Characterization of slow and fast phase nystagmus

A current literature review of the analog and digital process of vestibular and optical kinetic nystagmus reveals little agreement in the methods used by various labs. The strategies for detection of saccade (fast phase velocity component of nystagmus) vary between labs, and most of the process have not been evaluated and validated with a standard database. A survey was made of major vestibular labs in the U.S. that perform computer analyses of vestibular and optokinetic reflexes to stimuli, and a baseline was established from which to standardize data acquisition and analysis programs. The concept of an Error Index was employed as the criterium for evaluating the performance of the vestibular analysis software programs. The performance criterium is based on the detection of saccades and is the average of the percentages of missed detections and false detections. Evaluation of the programs produced results for lateral gaze with saccadic amplitude of one, two, three, five, and ten degrees with various signal-to-noise ratios. In addition, results were obtained for sinusoidal pursuit of 0.05, 0.10, and 0.50 Hz with saccades from one to ten degrees at various signal-to-noise ratios. Selection of the best program was made from the performance in the lateral gaze with three degrees of saccadic amplitude and in the 0.10 Hz sinusoid with three degrees of saccadic amplitude

Patient reported outcome measures in child and adolescent mental health services: associations between clinician demographic characteristics, attitudes and efficacy

BACKGROUND: Policy recommends using patient reported outcome measures (PROMs), yet their use is persistently low. Our aim was to examine the association between PROM use and clinician demographic characteristics, attitudes and efficacy. METHOD: A sample of N = 109 clinicians completed an online survey. RESULTS: Clinicians who reported higher levels of use of cognitive behaviour or humanistic approaches had higher levels of PROM use than clinicians who reported lower levels of use of these approaches. Clinicians who reported having received training had higher levels of self-efficacy regarding PROMs than clinicians who reported not having received training, but the effects of training on PROM attitudes and use were not significant. Still, clinicians with more positive attitudes or self-efficacy regarding PROMs had higher levels of PROM use than clinicians with less positive attitudes or self-efficacy regarding PROMs. CONCLUSION: Clinicians should be supported to have the knowledge, skills and confidence to effectively use PROMs in their clinical practice

A rare combination of an endocrine tumour of the common bile duct and a follicular lymphoma of the ampulla of Vater: a case report and review of the literature

Carcinoid tumours of the common bile duct represent an extremely rare entity. Similarly, primary follicular lymphomas of the ampulla of Vater constitute an infrequent neoplasia. Herein, we report the first case of a synchronous development of a carcinoid tumour of the common bile duct and an ampullary follicular lymphoma that was treated surgically with a Whipple's procedure, due to inability to establish definitive preoperative diagnosis despite the extensive diagnostic investigation

Inflammatory markers in depression: a meta-analysis of mean differences and variability in 5,166 patients and 5,083 controls

Importance The magnitude and variability of cytokine alterations in depression are not clear. Objective To perform an up to date meta-analysis of mean differences of immune markers in depression, and to quantify and test for evidence of heterogeneity in immune markers in depression by conducting a meta-analysis of variability to ascertain whether only a sub-group of patients with depression show evidence of inflammation. Data Sources Studies that reported immune marker levels in peripheral blood in patients with depression and matched healthy controls in the MEDLINE database from inception to August 29th 2018 were examined. Study Selection Case-control studies that reported immune marker levels in peripheral blood in patients with depression and healthy controls were selected. Data Extraction and Synthesis Means and variances (SDs) were extracted for each measure to calculate effect sizes, which were combined using multivariate meta-analysis. Main Outcomes and Measures Hedges g was used to quantify mean differences. Relative variability of immune marker measurements in patients compared with control groups as indexed by the coefficient of variation ratio (CVR). Results A total of 107 studies that reported measurements from 5,166 patients with depression and 5,083 controls were included in the analyses. Levels of CRP (g=0.71; 95%CI: 0.50-0.92; p<0.0001); IL-3 (g=0.60; 95%CI: 0.31-0.89; p<0.0001); IL-6 (g=0.61; 95%CI: 0.39-0.82; p<0.0001); IL-12 (g=1.18; 95%CI: 0.74-1.62; p<0.0001); IL-18 (g=1.97; 95%CI: 1.00-2.95; p<0.0001); sIL-2R (g=0.71; 95%CI: 0.44-0.98; p<0.0001); and TNFα (g=0.54; 95%CI: 0.32-0.76; p<0.0001) were significantly higher in patients with depression. These findings were robust to a range of potential confounds and moderators. Mean-scaled variability, measured as CVR, was significantly lower in patients with depression for CRP (CVR=0.85; 95%CI: 0.75-0.98; p=0.02); IL-12 (CVR=0.61; 95%CI: 0.46-0.80; p<0.01); and sIL-2R (CVR=0.85; 95%CI: 0.73-0.99; p=0.04), while it was unchanged for IL-3, IL-6, IL-18, and TNF α. Conclusions and Relevance Acute depression is confirmed as a pro-inflammatory state. Some of the inflammatory markers elevated in depression, including CRP and IL-12, show reduced variability in patients with depression, therefore supporting greater homogeneity in terms of an inflammatory phenotype in depression. Some inflammatory marker elevations in depression do not appear due to an inflamed sub-group, but rather to a right shift of the immune marker distribution

A Close Nuclear Black Hole Pair in the Spiral Galaxy NGC 3393

The current picture of galaxy evolution advocates co-evolution of galaxies and their nuclear massive black holes (MBHs), through accretion and merging. Quasar pairs (6,000-300,000 light-years separation) exemplify the first stages of this gravitational interaction. The final stages, through binary MBHs and final collapse with gravitational wave emission, are consistent with the sub-light-year separation MBHs inferred from optical spectra and light-variability of two quasars. The double active nuclei of few nearby galaxies with disrupted morphology and intense star formation (e.g., NGC 6240 and Mkn 463; ~2,400 and ~12,000 light-years separation respectively) demonstrate the importance of major mergers of equal mass spirals in this evolution, leading to an elliptical galaxy, as in the case of the double radio nucleus (~15 light-years separation) elliptical 0402+379. Minor mergers of galaxies with a smaller companion should be a more common occurrence, evolving into spiral galaxies with active MBH pairs, but have hitherto not been seen. Here we report the presence of two active MBHs, separated by ~430 light-years, in the Seyfert galaxy NGC 3393. The regular spiral morphology and predominantly old circum-nuclear stellar population of this galaxy, and the closeness of the MBHs embedded in the bulge, suggest the result of minor merger evolution.Comment: Preprint (not final) version of a paper to appear in Natur

Advances in imaging chest tuberculosis: blurring of differences between children and adults

This article reviews the ongoing role of imaging in the diagnosis of tuberculosis (TB) and its complications. A modern imaging classification of TB, taking into account both adults and children and the blurring of differences in the presentation patterns, must be absorbed into daily practice. Clinicians must not only be familiar with imaging features of TB but also become expert at detecting these when radiologists are unavailable. Communication between radiologists and clinicians with regard to local constraints, patterns of disease, human immunodeficiency virus (HIV) coinfection rates, and imaging parameters relevant for management (especially in drug resistance programs) is paramount for making an impact with imaging, and preserving clinician confidence. Recognition of special imaging, anatomic and vulnerability differences between children and adults is more important than trying to define patterns of disease exclusive to children

INTEGRAL/IBIS 7-year All-Sky Hard X-Ray Survey. Part II: Catalog of Sources

This paper is the second in a series devoted to the hard X-ray (17-60 keV) whole sky survey performed by the INTEGRAL observatory over seven years. Here we present a catalog of detected sources which includes 521 objects, 449 of which exceed a 5 sigma detection threshold on the time-averaged map of the sky, and 53 were detected in various subsamples of exposures. Among the identified sources with known and suspected nature, 262 are Galactic (101 low-mass X-ray binaries, 95 high-mass X-ray binaries, 36 cataclysmic variables, and 30 of other types) and 219 are extragalactic, including 214 active galactic nuclei (AGNs), 4 galaxy clusters, and galaxy ESO 389-G 002. The extragalactic (|b|>5 deg) and Galactic (|b|<5 deg) persistently detected source samples are of high identification completeness (respectively ~96% and ~94%) and valuable for population studies.Comment: 17 pages, 2 figures, accepted for publication in Astronomy and Astrophysic

Does Oil Price Volatility Matter for Asian Emerging Economies?

This article investigates the impact of oil price volatility on six major emerging economies in Asia using time-series cross-section and time-series econometric techniques. To assess the robustness of the findings, we further implement such heterogeneous panel data estimation methods as Mean Group (MG), Common Correlated Effects Mean Group (CCEMG) and Augmented Mean Group (AMG) estimators to allow for cross-sectional dependence. The empirical results reveal that oil price volatility has a detrimental effect on these emerging economies. In the short run, oil price volatility influenced output growth in China and affected both GDP growth and inflation in India. In the Philippines, oil price volatility impacted on inflation, but in Indonesia, it impacted on both GDP growth and inflation before and after the Asian financial crisis. In Malaysia, oil price volatility impacted on GDP growth, although there is notably little feedback from the opposite side. For Thailand, oil price volatility influenced output growth prior to the Asian financial crisis, but the impact disappeared after the crisis. It appears that oil subsidization by the Thai Government via introduction of the oil fund played a significant role in improving the economic performance by lessening the adverse effects of oil price volatility on macroeconomic indicators

L-Met Activates Arabidopsis GLR Ca2+ Channels Upstream of ROS Production and Regulates Stomatal Movement

Plant glutamate receptor homologs (GLRs) have long been proposed to function as ligand-gated Ca2+ channels, but no in planta evidence has been provided. Here, we present genetic evidence that Arabidopsis GLR3.1 and GLR3.5 form Ca2+ channels activated by L-methionine (L-Met) at physiological concentrations and regulate stomatal apertures and plant growth. The glr3.1/3.5 mutations resulted in a lower cytosolic Ca2+ level, defective Ca2+-induced stomatal closure, and Ca2+-deficient growth disorder, all of which involved L-Met. Patch-clamp analyses of guard cells showed that GLR3.1/3.5 Ca2+ channels are activated specifically by L-Met, with the activation abolished in glr3.1/3.5. Moreover, GLR3.1/3.5 Ca2+ channels are distinct from previously characterized ROS-activated Ca2+ channels and act upstream of ROS, providing Ca2+ transients necessary for the activation of NADPH oxidases. Our data indicate that GLR3.1/3.5 constitute L-Met-activated Ca2+ channels responsible for maintaining basal [Ca2+]cyt, play a pivotal role in plant growth, and act upstream of ROS, thereby regulating stomatal aperture. © 2016 Institute for Basic Science / DGIST1