Fuchs Heterochromic Iridocyclitis-Associated Glaucoma: A Retrospective Comparison of Primary Ahmed Glaucoma Valve implantation and Trabeculectomy with MMC

Purpose: To compare the safety and efficacy of a primary trabeculectomy with mitomycin C (T) and an Ahmed glaucoma valve (AGV) implantation in patients with Fuchs heterochromic iridocyclitis (FHIC) related glaucoma, a rare complication of an uncommon form of uveitis. Design: Retrospective comparative case series. Method: Twenty-six patients with uncontrolled FHIC-associated glaucoma received T (n=12) or an AGV (n=14). Primary outcome measures were the surgical success defined as IOP ≤ 21 mmHg and decreased ≥ 20% from the baseline and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, best corrected visual acuity (BCVA), and intraocular pressure. Results: The follow-up (mean±SD) was 34.0±17.7 in T and 33.4±18.6 months in AGV (p = 0.837). The cumulative probability of success rate at the final follow-up at three years was 41.7% for T and 85.7% for AGV. There was no significant difference in complications between the two groups (P>0.05). The mean preoperative IOP in T was 23.4±3.3 mmHg and 21.6±5.2 mmHg at the final visit (P= 0.041). In AGV, the preoperative IOP was 24±7.8 and 17.1±2.6 mmHg at the final visit (P= 0.003), respectively. AGV had a significantly lower average IOP at the final follow-up visit compared to T (P= 0.018). The number of glaucoma medications at baseline was 3.3±0.5 in T and 3±0.6 in AGV (P= 0.233). This decreased significantly to 2.4±1.0 and 1.7±0.6 at the final follow-up (P= 0.008 and 0.002, respectively). Patients in AGV needed fewer glaucoma medications (P= 0.041). BCVA was equal in both groups and did not change (p>0.05). Conclusion: Primary AGV had a higher success rate than T in the management of FHIC-associated glaucoma. The risk of cataract formation and progression was significantly higher following T in these patients

A novel onset detection technique for brain?computer interfaces using sound-production related cognitive tasks in simulated-online system

Objective. Self-paced EEG-based BCIs (SP-BCIs) have traditionally been avoided due to two sources of uncertainty: (1) precisely when an intentional command is sent by the brain, i.e., the command onset detection problem, and (2) how different the intentional command is when compared to non-specific (or idle) states. Performance evaluation is also a problem and there are no suitable standard metrics available. In this paper we attempted to tackle these issues. Approach. Self-paced covert sound-production cognitive tasks (i.e., high pitch and siren-like sounds) were used to distinguish between intentional commands (IC) and idle states. The IC states were chosen for their ease of execution and negligible overlap with common cognitive states. Band power and a digital wavelet transform were used for feature extraction, and the Davies?Bouldin index was used for feature selection. Classification was performed using linear discriminant analysis. Main results. Performance was evaluated under offline and simulated-online conditions. For the latter, a performance score called true-false-positive (TFP) rate, ranging from 0 (poor) to 100 (perfect), was created to take into account both classification performance and onset timing errors. Averaging the results from the best performing IC task for all seven participants, an 77.7% true-positive (TP) rate was achieved in offline testing. For simulated-online analysis the best IC average TFP score was 76.67% (87.61% TP rate, 4.05% false-positive rate). Significance. Results were promising when compared to previous IC onset detection studies using motor imagery, in which best TP rates were reported as 72.0% and 79.7%, and which, crucially, did not take timing errors into account. Moreover, based on our literature review, there is no previous covert sound-production onset detection system for spBCIs. Results showed that the proposed onset detection technique and TFP performance metric have good potential for use in SP-BCIs

Functional Folate Receptor Alpha Is Elevated in the Blood of Ovarian Cancer Patients

Background Despite low incidence, ovarian cancer is the fifth leading cause of cancer deaths and it has the highest mortality rate of all gynecologic malignancies among US women. The mortality rate would be reduced with an early detection marker. The folate receptor alpha (FRα) is one logical choice for a biomarker because of its prevalent overexpression in ovarian cancer and its exclusive expression in only a few normal tissues. In prior work, it was observed that patients with ovarian cancer had elevated serum levels of a protein that bound to a FRα-specific monoclonal antibody relative to healthy individuals. However, it was not shown that the protein detected was intact functional FRα. In the current study, the goal was to determine whether ovarian cancer patients (n = 30) had elevated serum levels of a fully functional intact FRα compared to matched healthy controls (n = 30). Methodology/Principal Findings FRα levels in serum were analyzed by two methods, immunoblotting analysis and a radiolabeled folic acid-based microfiltration binding assay. Using the immunoassay, we observed that levels of FRα were higher in serum of ovarian cancer patients as compared to controls. Similar results were also observed using the microfiltration binding assay, which showed that the circulating FRα is functional. Importantly, we also found that the levels of FRα were comparable between early and advanced stage patients. Conclusions Our results demonstrate that ovarian cancer patients have elevated levels of functional intact FRα. These findings support the potential use of circulating FRα as a biomarker of early ovarian cancer

Toward a model-based predictive controller design in brain-computer interfaces

A first step in designing a robust and optimal model-based predictive controller (MPC) for brain-computer interface (BCI) applications is presented in this article. An MPC has the potential to achieve improved BCI performance compared to the performance achieved by current ad hoc, nonmodel-based filter applications. The parameters in designing the controller were extracted as model-based features from motor imagery task-related human scalp electroencephalography. Although the parameters can be generated from any model-linear or non-linear, we here adopted a simple autoregressive model that has well-established applications in BCI task discriminations. It was shown that the parameters generated for the controller design can as well be used for motor imagery task discriminations with performance (with 8-23% task discrimination errors) comparable to the discrimination performance of the commonly used features such as frequency specific band powers and the AR model parameters directly used. An optimal MPC has significant implications for high performance BCI applications.Grants K25NS061001 (MK) and K02MH01493 (SJS) from the National Institute of Neurological Disorders And Stroke (NINDS) and the National Institute of Mental Health (NIMH), the Portuguese Foundation for Science and Technology (FCT) Grant SFRH/BD/21529/2005 (NSD), the Pennsylvania Department of Community and Economic Development Keystone Innovation Zone Program Fund (SJS), and the Pennsylvania Department of Health using Tobacco Settlement Fund (SJS)

Full Mouth Rehabilitation with Implant-Supported Prostheses for Severe Periodontitis: A Case Report

Oral rehabilitation for a patient with severe loss of alveolar bone and soft tissue resulting from severe periodontitis presents a challenge to clinicians. Replacing loosening natural teeth with fixed prostheses supported by dental implants often requires either gingival surgery or bone grafting. The outcome of the bone grafting is sometimes unpredictable and requires longer healing time and/ or multiple surgeries. The presence of periodontal inflammation and periapical lesions often delay the placement of bone grafts as well as dental implants. Here we present a clinical case of a patient undergone full mouth reconstruction with implant-supported fixed prostheses. We demonstrated that early placement of implants (three weeks after extractions) with minimal bone grafting may be an alternative to conventional bone grafting followed by implant placement. We believe that primary stability during implant placement may contribute to our success. In addition, composite resin gingival material may be indicated in cases of large fixed implant prostheses as an alternative to pink porcelain

Deficit of circulating stem – progenitor cells in opiate addiction: a pilot study

A substantial literature describes the capacity of all addictive drugs to slow cell growth and potentiate apoptosis. Flow cytometry was used as a means to compare two lineages of circulating progenitor cells in addicted patients. Buprenorphine treated opiate addicts were compared with medical patients. Peripheral venous blood CD34+ CD45+ double positive cells were counted as haemopoietic stem cells (HSC's), and CD34+ KDR+ (VEGFR2+) cells were taken as endothelial progenitor cells (EPC's). 10 opiate dependent patients with substance use disorder (SUD) and 11 non-addicted (N-SUD) were studied. The ages were (mean + S.D.) 36.2 + 8.6 and 56.4 + 18.6 respectively (P <0.01). HSC's were not different in the SUD (2.38 + 1.09 Vs. 3.40 + 4.56 cells/mcl). EPC's were however significantly lower in the SUD (0.09 + 0.14 Vs. 0.26 + 0.20 cells/mcl; No. > 0.15, OR = 0.09, 95% C.I. 0.01–0.97), a finding of some interest given the substantially older age of the N-SUD group. These laboratory data are thus consistent with clinical data suggesting accelerated ageing in addicted humans and implicate the important stem cell pool in both addiction toxicology and ageing. They carry important policy implications for understanding the fundamental toxicology of addiction, and suggest that the toxicity both of addiction itself and of indefinite agonist maintenance therapies may have been seriously underestimated

Myoblast sensitivity and fibroblast insensitivity to osteogenic conversion by BMP-2 correlates with the expression of Bmpr-1a

<p>Abstract</p> <p>Background</p> <p>Osteoblasts are considered to primarily arise from osseous progenitors within the periosteum or bone marrow. We have speculated that cells from local soft tissues may also take on an osteogenic phenotype. Myoblasts are known to adopt a bone gene program upon treatment with the osteogenic bone morphogenetic proteins (BMP-2,-4,-6,-7,-9), but their osteogenic capacity relative to other progenitor types is unclear. We further hypothesized that the sensitivity of cells to BMP-2 would correlate with BMP receptor expression.</p> <p>Methods</p> <p>We directly compared the BMP-2 sensitivity of myoblastic murine cell lines and primary cells with osteoprogenitors from osseous tissues and fibroblasts. Fibroblasts forced to undergo myogenic conversion by transduction with a MyoD-expressing lentiviral vector (LV-MyoD) were also examined. Outcome measures included alkaline phosphatase expression, matrix mineralization, and expression of osteogenic genes <it>(alkaline phosphatase, osteocalcin </it>and <it>bone morphogenetic protein receptor-1A) </it>as measured by quantitative PCR.</p> <p>Results</p> <p>BMP-2 induced a rapid and robust osteogenic response in myoblasts and osteoprogenitors, but not in fibroblasts. Myoblasts and osteoprogenitors grown in osteogenic media rapidly upregulated <it>Bmpr-1a </it>expression. Chronic BMP-2 treatment resulted in peak <it>Bmpr-1a </it>expression at day 6 before declining, suggestive of a negative feedback mechanism. In contrast, fibroblasts expressed low levels of <it>Bmpr-1a </it>that was only weakly up-regulated by BMP-2 treatment. Bioinformatics analysis confirmed the presence of myogenic responsive elements in the proximal promoter region of human and murine <it>BMPR-1A/Bmpr-1a</it>. Forced myogenic gene expression in fibroblasts was associated with a significant increase in <it>Bmpr-1a </it>expression and a synergistic increase in the osteogenic response to BMP-2.</p> <p>Conclusion</p> <p>These data demonstrate the osteogenic sensitivity of muscle progenitors and provide a mechanistic insight into the variable response of different cell lineages to BMP-2.</p