A novel investigation method for axonal damage in neuromyelitis optica spectrum disorder: In vivo corneal confocal microscopy

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory autoimmune disorder that damages optic nerves, brainstem, and spinal cord. In vivo corneal confocal microscopy (IVCM) is a noninvasive technique that provides corneal images with dendritic cells (DCs) and corneal subbasal nerve plexus (SBP), which arises from the trigeminal nerve. OBJECTIVE: We investigated corneal SBP changes in NMOSD and proposed IVCM as a potential new disease severity biomarker for NMOSD. METHODS: Seventeen age-sex matched NMOSD patients and 19 healthy participants underwent complete neurologic and ophthalmologic examinations. The duration of disease, first symptom, presence of optic neuritis attack, antibody status, Expanded Disability Status Scale(EDSS) score and disease severity score(DSS) were recorded. Retinal nerve fibre layer (RNFL) thickness was measured with optical coherence tomography, and corneal SBP images were taken with IVCM. RESULTS: NMOSD patients had significantly reduced corneal nerve fibre lenght-density and corneal nerve branch lenght-density compared with controls, while DC density was increased. NMOSD patients also showed significantly reduced RNFL thickness compared with controls. EDSS,DSS levels were inversely correlated with IVCM parameters. CONCLUSION: We observed significant corneal nerve fibre loss in NMOSD patients in relation to disease severity. IVCM can be a candidate noninvasive imaging method for axonal damage assessment in NMOSD that warrants further investigation

A self-adaptive multimeme memetic algorithm co-evolving utility scores to control genetic operators and their parameter settings

Memetic algorithms are a class of well-studied metaheuristics which combine evolutionary algorithms and local search techniques. A meme represents contagious piece of information in an adaptive information sharing system. The canonical memetic algorithm uses a fixed meme, denoting a hill climbing operator, to improve each solution in a population during the evolutionary search process. Given global parameters and multiple parametrised operators, adaptation often becomes a crucial constituent in the design of MAs. In this study, a self-adaptive self-configuring steady-state multimeme memetic algorithm (SSMMA) variant is proposed. Along with the individuals (solutions), SSMMA co-evolves memes, encoding the utility score for each algorithmic component choice and relevant parameter setting option. An individual uses tournament selection to decide which operator and parameter setting to employ at a given step. The performance of the proposed algorithm is evaluated on six combinatorial optimisation problems from a cross-domain heuristic search benchmark. The results indicate the success of SSMMA when compared to the static Mas as well as widely used self-adaptive Multimeme Memetic Algorithm from the scientific literature

A Subclass of Analytic-Functions Defined By Using Certain Operators of Fractional Calculus

Making use of certain operators of fractional calculus, we introduce a new class F-delta(n,lambda,alpha) of functions which are analytic in the open unit disk mu and obtain a necessary and sufficient condition for a function to be in the class F-delta(n,lambda,alpha). We also determine the radii of close-to-convexity, starlikeness, and convexity. Finally, an application involving fractional calculus of functions in the class F-delta(n,lambda,alpha) is considered.WoSScopu

Unusual case of frontal mucocele presenting with forehead ulcer

Paranasal mucoceles are benign slow-growing paranasal sinus lesions, which usually develop following the obstruction of the sinus ostiu. They most frequently occur in the frontal sinus. Frontal mucoceles are expansive lesions usually causing visual clinical signs and symptoms such as diminution of vision, visual field defects, diplopia, orbital swelling, retroorbital pain, displacement of eye globe, ptosis, and proptosis. When the frontal mucocele extends intracranially, it can manifest with meningitis, meningoencephalitis, intracranial abscess, seizures, or cerebrospinal fluid fistula. Very rarely it can cause forehead swelling. We report an 80-year-old woman presenting with a forehead skin ulcer and painless subcutaneous forehead induration. Histopathologic examination revealed mucin deposition and inflammation. Computerized tomography (CT) and magnetic resonance imaging (MRI) scans showed a mass originating from the frontal sinus with frontal bony defect and frontocutaneous fistula. Surgical excision of the mass confirmed the mucocele diagnosis. In this article, we present a case of frontocutaneous fistula and skin ulcer, which is an unexpected complication of frontal mucocele. We propose that in the case of a localized non-healing ulcerated forehead skin lesions, mucocele should be considered in the differential diagnosis

A new approximation to modulation effect analysis based on empirical mode decomposition method

\u27Modulation effect\u27 which represents the amplification or attenuation of the SS (small-scale) structures near the wall by the outer LS (large-scale) structures is one of the two commonly accepted influence of the outer large-scale energy containing motions on the near wall turbulent fluctuations. Mode decomposition based on filtering suggested by Mathis et al. [1] is a widely used method for the analysis of the modulation effect. In the present study a new approximation is proposed based on the empirical mode decomposition (EMD) to investigate the aforementioned amplitude modulation effect. Both Mathis et al. [1] and suggested methods are being used and results are compared for two-point and single-point analysis. It has been shown that the LS and SS signals that are decomposed by filtering and EMD follow identical path. Although the similarities of the signals, the correlation coefficient, R, differ for the two methods. We observed that the suggested method in the present work exhibits a slightly higher correlation coefficient compared to the method based on filtering for the two-point analysis. However for the one-point analysis existing method seems far away to give a rational correlation coefficient value, which is too low compared to the suggested method. Therefore we believe that the suggested method which decomposes the signal by EMD instead of filtering adresses many recent studies that questions the reliability of the calculation of the correlation coefficient, R, by existing method. We believe that the variation of the correlation coefficient, R, for the identical signals extends the discussion of the correlation coefficient calculations to the very first process, that is obtaining LS and SS from the original signal

Étude du ressenti d’étudiants en médecine sur le cadavre et son usage dans l'enseignement de l'anatomie

Purpose: Cadaver education in anatomy is one of the cornerstones of medical school education. The primary purpose of this study is to determine the importance of cadaver education from the students’ point of view by examining the effect of cadaver education on learning the anatomy course. In this study, the perspectives of second-term medical students who received or did not receive anatomy education with cadavers, on cadavers and on anatomy education with cadavers were investigated. Methods: The study was carried out with a total of 116 (66 females and 50 males) second-term medical faculty students. Participants were divided into 2 groups; the first group (n = 56) consisted of students who learned anatomy with cadavers, while the second group (n = 60) included students who had never seen a cadaver and learned anatomy through atlas and models. Results: As a result, it was determined that the students in both groups thought that there should be cadavers in anatomy education and education with cadavers would accelerate and facilitate the learning process of anatomy. It was also determined that, the students who received anatomy education with cadaver were psychologically affected by the cadaver compared to those who did not, and they thought that the cadaver was less effective in gaining a physician identity (P < 0.05). Conclusion: When the results of the study are evaluated, it is revealed that the anatomy course is difficult, but the education given on the cadaver significantly facilitates learning and makes it more attractive

Comparison of oral methylprednisolone and nebulized budesonide in children with acute asthma

Giriş: Astım atağı ile acil servise başvuran çocuklarda taburculuk sonrası oral metil prednizolon ve budesonid nebül tedavi seçeneği olarak tercih edilebilmektedir Bu çalışmanın amacı bu tedavi seçenekleri arasında fark olup olmadığını araştırmaktır. Gereç ve Yöntem: Çalışmaya 20 dakika ara ile 3 doz 0,15 mg/kg salbutamol nebül tedavisine yanıt vermeyen, 6-14 yaşları arasında 20 hasta alındı. Hastaların hepsine 3 gün süre ile 6x0,15 mg/kg/gün salbutamol nebül tedavisi uygulandı. 10 hastanın tedavisine 3 gün süre ile oral metilprednizolon 3x1mg/kg/gün (en çok 60mg/gün) (Grup 1), diğer hastaların tedavisine 3 gün süre ile 2x0,5mg/gün budesonid nebül eklendi (Grup 2). Bulgular: Her iki grup arasında yaş, cins, boy, ağırlık, hastalık süresi, atak sayısı, acile başvurduğu anda saptanan klinik parametreler ve astım bulguları yönünden bir fark yoktu (p>0,05). 0, 4, 8, 16, 24. saat, 3. ve 30. günlerde; astım skoru, pulmoner indeks, nabız ve solunum sayısı, öksürük, wheezing, PEF, arteriyel oksijen saturasyonu (SaO2 ), parsiyel arteriyel oksijen basıncı (PaO2), parsiyel arteriyel karbondioksit basıncı (PaCO2), FVC, FEV1, FEV1/FVC, FEF25-75, değerlendirildi. Hastalar taburcu edildikten 30 gün sonra tekrar değerlendirildi. Astım skoru, pulmoner indeks, solunum sayısı, öksürük ve wheezing'in düzelme süresi yönünden iki grup arasında anlamlı fark yoktu (p> 0,05). Nabız sayısı ise grup 1'de, grup 2'ye göre daha kısa sürede normal değerlere düştü (p0,05). Sonuç: Nebülize budesonidin orta-şiddetli astımlı çocuk hastalarda oral metilprednizolon kadar etkilidir. Bu grupta oral veya intravenöz metilprednizolon çeşitli nedenlerle verilemeyen çocuklarda, nebülize budesonidin kullanım kolaylığı, tolerabilitesi, etkinliği gözönüne alındığında oral metilprednizilona alternatif olabileceği kanaatine varıldı.Introduction: In the present study, we aimed to compare the efficiency of peroral (p.o.) methylprednisolone and nebulized budesonide in children with moderate-severe asthma exacerbations. Material and Method: Twenty patients between the age of 6-14 years were included to the study and were unresponsive to nebulized salbutamol treatment at the dosage of 0.15 mg/kg for 3 times with 20 min. intervals. All the patients received nebulized salbutamol at the dosage of 6x0.15 mg/kg/day for 3 days. Ten patients (Group 1) received additional p.o. metylprednisolone at the dosage of 1 mg/kg for three times a day (maximum 60 mg/day), rest of the patients (Group 2) received additional nebulised budesonide at the dosage of 0.5 mg b.i.d for three days. Results: In the first examination of the patients; age, gender, height, weight, duration of disease, frequency asthma exacerbations, symptoms and the clinic parameters were similar in both groups (p&gt;0,05). In the first day (0, 4, 8, 16, 24. hours), third day and the 30 th. day the following analyses were done: PEF, arterial oxygen saturation (SaO2), partial arterial oxygen pressure (PaO2), partial arterial carbon dioxide pressure (PaCO2), FVC, FEV1, FEV1/FVC, FEF25-75, pulmonary index, asthma score, pulse, cough, wheezing, respiration rate. The patients examined again 30 days after discharge. Asthma score, pulmonary index, respiratory rate, relief duration of cough and wheezing were similar in both groups (p&gt;0.05). Pulse rate decreased into normal limits earlier in Group 1 than Group 2 (p&lt;0,05). These clinical parameters were improved at the end of the study and it was statistically significant (p&lt;0.05). We found that the following parameters: PEF, SaO2, PaO2, PaCO2, FVC, FEV1, FEV1/FVC, FEF25-75 were improved in the group of receiving p.o. methylprednisolone better than the nebulized budesonide, but it was not statistically significant (p&gt;0.05). Pulse rate was returned to normal limits in shorter time in Group 1 than Group 2 (p&lt;0.05). Conclusion: We believed that nebulized budesonide has equal efficacy to p.o. metilprednizolon in children with moderate-severe asthma. In this group, because of practical using, tolerability and safety, nebulized budesonide can be an alternative to methylprednisolone in children who has contraindications for oral or intravenous steroid administration