Equal Occurrence Research Articles

Long-term pituitary function and functional and patient-reported outcomes in severe acquired brain injury.

Assessment of posttraumatic hypothalamic-pituitary dysfunctions is expected to be the most relevant assessment to offer patients with severe intracranial affection. In this study, we aim to investigate the prevalence of hypopituitarism in patients with severe acquired traumatic brain injury (TBI) compared with nontraumatic brain injury (NTBI) and to relate pituitary insufficiency to functional and patient-reported outcomes. This is a prospective study. We included patients admitted for inpatient neurorehabilitation after severe TBI (N = 42) and NTBI (N = 18). The patients underwent a pituitary function assessment at a mean of 2.4 years after the injury. Functional outcome was assessed by using Functional Independence Measure and Glasgow Outcome Scale-Extended (both 1 year after discharge from neurorehabilitation) and patient-reported outcome was assessed by using Multiple Fatigue Inventory-20 and EQ-5D-3L. Hypopituitarism was reported in 10/42 (24%) patients with TBI and 7/18 (39%) patients with NTBI (P = .23). Insufficiencies affected 1 axis in 14/17 (82%) patients (13 hypogonadotropic hypogonadism and 1 growth hormone [GH] deficiency) and 2 axes in 3/17 (18%) patients (1 hypogonadotropic hypogonadism and GH deficiency, and 2 hypogonadotropic hypogonadism and arginin vasopressin deficiency). None had central hypoadrenalism or central hypothyroidism. In patients with both TBI and NTBI, pituitary status was unrelated to functioning and ability scores at 1 year and to patient-reported outcome scores at a mean of 2.4 years after the injury. Patients with severe acquired brain injury may develop long-term hypothalamus-pituitary insufficiency, with an equal occurrence in patients with TBI and NTBI. In both types of patients, mainly isolated deficiencies, most commonly affecting the gonadal axis, were seen. Insufficiencies were unrelated to functional outcomes and patient-reported outcomes, probably reflecting the complexity and heterogeneous manifestations in both patient groups.

Differences in the dynamics of schizophrenia with the formation of episodic and persistent apathetic depressions

IntroductionApathy in endogenous depressions is a complex mental phenomenon (it is characterized by indifference and loss of interests, reduced incentives and motivation, decreased mental and physical activity). Apathy becomes the cause of pronounced social maladaptation and untimely seeking medical help. Different depressions vary in psychopathological features of apathy, in addition, there are also different dimensions of the general dynamics of endogenous disease.ObjectivesStudy of the features of the course of schizophrenia, in which apathetic depressions develop with episodic and persistent type of dynamicsMethodsThe study included 36 patients (15 men, 21 women, average age 34.9 years) with schizophrenia. In 17 cases, apathetic depressions occurred as short-term episodes, in 19 cases, depression took a persistent (close to chronic) course.Results Schizophrenia with an episodic type of dynamics of apathetic depressions was characterized by: the predominance of cases with early onset of the disease; alternation of apathetic and other type depressions; equal occurrence of mono- and bipolar types of desease; low severity of negative symptoms and slight changes in social and labor functioning. Apathy has always been present during the whole lenght of depression, its picture was dominated by a motivational decline. The studied cases were prognostically favorable. The features of the course of schizophrenia with chronic apathetic depression were: hyperthymic (10 out of 19 observations) and sensitive schizoid (6 out of 19 observations) premorbid personality; bipolar forms of the disease (94.7%, p < 0.05); the predominance of apathetic depression over other depression types, atypical form of depression; short duration of remissions; frequent course of the disease with the presence of only apathetic depressions (12 out of 19, 63.1%, p < 0.05); significant severity of negative symptoms. Apathy occupied only as a part of the duration of the state, as a rule, after anxiety depression. The picture of apathy was dominated by a decrease in initiative or motivation. This clinical group is the most prognostically unfavorable.ConclusionsSchizophrenia, occurring with the presence of persistent forms of apathetic depression, has a greater impact on the functioning of patients and has a less favorable prognosis.Disclosure of InterestNone Declared

Relationship between fintech by Google search and bank stock return: a case study of Vietnam

Due to the ongoing global debate regarding the relationship between fintech and banks, including developing countries, this study aims to investigate this relationship in the case of Vietnam, an emerging nation. The study analyzes the relationship between fintech search and bank stock returns, which are measures of fintech and banks, respectively. The time series data for fintech and bank stock returns were obtained from Google Trends and Vietstock, respectively. Exploratory factor analysis was utilized to derive the fintech variables, while the bank stock return variable was calculated using a basket of eight listed banks from 2017w46 to 2021w46. The results were estimated using the vector autoregression and Granger causality method and validated with the copula method. A key finding of this study is the presence of a simultaneous negative change and bidirectional causality between bank stock returns and fintech lending. Furthermore, several other interesting findings were discovered: (1) the causal relationship from fintech to bank stock returns is weaker compared with the opposite direction; (2) unidirectional causality exists between different types of fintech, such as influence from FinFintech to FinLending, from FinPayment to FinLending and FinWallet, from FinMoney to FinFintech, from FinWallet to FinLending, and from FinProduct to FinFintech; and (3) there is an equal occurrence of simultaneous increase or decrease between bank stock returns and certain types of fintech, specifically between BankReturn and FinPayment, BankReturn and FinLending, as well as BankReturn and FinWallet. These findings shed light on the complex relationship between fintech and banks, offering insights that contribute to our understanding of this dynamic interplay in the context of Vietnam’s emerging fintech landscape.

Eyelid Tumors at Razi and Farabi Hospitals, Tehran, Iran

Background: Eyelid tumors are common in the daily practice of skin tumors and are composed of benign and malignant lesions. Methods: This retrospective case series study collected histopathologic reports of eyelid tumors of patients treated between 2022 and 2023 in Razi and Farabi hospitals (Tehran, Iran). Patient data, including patient age, sex, location of the lesion, and recurrence, were collected. Descriptive and inferential statistics were used to characterize the subgroups. Results: The sample was composed of 154 eyelid tumor specimens, including 72 (47%) malignant cases, 80 (52%) benign cases, and 2 (1%) premalignant cases. Malignant tumors included 81.9% basal cell carcinomas (BCC), 15.3% basosquamous cell carcinomas (BSC), and 1.4% squamous cell carcinoma (SCC). The benign eyelid lesions were comprised of 20% intradermal melanocytic nevus, 11.3% epidermal cyst, 7.6% dermoid cyst, 10% seborrheic keratosis, 6.3% xanthelasma, 2.5% wart, 3.8% compound nevus, 5% fibroconnective tissue, 3.8% squamous papilloma, 3.8% neurofibroma, 2.5% comedone,2.5% apocrine hidrocystoma, 2.5% foreign body type granuloma, and 1.3% of others (arteriovenous hemangioma, cavernous hemangioma, cutaneous horn, etc.) The premalignant lesions were 2 cases of actinic keratosis. Benign lesions had an equal frequency of occurrence in the upper and lower lids. Malignant lesions were seen more in the lower lid. Premalignant lesions were seen in the lower lid. The mean age at diagnosis was 45.8 ± 23.06 years for patients with benign lesions and 63.5 ± 16.7 years for patients with malignant lesions. The mean age for patients with premalignant lesions was 81.5 ± 9.19 years (P < 0.001). Conclusions: In our study, benign lesions were seen predominantly in young persons and malignant lesions were mostly seen in elderly persons. There is an equal occurrence of malignant lesions in males and females, and recurrence after excision was infrequent.

Topological Dimensions from Disorder and Quantum Mechanics?

We have recently shown that the critical Anderson electron in D=3 dimensions effectively occupies a spatial region of the infrared (IR) scaling dimension dIR≈8/3. Here, we inquire about the dimensional substructure involved. We partition space into regions of equal quantum occurrence probabilities, such that the points comprising a region are of similar relevance, and calculate the IR scaling dimension d of each. This allows us to infer the probability density p(d) for dimension d to be accessed by the electron. We find that p(d) has a strong peak at d very close to two. In fact, our data suggest that p(d) is non-zero on the interval [dmin,dmax]≈[4/3,8/3] and may develop a discrete part (δ-function) at d=2 in the infinite-volume limit. The latter invokes the possibility that a combination of quantum mechanics and pure disorder can lead to the emergence of integer (topological) dimensions. Although dIR is based on effective counting, of which p(d) has no a priori knowledge, dIR≥dmax is an exact feature of the ensuing formalism. A possible connection of our results to the recent findings of dIR≈2 in Dirac near-zero modes of thermal quantum chromodynamics is emphasized.

Is there a promoting role for artificial sweeteners in the evolution of bladder cancer? A meta-analysis of current literature.

Urinary bladder cancer is a frequent neoplasia in the urogenital system. Ageing and smoking are the two main risk factors, however, some chemical agents such as artificial sweeteners could act as initiators or promoters. After identifying trends in scientific literature, we conducted a wide search in PubMed database and a meta-analysis was performed on extracted data to determine the role of artificial sweeteners in the development of urinary bladder cancer. Twenty-one full reports were enrolled from screening of PubMed database into final analysis involving 116,568 subjects in comparisons. Overall, 13,682 and 102,886 cases were identified for bladder cancer patients and healthy controls, respectively. Among artificial sweetener users, 12.5% was the incidence of bladder cancer. In the control group, 11.2% of cases suffered from urothelial carcinoma of the bladder. About 40.7% of the patients suffering from urinary neoplasms and 37.8% of the healthy cases were artificial sweetener users, respectively. There were only minor differences in overall descriptive data. The incidence of urinary bladder cancer among artificial sweetener users and control cases showed no risk difference (RD: 0.00, CI: -0.06 to 0.06). The frequency of artificial sweetener use among patients suffering from urinary bladder neoplasms and healthy subjects was compared which showed equal occurrences (OR: 0.96, CI: 0.79 to 1.17). According to our results, the carcinogenic risk of artificial sweeteners is not proven. Saccharin should not be kept as a promoter in urothelial malignant transformation.

Doppler Lidar Measurements of Wind Variability and LLJ Properties in Central Oklahoma during the August 2017 Land–Atmosphere Feedback Experiment

Abstract Low-level jets (LLJs) are an important nocturnal source of wind energy in the U.S. Great Plains. An August 2017 lidar-based field-measurement campaign [the Land–Atmosphere Feedback Experiment (LAFE)] studied LLJs over the central SGP site in Oklahoma and found nearly equal occurrences of the usual southerly jets and postfrontal northeasterly jets—typically rare during this season—for an opportunity to compare the two types of LLJs during this month. Southerly winds were stronger than the northeasterlies by more than 4 m s−1 on average, reflecting a significantly higher frequency of winds stronger than 12 m s−1. The analysis of this dataset has been expanded to other SGP Doppler-lidar sites to quantify the variability of winds and LLJ properties between sites of different land use. Geographic variations of winds over the study area were noted: on southerly wind nights, the winds blew stronger at the highest, westernmost sites by 2 m s−1, whereas on the northeasterly flow nights, the easternmost sites had the strongest wind speeds. Lidar measurements at 5 sites during August 2017, contrasted to the 2016–21 summertime data, revealed unusual wind and LLJ conditions. Temporal hodographs using hourly averaged winds at multiple heights revealed unorganized behavior in the turbulent stable boundary layer (SBL) below the jet nose. Above the nose, some nights showed veering qualitatively similar to inertial oscillation (IO) behavior, but at amplitudes much smaller than expected for an IO, whereas other nights showed little veering. Vertical hodographs had a linear shape in the SBL, indicating little directional shear there, and veering above, resulting in a hook-shaped hodograph with height. Significance Statement Doppler-lidar measurements at the Atmospheric Radiation Measurement (ARM) Southern Great Plains (SGP) were used to quantify the variability of winds and low-level jet (LLJ) properties between five sites of different land use and wind regimes across this area. Knowledge of wind and LLJ structure and dynamics is important for many applications, and strong southerly LLJ winds at night are an important resource for wind energy. The analysis of multiyear (2016–21) summertime LLJ parameters provided insight into the LLJ climatology in this part of the Great Plains.

Investigation of Bioaerosols and the Microbiological Indoor Air Quality in an Urban Nursery School in Port Harcourt, Nigeria

Aims: This study was aimed at investigating the microbial quality of air within the confines of nursery school children. Early exposure to these indoor pollutants can lead to major public health concerns which include acute respiratory tract infections, allergies as well as cancer.
 Study Design: Random sampling approach was used in the collection of the samples. Air samples were collected from two different classrooms in a nursery school.
 Place and Duration of Study: Air samples were collected within the confines of the nursery section of the Demonstration Primary School in the University of Port Harcourt, Rivers State, Nigeria every other weekday in the month of May 2022.
 Methodology: Culture media were placed at the four corners of two classrooms in the nursery section. This nursery class comprised of children between the ages of 4-5 years Nutrient, MacConkey and potato dextrose agar media were used to culture airborne microorganisms during the study. For differential identification of bacteria, citrate, motility, oxidase, indole, catalase, methyl red Voges Proskauer, triple salt iron agar, sugar fermentation tests were carried out.
 Results: Both bacterial and fungal species of medical importance, such as Bacillus, Shigella, Micrococcus, Serratia, Proteus, Yersinia, Enterobacter, Penicilium, Aspergillus, Candida, Microsporum. Exophiala and Mucor spp were isolated in this study. The most predominant bacterial species among the isolates in the study was Bacillus sp. with the percentage occurrence of 25%. Shigella and Yersinia species had the percentage occurrence of 16.67% respectively other species like Serratia, Micrococcus, Enterobacter and Proteus each had percentage occurrence of 8.33% which was the lowest occurrence. All the fungal isolates had similar or equal percentage occurrence (16.67%).
 Conclusion: Exposure to microbial aerosols in nursery schools can lead to several health complications. Thus, recognition, control and monitoring of air quality in schools are crucial in limiting the spread of airborne pathogens.

Genotype-Phenotype Correlations for Putative Haploinsufficient Genes in Deletions of 6q26-q27: Report of Eight Patients and Review of Literature.

Background Cytogenomic analyses have been used to detect pathogenic copy number variants. Patients with deletions at 6q26-q27 present variable clinical features. We reported clinical and cytogenomic findings of eight unrelated patients with a deletion of 6q26-q27. A systematic review of the literature found 28 patients with a deletion of 6q26-q27 from 2010 to 2020. Results For these 36 patients, the sex ratio showed equal occurrence between males and females; 29 patients (81%) had a terminal deletion and seven patients (19%) had a proximal or distal interstitial deletion. Of the 22 patients with parental studies, deletions of de novo, maternal, paternal, and bi-parental inheritance accounted for 64, 18, 14, and 4% of patients, respectively. The most common clinical findings were brain abnormalities (100%) in fetuses observed by ultrasonography followed by developmental delay and intellectual disability (81%), brain abnormalities (72%), facial dysmorphism (66%), hypotonia (63%), learning difficulty or language delay (50%), and seizures (47%) in pediatric and adult patients. Anti-epilepsy treatment showed the effect on controlling seizures in these patients. Cytogenomic mapping defined one proximal critical region at 6q26 containing the putative haploinsufficient gene PRKN and one distal critical region at 6q27 containing two haploinsufficient genes DLL1 and TBP . Deletions involving the PRKN gene could associate with early-onset Parkinson disease and autism spectrum disorder; deletions involving the DLL1 gene correlate with the 6q terminal deletion syndrome. Conclusion The genotype–phenotype correlations for putative haploinsufficient genes in deletions of 6q26-q27 provided evidence for precise diagnostic interpretation, genetic counseling, and clinical management of patients with a deletion of 6q26-q27.

High power short duration (HPSD) versus lower power longer duration (LPLD) atrial fibrillation ablation: a multi-centre randomised controlled trial (HiLo-HEAT study)

Abstract Funding Acknowledgements Type of funding sources: None. Background Lower power (25W) longer duration (LPLD) radiofrequency (RF) ablation has conventionally been used on the posterior wall during pulmonary vein isolation (PVI) for atrial fibrillation (AF), to attenuate the risk of esophageal thermal injury (ETI). High power (40-50 W) short duration (HPSD) RF ablation results in shorter procedural times with no increase in ETI. However evidence had been limited by non-randomised studies. Purpose To compare HPSD versus LPLD ablation and the effects on esophageal thermal injury (ETI) and procedural outcomes. Methods In this multi-centre, prospective, randomised control trial, 88 patients with paroxysmal/persistent AF undergoing their first RF ablation procedure were randomised 1:1 to HPSD or LPLD ablation. Anterior wall ablation was done in both arms using 40-50 W, with ablation target of AI 500-500/ LSI 5-5.5. Posterior wall ablation was done using 40-50W (HPSD group) versus 25 W (LPLD group), with target AI 400/ LSI 4. Ablation involves wide antral circumferential PVI using contact force sensing ablation catheters, with additional ablation lines as per operator discretion. Circa multi-sensor esophageal temperature monitoring (ETM) probe was utilized. Endoscopy was performed within 24 hours to assess for ETI. The primary outcome was incidence of ETI, with secondary outcomes including acute procedural endpoints. Results Mean age of the cohort was 61+/-9 years, with 31% females. 36 (41%) had PAF. PVI was achieved in 100% of patients, with posterior wall isolation (PWI) added in 19 PsAF patients (21.6%). There were more hypertensive patients in HPSD (p = 0.02). Significant esophageal luminal temperature rises (≥ 38 c) were seen in 93.2% of patients, with no difference between groups (p = 0.69). First pass isolation rates for left and right PVs were 85% and 61% respectively, with similar rates in both groups (p = 0.37, p = 0.65 respectively). HPSD group had shorter RF time (1613 vs 2303 secs, p <0.04), and fluoroscopy times (11.4 vs 13.1 mins, p = 0.05). Procedural times were lower in HPSD, although not significant (133.7 vs 150.8 mins, p = 0.10). Post ablation endoscopy showed 4 cases of ETI (4.5%), with equal occurrence in HPSD and LPLD (p = 1.0). All ETIs were class 2a (superficial ulcer), and treated with PPI therapy. Esophageal injuries not attributable to RF ablation occurred in 9 (10%), with no difference between groups (p = 0.29). There was no difference in AF recurrence between the 2 groups (post 3 months blanking period) after a mean follow up of 6.3 months (p = 0.71). Conclusion HPSD ablation was associated with lower RF ablation and fluoroscopy times compared to LPSD, with comparably low rates of ETI on post ablation endoscopy. Our findings suggest that HPSD ablation is a safe and efficacious approach to PVI. However clinicians should be cognisant of the potential injury risk related to esophageal instrumentation from transesophageal echo/ ETM probes.

The Neurological Basis of Developmental Dyslexia and Related Disorders: A Reappraisal of the Temporal Hypothesis, Twenty Years on.

In a now-classic article published a couple of decades ago (Brain, 2000; 123: 2373–2399), I proposed an “extended temporal processing deficit hypothesis of dyslexia”, suggesting that a deficit in temporal processing could explain not only language-related peculiarities usually noticed in dyslexic children, but also a wider range of symptoms related to impaired processing of time in general. In the present review paper, I will revisit this “historical” hypothesis both in the light of a new clinical perspective, including the central yet poorly explained notion of comorbidity, and also taking a new look at the most recent experimental work, mainly focusing on brain imaging data. First, consistent with daily clinical practice, I propose to distinguish three groups of children who fail to learn to read, of fairly equal occurrence, who share the same initial presentation (difficulty in mastering the rules of grapheme–phoneme correspondence) but with differing associated signs and/or comorbid conditions (language disorders in the first group, attentional deficits in the second one, and motor coordination problems in the last one), thus suggesting, at least in part, potentially different triggering mechanisms. It is then suggested, in the light of brain imaging information available to date, that the three main clinical presentations/associations of cognitive impairments that compromise reading skills acquisition correspond to three distinct patterns of miswiring or “disconnectivity” in specific brain networks which have in common their involvement in the process of learning and their heavy reliance on temporal features of information processing. With reference to the classic temporal processing deficit of dyslexia and to recent evidence of an inability of the dyslexic brain to achieve adequate coupling of oscillatory brain activity to the temporal features of external events, a general model is proposed according to which a common mechanism of temporal uncoupling between various disconnected—and/or mis-wired—processors may account for distinct forms of specific learning disorders, with reading impairment being a more or less constant feature. Finally, the potential therapeutic implications of such a view are considered, with special emphasis on methods seeking to enhance cross-modal connectivity between separate brain systems, including those using rhythmic and musical training in dyslexic patients.

Computerized Tomographic Patterns of Intracranial Tumors in Northwest Nigeria

Background: Brain tumors are among the most challenging disorders encountered worldwide. Early and accurate diagnosis is essential for the management of these tumors. Different patterns of distribution of intracranial tumors have been described in various regions of the world, with previous reports in Africa suggesting that brain tumors were uncommon. This relative rarity has been attributed to low detection due to lack of neurosurgical and advanced neuroimaging facilities previously, a limitation that has now been gradually surmounted with the establishment of neurosurgical and more advanced radiological facilities on the continent. Objectives: The objective of this study is to describe the current pattern of intracranial tumors on computed tomography (CT) scan seen in Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Northwest Nigeria. Methods: This is a retrospective study of CT images of 60 patients of all age groups diagnosed with brain tumors between January 2015 and December 2019. The CT scans of the brain were performed using General Electric Hi-Speed NX/i dual-slice CT scanner (Germany). The age, sex, diagnosis using the WHO histological, and the pattern on CT were recorded, and data were analyzed using Statistical Package for the Social Sciences version 22.0, ARMONK, NY, USA 2013. Only cases with conclusive histology diagnosis were analyzed. This study was approved by the Health Research Ethics Committee of the ABUTH, Zaria (approval Number ABUTH/HREC/M36/2015), on January 23, 2015, before commencement. Results: In the 60 cases of brain tumors studied, patients' age range was 6 months–65 years, with a peak in the fourth and fifth decades of life (accounting for 38.3%). The mean age was 33.04 years ± 17.73 standard deviation. There was equal occurrence among males and females. About 96.7% of the tumors were primary and 3.7% secondary tumors; meningioma (MEN) (45%) was the most common tumor seen. About 45% of the cases were extra-axial, while 55% were intra-axial. Most (81.67%) of the tumors were located in the supratentorial region, while 18.33% were infratentorial. Headache (75%) and visual impairment (53.3%) were the most frequent clinical presentations. Conclusion: MEN was the most common tumor type seen in this study. This corroborates most studies in Nigeria and other African countries but contradicts some studies among Caucasians that showed glioma to be more common. This affirms that racial factors and environmental influence could have significant effects on the pattern of diseases. The results of this study will provide useful data on the pattern of brain tumors in this environment.

Unique Members of the Adipokinetic Hormone Family in Butterflies and Moths (Insecta, Lepidoptera).

Lepidoptera is amongst one of the four most speciose insect orders and ecologically very successful because of their ability to fly. Insect flight is always aerobic and exacts a high metabolic demand on the animal. A family of structurally related neuropeptides, generically referred to as adipokinetic hormones (AKHs), play a key role in triggering the release of readily utilizable fuel metabolites into the hemolymph from the storage forms in the fat body. We used mass spectrometry to elucidate AKH sequences from 34 species of Lepidoptera and searched the literature and publicly available databases to compile (in a phylogenetic context) a comprehensive list of all Lepidoptera sequences published/predicted from a total of 76 species. We then used the resulting set of 15 biochemically characterized AKHs in a physiological assay that measures lipid or carbohydrate mobilization in three different lepidopteran species to learn about the functional cross-activity (receptor-ligand interactions) amongst the different butterfly/moth families. Our results include novel peptide structures, demonstrate structural diversity, phylogenetic trends in peptide distribution and order-specificity of Lepidoptera AKHs. There is almost an equal occurrence of octa-, nona-, and decapeptides, with an unparalleled emphasis on nonapeptides than in any insect order. Primitive species make Peram-CAH-II, an octapeptide found also in other orders; the lepidopteran signature peptide is Manse-AKH. Not all of the 15 tested AKHs are active in Pieris brassicae; this provides insight into structure-activity specificity and could be useful for further investigations into possible biorational insecticide development.

Handling imbalanced medical image data: A deep-learning-based one-class classification approach.

In clinical settings, a lot of medical image datasets suffer from the imbalance problem which hampers the detection of outliers (rare health care events), as most classification methods assume an equal occurrence of classes. In this way, identifying outliers in imbalanced datasets has become a crucial issue. To help address this challenge, one-class classification, which focuses on learning a model using samples from only a single given class, has attracted increasing attention. Previous one-class modeling usually uses feature mapping or feature fitting to enforce the feature learning process. However, these methods are limited for medical images which usually have complex features. In this paper, a novel method is proposed to enable deep learning models to optimally learn single-class-relevant inherent imaging features by leveraging the concept of imaging complexity. We investigate and compare the effects of simple but effective perturbing operations applied to images to capture imaging complexity and to enhance feature learning. Extensive experiments are performed on four clinical datasets to show that the proposed method outperforms four state-of-the-art methods.

P1828A PANEL OF URINE BIOMARKERS FOR EARLY KIDNEY INJURY DETECTION IN NEWBORNS

Abstract Background and Aims Neonatal kidney damage is a wide spread pathology, especially among preterm infants. Acute kidney injury (AKI) in newborns remains one of the most important problems because the features of neonatal nephrogenesis and physiology. The current clinical criteria for the diagnosis of AKI, including pediatric scales pRIFLE and nRIFLE, rely on glomerulal filtration rate (GFR), blood urea nitrogen (BUN), and serum creatinine (SCr), which are the late biomarkers detectable only within days or weeks after kidney damage occurred, and therefore have limitations when used within the first days after birth. Therefore, sensitive and specific tests for early diagnostics of kidney injury are extremely needed in neonatology. Urine biomarkers appear to be promising for early diagnosis of AKI. Quite often renal pathologies result in markedly increased (or decreased) urinary excretion of a number of protein biomarkers, indicating subclinical tubular injury while conventional AKI signs are not manifested yet. The aim of this study was to determine clinical value of urine molecular biomarkers for the prediction of acute kidney injury in newborns. Method Urine samples from newborns with congenital malformation were collected on the 1st day after born, and then once a week until the 21th postnatal day. Urine samples were centrifuged, aliquoted and stored at –80°С until testing. The next urinary biomarkers were analyzed: calbindin 1, clusterin, IL-18, KIM-1, GST-π, MCP-1 and NGAL. Quantitative determination was performed with immunoassay kit Bio-Plex Pro™ RBM Human Kidney Toxicity Panel 1 (Bio-Rad Inc., USA) and Human NGAL ELISA kit (Invitrogen, Germany). Control group included five age-matched healthy infants. Results 8 of 20 patients showed a direct correlation of increased NGAL levels in urine (50-fold compared to control group) with high levels of C-reactive protein in the blood (3-10-fold rise above the reference level). NGAL is the most sensitive marker for assessing AKI or tubular damage. These 8 patients were further investigated for other urine biomarkers. The IL-18 level in urine was slightly increased in 4 patients. IL-18 is proposed to be a predictor for AKI severity and mortality in children with critical illness. KIM-1 has low basal expression in the normal kidney but its appearance is highly specific and sensitive sign for nephrotoxicity in proximal tubules. We observed the increase of KIM-1 urinary excretion for 7 patients. However, we discover the equal occurrence of decrease or increase of urine MCP-1 through studied patients. Elevated levels of urine MCP-1 were earlier observed in experimental maleate induced azotemia, LPS injection and in model of unilateral ureteral obstruction (UUO). An increase of KIM-1 and/or MCP-1 urinary excretion is known to be associated with some risk of AKI development. We found 3-fold growth of urine clusterin in 7 children. It is noticed, that clusterin increased in damaged tubular cells during polycystic kidney disease and renal carcinoma. Additionally, we revealed 7-fold decrease of calbindin 1 in urine of 7 patients. Сalbindin 1 exclusively localized in the kidney distal nephron segment, and its decrease was discribed for models of UUO, glomerulonephritis and cisplatin nephropathy. GST-π protein is found in cells lining the lumen of the distal tubules and is elevated in the urine of patients with sepsis, independently of accompanied AKI. We also observed 10- to 20-fold rising of urine GST-π for all 8 NGAL-positive newborns. Conclusion The specificity, rate of increase, and non-invasive detection of urine markers studied in this work, make them indispensable in clinical practice. However, their use in neonatology is still experimental. We showed potential applicability of wide biomarker panel for early detection and prediction of AKI in newborns.

Majewski osteodysplastic primordial dwarfism type II (MOPD-II): A rare case report

Majewski osteodysplastic primordial dwarfism type II (MOPD-II) is a rare syndrome characterized by the presence of intrauterine growth restriction, post-natal growth deficiency and microcephaly. Individuals affected by this disease present at an adult height of less than 100 cm, a post-pubertal head circumference of 40 cm or less, mild mental retardation, an outgoing personality and skeletal dysplasia, renal, hematopoietic abnormalities, cerebral vascular anomalies (aneurysm and Moyamoya disease). It is an autosomal recessive syndrome with equal gender occurrence involving the DNA damage-response PCNT gene. Here is an interesting case report of a 15-year-old boy, who presented with growth failure since age of one year, noticed by his parents with history of low birth weight (1.5 kg), delayed developmental milestones, microcephaly, low IQ and difficulty in walking due to short left leg. He had bird like head with beaked nose, crowding of teeth and malocclusion. Complete blood picture and hormonal analysis are within normal range except low growth hormone, typical radiographic features including severe scoliosis and dislocation of hip correlated with MOPD-II. Growth hormone therapy was thought to be ineffective. Genetic counselling is important to prevent the occurrence of MOPD-II.
 Birdem Med J 2019; 9(3): 254-256

Learning the Causative Alternation in English and Japanese Speakers: Statistical and Non-statistical Effects

ABSTRACTChildren acquire argument structure through distributional evidence, but how does this interacts with event semantics and existing verb knowledge? The current study compares verb learning in adult speakers of Japanese (where lexical causatives span wider semantic categories) and English (where alternation is more restricted). In the Fully alternating familiarization, internally caused events (similar to descend) and externally caused events (similar to rock) occurred with novel verbs in transitive and intransitive frames. In the Semi-alternating familiarization, internally caused events occurred with intransitives only while externally caused events occurred with both frames. During the test, participants rated the naturalness of transitive and intransitive descriptions for all events. For internally caused events, transitives were rated equivalently low across speakers after the Semi-alternating familiarization (which featured only intransitives), while intransitives were more felicitous for English compared to Japanese speakers. For externally caused events, all participants rated transitives higher than intransitives, despite equal occurrence across familiarizations. This may be related to the presence of salient animate agents in scenes. Together, this suggests that syntactic and semantic biases concurrently influence the interpretation of distributional evidence. Input statistics are interpreted through existing syntactic representations, and salient semantic distinctions may exert a bias for syntactic instantiations.

EXPLORING TEXT-IMAGE RELATIONS IN ENGLISH COMICS FOR CHILDREN: THE CASE OF “LITTLE RED RIDING HOOD”

The present panorama of communication features the co-employment of language and other semiotic resources. This paper addresses this fledging field, multimodal discourse analysis, by investigating a genre targeted at children. Specifically, it studies how meanings in comics for children are constructed both verbally and visually. The data for the study is one comic - Little Red Riding Hood, which is presented via colored images and verbal texts in English. The analysis was based on Unsworth’s (2006) framework to explore the interplay of the two semiotics in the construction of the ideational contents. The results reveal that this comic displays both Expansion and Projection relations with nearly equal occurrence frequencies; however, within each type, the subtypes are vastly different with Verbal being the most predominant, which can be deemed as one of the typical features of the genre in focus. Regarding Expansion, Concurrence and Complementarity have nearly the same high percentage while Enhancement has a lower proportion. Theoretically, the findings concerning a complete full-length comic contribute to the literature on multimodal texts for young learners. The findings also have practical implications for the teaching and learning of English as a foreign language as to how to exploit the free online kid-targeted multimodal resources to engage the young learners in literary works in general and to develop their English proficiency in particular.

Progressive and Severe Proliferative Diabetic Retinopathy

Introduction Proliferative diabetic retinopathy (PDR) is a progressive condition leading to blindness. PDR develops in twenty percent of patients with diabetes mellitus (DM) with equal occurrence in type I and type II DM. This case study describes a relatively young patient who presented with deteriorating, severe PDR in both eyes.Case Description A 44-year-old male presented with a two-week history of blurred vision in the right eye. The history is significant for insulin dependent diabetes mellitus. Examination revealed retinal hemorrhages, exudates and microaneurysms in both eyes. Fluorescein angiography and Ocular Coherence Tomograph (OCT) were performed. There were macular edema, fibrous and vitreo-retinal traction for each eye. Color photographs demonstrated proliferative diabetic retinopathy with associated clinically significant macular edema, schemia and neovascularizations for both eyes. There was vitreo-retinal traction for each eye. Treatment included scatter photocoagulation, focal laser therapy and Avastin injections. DiscussionThe patient was diagnosed with PDR and leakage apparent in the mid to late stages of the angiogram consistent with the degree of macular edema noted clinically in both eyes. Furthermore, ischemia and neovascularizations were apparent in both eyes. Severe PDR increases the risk for blindness for which early diagnosis is crucial. The patient had significant macular edema and neovascularizations. He is at an increased risk for a retinal detachment due to vitreo-retinal traction. Focal laser treatment, scatter photocoagulation and a series of Avastin injections reduces macular edema, decreases neovascularization, and reduces the vascular component of fibrosis. The patient blurred vision improved after course of treatment. ConclusionEarly diagnosis of PDR is vital to reducing blindness. Focal laser treatment, scatter photocoagulation and Avastin injections reduce macular edema and neovascularizations resulting in improved prognosis. Patients with DM are encouraged to have annual eye examinations.

Stormtime substorm onsets: occurrence and flow channel triggering

Bright auroral emissions during geomagnetic storms provide a good opportunity for testing the proposal that substorm onset is frequently triggered by plasma sheet flow bursts that are manifested in the ionosphere as auroral streamers. We have used the broad coverage of the ionospheric mapping of the plasma sheet offered by the high-resolution THEMIS all-sky-imagers (ASIs) and chose the main phases of 9 coronal mass ejection (CME) related and 9 high-speed stream (HSS)-related geomagnetic storms, and identified substorm auroral onsets defined as brightening followed by poleward expansion. We found a detectable streamer heading to near the substorm onset location for all 60 onsets that we identified and were observed well by the ASIs. This indicates that substorm onsets are very often triggered by the intrusion of plasma with lower entropy than the surrounding plasma to the onset region, with the caveat that the ASIs do not give a direct measure of the intruding plasma. The majority of the triggering streamers are “tilted streamers,” which extend eastward as their eastern tip tilts equatorward to near the substorm onset location. Fourteen of the 60 cases were identified as “Harang streamers,” where the streamer discernibly turns toward the west poleward of reaching to near the onset latitude, indicating flow around the Harang reversal. Using the ASI observations, we observed substantially less substorm onsets for CME storms than for HSS storms, a result in disagreement with a recent finding of approximately equal substorm occurrences. We suggest that this difference is a result of strong non-substorm streamers that give substorm-like signatures in ground magnetic field observations but are not substorms based on their auroral signature. Our results from CME storms with steady, strong southward IMF are not consistent with the ~ 2–4 h repetition of substorms that has been suggested for moderate to strong southward IMF conditions. Instead, our results indicate substantially lower substorm occurrence during such steady driving conditions. Our results also show the much more frequent occurrence of substorms during HSS period, which is likely due to the highly fluctuating IMF.