Diagnosis and rehabilitation strategies for patients with hysterical hemiparesis: a report of four cases

BACKGROUND: Sulphidoleukotrienes (slt) are important mediators in allergic diseases that are synthesized after allergen-specific stimulation. OBJECTIVES: The aim of this study is to determine in vitro slt production after allergen-specific (Dermatophagoides pteronyssinus) stimulus of peripheral blood leucocytes and to observe whether histamine release in whole blood with the same allergen correlates with slt production. We also wanted to evaluate whether a correlation exists between the release of slt and histamine and other diagnostic procedures as well as various clinical situations. METHODS: We studied 62 patients sensitive to Dermatophagoides pteronyssinus (Der p), 30 atopic controls and 12 healthy donors. We determined slt production using the CAST-ELISA technique and histamine release using two concentrations of Der p extract (20 and 2 ng/mL). We also carried out quantification of specific and total IgE levels, skin tests and pulmonary function test on each patient. RESULTS: We observed a significantly increased slt release after in vitro stimulation with Der p. There was a significant difference in the slt release between controls and sensitive patients (P < 0.001) and between atopic controls and sensitive patients (P < 0.001). The data are similar to those obtained with histamine release. We noted a positive correlation (P < 0.001) between slt and histamine release (r = 0.71, at 2 ng/mL and r = 0.83 at 20 ng/mL). We also found a positive (P<0.001), although weak (r=0.4 with at 2ng/mL, and r = 0.34 with P = 0.003 at 20 ng/mL) correlation between slt release and specific IgE levels as well as between slt release and skin-test reactivity (r = 0.49 at 2 ng/mL and r = 0.45 at 20 ng/mL; P < 0.001). No significant correlation between slt release and asthma severity was observed, although a trend toward higher slt production in severe and moderate asthma was detected. We found a significant (P<0.001) but weak (r=-0.3) negative correlation between age and slt release. With respect to sex-related differences, we found significant differences (P < 0.05) in slt release between the sexes with a higher slt release in men than in women. CONCLUSION: We conclude that CAST-ELISA for quantification of slt production is a useful in vitro method for diagnosing sensitization to Der p. There also exists a close correlation between slt release and other parameters of allergic sensitization in vitro as well as in vivo.     

New nonsteroidal androgen receptor modulators based on 4-(trifluoromethyl)-2(1H)-pyrrolidino[3,2-g] quinolinone

Typhoid fever is often associated with abnormal liver biochemical tests, but severe hepatic involvement with a clinical feature of acute hepatitis is a rare complication. There have been more than 150 cases of salmonella hepatitis reported from both developed and developing countries. The documented incidence varies widely from less than 1% to 26% patients with enteric fever. The possible associated factors for development of salmonella hepatitis are virulence of the organisms, delayed treatment and poor general health of the patients. The pathogenesis of severe hepatic involvement in salmonella infection may be multifactorial and includes endotoxin, local inflammatory and/or host immune reactions. Clinical jaundice in salmonella hepatitis usually occurs within the first 2 weeks of the febrile illness. Hepatomegaly and moderate elevation of transaminase levels are common findings. Extreme hepatic dysfunction with hepatic encephalopathy is a rare coexisting complication in salmonella hepatitis. A positive culture for salmonella from blood or stool is essential to differentiate salmonella hepatitis from other causes of acute hepatitis. Hepatic pathology is characterized by the presence of typhoid nodules with marked hyperplasia of reticuloendothelial cells. The prognosis is usually good as salmonella hepatitis responds well to a specific antibiotic therapy and juandice resolves with clinical improvement. The clinical course can be severe with a mortality rate as high as 20%, particularly with delayed treatment or in patients with other complications of salmonella infection. As enteric fever is a common infection, the recognition of salmonella hepatitis is of clinical importance.     

Stochastic facility location with general long-run costs and convex short-run costs

This paper addresses the problem of minimizing the expected cost of locating a number of single product facilities and allocating uncertain customer demand to these facilities. The total costs consist of two components: firstly linear transportation cost and secondly the costs of investing in a facility as well as maintaining and operating it. These facility costs are general and non-linear in shape and could express both changing economies of scale and diseconomies of scale. We formulate the problem as a two-stage stochastic programming model where both demand and short-run costs may be uncertain at the investment time. We use a solution method based on Lagrangean relaxation, and show computational results for a slaughterhouse location case from the Norwegian meat industry.     

A graph-based framework for model-driven optimization facilitating impact analysis of mutation operator properties

Optimization problems in software engineering typically deal with structures as they occur in the design and maintenance of software systems. In model-driven optimization (MDO), domain-specific models are used to represent these structures while evolutionary algorithms are often used to solve optimization problems. However, designing appropriate models and evolutionary algorithms to represent and evolve structures is not always straightforward. Domain experts often need deep knowledge of how to configure an evolutionary algorithm. This makes the use of model-driven meta-heuristic search difficult and expensive. We present a graph-based framework for MDO that identifies and clarifies core concepts and relies on mutation operators to specify evolutionary change. This framework is intended to help domain experts develop and study evolutionary algorithms based on domain-specific models and operators. In addition, it can help in clarifying the critical factors for conducting reproducible experiments in MDO. Based on the framework, we are able to take a first step toward identifying and studying important properties of evolutionary operators in the context of MDO. As a showcase, we investigate the impact of soundness and completeness at the level of mutation operator sets on the effectiveness and efficiency of evolutionary algorithms.

     

Differences in detection of alcohol use in a prenatal population (on a Northern Plains Indian Reservation) using various methods of ascertainment

Although Fetal Alcohol Syndrome (FAS) rates have been reported to be higher in American Indian populations, no screening tool has been validated for alcohol use in American Indian women. The objectives of this study were to compare the detection of prenatal alcohol use by a self-administered questionnaire to detection by clinical interview; and to ascertain whether the screening tool would increase detection of pregnant women who are abusing alcohol. The hospital records of the women were reviewed for any history of alcohol-related illnesses or injuries to compare with results obtained from the questionnaire. Seventy women attending their first prenatal clinic visit on a reservation were screened for alcohol use. There was a wide range in detection of prenatal alcohol use (20%-71% of the sample detected) depending on the method used. There was a large variation in sensitivities (7%-93%) of the individual questions in identifying patients detected as "high risk" by the clinicians. The T-ACE screening questions significantly increased detection of alcohol use compared to detection by the clinicians (p = 0.04 Fisher's exact test). Due to the large variation between different methods of detection, it is recommended that screening tools that increase detection of alcohol use should be combined with methods of higher specificity such as using questions about quantity and frequency of alcohol intake, medical chart review and clinical interview. We also found that various interpretations of the screening questions by the patients highlighted the need to tailor the wording of individual questions to the particular patient population.     

A finite element study of microstructure-sensitive plasticity and crack nucleation in fretting

This paper is concerned with finite element modelling of microstructure-sensitive plasticity and crack initiation in fretting. The approach adopted is based on an existing method for microstructure-sensitive (uniaxial) fatigue life prediction, which proposes the use of a unit cell crystal plasticity model to identify the critical value of accumulated plastic slip associated with crack initiation. This approach is successfully implemented here, using a FCC unit cell crystal plasticity model, to predict the plain low-cycle fatigue behaviour of a stainless steel. A crystal plasticity frictional contact model for stainless steel is developed for microstructure-sensitive fretting analyses. A methodology for microstructure-sensitive fretting crack initiation is presented, based on identification of the number of cycles in the fretting contact at which the identified critical value of accumulated plastic slip is achieved. Significant polycrystal plasticity effects in fretting are predicted, leading to significant effects on contact pressure, fatigue indicator parameters and microstructural accumulated slip. The crystal plasticity fretting predictions are compared with J₂ continuum plasticity predictions. It is argued that the microstructural accumulated plastic slip parameter has the potential to unify the prediction of wear and fatigue crack initiation, leading in some cases, e.g. gross slip, to wear, via a non-localised distribution of critical crystallographic slip, and in other cases, e.g. partial slip, to fatigue crack initiation, via a highly-localised distribution of critical crystallographic slip with preferred orientation (cracking locations and directions).     

Capitalizing on the Koran to fuel online violent radicalization: A taxonomy of Koranic references in ISIS’s Dabiq

The current study set out to investigate to what extent ISIS is bolstering its jihadist ideology on a ‘cut-and-paste’ or ‘cherry-picked’ version of Islam in their renowned online propaganda magazine Dabiq. The main objective was to examine in a systematic and quantitative way to what extent ISIS utilizes the Koran in an atomistic, truncated and tailored manner to bolster its religious legitimacy. A total of 15 issues of Dabiq and 700 Koranic references were scrutinized. By means of a quantitative analysis we developed an innovative taxonomy of Koranic chapters and verses (i.e. surahs and ayat, respectively) on the basis of their appearance in Dabiq. Our large-scale data analysis provide consistent empirical evidence for severe decontextualization practices of the Koran in three ways: (1) a thin, Medinan-dominated religious layer, (2) ayah mutilation, and (3) clustered versus exclusive mentions. Limitations and implications for future research, policy makers and CVE initiatives are discussed.