Confusion and Slurred Speech in a 34-Year-Old Woman from India

A 34-year-old woman from India, presented with episodes of confusion and progressive speech deterioration. She also had a painless neck “lump”, which persisted despite antibiotics. She was diagnosed to have a space occupying lesion in the left parietal lobe, which was subsequently biopsied

A novel anomaly behavior detection scheme for mobile ad hoc networks

To sustain the security services in a Mobile Ad Hoc Networks (MANET), applications in terms of confidentially, authentication, integrity, authorization, key management, and abnormal behavior detection/anomaly detection are significant. The implementation of a sophisticated security mechanism requires a large number of network resources that degrade network performance. In addition, routing protocols designed for MANETs should be energy efficient in order to maximize network performance. In line with this view, this work proposes a new hybrid method called the data-driven zone-based routing protocol (DD-ZRP) for resource-constrained MANETs that incorporate anomaly detection schemes for security and energy awareness using Network Simulator 3. Most of the existing schemes use constant threshold values, which leads to false positive issues in the network. DD-ZRP uses a dynamic threshold to detect anomalies in MANETs. The simulation results show an improved detection ratio and performance for DD-ZRP over existing schemes; the method is substantially better than the prevailing protocols with respect to anomaly detection for security enhancement, energy efficiency, and optimization of available resources

Characterizing RNA Dynamics at Atomic Resolution Using Solution-state NMR Spectroscopy

Many recently discovered non-coding RNAs do not fold into a single native conformation, but rather, sample many different conformations along their free energy landscape to carry out their biological function. Unprecedented insights into the RNA dynamic structure landscape are provided by solution-state NMR techniques that measure the structural, kinetic, and thermodynamic characteristics of motions spanning picosecond to second timescales at atomic resolution. From these studies a basic description of the RNA dynamic structure landscape is emerging, bringing new insights into how RNA structures change to carry out their function as well as applications in RNA-targeted drug discovery and RNA bioengineering

Expression Profile of MicroRNAs in Epstein-Barr Virus-Infected AGS Gastric Carcinoma Cells

Latent infection with Epstein-Barr virus (EBV) is responsible for multiple types of malignancies, including 10% of all gastric carcinomas. The microRNA (miRNA) expression in several EBV-infected AGS gastric carcinoma cell lines was determined. Infected cells expressed the viral BamHI A rightward transcript (BART) miRNAs at high levels and had consistently decreased expression of a small fraction of cellular miRNAs with specific downregulation of tumor suppressor miRNAs. These changes likely reflect expression of the viral noncoding RNAs and not latent protein expression

Effects of Two Different Catheter Ablation Techniques on Spectral Characteristics of Atrial Fibrillation

ObjectivesThe aim of this study was to determine the effects of circumferential pulmonary vein ablation (CPVA) and electrogram-guided ablation (EGA) on the spectral characteristics of atrial fibrillation (AF) and the relationship between changes in dominant frequency (DF) and clinical outcome.BackgroundCircumferential pulmonary vein ablation and EGA have been used to eliminate AF. Spectral analysis may identify high-frequency sources.MethodsIn 84 consecutive patients, CPVA (n = 42) or EGA (n = 42) was performed for paroxysmal (n = 49) or persistent (n = 35) AF. During EGA, complex electrograms were targeted. Lead V1and electrograms from the left atrium and coronary sinus were analyzed to determine the DF of AF before and after ablation.ResultsThe left atrial DF was higher in persistent (5.83 ± 0.86 Hz) than paroxysmal AF (5.33 ± 0.76 Hz, p = 0.03). There was a frequency gradient from the left atrium to the coronary sinus (p = 0.02). Circumferential pulmonary vein ablation and EGA resulted in a similar decrease in DF (18 ± 17% vs. 17 ± 15%, p = 0.8). During a mean follow-up of 9 ± 6 months, the change in DF after CPVA was similar among patients with and without recurrent AF. An acute decrease in DF after EGA was associated with freedom from recurrent AF only in patients with persistent AF (19 ± 14% vs. 3 ± 6%, p = 0.02).ConclusionsBoth CPVA and EGA decrease the DF of AF, consistent with elimination of high-frequency sources. Whereas the efficacy of EGA is associated with a decrease in DF in patients with persistent AF, the efficacy of CPVA is independent of changes in DF. This suggests that CPVA and EGA eliminate different mechanisms in the genesis of persistent AF

Progressive hypertension and severe left ventricular outflow tract obstruction

No abstract available

The global impact of tobacco control policies on smokeless tobacco use: a systematic review

BACKGROUND: Smokeless tobacco, used by more than 300 million people globally, results in substantial morbidity and mortality. For smokeless tobacco control, many countries have adopted policies beyond the WHO Framework Convention on Tobacco Control, which has been instrumental in reducing smoking prevalence. The impact of these policies (within and outside the Framework Convention on Tobacco Control) on smokeless tobacco use remains unclear. We aimed to systematically review policies that are relevant to smokeless tobacco and its context and investigate their impact on smokeless tobacco use. METHODS: In this systematic review, we searched 11 electronic databases and grey literature between Jan 1, 2005, and Sept 20, 2021, in English and key south Asian languages, to summarise smokeless tobacco policies and their impact. Inclusion criteria were all types of studies on smokeless tobacco users that mentioned any smokeless tobacco relevant policies since 2005, except systematic reviews. Policies issued by organisations or private institutions were excluded as well as studies on e-cigarettes and Electronic Nicotine Delivery System except where harm reduction or switching were evaluated as a tobacco cessation strategy. Two reviewers independently screened articles, and data were extracted after standardisation. Quality of studies was appraised using the Effective Public Health Practice Project's Quality Assessment Tool. Outcomes for impact assessment included smokeless tobacco prevalence, uptake, cessation, and health effects. Due to substantial heterogeneity in the descriptions of policies and outcomes, data were descriptively and narratively synthesised. This systematic review was registered in PROSPERO (CRD42020191946). FINDINGS: 14 317 records were identified, of which 252 eligible studies were included as describing smokeless tobacco policies. 57 countries had policies targeting smokeless tobacco, of which 17 had policies outside the Framework Convention on Tobacco Control for smokeless tobacco (eg, spitting bans). 18 studies evaluated the impact, which were of variable quality (six strong, seven moderate, and five weak) and reported mainly on prevalence of smokeless tobacco use. The body of work evaluating policy initiatives based on the Framework Convention on Tobacco Control found that these initiatives were associated with reductions in smokeless tobacco prevalence of between 4·4% and 30·3% for taxation and 22·2% and 70·9% for multifaceted policies. Two studies evaluating the non-Framework policy of sales bans reported significant reductions in smokeless tobacco sale (6·4%) and use (combined sex 17·6%); one study, however, reported an increased trend in smokeless tobacco use in the youth after a total sales ban, likely due to cross-border smuggling. The one study reporting on cessation found a 13·3% increase in quit attempts in individuals exposed (47·5%) to Framework Convention on Tobacco Control policy: education, communication, training, and public awareness, compared with non-exposed (34·2%). INTERPRETATION: Many countries have implemented smokeless tobacco control policies, including those that extend beyond the Framework Convention on Tobacco Control. The available evidence suggests that taxation and multifaceted policy initiatives are associated with meaningful reductions in smokeless tobacco use. FUNDING: UK National Institute for Health Research