Computational intelligence in eye disease diagnosis: a comparative study.

In recent years, eye disorders are an important health issue among older people. Generally, individuals with eye diseases are unaware of the gradual growth of symptoms. Therefore, routine eye examinations are required for early diagnosis. Usually, eye disorders are identified by an ophthalmologist via a slit-lamp investigation. Slit-lamp interpretations are inadequate due to the differences in the analytical skills of the ophthalmologist, inconsistency in eye disorder analysis, and record maintenance issues. Therefore, digital images of an eye and computational intelligence (CI)-based approaches are preferred as assistive methods for eye disease diagnosis. A comparative study of CI-based decision support models for eye disorder diagnosis is presented in this paper. The CI-based decision support systems used for eye abnormalities diagnosis were grouped as anterior and retinal eye abnormalities diagnostic systems, and numerous algorithms used for diagnosing the eye abnormalities were also briefed. Various eye imaging modalities, pre-processing methods such as reflection removal, contrast enhancement, region of interest segmentation methods, and public eye image databases used for CI-based eye disease diagnosis system development were also discussed in this paper. In this comparative study, the reliability of various CI-based systems used for anterior eye and retinal disorder diagnosis was compared based on the precision, sensitivity, and specificity in eye disease diagnosis. The outcomes of the comparative analysis indicate that the CI-based anterior and retinal disease diagnosis systems attained significant prediction accuracy. Hence, these CI-based diagnosis systems can be used in clinics to reduce the burden on physicians, minimize fatigue-related misdetection, and take precise clinical decisions.

Soil Moisture Data Assimilation to Estimate Irrigation Water Use.

Knowledge of irrigation is essential to support food security, manage depleting water resources, and comprehensively understand the global water and energy cycles. Despite the importance of understanding irrigation, little consistent information exists on the amount of water that is applied for irrigation. In this study, we develop and evaluate a new method to predict daily to seasonal irrigation magnitude using a particle batch smoother data assimilation approach, where land surface model soil moisture is applied in different configurations to understand how characteristics of remotely sensed soil moisture may impact the performance of the method. The study employs a suite of synthetic data assimilation experiments, allowing for systematic diagnosis of known error sources. Assimilation of daily synthetic soil moisture observations with zero noise produces irrigation estimates with a seasonal bias of 0.66% and a correlation of 0.95 relative to a known truth irrigation. When synthetic observations were subjected to an irregular overpass interval and random noise similar to the Soil Moisture Active Passive satellite (0.04 cm3 cm-3), irrigation estimates produced a median seasonal bias of <1% and a correlation of 0.69. When systematic biases commensurate with those between NLDAS-2 land surface models and Soil Moisture Active Passive are imposed, irrigation estimates show larger biases. In this application, the particle batch smoother outperformed the particle filter. The presented framework has the potential to provide new information into irrigation magnitude over spatially continuous domains, yet its broad applicability is contingent upon identifying new method(s) of determining irrigation schedule and correcting biases between observed and simulated soil moisture, as these errors markedly degraded performance.

Resonant Formation of Strand Breaks in Sensitized Oligonucleotides Induced by Low-Energy Electrons (0.5-9†eV).

Halogenated nucleobases are used as radiosensitizers in cancer radiation therapy, enhancing the reactivity of DNA to secondary low-energy electrons (LEEs). LEEs induce DNA strand breaks at specific energies (resonances) by dissociative electron attachment (DEA). Although halogenated nucleobases show intense DEA resonances at various electron energies in the gas phase, it is inherently difficult to investigate the influence of halogenated nucleobases on the actual DNA strand breakage over the broad range of electron energies at which DEA can take place (<12 eV). By using DNA origami nanostructures, we determined the energy dependence of the strand break cross-section for oligonucleotides modified with 8-bromoadenine (8Br A). These results were evaluated against DEA measurements with isolated 8Br A in the gas phase. Contrary to expectations, the major contribution to strand breaks is from resonances at around 7 eV while resonances at very low energy (<2 eV) have little influence on strand breaks.

Single versus double blade technique for skin incision and deep dissection in surgery for closed fracture: a prospective randomised control study.

PURPOSE: To compare blade cultures in surgery for closed fracture using a single or double blade technique to determine whether the current practice of double blade technique is justified. METHODS: 155 men and 29 women aged 20 to 60 (mean, 35) years who underwent surgery for closed fracture with healthy skin at the incision site were included. Patients were block randomised to the single (n=92) or double (n=92) blade technique. Blades were sent for bacteriological analysis. Outcome measures were early surgical site infection (SSI) within 30 days and cultures from the blades. RESULTS: The 2 groups were comparable in baseline characteristics. In the single blade group, 6 surgical blades and 2 control blades showed positive cultures; 4 patients developed SSI, but only one had a positive culture from the surgical blade (with different organism isolated from the wound culture). In the double blade group, 6 skin blades, 7 deep blades, and 0 control blade showed positive culture; only 2 patients had the same bacteria grown from both skin and deep blade. Five patients developed SSI, but only one patient had a positive culture from the deep blade (with different organism isolated from the wound culture). The difference in incidence of culture-positive blade or SSI between the 2 groups was not significant. The relative risk of SSI in the single blade group was 0.8. Positive blade culture was not associated with SSI in the single or double blade group. CONCLUSION: The practice of changing blade following skin incision has no effect on reducing early SSI in surgery for closed fracture in healthy patients with healthy skin.

Dose controlled low energy electron irradiator for biomolecular films.

We have developed a multi target, Low Energy Electron (LEE), precise dose controlled irradiator for biomolecular films. Up to seven samples can be irradiated one after another at any preset electron energy and dose under UHV conditions without venting the chamber. In addition, one more sample goes through all the steps except irradiation, which can be used as control for comparison with the irradiated samples. All the samples are protected against stray electron irradiation by biasing them at -20 V during the entire period, except during irradiation. Ethernet based communication electronics hardware, LEE beam control electronics and computer interface were developed in house. The user Graphical User Interface to control the irradiation and dose measurement was developed using National Instruments Lab Windows CVI. The working and reliability of the dose controlled irradiator has been fully tested over the electron energy range of 0.5 to 500 eV by studying LEE induced single strand breaks to ΦX174 RF1 dsDNA.

Sertraline induced mandibular dystonia and bruxism.

Specific serotonin reuptake inhibitors have been associated with the occurrence of drug-induced parkinsonism, dystonia, dyskinesia, and akathisia. Here, we describe a young female patient with a diagnosis of the moderate depressive episode who developed mandibular dystonia and bruxism with sertraline in the absence of concurrent prescription of medications, which have potential action on the dopaminergic system.

An Interventional Study of Physical Activity on HbA1C and VO2max in Type 2 Diabetes Mellitus.

Low cardio-respiratory fitness is prevalent in type 2 diabetics. The objectives of the present study was to assess the effect of an exercise on VO2max and HbA1c in type 2 diabetic patient. The baseline VO2max and HbA1c of 30 diabetics were estimated. VO2max was estimated using the Bruce protocol. HbA1c was measured by ion-exchange chromatography with Bio-Rad D10. After an exercise regimen for a period of 6 months, they returned to check their VO2max and HbA1c. The baseline VO2max was 32.67±11.99 ml/kg/min (low for given age) and HbA1C% values were high (7.58±1.66). After walking it was found that VO2max increased and HbA1c decreased significantly. Exercise improves cardiorespiratory fitness and lower HbA1c. So, a suitable exercise should be incorporated along with diet and drug prescription.

Screening for diabetes among presumptive tuberculosis patients at a tertiary care centre in Pondicherry, India.

SETTING: Designated microscopy centre (DMC) attached to a tertiary care centre in Pondicherry, India. OBJECTIVES: To determine 1) the proportion of diabetes mellitus (DM), 2) the additional yield of newly diagnosed DM cases, and 3) the number needed to screen (NNS) to find a new case of DM among presumed TB patients. DESIGN: An institution-based cross-sectional study was carried out among 650 presumed TB patients attending the DMC. Capillary blood glucose was measured using fasting blood sugar and/or oral glucose tolerance test, and evaluated according to the World Health Organization criteria. RESULTS: Of 570 presumed TB patients evaluated for DM, 121 (21.2%) were found to be diabetic. Of these, 69 were previously known to have DM, while 52 were newly diagnosed. The additional yield of diabetes was 43%. The NNS to detect a new case of DM was 11; among those aged >40 years, the NNS was 9.3, and among smear-positive TB patients it was 4.6. CONCLUSION: One fifth of the presumed TB patients had diabetes, and nearly half of these patients were newly diagnosed. Opportunity screening of presumed TB patients for DM in routine care will help in early detection of diabetes and pre-diabetes.

Complete chloroplast genome sequence of MD-2 pineapple and its comparative analysis among nine other plants from the subclass Commelinidae.

BACKGROUND: Pineapple (Ananas comosus var. comosus) is known as the king of fruits for its crown and is the third most important tropical fruit after banana and citrus. The plant, which is indigenous to South America, is the most important species in the Bromeliaceae family and is largely traded for fresh fruit consumption. Here, we report the complete chloroplast sequence of the MD-2 pineapple that was sequenced using the PacBio sequencing technology. RESULTS: In this study, the high error rate of PacBio long sequence reads of A. comosus's total genomic DNA were improved by leveraging on the high accuracy but short Illumina reads for error-correction via the latest error correction module from Novocraft. Error corrected long PacBio reads were assembled by using a single tool to produce a contig representing the pineapple chloroplast genome. The genome of 159,636 bp in length is featured with the conserved quadripartite structure of chloroplast containing a large single copy region (LSC) with a size of 87,482 bp, a small single copy region (SSC) with a size of 18,622 bp and two inverted repeat regions (IRA and IRB) each with the size of 26,766 bp. Overall, the genome contained 117 unique coding regions and 30 were repeated in the IR region with its genes contents, structure and arrangement similar to its sister taxon, Typha latifolia. A total of 35 repeats structure were detected in both the coding and non-coding regions with a majority being tandem repeats. In addition, 205 SSRs were detected in the genome with six protein-coding genes contained more than two SSRs. Comparative chloroplast genomes from the subclass Commelinidae revealed a conservative protein coding gene albeit located in a highly divergence region. Analysis of selection pressure on protein-coding genes using Ka/Ks ratio showed significant positive selection exerted on the rps7 gene of the pineapple chloroplast with P less than 0.05. Phylogenetic analysis confirmed the recent taxonomical relation among the member of commelinids which support the monophyly relationship between Arecales and Dasypogonaceae and between Zingiberales to the Poales, which includes the A. comosus. CONCLUSIONS: The complete sequence of the chloroplast of pineapple provides insights to the divergence of genic chloroplast sequences from the members of the subclass Commelinidae. The complete pineapple chloroplast will serve as a reference for in-depth taxonomical studies in the Bromeliaceae family when more species under the family are sequenced in the future. The genetic sequence information will also make feasible other molecular applications of the pineapple chloroplast for plant genetic improvement.

Cerebral activations during viewing of food stimuli in adult patients with acquired structural hypothalamic damage: a functional neuroimaging study.

BACKGROUND/OBJECTIVES: Obesity is common following hypothalamic damage due to tumours. Homeostatic and non-homeostatic brain centres control appetite and energy balance but their interaction in the presence of hypothalamic damage remains unknown. We hypothesized that abnormal appetite in obese patients with hypothalamic damage results from aberrant brain processing of food stimuli. We sought to establish differences in activation of brain food motivation and reward neurocircuitry in patients with hypothalamic obesity (HO) compared with patients with hypothalamic damage whose weight had remained stable. SUBJECTS/METHODS: In a cross-sectional study at a University Clinical Research Centre, we studied 9 patients with HO, 10 age-matched obese controls, 7 patients who remained weight-stable following hypothalamic insult (HWS) and 10 non-obese controls. Functional magnetic resonance imaging was performed in the fasted state, 1 h and 3 h after a test meal, while subjects were presented with images of high-calorie foods, low-calorie foods and non-food objects. Insulin, glucagon-like peptide-1, Peptide YY and ghrelin were measured throughout the experiment, and appetite ratings were recorded. RESULTS: Mean neural activation in the posterior insula and lingual gyrus (brain areas linked to food motivation and reward value of food) in HWS were significantly lower than in the other three groups (P=0.001). A significant negative correlation was found between insulin levels and posterior insula activation (P=0.002). CONCLUSIONS: Neural pathways associated with food motivation and reward-related behaviour, and the influence of insulin on their activation may be involved in the pathophysiology of HO.

Comparative study of sexual dysfunction and serum prolactin level associated with olanzapine, risperidone, and clozapine in patients with remitted schizophrenia.

BACKGROUND: Sexual dysfunctions have been a major side effect of the second generation anti-psychotic drugs which often affects treatment compliance in patients with schizophrenia. There is no/few systematic review or research addressing sexual dysfunction and their effect on serum prolactin level among different atypical antipsychotics in India. AIMS: To determine and compare the frequency of sexual dysfunction associated with olanzapine, risperidone, and clozapine and their effect on serum prolactin level in remitted patients with schizophrenia. SETTINGS AND DESIGN: Cross-sectional hospital-based study. Recruitment by purposive sampling. Estimation of serum prolactin was done using enzyme-linked immunosorbent assay technique. MATERIALS AND METHODS: The total sample size was 103, consisting of 31, 23, and 19 patients in olanzapine, risperidone, and clozapine groups, respectively and 30 controls. A Brief Psychiatric Rating Scale, Udvalg for Kliniske Undersogelser (UKU) Side Effect Rating Scale and Sexual Functioning Questionnaire were administered. Analysis of variance was used to compare clinical variables. Chi-square test was used to identify the frequency of sexual dysfunction. Kruskal-Wallis test was used to compare UKU side effect, sexual dysfunction, and blood parameters across the study groups. RESULTS AND CONCLUSION: Eighty-six percentage reported sexual dysfunction in one or more domains of sexual functioning in risperidone group as compared to 48.3% in olanzapine and 31% in clozapine groups, respectively. Prolactin level elevation was statistically significant in risperidone group followed by clozapine and olanzapine groups, respectively.

Intracranial desmoplastic small round cell tumor presenting as a suprasellar mass.

Desmoplastic small round cell tumors (DSRCTs) are rare, aggressive neoplasms that typically arise from abdominal and pelvic peritoneum in young adults. Other primary sites are uncommon, and an intracranial origin is exceptionally rare. Here the authors report the first case of a DSRCT presenting as a primary suprasellar tumor causing panhypopituitarism and severe bitemporal hemianopia in a young man. Macroscopic debulking of the tumor was undertaken, and histology revealed features of DSRCT. Reverse transcription polymerase chain reaction confirmed the presence of Ewing's sarcoma-Wilms tumor 1 (EWS-WT1) gene rearrangement specific to DSRCT. Postoperative whole-body imaging showed no primary malignancy elsewhere. The tumor recurred 4 months after surgery, and this was followed by cervical and mediastinal lymph node metastases. The patient died 20 months after initial presentation of rapidly progressive disease. DSRCTs should be included in the differential diagnosis of an unusual suprasellar mass in young adults. Early diagnosis is essential, and once the tumor is identified histologically, gross-total resection and radical postoperative treatment involving radiotherapy, chemotherapy, and close surveillance are required because of the lesion's potential for rapidly progressive malignancy.

Protective effect of extracts of Baliospermum montanum (Willd.) Muell.-Arg. against paracetamol-induced hepatotoxicity-an in vivo and in vitro study.

AIM: Evaluation of hepatoprotective effect of ethyl methyl ketone and methanol sub-fractions obtained from methanol fraction of total methanol extract (ME) was carried out both in vivo and in vitro using paracetamol-induced toxicity. SETTINGS AND DESIGN: Hepatoprotective activity in vivo was assessed by determining the serum levels of glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), alkaline phosphatase, total bilirubin, total cholesterol, total protein (TPTN), and albumin in serum. The studies were supported by histopathological examination of liver sections. In vitro activity was assessed by determining the change in hepatocyte viability and other parameters such as GOT, GPT and TPTN. MATERIALS AND METHODS: The ME of the roots of Baliospermum montanum was prepared and fractionated with chloroform and methanol to get activity guided fraction. The bio-active guided methanol fraction was further fractionated with ethyl methyl ketone and methanol. Both the fractions were evaluated for hepatoprotective activity against paracetamol-induced toxicity. STATISTICAL ANALYSIS: For determining the significant intergroup difference each parameter was analyzed separately, and one-way analysis of variance was carried out and the individual comparisons of the group mean values were done using Dunnet's test. RESULTS: Methanol sub-fraction prevented hepatic damage in vivo, induced by paracetamol, whereas both the sub-fractions showed hepatoprotective effect by restoring altered parameters in the selected in vitro model. The results were comparable with the standard hepatoprotective drug silymarin. CONCLUSIONS: This study underlines the therapeutic potential of B. montanum as per claims in Ayurveda in liver disorders.

Hypothalamic obesity: prevalence, associations and longitudinal trends in weight in a specialist adult neuroendocrine clinic.

OBJECTIVE: Obesity is highly prevalent among adults with acquired, structural hypothalamic damage. We aimed to determine hormonal and neuroanatomical variables associated with weight gain and obesity in patients following hypothalamic damage and to evaluate the impact of early instigation of weight loss measures to prevent or limit the severity of obesity in these patients. DESIGN: Retrospective study of 110 adults with hypothalamic tumours attending a specialist neuroendocrine clinic. BMI was calculated at diagnosis and at last follow-up clinic visit. Endocrine data, procedures, treatments and weight loss measures were recorded and all available brain imaging reviewed. RESULTS: At last follow-up, 82.7% of patients were overweight or heavier (BMI≥25 kg/m(2)), 57.2% were obese (BMI≥30 kg/m(2)) and 14.5% were morbidly obese (BMI≥40 kg/m(2)). Multivariate analysis revealed that use of desmopressin (odds ratio (OR)=3.5; P=0.026), GH (OR=2.7; P=0.031) and thyroxine (OR=3.0; P=0.03) was associated with development of new or worsened obesity. Neuroimaging features were not associated with weight gain. Despite proactive treatments offered in clinic in recent years (counselling, dietetic and physical activity advice, and anti-obesity medications), patients have continued to gain weight. CONCLUSIONS: Despite increased awareness, hypothalamic obesity is difficult to prevent and to treat. Improved understanding of the underlying pathophysiologies and multicentre collaboration to examine efficacy of novel obesity interventions are warranted.

Effects of citric acid and EDTA on periodontally involved root surfaces: a SEM study.

AIM: Root debridement by scaling and root planing may not completely remove contaminated cementum particularly in more apical areas. The smear layer formed during root planing inhibits cell migration and attachment leading to impaired marginal periodontal healing. The present study was done to compare the morphological effects of root surface demineralization using citric acid and EDTA as root-conditioning agents. MATERIALS AND METHODS: Thirty fragments of human dental roots previously exposed to periodontal disease were scaled and randomly divided into the following groups of treatment: Group I: Hand instrumentation and conditioning with normal saline for 5 minutes as control; group II: Hand instrumentation and conditioning with citric acid (pH 1) for 5 minutes and group III: Hand instrumentation and conditioning with EDTA (pH-7.4) for 5 minutes. Scanning electron microscopy was used to check for the presence of residual smear layer and for measuring the number and area of exposed dentin tubules. RESULTS: The mean efficacy of smear layer removal was compared between groups I and II, groups I and III and groups II and III, it was found to be statistically significant at 5%. When the mean diameter of the dentinal tubules and mean total surface area occupied by the dentinal tubule orifices was compared between groups II and III it was found to be statistically significant at 1% level of significance. CONCLUSION: Citric acid causes greater degree of morphological alterations than EDTA and is considered to be a better root-conditioning agent. However, the use of EDTA cannot be ruled out. CLINICAL SIGNIFICANCE: This study supports the hypothesis that demineralizing agents can be used as an adjunct to the periodontal treatment aiming at restoring the biocompatibility of roots and helps in choosing an appropriate agent for root conditioning.

Low energy electron induced damage to plasmid DNA pQE30.

Low energy electrons (LEEs) are produced in copious amounts by the primary radiation used in radiation therapy. The damage caused to the DNA by these secondary electrons in the energy range 5-22 eV has been studied to understand their possible role in radiation induced damage. Electrons are irradiated on dried films of plasmid DNA (pQE30) and analysed using agarose gel electrophoresis. Single strand breaks (SSBs) induced by LEE to supercoiled plasmid DNA show resonance structures at 7, 12, and 15 eV for low doses and 6, 10, and ∼18 eV at saturation doses. The present measurements have an overall agreement with the literature that LEEs resonantly induce SSBs in DNA. Resonant peaks in the SSBs induced by LEEs at 7, 12, and 15 eV with the lowest employed dose in the current study are somewhat different from those reported earlier by two groups. The observed differences are perhaps related to the irradiation dose, conditions and the nature of DNA employed, which is further elaborated.

Maxillary molar with two palatal canals.

The endodontic treatment of maxillary molar with an aberrant root canal morphology can be diagnostically and technically challenging.1 Unusual root canal morphology in multirooted teeth is a constant challenge for diagnosis and successful endodontic treatment. Presence of extra canals, lateral canals, deltas is commonly encountered.2 This case report is presented to illustrate and describe the endodontic treatment of maxillary first molar with an unusual morphological variation of palatal root. The palatal root had two canals that appeared to unite in the apical third of the canal.

Development of ESTs and data mining of pineapple EST-SSRs.

Improving the quality of the non-climacteric fruit, pineapple, is possible with information on the expression of genes that occur during the process of fruit ripening. This can be made known though the generation of partial mRNA transcript sequences known as expressed sequence tags (ESTs). ESTs are useful not only for gene discovery but also function as a resource for the identification of molecular markers, such as simple sequence repeats (SSRs). This paper reports on firstly, the construction of a normalized library of the mature green pineapple fruit and secondly, the mining of EST-SSRs markers using the newly obtained pineapple ESTs as well as publically available pineapple ESTs deposited in GenBank. Sequencing of the clones from the EST library resulted in 282 good sequences. Assembly of sequences generated 168 unique transcripts (UTs) consisting of 34 contigs and 134 singletons with an average length of ≈500 bp. Annotation of the UTs categorized the known proteins transcripts into the three ontologies as: molecular function (34.88%), biological process (38.43%), and cellular component (26.69%). Approximately 7% (416) of the pineapple ESTs contained SSRs with an abundance of trinucleotide SSRs (48.3%) being identified. This was followed by dinucleotide and tetranucleotide SSRs with frequency of 46 and 57%, respectively. From these EST-containing SSRs, 355 (85.3%) matched to known proteins while 133 contained flanking regions for primer design. Both the ESTs were sequenced and the mined EST-SSRs will be useful in the understanding of non-climacteric ripening and the screening of biomarkers linked to fruit quality traits.

A time of flight mass spectrometer with field free interaction region for low energy charged particle-molecule collision studies.

A new design of a linear time of flight mass spectrometer (ToFMS) is implemented that gives nearly field-free interaction region without compromising on the mass resolution. The design addresses problems that would arise in a conventional Wiley-McLaren type of ToFMS: (i) field leakages into the charged particle-molecule interaction region from various components of the mass spectrometer, including that through the high transparency mesh used to obtain evenly distributed electric fields; (ii) complete collection and transportation of the ions produced in the interaction region to the detector, which is essential for high sensitivity and cross section measurements. This ToFMS works over a wide range of masses from H(+) to a few hundred Daltons and would be the most suitable for low energy charged particle-molecule interaction studies. Performance of the ToFMS has been tested by measuring the partial ionization cross sections for electron impact on CF(4).