Evaluation of fine needle aspiration cytology as the initial diagnostic test in cases of cervical lymphadenopathy

Background: Cervical lymph node enlargement is common amongst the various causes of neck swelling. Proper diagnosis and early treatment is necessary for cervical lymph node disease and it is also necessary to rule out potentially curable causes as against malignancy in which the treatment is generally palliative. Fine needle aspiration cytology (FNAC) is now a day the initial investigation in most of the cases of cervical lymph node enlargement. Aims and Objectives of the study were to evaluate the sensitivity and specificity of FNAC in the diagnosis of cervical lymph node disease with an emphasis on discordant cases between the cytology and the histopathology.Methods: Patients admitted with cervical lymph node enlargement in a tertiary hospital of western India (attached with a medical college) from October 2014 to September 2016 were prospectively studied. Detailed history, clinical examination and necessary investigations of all patients were done especially fine needle aspiration cytology and histopathology examination and inference was obtained after the diagnosis was confirmed.Results: The cytological diagnoses were found to be malignant in 48 cases (30.6%) and benign in 109 cases (69.4%). The overall diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of FNAC of cervical lymph nodes were 90.9%, 67.2%, 82.6%, and 81.3%, respectively. The overall diagnostic accuracy was 82.2%, while the overall discordance rate was 17.8%.Conclusions: FNAC is the initial investigation of choice in the diagnostic approach to most of the cases of cervical lymphadenopathy and it has good diagnostic sensitivity and specificity

Employing linked data and dialogue for modelling cultural awareness of a user

YesIntercultural competence is an essential 21st Century skill. A key issue for developers of cross-cultural training simulators is the need to provide relevant learning experience adapted to the learner’s abilities. This paper presents a dialogic approach for a quick assessment of the depth of a learner's current intercultural awareness as part of the EU ImREAL project. To support the dialogue, Linked Data is seen as a rich knowledge base for a diverse range of resources on cultural aspects. This paper investigates how semantic technologies could be used to: (a) extract a pool of concrete culturally-relevant facts from DBpedia that can be linked to various cultural groups and to the learner, (b) model a learner's knowledge on a selected set of cultural themes and (c) provide a novel, adaptive and user-friendly, user modelling dialogue for cultural awareness. The usability and usefulness of the approach is evaluated by CrowdFlower and Expert Inspection

Spatiotemporal Analysis of Flow-Induced Intermediate Filament Displacement in Living Endothelial Cells

The distribution of hemodynamic shear stress throughout the arterial tree is transduced by the endothelium into local cellular responses that regulate vasoactivity, vessel wall remodeling, and atherogenesis. Although the exact mechanisms of mechanotransduction remain unknown, the endothelial cytoskeleton has been implicated in transmitting extracellular force to cytoplasmic sites of signal generation via connections to the lumenal, intercellular, and basal surfaces. Direct observation of intermediate filament (IF) displacement in cells expressing green fluorescent protein-vimentin has suggested that cytoskeletal mechanics are rapidly altered by the onset of fluid shear stress. Here, restored images from time-lapse optical sectioning fluorescence microscopy were analyzed as a four-dimensional intensity distribution function that represented IF positions. A displacement index, related to the product moment correlation coefficient as a function of time and subcellular spatial location, demonstrated patterns of IF displacement within endothelial cells in a confluent monolayer. Flow onset induced a significant increase in IF displacement above the nucleus compared with that measured near the coverslip surface, and displacement downstream from the nucleus was larger than in upstream areas. Furthermore, coordinated displacement of IF near the edges of adjacent cells suggested the existence of mechanical continuity between cells. Thus, quantitative analysis of the spatiotemporal patterns of flow-induced IF displacement suggests redistribution of intracellular force in response to alterations in hemodynamic shear stress acting at the lumenal surface

Temporal Logic Control of POMDPs via Label-based Stochastic Simulation Relations

The synthesis of controllers guaranteeing linear temporal logic specifications on partially observable Markov decision processes (POMDP) via their belief models causes computational issues due to the continuous spaces. In this work, we construct a finite-state abstraction on which a control policy is synthesized and refined back to the original belief model. We introduce a new notion of label-based approximate stochastic simulation to quantify the deviation between belief models. We develop a robust synthesis methodology that yields a lower bound on the satisfaction probability, by compensating for deviations a priori, and that utilizes a less conservative control refinement

Self-medication amongst pregnant women in a tertiary care teaching hospital in India

Background: Self-medication is a popular practice in developing countries where there is no strict regulation of drugs sold in local pharmacies. General public is usually unaware of the adverse effects of drugs used for common illness and continue using them without prescription during pregnancy. This study was carried out to know the extent of self-medication practised by pregnant women and various factors associated with it.Methods: A questionnaire based, cross-sectional study of pregnant women visiting the OB GYN-OPD of a tertiary care teaching hospital was conducted. 303 eligible subjects were questioned and statistical analysis was carried out.Results: Total 16.5% women were found to be self-medicating during pregnancy for common conditions like headache (26%), fever (23%) and common cold (19%). Odds Ratio between the self-medicating and non-self-medicating groups for variables like age (<25 years; ≥25 years), education (illiterate; literate) and gestational age (<20 weeks; ≥20 weeks) are 1.6, 2 and 1.73 respectively. Women with a history of self-medicating before pregnancy were significantly more likely to continue doing so during pregnancy (p value <0.00001).Conclusions: A significant proportion of pregnant women have been found to self-medicate without knowing the adverse effects of the drug used. Thus, spreading awareness against this health-predicament is necessary

Developing Feedback Based Robotic Manufacturing Method for Earth-Based Materials

Although earth-based materials have the advantage of being locally sourced and have low embodied emissions, they can have an unpredictable material behavior due to their heterogeneous composition which potentially limits their use in manufacturing. As a result, it becomes challenging to standardise and maintain quality outcomes. Moreover, current industry methods are labour-intensive and require a high level of traditional knowledge. This research explores and develops a fabrication methodology for earthen materials that is location-agnostic. It involves an array of fabrication approaches, including the development of a robotic 'Impact Printing' setup using a UR10 robot and a custom tool to pick, place, and mechanically compact earth blocks. The 'Feedback System' employs Kinect 2.0 to scan the deformation of earth materials observed during fabrication and a computational algorithm to generate accurate and adapted toolpaths for the position and compaction of earthen blocks in real-time. To push the boundaries of architectural design for traditional building materials, the study investigates the construction of a closed Nubian vault using the aforementioned techniques and tools. Through the optimization of material behavior and manufacturing processes, the research opens up a pathway for automated onsite earth construction

Sequence analysis and transcript expression of the MEN1 gene in sporadic pituitary tumours

The majority of pituitary tumours are monoclonal in origin and arise sporadically or occasionally as part of multiple endocrine neoplasia type 1 (MEN1). Whilst a multi-step aetiology involving both oncogenes and tumour suppressor genes has been proposed for their development, the target(s) of these changes are less clearly defined. Both familial and sporadic pituitary tumours have been shown to harbour allelic deletion on 11q13, which is the location of the recently cloned MEN1 gene. We investigated 23 sporadic pituitary tumours previously shown to harbour allelic deletion on 11q13 with the marker PYGM centromeric and within 50 kb of the MEN1 locus. In addition, the use of intragenic polymorphisms in exon 9 and at D11S4946, and of telomeric loci at D11S4940 and D11S4936, revealed that five of 20 tumours had loss of heterozygosity (LOH) telomeric to the menin gene. However, the overall pattern of loss in informative cases was indicative of non-contiguous deletion that brackets the menin gene. Sequence analysis of all MEN1 coding exons and flanking intronic sequence, in tumours and matched patient leucocyte DNA, did not reveal mutation(s) in any of the 23 tumours studied. A benign polymorphism in exon 9 was encountered at the expected frequency, and in seven patients heterozygous for the polymorphism the tumour showed retention of both copies of the menin gene. Reverse transcription polymerase chain reaction analysis of ten evaluable tumours and four normal pituitaries revealed the presence of the menin transcript. Whilst these findings suggest that gene silencing is unlikely to be mechanistic in sporadic pituitary tumorigenesis, they do not exclude changes in the level or stability of the transcript or translation to mature protein. Our study would support and extend very recent reports of a limited role for mutations in the MEN1 gene in sporadic pituitary tumours. Alternatively, these findings may point to an, as yet, unidentified tumour suppressor gene in this region

Ontology-based discovery of time-series data sources for landslide early warning system

YesModern early warning system (EWS) requires sophisticated knowledge of the natural hazards, the urban context and underlying risk factors to enable dynamic and timely decision making (e.g., hazard detection, hazard preparedness). Landslides are a common form of natural hazard with a global impact and closely linked to a variety of other hazards. EWS for landslides prediction and detection relies on scientific methods and models which requires input from the time series data, such as the earth observation (EO) and urban environment data. Such data sets are produced by a variety of remote sensing satellites and Internet of things sensors which are deployed in the landslide prone areas. To this end, the automatic discovery of potential time series data sources has become a challenge due to the complexity and high variety of data sources. To solve this hard research problem, in this paper, we propose a novel ontology, namely Landslip Ontology, to provide the knowledge base that establishes relationship between landslide hazard and EO and urban data sources. The purpose of Landslip Ontology is to facilitate time series data source discovery for the verification and prediction of landslide hazards. The ontology is evaluated based on scenarios and competency questions to verify the coverage and consistency. Moreover, the ontology can also be used to realize the implementation of data sources discovery system which is an essential component in EWS that needs to manage (store, search, process) rich information from heterogeneous data sources

Role of Flavin-Containing Monooxygenase in Oxidative Metabolism of Voriconazole by Human Liver Microsomes

Voriconazole is a potent second generation triazole antifungal agent with broad-spectrum activity against clinically important fungi. It is cleared predominantly via metabolism in all species tested including humans. N-oxidation of the fluoropyrimidine ring, its hydroxylation, and hydroxylation of the adjacent methyl group are the known pathways of voriconazole oxidative metabolism, with the N-oxide being the major circulating metabolite in human. In vitro studies have shown that CYP2C19, CYP3A4, and to a lesser extent CYP2C9 contribute to the oxidative metabolism of voriconazole. When CYP-specific inhibitors and antibodies were used to evaluate the oxidative metabolism of voriconazole by human liver microsomes (HLM), the results suggested that CYP-mediated metabolism accounted for ~75% of the total oxidative metabolism. The studies presented here provide evidence that the remaining ~25% of the metabolic transformations are catalyzed by flavin-containing monooxygenase (FMO). This conclusion was based on the evidence that the NADPH-dependent metabolism of voriconazole was sensitive to heat (45 °C for 5 min), a condition known to selectively inactivate FMO without affecting CYP activity. The role of FMO in the metabolic formation of voriconazole N-oxide was confirmed by the use of recombinant FMO enzymes. Kinetic analysis of voriconazole metabolism by FMO1 and FMO3 yielded Km values of 3.0 mM and 3.4 mM and Vmax values of 0.025 pmol/min/pmol and 0.044 pmol/min/pmol, respectively. FMO5 did not metabolize voriconazole effectively. This is the first report of the role of FMO in the oxidative metabolism of voriconazole