Do Optic Disc Drusen Cause Unilateral Nyctalopia?

This is a case report of a patient with unilateral nyctalopia in whom ipsilateral optic disc drusen were the only finding despite extensive investigation

Moral Leadership A Business Imperative

The above Enron-centric quotations serve to set the stage for the spirit of this research. While care should be accorded to ensure that one does not generalize on the current leadership situation from this one high profile case of business failure, it is fair to note that the level of trust on current business leadership is being questioned and that business schools are beginning to focus on the softer aspects of the business leadership program. Moral leadership in business is about doing the right thing, with care and concern for the welfare of those affected by the business decision. This current crisis in leadership has spawned the calling for moral leadership in business. Many are seeking the kind of leadership that are aligned to the moral benchmark expected of businesses and in process, often find that back to basic time-tested value based principles are the foundations of successful business endeavor. Given the complexity and the many immoral temptations of modern day businesses, the business leader is faced with the daunting task of holding a moral based position in every of his business endeavor. While many will scoff at moral leadership as the ‘wished-for ideals, it is clear for all to appreciate that anything short of a moral based leadership approach will only result, at best in business mediocrity or at its worst, business failures or eventual collapse, as in the case of Enron.In this sense, moral leadership is not an alternative form of leadership but indeed, a business imperative

Global E-Hospital System

This project explores the strengths of information technology and employing the best E-business to improve hospital services. The current hospital services provided to the public, it is not sufficient to assist the patient or the doctor. The goal of this project is to provide a better and more efficient and effective for the health care sector and the patient. With attachment, there is a demonstration software (E-hospital system) and it is develop to demonstrate its function and benefits on it. Methodologies have been used for problem analysis, design and development of the project

Resolution of Severe Portopulmonary Hypertension With Inhaled Treprostinil and Liver Transplantation

Portopulmonary hypertension is a rare condition with a poor prognosis. Prompt management is essential for liver transplantation eligibility, a potentially curative option. This report presents a case of severe portopulmonary hypertension that resolved with a conservative therapeutic regimen of tadalafil, macitentan, and inhaled treprostinil, which ultimately enabled successful liver transplantation. There was no recurrence of pulmonary hypertension after transplantation, and the patient was weaned off most pulmonary arterial hypertension therapies. This case report is the first to provide evidence that inhaled treprostinil is a safe and effective alternative to continuous intravenous prostacyclins in portopulmonary hypertension

Global fecal and plasma metabolic dynamics related to Helicobacter pylori eradication

Background:Helicobacter pylori colonizes the gastric mucosa of more than half of the world's population. There is increasing evidence H. pylori protects against the development of obesity and childhood asthma/allergies in which the development of these diseases coincide with transient dysbiosis. However, the mechanism underlying the association of H. pylori eradication with human metabolic and immunological disorders is not well-established. In this study, we aimed to investigate the local and systemic effects of H. pylori eradication through untargeted fecal lipidomics and plasma metabolomics approaches by liquid chromatography mass spectrometry (LC-MS). Results: Our study revealed that eradication of H. pylori eradication (i.e., loss of H. pylori and/or H. pylori eradication therapy) changed many global metabolite/lipid features, with the majority being down-regulated. Our findings primarily show that H. pylori eradication affects the host energy and lipid metabolism which may eventually lead to the development of metabolic disorders. Conclusion: These predictive metabolic signatures of metabolic and immunological disorders following H. pylori eradication can provide insights into dynamic local and systemic metabolism related to H. pylori eradication in modulating human health

Synchronization in complex networks

Synchronization processes in populations of locally interacting elements are in the focus of intense research in physical, biological, chemical, technological and social systems. The many efforts devoted to understand synchronization phenomena in natural systems take now advantage of the recent theory of complex networks. In this review, we report the advances in the comprehension of synchronization phenomena when oscillating elements are constrained to interact in a complex network topology. We also overview the new emergent features coming out from the interplay between the structure and the function of the underlying pattern of connections. Extensive numerical work as well as analytical approaches to the problem are presented. Finally, we review several applications of synchronization in complex networks to different disciplines: biological systems and neuroscience, engineering and computer science, and economy and social sciences.Comment: Final version published in Physics Reports. More information available at http://synchronets.googlepages.com

Helicobacter pylori eradication causes perturbation of the human gut microbiome in young adults

BACKGROUND: Accumulating evidence shows that Helicobacter pylori protects against some metabolic and immunological diseases in which the development of these diseases coincide with temporal or permanent dysbiosis. The aim of this study was to assess the effect of H. pylori eradication on the human gut microbiome. METHODS: As part of the currently on-going ESSAY (Eradication Study in Stable Adults/Youths) study, we collected stool samples from 17 H. pylori-positive young adult (18-30 years-old) volunteers. The same cohort was followed up 6, 12 and 18 months-post H. pylori eradication. The impact of H. pylori on the human gut microbiome pre- and post-eradication was investigated using high throughput 16S rRNA gene (V3-V4 region) sequencing using the Illumina Miseq followed by data analysis using Qiime pipeline. RESULTS: We compared the composition and diversity of bacterial communities in the fecal microbiome of the H. pylori-positive volunteers, before and after H. pylori eradication therapy. The 16S rRNA gene was sequenced at an average of 150,000-170,000 reads/sample. The microbial diversity were similar pre- and post-H. pylori eradication with no significant differences in richness and evenness of bacterial species. Despite that the general profile of the gut microbiome was similar pre- and post-eradication, some changes in the bacterial communities at the phylum and genus levels were notable, particularly the decrease in relative abundance of Bacterioidetes and corresponding increase in Firmicutes after H. pylori eradication. The significant increase of short-chain fatty acids (SCFA)-producing bacteria genera could also be associated with increased risk of metabolic disorders. CONCLUSIONS: Our preliminary stool metagenomics study shows that eradication of H. pylori caused perturbation of the gut microbiome and may indirectly affect the health of human. Clinicians should be aware of the effect of broad spectrum antibiotics used in H. pylori eradication regimen and be cautious in the clinical management of H. pylori infection, particularly in immunocompromised patients

Developing lean and responsive supply chains : a robust model for alternative risk mitigation strategies in supply chain designs

This paper investigates how organization should design their supply chains (SCs) and use risk mitigation strategies to meet different performance objectives. To do this, we develop two mixed integer nonlinear (MINL) lean and responsive models for a four-tier SC to understand these four strategies: i) holding back-up emergency stocks at the DCs, ii) holding back-up emergency stock for transshipment to all DCs at a strategic DC (for risk pooling in the SC), iii) reserving excess capacity in the facilities, and iv) using other facilities in the SC’s network to back-up the primary facilities. A new method for designing the network is developed which works based on the definition of path to cover all possible disturbances. To solve the two proposed MINL models, a linear regression approximation is suggested to linearize the models; this technique works based on a piecewise linear transformation. The efficiency of the solution technique is tested for two prevalent distribution functions. We then explore how these models operate using empirical data from an automotive SC. This enables us to develop a more comprehensive risk mitigation framework than previous studies and show how it can be used to determine the optimal SC design and risk mitigation strategies given the uncertainties faced by practitioners and the performance objectives they wish to meet

Teacher led school-based surveillance can allow accurate tracking of emerging infectious diseases - evidence from serial cross-sectional surveys of febrile respiratory illness during the H1N1 2009 influenza pandemic in Singapore

10.1186/1471-2334-12-336BMC Infectious Diseases12-BIDM