Mutations in SRD5B1 (AKR1D1), the gene encoding δ 4-3-oxosteroid 5β-reductase, in hepatitis and liver failure in infancy

Background: A substantial group of patients with cholestatic liver disease in infancy excrete, as the major urinary bile acids, the glycine and taurine conjugates of 7α-hydroxy-3-oxo-4-cholenoic acid and 7α,12α -dihydroxy-3-oxo-4-cholenoic acid. It has been proposed that some (but not all) of these have mutations in the gene encoding Δ4-3-oxosteroid 5β-reductase (SRD5B1; AKR1D1, OMIM 604741). Aims: Our aim was to identify mutations in the SRD5B1 gene in patients in whom chenodeoxycholic acid and cholic acid were absent or present at low concentrations in plasma and urine, as these seemed strong candidates for genetic 5β-reductase deficiency. Patients and subjects: We studied three patients with neonatal onset cholestatic liver disease and normal γ-glutamyl transpeptidase in whom 3-oxo-Δ4 bile acids were the major bile acids in urine and plasma and saturated bile acids were at low concentration or undetectable. Any base changes detected in SRD5B1 were sought in the parents and siblings and in 50 ethnically matched control subjects. Methods: DNA was extracted from blood and the nine exons of SRD5B1 were amplified and sequenced. Restriction enzymes were used to screen the DNA of parents, siblings, and controls. Results: Mutations in the SRD5B1 gene were identified in all three children. Patient MS was homozygous for a missense mutation (662 C>T) causing a Pro198Leu amino acid substitution; patient BH was homozygous for a single base deletion (511 delT) causing a frame shift and a premature stop codon in exon 5; and patient RM was homozygous for a missense mutation (385 C>T) causing a Leu106Phe amino acid substitution. All had liver biopsies showing a giant cell hepatitis; in two, prominent extramedullary haemopoiesis was noted. MS was cured by treatment with chenodeoxycholic acid and cholic acid; BH showed initial improvement but then deteriorated and required liver transplantation; RM had advanced liver disease when treatment was started and also progressed to liver failure. Conclusions: Analysis of blood samples for SRD5B1 mutations can be used to diagnose genetic 5β-reductase deficiency and distinguish these patients from those who have another cause of 3-oxo-Δ4 bile aciduria, for example, severe liver damage. Patients with genetic 5β-reductase deficiency may respond well to treatment with chenodeoxycholic acid and cholic acid if liver disease is not too advanced

Parallel Write-Efficient Algorithms and Data Structures for Computational Geometry

In this paper, we design parallel write-efficient geometric algorithms that perform asymptotically fewer writes than standard algorithms for the same problem. This is motivated by emerging non-volatile memory technologies with read performance being close to that of random access memory but writes being significantly more expensive in terms of energy and latency. We design algorithms for planar Delaunay triangulation, $k$-d trees, and static and dynamic augmented trees. Our algorithms are designed in the recently introduced Asymmetric Nested-Parallel Model, which captures the parallel setting in which there is a small symmetric memory where reads and writes are unit cost as well as a large asymmetric memory where writes are $\omega$ times more expensive than reads. In designing these algorithms, we introduce several techniques for obtaining write-efficiency, including DAG tracing, prefix doubling, reconstruction-based rebalancing and $\alpha$-labeling, which we believe will be useful for designing other parallel write-efficient algorithms

Algorithms for Stable Matching and Clustering in a Grid

We study a discrete version of a geometric stable marriage problem originally proposed in a continuous setting by Hoffman, Holroyd, and Peres, in which points in the plane are stably matched to cluster centers, as prioritized by their distances, so that each cluster center is apportioned a set of points of equal area. We show that, for a discretization of the problem to an $n\times n$ grid of pixels with $k$ centers, the problem can be solved in time $O(n^2 \log^5 n)$, and we experiment with two slower but more practical algorithms and a hybrid method that switches from one of these algorithms to the other to gain greater efficiency than either algorithm alone. We also show how to combine geometric stable matchings with a $k$-means clustering algorithm, so as to provide a geometric political-districting algorithm that views distance in economic terms, and we experiment with weighted versions of stable $k$-means in order to improve the connectivity of the resulting clusters.Comment: 23 pages, 12 figures. To appear (without the appendices) at the 18th International Workshop on Combinatorial Image Analysis, June 19-21, 2017, Plovdiv, Bulgari

Computing the Fréchet Distance with a Retractable Leash

All known algorithms for the Fréchet distance between curves proceed in two steps: first, they construct an efficient oracle for the decision version; second, they use this oracle to find the optimum from a finite set of critical values. We present a novel approach that avoids the detour through the decision version. This gives the first quadratic time algorithm for the Fréchet distance between polygonal curves in (Formula presented.) under polyhedral distance functions (e.g., (Formula presented.) and (Formula presented.)). We also get a (Formula presented.)-approximation of the Fréchet distance under the Euclidean metric, in quadratic time for any fixed (Formula presented.). For the exact Euclidean case, our framework currently yields an algorithm with running time (Formula presented.). However, we conjecture that it may eventually lead to a faster exact algorithm

Developing serious games for cultural heritage: a state-of-the-art review

Although the widespread use of gaming for leisure purposes has been well documented, the use of games to support cultural heritage purposes, such as historical teaching and learning, or for enhancing museum visits, has been less well considered. The state-of-the-art in serious game technology is identical to that of the state-of-the-art in entertainment games technology. As a result, the field of serious heritage games concerns itself with recent advances in computer games, real-time computer graphics, virtual and augmented reality and artificial intelligence. On the other hand, the main strengths of serious gaming applications may be generalised as being in the areas of communication, visual expression of information, collaboration mechanisms, interactivity and entertainment. In this report, we will focus on the state-of-the-art with respect to the theories, methods and technologies used in serious heritage games. We provide an overview of existing literature of relevance to the domain, discuss the strengths and weaknesses of the described methods and point out unsolved problems and challenges. In addition, several case studies illustrating the application of methods and technologies used in cultural heritage are presented

Compressed Indexes for String Searching in Labeled Graphs

Storing and searching large labeled graphs is indeed becoming a key issue in the design of space/time efficient online platforms indexing modern social networks or knowledge graphs. But, as far as we know, all these results are limited to design compressed graph indexes which support basic access operations onto the link structure of the input graph, such as: given a node u, return the adjacency list of u. This paper takes inspiration from the Facebook Unicorn's platform and proposes some compressed-indexing schemes for large graphs whose nodes are labeled with strings of variable length - i.e., node's attributes such as user's (nick-)name - that support sophisticated search operations which involve both the linked structure of the graph and the string content of its nodes. An extensive experimental evaluation over real social networks will show the time and space efficiency of the proposed indexing schemes and their query processing algorithms

Every Large Point Set contains Many Collinear Points or an Empty Pentagon

We prove the following generalised empty pentagon theorem: for every integer $\ell \geq 2$, every sufficiently large set of points in the plane contains $\ell$ collinear points or an empty pentagon. As an application, we settle the next open case of the "big line or big clique" conjecture of K\'ara, P\'or, and Wood [\emph{Discrete Comput. Geom.} 34(3):497--506, 2005]

Effectiveness of a multidisciplinary care program on recovery and return to work of patients after gynaecological surgery; design of a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Return to work after gynaecological surgery takes much longer than expected, irrespective of the level of invasiveness. In order to empower patients in recovery and return to work, a multidisciplinary care program consisting of an e-health intervention and integrated care management including participatory workplace intervention was developed.</p> <p>Methods/Design</p> <p>We designed a randomized controlled trial to assess the effect of the multidisciplinary care program on full sustainable return to work in patients after gynaecological surgery, compared to usual clinical care. Two hundred twelve women (18-65 years old) undergoing hysterectomy and/or laparoscopic adnexal surgery on benign indication in one of the 7 participating (university) hospitals in the Netherlands are expected to take part in this study at baseline. The primary outcome measure is sick leave duration until full sustainable return to work and is measured by a monthly calendar of sickness absence during 26 weeks after surgery. Secondary outcome measures are the effect of the care program on general recovery, quality of life, pain intensity and complications, and are assessed using questionnaires at baseline, 2, 6, 12 and 26 weeks after surgery.</p> <p>Discussion</p> <p>The discrepancy between expected physical recovery and actual return to work after gynaecological surgery contributes to the relevance of this study. There is strong evidence that long periods of sick leave can result in work disability, poorer general health and increased risk of mental health problems. We expect that this multidisciplinary care program will improve peri-operative care, contribute to a faster return to work of patients after gynaecological surgery and, as a consequence, will reduce societal costs considerably.</p> <p>Trial registration</p> <p>Netherlands Trial Register (NTR): <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2087">NTR2087</a></p

Combining remote sensing and household level data for regional scale analysis of land cover change in the Brazilian Amazon

Land cover change in the Brazilian Amazon depends on the spatial variability of political, socioeconomic and biophysical factors, as well as on the land use history and its actors. A regional scale analysis was made in Rondônia State to identify possible differences in land cover change connected to spatial policies of land occupation, size and year of establishment of properties, accessibility measures and soil fertility. The analysis was made based on remote sensing data and household level data gathered with a questionnaire. Both types of analyses indicate that the highest level of total deforestation is found inside agrarian projects, especially in those established more than 20 years ago. Even though deforestation rates are similar inside and outside official settlements, inside agrarian projects forest depletion can exceed 50% at the property level within 10–14 years after establishment. The data indicate that both small-scale and medium to large-scale farmers contribute to deforestation processes in Rondônia State encouraged by spatial policies of land occupation, which provide better accessibility to forest fringes where soil fertility and forest resources are important determinants of location choic