data from clients in a privacy-preserving manner with strong local differential privacy guarantees. A recent such technology, RAPPOR [12], enables estimation of the marginal frequencies of a set of strings via privacy-preserving crowdsourcing. However, this original estimation process relies on a known dictionary of possible strings; in practice, this dictionary can be extremely large and/or unknown. In this paper, we propose a novel decoding algorithm for the RAPPOR mechanism that enables the estimation of “unknown unknowns,” i.e., strings we do not know we should be estimating. To enable learning without explicit dictionary knowledge, we develop methodology for estimating the joint distribution of multiple variables collected with RAPPOR. Our contributions are not RAPPOR-specific, and can be generalized to other local differential privacy mechanisms for learning distributions of string-valued random variables.

  6. M-MRAC Backstepping for Systems with Unknown Virtual Control Coefficients

    Stepanyan, Vahram; Krishnakumar, Kalmanje

    2015-01-01

    The paper presents an over-parametrization free certainty equivalence state feedback backstepping adaptive control design method for systems of any relative degree with unmatched uncertainties and unknown virtual control coefficients. It uses a fast prediction model to estimate the unknown parameters, which is independent of the control design. It is shown that the system's input and output tracking errors can be systematically decreased by the proper choice of the design parameters. The benefits of the approach are demonstrated in numerical simulations.

  7. Psychological profile: the problem of modeling the unknown criminal personality

    Г. М. Гетьман

    2013-10-01

    Full Text Available The article investigates the problem of modeling an unknown person in the preparation of criminal psychological profile. Some approaches to the concept of "psychological profile" and "psychological portrait", in particular the proposed delineation of these terms. We consider the system steps in the development of the psychological profile of an unknown perpetrator.

  8. Multiple chemical sensitivity

    Tran, Marie Thi Dao; Arendt-Nielsen, Lars; Kupers, Ron

    2013-01-01

    BACKGROUND: Multiple Chemical Sensitivity (MCS) is a chronic condition characterized by recurrent, non-specific symptoms in response to chemically unrelated exposures in non-toxic concentrations. Although the pathophysiology of MCS remains unknown, central sensitization may be an important factor...

  9. Minimal-Approximation-Based Distributed Consensus Tracking of a Class of Uncertain Nonlinear Multiagent Systems With Unknown Control Directions.

    Choi, Yun Ho; Yoo, Sung Jin

    2017-03-28

    A minimal-approximation-based distributed adaptive consensus tracking approach is presented for strict-feedback multiagent systems with unknown heterogeneous nonlinearities and control directions under a directed network. Existing approximation-based consensus results for uncertain nonlinear multiagent systems in lower-triangular form have used multiple function approximators in each local controller to approximate unmatched nonlinearities of each follower. Thus, as the follower's order increases, the number of the approximators used in its local controller increases. However, the proposed approach employs only one function approximator to construct the local controller of each follower regardless of the order of the follower. The recursive design methodology using a new error transformation is derived for the proposed minimal-approximation-based design. Furthermore, a bounding lemma on parameters of Nussbaum functions is presented to handle the unknown control direction problem in the minimal-approximation-based distributed consensus tracking framework and the stability of the overall closed-loop system is rigorously analyzed in the Lyapunov sense.

  10. Quantum jointly assisted cloning of an unknown three-dimensional equatorial state

    Ma, Peng-Cheng; Chen, Gui-Bin; Li, Xiao-Wei; Zhan, You-Bang

    2018-02-01

    We present two schemes for perfectly cloning an unknown single-qutrit equatorial state with assistance from two and N state preparers, respectively. In the first scheme, the sender wishes to teleport an unknown single-qutrit equatorial state from two state preparers to a remote receiver, and then to create a perfect copy of the unknown state at her location. The scheme consists of two stages. The first stage of the scheme requires the usual teleportation. In the second stage, to help the sender realize the quantum cloning, two state preparers perform single-qutrit projective measurements on their own qutrits from the sender, then the sender can acquire a perfect copy of the unknown state. It is shown that, only if the two state preparers collaborate with each other, the sender can create a copy of the unknown state by means of some appropriate unitary operations. In the second scheme, we generalized the jointly assisted cloning in the first scheme to the case of N state prepares. In the present schemes, the total probability of success for assisted cloning of a perfect copy of the unknown state can reach 1.

  11. Structure of a Trypanosoma brucei α/β-hydrolase fold protein with unknown function

    Merritt, Ethan A.; Holmes, Margaret; Buckner, Frederick S.; Van Voorhis, Wesley C.; Quartly, Erin; Phizicky, Eric M.; Lauricella, Angela; Luft, Joseph; DeTitta, George; Neely, Helen; Zucker, Frank; Hol, Wim G. J.

    2008-01-01

    T. brucei gene Tb10.6k15.0140 codes for an α/β-hydrolase fold protein of unknown function. The 2.2 Å crystal structure shows that members of this sequence family retain a conserved Ser residue at the expected site of a catalytic nucleophile, but that trypanosomatid sequences lack structural homologs for the other expected residues of the catalytic triad. The structure of a structural genomics target protein, Tbru020260AAA from Trypanosoma brucei, has been determined to a resolution of 2.2 Å using multiple-wavelength anomalous diffraction at the Se K edge. This protein belongs to Pfam sequence family PF08538 and is only distantly related to previously studied members of the α/β-hydrolase fold family. Structural superposition onto representative α/β-hydrolase fold proteins of known function indicates that a possible catalytic nucleophile, Ser116 in the T. brucei protein, lies at the expected location. However, the present structure and by extension the other trypanosomatid members of this sequence family have neither sequence nor structural similarity at the location of other active-site residues typical for proteins with this fold. Together with the presence of an additional domain between strands β6 and β7 that is conserved in trypanosomatid genomes, this suggests that the function of these homologs has diverged from other members of the fold family

  12. Nonexistence of a universal quantum machine to examine the precision of unknown quantum states

    Pang, Shengshi; Wu, Shengjun; Chen, Zeng-Bing

    2011-01-01

    In this work, we reveal a type of impossibility discovered in our recent research which forbids comparing the closeness of multiple unknown quantum states with any nontrivial threshold in a perfect or unambiguous way. This impossibility is distinct from the existing impossibilities in that it is a ''collective'' impossibility on multiple quantum states; most other ''no-go'' theorems are concerned with only one single state each time, i.e., it is an impossibility on a nonlocal quantum operation. This impossibility may provide new insight into the nature of quantum mechanics, and it implies more limitations on quantum information tasks than the existing no-go theorems.

  13. Multiple Perspectives / Multiple Readings

    Simon Biggs

    2005-01-01

    Full Text Available People experience things from their own physical point of view. What they see is usually a function of where they are and what physical attitude they adopt relative to the subject. With augmented vision (periscopes, mirrors, remote cameras, etc we are able to see things from places where we are not present. With time-shifting technologies, such as the video recorder, we can also see things from the past; a time and a place we may never have visited.In recent artistic work I have been exploring the implications of digital technology, interactivity and internet connectivity that allow people to not so much space/time-shift their visual experience of things but rather see what happens when everybody is simultaneously able to see what everybody else can see. This is extrapolated through the remote networking of sites that are actual installation spaces; where the physical movements of viewers in the space generate multiple perspectives, linked to other similar sites at remote locations or to other viewers entering the shared data-space through a web based version of the work.This text explores the processes involved in such a practice and reflects on related questions regarding the non-singularity of being and the sense of self as linked to time and place.

  14. Myelin Basic Protein-Induced Production of Tumor Necrosis Factor-α and Interleukin-6, and Presentation of the Immunodominant Peptide MBP85-99 by B Cells from Patients with Relapsing-Remitting Multiple Sclerosis

    Nielsen, Claus H; Börnsen, Lars; Sellebjerg, Finn

    2016-01-01

    to study cytokine production by B cells, but here we used the physiologically relevant self-antigen myelin basic protein (MBP) to stimulate B cells from untreated patients with RRMS and healthy donors. Moreover, we took advantage of the unique ability of the monoclonal antibody MK16 to recognize...... the immunodominant peptide MBP85-99 presented on HLA-DR15, and used it as a probe to directly study B-cell presentation of self-antigenic peptide. The proportions of B cells producing TNF-α or IL-6 after stimulation with MBP were higher in RRMS patients than in healthy donors, indicating a pro-inflammatory profile...... for self-reactive patient B cells. In contrast, polyclonal stimulation with PMA + ionomycin and MBP revealed no difference in cytokine profile between B cells from RRMS patients and healthy donors. Expanded disability status scale (EDSS) as well as multiple sclerosis severity score (MSSS) correlated...

  15. Robust Fault Detection for Switched Fuzzy Systems With Unknown Input.

    Han, Jian; Zhang, Huaguang; Wang, Yingchun; Sun, Xun

    2017-10-03

    This paper investigates the fault detection problem for a class of switched nonlinear systems in the T-S fuzzy framework. The unknown input is considered in the systems. A novel fault detection unknown input observer design method is proposed. Based on the proposed observer, the unknown input can be removed from the fault detection residual. The weighted H∞ performance level is considered to ensure the robustness. In addition, the weighted H₋ performance level is introduced, which can increase the sensibility of the proposed detection method. To verify the proposed scheme, a numerical simulation example and an electromechanical system simulation example are provided at the end of this paper.

  16. Severe Unresponsive Hypoglycemia Associated with Neuroendocrine Tumor of Unknown Primary Site - 18 Years after Rectal Cancer Surgery. Case Report.

    Rusu, Octavia Cristina; Costea, Radu Virgil; Popa, Cristian Constantin; Iliesiu, Andreea; Dumitru, Adrian; Becheanu, Gabriel; Neagu, Stefan Ilie

    2015-09-01

    Neuroendocrine tumors are derived from cells that have the unique ability to synthesize, store and secrete a variety of metabolically active substances, peptides and amines, characteristic of the tissue of origin, which can cause distinct clinical syndromes. We present the case of a 58-year-old patient diagnosed and surgically treated in January 1996 for stage III inferior rectal cancer, who was readmitted after 18 years presenting persistent diarrheic syndrome and asthenia. Investigations performed (abdominal CT) showed multiple liver metastases, initially suspected as being related to the rectal cancer. Biopsy of liver metastases and pathological and immunohistochemical analysis demonstrated the neuroendocrine origin (moderately differentiated neuroendocrine tumor). Seven months after the identification of liver metastases and after initiation of oncological therapy with Interferon and Somatostatin, the patient presented severe hypoglycemia (serum glucose 13-70 mg/dl) proved to be due to insulin-like factors (serum insulin level 64.9 ìU/ml) secreted by metastases. Due to the aggressive evolution of neuroendocrine tumor, with multiple episodes of severe hypoglycemia, resistant to treatment, the patient died approximately one month after the occurrence of hypoglycemic episodes. Despite comprehensive tests (abdominal CT scan, colonoscopy, bone scintigraphy and PET/CT), the primary site of the neuroendocrine tumors remained unknown.

  17. Kidnapping Detection and Recognition in Previous Unknown Environment

    Yang Tian

    2017-01-01

    Full Text Available An unaware event referred to as kidnapping makes the estimation result of localization incorrect. In a previous unknown environment, incorrect localization result causes incorrect mapping result in Simultaneous Localization and Mapping (SLAM by kidnapping. In this situation, the explored area and unexplored area are divided to make the kidnapping recovery difficult. To provide sufficient information on kidnapping, a framework to judge whether kidnapping has occurred and to identify the type of kidnapping with filter-based SLAM is proposed. The framework is called double kidnapping detection and recognition (DKDR by performing two checks before and after the “update” process with different metrics in real time. To explain one of the principles of DKDR, we describe a property of filter-based SLAM that corrects the mapping result of the environment using the current observations after the “update” process. Two classical filter-based SLAM algorithms, Extend Kalman Filter (EKF SLAM and Particle Filter (PF SLAM, are modified to show that DKDR can be simply and widely applied in existing filter-based SLAM algorithms. Furthermore, a technique to determine the adapted thresholds of metrics in real time without previous data is presented. Both simulated and experimental results demonstrate the validity and accuracy of the proposed method.

  18. Iterative Selection of Unknown Weights in Direct Weight Optimization Identification

    Xiao Xuan

    2014-01-01

    Full Text Available To the direct weight optimization identification of the nonlinear system, we add some linear terms about input sequences in the former linear affine function so as to approximate the nonlinear property. To choose the two classes of unknown weights in the more linear terms, this paper derives the detailed process on how to choose these unknown weights from theoretical analysis and engineering practice, respectively, and makes sure of their key roles between the unknown weights. From the theoretical analysis, the added unknown weights’ auxiliary role can be known in the whole process of approximating the nonlinear system. From the practical analysis, we learn how to transform one complex optimization problem to its corresponding common quadratic program problem. Then, the common quadratic program problem can be solved by the basic interior point method. Finally, the efficiency and possibility of the proposed strategies can be confirmed by the simulation results.

  19. Carcinoma of Unknown Primary Treatment (PDQ®)—Patient Version

    Carcinoma of unknown primary (CUP), treatment can include surgery, radiation therapy, chemotherapy, or hormone therapy. Get detailed information about the diagnosis and treatment of CUP in this expert-reviewed summary.

  20. RBF neural network based H∞ synchronization for unknown chaotic ...

    , 172 ... the effect of disturbance to an H∞ norm constraint. It is shown that ... unknown chaotic systems; linear matrix inequality (LMI); learning law. 1. Introduction .... (9) is RBFNN H∞ synchronized if the synchronization error e(t) satisfies. ∫ ∞.

  1. Classification of Unknown Thermocouple Types Using Similarity Factor Measurement

    Seshu K. DAMARLA

    2011-01-01

    Full Text Available In contrast to classification using PCA method, a new methodology is proposed for type identification of unknown thermocouple. The new methodology is based on calculating the degree of similarity between two multivariate datasets using two types of similarity factors. One similarity factor is based on principle component analysis and the angles between the principle component subspaces while the other is based on the Mahalanobis distance between the datasets. Datasets containing thermo-emfs against given temperature ranges are formed for each type of thermocouple (e.g. J, K, S, T, R, E, B and N type by experimentation are considered as reference datasets. Datasets corresponding to unknown type are captured. Similarity factor between the datasets one of which being the unknown type and the other being each known type are compared. When maximum similarity factor occurs, then the class of unknown type is allocated to that of known type.

  2. Chinese Unknown Word Recognition for PCFG-LA Parsing

    Qiuping Huang

    2014-01-01

    Full Text Available This paper investigates the recognition of unknown words in Chinese parsing. Two methods are proposed to handle this problem. One is the modification of a character-based model. We model the emission probability of an unknown word using the first and last characters in the word. It aims to reduce the POS tag ambiguities of unknown words to improve the parsing performance. In addition, a novel method, using graph-based semisupervised learning (SSL, is proposed to improve the syntax parsing of unknown words. Its goal is to discover additional lexical knowledge from a large amount of unlabeled data to help the syntax parsing. The method is mainly to propagate lexical emission probabilities to unknown words by building the similarity graphs over the words of labeled and unlabeled data. The derived distributions are incorporated into the parsing process. The proposed methods are effective in dealing with the unknown words to improve the parsing. Empirical results for Penn Chinese Treebank and TCT Treebank revealed its effectiveness.

  3. Delivery presentations

    Pregnancy - delivery presentation; Labor - delivery presentation; Occiput posterior; Occiput anterior; Brow presentation ... The mother can walk, rock, and try different delivery positions during labor to help encourage the baby ...

  4. [Multiple meningiomas].

    Terrier, L-M; François, P

    2016-06-01

    Multiple meningiomas (MMs) or meningiomatosis are defined by the presence of at least 2 lesions that appear simultaneously or not, at different intracranial locations, without the association of neurofibromatosis. They present 1-9 % of meningiomas with a female predominance. The occurrence of multiple meningiomas is not clear. There are 2 main hypotheses for their development, one that supports the independent evolution of these tumors and the other, completely opposite, that suggests the propagation of tumor cells of a unique clone transformation, through cerebrospinal fluid. NF2 gene mutation is an important intrinsic risk factor in the etiology of multiple meningiomas and some exogenous risk factors have been suspected but only ionizing radiation exposure has been proven. These tumors can grow anywhere in the skull but they are more frequently observed in supratentorial locations. Their histologic types are similar to unique meningiomas of psammomatous, fibroblastic, meningothelial or transitional type and in most cases are benign tumors. The prognosis of these tumors is eventually good and does not differ from the unique tumors except for the cases of radiation-induced multiple meningiomas, in the context of NF2 or when diagnosed in children where the outcome is less favorable. Each meningioma lesion should be dealt with individually and their multiple character should not justify their resection at all costs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Anticipated Guilt as Behavioral Motivation: An Examination of Appeals to Help Unknown Others through Bone Marrow Donation

    Lindsey, Lisa L. Massi

    2005-01-01

    The current study posits that messages used to elicit behaviors to help unknown others must present substantial perceptions of a threat and efficacy to be successful. Given that many prosocial helping messages depict a threat to unknown others, the current investigation proposed that anticipated guilt is a motivating force behind individuals'…

  6. A dynamical approach in exploring the unknown mass in the Solar system using pulsar timing arrays

    Guo, Y. J.; Lee, K. J.; Caballero, R. N.

    2018-04-01

    The error in the Solar system ephemeris will lead to dipolar correlations in the residuals of pulsar timing array for widely separated pulsars. In this paper, we utilize such correlated signals, and construct a Bayesian data-analysis framework to detect the unknown mass in the Solar system and to measure the orbital parameters. The algorithm is designed to calculate the waveform of the induced pulsar-timing residuals due to the unmodelled objects following the Keplerian orbits in the Solar system. The algorithm incorporates a Bayesian-analysis suit used to simultaneously analyse the pulsar-timing data of multiple pulsars to search for coherent waveforms, evaluate the detection significance of unknown objects, and to measure their parameters. When the object is not detectable, our algorithm can be used to place upper limits on the mass. The algorithm is verified using simulated data sets, and cross-checked with analytical calculations. We also investigate the capability of future pulsar-timing-array experiments in detecting the unknown objects. We expect that the future pulsar-timing data can limit the unknown massive objects in the Solar system to be lighter than 10-11-10-12 M⊙, or measure the mass of Jovian system to a fractional precision of 10-8-10-9.

  7. Root-MUSIC Based Angle Estimation for MIMO Radar with Unknown Mutual Coupling

    Jianfeng Li

    2014-01-01

    Full Text Available Direction of arrival (DOA estimation problem for multiple-input multiple-output (MIMO radar with unknown mutual coupling is studied, and an algorithm for the DOA estimation based on root multiple signal classification (MUSIC is proposed. Firstly, according to the Toeplitz structure of the mutual coupling matrix, output data of some specified sensors are selected to eliminate the influence of the mutual coupling. Then the reduced-dimension transformation is applied to make the computation burden lower as well as obtain a Vandermonde structure of the direction matrix. Finally, Root-MUSIC can be adopted for the angle estimation. The angle estimation performance of the proposed algorithm is better than that of estimation of signal parameters via rotational invariance techniques (ESPRIT-like algorithm and MUSIC-like algorithm. Furthermore, the proposed algorithm has lower complexity than them. The simulation results verify the effectiveness of the algorithm, and the theoretical estimation error of the algorithm is also derived.

  8. Data Series Subtraction with Unknown and Unmodeled Background Noise

    Vitale, Stefano; Congedo, Giuseppe; Dolesi, Rita; Ferroni, Valerio; Hueller, Mauro; Vetrugno, Daniele; Weber, William Joseph; Audley, Heather; Danzmann, Karsten; Diepholz, Ingo; hide

    2014-01-01

    LISA Pathfinder (LPF), the precursor mission to a gravitational wave observatory of the European Space Agency, will measure the degree to which two test masses can be put into free fall, aiming to demonstrate a suppression of disturbance forces corresponding to a residual relative acceleration with a power spectral density (PSD) below (30 fm/sq s/Hz)(sup 2) around 1 mHz. In LPF data analysis, the disturbance forces are obtained as the difference between the acceleration data and a linear combination of other measured data series. In many circumstances, the coefficients for this linear combination are obtained by fitting these data series to the acceleration, and the disturbance forces appear then as the data series of the residuals of the fit. Thus the background noise or, more precisely, its PSD, whose knowledge is needed to build up the likelihood function in ordinary maximum likelihood fitting, is here unknown, and its estimate constitutes instead one of the goals of the fit. In this paper we present a fitting method that does not require the knowledge of the PSD of the background noise. The method is based on the analytical marginalization of the posterior parameter probability density with respect to the background noise PSD, and returns an estimate both for the fitting parameters and for the PSD. We show that both these estimates are unbiased, and that, when using averaged Welchs periodograms for the residuals, the estimate of the PSD is consistent, as its error tends to zero with the inverse square root of the number of averaged periodograms. Additionally, we find that the method is equivalent to some implementations of iteratively reweighted least-squares fitting. We have tested the method both on simulated data of known PSD and on data from several experiments performed with the LISA Pathfinder end-to-end mission simulator.

  9. CUP Syndrome-Metastatic Malignancy with Unknown Primary Tumor.

    Zaun, Gregor; Schuler, Martin; Herrmann, Ken; Tannapfel, Andrea

    2018-03-09

    2-4% of newly diagnosed cases of malignant disease involve cancer of unknown primary (CUP). This mixed entity is one of the 6 most common types of malignant disease in Germany. Highly refined treatment strategies can now be offered to patients with CUP. This review is based on pertinent publications retrieved by a selective search in PubMed with an emphasis on articles from the past decade. The current guidelines and recommendations of specialty societies were also considered in the evaluation. CUP most commonly manifests itself as metastases to the lymph nodes, lungs, liver, or bones. With the aid of imaging studies, including functional hybrid imaging and further medical examination, a primary tumor can be discovered in up to 40% of patients initially diagnosed with CUP. Immunohistochemistry guided by histomorphology often enables precise characterization of the lesion and can be supplemented, in selected cases, by molecular-genetic diagnostic evaluation. The most commonly detected types of primary tumor are cancers of the lung, pancreas, liver, and biliary system. For patients with local metastases, surgical resection or radiotherapy with curative intent is usually indicated, sometimes in the framework of a multimodal treatment concept. The median 2-year survival of patients with disseminated CUP is only 20%. For such patients, specific types of systemic therapy are recommended on the basis of the diagnostic characterization of the disease. Immune-modulatory antibodies can be effective, particularly in the treatment of CUP that has been characterized with biomarkers, but should still be considered experimental at present. A combination of conventional and innovative diagnostic methods enables the provision of highly refined therapeutic strategies to patients with CUP who are undergoing treatment in interdisciplinary cancer centers.

  10. Known unknowns: indirect energy effects of information and communication technology

    Horner, Nathaniel C.; Shehabi, Arman; Azevedo, Inês L.

    2016-10-01

    Background. There has been sustained and growing interest in characterizing the net energy impact of information and communication technology (ICT), which results from indirect effects offsetting (or amplifying) the energy directly consumed by ICT equipment. These indirect effects may be either positive or negative, and there is considerable disagreement as to the direction of this sign as well as the effect magnitude. Literature in this area ranges from studies focused on a single service (such as e-commerce versus traditional retail) to macroeconomic studies attempting to characterize the overall impact of ICT. Methods. We review the literature on the indirect energy effect of ICT found via Google Scholar, our own research, and input from other researchers in the field. The various studies are linked to an effect taxonomy, which is synthesized from several different hierarchies present in the literature. References are further grouped according to ICT service (e.g., e-commerce, telework) and summarized by scope, method, and quantitative and qualitative findings. Review results. Uncertainty persists in understanding the net energy effects of ICT. Results of indirect energy effect studies are highly sensitive to scoping decisions and assumptions made by the analyst. Uncertainty increases as the impact scope broadens, due to complex and interconnected effects. However, there is general agreement that ICT has large energy savings potential, but that the realization of this potential is highly dependent on deployment details and user behavior. Discussion. While the overall net effect of ICT is likely to remain unknown, this review suggests several guidelines for improving research quality in this area, including increased data collection, enhancing traditional modeling studies with sensitivity analysis, greater care in scoping, less confidence in characterizing aggregate impacts, more effort on understanding user behavior, and more contextual integration across the

  11. Adaptive Incentive Controls for Stackelberg Games with Unknown Cost Functionals.

    1984-01-01

    APR EZT:: F I AN 73S e OsL:-: UNCLASSI?:-- Q4~.’~- .A.., 6, *~*i i~~*~~*.- U ADAPTIVE INCENTIVE CONTROLS FOR STACKELBERG GAMES WITH UNKNOWN COST...AD-A161 885 ADAPTIVE INCENTIVE CONTROLS FOR STACKELBERG GAMES WITH i/1 UNKNOWN COST FUNCTIONALSCU) ILLINOIS UNIV AT URBANA DECISION AND CONTROL LAB T...ORGANIZATION 6b. OFFICE SYMBOL 7.. NAME OF MONITORING ORGANIZATION CoriaeLcenef~pda~ Joint Services Electronics Program Laboratory, Univ. of Illinois N/A

  12. Vaginal symptoms of unknown etiology - a study in dutch general-practice

    Dekker, Janny H.; Boeke, A. Joan P.; Janssens, J; van Eijk, J.Th.M.

    Vaginal symptoms are frequently presented by women to general practitioners. In many cases, the aetiology of these symptoms remains unknown. This study focused on the factors associated with microbiologically unexplained vaginal symptoms, the course of symptoms and signs in these cases, and factors

  13. A highly abundant bacteriophage discovered in the unknown sequences of human faecal metagenomes

    Dutilh, Bas E; Cassman, Noriko; McNair, Katelyn; Sanchez, Savannah E; Silva, Genivaldo G Z; Boling, Lance; Barr, Jeremy J; Speth, Daan R; Seguritan, Victor; Aziz, Ramy K; Felts, Ben; Dinsdale, Elizabeth A; Mokili, John L; Edwards, Robert A

    2014-01-01

    Metagenomics, or sequencing of the genetic material from a complete microbial community, is a promising tool to discover novel microbes and viruses. Viral metagenomes typically contain many unknown sequences. Here we describe the discovery of a previously unidentified bacteriophage present in the

  14. A sensitivity analysis approach to control of manipulators with unknown load

    Tzes, A.; Yurkovich, S.

    1987-01-01

    This paper presents a straightforward control strategy applied to an N-link manipulator holding an unknown load and driving its end effector along a prespecified trajectory. The control is constituted into two primary components. The non-adaptive component is derived from the inverse problem technique while the adaptive component is computed via the application of sensitivity analysis applied to the complete, centralized dynamic model of the manipulator. The result is a robust adaptive controller which tunes its parameters at specified time instants and can withstand all expected variations of the payload. The control synthesis is illustrated by simulations in a 2-link planar manipulator holding an unknown load

  15. General methods for modified projective synchronization of hyperchaotic systems with known or unknown parameters

    Tang, Yang; Fang, Jian-an

    2008-03-01

    This work is concerned with the general methods for modified projective synchronization of hyperchaotic systems. A systematic method of active control is developed to synchronize two hyperchaotic systems with known parameters. Moreover, by combining the adaptive control and linear feedback methods, general sufficient conditions for the modified projective synchronization of identical or different chaotic systems with fully unknown or partially unknown parameters are presented. Meanwhile, the speed of parameters identification can be regulated by adjusting adaptive gain matrix. Numerical simulations verify the effectiveness of the proposed methods.

  16. Spontaneous acute subdural hematoma in a patient with multiple myeloma

    Abrar Ahad Wani

    2012-01-01

    Full Text Available Acute spontaneous subdural hematoma in a patient of multiple myeloma receiving chemotherapy is an unknown event, needing an urgent neurosurgical management. We report this patient who presented with progressive neurological deterioration and a low platelet count. She was successfully managed by craniotomy and evacuation of subdural hematoma with intraoperative transfusion of platelets. The acute spontaneous subdural hematoma in her was probably related to the bleeding diathesis due to thrombocytopenia associated with chemotherapy.

  17. Zero Distribution of System with Unknown Random Variables Case Study: Avoiding Collision Path

    Parman Setyamartana

    2014-07-01

    Full Text Available This paper presents the stochastic analysis of finding the feasible trajectories of robotics arm motion at obstacle surrounding. Unknown variables are coefficients of polynomials joint angle so that the collision-free motion is achieved. ãk is matrix consisting of these unknown feasible polynomial coefficients. The pattern of feasible polynomial in the obstacle environment shows as random. This paper proposes to model the pattern of this randomness values using random polynomial with unknown variables as coefficients. The behavior of the system will be obtained from zero distribution as the characteristic of such random polynomial. Results show that the pattern of random polynomial of avoiding collision can be constructed from zero distribution. Zero distribution is like building block of the system with obstacles as uncertainty factor. By scale factor k, which has range, the random coefficient pattern can be predicted.

  18. Structure Elucidation of Unknown Metabolites in Metabolomics by Combined NMR and MS/MS Prediction.

    Boiteau, Rene M; Hoyt, David W; Nicora, Carrie D; Kinmonth-Schultz, Hannah A; Ward, Joy K; Bingol, Kerem

    2018-01-17

    We introduce a cheminformatics approach that combines highly selective and orthogonal structure elucidation parameters; accurate mass, MS/MS (MS²), and NMR into a single analysis platform to accurately identify unknown metabolites in untargeted studies. The approach starts with an unknown LC-MS feature, and then combines the experimental MS/MS and NMR information of the unknown to effectively filter out the false positive candidate structures based on their predicted MS/MS and NMR spectra. We demonstrate the approach on a model mixture, and then we identify an uncatalogued secondary metabolite in Arabidopsis thaliana . The NMR/MS² approach is well suited to the discovery of new metabolites in plant extracts, microbes, soils, dissolved organic matter, food extracts, biofuels, and biomedical samples, facilitating the identification of metabolites that are not present in experimental NMR and MS metabolomics databases.

  19. Lecture Presentations

    2007-01-01

    The Heavy-Ion Collisions in the LHC workshop held in Cracow from 18 to 18 May 2007. The main subject of the workshop was to present the newest results of research provided at CERN LHC collider. Additionally some theoretical models and methods used for presented data analysis were discussed

  20. CATCHY PRESENTATIONS

    Eriksen, Kaare; Tollestrup, Christian; Ovesen, Nis

    2011-01-01

    An important competence for designers is the ability to communicate and present ideas and proposals for customers, partners, investors and colleagues. The Pecha Kucha principle, developed by Astrid Klein and Mark Dytham, has become a widely used and easy format for the presentation of new concepts...

  1. Liability for Unknown Risks: A Law and Economics Perspective

    M.G. Faure (Michael); L.T. Visscher (Louis); F. Weber (Franziska)

    2017-01-01

    textabstractIn the law and economics literature liability is generally regarded as an instrument which provides potential tortfeasors with incentives for optimal care taking. The question, however, arises whether liability can still provide those incentives when risks are unknown. That is the

  2. Fast grasping of unknown objects using principal component analysis

    Lei, Qujiang; Chen, Guangming; Wisse, Martijn

    2017-09-01

    Fast grasping of unknown objects has crucial impact on the efficiency of robot manipulation especially subjected to unfamiliar environments. In order to accelerate grasping speed of unknown objects, principal component analysis is utilized to direct the grasping process. In particular, a single-view partial point cloud is constructed and grasp candidates are allocated along the principal axis. Force balance optimization is employed to analyze possible graspable areas. The obtained graspable area with the minimal resultant force is the best zone for the final grasping execution. It is shown that an unknown object can be more quickly grasped provided that the component analysis principle axis is determined using single-view partial point cloud. To cope with the grasp uncertainty, robot motion is assisted to obtain a new viewpoint. Virtual exploration and experimental tests are carried out to verify this fast gasping algorithm. Both simulation and experimental tests demonstrated excellent performances based on the results of grasping a series of unknown objects. To minimize the grasping uncertainty, the merits of the robot hardware with two 3D cameras can be utilized to suffice the partial point cloud. As a result of utilizing the robot hardware, the grasping reliance is highly enhanced. Therefore, this research demonstrates practical significance for increasing grasping speed and thus increasing robot efficiency under unpredictable environments.

  3. A Size Exclusion Chromatography Laboratory with Unknowns for Introductory Students

    McIntee, Edward J.; Graham, Kate J.; Colosky, Edward C.; Jakubowski, Henry V.

    2015-01-01

    Size exclusion chromatography is an important technique in the separation of biological and polymeric samples by molecular weight. While a number of laboratory experiments have been published that use this technique for the purification of large molecules, this is the first report of an experiment that focuses on purifying an unknown small…

  4. Stochastic Online Learning in Dynamic Networks under Unknown Models

    2016-08-02

    The key is to develop online learning strategies at each individual node. Specifically, through local information exchange with its neighbors, each...infinitely repeated game with incomplete information and developed a dynamic pricing strategy referred to as Competitive and Cooperative Demand Learning...Stochastic Online Learning in Dynamic Networks under Unknown Models This research aims to develop fundamental theories and practical algorithms for

  5. Inventory control in case of unknown demand and control parameters

    Janssen, E.

    2010-01-01

    This thesis deals with unknown demand and control parameters in inventory control. Inventory control involves decisions on what to order when and in what quantity. These decisions are based on information about the demand. Models are constructed using complete demand information; these models ensure

  6. Editoria: EBOLA: Fear of the unknown | Comoro | Tanzania Journal ...

    Tanzania Journal of Health Research. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 3, No 2 (2001) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Editoria: EBOLA: Fear of the unknown. C. Comoro, J.

  7. Lod score curves for phase-unknown matings.

    Hulbert-Shearon, T; Boehnke, M; Lange, K

    1996-01-01

    For a phase-unknown nuclear family, we show that the likelihood and lod score are unimodal, and we describe conditions under which the maximum occurs at recombination fraction theta = 0, theta = 1/2, and 0 < theta < 1/2. These simply stated necessary and sufficient conditions seem to have escaped the notice of previous statistical geneticists.

  8. Teleportation of Unknown Superpositions of Collective Atomic Coherent States

    ZHENG ShiBiao

    2001-01-01

    We propose a scheme to teleport an unknown superposition of two atomic coherent states with different phases. Our scheme is based on resonant and dispersive atom-field interaction. Our scheme provides a possibility of teleporting macroscopic superposition states of many atoms first time.``

  9. Teleportation of an Unknown Atomic State via Adiabatic Passage

    2007-01-01

    We propose a scheme for teleporting an unknown atomic state via adiabatic passage. Taking advantage of adiabatic passage, the atom has no probability of being excited and thus the atomic spontaneous emission is suppressed.We also show that the fidelity can reach 1 under certain condition.

  10. Clostridium difficile: A healthcare-associated infection of unknown ...

    Clostridium difficile: A healthcare-associated infection of unknown significance in adults in sub-Saharan Africa. ... Abstract. Background: Clostridium difficile infection (CDI) causes a high burden of disease in high-resource healthcare systems, with significant morbidity, mortality, and financial implications. CDI is a ...

  11. Vision-based autonomous grasping of unknown piled objects

    Johnson, R.K.

    1994-01-01

    Computer vision techniques have been used to develop a vision-based grasping capability for autonomously picking and placing unknown piled objects. This work is currently being applied to the problem of hazardous waste sorting in support of the Department of Energy's Mixed Waste Operations Program

  12. Cancer of unknown primitive metastatic. About two clinical cases

    Cawen, L; Cordoba, A.

    2010-01-01

    This work is about the two clinical cases about the unknown primitive metastatic cancer. The main techniques used for the diagnosis, treatment and monitoring of different s carcinomas are: Electronic microscope, molecular biology and genetics, especially histopathological study, topographic survey, ultrasound, radiography, chemotherapy, radiotherapy

  13. Multiphasic presentation of Rasmussen's encephalitis

    Avbersek, A.; Miserocchi, A.; McEvoy, A.W.; Patel, A.V.; Aronica, E.; Blumcke, I.; Jacques, T.S.; Acheson, J.; Thom, M.; Sisodiya, S.M.

    2015-01-01

    Rasmussen's encephalitis is a rare, chronic inflammatory disorder of unknown cause, characterised by drug-resistant focal epilepsy that may rarely present in adolescence or adulthood. We present a case of Rasmussen's encephalitis with prominent recurrent fluctuation in symptoms and well-documented

  14. Bayesian source term determination with unknown covariance of measurements

    Belal, Alkomiet; Tichý, Ondřej; Šmídl, Václav

    2017-04-01

    Determination of a source term of release of a hazardous material into the atmosphere is a very important task for emergency response. We are concerned with the problem of estimation of the source term in the conventional linear inverse problem, y = Mx, where the relationship between the vector of observations y is described using the source-receptor-sensitivity (SRS) matrix M and the unknown source term x. Since the system is typically ill-conditioned, the problem is recast as an optimization problem minR,B(y - Mx)TR-1(y - Mx) + xTB-1x. The first term minimizes the error of the measurements with covariance matrix R, and the second term is a regularization of the source term. There are different types of regularization arising for different choices of matrices R and B, for example, Tikhonov regularization assumes covariance matrix B as the identity matrix multiplied by scalar parameter. In this contribution, we adopt a Bayesian approach to make inference on the unknown source term x as well as unknown R and B. We assume prior on x to be a Gaussian with zero mean and unknown diagonal covariance matrix B. The covariance matrix of the likelihood R is also unknown. We consider two potential choices of the structure of the matrix R. First is the diagonal matrix and the second is a locally correlated structure using information on topology of the measuring network. Since the inference of the model is intractable, iterative variational Bayes algorithm is used for simultaneous estimation of all model parameters. The practical usefulness of our contribution is demonstrated on an application of the resulting algorithm to real data from the European Tracer Experiment (ETEX). This research is supported by EEA/Norwegian Financial Mechanism under project MSMT-28477/2014 Source-Term Determination of Radionuclide Releases by Inverse Atmospheric Dispersion Modelling (STRADI).

  15. Workshop presentations

    Sanden, Per-Olof; Edland, Anne; Reiersen, Craig; Mullins, Peter; Ingemarsson, Karl-Fredrik; Bouchard, Andre; Watts, Germaine; Johnstone, John; Hollnagel, Erik; Ramberg, Patric; Reiman, Teemu

    2009-01-01

    An important part of the workshop was a series of invited presentations. The presentations were intended to both provide the participants with an understanding of various organisational approaches and activities as well as to stimulate the exchange of ideas during the small group discussion sessions. The presentation subjects ranged from current organisational regulations and licensee activities to new organisational research and the benefits of viewing organisations from a different perspective. There were more than a dozen invited presentations. The initial set of presentations gave the participants an overview of the background, structure, and aims of the workshop. This included a short presentation on the results from the regulatory responses to the pre-workshop survey. Representatives from four countries (Sweden, Canada, Finland, and the United Kingdom) expanded upon their survey responses with detailed presentations on both regulatory and licensee safety-related organisational activities in their countries. There were also presentations on new research concerning how to evaluate safety critical organisations and on a resilience engineering perspective to safety critical organisations. Below is the list of the presentations, the slides of which being available in Appendix 2: 1 - Workshop Welcome (Per-Olof Sanden); 2 - CSNI Working Group on Human and Organisational Factors (Craig Reiersen); 3 - Regulatory expectations on justification of suitability of licensee organisational structures, resources and competencies (Anne Edland); 4 - Justifying the suitability of licensee organisational structures, resources and competencies (Karl-Fredrik Ingemarsson); 5 - Nuclear Organisational Suitability in Canada (Andre Bouchard); 6 - Designing and Resourcing for Safety and Effectiveness (Germaine Watts); 7 - Organisational Suitability - What do you need and how do you know that you've got it? (Craig Reiersen); 8 - Suitability of Organisations - UK Regulator's View (Peter

  16. Multiple sclerosis: current immunological aspects

    Carlos Cuevas-García

    2017-02-01

    Full Text Available Multiple sclerosis is the most common inflammatory, chronic and degenerative condition of the central nervous system, and represents the first cause of disability in young adults. In Mexico, 11 to 20 out of every 100 000 people suffer from this disease. The causes of multiple sclerosis remain unknown, but several theories have been proposed on its origin: the interaction of environmental factors, viral infectious factors and genetic and immune susceptibility of each individual patient, which induce an autoimmune response and promote neuronal/axonal degeneration. In this review, the immune reaction main components and neurodegeneration present in multiple sclerosis are analyzed, as well as the inflammatory cascade associated with demyelination. Available treatments’ main purpose is to modulate aspects related to the adaptive immune response (B and T cells. The therapeutic challenge will be antigen-specific immune-tolerance induction, for example, with the use of tolerance protocols with peptides or DNA or nanoparticles vaccines. Future therapies should aim to control innate components (microglia, macrophages, astrocytes and to promote remyelination. To optimize the treatment, a combined therapeutic approach targeting the control of inflammatory and neurodegenerative components of the disease and monitoring of biomarkers will be necessary.

  17. Current status of cannabis treatment of multiple sclerosis with an illustrative case presentation of a patient with MS, complex vocal tics, paroxysmal dystonia, and marijuana dependence treated with dronabinol.

    Deutsch, Stephen I; Rosse, Richard B; Connor, Julie M; Burket, Jessica A; Murphy, Mary E; Fox, Fiona J

    2008-05-01

    Pain, spasticity, tremor, spasms, poor sleep quality, and bladder and bowel dysfunction, among other symptoms, contribute significantly to the disability and impaired quality of life of many patients with multiple sclerosis (MS). Motor symptoms referable to the basal ganglia, especially paroxysmal dystonia, occur rarely and contribute to the experience of distress. A substantial percentage of patients with MS report subjective benefit from what is often illicit abuse of extracts of the Cannabis sativa plant; the main cannabinoids include delta-9-tetrahydrocannabinol (delta9-THC) and cannabidiol. Clinical trials of cannabis plant extracts and synthetic delta9-THC provide support for therapeutic benefit on at least some patient self-report measures. An illustrative case is presented of a 52-year-old woman with MS, paroxysmal dystonia, complex vocal tics, and marijuana dependence. The patient was started on an empirical trial of dronabinol, an encapsulated form of synthetic delta9-THC that is usually prescribed as an adjunctive medication for patients undergoing cancer chemotherapy. The patient reported a dramatic reduction of craving and illicit use; she did not experience the "high" on the prescribed medication. She also reported an improvement in the quality of her sleep with diminished awakenings during the night, decreased vocalizations, and the tension associated with their emission, decreased anxiety and a decreased frequency of paroxysmal dystonia.

  18. CERN presentations

    CERN. Geneva

    2011-01-01

    Presentation by CERN (10 minutes each) Rolf Landua - Education and Outreach Salvatore Mele - Open Access Jean-Yves Le Meur - Digital Library in Africa Francois Fluckiger - Open Source/Standards (tbc) Tim Smith - Open Data for Science Tullio Basiglia - tbc

  19. Delivery presentations

    ... has entered the pelvis. If the presenting part lies above the ischial spines, the station is reported ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  20. Information Presentation

    Holden, K.L.; Boyer, J.L.; Sandor, A.; Thompson, S.G.; McCann, R.S.; Begault, D.R.; Adelstein, B.D.; Beutter, B.R.; Stone, L.S.

    2009-01-01

    The goal of the Information Presentation Directed Research Project (DRP) is to address design questions related to the presentation of information to the crew. The major areas of work, or subtasks, within this DRP are: 1) Displays, 2) Controls, 3) Electronic Procedures and Fault Management, and 4) Human Performance Modeling. This DRP is a collaborative effort between researchers at Johnson Space Center and Ames Research Center.

  1. Estimation of unknown nuclear masses by means of the generalized mass relations. Pt. 3

    Popa, S.M.

    1980-01-01

    A survey of the estimations of the unknown nuclear masses by means of the generalized mass relations is presented. One discusses the new hypotheses supplementing the original general Garvey-Kelson scheme, reviewing the generalized mass relations and formulae, according to the present status of this new formalism. A critical discussions is given of the reliability of these new Garvey-Kelson type extrapolation procedures. (author)

  2. Accessory papillary muscles and papillary muscle hypertrophy are associated with sudden cardiac arrest of unknown cause.

    Uhm, Jae-Sun; Youn, Jong-Chan; Lee, Hye-Jeong; Park, Junbeom; Park, Jin-Kyu; Shim, Chi Young; Hong, Geu-Ru; Joung, Boyoung; Pak, Hui-Nam; Lee, Moon-Hyoung

    2015-10-15

    The present study was performed for elucidating the associations between the morphology of the papillary muscles (PMs) and sudden cardiac arrest (SCA). We retrospectively reviewed history, laboratory data, electrocardiography, echocardiography, coronary angiography, and cardiac CT/MRI for 190 patients with SCA. The prevalence of accessory PMs and PM hypertrophy in patients with SCA of unknown cause was compared with that in patients with SCA of known causes and 98 age- and sex-matched patients without SCA. An accessory PM was defined as a PM with origins separated from the anterolateral and posteromedial PMs, or a PM that branched into two or three bellies at the base of the anterolateral or posteromedial PM. PM hypertrophy was defined as at least one of the two PMs having a diameter of ≥1.1cm. In 49 patients (age 49.9±15.9years; 38 men) the cause of SCA was unknown, whereas 141 (age 54.2±16.6years; 121 men) had a known cause. The prevalence of accessory PMs was significantly higher in the unknown-cause group than in the known-cause group (24.5% and 7.8%, respectively; p=0.002) or the no-SCA group (7.1%, p=0.003). The same was true for PM hypertrophy (unknown-cause 12.2%, known-cause 2.1%, p=0.010; no SCA group 1.0%, p=0.006). By logistic regression, accessory PM and PM hypertrophy were independently associated with sudden cardiac arrest of unknown cause. An accessory PM and PM hypertrophy are associated with SCA of unknown cause. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Voting Present

    James Lo

    2013-12-01

    Full Text Available During his time as a state senator in Illinois, Barack Obama voted “Present” 129 times, a deliberate act of nonvoting that subsequently became an important campaign issue during the 2008 presidential elections. In this article, I examine the use of Present votes in the Illinois state senate. I find evidence that Present votes can largely be characterized as protest votes used as a legislative tool by the minority party. Incorporating information from Present votes into a Bayesian polytomous item-response model, I find that this information increases the efficiency of ideal point estimates by approximately 35%. There is little evidence of significant moderation by Obama when Present votes are accounted for, though my results suggest that Obama’s voting record may have moderated significantly before his subsequent election to the U.S. Senate. My results also suggest that because legislative nonvoting may occur for a variety of reasons, naive inclusion of nonvoting behavior into vote choice models may lead to biased results.

  4. Lecture Presentations

    2008-01-01

    The Symposium on Physics of Elementary Interactions in the LHC Era held in Warsaw from 21 to 22 April 2008. The main subject of the workshop was to present the progress in CERN LHC collider project. Additionally some satellite activities in field of education, knowledge and technology transfer in the frame of CERN - Poland cooperation were shown

  5. Presentation Technique

    Froejmark, M.

    1992-10-01

    The report presents a wide, easily understandable description of presentation technique and man-machine communication. General fundamentals for the man-machine interface are illustrated, and the factors that affect the interface are described. A model is presented for describing the operators work situation, based on three different levels in the operators behaviour. The operator reacts routinely in the face of simple, known problems, and reacts in accordance with predetermined plans in the face of more complex, recognizable problems. Deep fundamental knowledge is necessary for truly complex questions. Today's technical status and future development have been studied. In the future, the operator interface will be based on standard software. Functions such as zooming, integration of video pictures, and sound reproduction will become common. Video walls may be expected to come into use in situations in which several persons simultaneously need access to the same information. A summary of the fundamental rules for the design of good picture ergonomics and design requirements for control rooms are included in the report. In conclusion, the report describes a presentation technique within the Distribution Automation and Demand Side Management area and analyses the know-how requirements within Vattenfall. If different systems are integrated, such as geographical information systems and operation monitoring systems, strict demands are made on the expertise of the users for achieving a user-friendly technique which is matched to the needs of the human being. (3 figs.)

  6. Towards high-speed autonomous navigation of unknown environments

    Richter, Charles; Roy, Nicholas

    2015-05-01

    In this paper, we summarize recent research enabling high-speed navigation in unknown environments for dynamic robots that perceive the world through onboard sensors. Many existing solutions to this problem guarantee safety by making the conservative assumption that any unknown portion of the map may contain an obstacle, and therefore constrain planned motions to lie entirely within known free space. In this work, we observe that safety constraints may significantly limit performance and that faster navigation is possible if the planner reasons about collision with unobserved obstacles probabilistically. Our overall approach is to use machine learning to approximate the expected costs of collision using the current state of the map and the planned trajectory. Our contribution is to demonstrate fast but safe planning using a learned function to predict future collision probabilities.

  7. Biomarkers for Ectopic Pregnancy and Pregnancy of Unknown Location

    Senapati, Suneeta; Barnhart, Kurt T.

    2013-01-01

    Early pregnancy failure is the most common complication of pregnancy, and 1–2% of all pregnancies will be ectopic. As one of the leading causes of maternal morbidity and mortality, diagnosing ectopic pregnancy and determining the fate of a pregnancy of unknown location are of great clinical concern. Several serum and plasma biomarkers for ectopic pregnancy have been investigated independently and in combination. The following is a review of the state of biomarker discovery and development for...

  8. Technical presentation

    FI Department

    2008-01-01

    RADIOSPARES, the leading catalogue distributor of components (electronic, electrical, automation, etc.) and industrial supplies will be at CERN on Friday 3 October 2008 (Main Building, Room B, from 9.00 a.m. to 3.00 p.m.) to introduce its new 2008/2009 catalogue. This will be the opportunity for us to present our complete range of products in more detail: 400 000 part numbers available on our web site (Radiospares France, RS International, extended range of components from other manufacturers); our new services: quotations, search for products not included in the catalogue, SBP products (Small Batch Production: packaging in quantities adapted to customers’ requirements); partnership with our focus manufacturers; demonstration of the on-line purchasing tool implemented on our web site in conjunction with CERN. RADIOSPARES will be accompanied by representatives of FLUKE and TYCO ELECTRONICS, who will make presentations, demonstrate materials and answer any technical questio...

  9. Characterizing unknown systematics in large scale structure surveys

    Agarwal, Nishant; Ho, Shirley; Myers, Adam D.; Seo, Hee-Jong; Ross, Ashley J.; Bahcall, Neta; Brinkmann, Jonathan; Eisenstein, Daniel J.; Muna, Demitri; Palanque-Delabrouille, Nathalie; Yèche, Christophe; Pâris, Isabelle; Petitjean, Patrick; Schneider, Donald P.; Streblyanska, Alina; Weaver, Benjamin A.

    2014-01-01

    Photometric large scale structure (LSS) surveys probe the largest volumes in the Universe, but are inevitably limited by systematic uncertainties. Imperfect photometric calibration leads to biases in our measurements of the density fields of LSS tracers such as galaxies and quasars, and as a result in cosmological parameter estimation. Earlier studies have proposed using cross-correlations between different redshift slices or cross-correlations between different surveys to reduce the effects of such systematics. In this paper we develop a method to characterize unknown systematics. We demonstrate that while we do not have sufficient information to correct for unknown systematics in the data, we can obtain an estimate of their magnitude. We define a parameter to estimate contamination from unknown systematics using cross-correlations between different redshift slices and propose discarding bins in the angular power spectrum that lie outside a certain contamination tolerance level. We show that this method improves estimates of the bias using simulated data and further apply it to photometric luminous red galaxies in the Sloan Digital Sky Survey as a case study

  10. Characterizing unknown systematics in large scale structure surveys

    Agarwal, Nishant; Ho, Shirley [McWilliams Center for Cosmology, Department of Physics, Carnegie Mellon University, Pittsburgh, PA 15213 (United States); Myers, Adam D. [Department of Physics and Astronomy, University of Wyoming, Laramie, WY 82071 (United States); Seo, Hee-Jong [Berkeley Center for Cosmological Physics, LBL and Department of Physics, University of California, Berkeley, CA 94720 (United States); Ross, Ashley J. [Institute of Cosmology and Gravitation, University of Portsmouth, Portsmouth, PO1 3FX (United Kingdom); Bahcall, Neta [Princeton University Observatory, Peyton Hall, Princeton, NJ 08544 (United States); Brinkmann, Jonathan [Apache Point Observatory, P.O. Box 59, Sunspot, NM 88349 (United States); Eisenstein, Daniel J. [Harvard-Smithsonian Center for Astrophysics, 60 Garden St., Cambridge, MA 02138 (United States); Muna, Demitri [Department of Astronomy, Ohio State University, Columbus, OH 43210 (United States); Palanque-Delabrouille, Nathalie; Yèche, Christophe [CEA, Centre de Saclay, Irfu/SPP, F-91191 Gif-sur-Yvette (France); Pâris, Isabelle [Departamento de Astronomía, Universidad de Chile, Casilla 36-D, Santiago (Chile); Petitjean, Patrick [Université Paris 6 et CNRS, Institut d' Astrophysique de Paris, 98bis blvd. Arago, 75014 Paris (France); Schneider, Donald P. [Department of Astronomy and Astrophysics, Pennsylvania State University, University Park, PA 16802 (United States); Streblyanska, Alina [Instituto de Astrofisica de Canarias (IAC), E-38200 La Laguna, Tenerife (Spain); Weaver, Benjamin A., E-mail: nishanta@andrew.cmu.edu [Center for Cosmology and Particle Physics, New York University, New York, NY 10003 (United States)

    2014-04-01

    Photometric large scale structure (LSS) surveys probe the largest volumes in the Universe, but are inevitably limited by systematic uncertainties. Imperfect photometric calibration leads to biases in our measurements of the density fields of LSS tracers such as galaxies and quasars, and as a result in cosmological parameter estimation. Earlier studies have proposed using cross-correlations between different redshift slices or cross-correlations between different surveys to reduce the effects of such systematics. In this paper we develop a method to characterize unknown systematics. We demonstrate that while we do not have sufficient information to correct for unknown systematics in the data, we can obtain an estimate of their magnitude. We define a parameter to estimate contamination from unknown systematics using cross-correlations between different redshift slices and propose discarding bins in the angular power spectrum that lie outside a certain contamination tolerance level. We show that this method improves estimates of the bias using simulated data and further apply it to photometric luminous red galaxies in the Sloan Digital Sky Survey as a case study.

  11. Multi-Attribute Vickrey Auctions when Utility Functions are Unknown

    Máhr, T.; De Weerdt, M.M.

    2006-01-01

    Multi-attribute auctions allow negotiations over multiple attributes besides price. For example in task allocation, service providers can define their service by means of multiple attributes, such as quality of service, deadlines, or delay penalties. Auction mechanisms assume that the players have

  12. Prevalence and Impact of Unknown Diabetes in the ICU.

    Carpenter, David L; Gregg, Sara R; Xu, Kejun; Buchman, Timothy G; Coopersmith, Craig M

    2015-12-01

    Many patients with diabetes and their care providers are unaware of the presence of the disease. Dysglycemia encompassing hyperglycemia, hypoglycemia, and glucose variability is common in the ICU in patients with and without diabetes. The purpose of this study was to determine the impact of unknown diabetes on glycemic control in the ICU. Prospective observational study. Nine ICUs in an academic, tertiary hospital and a hybrid academic/community hospital. Hemoglobin A1c levels were ordered at all ICU admissions from March 1, 2011 to September 30, 2013. Electronic medical records were examined for a history of antihyperglycemic medications or International Classification of Diseases, 9th Edition diagnosis of diabetes. Patients were categorized as having unknown diabetes (hemoglobin A1c > 6.5%, without history of diabetes), no diabetes (hemoglobin A1c 6.5%, with documented history of diabetes). None. A total of 15,737 patients had an hemoglobin A1c and medical record evaluable for the history of diabetes, and 5,635 patients had diabetes diagnosed by either medical history or an elevated hemoglobin A1c in the ICU. Of these, 1,460 patients had unknown diabetes, accounting for 26.0% of all patients with diabetes. This represented 41.0% of patients with an hemoglobin A1c > 6.5% and 9.3% of all ICU patients. Compared with patients without diabetes, patients with unknown diabetes had a higher likelihood of requiring an insulin infusion (44.3% vs 29.3%; p 180 mg/dL; p < 0.0001) and hypoglycemia (8.9% vs 2.5%; blood glucose < 70 mg/dL; p < 0.0001), higher glycemic variability (55.6 vs 28.8, average of patient SD of glucose; p < 0.0001), and increased mortality (13.8% vs 11.4%; p = 0.01). Patients with unknown diabetes represent a significant percentage of ICU admissions. Measurement of hemoglobin A1c at admission can prospectively identify a population that are not known to have diabetes but have significant challenges in glycemic control in the ICU.

  13. Neutron Multiplicity Analysis

    Frame, Katherine Chiyoko [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-06-28

    Neutron multiplicity measurements are widely used for nondestructive assay (NDA) of special nuclear material (SNM). When combined with isotopic composition information, neutron multiplicity analysis can be used to estimate the spontaneous fission rate and leakage multiplication of SNM. When combined with isotopic information, the total mass of fissile material can also be determined. This presentation provides an overview of this technique.

  14. Technical presentation

    FP Department

    2009-01-01

    07 April 2009 Technical presentation by Leuze Electronics: 14.00 – 15.00, Main Building, Room 61-1-017 (Room A) Photoelectric sensors, data identification and transmission systems, image processing systems. We at Leuze Electronics are "the sensor people": we have been specialising in optoelectronic sensors and safety technology for accident prevention for over 40 years. Our dedicated staff are all highly customer oriented. Customers of Leuze Electronics can always rely on one thing – on us! •\tFounded in 1963 •\t740 employees •\t115 MEUR turnover •\t20 subsidiaries •\t3 production facilities in southern Germany Product groups: •\tPhotoelectric sensors •\tIdentification and measurements •\tSafety devices

  15. Identification of fractional-order systems with unknown initial values and structure

    Du, Wei, E-mail: duwei0203@gmail.com [Key Laboratory of Advanced Control and Optimization for Chemical Processes, Ministry of Education, East China University of Science and Technology, Shanghai 200237 (China); Miao, Qingying, E-mail: qymiao@sjtu.edu.cn [School of Continuing Education, Shanghai Jiao Tong University, Shanghai 200030 (China); Tong, Le, E-mail: tongle0328@gmail.com [Faculty of Applied Science and Textiles, The Hong Kong Polytechnic University, Hong Kong (China); Tang, Yang [Key Laboratory of Advanced Control and Optimization for Chemical Processes, Ministry of Education, East China University of Science and Technology, Shanghai 200237 (China)

    2017-06-21

    In this paper, the identification problem of fractional-order chaotic systems is proposed and investigated via an evolutionary optimization approach. Different with other studies to date, this research focuses on the identification of fractional-order chaotic systems with not only unknown orders and parameters, but also unknown initial values and structure. A group of fractional-order chaotic systems, i.e., Lorenz, Lü, Chen, Rössler, Arneodo and Volta chaotic systems, are set as the system candidate pool. The identification problem of fractional-order chaotic systems in this research belongs to mixed integer nonlinear optimization in essence. A powerful evolutionary algorithm called composite differential evolution (CoDE) is introduced for the identification problem presented in this paper. Extensive experiments are carried out to show that the fractional-order chaotic systems with unknown initial values and structure can be successfully identified by means of CoDE. - Highlights: • Unknown initial values and structure are introduced in the identification of fractional-order chaotic systems; • Only a series of output is utilized in the identification of fractional-order chaotic systems; • CoDE is used for the identification problem and the results are satisfactory when compared with other DE variants.

  16. Unknown loads affect force production capacity in early phases of bench press throws.

    Hernández Davó, J L; Sabido Solana, R; Sarabia Marínm, J M; Sánchez Martos, Á; Moya Ramón, M

    2015-10-01

    Explosive strength training aims to improve force generation in early phases of movement due to its importance in sport performance. The present study examined the influence of lack of knowledge about the load lifted in explosive parameters during bench press throws. Thirteen healthy young men (22.8±2.0 years) participated in the study. Participants performed bench press throws with three different loads (30, 50 and 70% of 1 repetition maximum) in two different conditions (known and unknown loads). In unknown condition, loads were changed within sets in each repetition and participants did not know the load, whereas in known condition the load did not change within sets and participants had knowledge about the load lifted. Results of repeated-measures ANOVA revealed that unknown conditions involves higher power in the first 30, 50, 100 and 150 ms with the three loads, higher values of ratio of force development in those first instants, and differences in time to reach maximal rate of force development with 50 and 70% of 1 repetition maximum. This study showed that unknown conditions elicit higher values of explosive parameters in early phases of bench press throws, thereby this kind of methodology could be considered in explosive strength training.

  17. Maduración sexual en niños con diabetes mellitus tipo 1 tratados con dosis múltiples de insulina Sexual maturation in children presenting with Type 1 diabetes mellitus treated with multiple dose of insulin.

    Tania Espinosa Reyes

    2007-04-01

    Infantile Endocrinlogy. A non-concurrent prospective study of medical records of patients treated withmultiple dose of insulin, from 32 boys and 28 girls resident in urban areas lenghwise followed by clinical examinatio and periodic biochemical determinarions fron onset of 1 MD to achieve its final height. Metabolic control was assessed by means of glycolised hemoglobin (HbA1 performed quarterly, and classified by Institution criteria as good (G; 10 %. Mean age with a testicular volume of 4 mL was of 12,5 ? 8 years; in girls onset of breast development contrasted with average age of 11,4 years, and menarche occured at 12,9 ? 1,2 years. Also, it was confirmed that 31 patients have a B metabolic control (51,6 %, 11 R (36,7 %, and 7 M (11,7 %. It was conclude that treatment with multiple dose of insulin has a favourable end decisive influence on degree of metabolic control, whith allows a appropriate pubertal development in patients presenting 1 MD.

  18. Pretreatment costs of care and time to initial treatment for patients with cancer of unknown primary.

    Walker, Mark S; Weinstein, Laura; Luo, Roger; Marino, Ingrid

    2018-06-01

    Time to treatment and pretreatment costs may be affected by unknown primary tumor site. This retrospective study used electronic medical record data from patients in ten US community oncology practices. Eligible patients were ≥18 years, diagnosed with cancer of unknown primary (CUP) or known metastatic solid tumor, and presented between 1 January 2012 and 30 June 2014. Patients with CUP (n = 294) had a longer interval than non-CUP patients (n = 92) from presentation to treatment initiation (1.18 vs 0.49 months, p < 0.0001), and had higher pretreatment costs (US$27,882 vs US$20,449, p = 0.0075). When analyzed as monthly cost, the difference between groups in log-cost per month was nonsignificant. Higher pretreatment costs in CUP patients appeared attributable to significantly longer time to initiation of therapy.

  19. Estimating unknown input parameters when implementing the NGA ground-motion prediction equations in engineering practice

    Kaklamanos, James; Baise, Laurie G.; Boore, David M.

    2011-01-01

    The ground-motion prediction equations (GMPEs) developed as part of the Next Generation Attenuation of Ground Motions (NGA-West) project in 2008 are becoming widely used in seismic hazard analyses. However, these new models are considerably more complicated than previous GMPEs, and they require several more input parameters. When employing the NGA models, users routinely face situations in which some of the required input parameters are unknown. In this paper, we present a framework for estimating the unknown source, path, and site parameters when implementing the NGA models in engineering practice, and we derive geometrically-based equations relating the three distance measures found in the NGA models. Our intent is for the content of this paper not only to make the NGA models more accessible, but also to help with the implementation of other present or future GMPEs.

  20. Optimal unambiguous comparison of two unknown squeezed vacua

    Olivares, Stefano; Paris, Matteo G. A.; Sedlak, Michal; Rapsan, Peter; Busek, Vladimir

    2011-01-01

    We propose a scheme for the unambiguous state comparison (USC) of two unknown squeezed vacuum states of the electromagnetic field. Our setup is based on linear optical elements and photon-number detectors, and it achieves optimal USC in an ideal case of unit quantum efficiency. In realistic conditions, i.e., for nonunit quantum efficiency of photodetectors, we evaluate the probability of getting an ambiguous result as well as the reliability of the scheme, thus showing its robustness in comparison to previous proposals.

  1. Fast entanglement detection for unknown states of two spatial qutrits

    Lima, G.; Gomez, E. S.; Saavedra, C.; Vargas, A.; Vianna, R. O.

    2010-01-01

    We investigate the practicality of the method proposed by Maciel et al. [Phys. Rev. A. 80, 032325 (2009).] for detecting the entanglement of two spatial qutrits (three-dimensional quantum systems), which are encoded in the discrete transverse momentum of single photons transmitted through a multislit aperture. The method is based on the acquisition of partial information of the quantum state through projective measurements, and a data processing analysis done with semidefinite programs. This analysis relies on generating gradually an optimal entanglement witness operator, and numerical investigations have shown that it allows for the entanglement detection of unknown states with a cost much lower than full state tomography.

  2. Algorithms for Rapidly Dispersing Robot Swarms in Unknown Environments

    Hsiang, Tien-Ruey; Arkin, Esther M.; Bender, Michael; Fekete, Sandor P.; Mitchell, Joseph S. B.

    2002-01-01

    We develop and analyze algorithms for dispersing a swarm of primitive robots in an unknown environment, R. The primary objective is to minimize the makespan, that is, the time to fill the entire region. An environment is composed of pixels that form a connected subset of the integer grid. There is at most one robot per pixel and robots move horizontally or vertically at unit speed. Robots enter R by means of k>=1 door pixels Robots are primitive finite automata, only having local communicatio...

  3. Modal Parameter Identification from Responses of General Unknown Random Inputs

    Ibrahim, S. R.; Asmussen, J. C.; Brincker, Rune

    1996-01-01

    Modal parameter identification from ambient responses due to a general unknown random inputs is investigated. Existing identification techniques which are based on assumptions of white noise and or stationary random inputs are utilized even though the inputs conditions are not satisfied....... This is accomplished via adding. In cascade. A force cascade conversion to the structures system under consideration. The input to the force conversion system is white noise and the output of which is the actual force(s) applied to the structure. The white noise input(s) and the structures responses are then used...

  4. Tectonic history in the Fort Worth Basin, north Texas, derived from well-log integration with multiple 3D seismic reflection surveys: implications for paleo and present-day seismicity in the basin

    Magnani, M. B.; Hornbach, M. J.

    2016-12-01

    Oil and gas exploration and production in the Fort Worth Basin (FWB) in north Texas have accelerated in the last 10 years due to the success of unconventional gas production. Here, hydraulic fracturing wastewater is disposed via re-injection into deep wells that penetrate Ordovician carbonate formations. The rise in wastewater injection has coincided with a marked rise in earthquake rates, suggesting a causal relationship between industry practices and seismicity. Most studies addressing this relationship in intraplate regions like the FWB focus on current seismicity, which provides an a-posteriori assessment of the processes involved. 3D seismic reflection data contribute complementary information on the existence, distribution, orientation and long-term deformation history of faults that can potentially become reactivated by the injection process. Here we present new insights into the tectonic evolution of faults in the FWB using multiple 3D seismic reflection surveys in the basin, west of the Dallas Fort-Worth Metroplex, where high-volume wastewater injection wells have increased most significantly in number in the past few years. The datasets image with remarkable clarity the 3,300 m-thick sedimentary rocks of the basin, from the crystalline basement to the Cretaceous cover, with particular detail of the Paleozoic section. The data, interpreted using coincident and nearby wells to correlate seismic reflections with stratigraphic markers, allow us to identify faults, extract their orientation, length and displacements at several geologic time intervals, and therefore, reconstruct the long-term deformation history. Throughout the basin, the data show that all seismically detectable faults were active during the Mississippian and Pennsylvanian, but that displacement amounts drop below data resolution ( 7 m) in the post-Pennsylvanian deposits. These results indicate that faults have been inactive for at least the past 300 Ma, until the recent 2008 surge in

  5. Mysteries and unknowns of single bubble sonoluminescence from viewpoint of plasma spectroscopy

    Lavrov, B.P.

    2001-01-01

    The main goal of the present work is to propose and consider electronically excited H 2 * (a 3 Σ g + ) molecules (and possibly hydrides of rare gases like ArH*(A 2 Σ)) as light emitters responsible for continua observed in both MBSL and SBSL experiments with hydrogen-containing liquids. This provides new sight on the well known ''mysteries and unknowns'' of the SBSL phenomenon

  6. AN ADAPTIVE OPTIMAL KALMAN FILTER FOR STOCHASTIC VIBRATION CONTROL SYSTEM WITH UNKNOWN NOISE VARIANCES

    Li Shu; Zhuo Jiashou; Ren Qingwen

    2000-01-01

    In this paper, an optimal criterion is presented for adaptive Kalman filter in a control sys tem with unknown variances of stochastic vibration by constructing a function of noise variances and minimizing the function. We solve the model and measure variances by using DFP optimal method to guarantee the results of Kalman filter to be optimized. Finally, the control of vibration can be implemented by LQG method.

  7. Marked improvement of vulvovaginitis of unknown origin in a pediatric patient--case report.

    Check, J H; Cohen, R

    2014-01-01

    To present a novel therapy for pediatric vulvovaginitis. An eight-year-old girl with persistent severe vulvovaginitis of unknown origin also complained of unexplained weight gain and sudden academic difficulties. She was treated with dextroamphetamine sulfate. She not only showed very quick and excellent relief from her vulvovaginitis but she also lost weight and improved her mentality. Sympathomimetic amine therapy may benefit pediatric vulvovaginitis when an infectious cause cannot be ascertained.

  8. Quantum Logic Networks for Probabilistic and Controlled Teleportation of Unknown Quantum States

    GAO Ting

    2004-01-01

    We present simplification schemes for probabilistic and controlled teleportation of the unknown quantum states of both one particle and two particles and construct efficient quantum logic networks for implementing the new schemes by means of the primitive operations consisting of single-qubit gates, two-qubit controlled-not gates, Von Neumann measurement, and classically controlled operations. In these schemes the teleportation are not always successful but with certain probability.

  9. Scheme for Entanglement Concentration of Unknown Multiparticle Greenberger-Horne-Zeilinger or W Class States

    Song Wei

    2007-01-01

    We present two schemes for concentrating unknown nonmaximally entangled Greenberger-Horme-Zeilinger (GHZ) or W class states. The first scheme for concentrating the nonmaximally entangled GHZ state is based on linear optical devices. The second scheme for concentrating the W class states can be applied to a wide variety of atomic state. Both of our schemes are not postselection ones and are within the current technologies.

  10. Vascular aspects of multiple sclerosis

    D'haeseleer, Miguel; Cambron, Melissa; Vanopdenbosch, Ludo; De Keyser, Jacques

    Three types of vascular dysfunction have been described in multiple sclerosis (MS). First, findings from epidemiological studies suggest that patients with MS have a higher risk for ischaemic stroke than people who do not have MS. The underlying mechanism is unknown, but might involve endothelial

  11. Accounting for unknown foster dams in the genetic evaluation of embryo transfer progeny.

    Suárez, M J; Munilla, S; Cantet, R J C

    2015-02-01

    Animals born by embryo transfer (ET) are usually not included in the genetic evaluation of beef cattle for preweaning growth if the recipient dam is unknown. This is primarily to avoid potential bias in the estimation of the unknown age of dam. We present a method that allows including records of calves with unknown age of dam. Assumptions are as follows: (i) foster cows belong to the same breed being evaluated, (ii) there is no correlation between the breeding value (BV) of the calf and the maternal BV of the recipient cow, and (iii) cows of all ages are used as recipients. We examine the issue of bias for the fixed level of unknown age of dam (AOD) and propose an estimator of the effect based on classical measurement error theory (MEM) and a Bayesian approach. Using stochastic simulation under random mating or selection, the MEM estimating equations were compared with BLUP in two situations as follows: (i) full information (FI); (ii) missing AOD information on some dams. Predictions of breeding value (PBV) from the FI situation had the smallest empirical average bias followed by PBV obtained without taking measurement error into account. In turn, MEM displayed the highest bias, although the differences were small. On the other hand, MEM showed the smallest MSEP, for either random mating or selection, followed by FI, whereas ignoring measurement error produced the largest MSEP. As a consequence from the smallest MSEP with a relatively small bias, empirical accuracies of PBV were larger for MEM than those for full information, which in turn showed larger accuracies than the situation ignoring measurement error. It is concluded that MEM equations are a useful alternative for analysing weaning weight data when recipient cows are unknown, as it mitigates the effects of bias in AOD by decreasing MSEP. © 2014 Blackwell Verlag GmbH.

  12. Unknown facets of Well-Known Scientists Series - Part II

    V S Dixit

    2016-01-01

    Full Text Available 1st in the series of articles on “Unknown Facets of well-known Scientists” was about Sir Frederick Grant Banting, co-discoverer of Insulin, who also researched in Aviation and Diving Medicines, results of which brought extraordinary benefits for Flight crew during the World War II. The article was published in the previous issue of the Journal Unknown facets could be celebrated attributes, talents or otherwise, but it is necessary that we get to know fully about the “great mind". THIS ARTICLE IS ABOUT DR WERNER THEODOR OTTO FORSSMANN, A CARDIOLOGIST, WHO BECAME A UROLOGIST! Does the name Dr Forssmann ring a bell? He shared the 1956 Nobel Prize in Physiology or Medicine with “Andre Cournand and Dickinson Richards". The trio was awarded for their “discoveries concerning heart catheterization and pathological changes in the circulatory system". Dr Forssmann was nominated for performing an experiment in which he introduced a catheter into a vein of his arm, further passing it onward into his heart It was risky. This was in the year 1929. Subject of this article is the self-experimentation he carried out and what happened later.

  13. Parameter identification of chaos system based on unknown parameter observer

    Wang Shaoming; Luo Haigeng; Yue Chaoyuan; Liao Xiaoxin

    2008-01-01

    Parameter identification of chaos system based on unknown parameter observer is discussed generally. Based on the work of Guan et al. [X.P. Guan, H.P. Peng, L.X. Li, et al., Acta Phys. Sinica 50 (2001) 26], the design of unknown parameter observer is improved. The application of the improved approach is extended greatly. The works in some literatures [X.P. Guan, H.P. Peng, L.X. Li, et al., Acta Phys. Sinica 50 (2001) 26; J.H. Lue, S.C. Zhang, Phys. Lett. A 286 (2001) 148; X.Q. Wu, J.A. Lu, Chaos Solitons Fractals 18 (2003) 721; J. Liu, S.H. Chen, J. Xie, Chaos Solitons Fractals 19 (2004) 533] are only the special cases of our Corollaries 1 and 2. Some observers for Lue system and a new chaos system are designed to test our improved method, and simulations results demonstrate the effectiveness and feasibility of the improved approach

  14. Atmospheric turbulence profiling with unknown power spectral density

    Helin, Tapio; Kindermann, Stefan; Lehtonen, Jonatan; Ramlau, Ronny

    2018-04-01

    Adaptive optics (AO) is a technology in modern ground-based optical telescopes to compensate for the wavefront distortions caused by atmospheric turbulence. One method that allows to retrieve information about the atmosphere from telescope data is so-called SLODAR, where the atmospheric turbulence profile is estimated based on correlation data of Shack-Hartmann wavefront measurements. This approach relies on a layered Kolmogorov turbulence model. In this article, we propose a novel extension of the SLODAR concept by including a general non-Kolmogorov turbulence layer close to the ground with an unknown power spectral density. We prove that the joint estimation problem of the turbulence profile above ground simultaneously with the unknown power spectral density at the ground is ill-posed and propose three numerical reconstruction methods. We demonstrate by numerical simulations that our methods lead to substantial improvements in the turbulence profile reconstruction compared to the standard SLODAR-type approach. Also, our methods can accurately locate local perturbations in non-Kolmogorov power spectral densities.

  15. Three-dimensional cinematography with control object of unknown shape.

    Dapena, J; Harman, E A; Miller, J A

    1982-01-01

    A technique for reconstruction of three-dimensional (3D) motion which involves a simple filming procedure but allows the deduction of coordinates in large object volumes was developed. Internal camera parameters are calculated from measurements of the film images of two calibrated crosses while external camera parameters are calculated from the film images of points in a control object of unknown shape but at least one known length. The control object, which includes the volume in which the activity is to take place, is formed by a series of poles placed at unknown locations, each carrying two targets. From the internal and external camera parameters, and from locations of the images of point in the films of the two cameras, 3D coordinates of the point can be calculated. Root mean square errors of the three coordinates of points in a large object volume (5m x 5m x 1.5m) were 15 mm, 13 mm, 13 mm and 6 mm, and relative errors in lengths averaged 0.5%, 0.7% and 0.5%, respectively.

  16. Generalized internal multiple imaging

    Zuberi, Mohammad Akbar Hosain

    2014-12-04

    Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green\\'s function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green\\'s function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green\\'s function and renders the higher order internal multiple image for display on a display device.

  17. Generalized internal multiple imaging

    Zuberi, Mohammad Akbar Hosain; Alkhalifah, Tariq

    2014-01-01

    Various examples are provided for generalized internal multiple imaging (GIMI). In one example, among others, a method includes generating a higher order internal multiple image using a background Green's function and rendering the higher order internal multiple image for presentation. In another example, a system includes a computing device and a generalized internal multiple imaging (GIMI) application executable in the computing device. The GIMI application includes logic that generates a higher order internal multiple image using a background Green's function and logic that renders the higher order internal multiple image for display on a display device. In another example, a non-transitory computer readable medium has a program executable by processing circuitry that generates a higher order internal multiple image using a background Green's function and renders the higher order internal multiple image for display on a display device.

  18. Cervical lymph node metastases from unknown primary tumours. Results from a national survey by the Danish Society for Head and Neck Oncology

    Grau, Cai; Johansen, L V; Jakobsen, J

    2000-01-01

    The management of patients with cervical lymph node metastases from unknown primary tumours is a major challenge in oncology. This study presents data collected from all five oncology centres in Denmark.......The management of patients with cervical lymph node metastases from unknown primary tumours is a major challenge in oncology. This study presents data collected from all five oncology centres in Denmark....

  19. Multiple sclerosis

    ... indwelling catheter Osteoporosis or thinning of the bones Pressure sores Side effects of medicines used to treat the ... Daily bowel care program Multiple sclerosis - discharge Preventing pressure ulcers Swallowing problems Images Multiple sclerosis MRI of the ...

  20. Adaptive fuzzy wavelet network control of second order multi-agent systems with unknown nonlinear dynamics.

    Taheri, Mehdi; Sheikholeslam, Farid; Najafi, Majddedin; Zekri, Maryam

    2017-07-01

    In this paper, consensus problem is considered for second order multi-agent systems with unknown nonlinear dynamics under undirected graphs. A novel distributed control strategy is suggested for leaderless systems based on adaptive fuzzy wavelet networks. Adaptive fuzzy wavelet networks are employed to compensate for the effect of unknown nonlinear dynamics. Moreover, the proposed method is developed for leader following systems and leader following systems with state time delays. Lyapunov functions are applied to prove uniformly ultimately bounded stability of closed loop systems and to obtain adaptive laws. Three simulation examples are presented to illustrate the effectiveness of the proposed control algorithms. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  1. Performance study of LMS based adaptive algorithms for unknown system identification

    Javed, Shazia; Ahmad, Noor Atinah

    2014-01-01

    Adaptive filtering techniques have gained much popularity in the modeling of unknown system identification problem. These techniques can be classified as either iterative or direct. Iterative techniques include stochastic descent method and its improved versions in affine space. In this paper we present a comparative study of the least mean square (LMS) algorithm and some improved versions of LMS, more precisely the normalized LMS (NLMS), LMS-Newton, transform domain LMS (TDLMS) and affine projection algorithm (APA). The performance evaluation of these algorithms is carried out using adaptive system identification (ASI) model with random input signals, in which the unknown (measured) signal is assumed to be contaminated by output noise. Simulation results are recorded to compare the performance in terms of convergence speed, robustness, misalignment, and their sensitivity to the spectral properties of input signals. Main objective of this comparative study is to observe the effects of fast convergence rate of improved versions of LMS algorithms on their robustness and misalignment

  2. Performance study of LMS based adaptive algorithms for unknown system identification

    Javed, Shazia; Ahmad, Noor Atinah [School of Mathematical Sciences, Universiti Sains Malaysia, 11800 Penang (Malaysia)

    2014-07-10

    Adaptive filtering techniques have gained much popularity in the modeling of unknown system identification problem. These techniques can be classified as either iterative or direct. Iterative techniques include stochastic descent method and its improved versions in affine space. In this paper we present a comparative study of the least mean square (LMS) algorithm and some improved versions of LMS, more precisely the normalized LMS (NLMS), LMS-Newton, transform domain LMS (TDLMS) and affine projection algorithm (APA). The performance evaluation of these algorithms is carried out using adaptive system identification (ASI) model with random input signals, in which the unknown (measured) signal is assumed to be contaminated by output noise. Simulation results are recorded to compare the performance in terms of convergence speed, robustness, misalignment, and their sensitivity to the spectral properties of input signals. Main objective of this comparative study is to observe the effects of fast convergence rate of improved versions of LMS algorithms on their robustness and misalignment.

  3. Reinforcement learning for adaptive optimal control of unknown continuous-time nonlinear systems with input constraints

    Yang, Xiong; Liu, Derong; Wang, Ding

    2014-03-01

    In this paper, an adaptive reinforcement learning-based solution is developed for the infinite-horizon optimal control problem of constrained-input continuous-time nonlinear systems in the presence of nonlinearities with unknown structures. Two different types of neural networks (NNs) are employed to approximate the Hamilton-Jacobi-Bellman equation. That is, an recurrent NN is constructed to identify the unknown dynamical system, and two feedforward NNs are used as the actor and the critic to approximate the optimal control and the optimal cost, respectively. Based on this framework, the action NN and the critic NN are tuned simultaneously, without the requirement for the knowledge of system drift dynamics. Moreover, by using Lyapunov's direct method, the weights of the action NN and the critic NN are guaranteed to be uniformly ultimately bounded, while keeping the closed-loop system stable. To demonstrate the effectiveness of the present approach, simulation results are illustrated.

  4. Obstacle Avoidance for Unmanned Undersea Vehicle in Unknown Unstructured Environment

    Zheping Yan

    2013-01-01

    Full Text Available To avoid obstacle in the unknown environment for unmanned undersea vehicle (UUV, an obstacle avoiding system based on improved vector field histogram (VFH is designed. Forward looking sonar is used to detect the environment, and the divisional sonar modal is applied to deal with the measure uncertainty. To adapt to the VFH, rolling occupancy grids are used for the map building, and high accuracy details of local environment are obtained. The threshold is adaptively adjusted by the statistic of obstacles to solve the problem that VFH is sensitive to threshold. To improve the environment adaptability, the hybrid-behaviors strategy is proposed, which selects the optimal avoidance command according to the motion status and environment character. The simulation shows that UUV could avoid the obstacles fast and escape from the U shape obstacles.

  5. Impact of CT in patients with sepsis of unknown origin

    Barkhausen, J.; Stoeblen, F.; Mueller, R.D.

    1999-01-01

    Purpose: To evaluate the diagnostic relevance of CT in patients with sepsis of unknown origin. Material and Methods: Sixty-three consecutive intensive care patients with suspicion of an abscess and negative or inconclusive previous radiological examinations were included. CT was performed using the helical technique. A total of 45 abdominal and 38 chest examinations were evaluated. Results: 5/38 examinations of the chest revealed the source of sepsis (pleural empyema 2, lung abscess 1, mediastinitis 1, retrosternal abscess 1). 7/45 abdominal CT examinations showed the source of sepsis (intraabdominal abscess 2, hepatic abscess 3, intestinal perforation 1, gangrenous colitis 1). Conclusion: CT is useful for the evaluation of patients with fever or sepsis without a known source. Due to the detection of a spetic focus by CT, 19% of the patients in our study could be immediately referred to causal therapy as percutaneous drainage or surgery. (orig.)

  6. Impact of CT in patients with sepsis of unknown origin

    Barkhausen, J.; Stoeblen, F.; Mueller, R.D. [University Hospital Essen (Germany). Dept. of Radiology; Dominguez-Fernandez, E. [University Hospital Essen (Germany). Dept. of General Surgery; Henseke, P. [Nycomed-Amersham Arzneimittel GmbH, Muenchen (Germany)

    1999-09-01

    Purpose: To evaluate the diagnostic relevance of CT in patients with sepsis of unknown origin. Material and Methods: Sixty-three consecutive intensive care patients with suspicion of an abscess and negative or inconclusive previous radiological examinations were included. CT was performed using the helical technique. A total of 45 abdominal and 38 chest examinations were evaluated. Results: 5/38 examinations of the chest revealed the source of sepsis (pleural empyema 2, lung abscess 1, mediastinitis 1, retrosternal abscess 1). 7/45 abdominal CT examinations showed the source of sepsis (intraabdominal abscess 2, hepatic abscess 3, intestinal perforation 1, gangrenous colitis 1). Conclusion: CT is useful for the evaluation of patients with fever or sepsis without a known source. Due to the detection of a spetic focus by CT, 19% of the patients in our study could be immediately referred to causal therapy as percutaneous drainage or surgery. (orig.)

  7. Metastatic cancer of unknown primary in 21 dogs.

    Rossi, F; Aresu, L; Vignoli, M; Buracco, P; Bettini, G; Ferro, S; Gattino, F; Ghiani, F; Costantino, R; Ressel, L; Bellei, E; Marconato, L

    2015-03-01

    The aim of this retrospective study was to describe clinical features, treatment and outcome of 21 dogs with metastatic cancer of unknown primary (MCUP), a biopsy-proven malignancy being diagnosed at a metastatic stage, in which the anatomical origin of the primary tumour cannot be detected. All dogs underwent total-body computed tomography. Signalment, type and duration of clinical signs, metastasis site, pathology results, treatment and outcome were recorded. Carcinoma was the most common diagnosis (57.1%), followed by sarcoma, melanoma and mast cell tumour. The median number of disease sites per dog was 2, with bones, lymph nodes, lungs and spleen being the most frequent metastatic locations. The median survival for all dogs was 30 days. Overall, a primary site was not identified in 20 (95.2%) dogs. MCUP encompasses a variety of different pathologic entities and harbours a poor prognosis. © 2013 Blackwell Publishing Ltd.

  8. Distributed Synchronization Control of Multiagent Systems With Unknown Nonlinearities.

    Su, Shize; Lin, Zongli; Garcia, Alfredo

    2016-01-01

    This paper revisits the distributed adaptive control problem for synchronization of multiagent systems where the dynamics of the agents are nonlinear, nonidentical, unknown, and subject to external disturbances. Two communication topologies, represented, respectively, by a fixed strongly-connected directed graph and by a switching connected undirected graph, are considered. Under both of these communication topologies, we use distributed neural networks to approximate the uncertain dynamics. Decentralized adaptive control protocols are then constructed to solve the cooperative tracker problem, the problem of synchronization of all follower agents to a leader agent. In particular, we show that, under the proposed decentralized control protocols, the synchronization errors are ultimately bounded, and their ultimate bounds can be reduced arbitrarily by choosing the control parameter appropriately. Simulation study verifies the effectiveness of our proposed protocols.

  9. Keratosis of unknown significance and leukoplakia: a preliminary study.

    Woo, Sook-Bin; Grammer, Rebecca L; Lerman, Mark A

    2014-12-01

    The objectives were to (1) determine the frequency of specific diagnoses in a series of white lesions, and (2) describe the nature of keratotic lesions that are neither reactive nor dysplastic. White lesions were analyzed and diagnosed as reactive keratoses, dysplastic/malignant, or keratoses of unknown significance (KUS). Of the 1251 specimens that were evaluated, 703 met criteria for inclusion, and approximately 75% were reactive, 10% dysplastic/malignant, and 14% KUS. Excluding reactive keratoses, 43% were dysplastic/malignant and 57% were KUS. Reactive keratoses were the most common white lesions followed by lichen planus. Dysplastic/malignant lesions constituted almost 50% of all true leukoplakias. KUS constituted the remaining cases and do not show typical reactive histopathology as well as clear dysplasia. They may represent evolving or devolving reactive keratoses but may also represent the very earliest dysplasia phenotype. Clinical findings may be helpful in differentiating the two. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Villitis of unknown aetiology: correlation of recurrence with clinical outcome.

    Feeley, L

    2010-01-01

    Villitis of unknown aetiology (VUA) is associated with adverse pregnancy outcome. Consequently, an ability to predict recurrence could be clinically relevant. We examined placentas where villitis was diagnosed in a previous pregnancy to establish the risk of recurrence and outcome. A total of 304 cases of VUA were diagnosed in our laboratory over a 4-year period. Subsequently, 19 of this cohort had a second placenta examined histologically. Recurrence and clinical outcome were recorded. Villitis recurred in 7 of 19 cases (37%). There was a high level of adverse pregnancy outcome in this cohort overall, characterised by small for gestational age infants and stillbirth, particularly in cases with high-grade villitis. We identified recurrent villitis more frequently than previously reported. Our findings confirm an association between high-grade villitis and poor outcome. Adequately powered prospective studies are required to determine if enhanced surveillance of subsequent pregnancies is indicated following a diagnosis of villitis.

  11. A Brief Introduction on Mystery, the Unknown, Surprise

    Sean Scanlan

    2012-03-01

    Full Text Available In this age of globalization, this age of so many ways to know—and so many ways to know things so quickly—it is both satisfying and deeply unnerving to come upon things and events that are really hard to understand, things and events so shocking or strange or mysterious, that they seem Unknown. Perhaps even unknowable. The first note of NANO Issue 2 focuses on an unsolved murder and reveals a mystery that is confounding, creepy, and yet oddly compelling. In “Karr’s Kill Cult: Virtual Cults and Pseudo-Killing in the Digital Age,” Jeremy Biles and Brian Collins explore the edges of where cyber-crime threatens to turn real—and vice versa. In the second note, Jennifer Ballengee compares Oedipus at Colonus with Don DeLillo’s Falling Man.

  12. Cancer of unknown primary origin: a case report

    Elisa De Carlo

    2013-03-01

    Full Text Available Carcinoma of unknown primary origin (CUP accounts for 2-10% of all malignancies. The apparent absence of the primary tumour, the development of early, uncommon systemic metastases and the resistance to therapy and poor prognosis are hallmarks of this heterogeneous clinical entity and are a challenge for physicians. The diagnostic workup of patients with CUP includes a large amount of histopathological examination, as well as the use of imaging techniques that often fail to identify the primary tumour. Therefore, the optimal workup and treatment for these patients remains to be determined. Molecular diagnostic tools, such as DNA microarray analysis, could help in the search for "lost" CUP origin and guide the further treatment approach. We report the case of a 66-year-old man, with mediastinal lymph nodes metastasis of carcinoma and neurological syndrome with diplopia and balance disorders, in which many exams have been performed without finding the primary tumour.

  13. Searching for unknown transfusion-transmitted hepatitis viruses

    Edgren, G.; Hjalgrim, H.; Rostgaard, K.

    2018-01-01

    Background: Both hepatitis B and C viruses were transmitted through blood transfusion before implementation of donor screening. The existence of additional, yet unknown transfusion transmittable agents causing liver disease could have important public health implications. Methods: Analyses were...... 1992 to account for the effect of screening for hepatitis C virus. Results: A total of 1 482 922 transfused patients were included in the analyses. Analyses showed evidence of transfusion transmission of liver diseases before, but not after the implementation of hepatitis C virus screening in 1992...... for transfusion transmission of agents causing liver disease after the implementation of screening for hepatitis B and C, and suggest that if such transmission does occur, it is rare....

  14. Heuristic method for searching global maximum of multimodal unknown function

    Kamei, K; Araki, Y; Inoue, K

    1983-06-01

    The method is composed of three kinds of searches. They are called g (grasping)-mode search, f (finding)-mode search and c (confirming)-mode search. In the g-mode search and the c-mode search, a heuristic method is used which was extracted from search behaviors of human subjects. In f-mode search, the simplex method is used which is well known as a search method for unimodal unknown function. Each mode search and its transitions are shown in the form of flowchart. The numerical results for one-dimensional through six-dimensional multimodal functions prove the proposed search method to be an effective one. 11 references.

  15. Calculation of Unknown Preoperative K Readings in Postrefractive Surgery Patients

    Nicola Rosa

    2018-01-01

    Full Text Available Purpose. To determine the unknown preoperative K readings (Kpre to be used in history-based methods, for intraocular lens (IOL power calculation in patients who have undergone myopic photorefractive keratectomy (PRK. Methods. A regression formula generated from the left eyes of 174 patients who had undergone PRK for myopia or for myopic astigmatism was compared with other methods in 168 right eyes. The Pearson index and paired t-test were utilized for statistical analysis. Results. The differences between Kpre and those obtained with the other methods were as follows: 0.61 ± 0.94 D (range: −3.94 to 2.05 D, p<0.01 subtracting the effective treatment, 0.01 ± 0.86 D (range: −2.61 to 2.34 D, p=0.82 with Rosa’s formula, −0.02 ± 1.31 D (range: −3.43 to 3.68 D, p=0.82 with the current study formula, and −0.43 ± 1.40 D (range: −3.98 to 3.12 D, p<0.01 utilizing a mean K (Km of 43.5 D. Conclusions. These formulas may permit the utilization of history-based methods, that is, the double-K method in calculating the IOL power following PRK when Kpre are unknown.

  16. Smooth extrapolation of unknown anatomy via statistical shape models

    Grupp, R. B.; Chiang, H.; Otake, Y.; Murphy, R. J.; Gordon, C. R.; Armand, M.; Taylor, R. H.

    2015-03-01

    Several methods to perform extrapolation of unknown anatomy were evaluated. The primary application is to enhance surgical procedures that may use partial medical images or medical images of incomplete anatomy. Le Fort-based, face-jaw-teeth transplant is one such procedure. From CT data of 36 skulls and 21 mandibles separate Statistical Shape Models of the anatomical surfaces were created. Using the Statistical Shape Models, incomplete surfaces were projected to obtain complete surface estimates. The surface estimates exhibit non-zero error in regions where the true surface is known; it is desirable to keep the true surface and seamlessly merge the estimated unknown surface. Existing extrapolation techniques produce non-smooth transitions from the true surface to the estimated surface, resulting in additional error and a less aesthetically pleasing result. The three extrapolation techniques evaluated were: copying and pasting of the surface estimate (non-smooth baseline), a feathering between the patient surface and surface estimate, and an estimate generated via a Thin Plate Spline trained from displacements between the surface estimate and corresponding vertices of the known patient surface. Feathering and Thin Plate Spline approaches both yielded smooth transitions. However, feathering corrupted known vertex values. Leave-one-out analyses were conducted, with 5% to 50% of known anatomy removed from the left-out patient and estimated via the proposed approaches. The Thin Plate Spline approach yielded smaller errors than the other two approaches, with an average vertex error improvement of 1.46 mm and 1.38 mm for the skull and mandible respectively, over the baseline approach.

  17. A 'range test' for determining scatterers with unknown physical properties

    Potthast, Roland; Sylvester, John; Kusiak, Steven

    2003-06-01

    We describe a new scheme for determining the convex scattering support of an unknown scatterer when the physical properties of the scatterers are not known. The convex scattering support is a subset of the scatterer and provides information about its location and estimates for its shape. For convex polygonal scatterers the scattering support coincides with the scatterer and we obtain full shape reconstructions. The method will be formulated for the reconstruction of the scatterers from the far field pattern for one or a few incident waves. The method is non-iterative in nature and belongs to the type of recently derived generalized sampling schemes such as the 'no response test' of Luke-Potthast. The range test operates by testing whether it is possible to analytically continue a far field to the exterior of any test domain Omegatest. By intersecting the convex hulls of various test domains we can produce a minimal convex set, the convex scattering support of which must be contained in the convex hull of the support of any scatterer which produces that far field. The convex scattering support is calculated by testing the range of special integral operators for a sampling set of test domains. The numerical results can be used as an approximation for the support of the unknown scatterer. We prove convergence and regularity of the scheme and show numerical examples for sound-soft, sound-hard and medium scatterers. We can apply the range test to non-convex scatterers as well. We can conclude that an Omegatest which passes the range test has a non-empty intersection with the infinity-support (the complement of the unbounded component of the complement of the support) of the true scatterer, but cannot find a minimal set which must be contained therein.

  18. Identification of unknown sample using NAA, EDXRF, XRD techniques

    Dalvi, Aditi A.; Swain, K.K.; Chavan, Trupti; Remya Devi, P.S.; Wagh, D.N.; Verma, R.

    2015-01-01

    Analytical Chemistry Division (ACD), Bhabha Atomic Research Centre (BARC) receives samples from law enforcement agencies such as Directorate of Revenue Intelligence, Customs for analysis. Five unknown grey powdered samples were received for identification and were suspected to be Iridium (Ir). Identification of unknown sample is always a challenging task and suitable analytical techniques have to be judiciously utilized for arriving at the conclusion. Qualitative analysis was carried out using Jordan Valley, EX-3600 M Energy dispersive X-ray fluorescence (EDXRF) spectrometer at ACD, BARC. A SLP series LEO Si (Li) detector (active area: 30 mm 2 ; thickness: 3.5 mm; resolution: 140 eV at 5.9 keV of Mn K X-ray) was used during the measurement and only characteristic X-rays of Ir (Lα: 9.17 keV and Lβ: 10.70 keV) was seen in the X-ray spectrum. X-ray diffraction (XRD) measurement results indicated that the Ir was in the form of metal. To confirm the XRD data, neutron activation analysis (NAA) was carried out by irradiating samples and elemental standards (as comparator) in graphite reflector position of Advanced Heavy Water Reactor Critical Facility (AHWR CF) reactor, BARC, Mumbai. After suitable decay period, gamma activity measurements were carried out using 45% HPGe detector coupled to 8 k multi channel analyzer. Characteristic gamma line at 328.4 keV of the activation product 194 Ir was used for quantification of iridium and relative method of NAA was used for concentration calculations. NAA results confirmed that all the samples were Iridium metal. (author)

  19. Presentations: Adverse Outcome Pathways for Abnormal Phenotypes

    Birth defects affect many infants and the etiology for most are unknown. Although environmental factors are known to influence pregnancy outcome, thousands of chemicals, present in the environment, are untested for developmental toxicity potential. Application of computational p...

  20. Iterative MIMO Turbo Multiuser Detection and Equalization for STTrC-Coded Systems with Unknown Interference

    Veselinovic Nenad

    2004-01-01

    Full Text Available Iterative multiuser detection in a single-carrier broadband multiple-input multiple-output (MIMO system is studied in this paper. A minimum mean squared error (MMSE low-complexity multiuser receiver is derived for space-division multiple-access (SDMA space-time trellis-coded (STTrC systems in frequency-selective fading channels. The receiver uses MMSE filtering to jointly detect several transmit antennas of the user of interest, while the interference from the undetected transmit antennas, cochannel interference (CCI, and intersymbol interference (ISI are all cancelled by the soft cancellation. The performances of two extreme receiver cases are evaluated. In the first case, only one transmit antenna of the user of interest is detected at a time and the remaining ones are cancelled by soft cancellation. In the second case, all the transmit antennas are detected jointly. The comparison of the two cases shows improvement with the latter one, both in single-user and multiuser communications and in the presence of unknown cochannel interference (UCCI. It is further shown that in the multiuser case, the proposed receivers approach the corresponding single-user bounds. The number of receive antenna elements required to achieve single-user bound is thereby equal to the number of users and not to the total number of transmit antennas.

  1. [Future challenges in multiple sclerosis].

    Fernández, Óscar

    2014-12-01

    Multiple sclerosis occurs in genetically susceptible individuals, in whom an unknown environmental factor triggers an immune response, giving rise to a chronic and disabling autoimmune disease. Currently, significant progress is being made in our knowledge of the frequency and distribution of multiple sclerosis and its risk factors, genetics, pathology, pathogenesis, diagnostic and prognostic markers, and treatment. This has radically changed patients' and clinicians' expectations of multiple sclerosis and has raised hope that there will soon be a way to control the disease. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  2. Switched-Observer-Based Adaptive Neural Control of MIMO Switched Nonlinear Systems With Unknown Control Gains.

    Long, Lijun; Zhao, Jun

    2017-07-01

    In this paper, the problem of adaptive neural output-feedback control is addressed for a class of multi-input multioutput (MIMO) switched uncertain nonlinear systems with unknown control gains. Neural networks (NNs) are used to approximate unknown nonlinear functions. In order to avoid the conservativeness caused by adoption of a common observer for all subsystems, an MIMO NN switched observer is designed to estimate unmeasurable states. A new switched observer-based adaptive neural control technique for the problem studied is then provided by exploiting the classical average dwell time (ADT) method and the backstepping method and the Nussbaum gain technique. It effectively handles the obstacle about the coexistence of multiple Nussbaum-type function terms, and improves the classical ADT method, since the exponential decline property of Lyapunov functions for individual subsystems is no longer satisfied. It is shown that the technique proposed is able to guarantee semiglobal uniformly ultimately boundedness of all the signals in the closed-loop system under a class of switching signals with ADT, and the tracking errors converge to a small neighborhood of the origin. The effectiveness of the approach proposed is illustrated by its application to a two inverted pendulum system.

  3. MULTIPLE OBJECTS

    A. A. Bosov

    2015-04-01

    Full Text Available Purpose. The development of complicated techniques of production and management processes, information systems, computer science, applied objects of systems theory and others requires improvement of mathematical methods, new approaches for researches of application systems. And the variety and diversity of subject systems makes necessary the development of a model that generalizes the classical sets and their development – sets of sets. Multiple objects unlike sets are constructed by multiple structures and represented by the structure and content. The aim of the work is the analysis of multiple structures, generating multiple objects, the further development of operations on these objects in application systems. Methodology. To achieve the objectives of the researches, the structure of multiple objects represents as constructive trio, consisting of media, signatures and axiomatic. Multiple object is determined by the structure and content, as well as represented by hybrid superposition, composed of sets, multi-sets, ordered sets (lists and heterogeneous sets (sequences, corteges. Findings. In this paper we study the properties and characteristics of the components of hybrid multiple objects of complex systems, proposed assessments of their complexity, shown the rules of internal and external operations on objects of implementation. We introduce the relation of arbitrary order over multiple objects, we define the description of functions and display on objects of multiple structures. Originality.In this paper we consider the development of multiple structures, generating multiple objects.Practical value. The transition from the abstract to the subject of multiple structures requires the transformation of the system and multiple objects. Transformation involves three successive stages: specification (binding to the domain, interpretation (multiple sites and particularization (goals. The proposed describe systems approach based on hybrid sets

  4. Fault diagnosis of an intelligent hydraulic pump based on a nonlinear unknown input observer

    Zhonghai MA

    2018-02-01

    Full Text Available Hydraulic piston pumps are commonly used in aircraft. In order to improve the viability of aircraft and energy efficiency, intelligent variable pressure pump systems have been used in aircraft hydraulic systems more and more widely. Efficient fault diagnosis plays an important role in improving the reliability and performance of hydraulic systems. In this paper, a fault diagnosis method of an intelligent hydraulic pump system (IHPS based on a nonlinear unknown input observer (NUIO is proposed. Different from factors of a full-order Luenberger-type unknown input observer, nonlinear factors of the IHPS are considered in the NUIO. Firstly, a new type of intelligent pump is presented, the mathematical model of which is established to describe the IHPS. Taking into account the real-time requirements of the IHPS and the special structure of the pump, the mechanism of the intelligent pump and failure modes are analyzed and two typical failure modes are obtained. Furthermore, a NUIO of the IHPS is performed based on the output pressure and swashplate angle signals. With the residual error signals produced by the NUIO, online intelligent pump failure occurring in real-time can be detected. Lastly, through analysis and simulation, it is confirmed that this diagnostic method could accurately diagnose and isolate those typical failure modes of the nonlinear IHPS. The method proposed in this paper is of great significance in improving the reliability of the IHPS. Keywords: Fault diagnosis, Hydraulic piston pump, Model-based, Nonlinear unknown input observer (NUIO, Residual error

  5. Blind Identification of FIR Channels in the Presence of Unknown Noise

    Kon Max Wong

    2007-01-01

    Full Text Available Blind channel identification techniques based on second-order statistics (SOS of the received data have been a topic of active research in recent years. Among the most popular is the subspace method (SS proposed by Moulines et al. (1995. It has good performance when the channel output is corrupted by white noise. However, when the channel noise is correlated and unknown as is often encountered in practice, the performance of the SS method degrades severely. In this paper, we address the problem of estimating FIR channels in the presence of arbitrarily correlated noise whose covariance matrix is unknown. We propose several algorithms according to the different available system resources: (1 when only one receiving antenna is available, by upsampling the output, we develop the maximum a posteriori (MAP algorithm for which a simple criterion is obtained and an efficient implementation algorithm is developed; (2 when two receiving antennae are available, by upsampling both the outputs and utilizing canonical correlation decomposition (CCD to obtain the subspaces, we present two algorithms (CCD-SS and CCD-ML to blindly estimate the channels. Our algorithms perform well in unknown noise environment and outperform existing methods proposed for similar scenarios.

  6. Iron overload patients with unknown etiology from national survey in Japan.

    Ikuta, Katsuya; Hatayama, Mayumi; Addo, Lynda; Toki, Yasumichi; Sasaki, Katsunori; Tatsumi, Yasuaki; Hattori, Ai; Kato, Ayako; Kato, Koichi; Hayashi, Hisao; Suzuki, Takahiro; Kobune, Masayoshi; Tsutsui, Miyuki; Gotoh, Akihiko; Aota, Yasuo; Matsuura, Motoo; Hamada, Yuzuru; Tokuda, Takahiro; Komatsu, Norio; Kohgo, Yutaka

    2017-03-01

    Transfusion is believed to be the main cause of iron overload in Japan. A nationwide survey on post-transfusional iron overload subsequently led to the establishment of guidelines for iron chelation therapy in this country. To date, however, detailed clinical information on the entire iron overload population in Japan has not been fully investigated. In the present study, we obtained and studied detailed clinical information on the iron overload patient population in Japan. Of 1109 iron overload cases, 93.1% were considered to have occurred post-transfusion. There were, however, 76 cases of iron overload of unknown origin, which suggest that many clinicians in Japan may encounter some difficulty in correctly diagnosing and treating iron overload. Further clinical data were obtained for 32 cases of iron overload of unknown origin; median of serum ferritin was 1860.5 ng/mL. As occurs in post-transfusional iron overload, liver dysfunction was found to be as high as 95.7% when serum ferritin levels exceeded 1000 ng/mL in these patients. Gene mutation analysis of the iron metabolism-related genes in 27 cases of iron overload with unknown etiology revealed mutations in the gene coding hemojuvelin, transferrin receptor 2, and ferroportin; this indicates that although rare, hereditary hemochromatosis does occur in Japan.

  7. Kriging with Unknown Variance Components for Regional Ionospheric Reconstruction

    Ling Huang

    2017-02-01

    Full Text Available Ionospheric delay effect is a critical issue that limits the accuracy of precise Global Navigation Satellite System (GNSS positioning and navigation for single-frequency users, especially in mid- and low-latitude regions where variations in the ionosphere are larger. Kriging spatial interpolation techniques have been recently introduced to model the spatial correlation and variability of ionosphere, which intrinsically assume that the ionosphere field is stochastically stationary but does not take the random observational errors into account. In this paper, by treating the spatial statistical information on ionosphere as prior knowledge and based on Total Electron Content (TEC semivariogram analysis, we use Kriging techniques to spatially interpolate TEC values. By assuming that the stochastic models of both the ionospheric signals and measurement errors are only known up to some unknown factors, we propose a new Kriging spatial interpolation method with unknown variance components for both the signals of ionosphere and TEC measurements. Variance component estimation has been integrated with Kriging to reconstruct regional ionospheric delays. The method has been applied to data from the Crustal Movement Observation Network of China (CMONOC and compared with the ordinary Kriging and polynomial interpolations with spherical cap harmonic functions, polynomial functions and low-degree spherical harmonic functions. The statistics of results indicate that the daily ionospheric variations during the experimental period characterized by the proposed approach have good agreement with the other methods, ranging from 10 to 80 TEC Unit (TECU, 1 TECU = 1 × 1016 electrons/m2 with an overall mean of 28.2 TECU. The proposed method can produce more appropriate estimations whose general TEC level is as smooth as the ordinary Kriging but with a smaller standard deviation around 3 TECU than others. The residual results show that the interpolation precision of the

  8. An Evidence-Based Review Literature About Risk Indicators and Management of Unknown-Origin Xerostomia

    Farzaneh Agha-hosseini

    2013-01-01

    Full Text Available Objective: This evidence-based article reviews risk indicators and management of unknown-origin xerostomia. Xerostomia and hyposalivation refer to different aspects of dry mouth. Xerostomia is a subjective sensation of dry mouth, whilst hyposalivation is defined as an objective assessment of reduced salivary flow rate. About 30% of the elderly (65 years and older experience xerostomia and hyposalivation. Structural and functional factors, or both may lead to salivary gland dysfunction.Study Selection: The EBM literature search was conducted by using the medical literature database MEDLINE via PubMed and OvidMedline search engines. Results were limited to English language articles (1965 to present including clinical trials (CT, randomized controlled trials (RCT, systematic reviews and review articles. Case control or cohort studies were included for the etiology.Results: Neuropathic etiology such as localized oral alteration of thermal sensations, saliva composition change (for example higher levels of K, Cl, Ca, IgA, amylase, calcium, PTH and cortisol, lower levels of estrogen and progesterone, smaller salivary gland size, and illnesses such as lichen planus, are risk indicators for unknown-origin xerostomia. The management is palliative and preventative. Management of symptoms includes drug administration (systemic secretogogues, saliva substitutes and bile secretion-stimulator, night guard, diet and habit modifications. Other managements may be indicated to treat adverse effects.Conclusion: Neuropathic etiology, saliva composition change, smaller salivary gland size, and illnesses such as oral lichen planus can be suggestive causes for unknown-origin xerostomia. However, longitudinal studies will be important to elucidate the causes of unknown-origin xerostomia.

  9. How to know unknown fungi: the role of a herbarium.

    Brock, Patrick M; Döring, Heidi; Bidartondo, Martin I

    2009-01-01

    The development of a universal approach to the identification of fungi from the environment is impeded by the limited number and narrow phylogenetic range of the named internal transcribed spacer DNA sequences available on GenBank. The goal here was to assess the potential impact of systematic DNA sequencing from a fungal herbarium collection. DNA sequences were generated from a diverse set of 279 specimens deposited at the fungal herbarium of the Royal Botanic Gardens at Kew (UK) and bioinformatic analyses were used to study their overlap with the public database. It is estimated that c. 70% of the herbarium taxonomic diversity is not yet represented in GenBank and that a further c. 10% of our sequences match solely to 'environmental samples' or fungi otherwise unidentified. Here it is shown that the unsampled diversity residing in fungal herbaria can substantially enlarge the coverage of GenBank's fully identified sequence pool to ameliorate the problem of environmental unknowns and to aid in the detection of truly novel fungi by molecular data.

  10. Developing Probabilistic Safety Performance Margins for Unknown and Underappreciated Risks

    Benjamin, Allan; Dezfuli, Homayoon; Everett, Chris

    2015-01-01

    Probabilistic safety requirements currently formulated or proposed for space systems, nuclear reactor systems, nuclear weapon systems, and other types of systems that have a low-probability potential for high-consequence accidents depend on showing that the probability of such accidents is below a specified safety threshold or goal. Verification of compliance depends heavily upon synthetic modeling techniques such as PRA. To determine whether or not a system meets its probabilistic requirements, it is necessary to consider whether there are significant risks that are not fully considered in the PRA either because they are not known at the time or because their importance is not fully understood. The ultimate objective is to establish a reasonable margin to account for the difference between known risks and actual risks in attempting to validate compliance with a probabilistic safety threshold or goal. In this paper, we examine data accumulated over the past 60 years from the space program, from nuclear reactor experience, from aircraft systems, and from human reliability experience to formulate guidelines for estimating probabilistic margins to account for risks that are initially unknown or underappreciated. The formulation includes a review of the safety literature to identify the principal causes of such risks.

  11. Systemic treatment of cancer of unknown primary origin

    Reckova, M.

    2013-01-01

    Cancer of unknown primary origin (CUP) comprises a heterogenous group of cancers with distinct biology and prognosis. There is, however, a specific group of patients with curable diseases, or incurable diseases with good prognosis. The main aim of treatment in the group of patients with CUP is timely initiation of therapy in the cases of curable disease. There is no known standard of care in the cases of CUP with poor prognosis, but most frequently, platinum-based regimens are used. In the cases of specific immunohistochemistry (IHC) or molecular gene expression profile, there are used the treatment regimens similar to those used in the patients with known primary tumor and similar IHC or molecular profile. Currently, most of data in patients with CUP are from phase II clinical trials. Thus proficiently designed phase III randomized clinical trials with translation research is priority, with aim to improve our knowledge and personalize treatment of such heterogenous group of patients as is a group of patients with CUP. (author)

  12. Radiotherapeutic concepts in cancer of unknown primary site

    Krug, D.; Debus, J.; Sterzing, F.

    2014-01-01

    The term cancer of unknown primary (CUP) encompasses a group of entities which differ to a great extent regarding etiology, prognosis and therapeutic management. The aim of the study was an elaboration of the role of radiotherapy in CUP syndrome. Systematic literature search and specification of the available treatment options. Radiotherapy is an integral part of interdisciplinary management approaches for patients with CUP in both curative and palliative situations. Radio-oncological techniques, such as intensity-modulated radiotherapy and stereotactic body radiotherapy increase the therapeutic window. Modern diagnostic modalities from radiology and nuclear medicine are the cornerstone of radiotherapeutic interventions, especially in terms of target volume definition and pretherapeutic staging. In the interdisciplinary setting radiation oncology offers the possibility of curative and often organ preserving approaches in patients with axillary and cervical CUP. In addition, improvement and preservation of quality of life can be achieved in patients with metastatic disease. Radiation oncology is a crucial component of the interdisciplinary management of patients with CUP. Therapeutic decisions in patients with CUP should be made in an interdisciplinary setting. (orig.) [de

  13. Crowdsourcing the unknown: the satellite search for Genghis Khan.

    A Y M Lin

    Full Text Available Massively parallel collaboration and emergent knowledge generation is described through a large scale survey for archaeological anomalies within ultra-high resolution earth-sensing satellite imagery. Over 10K online volunteers contributed 30K hours (3.4 years, examined 6,000 km², and generated 2.3 million feature categorizations. Motivated by the search for Genghis Khan's tomb, participants were tasked with finding an archaeological enigma that lacks any historical description of its potential visual appearance. Without a pre-existing reference for validation we turn towards consensus, defined by kernel density estimation, to pool human perception for "out of the ordinary" features across a vast landscape. This consensus served as the training mechanism within a self-evolving feedback loop between a participant and the crowd, essential driving a collective reasoning engine for anomaly detection. The resulting map led a National Geographic expedition to confirm 55 archaeological sites across a vast landscape. A increased ground-truthed accuracy was observed in those participants exposed to the peer feedback loop over those whom worked in isolation, suggesting collective reasoning can emerge within networked groups to outperform the aggregate independent ability of individuals to define the unknown.

  14. Chronic kidney disease of unknown etiology in Sri Lanka.

    Rajapakse, Senaka; Shivanthan, Mitrakrishnan Chrishan; Selvarajah, Mathu

    2016-07-01

    In the last two decades, chronic kidney disease of unknown etiology (CKDu) has emerged as a significant contributor to the burden of chronic kidney disease (CKD) in rural Sri Lanka. It is characterized by the absence of identified causes for CKD. The prevalence of CKDu is 15.1-22.9% in some Sri Lankan districts, and previous research has found an association with farming occupations. A systematic literature review in Pubmed, Embase, Scopus, and Lilacs databases identified 46 eligible peer-reviewed articles and one conference abstract. Geographical mapping indicates a relationship between CKDu and agricultural irrigation water sources. Health mapping studies, human biological studies, and environment-based studies have explored possible causative agents. Most studies focused on likely causative agents related to agricultural practices, geographical distribution based on the prevalence and incidence of CKDu, and contaminants identified in drinking water. Nonetheless, the link between agrochemicals or heavy metals and CKDu remains to be established. No definitive cause for CKDu has been identified. Evidence to date suggests that the disease is related to one or more environmental agents, however pinpointing a definite cause for CKDu is challenging. It is plausible that CKDu is multifactorial. No specific guidelines or recommendations exist for treatment of CKDu, and standard management protocols for CKD apply. Changes in agricultural practices, provision of safe drinking water, and occupational safety precautions are recommended by the World Health Organization.

  15. Dead or Alive? Dealing with Unknown Eligibility in Longitudinal Surveys

    Watson Nicole

    2016-12-01

    Full Text Available Longitudinal surveys follow people over time and some of these people will die during the life of the panel. Through fieldwork effort, some deaths will be reported or known, but others will be unobserved due to sample members no longer being issued to field or having inconclusive fieldwork outcomes (such as a noncontact that is not followed by a contact at a later wave. The coverage of deaths identified among sample members has flow-on implications to nonresponse correction. Using the Household, Income and Labour Dynamics in Australia (HILDA Survey, four methods are used to examine the extent of missing death reports. The first method matches the sample to the national death register. The second method uses life-expectancy tables to extrapolate the expected number of deaths among the sample with unknown eligibility. The third method is similar but models deaths from data internal to the survey. The fourth method models deaths as part of the attrition process of a longitudinal survey. The last three methods are compared to the first method and the implications for the construction of balanced panel weights and subsequent population inference are explored.

  16. Physics at 13 TeV: CMS - scanning the unknown

    Antonella Del Rosso

    2014-01-01

    CMS is getting ready to use its accurate detector to scan the many ripples of the unknown physics that may lie beyond the Standard Model. Foremost in everyone’s mind is the search for signs of the production of dark matter at a man-made machine.   Interestingly, the observation of dark matter or new weakly interacting particles implies detecting that some energy has escaped, i.e. it’s missing from the upcoming proton collisions at the LHC. This is why measuring and understanding “missing energy” will be a very important step in that direction. “A large amount of missing energy is the signature for many processes of physics beyond the Standard Model. However, it’s not the only interesting signature that we will be able to exploit when the new collision energy is available,” explains Luca Malgeri, CMS Physics Coordinator. Among the interesting things not associated with missing energy are high-mass resonanc...

  17. Investigation of cervical lymph node metastasis from primary unknown carcinoma

    Sagawa, Kosuke; Terada, Tomonori; Saeki, Nobuo; Uwa, Nobuhiro; Mohri, Takeshi; Sakagami, Masafumi

    2012-01-01

    We retrospectively evaluated 41 patients with metastatic cervical tumors from unknown primary sites at the Hyogo College of Medicine between 1997 and 2007. The N stage classification of cervical lymph nodes was: N1 in 3 cases, N2a in 10 cases, N2b in 10 cases, N2c in 4 cases, and N3 in 14 cases. The histopathological diagnoses of cervical lymph node were: squamous cell carcinoma in 33 cases, adenocarcinoma in 5 cases, undifferentiated carcinoma in 2 cases, and papillary carcinoma in 1 cases. Primary tumor sites were: tonsil in 5 cases, esophaguses in 2 cases, hypopharynxies in 2 cases, and thyroid, oral floor, submandibular gland, lung, gastric and colon in 1 case each. The useful tests were gastric endoscope, positron emission tomography-computed tomography (PET-CT), and blind biopsy of tonsil. We treated 24 of the 41 patients. Therapies were: neck dissection with postoperative radiation therapy in 11 cases, neck dissection alone in 1 case, only radiation or chemoradiation therapy alone in 8 cases, and chemotherapy alone in 4 cases. The 5-year survival rate was 40.1% in all cases and 81.5% in cases who underwent neck dissection. (author)

  18. Gravity, strings and particles a journey into the unknown

    Gasperini, Maurizio

    2014-01-01

    New fundamental forces of Nature? New forms of "dark'' energy? Signals from epochs preceding the Big Bang? Is our space-time unique? Only a joint study of the three topics examined in this book – gravity, strings and particles – may provide answers to these questions. Such a study may also provide the key to solving one of the most fascinating mysteries of modern science, namely: Besides time and the three spatial dimensions, how many other dimensions exist in our universe? The book is primarily addressed to readers who do not necessarily have a specific background in physics but are nevertheless interested in discovering the originality and the possible implications of some of the amazing ideas in modern theoretical physics. The emphasis is on conveying ideas rather than explaining formulas, focusing not on what is known but -- mainly -- on what is still unknown. Many parts of the book are devoted to fundamental theoretical models and results which are potentially highly relevant for a deeper understand...

  19. Security Measurement for Unknown Threats Based on Attack Preferences

    Lihua Yin

    2018-01-01

    Full Text Available Security measurement matters to every stakeholder in network security. It provides security practitioners the exact security awareness. However, most of the works are not applicable to the unknown threat. What is more, existing efforts on security metric mainly focus on the ease of certain attack from a theoretical point of view, ignoring the “likelihood of exploitation.” To help administrator have a better understanding, we analyze the behavior of attackers who exploit the zero-day vulnerabilities and predict their attack timing. Based on the prediction, we propose a method of security measurement. In detail, we compute the optimal attack timing from the perspective of attacker, using a long-term game to estimate the risk of being found and then choose the optimal timing based on the risk and profit. We design a learning strategy to model the information sharing mechanism among multiattackers and use spatial structure to model the long-term process. After calculating the Nash equilibrium for each subgame, we consider the likelihood of being attacked for each node as the security metric result. The experiment results show the efficiency of our approach.

  20. State, Parameter, and Unknown Input Estimation Problems in Active Automotive Safety Applications

    Phanomchoeng, Gridsada

    A variety of driver assistance systems such as traction control, electronic stability control (ESC), rollover prevention and lane departure avoidance systems are being developed by automotive manufacturers to reduce driver burden, partially automate normal driving operations, and reduce accidents. The effectiveness of these driver assistance systems can be significant enhanced if the real-time values of several vehicle parameters and state variables, namely tire-road friction coefficient, slip angle, roll angle, and rollover index, can be known. Since there are no inexpensive sensors available to measure these variables, it is necessary to estimate them. However, due to the significant nonlinear dynamics in a vehicle, due to unknown and changing plant parameters, and due to the presence of unknown input disturbances, the design of estimation algorithms for this application is challenging. This dissertation develops a new approach to observer design for nonlinear systems in which the nonlinearity has a globally (or locally) bounded Jacobian. The developed approach utilizes a modified version of the mean value theorem to express the nonlinearity in the estimation error dynamics as a convex combination of known matrices with time varying coefficients. The observer gains are then obtained by solving linear matrix inequalities (LMIs). A number of illustrative examples are presented to show that the developed approach is less conservative and more useful than the standard Lipschitz assumption based nonlinear observer. The developed nonlinear observer is utilized for estimation of slip angle, longitudinal vehicle velocity, and vehicle roll angle. In order to predict and prevent vehicle rollovers in tripped situations, it is necessary to estimate the vertical tire forces in the presence of unknown road disturbance inputs. An approach to estimate unknown disturbance inputs in nonlinear systems using dynamic model inversion and a modified version of the mean value theorem is

  1. Brooke-Spiegler syndrome presenting multiple concurrent cutaneous and parotid gland neoplasms: cytologic findings on fine-needle sample and description of a novel mutation of the CYLD gene.

    Malzone, Maria Gabriella; Campanile, Anna Cipolletta; Losito, Nunzia Simona; Longo, Francesco; Perri, Francesco; Caponigro, Francesco; Schiavone, Concetta; Ionna, Franco; Maiello, Francesco; Martinuzzi, Claudia; Nasti, Sabina; Botti, Gerardo; Fulciniti, Franco

    2015-08-01

    Multiple dermal cylindromas and membranous basal cell adenoma of parotid gland in a 67-year-old woman with Brooke-Spiegler syndrome (BSS) were examined by fine-needle cytology. Histology, immunochemistry, and CYLD germline mutation testing were also performed. Cytomorphology and immunochemistry of the two lesions showed basaloid neoplasms, remarkably similar, composed by proliferating epithelial cells of basal type accompanied by a smaller proportion of myoepithelial cells. CYLD gene showed a novel germline splice acceptor site mutation (c.2042-1G>C) with skipping of the entire exon 15. The occurrence of analogous tumors, dermal cylindromas, and membranous basal cell adenoma of the parotid gland, in the same patient may result from the action of a single gene on ontogenetically similar stem cells. Therefore, patients with BSS should be offered a genetic counselling for an early and correct diagnosis. © 2015 Wiley Periodicals, Inc.

  2. Sarcoidosis presenting as penile mass

    Hüseyin Semiz

    2017-01-01

    Full Text Available Sarcoidosis is an inflammatory disease with unknown cause characterized by noncaseating granuloma formations. It may present with bilateral hilar lymphadenopathy, skin lesions, eye, and musculoskeletal system involvement. Rare involvement of the genital organs (prostate, testis, epididymis has also been reported. However, penile involvement is observed quite rare. In this paper, we report a patient with penile mass who was diagnosed with sarcoidosis on the basis of the laboratory, radiological, and pathological investigations.

  3. Burning mouth syndrome: Present perspective

    Ramesh Parajuli

    2015-01-01

    Introduction: Burning mouth syndrome is characterized by chronic oral pain or burning sensation affecting the oral mucosa in the absence of obvious visible mucosal lesions. Patient presenting with the burning mouth sensation or pain is frequently encountered in clinical practice which poses a challenge to the treating clinician. Its exact etiology remains unknown which probably has multifactorial origin. It often affects middle or old age women and it may be accompanied by xerostomia and alte...

  4. Glory on Venus and selection among the unknown UV absorbers

    Petrova, Elena V.

    2018-05-01

    The comparison of the phase profiles of glories observed on the cloud top of Venus by the Venus Monitoring Camera (Venus Express) and the light-scattering characteristics of sulfuric acid droplets, containing admixtures with a high refractive index, makes it easier to choose between some candidates for the so-called unknown UV absorber in the Venus clouds. Since among the candidates there are materials wetted and not wetted by sulfuric acid, we analyze whether small submicron particles adhered to or embedded into the 1-μm H2SO4 droplets may actually change the glory pattern normally produced by homogeneous spherical particles and what the conditions are, under which the composite particles formed in heterogeneous nucleation may still produce a glory feature. We have found that one of the most frequently considered candidates, sulfur, can hardly be responsible for the contrasts observed at 0.365 μm on the upper clouds, since it is not wetted by sulfuric acid and submicron sulfur particles, serving as condensation nuclei for sulfuric acid, can only adhere to the H2SO4 droplets rather than be enveloped by them. Such droplets decorated by sulfur blobs substantially distort the glory feature characteristic of the scattering by spherical particles or even smooth it at all, while a glory pattern is practically always seen in the images of Venus taken at small phase angles. At the same time, the grains of the other UV absorbers that can be embedded in H2SO4 droplets, e.g., the widely discussed ferric chloride, pose no problem in terms of interpretation of the observations of glory.

  5. Treatment of Regional Metastatic Melanoma of Unknown Primary Origin

    Elke J. A. H. van Beek

    2015-08-01

    Full Text Available (1 Background: The purpose of this retrospective study was to evaluate the recurrence and survival rates of metastatic melanoma of unknown primary origin (MUP, in order to further refine current recommendations for the surgical treatment; (2 Methods: Medical data of all MUP patients registered between 2000 and 2011, were analyzed. Seventy-eight patients were categorized in either lymph node (axilla, groin, head-and neck or subcutaneous MUP. Axillary node MUPs were generally treated with dissections of levels I-III, inguinal node MUPs with combined superficial and deep groin dissections, and head-and-neck node MUPs with neck dissections to various extents, based on lymph drainage patterns. Subcutaneous lesions were excised with 1–2 cm margins. The primary outcome was treatment outcomes in terms of (locoregional recurrence and survival rates; (3 Results: Lymph node MUP recurred regionally in 11% of patients, with an overall recurrence rate of 45%. In contrast, subcutaneous MUP recurred locally in 65% of patients with an overall recurrence rate of 78%. This latter group had a significantly shorter disease-free interval than patients with lymph node MUP (p = 0.000. In the entire study population, 5-year and 10-year overall survival rates were 56% and 47% respectively, with no differences observed between the various subgroups; (4 Conclusion: The relatively low regional recurrence rate after regional lymph node dissection (11% supports its current status as standard surgical treatment for lymph node MUP. Subcutaneous MUP, on the contrary, appears to recur both locally (65% and overall (78% at a significantly higher rate, suggesting a different biological behavior. However, wide local excision remains the best available option for this specific group.

  6. Popular Music in Jia Zhangke’s Unknown Pleasures

    Jie Zhang

    2011-04-01

    Full Text Available With his documentary-style films reflecting upon China’s unprecedented transformation from a state-controlled to a market-driven economy, Jia Zhangke has risen from within the movement of independent Chinese cinema that began to flourish in the late 1990s to become one of the most recognized filmmakers of contemporary China. Born in 1970 and raised in the underdeveloped Shanxi Province, Jia studied film theory at Beijing Film Academy and was first noticed for his controversial “Hometown Trilogy”—'Pickpocket '('Xiao Wu', 1997, 'Platform '('Zhantai', 1999, and 'Unknown Pleasures '('Ren xiao yao', 2002. These three films, shot with handheld video camera on the streets of his hometown province, focus on the reckless changes that China’s aggressive economic growth and globalization have brought to socially marginalized groups. Like other independently made films—films that are produced with capital from outside the state-sponsored avenues and without the approval of film censorship, and that are not allowed to be shown in China’s public theaters—Jia’s first three films reach domestic audiences only through unofficial DVD copies and small-scaled screenings at universities, film bars, and art salons. His limited domestic influence sharply contrasts with the critical acclaim that he receives from international film festival audiences, who are searching for alternative film culture from China after the Fifth Generation directors. By the late 1990s, Jia had become a spokesperson for an ever-increasing group of aspiring Chinese independent filmmakers, particularly through writings and interviews that theorize independent Chinese cinema’s practice.

  7. Vestibular Function in Adults With Epilepsy of Unknown Etiology.

    Hamed, Sherifa A; Tohamy, Amal M; Oseilly, Amira M

    2017-09-01

    This study aimed to evaluate vestibular function in adults with chronic epilepsy of unknown etiology in the inter-ictal period. Epilepsy is a chronic medical disorder. Life-long therapy may be required in one-third of patients. Epilepsy is associated with comorbid somatic conditions which impairs patients' quality of life. This cross-sectional study included 28 with generalized tonic clonic (GTC) convulsions and 14 and 3 with temporal (TLE) and frontal lobe (FLE) epilepsies with secondary generalization (all were on regular carbamazepine therapy) and 40 healthy control subjects. The patients' mean age was 34.97 ± 7.35 years and the duration of illness was 18.75 ± 7.99 years. All underwent videonystagmography (VNG). Compared with controls, patients had frequent vestibular symptoms including dizziness (62.22%) (p = 0.0001) and sense of imbalance (44.44%) (p = 0.0001). Eleven patients (24.44%) had central vestibular dysfunction (p = 0.0001); 9 (20%) had mixed vestibular dysfunction and one (2.22%) had peripheral vestibular dysfunction (p = 0.0001). Abnormalities were observed in saccadic (44.4%) and pursuit (42.2%) eye movements, optokinetic nystagmus (42.2%) and positioning/positional (11.11%) and caloric (13.33%) testing. TLE and FLE were associated with more VNG abnormalities than GTC. No significant differences were observed in the demographic and clinical characteristics between patients with and without VNG abnormalities. Vestibular manifestations are frequent in patients with epilepsy. This may be a result of the permanent damaging effect of chronic epilepsy on the vestibular cortical areas and/or a toxic effect from prolonged carbamazepine therapy on the peripheral and central vestibular systems.

  8. Hyperprolactinemia after laparoscopic ovarian drilling: An unknown phenomenon

    Omrani Gholamhossein R

    2005-08-01

    Full Text Available Abstract Background The effects of ovarian drilling on the serum levels of gonadotropins and androgens have been studied previously. The aim of this study is to evaluate the effects of ovarian drilling on the serum prolactin levels and its relation to ovulation in women with polycystic ovary syndrome. Methods This is a prospective controlled study. Thirty-six women with PCOS underwent ovarian electrocauterization in university hospitals. Control group consisted of 35 ovulatory women with unexplained infertility. Hormonal assessment performed in early follicular phase of spontaneous or induced cycle before operation in the two groups and repeated one week after operation. Hormonal assay was also performed in the early follicular phase of the first post-operative menstruation, folliculometry and progesterone assay were also performed in the same cycle. Data were analyzed by "repeated measurement design, discriminant analysis, correlation coefficient, and Fisher exact test". Results Six to ten weeks after operation the serum mean +/- SD prolactin levels increased from 284.41 +/- 114.32 mIU/ml to 354.06 +/- 204.42 mIU/ml (P = 0.011. The same values for the control group were 277.73 +/- 114.65 to 277.4 +/- 111.4 (P = 0.981 respectively. Approximately 45% of subjects in PCOS group remained anovulatory in spite of decreased level of LH and testosterone. Prolactin level remained elevated in 73.2% of women who did not ovulate 6–10 weeks after the procedure. Conclusion Hyperprolactinemia after ovarian cauterization may be considered as a possible cause of anovulation in women with polycystic ovaries and improved gonadotropin and androgen levels. The cause of hyperprolactinemia is unknown. Hormonal assay particularly PRL in anovulatory patients after ovarian cauterization is recommended.

  9. [The diagnostic value of human chorionic gonadotrophin ratio compared to single measurements of S-human chorionic gonadotrophin on the outcome of pregnancy of unknown location].

    Majeed, Huda Galib; Lyngsø, Julie; Bor, Pinar

    2014-10-13

    Pregnancy of unknown location is defined by a positive pregnancy test, without visualizing of the intrauterine or extrauterine pregnancy by transvaginal sonography. We present the advantages of using human chorionic gonadotrophin (hCG) ratio instead of single measurements of S-hCG for predicting the outcomes of pregnancies of unknown location.

  10. Non-alcoholic beverages, unknown influence on cell proliferation - an in vitro study.

    Nowacki, Maciej; Adamowicz, Jan; Olkowska, Joanna; Pietkun, Katarzyna; Kloskowski, Tomasz; Bajek, Anna; Drewa, Tomasz

    2014-01-01

    The aim of the presented study was to check differences between 'Diet' and 'non-Diet' soft drinks on cell proliferation. Coca Cola and Pepsi Cola of different origin and their dietetic versions were examined at concentrations of 2% and 4%. Fructose and glucose as well as medium alone (control) were examined. Cell number was higher in media supplemented with soft drinks, compared to control. Proliferation depended on the soft drink concentration and its origin, but not on sugar and calorific content. An unknown factor is responsible for the increase in proliferation.

  11. Identifying an unknown function in a parabolic equation with overspecified data via He's variational iteration method

    Dehghan, Mehdi; Tatari, Mehdi

    2008-01-01

    In this research, the He's variational iteration technique is used for computing an unknown time-dependent parameter in an inverse quasilinear parabolic partial differential equation. Parabolic partial differential equations with overspecified data play a crucial role in applied mathematics and physics, as they appear in various engineering models. The He's variational iteration method is an analytical procedure for finding solutions of differential equations, is based on the use of Lagrange multipliers for identification of an optimal value of a parameter in a functional. To show the efficiency of the new approach, several test problems are presented for one-, two- and three-dimensional cases

  12. First all-sky search for continuous gravitational waves from unknown sources in binary systems

    Aasi, J.; Abbott, B.; Abbott, R.; Abbott, T.; Abernathy, M.; Accadia, T.; Acernese, F.; Ackley, K.; Adams, C.; Adams, T.; Addesso, P.; Adhikari, R.; Affeldt, C.; Agathos, M.; Aggarwal, N.

    2014-01-01

    We present the first results of an all-sky search for continuous gravitational waves from unknown spinning neutron stars in binary systems using LIGO and Virgo data. Using a specially developed analysis program, the TwoSpect algorithm, the search was carried out on data from the sixth LIGO Science Run and the second and third Virgo Science Runs. The search covers a range of frequencies from 20 Hz to 520 Hz, a range of orbital periods from 2 to ~2,254 h and a frequency- and period-dependent ra...

  13. The determination of an unknown boundary condition in a fractional diffusion equation

    Rundell, William

    2013-07-01

    In this article we consider an inverse boundary problem, in which the unknown boundary function ∂u/∂v = f(u) is to be determined from overposed data in a time-fractional diffusion equation. Based upon the free space fundamental solution, we derive a representation for the solution f as a nonlinear Volterra integral equation of second kind with a weakly singular kernel. Uniqueness and reconstructibility by iteration is an immediate result of a priori assumption on f and applying the fixed point theorem. Numerical examples are presented to illustrate the validity and effectiveness of the proposed method. © 2013 Copyright Taylor and Francis Group, LLC.

  14. Multiple sclerosis

    Grunwald, I.Q.; Kuehn, A.L.; Backens, M.; Papanagiotou, P.; Shariat, K.; Kostopoulos, P.

    2008-01-01

    Multiple sclerosis is the most common chronic inflammatory disease of myelin with interspersed lesions in the white matter of the central nervous system. Magnetic resonance imaging (MRI) plays a key role in the diagnosis and monitoring of white matter diseases. This article focuses on key findings in multiple sclerosis as detected by MRI. (orig.) [de

  15. Adenocarcinoid of the appendix presenting with metastases to the liver

    Bak, Martin; Jørgensen, L J

    1987-01-01

    A case of hepatomegalia due to multiple metastases of unknown origin to the liver is described. At autopsy the primary tumor, an adenocarcinoid tumor of the appendix, was identified along with multiple metastases to the lymph nodes and widespread peritoneal carcinoidosis. Hepatic metastases from...

  16. Nonbacterial thrombotic endocarditis associated with cancer of unknown origin complicated with thrombus in the left auricular appendage: case report

    Morinaga Yukiko

    2011-02-01

    Full Text Available Abstract A 63-year-old man was admitted to our hospital with a complaint of right lateroabdominal pain. He was diagnosed with metastatic colon cancer, and then developed multiple brain embolic infarctions 7 days after admission. Transesophageal echocardiography showed that mobile, echo-dense masses were attached to the anterior and posterior mitral valve leaflet. Furthermore, there was a thrombus in the left auricular appendage despite sinus rhythm. These findings led to a diagnosis of suspected infectious endocarditis with subsequent multiple brain infarctions. The patient's general condition worsened and he died 13 days after admission. An autopsy was performed, and, while poorly differentiated cancer was observed in multiple organs, no primary tumor could be identified. Histological analysis showed that the masses of the mitral valve consisted mainly of fibrin without bacteria or oncocytes. This patient was therefore diagnosed with nonbacterial thrombotic endocarditis associated with cancer of unknown origin complicated with thrombus in the left auricular appendage.

  17. Stability of Nonlinear Systems with Unknown Time-varying Feedback Delay

    Chunodkar, Apurva A.; Akella, Maruthi R.

    2013-12-01

    This paper considers the problem of stabilizing a class of nonlinear systems with unknown bounded delayed feedback wherein the time-varying delay is 1) piecewise constant 2) continuous with a bounded rate. We also consider application of these results to the stabilization of rigid-body attitude dynamics. In the first case, the time-delay in feedback is modeled specifically as a switch among an arbitrarily large set of unknown constant values with a known strict upper bound. The feedback is a linear function of the delayed states. In the case of linear systems with switched delay feedback, a new sufficiency condition for average dwell time result is presented using a complete type Lyapunov-Krasovskii (L-K) functional approach. Further, the corresponding switched system with nonlinear perturbations is proven to be exponentially stable inside a well characterized region of attraction for an appropriately chosen average dwell time. In the second case, the concept of the complete type L-K functional is extended to a class of nonlinear time-delay systems with unknown time-varying time-delay. This extension ensures stability robustness to time-delay in the control design for all values of time-delay less than the known upper bound. Model-transformation is used in order to partition the nonlinear system into a nominal linear part that is exponentially stable with a bounded perturbation. We obtain sufficient conditions which ensure exponential stability inside a region of attraction estimate. A constructive method to evaluate the sufficient conditions is presented together with comparison with the corresponding constant and piecewise constant delay. Numerical simulations are performed to illustrate the theoretical results of this paper.

  18. Fever as a Presentation of Tumoral Calcinosis: A Case Report

    Nga V Nguyen

    2018-03-01

    Full Text Available Tumoral calcinosis (TC is a rare condition in which there is periarticular calcium deposition in the soft tissue forming a mass. The most common locations of TC are the larger joints such as the hip, shoulder, and knee, as well as the hands and wrists. Patients will often present with localized swelling, pain, and reduced joint mobility. We will discuss a 48-year-old male on hemodialysis who presented with a fever of unknown source and diffuse joint pain. He was found to have progressive, multiple tumor-like swellings on his shoulders, hands, and knees. He was diagnosed with TC and managed with a high dose phosphate binder with resolution of his fever and improvement in his pain.

  19. Multiple homicides.

    Copeland, A R

    1989-09-01

    A study of multiple homicides or multiple deaths involving a solitary incident of violence by another individual was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, during 1983-1987. A total of 107 multiple homicides were studied: 88 double, 17 triple, one quadruple, and one quintuple. The 236 victims were analyzed regarding age, race, sex, cause of death, toxicologic data, perpetrator, locale of the incident, and reason for the incident. This article compares this type of slaying with other types of homicide including those perpetrated by serial killers. Suggestions for future research in this field are offered.

  20. Multiple cerebral infarctions following a snakebite by Bothrops caribbaeus.

    Numeric, Patrick; Moravie, Victor; Didier, Martin; Chatot-Henry, Didier; Cirille, Sylvia; Bucher, Bernard; Thomas, Laurent

    2002-09-01

    Bothrops caribbaeus, a species of the Bothrops complex, is found only in the island of Saint Lucia, West Indies. Snakebite from this pitviper is very rare. We report the case of a healthy 32-year-old Saint Lucian man who developed multiple cerebral infarctions following envenoming by this snake. This patient developed signs and symptoms very similar to those observed in patients envenomed by Bothrops lanceolatus, a snake found only in Martinique, the neighbor island of Saint Lucia. This clinical presentation differs dramatically from coagulopathies and systemic bleeding observed with the Central and South American bothropic envenomings. The exact mechanism of this thrombogenic phenomenon, leading to a unique envenoming syndrome, remains unknown.

  1. Fundamentals unknown : momentum, mean-reversion and price-to-earnings trading in an artificial stock market

    Schasfoort, Joeri; Stockermans, Christopher

    2017-01-01

    The use of fundamentalist traders in the stock market models is problematic since fundamental values in the real world are unknown. Yet, in the literature to date, fundamentalists are often required to replicate key stylized facts. The authors present an agent-based model of the stock market in

  2. Multiple Sclerosis: Pathogenesis and Treatment

    Loma, Ingrid; Heyman, Rock

    2011-01-01

    Multiple sclerosis (MS) is a chronic inflammatory autoimmune demyelinating disease of the central nervous system. It affects approximately 400,000 people in the United States and onset is usually during young adulthood. There are four clinical forms of MS, of which relapsing remitting type is the most common. As the etiology of MS is unknown, finding a cure will remain challenging. The main mechanism of injury appears to be inflammation and 8 agents are now FDA approved to help control MS. Th...

  3. Prediction of unknown deep foundation lengths using the Hilbert Huang Transform (HHT

    Ahmed T.M. Farid

    2012-08-01

    Full Text Available Prediction of unknown deep foundation embedment depth is a great deal nowadays, especially in case of upgrading or rehabilitation of old structures. Many old bridges and marine or pier structures in the United States are established using deep foundations system of timber piles and their foundation records do not exist. Non-Destructive Testing (NDT or Non-Destructive Evaluation (NDE method for a great variety of materials and structures has become an integral part of many tests. However, the process of testing long piles, deeply embedded in the ground, is more complex than (NDT of the other structural materials. This paper summarizes some of the most common non-destructive test methods for deep foundations and presents a new method called the Hilbert Huang Transform (HHT. This Hilbert Huang Transform (HHT method is used now by a wide range in a different health monitoring of many systems. In this paper, some field tests on the timber Piles of one bridge at North Carolina was performed to verify the using the (HHT method for predicting the embedded depth of the unknown piles. Percentage of the accuracy achieved using HHT method for pile length compared to the actual pile length data was performed. Finally, a recommendation is presented for the limitation of using this new method as a new non-destructive method for deep foundations.

  4. Multiple Sclerosis

    Multiple sclerosis (MS) is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down ...

  5. Multiple myeloma.

    Collins, Conor D

    2012-02-01

    Advances in the imaging and treatment of multiple myeloma have occurred over the past decade. This article summarises the current status and highlights how an understanding of both is necessary for optimum management.

  6. Multiple mononeuropathy

    ... with multiple mononeuropathy are prone to new nerve injuries at pressure points such as the knees and elbows. They should avoid putting pressure on these areas, for example, by not leaning on the elbows, crossing the knees, ...

  7. Streamlined structure elucidation of an unknown compound in a pigment formulation.

    Yüce, Imanuel; Morlock, Gertrud E

    2016-10-21

    A fast and reliable quality control is important for ink manufacturers to ensure a constant production grade of mixtures and chemical formulations, and unknown components attract their attention. Structure elucidating techniques seem time-consuming in combination with column-based methods, but especially the low solubility of pigment formulations is challenging the analysis. In contrast, layer chromatography is more tolerant with regard to pigment particles. One PLC plate for NMR and FTIR analyses and one HPTLC plate for recording of high resolution mass spectra, MS/MS spectra and for gathering information on polarity and spectral properties were needed to characterize a structure, exemplarily shown for an unknown component in pigment Red 57:1 to be 3-hydroxy-2-naphtoic acid. A preparative layer chromatography (PLC) workflow was developed that used an Automated Multiple Development 2 (AMD 2) system. The 0.5-mm PLC plate could still be operated in the AMD 2 system and allowed a smooth switch from the analytical to the preparative gradient separation. Through automated gradient development and the resulting focusing of bands, the sharpness of the PLC bands was improved. For NMR, the necessary high load of the target compound on the PLC plate was achieved via a selective solvent extraction that discriminated the polar sample matrix and thus increased the application volume of the extract that could maximally be applied without overloading. By doing so, the yield for NMR analysis was improved by a factor of 9. The effectivity gain through a simple, but thoroughly chosen extraction solvent is often overlooked, and for educational purpose, it was clearly illustrated and demonstrated by an extended solvent screening. Thus, PLC using an automated gradient development after a selective extraction was proven to be a new powerful combination for structural elucidation by NMR. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Organizational conditions for dealing with the unknown unknown : illustrated by how a Dutch water management authority is preparing for climate change

    Termeer, C.J.A.M.; Brink, van den M.A.

    2013-01-01

    The central question of this article is the extent to which organizations, governmental authorities in particular, are able to deal with the unknown unknown. Drawing on Weick’s work on sensemaking, we introduce seven organizational conditions that can facilitate organizations to be reliable under

  9. Organizational Conditions for Dealing with The Unknown Unknown Illustrated by how a Dutch water management authority is preparing for climate change

    Termeer, Catrien J. A. M.; van den Brink, Margo A.

    2013-01-01

    The central question of this article is the extent to which organizations, governmental authorities in particular, are able to deal with the unknown unknown. Drawing on Weick's work on sensemaking, we introduce seven organizational conditions that can facilitate organizations to be reliable under

  10. Fission neutron multiplicity calculations

    Maerten, H.; Ruben, A.; Seeliger, D.

    1991-01-01

    A model for calculating neutron multiplicities in nuclear fission is presented. It is based on the solution of the energy partition problem as function of mass asymmetry within a phenomenological approach including temperature-dependent microscopic energies. Nuclear structure effects on fragment de-excitation, which influence neutron multiplicities, are discussed. Temperature effects on microscopic energy play an important role in induced fission reactions. Calculated results are presented for various fission reactions induced by neutrons. Data cover the incident energy range 0-20 MeV, i.e. multiple chance fission is considered. (author). 28 refs, 13 figs

  11. STUDY OF SPECTRUM OF PYREXIA OF UNKNOWN ORIGIN PATIENTS IN A TERTIARY CARE HOSPITAL IN COASTAL ANDHRA PRADESH

    Suryaprakasa Rao Salla

    2017-09-01

    Full Text Available BACKGROUND Pyrexia of Unknown Origin (PUO/Fever of Unknown Origin (FUO was defined in 1961 by Petersdorf RG and Beeson PB2 as the following- A temperature greater than 38.3°C (101°F on several occasions; more than 3 weeks' duration of illness; and failure to reach a diagnosis despite 1 week of inpatient investigation. The aim of the study is to study the spectrum of cases of Pyrexia of Unknown Origin (PUO/Fever of Unknown Origin (FUO in a tertiary care hospital in coastal Andhra Pradesh. MATERIALS AND METHODS All patients with PUO admitted under the Department of General Medicine in the NRI Institute of Medical Sciences (Anil Neerukonda Hospital Sangivalasa, Visakhapatnam, during the period from 1st September, 2016, to 31st August, 2017, and who fulfil inclusion and exclusion criteria of classic PUO defined by Durrack and AC street1 were selected for the study. RESULTS The present study included 34 patients with pyrexia of unknown origin in which the patients’ age ranged from 15 years to 77 years. Most of the cases, 41.2% were in the age group 21 to 40 years and 35.3% in the age group 41 to 60 yrs. This indicates PUO is common in middle age group in our study. CONCLUSION Noninfectious causes like collagen vascular disease and neoplasms are becoming important differential diagnosis. But, in India, infections like tuberculosis, enteric fever are still the most common cause of FUO.

  12. Estimating Functions of Distributions Defined over Spaces of Unknown Size

    David H. Wolpert

    2013-10-01

    Full Text Available We consider Bayesian estimation of information-theoretic quantities from data, using a Dirichlet prior. Acknowledging the uncertainty of the event space size m and the Dirichlet prior’s concentration parameter c, we treat both as random variables set by a hyperprior. We show that the associated hyperprior, P(c, m, obeys a simple “Irrelevance of Unseen Variables” (IUV desideratum iff P(c, m = P(cP(m. Thus, requiring IUV greatly reduces the number of degrees of freedom of the hyperprior. Some information-theoretic quantities can be expressed multiple ways, in terms of different event spaces, e.g., mutual information. With all hyperpriors (implicitly used in earlier work, different choices of this event space lead to different posterior expected values of these information-theoretic quantities. We show that there is no such dependence on the choice of event space for a hyperprior that obeys IUV. We also derive a result that allows us to exploit IUV to greatly simplify calculations, like the posterior expected mutual information or posterior expected multi-information. We also use computer experiments to favorably compare an IUV-based estimator of entropy to three alternative methods in common use. We end by discussing how seemingly innocuous changes to the formalization of an estimation problem can substantially affect the resultant estimates of posterior expectations.

  13. Structure-based inference of molecular functions of proteins of unknown function from Berkeley Structural Genomics Center

    Kim, Sung-Hou; Shin, Dong Hae; Hou, Jingtong; Chandonia, John-Marc; Das, Debanu; Choi, In-Geol; Kim, Rosalind; Kim, Sung-Hou

    2007-09-02

    Advances in sequence genomics have resulted in an accumulation of a huge number of protein sequences derived from genome sequences. However, the functions of a large portion of them cannot be inferred based on the current methods of sequence homology detection to proteins of known functions. Three-dimensional structure can have an important impact in providing inference of molecular function (physical and chemical function) of a protein of unknown function. Structural genomics centers worldwide have been determining many 3-D structures of the proteins of unknown functions, and possible molecular functions of them have been inferred based on their structures. Combined with bioinformatics and enzymatic assay tools, the successful acceleration of the process of protein structure determination through high throughput pipelines enables the rapid functional annotation of a large fraction of hypothetical proteins. We present a brief summary of the process we used at the Berkeley Structural Genomics Center to infer molecular functions of proteins of unknown function.

  14. Multiple Hierarchies and Organizational Control

    Evans, Peter B.

    1975-01-01

    Uses a control-loss model to explore the effects of multiple channels in formal organizations, and presents an argument for the superior control properties of dual hierarchies. Two variant forms of multiple hierarchies are considered. (Author)

  15. Reconstruction of signals with unknown spectra in information field theory with parameter uncertainty

    Ensslin, Torsten A.; Frommert, Mona

    2011-01-01

    The optimal reconstruction of cosmic metric perturbations and other signals requires knowledge of their power spectra and other parameters. If these are not known a priori, they have to be measured simultaneously from the same data used for the signal reconstruction. We formulate the general problem of signal inference in the presence of unknown parameters within the framework of information field theory. To solve this, we develop a generic parameter-uncertainty renormalized estimation (PURE) technique. As a concrete application, we address the problem of reconstructing Gaussian signals with unknown power-spectrum with five different approaches: (i) separate maximum-a-posteriori power-spectrum measurement and subsequent reconstruction, (ii) maximum-a-posteriori reconstruction with marginalized power-spectrum, (iii) maximizing the joint posterior of signal and spectrum, (iv) guessing the spectrum from the variance in the Wiener-filter map, and (v) renormalization flow analysis of the field-theoretical problem providing the PURE filter. In all cases, the reconstruction can be described or approximated as Wiener-filter operations with assumed signal spectra derived from the data according to the same recipe, but with differing coefficients. All of these filters, except the renormalized one, exhibit a perception threshold in case of a Jeffreys prior for the unknown spectrum. Data modes with variance below this threshold do not affect the signal reconstruction at all. Filter (iv) seems to be similar to the so-called Karhune-Loeve and Feldman-Kaiser-Peacock estimators for galaxy power spectra used in cosmology, which therefore should also exhibit a marginal perception threshold if correctly implemented. We present statistical performance tests and show that the PURE filter is superior to the others, especially if the post-Wiener-filter corrections are included or in case an additional scale-independent spectral smoothness prior can be adopted.

  16. Multiple Thymoma with Myasthenia Gravis

    Dong Hyun Seo

    2017-02-01

    Full Text Available The actual incidence of multiple thymoma is unknown and rarely reported because it remains controversial whether the cases represent a disease of multicentric origin or a disease resulting from intrathymic metastasis. In this case, a patient underwent total thymectomy for multiple thymoma with myasthenia gravis via bilateral video-assisted thoracic surgery. A well-encapsulated multinodular cystic mass, measuring 57 mm×50 mm×22 mm in the right lobe of the thymus, and a well-encapsulated mass, measuring 32 mm×15 mm×14 mm in the left lobe, were found. Both tumors were type B2 thymoma. Few cases of multiple thymoma with myasthenia gravis have ever been reported in the literature. We report a case of synchronous multiple thymoma associated with myasthenia gravis.

  17. Transfusion as an Inflammation Hit: Knowns and Unknowns

    Garraud, Olivier; Tariket, S.; Sut, C.; Haddad, A.; Aloui, C.; Chakroun, T.; Laradi, S.; Cognasse, F.

    2016-01-01

    Transfusion of blood cell components is frequent in the therapeutic arsenal; it is globally safe or even very safe. At present, residual clinical manifestations are principally inflammatory in nature. If some rare clinical hazards manifest as acute inflammation symptoms of various origin, most of them linked with conflicting and undesirable biological material accompanying the therapeutic component (infectious pathogen, pathogenic antibody, unwanted antigen, or allergen), the general feature is subtler and less visible, and essentially consists of alloimmunization or febrile non-hemolytic transfusion reaction. The present essay aims to present updates in hematology and immunology that help understand how, when, and why subclinical inflammation underlies alloimmunization and circumstances characteristic of red blood cells and – even more frequently – platelets that contribute inflammatory mediators. Modern transfusion medicine makes sustained efforts to limit such inflammatory hazards; efforts can be successful only if one has a clear view of each element’s role. PMID:27965664

  18. Future trends in microelectronics journey into the unknown

    Xu, Jimmy; Zaslavsky, Alexander

    2016-01-01

    Presents the developments in microelectronic-related fields, with comprehensive insight from a number of leading industry professionals. The book presents the future developments and innovations in the developing field of microelectronics. The book’s chapters contain contributions from various authors, all of whom are leading industry professionals affiliated either with top universities, major semiconductor companies, or government laboratories, discussing the evolution of their profession. A wide range of microelectronic-related fields are examined, including solid-state electronics, material science, optoelectronics, bioelectronics, and renewable energies. The topics covered range from fundamental physical principles, materials and device technologies, and major new market opportunities.

  19. Lung volume recruitment in multiple sclerosis.

    Nadim Srour

    Full Text Available INTRODUCTION: Pulmonary function abnormalities have been described in multiple sclerosis including reductions in forced vital capacity (FVC and cough but the time course of this impairment is unknown. Peak cough flow (PCF is an important parameter for patients with respiratory muscle weakness and a reduced PCF has a direct impact on airway clearance and may therefore increase the risk of respiratory tract infections. Lung volume recruitment is a technique that improves PCF by inflating the lungs to their maximal insufflation capacity. OBJECTIVES: Our goals were to describe the rate of decline of pulmonary function and PCF in patients with multiple sclerosis and describe the use of lung volume recruitment in this population. METHODS: We reviewed all patients with multiple sclerosis referred to a respiratory neuromuscular rehabilitation clinic from February 1999 until December 2010. Lung volume recruitment was attempted in patients with FVC <80% predicted. Regular twice daily lung volume recruitment was prescribed if it resulted in a significant improvement in the laboratory. RESULTS: There were 79 patients included, 35 of whom were seen more than once. A baseline FVC <80% predicted was present in 82% of patients and 80% of patients had a PCF insufficient for airway clearance. There was a significant decline in FVC (122.6 mL/y, 95% CI 54.9-190.3 and PCF (192 mL/s/y, 95% 72-311 over a median follow-up time of 13.4 months. Lung volume recruitment was associated with a slower decline in FVC (p<0.0001 and PCF (p = 0.042. CONCLUSION: Pulmonary function and cough decline significantly over time in selected patients with multiple sclerosis and lung volume recruitment is associated with a slower rate of decline in lung function and peak cough flow. Given design limitations, additional studies are needed to assess the role of lung volume recruitment in patients with multiple sclerosis.

  20. Evaluation of fever of unknown origin before starting antiretroviral ...

    A 34-year-old woman tested HIV-positive in December 2005, and was referred to a specialist HIV unit in mid-January 2006. She had presented to her general practitioner with oesophageal candidiasis and a history of a cough and occasional loose stools since November 2005, with an 8 kg weight loss over the past 6 ...

  1. Known-to-Unknown Approach to Teach about Coulomb's Law

    Thamburaj, P. K.

    2007-01-01

    Analogies from life experiences help students understand various relationships presented in an introductory chemistry course. Coulomb's law is a complex relationship encountered in introductory general chemistry. A proper understanding of the relationships between the quantities involved in Coulomb's law is necessary in order for students to…

  2. Characteristics of Children with Phonologic Disorders of Unknown Origin.

    Shriberg, Lawrence D.; And Others

    1986-01-01

    Descriptive data are presented from three studies of children referred for assessment of developmental speech disorders. Group findings indicate involvements in mechanism, cognitive, and psychosocial areas. The reliability, learnability, and efficiency of a diagnostic classification system is also considered. (Author/CL)

  3. Hunting the unknown: White-box database leakage detection

    Costante, E.; Hartog, den J.I.; Petkovic, M.; Etalle, S.; Pechenizkiy, M.; Atluri, V.; Pernul, G.

    2014-01-01

    Data leakage causes significant losses and privacy breaches worldwide. In this paper we present a white-box data leakage detection system to spot anomalies in database transactions. We argue that our approach represents a major leap forward w.r.t. previous work because: i) it significantly decreases

  4. Active learning for ontological event extraction incorporating named entity recognition and unknown word handling.

    Han, Xu; Kim, Jung-jae; Kwoh, Chee Keong

    2016-01-01

    Biomedical text mining may target various kinds of valuable information embedded in the literature, but a critical obstacle to the extension of the mining targets is the cost of manual construction of labeled data, which are required for state-of-the-art supervised learning systems. Active learning is to choose the most informative documents for the supervised learning in order to reduce the amount of required manual annotations. Previous works of active learning, however, focused on the tasks of entity recognition and protein-protein interactions, but not on event extraction tasks for multiple event types. They also did not consider the evidence of event participants, which might be a clue for the presence of events in unlabeled documents. Moreover, the confidence scores of events produced by event extraction systems are not reliable for ranking documents in terms of informativity for supervised learning. We here propose a novel committee-based active learning method that supports multi-event extraction tasks and employs a new statistical method for informativity estimation instead of using the confidence scores from event extraction systems. Our method is based on a committee of two systems as follows: We first employ an event extraction system to filter potential false negatives among unlabeled documents, from which the system does not extract any event. We then develop a statistical method to rank the potential false negatives of unlabeled documents 1) by using a language model that measures the probabilities of the expression of multiple events in documents and 2) by using a named entity recognition system that locates the named entities that can be event arguments (e.g. proteins). The proposed method further deals with unknown words in test data by using word similarity measures. We also apply our active learning method for the task of named entity recognition. We evaluate the proposed method against the BioNLP Shared Tasks datasets, and show that our method

  5. Nonlinear unknown input sliding mode observer based chaotic system synchronization and message recovery scheme with uncertainty

    Sharma, Vivek; Sharma, B.B.; Nath, R.

    2017-01-01

    In the present manuscript, observer based synchronization and message recovery scheme is discussed for a system with uncertainties. LMI conditions are analytically derived solution of which gives the observer design matrices. Earlier approaches have used adaptive laws to address the uncertainties, however in present work, decoupling approach is used to make observer robust against uncertainties. The methodology requires upper bounds on nonlinearity and the message signal and estimates for these bounds are generated adaptively. Thus no information about the nature of nonlinearity and associated Lipschitz constant is needed in proposed approach. Message signal is recovered using equivalent output injection which is a low pass filtered equivalent of the discontinuous effort required to maintain the sliding motion. Finally, the efficacy of proposed Nonlinear Unknown Input Sliding Mode Observer (NUISMO) for chaotic communication is verified by conducting simulation studies on two chaotic systems i.e. third order Chua circuit and Rossler system.

  6. Analysis of the maximum likelihood channel estimator for OFDM systems in the presence of unknown interference

    Dermoune, Azzouz; Simon, Eric Pierre

    2017-12-01

    This paper is a theoretical analysis of the maximum likelihood (ML) channel estimator for orthogonal frequency-division multiplexing (OFDM) systems in the presence of unknown interference. The following theoretical results are presented. Firstly, the uniqueness of the ML solution for practical applications, i.e., when thermal noise is present, is analytically demonstrated when the number of transmitted OFDM symbols is strictly greater than one. The ML solution is then derived from the iterative conditional ML (CML) algorithm. Secondly, it is shown that the channel estimate can be described as an algebraic function whose inputs are the initial value and the means and variances of the received samples. Thirdly, it is theoretically demonstrated that the channel estimator is not biased. The second and the third results are obtained by employing oblique projection theory. Furthermore, these results are confirmed by numerical results.

  7. Intravenous thrombolysis in ischemic stroke with unknown onset using CT perfusion.

    Cortijo, E; García-Bermejo, P; Calleja, A I; Pérez-Fernández, S; Gómez, R; del Monte, J M; Reyes, J; Arenillas, J F

    2014-03-01

    Acute ischemic stroke patients with unclear onset time presenting >4.5 h from last-seen-normal (LSN) time are considered late patients and excluded from i.v. thrombolysis. We aimed to evaluate whether this subgroup of patients is different from patients presenting >4.5 h from a witnessed onset, in terms of eligibility and response to computed tomography perfusion (CTP)-guided i.v. thrombolysis. We prospectively studied consecutive acute non-lacunar middle cerebral artery (MCA) ischemic stroke patients presenting >4.5 h from LSN. All patients underwent multimodal CT and were considered eligible for i.v. thrombolysis according to CTP criteria. Two patient groups were established based on the knowledge of the stroke onset time. We compared the proportion of candidates suitable for intravenous thrombolysis between both groups, and their outcome after thrombolytic therapy. Among 147 MCA ischemic stroke patients presenting >4.5 h from LSN, stroke onset was witnessed in 74 and unknown in 73. Thirty-seven (50%) patients in the first group and 32 (44%) in the second met CTP criteria for thrombolysis (P = 0.7). Baseline variables were comparable between both groups with the exception of age, which was higher in the unclear onset group. The rates of early neurological improvement (54.1% vs 46.9%), 2-h MCA recanalization (43.5% vs 37%), symptomatic hemorrhagic transformation (3% vs 0%) and good 3-month functional outcome (62.2% vs 56.3%) did not differ significantly between both groups. Delayed stroke patients with unknown onset time were no different than patients >4.5 h regarding eligibility and response to CTP-based i.v. thrombolysis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Acting under interference by other agents with unknown goals

    Sønderberg-Madsen, Nicolaj; Jensen, Finn V.

    2008-01-01

    We consider the situation where two agents try to solve each their own task in a common environment. A general framework for representing that kind of scenario is presented. The framework is used to model the analysis depth of the opponent agent and to determine an optimal policy under various as...... assumptions on analysis depth of the opponent. The framework is applied on a strategic game, Ausgetrickst, and experiments are reported....

  9. Multiple Mucous Retention Cysts (Mucocele of the Oral Mucosa: A Case Report

    Gholamreza Jahanshahi

    2007-01-01

    Full Text Available To our knowledge, the occurrence of multiple mucoceles is not very common. This case report presents a 62-year-old man with multiple nodules on the upper and lower labial mucosa as well as both buccal mucosae with unknown history. Histopathology evaluation showed minor salivary gland ducts dilated to the point of cyst formation. The cysts seemed to be formed either as a result of dilatation of salivary ducts due to altered secretion or because of an acquired or congenital weakness in the ductal structure. The physiopathology of these findings is discussed.

  10. Random neural Q-learning for obstacle avoidance of a mobile robot in unknown environments

    Jing Yang

    2016-07-01

    Full Text Available The article presents a random neural Q-learning strategy for the obstacle avoidance problem of an autonomous mobile robot in unknown environments. In the proposed strategy, two independent modules, namely, avoidance without considering the target and goal-seeking without considering obstacles, are first trained using the proposed random neural Q-learning algorithm to obtain their best control policies. Then, the two trained modules are combined based on a switching function to realize the obstacle avoidance in unknown environments. For the proposed random neural Q-learning algorithm, a single-hidden layer feedforward network is used to approximate the Q-function to estimate the Q-value. The parameters of the single-hidden layer feedforward network are modified using the recently proposed neural algorithm named the online sequential version of extreme learning machine, where the parameters of the hidden nodes are assigned randomly and the sample data can come one by one. However, different from the original online sequential version of extreme learning machine algorithm, the initial output weights are estimated subjected to quadratic inequality constraint to improve the convergence speed. Finally, the simulation results demonstrate that the proposed random neural Q-learning strategy can successfully solve the obstacle avoidance problem. Also, the higher learning efficiency and better generalization ability are achieved by the proposed random neural Q-learning algorithm compared with the Q-learning based on the back-propagation method.

  11. Analysis of sensorless control of brushless DC motor using unknown input observer with different gains

    Astik, Mitesh B.; Bhatt, Praghnesh; Bhalja, Bhavesh R.

    2017-03-01

    A sensorless control scheme based on an unknown input observer is presented in this paper in which back EMF of the Brushless DC Motor (BLDC) is continuously estimated from available line voltages and currents. During negative rotation of motor, actual and estimated speed fail to track the reference speed and if the corrective action is not taken by the observer, the motor goes into saturation. To overcome this problem, the speed estimation algorithm has been implemented in this paper to control the dynamic behavior of the motor during negative rotation. The Ackermans method was used to calculate the gains of an unknown input observer which is based on the appropriate choice of the eigenvalues in advance. The criteria to choose eigenvalue is to obtain a balance between faster convergence rate and the least noise level. Simulations have been carried out for different disturbances such as step changes in motor reference speed and load torque. The comparative simulation results clearly depict that the disturbance effects in actual and estimated responses minimizes as observer gain setting increases.

  12. THE ANALYSIS OF PHYSICO-CHEMICAL PROPERTIES OF TWO UNKNOWN FILTER MATERIALS

    Iwona Skoczko

    2016-07-01

    Full Text Available One of the most important technological processes of water treatment is the process of filtration. Scientists and producers keep on searching new filtration materials which allow for better water purification, are simple in exploitation and do not add chemical substances to the treated water. Therefore, the aim of the present study was to analyze physical and chemical parameters of two unknown porous masses X1 and X2. Such physical parameters as color, granulation, bulk density, the equivalent diameter, the coefficient of uniformity and the porosity of the material were measured and determined. Additionally, the possibility of water treatment was studied during the filtration process in the laboratory tests. Chemical parameters were examined in the water flowing through the mass, such as pH, conductivity and COD-Mn as a general indicator of the content of organic substances in the water. Both studied porous masses were characterized by uniform size of particles. But they were not efficient enough in satisfactory reduction of oxygen consumption. Mass X2 slightly better adsorbed organic substances. It was found that the tested unknown mass filter slightly increase the pH of the filtered water.

  13. Novel polyomaviruses of nonhuman primates: genetic and serological predictors for the existence of multiple unknown polyomaviruses within the human population.

    Nelly Scuda

    Full Text Available Polyomaviruses are a family of small non-enveloped DNA viruses that encode oncogenes and have been associated, to greater or lesser extent, with human disease and cancer. Currently, twelve polyomaviruses are known to circulate within the human population. To further examine the diversity of human polyomaviruses, we have utilized a combinatorial approach comprised of initial degenerate primer-based PCR identification and phylogenetic analysis of nonhuman primate (NHP polyomavirus species, followed by polyomavirus-specific serological analysis of human sera. Using this approach we identified twenty novel NHP polyomaviruses: nine in great apes (six in chimpanzees, two in gorillas and one in orangutan, five in Old World monkeys and six in New World monkeys. Phylogenetic analysis indicated that only four of the nine chimpanzee polyomaviruses (six novel and three previously identified had known close human counterparts. To determine whether the remaining chimpanzee polyomaviruses had potential human counterparts, the major viral capsid proteins (VP1 of four chimpanzee polyomaviruses were expressed in E. coli for use as antigens in enzyme-linked immunoassay (ELISA. Human serum/plasma samples from both Côte d'Ivoire and Germany showed frequent seropositivity for the four viruses. Antibody pre-adsorption-based ELISA excluded the possibility that reactivities resulted from binding to known human polyomaviruses. Together, these results support the existence of additional polyomaviruses circulating within the human population that are genetically and serologically related to existing chimpanzee polyomaviruses.

  14. The Iranian nuclear programme-an equation with many unknowns; Le programme nucleaire iranien, une equation aux multiple inconnues

    Hamel, T. [Universite Robert Schuman, 67 - Strasbourg (France)

    2007-07-15

    So, is Iran a threat or a victim? Although it has no previous history of aggression, Iran continues to disturb the international community with its nuclear programme, while declaring that it is under threat from its neighbours and the victim of propaganda. Yet why does a country with such large reserves of oil and gas need a nuclear industry? This question arose as long ago as the early 1970, and it arises again today. The Shah was a Gaullist, Khomenei a Gaullist ayatollah, and today it is not the Ayatollah but the Gaullist posture that is the more disturbing. A Blairite ayatollah will surely suit Washington nicely. (author)

  15. Novel Polyomaviruses of Nonhuman Primates: Genetic and Serological Predictors for the Existence of Multiple Unknown Polyomaviruses within the Human Population

    Scuda, Nelly; Madinda, Nadege Freda; Akoua-Koffi, Chantal; Adjogoua, Edgard Valerie; Wevers, Diana; Hofmann, Jörg; Cameron, Kenneth N.; Leendertz, Siv Aina J.; Couacy-Hymann, Emmanuel; Robbins, Martha; Boesch, Christophe; Jarvis, Michael A.; Moens, Ugo; Mugisha, Lawrence; Calvignac-Spencer, Sébastien; Leendertz, Fabian H.; Ehlers, Bernhard

    2013-01-01

    Polyomaviruses are a family of small non-enveloped DNA viruses that encode oncogenes and have been associated, to greater or lesser extent, with human disease and cancer. Currently, twelve polyomaviruses are known to circulate within the human population. To further examine the diversity of human polyomaviruses, we have utilized a combinatorial approach comprised of initial degenerate primer-based PCR identification and phylogenetic analysis of nonhuman primate (NHP) polyomavirus species, followed by polyomavirus-specific serological analysis of human sera. Using this approach we identified twenty novel NHP polyomaviruses: nine in great apes (six in chimpanzees, two in gorillas and one in orangutan), five in Old World monkeys and six in New World monkeys. Phylogenetic analysis indicated that only four of the nine chimpanzee polyomaviruses (six novel and three previously identified) had known close human counterparts. To determine whether the remaining chimpanzee polyomaviruses had potential human counterparts, the major viral capsid proteins (VP1) of four chimpanzee polyomaviruses were expressed in E. coli for use as antigens in enzyme-linked immunoassay (ELISA). Human serum/plasma samples from both Côte d'Ivoire and Germany showed frequent seropositivity for the four viruses. Antibody pre-adsorption-based ELISA excluded the possibility that reactivities resulted from binding to known human polyomaviruses. Together, these results support the existence of additional polyomaviruses circulating within the human population that are genetically and serologically related to existing chimpanzee polyomaviruses. PMID:23818846

  16. Multiple sclerosis

    Stenager, Egon; Stenager, E N; Knudsen, Lone

    1994-01-01

    In a cross-sectional study of 117 randomly selected patients (52 men, 65 women) with definite multiple sclerosis, it was found that 76 percent were married or cohabitant, 8 percent divorced. Social contacts remained unchanged for 70 percent, but outgoing social contacts were reduced for 45 percent......, need for structural changes in home and need for pension became greater with increasing physical handicap. No significant differences between gender were found. It is concluded that patients and relatives are under increased social strain, when multiple sclerosis progresses to a moderate handicap...

  17. O conceito de campo: polissemia nos manuais, significados na física do passado e da atualidade The field concept: multiple character within textbooks, meanings in past and present Physics

    Sonia Krapas

    2008-01-01

    Full Text Available Este trabalho objetiva evidenciar o caráter polissêmico do termo campo em livros didáticos de ensino médio; estudar seus significados em textos históricos; mostrar que a polissemia desse conceito tem raízes nos significados atribuídos tanto no passado como na atualidade. Sob a luz do marco teórico atual da física e de textos históricos, analisaram-se sete manuais de ensino médio em circulação que, quando oportuno, foram cotejados com livros didáticos universitários e manuais antigos. Destacam-se as seguintes atribuições de significado, algumas na forma de definições explícitas, outras implicitamente apresentadas: é espaço; é um vetor; propaga-se, é suporte para a propagação de energia; é curvatura do espaço; armazena energia; interage com partículas, media a interação entre partículas; preenche o espaço. A polissemia pode ser creditada, em parte, à forma velada de introdução da física moderna nos manuais. Faz-se uma tentativa de compreender essa introdução segundo a perspectiva da transposição didática de Chevallard.This paper aims at: evidencing the polissemic character of the term field within High School textbooks; studying its meanings in historical texts; showing that the roots of such meaning variety are found in both past and present days. Considering as reference the current theoretical mark of Physics and historical texts, seven secondary education manuals were analyzed. When appropriate, such manuals were compared to those found in old education and undergraduate textbooks. Meaning differences could be pointed out, both implicitly and explicitly. Such meanings are: space; vector; something that propagates itself and supports energy propagation; space curvature; energy resevoir; it interacts with particles and mediates their interaction; it fills space. Partly, this polissemy can be credited to the concealed form of introducing Modern Physics in manuals. An attempt is made to understand this

  18. Diagnostic investigations in 101 dogs with pyrexia of unknown origin

    Dunn, K.J.; Dunn, J.K.

    1998-01-01

    Records from 101 dogs presented for investigation of unexplained pyrexia were reviewed. The most common diagnosis was immune-mediated disease (22 per cent of cases), with immune-mediated polyarthritis accounting for 20 per cent of all diagnoses. The frequency of positive results obtained in investigative tests was also assessed. Cytological and radiological examinations provided a high diagnostic success rate, although routine haematology and plasma biochemistry were also useful screening tests. On the basis of these results it is suggested that, in the investigation of unexplained pyrexia, a diagnosis of immune-mediated polyarthritis should be excluded before less common diagnoses are considered

  19. [69-year-old patient with seizure of unknown origin].

    Riediger, Ch; Iff, S; Stucki, A; Donati, F; Stanga, Z

    2007-03-07

    Diseases associated with cobalamin deficiency often present a variety of neurological disorders apart from the well known megaloblastic anaemia as haematological manifestation. The peripheral and the central nervous system can be affected in different levels by the metabolic changes due to an impaired Vitamin B12 metabolism. Based upon an observed case we discuss the manifestation of cerebral convulsion possibly due to a secondarily acquired cobalamin deficiency. We conclude that in de novo cerebral convulsion in the elderly a cobalamin deficiency could play an important role.

  20. Balancing the unknown: Consumer judgment of unfamiliar technologies

    Hagemann, Kit; Scholderer, Joachim

    The aim of the present paper is to explain how consumers form attitudes towards upstream food technologies in the absence of direct experience or in-depth information about the technology and the products resulting from its application. Using Structural Equation Modelling (SEM) we compared three...... food technologies against genetically modification (GM) and found that previously held attitude toward GM influenced attitude toward all three food technologies. The findings suggest that consumers form a set of heuristics that consist of general socio-political attitudes and these heuristics are used...

  1. Predictive Feedback and Feedforward Control for Systems with Unknown Disturbances

    Juang, Jer-Nan; Eure, Kenneth W.

    1998-01-01

    Predictive feedback control has been successfully used in the regulation of plate vibrations when no reference signal is available for feedforward control. However, if a reference signal is available it may be used to enhance regulation by incorporating a feedforward path in the feedback controller. Such a controller is known as a hybrid controller. This paper presents the theory and implementation of the hybrid controller for general linear systems, in particular for structural vibration induced by acoustic noise. The generalized predictive control is extended to include a feedforward path in the multi-input multi-output case and implemented on a single-input single-output test plant to achieve plate vibration regulation. There are cases in acoustic-induce vibration where the disturbance signal is not available to be used by the hybrid controller, but a disturbance model is available. In this case the disturbance model may be used in the feedback controller to enhance performance. In practice, however, neither the disturbance signal nor the disturbance model is available. This paper presents the theory of identifying and incorporating the noise model into the feedback controller. Implementations are performed on a test plant and regulation improvements over the case where no noise model is used are demonstrated.

  2. Measurements Conducted on an Unknown Object Labeled Pu-239

    Hoteling, Nathan

    2013-01-01

    Measurements were carried out on 12 November 2013 to determine whether Pu-239 was present on an object discovered in a plastic bag with label ''Pu-239 6 uCi''. Following initial survey measurements to verify that the object was not leaking or contaminated, spectra were collected with a High Purity Germanium (HPGe) detector with object positioned in two different configurations. Analysis of the spectra did not yield any direct evidence of Pu-239. From the measured spectra, minimum detectable activity (MDA) was determined to be approximately 2 uCi for the gamma ray measurements. Although there was no direct evidence of Pu-239, a peak at 60 keV characteristic of Am-241 decay was observed. Since it is very likely that Am-241 would be present in aged plutonium samples, this was interpreted as indirect evidence for the presence of plutonium on the object. Analysis of this peak led to an estimated Pu-239 activity of 0.02-0.04 uCi, or <1x10 -6 grams.

  3. Takotsubo cardiomyopathy: A known unknown foe of asthma.

    Kotsiou, Ourania S; Douras, Alexandros; Makris, Demosthenes; Mpaka, Nikoleta; Gourgoulianis, Konstantinos I

    2017-10-01

    Patients with uncontrolled asthma are at a greater risk of asthma attacks requiring emergency room visits or hospital admissions. Takotsubo cardiomyopathy is potentially a significant complication in a course of status asthmaticus. We describe a 43-year-old female patient who presented with status asthmaticus that was further complicated with takotsubo cardiomyopathy. Recognizing apical ballooning syndrome is challenging in patients with a history of respiratory disease because the symptoms of the last entity may complicate the diagnostic approach. It is difficult to distinguish clinically apical ballooning syndrome from the acute airway exacerbation itself. Both asthma and takotsubo cardiomyopathy share the same clinical presentation with dyspnea and chest tightness. In our patient, the electrocardiographic abnormalities, the rapidly reversible distinctive characteristics of echocardiography, and the modest elevation of serum cardiac biomarkers levels, in combination with the presence of a stress trigger (severe asthma attack), strongly supported the diagnosis of broken heart syndrome. Clinicians should re-evaluate asthma management and be aware of the complications associated with asthma attacks such as stress-induced cardiomyopathy.

  4. A robust approach towards unknown transformation, regional adjacency graphs, multigraph matching, segmentation video frames from unnamed aerial vehicles (UAV)

    Gohatre, Umakant Bhaskar; Patil, Venkat P.

    2018-04-01

    In computer vision application, the multiple object detection and tracking, in real-time operation is one of the important research field, that have gained a lot of attentions, in last few years for finding non stationary entities in the field of image sequence. The detection of object is advance towards following the moving object in video and then representation of object is step to track. The multiple object recognition proof is one of the testing assignment from detection multiple objects from video sequence. The picture enrollment has been for quite some time utilized as a reason for the location the detection of moving multiple objects. The technique of registration to discover correspondence between back to back casing sets in view of picture appearance under inflexible and relative change. The picture enrollment is not appropriate to deal with event occasion that can be result in potential missed objects. In this paper, for address such problems, designs propose novel approach. The divided video outlines utilizing area adjancy diagram of visual appearance and geometric properties. Then it performed between graph sequences by using multi graph matching, then getting matching region labeling by a proposed graph coloring algorithms which assign foreground label to respective region. The plan design is robust to unknown transformation with significant improvement in overall existing work which is related to moving multiple objects detection in real time parameters.

  5. An Infant With Transient Neonatal Pustular Melanosis Presenting as Pustules

    Pei-San Chia

    2010-12-01

    Full Text Available Transient neonatal pustular melanosis is mostly found in full-term black infants. It is a benign and self-limited disease, and the etiology is still unknown. We present a full-term female neonate with multiple vesiculopustular and pigmented macular lesions found immediately after her birth. A skin biopsy showed vesicles consisting of intracorneal and subcorneal aggregates of neutrophils, which is compatible with transient neonatal pustular melanosis. Although it is rare in Taiwan and Asian countries, transient neonatal pustular melanosis should always be considered when pustulosis is found in the neonatal period to prevent the use of unnecessary antibiotics. Dermatological consultation and histological confirmation are sometimes required for the final diagnosis.

  6. Unknown Aspects of Self-Assembly of PbS Microscale Superstructures

    Querejeta-Fernández, Ana; Hernández-Garrido, Juan C.; Yang, Hengxi; Zhou, Yunlong; Varela, Aurea; Parras, Marina; Calvino-Gámez, José J.; González-Calbet, Jose M.; Green, Peter F.; Kotov, Nicholas A.

    2012-01-01

    A lot of interesting and sophisticated examples of nanoparticle (NP) self-assembly (SA) are known. From both fundamental and technological standpoints this field requires advancements in three principle directions: a) understanding the mechanism and driving forces of three-dimensional (3D) SA with both nano- and micro-levels of organization; b) understanding of disassembly/deconstruction processes; and c) finding synthetic methods of assembly into continuous superstructures without insulating barriers. From this perspective, we investigated the formation of well-known star-like PbS superstructures and found a number of previously unknown or overlooked aspects that can advance the knowledge of NP self-assembly in these three directions. The primary one is that the formation of large seemingly monocrystalline PbS superstructures with multiple levels of octahedral symmetry can be explained only by SA of small octahedral NPs. We found five distinct periods in the formation PbS hyperbranched stars: 1) nucleation of early PbS NPs with an average diameter of 31 nm; 2) assembly into 100–500 nm octahedral mesocrystals; 3) assembly into 1000–2500 nm hyperbranched stars; 4) assembly and ionic recrystallization into six-arm rods accompanied by disappearance of fine nanoscale structure; 5) deconstruction into rods and cubooctahedral NPs. The switches in assembly patterns between the periods occur due to variable dominance of pattern–determining forces that include vander Waals and electrostatic (charge-charge, dipole-dipole, and polarization) interactions. The superstructure deconstruction is triggered by chemical changes in the deep eutectic solvent (DES) used as the media. PbS superstructures can be excellent models for fundamental studies of nanoscale organization and SA manufacturing of (opto)electronics and energy harvesting devices which require organization of PbS components at multiple scales. PMID:22515512

  7. Multiple myeloma

    Sohn, Jeong Ick; Ha, Choon Ho; Choi, Karp Shik

    1994-01-01

    Multiple myeloma is a malignant plasma cell tumor that is thought to originate proliferation of a single clone of abnormal plasma cell resulting production of a whole monoclonal paraprotein. The authors experienced a case of multiple myeloma with severe mandibular osteolytic lesions in 46-year-old female. As a result of careful analysis of clinical, radiological, histopathological features, and laboratory findings, we diagnosed it as multiple myeloma, and the following results were obtained. 1. Main clinical symptoms were intermittent dull pain on the mandibular body area, abnormal sensation of lip and pain due to the fracture on the right clavicle. 2. Laboratory findings revealed M-spike, reversed serum albumin-globulin ratio, markedly elevated ESR and hypercalcemia. 3. Radiographically, multiple osteolytic punched-out radiolucencies were evident on the skull, zygoma, jaw bones, ribs, clavicle and upper extremities. Enlarged liver and increased uptakes on the lesional sites in RN scan were also observed. 4. Histopathologically, markedly hypercellular marrow with sheets of plasmoblasts and megakaryocytes were also observed.

  8. Multiple sclerosis

    Stenager, E; Jensen, K

    1988-01-01

    Forty-two (12%) of a total of 366 patients with multiple sclerosis (MS) had psychiatric admissions. Of these, 34 (81%) had their first psychiatric admission in conjunction with or after the onset of MS. Classification by psychiatric diagnosis showed that there was a significant positive correlation...

  9. Multiple sclerosis

    Stenager, E; Knudsen, L; Jensen, K

    1991-01-01

    In a cross-sectional investigation of 116 patients with multiple sclerosis, the social and sparetime activities of the patient were assessed by both patient and his/her family. The assessments were correlated to physical disability which showed that particularly those who were moderately disabled...

  10. Multiple sclerosis

    Stenager, E; Jensen, K

    1990-01-01

    An investigation on the correlation between ability to read TV subtitles and the duration of visual evoked potential (VEP) latency in 14 patients with definite multiple sclerosis (MS), indicated that VEP latency in patients unable to read the TV subtitles was significantly delayed in comparison...

  11. Multiple sclerosis

    Stenager, E; Knudsen, L; Jensen, K

    1994-01-01

    In a cross-sectional study of 94 patients (42 males, 52 females) with definite multiple sclerosis (MS) in the age range 25-55 years, the correlation of neuropsychological tests with the ability to read TV-subtitles and with the use of sedatives is examined. A logistic regression analysis reveals...

  12. Multiple Sclerosis.

    Plummer, Nancy; Michael, Nancy, Ed.

    This module on multiple sclerosis is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first. The module goal and objectives are then…

  13. Parenting Multiples

    ... when your babies do. Though it can be hard to let go of the thousand other things you need to do, remember that your well-being is key to your ability to take care of your babies. What Problems Can Happen? It may be hard to tell multiple babies apart when they first ...

  14. Methods for Characterisation of unknown Suspect Radioactive Samples

    Sahagia, M.; Grigorescu, E.L.; Luca, A.; Razdolescu, A.C.; Ivan, C.

    2001-01-01

    Full text: The paper presents various identification and measurement methods, used for the expertise of a wide variety of suspect radioactive materials, whose circulation was not legally stated. The main types of examined samples were: radioactive sources, illegally trafficked; suspect radioactive materials or radioactively contaminated devices; uranium tablets; fire detectors containing 241 Am sources; osmium samples containing radioactive 185 Os or enriched 187 Os. The types of analyses and determination methods were as follows: the chemical composition was determined by using identification reagents or by neutron activation analysis; the radionuclide composition was determined by using gamma-ray spectrometry; the activity and particle emission rates were determined by using calibrated radiometric equipment; the absorbed dose rate at the wall of all types of containers and samples was determined by using calibrated dose ratemeters. The radiation exposure risk for population, due to these radioactive materials, was evaluated for every case. (author)

  15. Simultaneous identification of unknown groundwater pollution sources and estimation of aquifer parameters

    Datta, Bithin; Chakrabarty, Dibakar; Dhar, Anirban

    2009-09-01

    Pollution source identification is a common problem encountered frequently. In absence of prior information about flow and transport parameters, the performance of source identification models depends on the accuracy in estimation of these parameters. A methodology is developed for simultaneous pollution source identification and parameter estimation in groundwater systems. The groundwater flow and transport simulator is linked to the nonlinear optimization model as an external module. The simulator defines the flow and transport processes, and serves as a binding equality constraint. The Jacobian matrix which determines the search direction in the nonlinear optimization model links the groundwater flow-transport simulator and the optimization method. Performance of the proposed methodology using spatiotemporal hydraulic head values and pollutant concentration measurements is evaluated by solving illustrative problems. Two different decision model formulations are developed. The computational efficiency of these models is compared using two nonlinear optimization algorithms. The proposed methodology addresses some of the computational limitations of using the embedded optimization technique which embeds the discretized flow and transport equations as equality constraints for optimization. Solution results obtained are also found to be better than those obtained using the embedded optimization technique. The performance evaluations reported here demonstrate the potential applicability of the developed methodology for a fairly large aquifer study area with multiple unknown pollution sources.

  16. A multiplicity logic unit

    Bialkowski, J.; Moszynski, M.; Zagorski, A.

    1981-01-01

    The logic diagram principle of operation and some details of the design of the multiplicity logic unit are presented. This unit was specially designed to fulfil the requirements of a multidetector arrangement for gamma-ray multiplicity measurements. The unit is equipped with 16 inputs controlled by a common coincidence gate. It delivers a linear output pulse with the height proportional to the multiplicity of coincidences and logic pulses corresponding to 0, 1, ... up to >= 5-fold coincidences. These last outputs are used to steer the routing unit working with the multichannel analyser. (orig.)

  17. Two similar cases of elderly women with moderate abdominal pain and pneumoperitoneum of unknown origin: a surgeon's successful conservative management.

    Vinzens, Fabrizio; Zumstein, Valentin; Bieg, Christian; Ackermann, Christoph

    2016-05-26

    Patients presenting with abdominal pain and pneumoperitoneum in radiological examination usually require emergency explorative laparoscopy or laparotomy. Pneumoperitoneum mostly associates with gastrointestinal perforation. There are very few cases where surgery can be avoided. We present 2 cases of pneumoperitoneum with unknown origin and successful conservative treatment. Both patients were elderly women presenting to our emergency unit, with moderate abdominal pain. There was neither medical intervention nor trauma in their medical history. Physical examination revealed mild abdominal tenderness, but no clinical sign of peritonitis. Cardiopulmonary examination remained unremarkable. Blood studies showed only slight abnormalities, in particular, inflammation parameters were not significantly increased. Finally, obtained CTs showed free abdominal gas of unknown origin in both cases. We performed conservative management with nil per os, nasogastric tube, total parenteral nutrition and prophylactic antibiotics. After 2 weeks, both were discharged home. 2016 BMJ Publishing Group Ltd.

  18. Huygens begins its final journey into the unknown

    2004-12-01

    and the Cassini orbiter is visible over the horizon at the landing site, i.e. not more than 130 minutes. At that time, the Cassini orbiter will reorient its main antenna dish toward Earth in order to play back the data collected by Huygens, which will be received by NASA’s 70-m diameter antenna in Canberra, Australia, 67 minutes later. Three playbacks are planned, to ensure that all recorded data are safely transmitted to Earthl. Then Cassini will continue its mission exploring Saturn and its moons, which includes multiple additional flybys of Titan in the coming months and years. A probe deep into space and time Bigger than Mercury and slightly smaller than Mars, Titan is unique in having a thick hazy nitrogen-rich atmosphere containing carbon-based compounds that could yield important clues about how Earth came to be habitable. The chemical makeup of the atmosphere is thought to be very similar to Earth’s before life began, although colder (-180°C) and so lacking liquid water. The in-situ results from Huygens, combined with global observations from repeated flybys of Titan by the Cassini orbiter, are thus expected to help us understand not only one of the most exotic members of our solar system but also the evolution of the early Earth's atmosphere and the mechanisms that led to the dawn of life on our planet. Europe’s main contribution to the Cassini mission, the Huygens probe was built for ESA by an industrial team led by Alcatel Space. This 320 kg spacecraft is carrying six science instruments to study the atmosphere during its descent. Laboratories and research centres from all ESA member countries, the United States, Poland and Israel have been involved in developing this science payload. The Huygens atmospheric structure instrument package (HASI) will measure temperature and pressure profiles, and characterise winds and turbulences. It will also be able to detect lightning and even to measure the conductivity and permittivity of the surface if the probe

  19. Echinococcus multilocularis in North America: the great unknown

    Massolo, Alessandro; Liccioli, Stefano; Budke, Christine; Klein, Claudia

    2014-01-01

    Over the last decade, studies have begun to shed light on the distribution and genetic characterization of Echinococcus multilocularis, the causative agent of alveolar echinococcosis (AE), in North America. Recent findings indicate that the parasite is likely expanding its range in the central region of the United States and Canada and that invasions of European strains might have occurred. In our review, we present the available data on E. multilocularis infections in wild and domestic animals and humans in North America and emphasize the lack of knowledge on the distribution of the parasite in wild and domestic hosts. Furthermore, we stress the need to better understand the complexity of host communities and their roles in shaping the transmission and distribution of the parasite. We hypothesize that a lack of knowledge about AE by North American physicians might result in the misdiagnosis of cases and an underestimation of disease incidence. The endemic presence of the parasite in urban areas and a recent human case in Alberta, Canada, suggest that the scientific community may need to reconsider the local public health risks, re-assess past cases that might have been overlooked and increase surveillance efforts to identify new cases of human AE. PMID:25531581

  20. Modeling spatial processes with unknown extremal dependence class

    Huser, Raphaël G.

    2017-03-17

    Many environmental processes exhibit weakening spatial dependence as events become more extreme. Well-known limiting models, such as max-stable or generalized Pareto processes, cannot capture this, which can lead to a preference for models that exhibit a property known as asymptotic independence. However, weakening dependence does not automatically imply asymptotic independence, and whether the process is truly asymptotically (in)dependent is usually far from clear. The distinction is key as it can have a large impact upon extrapolation, i.e., the estimated probabilities of events more extreme than those observed. In this work, we present a single spatial model that is able to capture both dependence classes in a parsimonious manner, and with a smooth transition between the two cases. The model covers a wide range of possibilities from asymptotic independence through to complete dependence, and permits weakening dependence of extremes even under asymptotic dependence. Censored likelihood-based inference for the implied copula is feasible in moderate dimensions due to closed-form margins. The model is applied to oceanographic datasets with ambiguous true limiting dependence structure.

  1. Stinging Nettle: the Bad, the Good, the Unknown

    Dennis J. Baumgardner

    2016-01-01

    Full Text Available Stinging nettle (Urtica dioica is native to most of the United States. It has a characteristic description and distribution in the environment. Physical contact with numerous tiny needlelike hairs present on leaves and stems of this plant may result in a contact urticarial dermatitis due to chemical and mechanical irritation triggered by skin penetration of the hairs. The manifestations are self-limited in humans and may be treated by washing the skin, topical preparations and oral antihistamines. Explanation of the natural history of these encounters to the patient is helpful in reducing the sometimes significant anxiety. Preparations and extracts of stinging nettle have been proposed for treatment of a variety of inflammatory and other disorders including osteoarthritis, benign prostatic hypertrophy, allergic rhinitis and asthma, bleeding problems and diabetes. While in vitro studies have shown that stinging nettle possesses a number of potentially beneficial anti-inflammatory and modulating properties, beneficial effects have often not been confirmed by well-designed clinical trials. Further study, perhaps with novel types of extracts, are needed to determine the clinical utility of this plant in human inflammatory-related conditions and diabetes mellitus.

  2. Business plan: A preliminary approach to an unknown genre

    Federico Navarro

    2015-11-01

    Full Text Available The business plan has been widely included in the curricula of economics degrees and is key to business practice worldwide, but has not been studied from a socio-discursive perspective yet due to restrictions in its social, spatial, and temporal circulation. Based on interviews and a qualitative analysis of a corpus of 38 texts written in Spanish, I aim to provide a preliminary description of the genre. Results indicate that a chain of four phases is associated to a continuum of social settings organized through entrepreneurial/corporate and expert/training variables; its rhetorical structure includes “describing present/potential situation of the company and market” and “describing future processes of strategic actions regarding the marketing, production, and financial plans”. This analysis offers methodological innovations to account for occluded genres, encourages the contrastive study of the business plan in different cultural and linguistic environments, and assists business teachers with a situated picture of the genre

  3. Biodiversity and global health—hubris, humility and the unknown

    Stephens, Carolyn

    2012-03-01

    biodiversity and well-being; and the links of biodiversity to the green economy in the context of sustainable development and poverty alleviation. References [1] Schuiteman A et al 2011 Nocturne for an unknown pollinator: first description of a night-flowering orchid (Bulbophyllum nocturnum) Bot. J. Linean Soc. 167 344-50 [2] Kinver M and Gill V 2011 Botanists discover 'remarkable' night-flowering orchid BBC News Science and Environment (www.bbc.co.uk/news/science-environment-15818662) [3] Rudd M A 2011 Scientists' opinions on the global status and management of biological diversity Conserv. Biol. 25 1165-75 [4] Bottrill M C et al 2008 Is conservation triage just smart decision making? Trends Ecol. Evol. 23 649-54 [5] Parr M J et al 2009 Why we should aim for zero extinction Trends Ecol. Evol. 24 181 Bottrill M C et al 2009 Finite conservation funds mean triage is unavoidable Trends Ecol. Evol. 24 183-4 [6] Pushpangadan P and Behl H M 2005 Environment & Biodiversity: Agenda for Future (Lucknow: International Society of Environmental Botanists) (http://isebindia.com/icpep-3/icpep3-s-2.html) [7] Alves R and Rosa I 2007 Biodiversity, traditional medicine and public health: where do they meet? J. Ethnobiol. Ethnomed. 3 14 [8] Center for Biodiversity and Conservation 1997 Biodiversity and Human Health: A Guide for Policymakers (New York: American Museum of Natural History) [9] Chivian E 1997 Global environmental degradation and biodiversity loss: implications for human health Biodiversity and Human Health ed F Grifo and J Rosenthal (Washington, DC: Island) pp 7-38 [10] UNEP-WCMC 2011 Health and Well Being of Communities Directly Dependent on Ecosystem Goods and Services: An Indicator for the Convention on Biological Diversity (Cambridge: UNEP-World Conservation Monitoring Centre) [11] Nettleton C, Stephens C and Bristow F 2007 Utz Wachil: a study of indigenous perceptions of health and environment in five countries Ecohealth 4 461-772 [12] Jones G P et al 2004 Coral decline

  4. The Roles of Feedback and Feedforward as Humans Learn to Control Unknown Dynamic Systems.

    Zhang, Xingye; Wang, Shaoqian; Hoagg, Jesse B; Seigler, T Michael

    2018-02-01

    We present results from an experiment in which human subjects interact with an unknown dynamic system 40 times during a two-week period. During each interaction, subjects are asked to perform a command-following (i.e., pursuit tracking) task. Each subject's performance at that task improves from the first trial to the last trial. For each trial, we use subsystem identification to estimate each subject's feedforward (or anticipatory) control, feedback (or reactive) control, and feedback time delay. Over the 40 trials, the magnitudes of the identified feedback controllers and the identified feedback time delays do not change significantly. In contrast, the identified feedforward controllers do change significantly. By the last trial, the average identified feedforward controller approximates the inverse of the dynamic system. This observation provides evidence that a fundamental component of human learning is updating the anticipatory control until it models the inverse dynamics.

  5. Manipulation of Unknown Objects to Improve the Grasp Quality Using Tactile Information.

    Montaño, Andrés; Suárez, Raúl

    2018-05-03

    This work presents a novel and simple approach in the area of manipulation of unknown objects considering both geometric and mechanical constraints of the robotic hand. Starting with an initial blind grasp, our method improves the grasp quality through manipulation considering the three common goals of the manipulation process: improving the hand configuration, the grasp quality and the object positioning, and, at the same time, prevents the object from falling. Tactile feedback is used to obtain local information of the contacts between the fingertips and the object, and no additional exteroceptive feedback sources are considered in the approach. The main novelty of this work lies in the fact that the grasp optimization is performed on-line as a reactive procedure using the tactile and kinematic information obtained during the manipulation. Experimental results are shown to illustrate the efficiency of the approach.

  6. Chronic kidney disease of unknown aetiology and ground-water ionicity: study based on Sri Lanka.

    Dharma-Wardana, M W C; Amarasiri, Sarath L; Dharmawardene, Nande; Panabokke, C R

    2015-04-01

    High incidence of chronic kidney disease of unknown aetiology (CKDU) in Sri Lanka is shown to correlate with the presence of irrigation works and rivers that bring-in 'nonpoint source' fertilizer runoff from intensely agricultural regions. We review previous attempts to link CKDU with As, Cd and other standard toxins. Those studies (e.g. the WHO-sponsored study), while providing a wealth of data, are inconclusive in regard to aetiology. Here, we present new proposals based on increased ionicity of drinking water due to fertilizer runoff into the river system, redox processes in the soil and features of 'tank'-cascades and aquifers. The consequent chronic exposure to high ionicity in drinking water is proposed to debilitate the kidney via a Hofmeister-type (i.e. protein-denaturing) mechanism.

  7. Neural-network-observer-based optimal control for unknown nonlinear systems using adaptive dynamic programming

    Liu, Derong; Huang, Yuzhu; Wang, Ding; Wei, Qinglai

    2013-09-01

    In this paper, an observer-based optimal control scheme is developed for unknown nonlinear systems using adaptive dynamic programming (ADP) algorithm. First, a neural-network (NN) observer is designed to estimate system states. Then, based on the observed states, a neuro-controller is constructed via ADP method to obtain the optimal control. In this design, two NN structures are used: a three-layer NN is used to construct the observer which can be applied to systems with higher degrees of nonlinearity and without a priori knowledge of system dynamics, and a critic NN is employed to approximate the value function. The optimal control law is computed using the critic NN and the observer NN. Uniform ultimate boundedness of the closed-loop system is guaranteed. The actor, critic, and observer structures are all implemented in real-time, continuously and simultaneously. Finally, simulation results are presented to demonstrate the effectiveness of the proposed control scheme.

  8. A significant abiotic pathway for the formation of unknown nitrogen in nature

    Jokic, A.; Schulten, H.-R.; Cutler, J. N.; Schnitzer, M.; Huang, P. M.

    2004-03-01

    The global nitrogen cycle is of prime importance in natural ecosystems. However, the origin and nature of up to one-half of total soil N remains obscure despite all attempts at elucidation. Our data provide, for the first time, unequivocal evidence that the promoting action of Mn (IV) oxide on the Maillard reaction (sugar-amino acid condensation) under ambient conditions results in the abiotic formation of heterocyclic N compounds, which are often referred to as unknown nitrogen, and of amides which are apparently the dominant N moieties in nature. The information presented is of fundamental significance in understanding the role of mineral colloids in abiotic transformations of organic N moieties, the incorporation of N in the organic matrix of fossil fuels, and the global N cycle.

  9. Random Access Performance of Distributed Sensors Attacked by Unknown Jammers

    Dae-Kyo Jeong

    2017-11-01

    Full Text Available In this paper, we model and investigate the random access (RA performance of sensor nodes (SN in a wireless sensor network (WSN. In the WSN, a central head sensor (HS collects the information from distributed SNs, and jammers disturb the information transmission primarily by generating interference. In this paper, two jamming attacks are considered: power and code jamming. Power jammers (if they are friendly jammers generate noises and, as a result, degrade the quality of the signal from SNs. Power jamming is equally harmful to all the SNs that are accessing HS and simply induces denial of service (DoS without any need to hack HS or SNs. On the other hand, code jammers mimic legitimate SNs by sending fake signals and thus need to know certain system parameters that are used by the legitimate SNs. As a result of code jamming, HS falsely allocates radio resources to SNs. The code jamming hence increases the failure probability in sending the information messages, as well as misleads the usage of radio resources. In this paper, we present the probabilities of successful preamble transmission with power ramping according to the jammer types and provide the resulting throughput and delay of information transmission by SNs, respectively. The effect of two jamming attacks on the RA performances is compared with numerical investigation. The results show that, compared to RA without jammers, power and code jamming degrade the throughput by up to 30.3% and 40.5%, respectively, while the delay performance by up to 40.1% and 65.6%, respectively.

  10. Acute Lymphoblastic Leukemia Presented as Multiple Breast Masses

    Bayrak, Ilkay Koray; Yalin, Turkay; Ozmen, Zafer; Aksoz, Tolga; Doughanji, Roula

    2009-01-01

    Breast metastases in cases leukemia are very rare and occur primarily in patients with acute myeloid leukemia. We report the involvement of breast metastases in a 30-year-old woman with acute T cell lymphoblastic leukemia. The patient's mammograms revealed an extremely dense pattern with ill-defined, denser mass-like lesions in both breasts. A bilateral breast ultrasonographic evaluation revealed lobular-shaped and partly ill-defined hypoechoic masses with a multi-septated nodular (mottled) appearance

  11. "The Boys" Present... Hegemonic Masculinity: A Performance of Multiple Acts

    Dalley-Trim, Leanne

    2007-01-01

    This article explores the performance of masculinity(ies) within the classroom site. Drawing upon research conducted in two co-educational secondary classrooms, it examines the ways in which two groups of boys took up positions of dominance within their respective classrooms and, more specifically, focuses upon the ways in which they came to…

  12. Presentation of Malaria Epidemics Using Multiple Optimal Controls

    Abid Ali Lashari

    2012-01-01

    Full Text Available An existing model is extended to assess the impact of some antimalaria control measures, by re-formulating the model as an optimal control problem. This paper investigates the fundamental role of three type of controls, personal protection, treatment, and mosquito reduction strategies in controlling the malaria. We work in the nonlinear optimal control framework. The existence and the uniqueness results of the solution are discussed. A characterization of the optimal control via adjoint variables is established. The optimality system is solved numerically by a competitive Gauss-Seidel-like implicit difference method. Finally, numerical simulations of the optimal control problem, using a set of reasonable parameter values, are carried out to investigate the effectiveness of the proposed control measures.

  13. Bifunctional dendrons for multiple carbohydrate presentation via carbonyl chemistry

    Davide Bini

    2014-07-01

    Full Text Available The synthesis of new dendrons of the generations 0, 1 and 2 with a double bond at the focal point and a carbonyl group at the termini has been carried out. The carbonyl group has been exploited for the multivalent conjugation to a sample saccharide by reductive amination and alkoxyamine conjugation.

  14. Elderly woman with multiple morbidities presenting with a funny ...

    Multi morbidity is the occurrence of more than one concurrant chronic diseases in a patient1,2. It is very common in the elderly and common to both sexes2.It is more or less the norm in Family Practice than the exception. Its importance lies in the fact that it not only affects the patient's quality of life, it poses a big challenge to ...

  15. Acute Lymphoblastic Leukemia Presented as Multiple Breast Masses

    Bayrak, Ilkay Koray; Yalin, Turkay; Ozmen, Zafer; Aksoz, Tolga; Doughanji, Roula [Ondokuz Mayis University, Samsun (Turkmenistan)

    2009-10-15

    Breast metastases in cases leukemia are very rare and occur primarily in patients with acute myeloid leukemia. We report the involvement of breast metastases in a 30-year-old woman with acute T cell lymphoblastic leukemia. The patient's mammograms revealed an extremely dense pattern with ill-defined, denser mass-like lesions in both breasts. A bilateral breast ultrasonographic evaluation revealed lobular-shaped and partly ill-defined hypoechoic masses with a multi-septated nodular (mottled) appearance.

  16. Multiple sclerosis

    Sadashima, Hiromichi; Kusaka, Hirofumi; Imai, Terukuni; Takahashi, Ryosuke; Matsumoto, Sadayuki; Yamamoto, Toru; Yamasaki, Masahiro; Maya, Kiyomi

    1986-01-01

    Eleven patients with a definite diagnosis of multiple sclerosis were examined in terms of correlations between the clinical features and the results of cranial computed tomography (CT), and magnetic resonance imaging (MRI). Results: In 5 of the 11 patients, both CT and MRI demonstrated lesions consistent with a finding of multiple sclerosis. In 3 patients, only MRI demonstrated lesions. In the remaining 3 patients, neither CT nor MRI revealed any lesion in the brain. All 5 patients who showed abnormal findings on both CT and MRI had clinical signs either of cerebral or brainstem - cerebellar lesions. On the other hand, two of the 3 patients with normal CT and MRI findings had optic-nerve and spinal-cord signs. Therefore, our results suggested relatively good correlations between the clinical features, CT, and MRI. MRI revealed cerebral lesions in two of the four patients with clinical signs of only optic-nerve and spinal-cord lesions. MRI demonstrated sclerotic lesions in 3 of the 6 patients whose plaques were not detected by CT. In conclusion, MRI proved to be more helpful in the demonstration of lesions attributable to chronic multiple sclerosis. (author)

  17. Multiple Intelligences and quotient spaces

    Malatesta, Mike; Quintana, Yamilet

    2006-01-01

    The Multiple Intelligence Theory (MI) is one of the models that study and describe the cognitive abilities of an individual. In [7] is presented a referential system which allows to identify the Multiple Intelligences of the students of a course and to classify the level of development of such Intelligences. Following this tendency, the purpose of this paper is to describe the model of Multiple Intelligences as a quotient space, and also to study the Multiple Intelligences of an individual in...

  18. Auditory Brainstem Response Wave Amplitude Characteristics as a Diagnostic Tool in Children with Speech Delay with Unknown Causes

    Susan Abadi

    2016-09-01

    Full Text Available Speech delay with an unknown cause is a problem among children. This diagnosis is the last differential diagnosis after observing normal findings in routine hearing tests. The present study was undertaken to determine whether auditory brainstem responses to click stimuli are different between normally developing children and children suffering from delayed speech with unknown causes. In this cross-sectional study, we compared click auditory brainstem responses between 261 children who were clinically diagnosed with delayed speech with unknown causes based on normal routine auditory test findings and neurological examinations and had >12 months of speech delay (case group and 261 age- and sex-matched normally developing children (control group. Our results indicated that the case group exhibited significantly higher wave amplitude responses to click stimuli (waves I, III, and V than did the control group (P=0.001. These amplitudes were significantly reduced after 1 year (P=0.001; however, they were still significantly higher than those of the control group (P=0.001. The significant differences were seen regardless of the age and the sex of the participants. There were no statistically significant differences between the 2 groups considering the latency of waves I, III, and V. In conclusion, the higher amplitudes of waves I, III, and V, which were observed in the auditory brainstem responses to click stimuli among the patients with speech delay with unknown causes, might be used as a diagnostic tool to track patients’ improvement after treatment.

  19. Necrotizing Infundibular Crystalline Folliculitis: A Case Report of an Exceptional Lesion of Unknown Etiology

    Nikolina Saxer-Sekulic

    2014-01-01

    Full Text Available Necrotizing infundibular crystalline folliculitis is a rare follicular lesion of which the etiology is not well understood. Here we describe the case of a 71-year-old male patient presenting with multiple hyperkeratotic lesions localized on the forehead. Histopathological analysis of one of the lesions revealed a follicular invagination containing cellular debris and keratin lamellae containing filamentous mucinous material and numerous crystals birefringent in polarized light microscopy. © 2014 S. Karger AG, Basel

  20. Improving neutron multiplicity counting for the spatial dependence of multiplication: Results for spherical plutonium samples

    Göttsche, Malte, E-mail: malte.goettsche@physik.uni-hamburg.de; Kirchner, Gerald

    2015-10-21

    The fissile mass deduced from a neutron multiplicity counting measurement of high mass dense items is underestimated if the spatial dependence of the multiplication is not taken into account. It is shown that an appropriate physics-based correction successfully removes the bias. It depends on four correction coefficients which can only be exactly determined if the sample geometry and composition are known. In some cases, for example in warhead authentication, available information on the sample will be very limited. MCNPX-PoliMi simulations have been performed to obtain the correction coefficients for a range of spherical plutonium metal geometries, with and without polyethylene reflection placed around the spheres. For hollow spheres, the analysis shows that the correction coefficients can be approximated with high accuracy as a function of the sphere's thickness depending only slightly on the radius. If the thickness remains unknown, less accurate estimates of the correction coefficients can be obtained from the neutron multiplication. The influence of isotopic composition is limited. The correction coefficients become somewhat smaller when reflection is present.