The Royal Free Hospital score: a calibrated prognostic model for patients with cirrhosis admitted to intensive care unit. Comparison with current models and CLIF-SOFA score

Prognosis for patients with cirrhosis admitted to intensive care unit (ICU) is poor. ICU prognostic models are more accurate than liver-specific models. We identified predictors of mortality, developed a novel prognostic score (Royal Free Hospital (RFH) score), and tested it against established prognostic models and the yet unvalidated Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) model

Solving kk-means on High-dimensional Big Data

In recent years, there have been major efforts to develop data stream algorithms that process inputs in one pass over the data with little memory requirement. For the $k$-means problem, this has led to the development of several $(1+\varepsilon)$-approximations (under the assumption that $k$ is a constant), but also to the design of algorithms that are extremely fast in practice and compute solutions of high accuracy. However, when not only the length of the stream is high but also the dimensionality of the input points, then current methods reach their limits. We propose two algorithms, piecy and piecy-mr that are based on the recently developed data stream algorithm BICO that can process high dimensional data in one pass and output a solution of high quality. While piecy is suited for high dimensional data with a medium number of points, piecy-mr is meant for high dimensional data that comes in a very long stream. We provide an extensive experimental study to evaluate piecy and piecy-mr that shows the strength of the new algorithms.Comment: 23 pages, 9 figures, published at the 14th International Symposium on Experimental Algorithms - SEA 201

Catalytic decomposition of 2-chlorophenol using an ultrasonic-assisted Fe3O4-TiO2@MWCNT system: Influence factors, pathway and mechanism study.

As a reusable sonocatalyst, magnetically separable Fe3O4-TiO2@MWCNT (FMT) was synthesized by an ultrasound-assisted wet impregnation method and was evaluated in the removal of 2-chlorophenol (2CP). Physical and chemical properties of the catalyst composite materials were investigated by all catalysts were systematically characterized using Transmission Electron Microscopy (TEM), X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), X-ray Photoelectron Spectroscopy (XPS), Energy Dispersive X-ray Analysis (EDX), Dynamic light scattering (DLS), and N2-physisorption. The efficiency and kinetics of 2CP removal by FMT-assisted sonocatalysis (FMT-US) was systematically investigated under various operational parameters i.e. pH, FMT and 2CP concentration, temperature and ultrasonic power. The results indicated that 0.4gL-1 FMT dosage, pH 5, temperature of 35°C as well as 50 w ultrasound power are the most favorable conditions for the degradation of the 2CP. Furthermore, both of the superoxide and hydroxyl radicals were produced in the reaction, however, superoxide radicals were assumed to be the dominating reactive species for the 2CP degradation, according to the scavenging tests and electron paramagnetic resonance tests. Moreover, the FMT catalyst exhibited a high reusability and stability in the US/FMT system during the five repetitive experiments. The intermediate products were identified by GC-MS, thereby a possible degradation pathway is proposed. The chemical oxygen demand (COD) and corresponding total organic carbon (TOC) removal efficiencies were 64.9% and 56.7%, respectively. Finally, toxicity tests showed that the toxicity of the solution increased during the first 5min and then decreased significantly with the progress of the oxidation. The mechanisms of ultrasound irritation enhanced FMT activation were also proposed. Copyright © 2017 Elsevier Inc. All rights reserved

Bio-Ecology of the Louse, Upupicola upupae, Infesting the Common Hoopoe, Upupa epops

The population characteristics of the louse, Upupicola upupae (Shrank) (Mallophaga: Philopteridae: Ishnocera), infesting the Common Hoopae, Upupa epops L. (Aves: Upupiformes), were recorded during 2007–08 in District Rampur, Uttar Pradesh India. The pattern of frequency distribution of the louse conformed to the negative binomial model. The lice and its nits were reared in vitro at 35 ± 1° C, 75–82 % RH, on a feather diet. The data obtained was used to construct the life table and to determine the intrinsic rate of natural increase (0.035 female/day), the net reproductive rate was 3.67 female eggs/female, the generation time was 37 days, and the doubling time of the population was 19 days. The chaetotaxy of the three nymphal instars has also been noted to record their diagnostic characteristics. Information on egg morphology and antennal sensilla is also presented

Clinical and Genomic Profile of Primary Cranial Neurolymphomatosis

Emily B Wolf,1 Robin Imperial,1 Liuyan Jiang,2 Amit K Agarwal,3 Han W Tun1 1Division of Hematology and Medical Oncology, Mayo Clinic Florida, Jacksonville, FL, USA; 2Department of Laboratory Medicine and Pathology, Mayo Clinic Florida, Jacksonville, FL, USA; 3Department of Radiology, Mayo Clinic Florida, Jacksonville, FL, USACorrespondence: Han W Tun, Division of Hematology and Medical Oncology, Mayo Clinic Florida, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA, Email [email protected]: Primary cranial neurolymphomatosis (PCNL) is a rare subtype of primary CNS lymphoma (PCNSL) in which infiltrative lymphomatous involvement is confined to cranial nerves. Here, we report a case of PCNL with successful genomic profiling. A 57-year-old male had a lengthy prediagnostic phase spanning approximately 30 months, characterized by multiple episodes of cranial neuropathies managed by steroids. At the time of diagnosis, the patient had right-sided cranial neuropathies involving cranial nerves (CN) V, VI, and VII. Pathological findings of the right cavernous lesion biopsy were consistent with large B-cell lymphoma-infiltrating nerve fibers. The clinical course was aggressive and refractory, characterized by relentless progression with the development of cervical spinal neurolymphomatosis, cerebrospinal fluid involvement, and ependymal and intraparenchymal cerebral involvement, despite multiple lines of therapy, including chemoimmunotherapy, Bruton’s tyrosine kinase inhibitor, radiation, autologous stem cell transplant, chimeric antigen receptor T-cell therapy (CAR-T), and whole-brain radiation. The patient survived for 22 months from the time of the initial diagnosis and 52 months after the first episode of cranial neuropathy. Next-generation sequencing identified mutations (MYD88, CD79b, and PIM1) that are frequently observed in PCNSL. The unusual findings included a total of 22 mutations involving PIM1, indicating a highly active aberrant somatic hypermutation and two missense CXCR4 mutations. CXCR4 mutations have never been described in PCNSL and may have implications for disease biology and therapeutic interventions. We provide a literature review to further elucidate PCNL.Keywords: DLBCL, cranial nerve, autologous stem cell transplant, CAR-T cell therapy, next generation sequencin

Structural Causes of Right Bundle Branch Block—Time for a Closer Look?

Right bundle branch block is an electrocardiographic phenomenon with specific criteria

What is in Name?

abstract An interesting and rare case of name syndrome is reported here. A young patient presented with stroke (left side hemiperesis due to cardiac embolic stroke) and cutaneous lesions. Further investigations revealed that left atrial myxoma was the cause of cardioembolic stroke. skin lesions were also present which included, nevi, ephelides and neurofibroma hence diagnosis of "NAME sYNDROME" was made

New variants of Perfect Non-crossing Matchings

Given a set of points in the plane, we are interested in matching them with straight line segments. We focus on perfect (all points are matched) non-crossing (no two edges intersect) matchings. Apart from the well known MinMax variation, where the length of the longest edge is minimized, we extend work by looking into different optimization variants such as MaxMin, MinMin, and MaxMax. We consider both the monochromatic and bichromatic versions of these problems and by employing diverse techniques we provide efficient algorithms for various input point configurations

Hexose-6-phosphate Dehydrogenase Modulates 11β-Hydroxysteroid Dehydrogenase Type 1-Dependent Metabolism of 7-keto- and 7β-hydroxy-neurosteroids

BACKGROUND: The role of 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) in the regulation of energy metabolism and immune system by locally reactivating glucocorticoids has been extensively studied. Experiments determining initial rates of enzyme activity revealed that 11beta-HSD1 can catalyze both the reductase and the dehydrogenase reaction in cell lysates, whereas it predominantly catalyzes the reduction of cortisone to cortisol in intact cells that also express hexose-6-phosphate dehydrogenase (H6PDH), which provides cofactor NADPH. Besides its role in glucocorticoid metabolism, there is evidence that 11beta-HSD1 is involved in the metabolism of 7-keto- and 7-hydroxy-steroids; however the impact of H6PDH on this alternative function of 11beta-HSD1 has not been assessed. METHODOLOGY: We investigated the 11beta-HSD1-dependent metabolism of the neurosteroids 7-keto-, 7alpha-hydroxy- and 7beta-hydroxy-dehydroepiandrosterone (DHEA) and 7-keto- and 7beta-hydroxy-pregnenolone, respectively, in the absence or presence of H6PDH in intact cells. 3D-structural modeling was applied to study the binding of ligands in 11beta-HSD1. PRINCIPAL FINDINGS: We demonstrated that 11beta-HSD1 functions in a reversible way and efficiently catalyzed the interconversion of these 7-keto- and 7-hydroxy-neurosteroids in intact cells. In the presence of H6PDH, 11beta-HSD1 predominantly converted 7-keto-DHEA and 7-ketopregnenolone into their corresponding 7beta-hydroxy metabolites, indicating a role for H6PDH and 11beta-HSD1 in the local generation of 7beta-hydroxy-neurosteroids. 3D-structural modeling offered an explanation for the preferred formation of 7beta-hydroxy-neurosteroids. CONCLUSIONS: Our results from experiments determining the steady state concentrations of glucocorticoids or 7-oxygenated neurosteroids suggested that the equilibrium between cortisone and cortisol and between 7-keto- and 7-hydroxy-neurosteroids is regulated by 11beta-HSD1 and greatly depends on the coexpression with H6PDH. Thus, the impact of H6PDH on 11beta-HSD1 activity has to be considered for understanding both glucocorticoid and neurosteroid action in different tissues