Modelling and Control of a Reconfigurable Robot for Achieving Reconfiguration and Locomotion with Different Shapes.

Area coverage is a crucial factor for a robot intended for applications such as floor cleaning, disinfection, and inspection. Robots with fixed shapes could not realize an adequate level of area coverage performance. Reconfigurable robots have been introduced to overcome the limitations of fixed-shape robots, such as accessing narrow spaces and cover obstacles. Although state-of-the-art reconfigurable robots used for coverage applications are capable of shape-changing for improving the area coverage, the reconfiguration is limited to a few predefined shapes. It has been proven that the ability of reconfiguration beyond a few shapes can significantly improve the area coverage performance of a reconfigurable robot. In this regard, this paper proposes a novel robot model and a low-level controller that can facilitate the reconfiguration beyond a small set of predefined shapes and locomotion per instructions while firmly maintaining the shape. A prototype of a robot that facilitates the aim mentioned above has been designed and developed. The proposed robot model and controller have been integrated into the prototype, and experiments have been conducted considering various reconfiguration and locomotion scenarios. Experimental results confirm the validity of the proposed model and controller during reconfiguration and locomotion of the robot. Moreover, the applicability of the proposed model and controller for achieving high-level autonomous capabilities has been proven.

Who Watches the "Watchman" and How Often?

Atrial fibrillation (AF) is a common cardiac arrhythmia that is encountered during the hospitalization. Sometimes, many patients cannot be anticoagulated to prevent AF-related cardiovascular accidents because of the risk of bleeding. In these cases, we recommend putting left atrial appendage (LAA) to prevent thrombus formation in the left atrium due to AF. There is no clear time frame of how long we need to follow up with echocardiogram to monitor device-related blood clot formation and continue anticoagulation therapy if there is recurrent thrombus formation after LAA placement. We would like to present a case with AF in which the patient had epistaxis, which required to hold anticoagulation and arterial embolization. The patient agreed to the placement of the Watchman device and subsequently it was complicated by device-related thrombosis (DRT). The patient required prolonged anticoagulation treatment and follow-up echocardiogram to prevent DRT in the future.

Diagnostic Challenges of a Mass in the Left Atrium.

A 61-year-old female former smoker with history of bronchial-associated lymphoid tissue lymphoma presented with increasing dyspnea, cough with white phlegm and significant weight loss. Chest X-ray showed complete opacification of the left hemithorax. A computed tomography (CT) pulmonary angiogram ruled out pulmonary embolism but revealed mass within the left atrium. A transthoracic echocardiography showed an echogenic mass in the left atrium. A cardiac MRI confirmed a bulky left lung mass suggestive of carcinoma invading the left atrium via the left pulmonary veins. CT-guided biopsy of left lung mass was suggestive of non-small cell lung carcinoma (NSCLC, adenocarcinoma). We would like to discuss the challenges and the importance of making the correct diagnosis of intracardiac mass.

Serotyping of dengue virus in 2016-17 outbreak in Kudat, Sabah, Malaysia.

An outbreak of dengue in Kudat, northern Sabah in 2016-2017 provided an opportunity to investigate the circulating serotypes of dengue viruses of cases at Hospital Kudat. Between September 2016 and December 2017, a total of 156 dengue positive sera (tested positive by either NS1 antigen, or IgM and IgG antibody rapid test) were collected from dengue patients who had acute fever and showed signs and symptoms suggestive of dengue. RNA was extracted from the sera using QIAamp RNA Blood Mini Kit, and molecular amplification was performed using one-step RT-PCR kit, followed by nested PCR using HotStart Taq master mix kit with the primers of the dengue C-prM gene. There were 81 (52%) male and 75 (48%) female cases. The age group with the highest number of cases was the 10-19 years old, while the youngest infected was 8 months old and the oldest was 83 years old. RT-PCR results showed 88 sera dengue positive, 48 infected with a single serotype while another 40 with multiple serotypes. All four DENV serotypes were co-circulating during the outbreak period and DENV-1 was predominant. Molecular analysis also indicated 69.2%, 50.0%, 51.9% and 48.9% respectively of the NS1, IgM, IgG and IgM and IgG positive sera were RT-PCR positive for dengue. High number of cases were seen in December 2016, February and May 2017. The dengue outbreak might be related to switching of predominant serotype from DENV 4 to DENV 1.

Serotyping of dengue virus in 2016-17 outbreak in Kudat, Sabah, Malaysia

@# An outbreak of dengue in Kudat, northern Sabah in 2016-2017 provided an opportunity to investigate the circulating serotypes of dengue viruses of cases at Hospital Kudat. Between September 2016 and December 2017, a total of 156 dengue positive sera (tested positive by either NS1 antigen, or IgM & IgG antibody rapid test) were collected from dengue patients who had acute fever and showed signs and symptoms suggestive of dengue. RNA was extracted from the sera using QIAamp RNA Blood Mini Kit, and molecular amplification was performed using one-step RT-PCR kit, followed by nested PCR using HotStart Taq master mix kit with the primers of the dengue C-prM gene. There were 81 (52%) male and 75 (48%) female cases. The age group with the highest number of cases was the 10-19 years old, while the youngest infected was 8 months old and the oldest was 83 years old. RT-PCR results showed 88 sera dengue positive, 48 infected with a single serotype while another 40 with multiple serotypes. All four DENV serotypes were co-circulating during the outbreak period and DENV-1 was predominant. Molecular analysis also indicated 69.2%, 50.0%, 51.9% and 48.9% respectively of the NS1, IgM, IgG and IgM & IgG positive sera were RT-PCR positive for dengue. High number of cases were seen in December 2016, February and May 2017. The dengue outbreak might be related to switching of predominant serotype from DENV 4 to DENV 1.

Water, Sanitation, and Hygiene Facilities and Hygiene Practices Associated with Diarrhea and Vomiting in Monastic Schools, Myanmar.

Gastrointestinal diseases are major contributors to mortality among children globally, causing one in 10 child deaths. Although most deaths are in children aged ≤ 5 years, the burden of disease in school-aged children is still considerable and contributes to high rates of school absenteeism. This study investigates behavioral and structural risk factors associated with diarrhea and/or vomiting among schoolchildren in Myanmar. Cross-sectional data from a school-based multistage cluster sample of grade 4 and 5 students were analyzed to explore water, sanitation, and hygiene (WASH) facilities and hygiene-related practices of students in monastic schools in Myanmar. The outcome of interest was student self-reported diarrhea and/or vomiting in the past week. Random effects multinomial logistic regression models were used to explore correlates at the student and school level. A total of 2,082 students from 116 schools across eight states/regions were included. Of these, 11% (223) self-reported at least one episode of diarrhea only, 12% (253) at least one episode of vomiting only, and 12% (244) diarrhea and vomiting in the past week. Independent risk factors associated with the outcome included poor availability of handwash stations, no access to a septic tank toilet, inconsistent toilet use, and lower student grade. These findings highlight the importance of having an adequate number of handwash stations for students, the provision of septic tank toilets, and consistent toilet use. Future WASH programs need to target not only the provision of these WASH facilities but also their utilization, particularly among younger school-aged children.

Recurrent acute coronary events in a young adult.

Acute myocardial infarction (MI) in young adults is rare. Clinicopathological conditions such as nephrotic syndrome, antiphospholipid syndrome, spontaneous coronary artery spasms or embolism can be attributed to such events. In this case report, we present a 30-year-old male who had his first MI at the age of 20 years. He received percutaneous intervention as initial treatment. Despite aggressive risk factor management, he continued to have acute coronary events and was later diagnosed with antiphospholipid syndrome (APS). At the same time, he was diagnosed with severe chronic thromboembolic pulmonary hypertension and severe tricuspid regurgitation. He underwent pulmonary endartererectomy, tricuspid annuloplasty and radial artery bypass graft to the first obtuse marginal artery. Warfarin therapy was initiated upon the diagnosis of APS. Despite being therapeutic on warfarin and aggressive risk factor management, he had yet another MI. Coronary angiogram at this time showed fresh occlusion of the right coronary artery at the mid-segment, and the patient received two overlapping stents that achieved a good effect. This case emphasizes the importance of awareness, early recognition and aggressive management of patients with APS presenting chest pain or acute coronary events. Despite appropriate treatment, such as risk factor management and percutaneous interventions, recurrence of an acute coronary event is high. The presentation of younger patients with recurrent coronary events but no significant risk factors of atherosclerosis should evoke the suspicion of APS-related coronary artery disease, and all risk factors should be aggressively managed.

A new anthropoid from the latest middle Eocene of Pondaung, central Myanmar.

A new genus and species of medium-sized fossil primate, Myanmarpithecus yarshensis, is described from the lastest middle Eocene sediments of Pondaung, central Myanmar (Burma). The specimens consist of right maxillary fragments with P(4)-M(3)and a left mandibular corpus with C-P(3)and M(2-3). To date, three purported anthropoids have been discovered from the Pondaung Formation: Pondaungia and Amphipithecus (Amphipithecidae) and Bahinia (Eosimiidae). Myanmarpithecus differs from these other Pondaung primates in having cingular hypocones on upper molars and in lacking paraconids on M(2-3). Although Myanmarpithecus resembles some utahiin omomyines in superficial aspects of the morphology of M(2-3)(i.e., mesiodistally compressed molar trigonid and enamel crenulation), the morphological analysis of upper molars and lower premolars indicates that it is neither an omomyoid nor an adapoid but is more derived than fossil prosimians (such as adapoids, omomyoids, and tarsiers) and more anthropoid-like. On the other hand, it is more primitive (prosimian-like) than early anthropoids from the late Eocene/early Oligocene of the Fayum, Egypt. Myanmarpithecus is likely to be an early, primitive anthropoid ("protoanthropoid").

A lower jaw of Pondaungia cotteri from the Late Middle Eocene Pondaung Formation (Myanmar) confirms its anthropoid status.

Pondaungia cotteri is the largest primate known from the Late Middle Eocene Pondaung Formation, Myanmar. Its taxonomic status has been the subject of much debate because of the fragmentary nature of its remains. Initially described as an anthropoid, some authors recently have associated it with adapid primates. These debates have been fueled not only by the incompleteness of the fossils attributed to Pondaungia but also by the reticence of many authors to regard Asia as an important evolutionary theater for Eocene anthropoids. During the November 1998 Myanmar-French Pondaung Expedition, a right lower jaw was discovered that yields the most nearly complete dentition of Pondaungia cotteri ever found: it shows the complete horizontal ramus, alveoli for the second incisor and canine, three premolars, and three molars. The symphysis showed all characteristics of anthropoids but was unfused. The canine root is large, the first premolar is absent, and the second premolar is single-rooted, reduced, and oblique in the tooth row, as in anthropoids. The premolars show a reduced mesio-distal length compared with the tooth row, and their morphology is very similar to that of Amphipithecus mogaungensis. Therefore, the two Pondaung taxa appear to be closely related to each other, with Siamopithecus as their sister taxon.

A new primate from the Middle Eocene of Myanmar and the Asian early origin of anthropoids.

A new genus and species of anthropoid primate, Bahinia pondaungensis gen. et sp. nov., is described from the Yashe Kyitchaung locality in the Late Middle Eocene Pondaung Formation (Myanmar). It is related to Eosimias, but it is represented by more complete remains, including upper dentition with associated lower jaw fragment. It is interpreted as a new representative of the family Eosimiidae, which corresponds to the sister group of the Amphipithecidae and of all other anthropoids. Eosimiidae are now recorded from three distinct Middle Eocene localities in Asia, giving support to the hypothesis of an Asian origin of anthropoids.

The value of DNA flow cytometry in predicting the development of lymph node metastasis and survival in patients with locally recurrent oral squamous cell carcinoma.

BACKGROUND: DNA flow cytometry studies of squamous cell carcinoma of the head and neck have shown that patients with diploid tumors have favorable prognoses, whereas the outcomes of those with, aneuploid tumors are poor. This study was conducted to examine the importance of DNA ploidy in patients with locally recurrent oral carcinoma. METHODS: DNA flow cytometry was performed on 93 primary oral carcinomas and their subsequent recurrences. RESULTS: Eight patients with diploidy of both the primary tumor and the recurrence never developed lymph node metastasis. The 5-year overall survival rate of this group was 87%. For 80 aneuploid primary carcinomas, recurrences developed that were also aneuploid. Only 31% of these patients were 5-year survivors (P < 0.001). Lymph node metastasis at presentation was found in 55% of this group, whereas 13% of initially lymph node negative patients presented with regional disease at second surgery. Five of 13 diploid primary tumors recurred with aneuploid cell lines. Three of these five patients died, two with regional metastasis. The 5-year survival rate of patients with aneuploid recurrences who were never afflicted with lymph node involvement (41%) was better (P < 0.05) than the 5-year survival rate of those with metastasis at presentation or at second surgery (26%). CONCLUSIONS: The excellent prognosis of patients with diploid primary tumors can be reestablished by treating local recurrences with radical surgery, if the surgery is performed before aneuploid cell lines have emerged. It appears that aneuploid tumor cell lines acquire unique properties that make them capable of invasion and metastasis.

Morphology and blood supply of the iliac crest applied to jaw reconstruction.

The aim of this study was to improve vessel and nerve security and the harvesting procedure of the iliac crest in the microvascular reconstruction of the upper and lower jaw by iliac crest flap in cases of tumour invasion or trauma. The critical points for the surgeon in harvesting the iliac crest are the course of the deep circumflex iliac artery and lateral cutaneous nerve of the thigh in relation to the iliac crest and the position of their subsequent ramifications. Bilateral anatomical preparations of the iliac bone (total 90 dissections) were examined in 45 formalin preserved cadavers (21 male, 24 female) with the course of the vessel and nerve supply being mapped. Topographic variations of muscles, bones, vessels and nerves were documented by measurement by photographic documentation and diagrams. In 78% (70 cases) a standard-type arrangement with a single main vessel coming from the external iliac artery above the inguinal ligament and crossing the upper part of the iliac crest with second ramifications was observed. In 12% (11 cases) the main vessel was observed to be 2-3 cm below the iliac crest, in 7% (6 cases) a second main branch of the deep circumflex iliac artery was found to run parallel to the iliac crest. In other cases the following variations were observed: one main vessel without ramification, separate branching of the main vessel and ramifications or common trunks of the deep and superficial circumflex iliac arteries. Because of these results it might be possible to perform window resection of the iliac crest in some cases rather than bloc resection: this may have postoperative advantages for the patient.

[The Nikolowski trichoadenoma: a rare tumor of the ENT area]. / Das Trichoadenom Nikolowski: ein seltener Tumor im HNO-Gebiet.

A case of trichoadenoma Nikolowski in a 74-year-old woman is reported. The tumour invaded the upper lip, the base of the columella and the left nasal entrance. The tumour was cured by surgery and plastic reconstruction of the defect. This benign lesion of the hair follicles is rare and therefore often misdiagnosed as basal cell carcinoma or seborrheic keratosis. Examination of tumour cells by DNA-flow cytophotometry showed a normal diploid DNA-content of the tumour cells.

Comparison of flow cytometric DNA content in the primary tumor and in the corresponding lymph-node metastasis of patients with squamous cells carcinomas of the head and neck.

The clonal DNA content of the cell populations of primary tumors and corresponding lymph node metastases was analysed by DNA flow cytometry in 48 patients with squamous cell carcinoma of the oral cavity. Three primary tumors were diploid, two associated with diploid metastases, one showing an aneuploid cell line in the secondary lesion. Fourty-five cases were aneuploid in both the primary tumors and in the synchronous metastases, all characterized by nearly identical DNA indices of the corresponding primary and secondary lesions. With few exceptions, aneuploidy formation appears to take place prior to dissemination of metastatic cells.