Brain abscess following rituximab infusion in a patient with pemphigus vulgaris.

BackgroundImmunocompromised patients are at increased risk for developing meningitis or, rarely, brain abscess with opportunistic organisms like Listeria monocytogenes.Case reportA 52 year-old Saudi Arabian woman who was diagnosed with pemphigus vulgaris and diabetes and had been on prednisolone and azathioprine for about 4 years. She presented with headache, low-grade fever, and left-sided weakness 2 weeks after receiving the second dose of rituximab infusion. Magnetic resonance imaging revealed an enhanced space-occupying lesion with multiple small cyst-like structures and vasogenic edema in the right temporoparietal area. Her blood culture was positive for Listeria monocytogenes, and a brain biopsy showed necrotic tissues with pus and inflammatory cells. She recovered after a 6-week course of antibiotics with ampicillin and gentamycin.ConclusionsBrain abscess due to Listeria monocytogenes is a risk that should be considered when adding rituximab to the regimen of a patient who is already Immunocompromised

Rekonfigurasi Jaringan Distribusi Untuk Meminimalisasi Rugi-Rugi Daya Dengan Menggunakan Metode Grey Wolf Optimizer (GWO)

Rekonfigurasi jaringan pada jaringan distribusi merupakan suatu proses atau usaha untuk mengubah status sakelar pada saluran yang terhubung (sectionalizing switch) dan yang tidak terhubung (tie switch) dengan tujuan untuk meminimalisasi rugi-rugi daya dan memperbaiki profil tegangan pada sistem. Rekonfigurasi dilakukan dengan mengganti jalur saluran baru yang terhubung tanpa menambah jumlah saluran. Namun, proses rekonfigurasi yang tidak tepat akan menyebabkan rugi-rugi daya menjadi lebih besar. Pada penelitian ini, metode Grey Wolf Optimizer (GWO) digunakan untuk melakukan rekonfigurasi yang optimal terhadap kasus sistem standar IEEE 33-bus dan sistem standar IEEE 69-bus. Hasil simulasi pada sistem standar IEEE 33-bus menunjukkan bahwa setelah dilakukan optimasi rekonfigurasi, rugi-rugi daya aktif pada sistem menjadi sebesar 139,5513 kW atau berkurang sebesar 31,146% dari sebelum rekonfigurasi, yaitu 202,6771 kW. Sedangkan pada sistem standar IEEE 69-bus, rugi-rugi daya aktif menjadi sebesar 98,6056 kW atau berkurang sebesar 56,1754% dari sebelum rekonfigurasi, yaitu 225,0007 kW. Dengan menggunakan metode GWO mampu mengurangi rugi-rugi daya aktif yang lebih baik dibandingkan dengan beberapa metode lain. Kata kunci — Rekonfigurasi, minimalisasi rugi-rugi, optimasi, Grey Wolf Optimizer (GWO

The Category 'D' Reconsidered

This study deals with the categorial status of a set of words known as 'determiners' and the features encoded in them. We argue, following a suggestion in Chomsky, 1975, that 'Optimality' conditions on grammar require grammatical categories to be 'primitive' in the sense that they must be unanalysable into further entities. The status of many words classified as determiners does not conform with this suggestion. The category 'D' is therefore a non-standard grammatical category. We have provided mathematical, morphological and syntactic arguments and facts drawn from a number of languages including Arabic, English, French, German, Hebrew, Italian, ...etc. showing that the category 'D' is not a 'primitive' category and therefore should be suspended and replaced by its 'primitive5 components. We have shown that 'genuine' determiners are morphologically complex where each element encodes a functional feature, such as 'person9, 'number9, 'gender9, 'proximate', 'definite', ...etc. These features, we claim, are functional categories. Many words classified as belonging to the category 'd' are in fact nouns or adjectives. Adopting an articulated theory of 'D' in which functional features are taken as functional categories is not only theoretically motivated but also has implications for language learn ability

Solution of Second Kind Volterra Integral Equations Using Non-Polynomial Spline Functions

In this paper we use non-polynomial spline functions to develop numerical methods to approximate the solution of 2nd kind Volterra integral equations. Numerical examples are presented to illustrate the applications of these method, and to compare the computed results with other known methods

Clock drawing test digit recognition using static and dynamic features

The clock drawing test (CDT) is a standard neurological test for detection of cognitive impairment. A computerised version of the test promises to improve the accessibility of the test in addition to obtaining more detailed data about the subject's performance. Automatic handwriting recognition is one of the first stages in the analysis of the computerised test, which produces a set of recognized digits and symbols together with their positions on the clock face. Subsequently, these are used in the test scoring. This is a challenging problem because the average CDT taker has a high likelihood of cognitive impairment, and writing is one of the first functional activities to be affected. Current handwritten digit recognition system perform less well on this kind of data due to its unintelligibility. In this paper, a new system for numeral handwriting recognition in the CDT is proposed. The system is based on two complementary sources of data, namely static and dynamic features extracted from handwritten data. The main novelty of this paper is the new handwriting digit recognition system, which combines two classifiers—fuzzy k-nearest neighbour for dynamic stroke-based features and convolutional neural network for static image- based features, which can take advantage of both static and dynamic data. The proposed digit recognition system is tested on two sets of data: first, Pendigits online handwriting digits; and second, digits from the actual CDTs. The latter data set came from 65 drawings made by healthy people and 100 drawings reproduced from the drawings by dementia patients. The test on both data sets shows that the proposed combination system can outperform each classifier individually in terms of recognition accuracy, especially when assessing the handwriting of people with dementi

Maximum Norm Analysis of a Nonmatching Grids Method for Nonlinear Elliptic PDES

We provide a maximum norm analysis of a finite element Schwarz alternating method for a nonlinear elliptic PDE on two overlapping subdomains with nonmatching grids. We consider a domain which is the union of two overlapping subdomains where each subdomain has its own independently generated grid. The two meshes being mutually independent on the overlap region, a triangle belonging to one triangulation does not necessarily belong to the other one. Under a Lipschitz asssumption on the nonlinearity, we establish, on each subdomain, an optimal L∞ error estimate between the discrete Schwarz sequence and the exact solution of the PDE

29. No association between MTHFR C677T polymorphism and congenital heart disease in Saudi Arabian population

Congenital heart diseases (CHD) are the most common birth defects in the world. It is a major cause of childhood mortality and morbidity worldwide with about 7 per 1000 live birth. Studies suggest that Methylenetetrahydrofolate reductase (MTHFR) polymorphism C667T has been associated with congenital malformation; this common missense mutation in the MTHFR gene may reduce enzymatic action, and may be involved in the etiology of congenital heart defects (CHD), but the evidence remains inconclusive. The aim of this study is to determine whether this association exists in the Saudi Arabian population.MethodDNA sequencing was used to detect genotype MTHFR C677T in 75 CHD patients and 100 ethnically similar controls. The type of cardiac defect was diagnosed by cardiovascular specialist and confirmed by echocardiographic.ResultsThe distribution of the MTHFR 677C >T SNP genotypes and alleles in both CHD and control groups were 70.0% CC, 26.0% CT, 4.0% TT in cases and 70.8% CC, 25.4% CT, 3.8% TT in controls. The T allele frequency was 17.0% in cases and 16.5% in controls. The difference between genotypes and alleles was not statistically significant between controls and the CHD groups.ConclusionWe did not find sufficient evidence for an association between MTHFR C677T genotype and congenital heart disease in Saudi Arabian population. We agree that the sample size is a limitation to our above conclusions

A novel homozygous TPM1 mutation in familial pediatric hypertrophic cardiomyopathy and in silico screening of potential targeting drugs.

Familial hypertrophic cardiomyopathy (HCM) is the most common genetic cardiac disease. While sarcomeric gene mutations explain many HCM cases, the genetic basis of about half of HCM cases remains elusive. Here we aimed to identify the gene causing HCM in a non-consanguineous Saudi Arabian family with affected family members and a history of sudden death. The impact of the identified mutation on protein structure and potential drug targets were evaluated in silico. Triplets (two HCM subjects and one patent ductus arteriosus (PDA) case) and unaffected parents were screened by targeted next-generation sequencing (NGS) for 181 candidate cardiomyopathy genes. In silico structural and functional analyses, including protein modeling, structure prediction, drug screening, drug binding, and dynamic simulations were performed to explore the potential pathogenicity of the variant and to identify candidate drugs. A homozygous missense mutation in exon 1 of TMP1 (assembly GRCh37-chr15: 63340781; G>A) was identified in the triplets [two HCM and one patent ductus arteriosus (PDA)] that substituted glycine for arginine at codon 3 (p.Gly3Arg). The parents were heterozygous for the variant. The mutation was predicted to cause a significant and deleterious change in the TPM1 protein structure that slightly affected drug binding, stability, and conformation. In addition, we identified several putative TPM1-targeting drugs through structure-based in silico screening. TPM1 mutations are a common cause of HCM and other congenital heart defects. To date, TPM1 has not been associated with isolated PDA; to our knowledge, this is the first report of the homozygous missense variation p.Gly3Arg in TPM1 associated with familial autosomal recessive pediatric HCM and PDA. The identified candidate TPM1 inhibitors warrant further prospective investigation.This research was supported by the Strategic Technologies Programs of the National Plan for Science, Technology and Innovation (MAARIFAH), Kingdom of Saudi Arabia. Project No: 12-MED3174-05, through the Science and Technology Unit (STU), Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia