Percutaneous Ureteral Elevation in Laparoendoscopic Single-Site Radical Nephrectomy

Laparoendoscopic single-site radical nephrectomy may be feasible in select patients. Suture-assisted retraction of the ureteral and lower pole attachments facilitate safe dissection

The chemistry and action of 6-alkylsalicylates of Indian Ginkgo biloba

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DFUNet: Convolutional Neural Networks for Diabetic Foot Ulcer Classification

Globally, in 2016, 1 out of 11 adults suffered from diabetes mellitus. Diabetic foot ulcers (DFU) are a major complication of this disease, which if not managed properly can lead to amputation. Current clinical approaches to DFU treatment rely on patient and clinician vigilance, which has significant limitations, such as the high cost involved in the diagnosis, treatment, and lengthy care of the DFU. We collected an extensive dataset of foot images, which contain DFU from different patients. In this DFU classification problem, we assessed the two classes as normal skin (healthy skin) and abnormal skin (DFU). In this paper, we have proposed the use of machine learning algorithms to extract the features for DFU and healthy skin patches to understand the differences in the computer vision perspective. This experiment is performed to evaluate the skin conditions of both classes that are at high risk of misclassification by computer vision algorithms. Furthermore, we used convolutional neural networks for the first time in this binary classification. We have proposed a novel convolutional neural network architecture, DFUNet, with better feature extraction to identify the feature differences between healthy skin and the DFU. Using 10-fold cross validation, DFUNet achieved an AUC score of 0.961. This outperformed both the traditional machine learning and deep learning classifiers we have tested. Here, we present the development of a novel and highly sensitive DFUNet for objectively detecting the presence of DFUs. This novel approach has the potential to deliver a paradigm shift in diabetic foot care among diabetic patients, which represent a cost-effective, remote, and convenient healthcare solution

Atlantoaxial subluxation as an early manifestation in an adolescent with undifferentiated spondyloarthritis: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Atlantoaxial instability has been described as a manifestation of ankylosing spondylitis (juvenile and adult onset), reactive arthritis, juvenile idiopathic arthritis, and rheumatoid arthritis; however, it has rarely been reported as an early manifestation of these disorders. We present this case report to increase awareness of the condition in the hope that earlier recognition of this disease may prevent further serious injury.</p> <p>Case presentation</p> <p>We report the case of a 17-year-old Hispanic adolescent woman who was initially diagnosed with undifferentiated spondyloarthritis due to peripheral arthritis, enthesitis, a positive human leukocyte antigen B27 result, and inflammatory spinal pain lasting two months. Our patient experienced persistent and worsening occipitocervical pain and signs of myelopathy three months after diagnosis; consequently, we found atlantoaxial instability along with cervical spine bone erosion and pannus formation. She was treated surgically with a C1-2 posterior instrumented fusion and at six weeks post-operatively was started on tumor necrosis factor α blockade. Her occipitocervical symptoms subsided following surgery and initiation of immunomodulation.</p> <p>Conclusions</p> <p>Our report serves to emphasize to pediatric and adult general practitioners, pediatricians, internists, family physicians, pediatric and adult rheumatologists and spine surgeons that atlantoaxial subluxation may be an early manifestation of spondyloarthritis, and that the condition is treatable by surgical intervention and immunomodulation.</p

Isothiocyanate NB7M causes selective cytotoxicity, pro-apoptotic signalling and cell-cycle regression in ovarian cancer cells

The present report identifies indole-3-ethyl isothiocyanate NB7M as a potent cytotoxic agent with selective activity against cell lines derived from various tumour types. Ovarian cancer cell lines showed sensitivity to NB7M (60–70% cytotoxicity at 2.5 μM), in contrast to control cells (TCL-1 and HTR-8; IC50 ∼15 μM). In a screen performed by the National Cancer Institute (NCI) (NCI60 cancer cell-line assay) NB7M (NSC746077) reduced growth up to 100% with an IC50 between 0.1 and 10 μM depending on the cell line studied. Using SKOV-3 ovarian cancer cells as a model, mechanisms of cytotoxicity were analysed. NB7M caused hallmarks of apoptosis such as PARP-1 deactivation, chromatin condensation, DNA nicks, activation of caspases-9, -8, -3, loss of mitochondrial transmembrane depolarisation potential and upregulation of pro-apoptotic mitogen activated protein kinases (p38, SAP/JNK). NB7M downregulated phosphorylation of prosurvival kinases (PI-3K, AKT, IKKα), transcription factor NF-κB, and expression of DNA-Pk and AXL receptor tyrosine kinase. Subcytotoxic doses of NB7M inhibited DNA synthesis, caused G1-phase cell-cycle arrest and upregulated p27 expression. The present report suggests that NB7M is a selective cytotoxic agent in vitro for cell lines derived from ovarian and certain other tumours. In addition, NB7M acts as a growth/cell-cycle-suppressing agent and may be developed as a potential therapeutic drug to treat ovarian cancer

Medicinal and ethnoveterinary remedies of hunters in Trinidad

BACKGROUND: Ethnomedicines are used by hunters for themselves and their hunting dogs in Trinidad. Plants are used for snakebites, scorpion stings, for injuries and mange of dogs and to facilitate hunting success. RESULTS: Plants used include Piper hispidum, Pithecelobium unguis-cati, Bauhinia excisa, Bauhinia cumanensis, Cecropia peltata, Aframomum melegueta, Aristolochia rugosa, Aristolochia trilobata, Jatropha curcas, Jatropha gossypifolia, Nicotiana tabacum, Vernonia scorpioides, Petiveria alliacea, Renealmia alpinia, Justicia secunda, Phyllanthus urinaria,Phyllanthus niruri,Momordica charantia, Xiphidium caeruleum, Ottonia ovata, Lepianthes peltata, Capsicum frutescens, Costus scaber, Dendropanax arboreus, Siparuma guianensis, Syngonium podophyllum, Monstera dubia, Solanum species, Eclipta prostrata, Spiranthes acaulis, Croton gossypifolius, Barleria lupulina, Cola nitida, Acrocomia ierensis (tentative ID). CONCLUSION: Plant use is based on odour, and plant morphological characteristics and is embedded in a complex cultural context based on indigenous Amerindian beliefs. It is suggested that the medicinal plants exerted a physiological action on the hunter or his dog. Some of the plants mentioned contain chemicals that may explain the ethnomedicinal and ethnoveterinary use. For instance some of the plants influence the immune system or are effective against internal and external parasites. Plant baths may contribute to the health and well being of the hunting dogs

The association of surface wind stresses over Indian Ocean with monsoon rainfall

Variability of Indian summer monsoon rainfall is examined with respect to variability of surface wind stresses over Indian Ocean. The Indian Ocean region extending from 40°-120° E, and 30° S-25° N, has been divided into 8 homogeneous subregions, viz (1) Arabian Sea (AS), (2) Bay of Bengal (BB), (3) West-equatorial Indian Ocean (WEIO), (4) Central-equatorial Indian Ocean (CEIO), (5) East-equatorial Indian Ocean (EEIO), (6) South-west Indian Ocean (SWIO), (7) South-central Indian Ocean (SCIO), and (8) South-east Indian Ocean (SEIO). The period of study extends for 13 years from 1982-1994. Monthly NCEP surface wind stress data of five months - May through September, have been used in the study. The spatial variability of seasonal and monthly surface wind stresses shows very low values over CEIO and EEIO and very high values over AS, SWIO, and SEIO regions. On the seasonal scale, all India summer monsoon rainfall (AISMR) shows concurrent positive relationships with the surface wind stresses over AS, BB, WEIO, SWIO and SCIO and negative relationships with the surface wind stresses over EEIO and SEIO. The relationships of AISMR with the surface wind stresses over AS and WEIO are significant at 5 level. The concurrent relationships between monthly surface wind stresses over these 8 oceanic sub-regions and monthly subdivisional rainfalls over 29 sub-divisions have been studied. The rainfalls over the subdivisions in the central India and on the west coast of India are found to be significantly related with surface wind stresses over AS, SWIO, SCIO. Monthly subdivisional rainfalls of four subdivisions in the peninsular India show negative relationship with BB surface wind stresses. May surface wind stresses over AS, BB, WEIO, CEIO and SWIO have been found to be positively related with ensuing AISMR. The relationship with AS wind stresses is significant at 5 level and hence may be considered as a potential predictor of AISMR