Massive pulmonary embolism – what you may be missing?

Our patient is a 68-year-old woman with no known comorbid illnesses, who presented with fever, cough and haemoptysis of 20-days duration. The fever was insidious in onset, intermittent, high grade and was associated with productive cough. There were intermittent episodes of scoughing up of blood-tinged sputum mixed with clots. She was evaluated at another centre and was diagnosed with a pulmonary embolism based on a computed tomographic imaging of the thorax. When she presentation to us, she was hemodynamically stable and her systemic examination was within normal limits. Her computed tomography (CT) scan were reviewed and she was labelled to have an intermediate risk pulmonary embolism. She was initiated on Injection enoxaparin and was simultaneously evaluated for the aetiology of her illness wherein an USG guided supraclavicular lymph node biopsy lead to a diagnosis of extrapulmonary tuberculosis. She was initiated on first line ATT and was discharged on the same. Anticoagulation was continued on discharge. She is currently doing well on follow up. Our objective is to shed light on the association between tuberculosis and pulmonary embolism and to emphasize the need for a thorough evaluation to identify an occult infective focus in patients presenting with venous thromboembolism

Ballistic Performance of Alumina and Zirconia-toughened Alumina Against 7.62 Armour Piercing Projectile

A study was carried out to compare the ballistic performance of high purity alumina and zirconia-toughened alumina (ZTA) using depth of penetration (DoP) test configuration against 7.62 mm armour piercing (AP) ammunition. The effect of tile thickness on the differential efficiency factor (DEF) was studied for tile thickness in the range of 3 mm to 6 mm for alumina tiles and 3 mm to 5 mm for ZTA tiles. The DEF is found to increase as tile thickness increases. An analysis on the failed shots showed that the residual shot weight does not follow a single linear relationship with ceramic tile thickness unlike the residual DoP for all thicknesses of tiles. Post-ballistic analysis on ceramic powder for particle size distribution was carried out and the results are presented.Defence Science Journal, Vol. 64, No. 5, September 2014, pp.477-483, DOI:http://dx.doi.org/10.14429/dsj.64.674

Counting reducible, powerful, and relatively irreducible multivariate polynomials over finite fields

We present counting methods for some special classes of multivariate polynomials over a finite field, namely the reducible ones, the s-powerful ones (divisible by the s-th power of a nonconstant polynomial), and the relatively irreducible ones (irreducible but reducible over an extension field). One approach employs generating functions, another one uses a combinatorial method. They yield exact formulas and approximations with relative errors that essentially decrease exponentially in the input size.Comment: to appear in SIAM Journal on Discrete Mathematic

Utility and lower limits of frequency detection in surface electrode stimulation for somatosensory brain-computer interface in humans

Objective: Stimulation of the primary somatosensory cortex (S1) has been successful in evoking artificial somatosensation in both humans and animals, but much is unknown about the optimal stimulation parameters needed to generate robust percepts of somatosensation. In this study, the authors investigated frequency as an adjustable stimulation parameter for artificial somatosensation in a closed-loop brain-computer interface (BCI) system. Methods: Three epilepsy patients with subdural mini-electrocorticography grids over the hand area of S1 were asked to compare the percepts elicited with different stimulation frequencies. Amplitude, pulse width, and duration were held constant across all trials. In each trial, subjects experienced 2 stimuli and reported which they thought was given at a higher stimulation frequency. Two paradigms were used: first, 50 versus 100 Hz to establish the utility of comparing frequencies, and then 2, 5, 10, 20, 50, or 100 Hz were pseudorandomly compared. Results: As the magnitude of the stimulation frequency was increased, subjects described percepts that were “more intense” or “faster.” Cumulatively, the participants achieved 98.0% accuracy when comparing stimulation at 50 and 100 Hz. In the second paradigm, the corresponding overall accuracy was 73.3%. If both tested frequencies were less than or equal to 10 Hz, accuracy was 41.7% and increased to 79.4% when one frequency was greater than 10 Hz (p = 0.01). When both stimulation frequencies were 20 Hz or less, accuracy was 40.7% compared with 91.7% when one frequency was greater than 20 Hz (p < 0.001). Accuracy was 85% in trials in which 50 Hz was the higher stimulation frequency. Therefore, the lower limit of detection occurred at 20 Hz, and accuracy decreased significantly when lower frequencies were tested. In trials testing 10 Hz versus 20 Hz, accuracy was 16.7% compared with 85.7% in trials testing 20 Hz versus 50 Hz (p < 0.05). Accuracy was greater than chance at frequency differences greater than or equal to 30 Hz. Conclusions: Frequencies greater than 20 Hz may be used as an adjustable parameter to elicit distinguishable percepts. These findings may be useful in informing the settings and the degrees of freedom achievable in future BCI systems

Comparative study between proximal femoral nail and proximal femoral nail antirotation in management of unstable trochanteric fractures

Background: In the management of peri-trochanteric fractures, intramedullary (IM) devices have proven advantage over extramedullary devices. IM devices allow for stable anatomical fixation of more comminuted fractures without shortening the abductor lever arm or changing the proximal femoral anatomy. Between IM devices like proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA), the helical blade of latter is believed to provide stability, compression and rotational control of the fracture with higher cut out strength. The following study was undertaken in an attempt to compare these two types of Intra-medullary devices.Methods: Between January 2012 and June 2013, 50 patients with unstable intertrochanteric fractures fulfilling inclusion and exclusion criteria, were randomized into 2 groups to undergo CRIF with either standard PFN (n=25) or PFNA (n=25). They were compared in terms of demography, per-operative variables and postoperative parameters including functional evaluation till 1year postoperatively.Results: Background demographic variables, fracture type and pre-injury ambulatory status were comparable between the groups. Operative duration of surgery, amount of blood loss and number of fluoroscopic images were significantly lower in PFNA group as compared to PFN group. Post op complications like infection, non-union, cut out/z-effect, loss of reduction, re-operation and mortality rates didn’t differ significantly between the groups. Post op functional recovery as evaluated by pain, use of walking aids and Harris hip scores were similar in both groups. Conclusions: PFNA significantly reduces the operative time, amount of blood loss and fluoroscopic imaging as compared to PFN. However PFNA offers no significant benefits over PFN in terms of post-operative functional recovery or complications

Raman Scattering Study of Ba-doped C60 with t1g States

Raman spectra are reported for Ba doped fullerides, BaxC60(x=3,4,and 6). The lowest frequency Hg modes split into five components for Ba4C60 and Ba6C60 even at room temperature, allowing us a quantitative analysis based on the electron-phonon couping theory. For the superconducting Ba4C60, the density of states at the Fermi energy was derived as 7 eV-1, while the total value of electron-phonon coupling \lambda was found to be 1.0, which is comparable to that of K3C60. The tangential Ag(2) mode, which is known as a sensitive probe for the degree of charge transfer on C60 molecule, shows a remarkable shift depending on the Ba concentration, being roughly consistent with the full charge transfer from Ba to C60. An effect of hybridization between Ba and C60 \pi orbitals is also discussed.Comment: 15 pages, 6 figures submitted to Phys. Rev. B (December 1,1998

Neuronal expression in Drosophila of an evolutionarily conserved metallophosphodiesterase reveals pleiotropic roles in longevity and odorant response

Evolutionarily conserved genes often play critical roles in organismal physiology. Here, we describe multiple roles of a previously uncharacterized Class III metallophosphodiesterase in Drosophila, an ortholog of the MPPED1 and MPPED2 proteins expressed in the mammalian brain. dMpped, the product of CG16717, hydrolyzed phosphodiester substrates including cAMP and cGMP in a metal-dependent manner. dMpped is expressed during development and in the adult fly. RNA-seq analysis of dMppedKO flies revealed misregulation of innate immune pathways. dMppedKO flies showed a reduced lifespan, which could be restored in Dredd hypomorphs, indicating that excessive production of antimicrobial peptides contributed to reduced longevity. Elevated levels of cAMP and cGMP in the brain of dMppedKO flies was restored on neuronal expression of dMpped, with a concomitant reduction in levels of antimicrobial peptides and restoration of normal life span. We observed that dMpped is expressed in the antennal lobe in the fly brain. dMppedKO flies showed defective specific attractant perception and desiccation sensitivity, correlated with the overexpression of Obp28 and Obp59 in knock-out flies. Importantly, neuronal expression of mammalian MPPED2 restored lifespan in dMppedKO flies. This is the first description of the pleiotropic roles of an evolutionarily conserved metallophosphodiesterase that may moonlight in diverse signaling pathways in an organism

Utility and lower limits of frequency detection in surface electrode stimulation for somatosensory brain-computer interface in humans

Objective: Stimulation of the primary somatosensory cortex (S1) has been successful in evoking artificial somatosensation in both humans and animals, but much is unknown about the optimal stimulation parameters needed to generate robust percepts of somatosensation. In this study, the authors investigated frequency as an adjustable stimulation parameter for artificial somatosensation in a closed-loop brain-computer interface (BCI) system. Methods: Three epilepsy patients with subdural mini-electrocorticography grids over the hand area of S1 were asked to compare the percepts elicited with different stimulation frequencies. Amplitude, pulse width, and duration were held constant across all trials. In each trial, subjects experienced 2 stimuli and reported which they thought was given at a higher stimulation frequency. Two paradigms were used: first, 50 versus 100 Hz to establish the utility of comparing frequencies, and then 2, 5, 10, 20, 50, or 100 Hz were pseudorandomly compared. Results: As the magnitude of the stimulation frequency was increased, subjects described percepts that were “more intense” or “faster.” Cumulatively, the participants achieved 98.0% accuracy when comparing stimulation at 50 and 100 Hz. In the second paradigm, the corresponding overall accuracy was 73.3%. If both tested frequencies were less than or equal to 10 Hz, accuracy was 41.7% and increased to 79.4% when one frequency was greater than 10 Hz (p = 0.01). When both stimulation frequencies were 20 Hz or less, accuracy was 40.7% compared with 91.7% when one frequency was greater than 20 Hz (p < 0.001). Accuracy was 85% in trials in which 50 Hz was the higher stimulation frequency. Therefore, the lower limit of detection occurred at 20 Hz, and accuracy decreased significantly when lower frequencies were tested. In trials testing 10 Hz versus 20 Hz, accuracy was 16.7% compared with 85.7% in trials testing 20 Hz versus 50 Hz (p < 0.05). Accuracy was greater than chance at frequency differences greater than or equal to 30 Hz. Conclusions: Frequencies greater than 20 Hz may be used as an adjustable parameter to elicit distinguishable percepts. These findings may be useful in informing the settings and the degrees of freedom achievable in future BCI systems