Biomarker for tracking progression of Alzheimer's disease in clinical trials

Currently, there are no treatments available for mitigating the neurological effects of Alzheimer's disease. All clinical trials of disease-modifying treatments, which showed promise in animal models, have failed to show a significant treatment effect in human trials. The lack of a sensitive outcome measure and the focus on the dementia stage for investigating treatments are believed to be the primary reasons behind the failure of all clinical trials till date. The currently used outcome measure, the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog), suffers from low sensitivity in tracking progression of cognitive impairment in clinical trials. A shift in the focus to the prodromal mild cognitive impairment (MCI) stage may help improve the efficiency of clinical trials. However, even lower sensitivity of the ADAS-Cog and an inability to specifically select progressive MCI patients limit the efficiency of clinical trials in the MCI stage. Cerebral atrophy measured on structural magnetic resonance (MR) imaging is highly promising for tracking disease progression in clinical trials. However, cerebral atrophy has not been yet approved as a valid biomarker due to the lack of an understanding behind its relationship with cognitive impairment. The focus of this dissertation spans across the two research areas of (i) developing automatic algorithms for analysis of patients' brain MR volumes, and (ii) improving the efficiency of clinical trials of disease-modifying treatments. This dissertation presents a novel knowledge-driven decision theory approach for automatic tissue segmentation of brain MR volumes, which shows better segmentation performance than the existing approaches. The remaining dissertation contributions focus at improving the efficiency of clinical trials of disease-modifying treatments. An improved scoring methodology is presented for the ADAS-Cog outcome measure, which measures cognitive impairment with better accuracy and significantly improves the sensitivity of the ADAS-Cog in the mild-to-moderate Alzheimer's disease stage. However, the ADAS-Cog continues to suffers from low sensitivity in the MCI stage due to inherent limitations of its items. For improving the efficiency of clinical trials in the MCI stage, a biomarker has been developed that combines the ADAS-Cog with cerebral atrophy for more accurate tracking of Alzheimer's progression and facilitating selection of MCI patients in clinical trials.Biomedical Engineerin

Cysticercal encephalitis with disseminated cutaneous cysticercosis: A case report

Cysticercal encephalitis is a severe and frequently fatal neurological disorder seen in endemic regions. We report a young male whopresented with refractory status epilepticus along with numerous subcutaneous swellings over the body. His neuroimaging revealedthe classic “starry sky” appearance, suggesting a diagnosis of cysticercal encephalitis along with disseminated cutaneous cysticercosis.He was managed with supportive care, antiepileptics and steroids. In endemic regions, neurocysticercosis should be consideredas a differential diagnosis in children presenting as acute encephalitis syndrome. A careful physical examination along with earlyneuroimaging will help in establishing the diagnosis promptly

PERFORMANCE OF HYBRID SYSTEM FOR AUTOMOBILE

Studies on new fuel-saving technologies have been popular in recent years because of decreasing global crude oil supplies and growing environmental concerns. The price of crude oil, according to the Department of Energy (2007), is over 400% higher than ten years ago (Figure 1.1) and is likely to continue to surge in the future because of shrinking oil supplies. To reduce oil consumption byground vehicles, the Corporate Average Fuel Economy (CAFE) was enacted by the US Congress in 1975. The CAFE legislation is overseen by the National Highway Traffic Safety Administration (NHTSA), which sets fuel economy standards for cars and light trucks (trucks, vans, and sport utility vehicles) sold in the US and other countries fallow it's rule as suitable change . While the CAFE standards have remained relatively constant for the last twenty years, the discussion of increasing it is significant in the past fifteen years regarding shrinking oil supplies and increasing oil demand

URINE POWERED BATTERY AND IT'S UTILIZATION WITH EXPERIMENTAL STUDY

This paper describes the power generation from urine, and able to run various d.c. electrical equipments. It provides a lot of detail into the challenges of modifying the chemical cells by using urine as electrolyte. The design of urine powered battery basically works in principle, of electrochemical cells which is used to generate 1.6 volts (approx.). Also shows the characteristic curve between the human urine and cow urine on various parameters. And the application of urine powered battery. This battery is future changeable according to the requirement

Between “Voluntary Migrants” and War Refugees: The Health of the Shan Burmese Migrant Workers in Northern Thailand

The Shan are a large migrant group from Burma (Myanmar) found within Thailand. While some Shan migrate to escape the civil war within Burma, others migrate for economic opportunity. Despite the size of this population, little is known about their health. Our study highlights the need for expanded access to primary care among this Shan population. Despite the arduous and trying journeys of these Shan migrants, they do not display the level of health sometimes attributed to health selection among immigrant groups

Online meeting assistance

Online meetings sometimes offer a poor user experience to participants. Participants benefit from being able to access prior portions of an ongoing meeting, e.g., that they missed due to connectivity problems or because of interruptions. This disclosure describes a meeting helper that, with user permission, records and transcribes meeting content. The content is made available during and after the meeting. The meeting helper eliminates the need for participants to take notes during a meeting and offers improved user experience

The Psychosocial Health of Shan Children in Northwest Thailand

We administered the Strengths and Difficulties Questionnaire (SDQ) to 51 Shan refugee children from Burma who are living in northern Thailand, and collected life histories from 11 of their families. Of the sample, 63% of the children were stateless, and none were Thai citizens. About 30% of the children had normal peer relationship subscores—a number well below Thai norms after correcting for multiple comparisons (p < .001). However, their overall functioning was not different from the Thai population as a whole

On-treatment comparison between corrective His bundle pacing and biventricular pacing for cardiac resynchronization: A secondary analysis of His-SYNC

Background The His-SYNC pilot trial was the first randomized comparison between His bundle pacing in lieu of a left ventricular lead for cardiac resynchronization therapy (His-CRT) and biventricular pacing (BiV-CRT), but was limited by high rates of crossover. Objective To evaluate the results of the His-SYNC pilot trial utilizing treatment-received (TR) and per-protocol (PP) analyses. Methods The His-SYNC pilot was a multicenter, prospective, single-blinded, randomized, controlled trial comparing His-CRT vs BiV-CRT in patients meeting standard indications for CRT (eg, NYHA II–IV patients with QRS >120 ms). Crossovers were required based on prespecified criteria. The primary endpoints analyzed included improvement in QRS duration, left ventricular ejection fraction (LVEF), and freedom from cardiovascular (CV) hospitalization and mortality. Results Among 41 patients enrolled (aged 64 ± 13 years, 38% female, LVEF 28%, QRS 168 ± 18 ms), 21 were randomized to His-CRT and 20 to BiV-CRT. Crossover occurred in 48% of His-CRT and 26% of BiV-CRT. The most common reason for crossover from His-CRT was inability to correct QRS owing to nonspecific intraventricular conduction delay (n = 5). Patients treated with His-CRT demonstrated greater QRS narrowing compared to BiV (125 ± 22 ms vs 164 ± 25 ms [TR], P < .001;124 ± 19 ms vs 162 ± 24 ms [PP], P < .001). A trend toward higher echocardiographic response was also observed (80 vs 57% [TR], P = .14; 91% vs 54% [PP], P = .078). No significant differences in CV hospitalization or mortality were observed. Conclusions Patients receiving His-CRT on-treatment demonstrated superior electrical resynchronization and a trend toward higher echocardiographic response than BiV-CRT. Larger prospective studies may be justifiable with refinements in patient selection and implantation techniques to minimize crossovers