Scan-Negative Cauda Equina Syndrome A Prospective Cohort Study

Objective: To describe clinical features relevant to diagnosis, mechanism, and etiology in patients with “scan-negative” cauda equina syndrome (CES). Methods: We carried out a prospective study of consecutive patients presenting with the clinical features of CES to a regional neurosurgery center comprising semi-structured interview and questionnaires investigating presenting symptoms, neurologic examination, psychiatric and functional disorder comorbidity, bladder/bowel/sexual function, distress, and disability. Results: A total of 198 patients presented consecutively over 28 months. A total of 47 were diagnosed with scan-positive CES (mean age 48 years, 43% female). A total of 76 mixed category patients had nerve root compression/displacement without CES compression (mean age 46 years, 71% female) and 61 patients had scan-negative CES (mean age 40 years, 77% female). An alternative neurologic cause of CES emerged in 14/198 patients during admission and 4/151 patients with mean duration 25 months follow-up. Patients with scan-negative CES had more positive clinical signs of a functional neurologic disorder (11% scan-positive CES vs 34% mixed and 68% scan-negative, p < 0.0001), were more likely to describe their current back pain as worst ever (41% vs 46% and 70%, p = 0.005), and were more likely to have symptoms of a panic attack at onset (37% vs 57% and 70%, p = 0.001). Patients with scan-positive CES were more likely to have reduced/absent bilateral ankle jerks (78% vs 30% and 12%, p < 0.0001). There was no significant difference between groups in the frequency of reduced anal tone and urinary retention. Conclusion: The first well-phenotyped, prospective study of scan-negative CES supports a model in which acute pain, medication, and mechanisms overlapping with functional neurologic disorders may be relevant

A Many-Valued Empirical Machine for Thyroid Dysfunction Assessment

Thyroid Dysfunction is a clinical condition that affects thyroid behaviour and is reported to be the most common in all endocrine disorders. It is a multiple factorial pathology condition due to the high incidence of hypothyroidism and hyperthyroidism, which is becoming a serious health problem requiring a detailed study for early diagnosis and monitoring. Understanding the prevalence and risk factors of thyroid disease can be very useful to identify patients for screening and/or follow-up and to minimize their collateral effects. Thus, this paper describes the development of a decision support system that aims to help physicians in the decision-making process regarding thyroid dysfunction assessment. The proposed problem-solving method is based on a symbolic/sub-symbolic line of logical formalisms that have been articulated as an Artificial Neural Network approach to data processing, complemented by an unusual approach to Knowledge Representation and Argumentation that takes into account the data elements entropic states. The model performs well in the thyroid dysfunction assessment with an accuracy ranging between 93.2% and 96.9%

Electrodeposition of CdTe thin films using nitrate precursor for applications in solar cells

Cadmium telluride (CdTe) thin films have been electrodeposited (ED) on glass/fluorine-doped tin oxide (FTO) substrates using simplified two-electrode system in acidic and aqueous solution containing Cd(NO3)2 4H2O and TeO2. The X-ray diffraction (XRD), optical absorption, photoelectrochemical (PEC) cell measurements, scanning electron microscopy (SEM) and transmission electron microscopy (TEM) have been carried out to study the structural, optical, electrical and morphological properties of the CdTe layers. The XRD study shows that the ED-CdTe layers are polycrystalline with cubic crystal structure. Results obtained from optical absorption reveal that the bandgaps of the as-deposited and the CdCl2 treated CdTe layers are in the ranges ~1.50 to ~1.54 eV and ~1.46 to ~1.51 eV, respectively. Observation from PEC measurements indicates a p-, i- and n-type electrical conductivity for as-deposited CdTe layers grown in the cathodic voltage range (1,247–1,258) mV. The SEM images indicate noticeable change in CdTe grain size from ~85 to ~430 nm after CdCl2 treatment with uniform surface coverage of the glass/FTO substrate. The TEM images show the columnar growth structure for as-deposited and CdCl2 treated CdTe layers. The TEM images also indicate an increase in grain’s diameter from ~50 to ~200 nm after CdCl2 treatment

Water Extract from the Leaves of Withania somnifera Protect RA Differentiated C6 and IMR-32 Cells against Glutamate-Induced Excitotoxicity

Glutamate neurotoxicity has been implicated in stroke, head trauma, multiple sclerosis and neurodegenerative disorders. Search for herbal remedies that may possibly act as therapeutic agents is an active area of research to combat these diseases. The present study was designed to investigate the neuroprotective role of Withania somnifera (Ashwagandha), also known as Indian ginseng, against glutamate induced toxicity in the retinoic acid differentiated rat glioma (C6) and human neuroblastoma (IMR-32) cells. The neuroprotective activity of the Ashwagandha leaves derived water extract (ASH-WEX) was evaluated. Cell viability and the expression of glial and neuronal cell differentiation markers was examined in glutamate challenged differentiated cells with and without the presence of ASH-WEX. We demonstrate that RA-differentiated C6 and IMR-32 cells, when exposed to glutamate, undergo loss of neural network and cell death that was accompanied by increase in the stress protein HSP70. ASH-WEX pre-treatment inhibited glutamate-induced cell death and was able to revert glutamate-induced changes in HSP70 to a large extent. Furthermore, the analysis on the neuronal plasticity marker NCAM (Neural cell adhesion molecule) and its polysialylated form, PSA-NCAM revealed that ASH-WEX has therapeutic potential for prevention of neurodegeneration associated with glutamate-induced excitotoxicty

The architecture and effect of participation: a systematic review of community participation for communicable disease control and elimination. Implications for malaria elimination

Community engagement and participation has played a critical role in successful disease control and elimination campaigns in many countries. Despite this, its benefits for malaria control and elimination are yet to be fully realized. This may be due to a limited understanding of the influences on participation in developing countries as well as inadequate investment in infrastructure and resources to support sustainable community participation. This paper reports the findings of an atypical systematic review of 60 years of literature in order to arrive at a more comprehensive awareness of the constructs of participation for communicable disease control and elimination and provide guidance for the current malaria elimination campaign.Evidence derived from quantitative research was considered both independently and collectively with qualitative research papers and case reports. All papers included in the review were systematically coded using a pre-determined qualitative coding matrix that identified influences on community participation at the individual, household, community and government/civil society levels. Colour coding was also carried out to reflect the key primary health care period in which community participation programmes originated. These processes allowed exhaustive content analysis and synthesis of data in an attempt to realize conceptual development beyond that able to be achieved by individual empirical studies or case reports.Of the 60 papers meeting the selection criteria, only four studies attempted to determine the effect of community participation on disease transmission. Due to inherent differences in their design, interventions and outcome measures, results could not be compared. However, these studies showed statistically significant reductions in disease incidence or prevalence using various forms of community participation. The use of locally selected volunteers provided with adequate training, supervision and resources are common and important elements of the success of the interventions in these studies. In addition, qualitative synthesis of all 60 papers elucidates the complex architecture of community participation for communicable disease control and elimination which is presented herein.The current global malaria elimination campaign calls for a health systems strengthening approach to provide an enabling environment for programmes in developing countries. In order to realize the benefits of this approach it is vital to provide adequate investment in the 'people' component of health systems and understand the multi-level factors that influence their participation. The challenges of strengthening this component of health systems are discussed, as is the importance of ensuring that current global malaria elimination efforts do not derail renewed momentum towards the comprehensive primary health care approach. It is recommended that the application of the results of this systematic review be considered for other diseases of poverty in order to harmonize efforts at building 'competent communities' for communicable disease control and optimising health system effectiveness

The dominant Anopheles vectors of human malaria in the Asia-Pacific region: occurrence data, distribution maps and bionomic précis

<p>Abstract</p> <p>Background</p> <p>The final article in a series of three publications examining the global distribution of 41 dominant vector species (DVS) of malaria is presented here. The first publication examined the DVS from the Americas, with the second covering those species present in Africa, Europe and the Middle East. Here we discuss the 19 DVS of the Asian-Pacific region. This region experiences a high diversity of vector species, many occurring sympatrically, which, combined with the occurrence of a high number of species complexes and suspected species complexes, and behavioural plasticity of many of these major vectors, adds a level of entomological complexity not comparable elsewhere globally. To try and untangle the intricacy of the vectors of this region and to increase the effectiveness of vector control interventions, an understanding of the contemporary distribution of each species, combined with a synthesis of the current knowledge of their behaviour and ecology is needed.</p> <p>Results</p> <p>Expert opinion (EO) range maps, created with the most up-to-date expert knowledge of each DVS distribution, were combined with a contemporary database of occurrence data and a suite of open access, environmental and climatic variables. Using the Boosted Regression Tree (BRT) modelling method, distribution maps of each DVS were produced. The occurrence data were abstracted from the formal, published literature, plus other relevant sources, resulting in the collation of DVS occurrence at 10116 locations across 31 countries, of which 8853 were successfully geo-referenced and 7430 were resolved to spatial areas that could be included in the BRT model. A detailed summary of the information on the bionomics of each species and species complex is also presented.</p> <p>Conclusions</p> <p>This article concludes a project aimed to establish the contemporary global distribution of the DVS of malaria. The three articles produced are intended as a detailed reference for scientists continuing research into the aspects of taxonomy, biology and ecology relevant to species-specific vector control. This research is particularly relevant to help unravel the complicated taxonomic status, ecology and epidemiology of the vectors of the Asia-Pacific region. All the occurrence data, predictive maps and EO-shape files generated during the production of these publications will be made available in the public domain. We hope that this will encourage data sharing to improve future iterations of the distribution maps.</p

Counter-ions diffusion properties of silica embedded poly(perfluorosulfonic) acid membrane

To study the possibility of modifying diffusional-transport properties of the poly(perfluorosulfonic) acid (Nafion-117) membrane, the silica particles were incorporated in its matrix by in situ sol-gel method. The amount of silica incorporated in the membrane samples was varied by controlling the equilibrating time of the membrane sample in solution containing fixed proportion of precursor tetraethylorthosilicate (TEOS), methanol and water. The silica contents in the membrane samples were characterized by gravimetry, energy dispersive X-ray analysis (EDXRF) and transmission electron microscopy (TEM). Differential scanning calorimetry (DSC) studies showed that there were no significant difference in transition peak temperatures of both samples (Nafion-117 and Nafion/SiO(2)) in same ionic form except that enthalpies were increased in Nafion/SiO(2) samples in all the ionic forms. The increase in enthalpy was due to higher water content in Nafion/SiO(2) as compared to Nafion-117 in given ionic form as enthalpies normalized with water content of the respective membrane were comparable. The ion-exchange capacity, water uptake capacity and ion-exchange isotherms of the Na(+) + Cs(+) and Na(+) + Ba(2+) binary systems in silica embedded membrane samples were experimentally measured using appropriate radiotracers, and compared with that of pristine Nafion-117 membrane. The specific conductivities of the membrane samples with and without silica were studied in Na(+), Cs(+) and Ba(2+) ionic forms by electrochemical impedance spectroscopy (EIS). The self-diffusion coefficients of Na(+), Cs(+) and Ba(2+) ions in the Nafion/SiO(2) were measured by the radiotracer method. It was observed from the experimentally measured specific conductivities and self-diffusion coefficients data that diffusion mobility of Cs(+) and Ba(2+) counter-ions were enhanced significantly after incorporation of SiO(2) in the Nafion-117 matrix. Contrary to this, diffusion mobility of Na(+). counter-ion decreased in Nafion/SiO(2) sample. The selectivity of Cs(+) and Ba(2+) counter-ions was reduced in Nafion/SiO(2) sample with respect to pristine Nafion-117. (C) 2011 Elsevier B.V. All rights reserved

Tethered balloon-born and ground-based measurements of black carbon and particulate profiles within the lower troposphere during the foggy period in Delhi, India

The ground and vertical profiles of particulate matter (PM) were mapped as part of a pilot study using a Tethered balloon within the lower troposphere (1000 m) during the foggy episodes in the winter season of 2015–16 in New Delhi, India. Measurements of black carbon (BC) aerosol and PM < 2.5 and 10 μm (PM2.5 & PM10 respectively) concentrations and their associated particulate optical properties along with meteorological parameters were made. The mean concentrations of PM2.5, PM10, BC370 nm, and BC880 nm were observed to be 146.8 ± 42.1, 245.4 ± 65.4, 30.3 ± 12.2, and 24.1 ± 10.3 μg m− 3, respectively. The mean value of PM2.5 was ~ 12 times higher than the annual US-EPA air quality standard. The fraction of BC in PM2.5 that contributed to absorption in the shorter visible wavelengths (BC370 nm) was ~ 21%. Compared to clear days, the ground level mass concentrations of PM2.5 and BC370 nm particles were substantially increased (59% and 24%, respectively) during the foggy episode. The aerosol light extinction coefficient (σext) value was much higher (mean: 610 Mm− 1) during the lower visibility (foggy) condition. Higher concentrations of PM2.5 (89 μg m− 3) and longer visible wavelength absorbing BC880 nm (25.7 μg m− 3) particles were observed up to 200 m. The BC880 nm and PM2.5 aerosol concentrations near boundary layer (1 km) were significantly higher (~ 1.9 and 12 μg m− 3), respectively. The BC (i.e BCtot) aerosol direct radiative forcing (DRF) values were estimated at the top of the atmosphere (TOA), surface (SFC), and atmosphere (ATM) and its resultant forcing were - 75.5 Wm− 2 at SFC indicating the cooling effect at the surface. A positive value (20.9 Wm− 2) of BC aerosol DRF at TOA indicated the warming effect at the top of the atmosphere over the study region. The net DRF value due to BC aerosol was positive (96.4 Wm− 2) indicating a net warming effect in the atmosphere. The contribution of fossil and biomass fuels to the observed BC aerosol DRF values was ~ 78% and ~ 22%, respectively. The higher mean atmospheric heating rate (2.71 K day− 1) by BC aerosol in the winter season would probably strengthen the temperature inversion leading to poor dispersion and affecting the formation of clouds. Serious detrimental impacts on regional climate due to the high concentrations of BC and PM (especially PM2.5) aerosol are likely based on this study and suggest the need for immediate, stringent measures to improve the regional air quality in the northern India