Patient operated for an intraparenchymal brain tumor with serious lower limb weakness. The role of in-hospital physiotherapy

The aim of this case study is to present the role of hospital physiotherapy in a patient who was operated for an intraparenchymal brain tumor, from admission to intensive care unit until his discharge from hospital. Following acute surgical management, physiotherapy commenced and was devided in four phases:  1) Patient in ICU under mechanical support, 2) Patient in ICU without mechanical support, 3) Patient in step down unit, 4) Patient on the neurosurgical ward. During all phases of patient management, physiotherapy focused on daily assessment of respiratory and musculoskeletal function as well as the prevention and management of acute complications in intensive care unit and acquired physical impairments. Interventions included state of the art chest physiotherapy techniques as well as an early rehabilitation regimen from ICU to the step down unit and the ward. Significant improvements were noted before the patient was discharged, in respiratory function, muscle power and mobility. Planning and application of all physiotherapy techniques was in accordance to the most recent research evidence and clinical guidelines and contributed significantly to the patient’s overall clinical outcome

Adjacent LSTM-Based Page Scheduling for Hybrid DRAM/NVM Memory Systems

Recent advances in memory technologies have led to the rapid growth of hybrid systems that combine traditional DRAM and Non Volatile Memory (NVM) technologies, as the latter provide lower cost per byte, low leakage power and larger capacities than DRAM, while they can guarantee comparable access latency. Such kind of heterogeneous memory systems impose new challenges in terms of page placement and migration among the alternative technologies of the heterogeneous memory system. In this paper, we present a novel approach for efficient page placement on heterogeneous DRAM/NVM systems. We design an adjacent LSTM-based approach for page placement, which strongly relies on page accesses prediction, while sharing knowledge among pages with behavioral similarity. The proposed approach leads up to 65.5% optimized performance compared to existing approaches, while achieving near-optimal results and saving 20.2% energy consumption on average. Moreover, we propose a new page replacement policy, namely clustered-LRU, achieving up to 8.1% optimized performance, compared to the default Least Recently Used (LRU) policy

Το ενδομόσχευμα Anaconda στην ενδαγγειακή αποκατάσταση του ανευρύσματος της κοιλιακής αορτής: Συστηματική ανασκόπηση της βιβλιογραφίας και μετα-ανάλυση

Σκοπός. Σκοπός της παρούσας μελέτης είναι η συστηματική ανασκόπηση και μετα-ανάλυση των μελετών που αναφέρουν τη χρήση του ενδομοσχεύματος Anaconda στην EVAR σε ασθενείς με υπονεφρικό ΑΚΑ. Μέθοδος. Στις ηλεκτρονικές βάσεις δεδομένων έγινε αναζήτηση μελετών που συμπεριλαμβάνουν ασθενείς με υπονεφρικό ΑΚΑ που υποβλήθηκαν σε EVAR με το ενδομόσχευμα Anaconda από το 2000 και μεταγενέστερα και αναφέρουν τα δημογραφικά στοιχεία των ασθενών, τις συνοσηρότητές τους, την επιβίωση και τη θνητότητα αυτών καθώς και τη συχνότητα εμφάνισης επιπλοκών κατόπιν της EVAR. Τα δεδομένα συγκεντρώθηκαν σε πίνακες. Διενεργήθηκε στατιστική ανάλυση για κάθε υπό μελέτη παράγοντα ξεχωριστά. Αποτελέσματα. Από την αναζήτηση προέκυψαν 7 μελέτες παρατήρησης που πληρούσαν τα κριτήρια επιλογής, 5 προοπτικές και 2 αναδρομικές, με 954 ασθενείς συνολικά. Tο 91,9% των ασθενών είναι άνδρες και η μέση ηλικία του συνόλου των ασθενών είναι 73,38 έτη. Το 25,1% των ασθενών είναι καπνιστές και οι συνοσηρότητες εμφανίζονται με σειρά συχνότητας ως εξής: αρτηριακή υπέρταση (79,2%), δυσλιπιδαιμία (57,2%), στεφανιαία νόσος (31,1%), ΧΑΠ (24,4%), ΧΝΝ (16,9%) και σακχαρώδης διαβήτης (16,8%). Η μέση τιμή της μέγιστης εγκάρσιας διαμέτρου των ΑΚΑ των ασθενών είναι 56,8mm. Το μέσο χρονικό διάστημα μετεγχειρητικής παρακολούθησης των ασθενών κυμαίνεται στις μελέτες από 2 έως 6 έτη. Η συνολική θνητότητα κατά τον 1ο μήνα είναι 1,3%, ενώ η επιβίωση κατά το 1ο και 2ο έτος 95,8% και 91,3% αντίστοιχα. Το ποσοστό των θανάτων που συσχετίζονταν με το ΑΚΑ είναι 2,9%. Η συχνότητα εμφάνισης των ενδοδιαφυγών είναι: 2,4% για την τύπου Ia, 2,2% για την τύπου Ib, 18,1% για την τύπου II και 1% τόσο για την τύπου ΙΙΙ όσο και για την τύπου ΙV. Μετανάστευση ενδομοσχεύματος εμφάνισε το 2% των ασθενών και θρόμβωση αυτού εμφάνισε το 6,9% των ασθενών. Συμπέρασμα. Η χρήση του ενδομοσχεύματος Anaconda στην EVAR για την αντιμετώπιση των ασθενών με υπονεφρικό ΑΚΑ χαρακτηρίζεται από ικανοποιητικά αποτελέσματα και ασφάλεια. Περισσότερες μελέτες απαιτούνται στο μέλλον για τη δημιουργία μετα-αναλύσεων με μεγαλύτερο δείγμα πληθυσμού και την εξαγωγή ασφαλέστερων συμπερασμάτων.Purpose. The aim of this study is the systematic review and meta-analysis of studies regarding the use of Anaconda endograft in EVAR in patients with infrarenal AAA. Methods. We searched electronic databases for studies including patients with infrarenal AAA who were subjected to EVAR with Anaconda endograft after 2000 and mentioning patients’ characteristics, their comorbidities, survival, mortality and incidence of complications after EVAR. Data are collected in tables. Statistical analysis is conducted for each studied factor separately. Results. We selected 7 observational studies, 5 prospective and 2 retrospective ones, by following the inclusion criteria including 954 patients totally. 91.9% of the patients are male and mean age of all patients is 73.38 years. 25.1% of the patients are smokers and their comorbidities are present from the highest to the lowest incidence as following: arterial hypertension (79.2%), dyslipidemia (57.2%), coronary disease (31.1%), COPD (24.4%), CKD (16.9%) and diabetes mellitus (16.8%). The mean of largest transverse diameter of AAA of the patients is 56.8mm. Mean follow-up period postoperatively varies between the studies from 2 to 6 years. Total 1st month mortality is 1.3%, while 1st and 2nd year survivals are 95.8% και 91.3% respectively. The percentage of aneurysm-related deaths is 2.9%. The incidence of endoleaks is: 2.4% for Ia type, 2.2% for Ib type, 18.1% for type II and 1% for type ΙΙΙ and type ΙV. 2% of the patients presented endograft migration and 6.9% endograft thrombosis. Conclusion. The use of Anaconda endograft in EVAR in patients with infrarenal AAA presents satisfactory results and safety. Further studies with larger patient samples should be conducted in the future, so that more reliable results and conclusions could be reached

Accurate microRNA Target Prediction Using Detailed Binding Site Accessibility and Machine Learning on Proteomics Data

MicroRNAs (miRNAs) are a class of small regulatory genes regulating gene expression by targeting messenger RNA. Though computational methods for miRNA target prediction are the prevailing means to analyze their function, they still miss a large fraction of the targeted genes and additionally predict a large number of false positives. Here we introduce a novel algorithm called DIANA-microT-ANN which combines multiple novel target site features through an artificial neural network (ANN) and is trained using recently published high-throughput data measuring the change of protein levels after miRNA overexpression, providing positive and negative targeting examples. The features characterizing each miRNA recognition element include binding structure, conservation level, and a specific profile of structural accessibility. The ANN is trained to integrate the features of each recognition element along the 3′untranslated region into a targeting score, reproducing the relative repression fold change of the protein. Tested on two different sets the algorithm outperforms other widely used algorithms and also predicts a significant number of unique and reliable targets not predicted by the other methods. For 542 human miRNAs DIANA-microT-ANN predicts 120000 targets not provided by TargetScan 5.0. The algorithm is freely available at http://microrna.gr/microT-ANN

Therapeutic Applications of Neuromuscular Electrical Stimulation in Critical Care Patients

Neuromuscular Electrical Stimulation (NMES) is commonly used by physiotherapists for pain relief, stimulation of denervated or disused muscles, and the promotion of wound healing.  The purpose of this review is to discus the applications of NMES in Intensive Care Unit (ICU) patients according to the current research evidence. The first application is the neuromuscular electrical stimulation (NMES) in  ICU acquired weakness with research evidence indicating significant benefits such as preservation of  muscle mass, prevention of  polyneuromyopathy and improvement of muscle performance. Secondly, NMES has been proved to be effective in preventing pressure ulcers and accelerating wound healing through mechanisms which are clearly demonstrated by many experimental and clinical studies. However, very few studies have examined the effect of E.S. in pressure ulcers of long term hospitalized ICU patients. Lastly, NMES in ICU can be applied in the form of functional electrical stimulation (FES), a well known technique used to mobilize patients with permanent neurological deficits such as stroke and spinal cord injury. Current evidence in this area is reviewed and future research is proposed

The DIANA-mirExTra Web Server: From Gene Expression Data to MicroRNA Function

Background: High-throughput gene expression experiments are widely used to identify the role of genes involved in biological conditions of interest. MicroRNAs (miRNA) are regulatory molecules that have been functionally associated with several developmental programs and their deregulation with diverse diseases including cancer. Methodology/Principal Findings: Although miRNA expression levels may not be routinely measured in high-throughput experiments, a possible involvement of miRNAs in the deregulation of gene expression can be computationally predicted and quantified through analysis of overrepresented motifs in the deregulated genes 39 untranslated region (39UTR) sequences. Here, we introduce a user-friendly web-server, DIANA-mirExTra (www.microrna.gr/mirextra) that allows the comparison of frequencies of miRNA associated motifs between sets of genes that can lead to the identification of miRNAs responsible for the deregulation of large numbers of genes. To this end, we have investigated different approaches and measures, and have practically implemented them on experimental data. Conclusions/Significance: On several datasets of miRNA overexpression and repression experiments, our proposed approaches have successfully identified the deregulated miRNA. Beyond the prediction of miRNAs responsible for the deregulation of transcripts, the web-server provides extensive links to DIANA-mirPath, a functional analysis tool incorporating miRNA targets in biological pathways. Additionally, in case information about miRNA expression changes i