BACKGROUND: Pulmonary arterial systolic pressure (PASP) can be estimated with transthoracic echocardiography. However, the significance of raised PASP on routine echocardiography is uncertain. In this study, we evaluated the mortality and hospitalization rates of subjects with raised PASP in a cohort of patients referred directly by their general practitioners for routine outpatient (open access) echocardiography for further analysis of suspected heart failure.
RESULTS: A total of 485 subjects were referred for open access echocardiography at our hospital in 2002. A cohort of 209/485 (43%) consecutive subjects with measurable tricuspid regurgitation were followed for a minimum of five years investigating hospitalization rates and survival. Some 62 of 209 (30%) subjects had pulmonary hypertension (PH). Subjects with PH were significantly more likely to have four or more hospital admissions (22% vs. 8%; P < 0.01) and > 30 days of cumulative hospital stay over five years (29% vs. 13%; P < 0.01). PH was significantly associated with mortality (P = 0.003), while moderate to severe PH was an independent predictor of mortality (hazard ratio: 4.31; 95% confidence interval (95% CI): 1.51-12.30). Records from the Office of National Statistics revealed that subjects with PH were more likely to have chronic lung diseases recorded as immediate or contributory causes of death (50% vs. 14%; P < 0.05).
CONCLUSIONS: PASP ≥ 36 mmHg on routine echocardiography is associated with recurrent hospital admissions, prolonged hospitalizations and increased cause of mortality. Therefore, the diagnosis of PH on echocardiography deserves further clinical evaluation, with future studies designed at defining a suitable diagnostic strategy.
KEYWORDS: Chronic lung disease; Dyspnoea; Heart failure; Pulmonary hypertension; Transthoracic echocardiography
Study site: Sunderland Royal Hospital, United Kingdom
MeSH terms: Echocardiography*; Great Britain; Hospitals; Humans
At present, there is no consensus in the scientific community regarding the ability for human papillomavirus (HPV) infections to establish latency. Based on animal studies, a model of papillomavirus latency has been proposed in which papillomaviruses can be retained in the basal epithelial stem cell pool as latent infections and periodically induced to reactivate when the stem cell divides and one daughter cell is committed to terminal differentiation and induction of the viral life cycle. Tissue resident memory T-cells are hypothesized to control these periodic reactivation episodes and thus limit their duration. In this paper, evidence from human studies consistent with this model of papillomavirus latency is reviewed. Given the strong circumstantial evidence supporting a natural history of HPV infection which includes a immunologically controlled latent state, the longer term implications of HPV latency on a highly infected and aging population may warrant a more serious evaluation.
To date, little is known about the effects of a reduced level of jumping exercise regimens on bone turnover markers and mass. This study investigates the effects of different jumping exercise regimens with varying exercise loads on serum bone turnover markers and bone mass in female rats.
Urtica dioica or stinging nettle is traditionally used as an herbal medicine in Western Asia. The current study represents the investigation of antimicrobial activity of U. dioica from nine crude extracts that were prepared using different organic solvents, obtained from two extraction methods: the Soxhlet extractor (Method I), which included the use of four solvents with ethyl acetate and hexane, or the sequential partitions (Method II) with a five solvent system (butanol). The antibacterial and antifungal activities of crude extracts were tested against 28 bacteria, three yeast strains and seven fungal isolates by the disc diffusion and broth dilution methods. Amoxicillin was used as positive control for bacteria strains, vancomycin for Streptococcus sp., miconazole nitrate (30 microg/mL) as positive control for fungi and yeast, and pure methanol (v/v) as negative control. The disc diffusion assay was used to determine the sensitivity of the samples, whilst the broth dilution method was used for the determination of the minimal inhibition concentration (MIC). The ethyl acetate and hexane extract from extraction method I (EA I and HE I) exhibited highest inhibition against some pathogenic bacteria such as Bacillus cereus, MRSA and Vibrio parahaemolyticus. A selection of extracts that showed some activity was further tested for the MIC and minimal bactericidal concentrations (MBC). MIC values of Bacillus subtilis and Methicillin-resistant Staphylococcus aureus (MRSA) using butanol extract of extraction method II (BE II) were 8.33 and 16.33mg/mL, respectively; while the MIC value using ethyl acetate extract of extraction method II (EAE II) for Vibrio parahaemolyticus was 0.13mg/mL. Our study showed that 47.06% of extracts inhibited Gram-negative (8 out of 17), and 63.63% of extracts also inhibited Gram-positive bacteria (7 out of 11); besides, statistically the frequency of antimicrobial activity was 13.45% (35 out of 342) which in this among 21.71% belongs to antimicrobial activity extracts from extraction method I (33 out of 152 of crude extracts) and 6.82% from extraction method II (13 out of 190 of crude extracts). However, crude extracts from method I exhibited better antimicrobial activity against the Gram-positive bacteria than the Gram-negative bacteria. The positive results on medicinal plants screening for antibacterial activity constitutes primary information for further phytochemical and pharmacological studies. Therefore, the extracts could be suitable as antimicrobial agents in pharmaceutical and food industry.
Eleven compounds:goniomicin A (1), goniomicin B (2), goniomicin C (3), goniomicin D (4), tapisoidin (5), goniothalamin (6), 9-deoxygoniopypyrone (7), pterodondiol (8), liriodenine (9), benzamide (10) and cinnamic acid (11), were isolated from the stem bark of Goniothalamus tapisoides. All compounds were identified by spectroscopic analysis and, for known compounds, by comparison with published data. Goniothalamin (6) exhibited mild cytotoxic activity towards a colon cancer cell line (HT-29), with an IC(50)value of 64.17 ± 5.60 µM. Goniomicin B (2) give the highest antioxidant activity in the DPPH assay among all compounds tested, with an IC(50) of 0.207 µM.
Passive dendrites become active as a result of electrostatic interactions by dielectric polarization in proteins in a segment of a dendrite. The resultant nonlinear cable equation for a cylindrical volume representation of a dendritic segment is derived from Maxwell's equations under assumptions: (i) the electric field is restricted longitudinally along the cable length; (ii) extracellular isopotentiality; (iii) quasi-electrostatic conditions; (iv) isotropic membrane and homogeneous medium with constant conductivity; and (v) protein polarization contributes to intracellular capacitive effects through a well defined nonlinear capacity-voltage characteristic; (vi) intracellular resistance and capacitance in parallel are connected to the membrane in series. Under the above hypotheses, traveling wave solutions of the cable equation are obtained as propagating fronts of electrical excitation associated with capacitive charge-equalization and dispersion of continuous polarization charge densities in an Ohmic cable. The intracellular capacitative effects of polarized proteins in dendrites contribute to the conduction process.
MeSH terms: Animals; Dendrites/physiology*; Electric Conductivity; Humans; Models, Neurological*; Proteins/physiology*
The objective of the present investigation is to formulate gastro retentive floating drug delivery systems (GRFDDS) of propranolol HCl by central composite design and to study the effect of formulation variables on floating lag time, D1hr (% drug release at 1 hr) and t90 (time required to release 90% of the drug). 3 factor central composite design was employed for the development of GRFDDS containing novel semi synthetic polymer carboxymethyl ethyl cellulose (CMEC) as a release retarding polymer. CMEC, sodium bicarbonate and Povidone concentrations were included as independent variables. The tablets were prepared by direct compression method and were evaluated for in vitro buoyancy and dissolution studies. From the polynomial model fitting statistical analysis, it was confirmed that the response floating lag time and D1hr is suggested to quadratic model and t90 is suggested to linear model. All the statistical formulations followed first order rate kinetics with non-Fickian diffusion mechanism. The desirability function was used to optimize the response variables, each having a different target, and the observed responses were highly agreed with experimental values. Statistically optimized formulation was characterized by FTIR and DSC studies and found no interactions between drug and polymer. The results demonstrate the feasibility of the model in the development of GRFDDS containing a propranolol HCl. Statistically optimized formulation was evaluated for in vivo buoyancy studies in healthy humans for both fed and fasted states. From the results, it was concluded that gastric residence time of the floating tablets were enhanced at fed stage but not in fasted state.
Development of resistance to imatinib mesylate (IM) in chronic myeloid leukemia (CML) patients is mediated by different mechanisms that can be classified as BCR-ABL dependent or BCR-ABL independent pathways. BCR-ABL dependent mechanisms are most frequently associated with point mutations in tyrosine kinase domain (TKD) of BCR-ABL1 and also with BCR-ABL gene amplification. Many different types and frequencies of mutations have been reported in different studies, probably due to the different composition of study cohorts. Since no reports are available from Malaysia, this study was undertaken to investigate the frequency and pattern of BCR-ABL kinase domain mutations using dHPLC followed by sequencing, and also status of BCR-ABL gene amplification using fluorescence in situ hybridization (FISH) on 40 IM resistant Malaysian CML patients. Mutations were detected in 13 patients (32.5%). Five different types of mutations (T315I, E255K, Y253H, M351T, V289F) were identified in these patients. In the remaining 27 IM resistant CML patients, we investigated the contribution made by BCR-ABL gene amplification, but none of these patients showed amplification. It is presumed that the mechanisms of resistance in these 27 patients might be due to BCR-ABL independent pathways. Different mutations confer different levels of resistance and, therefore, detection and characterization of TKD mutations is highly important in order to guide therapy in CML patients.
The research purpose was to experimentally investigate the effect of allicin administration on the levels of main type 1 diabetes (IDDM) autoantibodies which are anti-islet cell antibodies (ICA) with an attempt to find a relation between this immunological effect and histological and/or biochemical findings. We have evaluated, with the help of ELISA kits, the levels of ICA and serum insulin in male Sprague-Dawley rats with Streptozotocin-induced IDDM in addition to pancreatic histological findings. The four groups (6 rats each) under study received or not different intraperitoneal doses of allicin for a period of 30 days. Daily intraperitoneal administration of allicin (either at as low dose of 8 mg/kg or high dose of 16 mg/kg) for up to 30 days to type 1 diabetic rats effectively reduces levels of anti-islet cell antibodies and in addition, reduced the level of insulin due to damaged Langerhans islet cell was significantly increased in the serum due to a repairing tissue process in pancreatic tissues. These experimental results suggest that allicin treatment has a therapeutic protective effect against autoimmune reactions occurring in IDDM. The data may provide new strategies for using allicin to be recommended as an excellent candidate in the clinical management, control, and prevention of IDDM.
A study on physico-chemical parameters and pathogenic bacterial community was carried out at the coastal waters of Pulau Tuba island, Langkawi. The physico-chemical parameters such as temperature (27.43-28.88 degrees C), dissolved oxygen (3.79-6.49 mg l(-1)), pH (7.72-8.20), salinity (33.10-33.96 ppt), total dissolved solids (32.27-32.77 g l(-1)) and specific conductivity (49.83-51.63 mS cm(-1)) were observed. Station 3 and station 4 showed highest amount of nitrates (26.93 and 14.61 microg at N l(-1)) than station 1 (2.04 microg at N l(-1)) and station 2 (4.18 microg at N l(-1)). The highest concentration (12.4 +/- microg l(-1)) of chlorophyll a was observed in station 4 in October 2005. High phosphorus content (561 microg P l(-1)) was found in the station 2. Thirteen bacterial isolates were successfully identified using API 20E system. The highest amount of bacteria was observed at Station 4 (3400 CFU ml(-1)) and the lowest numberwas at Station 2 (890 CFU ml(-1)). Out of identified 13 Gram-negative bacterial isolates dominant species were Aeromonas hydrophila, Klebsiella oxytoca, Pseudomonas baumannii, Vibrio vulnificus, Proteus mirabilis, Providencia alcalifaciens and Serratia liquefaciens. Apart from this, oil biodegrading Pseudomonas putida were also identified. The study reveals the existing status of water quality is still conducive and the reasonably diverse with Gram-negative bacteria along the Pulau Tuba Langkawi.
MeSH terms: Gram-Negative Bacteria/isolation & purification*; Malaysia; Seawater/microbiology*; Time Factors; Water Microbiology*; Water Pollutants; Water Pollution
Polygonum chinense is a Malaysian ethnic plant with various healing effects. This study was to determine preventive effect of aqueous leaf extract of P. chinense against ethanol-induced gastric mucosal injury in rats. Sprague Dawley rats were divided into seven groups. The normal and ulcer control groups were orally administered with distilled water. The reference group was orally administered with 20 mg/kg omeprazole. The experimental groups received the extracts 62.5, 125, 250, and 500 mg/kg, accordingly. After sixty minutes, distilled water and absolute ethanol were given (5 mL/kg) to the normal control and the others, respectively. In addition to histology, immunohistochemical and periodic acid schiff (PAS) stains, levels of lipid peroxidation, malondialdehyde (MDA), antioxidant enzymes, and superoxide dismutase (SOD) were measured. The ulcer group exhibited severe mucosal damages. The experimental groups significantly reduced gastric lesions and MDA levels and increased SOD level. Immunohistochemistry of the experimental groups showed upregulation and downregulation of Hsp70 and Bax proteins, respectively. PAS staining in these groups exhibited intense staining as compared to the ulcer group. Acute toxicity study revealed the nontoxic nature of the extract. Our data provide first evidence that P. chinense extract could significantly prevent gastric ulcer.
A double-lateral-gate p-type junctionless transistor is fabricated on a low-doped (10(15)) silicon-on-insulator wafer by a lithography technique based on scanning probe microscopy and two steps of wet chemical etching. The experimental transfer characteristics are obtained and compared with the numerical characteristics of the device. The simulation results are used to investigate the pinch-off mechanism, from the flat band to the off state. The study is based on the variation of the carrier density and the electric-field components. The device is a pinch-off transistor, which is normally in the on state and is driven into the off state by the application of a positive gate voltage. We demonstrate that the depletion starts from the bottom corner of the channel facing the gates and expands toward the center and top of the channel. Redistribution of the carriers due to the electric field emanating from the gates creates an electric field perpendicular to the current, toward the bottom of the channel, which provides the electrostatic squeezing of the current.
The effects of curvature and tapering on the flow progression in the aorta were studied using numerical simulations on a realistic geometrical model of the aorta and three different versions of the ideal aorta models. The results showed that tapering increases velocity magnitude and wall shear stress while local curvatures affect the skewness of the velocity profile, the thickness of the boundary layer as well as the recirculation regions. Wall shear stress distribution in the aorta serves as an important determinant in the progression of arterial disease.
Infant asphyxia is a condition due to insufficient oxygen intake suffered by newborn babies. A 4 to 9 million occurrences of infant asphyxia are reported each year by WHO. Early diagnosis of asphyxia is important to avoid complications such as damage to the brain, organ and tissue that could lead to fatality. This is possible with the automation of screening of infant asphyxia. Here, a non-invasive Asphyxia Screening Kit is developed. It is a Graphical User Interface that automatically detects asphyxia in infants from early birth to 6 months from their cries and displays the outcome of analysis. It is built with Matlab GUI underlied with signal processing algorithms, capable of achieving a classification accuracy of 96.03%. Successful implementation of ASK will assist to screen infant asphyxia for reference to clinicians for early diagnosis. In addition, ASK also provides an interface to enter patient information and images to be integrated with existing Hospital Information Management System.
MeSH terms: Algorithms; Asphyxia Neonatorum/diagnosis*; Asphyxia Neonatorum/physiopathology; Crying/physiology; Humans; Infant, Newborn; Mass Screening/methods; ROC Curve; Signal Processing, Computer-Assisted*; User-Computer Interface; Neural Networks (Computer)*; Early Diagnosis
People typically associate health with only physical health. However, health is also interconnected to mental and emotional health. People who are emotionally healthy are in control of their behaviors and experience better quality of life. Hence, understanding human behavior is very important in ensuring the complete understanding of one's holistic health. In this paper, we attempt to map human behavior state (HBS) profiles onto recalibrated speech affective space model (rSASM). Such an approach is derived from hypotheses that: 1) Behavior is influenced by emotion, 2) Emotion can be quantified through speech, 3) Emotion is dynamic and changes over time and 4) the emotion conveyance is conditioned by culture. Empirical results illustrated that the proposed approach can complement other types of behavior analysis in such a way that it offers more explanatory components from the perspective of emotion primitives (valence and arousal). Four different driving HBS; namely: distracted, laughing, sleepy and normal are profiled onto the rSASM to visualize the correlation between HBS and emotion. This approach can be incorporated in the future behavior analysis to envisage better performance.
MeSH terms: Algorithms; Behavior/physiology*; Calibration; Emotions/physiology; Humans; Models, Biological*; Speech/physiology*; Databases as Topic; Asian Continental Ancestry Group
Cerebral activation and autonomic nervous system have importance in studies such as mental stress. The aim of this study is to analyze variations in EEG scalp potential which may influence autonomic activation of heart while playing video games. Ten healthy participants were recruited in this study. Electroencephalogram (EEG) and electrocardiogram (ECG) signals were measured simultaneously during playing video game and rest conditions. Sympathetic and parasympathetic innervations of heart were evaluated from heart rate variability (HRV), derived from the ECG. Scalp potential was measured by the EEG. The results showed a significant upsurge in the value theta Fz/alpha Pz (p<0.001) while playing game. The results also showed tachycardia while playing video game as compared to rest condition (p<0.005). Normalized low frequency power and ratio of low frequency/high frequency power were significantly increased while playing video game and normalized high frequency power sank during video games. Results showed synchronized activity of cerebellum and sympathetic and parasympathetic innervation of heart.
MeSH terms: Adult; Autonomic Nervous System/physiology*; Electrocardiography; Electroencephalography/methods*; Female; Heart Rate; Humans; Male; Scalp/physiology*; Video Games*; Young Adult
This paper describes how to employ distributed clock gating to achieve an overall low power design of a programmable waveform generator intended for a neural stimulator. The power efficiency is enabled using global timing control combined with local amplitude distribution over a bus to the local stimulator frontends. This allows the combination of local and global clock gating for complete sub-blocks of the design. A counter and a shifter employed at the local digital stimulator reduce the design complexity for the waveform generation and thus the overall power consumptions. The average power results indicate that 63% power can be saved for the global stimulator control unit and 89-96% power can be saved for the local digital stimulator by using the proposed approach. The circuit has been implemented and successfully tested in a 0.35 µm AMS HVCMOS technology.
Psoriasis is a common skin disorder with a prevalence of 0.6 - 4.8% around the world. The most common is plaques psoriasis and it appears as red scaling plaques. Psoriasis is incurable but treatable in a long term treatment. Although PASI (Psoriasis Area and Severity Index) scoring is recognised as gold standard for psoriasis assessment, this method is still influenced by inter and intra-rater variation. An imaging and analysis system called α-PASI is developed to perform PASI scoring objectively. Percentage of lesion area to the body surface area is one of PASI parameter. In this paper, enhanced imaging methods are developed to improve the determination of body surface area (BSA) and lesion area. BSA determination method has been validated on medical mannequin. BSA accuracies obtained at four body regions are 97.80% (lower limb), 92.41% (trunk), 87.72% (upper limb), and 83.82% (head). By applying fuzzy c-means clustering algorithm, the membership functions of lesions area for PASI area scoring have been determined. Performance of scoring result has been tested with double assessment by α-PASI area algorithm on body region images from 46 patients. Kappa coefficients for α-PASI system are greater than or equal to 0.72 for all body regions (Head - 0.76, Upper limb - 0.81, Trunk - 0.85, Lower limb - 0.72). The overall kappa coefficient for the α-PASI area is 0.80 that can be categorised as substantial agreement. This shows that the α-PASI area system has a high reliability and can be used in psoriasis area assessment.
MeSH terms: Algorithms; Body Surface Area*; Humans; Image Enhancement/methods; Image Interpretation, Computer-Assisted/methods*; Pattern Recognition, Automated/methods*; Psoriasis/pathology*; Sensitivity and Specificity; Severity of Illness Index*; Reproducibility of Results; Imaging, Three-Dimensional/methods; Dermoscopy/methods*; Whole Body Imaging/methods*
Selected landmarks from each of 47 maxillary dental casts were used to define a Cartesian-coordinate system from which the positions of selected teeth were determined on standardized digital images. The position of the i-th tooth was defined by a line of length (l(i)) joining the tooth to the origin, and the angle (θ(i)) of this line to the horizontal Cartesian axis. Four teeth, the central incisor, lateral incisor, canine and first molar were selected and their position were collectively used to represent the shape of the dental arch. A pilot study using clustering and principal component analysis strongly suggest the existence of 3 groups of arch shape. In this study, the homogeneity of the 3 groups was further investigated and confirmed by the Dunn and Davies-Bouldein validity indices. This is followed by an investigation of the probability distribution of these 3 groups. The main result of this study suggests 3 groups of multivariate (MV) normal distribution. The MV normal probability distribution of these groups may be used in further studies to investigate the issues of variation of arch shape, which is fundamental to the practice of prosthodontics and orthodontics.
Emotions are ambiguous. Many techniques have been employed to perform emotion prediction and to understand emotional elicitations. Brain signals measured using electroencephalogram (EEG) are also used in studies about emotions. Using KDE as feature extraction technique and MLP for performing supervised learning on the brain signals. It has shown that all channels in EEG can capture emotional experience. In addition it was also indicated that emotions are dynamic as represented by the level of valence and the intensity of arousal. Such findings are useful in biomedical studies, especially in dealing with emotional disorders which can results in using a two-channel EEG device for neurofeedback applications.