INTRODUCTION: HPS is a potentially life-threatening histiocytic disorder that has been described in various viral infections including dengue. Its involvement in severe and fatal dengue is probably more common but is presently under recognized.
CASE DESCRIPTION: A 38-year-old female was admitted after 5 days of fever. She was deeply jaundiced, leukopenic and thrombocytopenic. Marked elevation of transaminases, hyperbilirubinemia and hypoalbuminemia were observed. She had deranged INR values and prolonged aPTT accompanied with hypofibrinogenemia. She also had splenomegaly. She was positive for dengue IgM. Five days later she became polyuric and CT brain image showed gross generalized cerebral edema. Her conditions deteriorated by day 9, became confused with GCS of 9/15. Her BMAT showed minimal histiocytes. Her serum ferritin level peaked at 13,670.00 µg/mL and her sCD163 and sCD25 values were markedly elevated at 4750.00 ng/mL and 4191.00 pg/mL, respectively. She succumbed to the disease on day 10 and examination of her tissues showed the presence of dengue virus genome in the bone marrow.
DISCUSSION AND EVALUATION: It is described here, a case of fatal dengue with clinical features of HPS. Though BMAT results did not show the presence of macrophage hemophagocytosis, other laboratory features were consistent with HPS especially marked elevation of ferritin, sCD163 and sCD25. Detection of dengue virus in the patient's bone marrow, fifteen days after the onset of fever was also consistent with the suggestion that the HPS is associated with dengue virus infection.
CONCLUSIONS: The findings highlight HPS as a possible complication leading to severe dengue and revealed persistent dengue virus infection of the bone marrow. Detection of HPS markers; ferritin, sCD163 and sCD25, therefore, should be considered for early recognition of HPS-associated dengue.
KEYWORDS: Bone marrow; Dengue; Ferritin; Hemophagocytic syndrome; MAS; Macrophage
Study site: University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
The quality of underwater image is poor due to the properties of water and its impurities. The properties of water cause attenuation of light travels through the water medium, resulting in low contrast, blur, inhomogeneous lighting, and color diminishing of the underwater images. This paper proposes a method of enhancing the quality of underwater image. The proposed method consists of two stages. At the first stage, the contrast correction technique is applied to the image, where the image is applied with the modified Von Kries hypothesis and stretching the image into two different intensity images at the average value with respects to Rayleigh distribution. At the second stage, the color correction technique is applied to the image where the image is first converted into hue-saturation-value (HSV) color model. The modification of the color component increases the image color performance. Qualitative and quantitative analyses indicate that the proposed method outperforms other state-of-the-art methods in terms of contrast, details, and noise reduction.
This study investigates the clinicopathological features of acute experimental streptococcosis in red tilapia using various routes of infection; intraperitoneal (IP), immersion (IM) and immersion cut (IC). Twenty four red tilapia in duplicates were inoculated intraperitoneally with 10(9) CFU/ml of S. agalactiae while another sets: intact, one with sharp cut at the tail end were exposed to bacterial inoculums 10(9) CFU/ml diluted in water while two groups of control fish were similarly manipulated. Clinical signs were recorded; samples from the gills, brain, eyes and kidneys were also taken for bacterial isolation and histopathology. Immunohistochemistry (IHC) and polymerase chain reaction (PCR) were employed to detect the antigen. The diseased fish showed skin, fin haemorrhages and exophthalmia with obvious signs in IP at 2 hpc followed by IC and IM at 4 hpc. The lesions were noticed earlier in the kidney and most severe in IP. IHC detected antigen as early as PCR and isolation with intense staining in blood vessel lumen and wall, macrophages in choroid, focal haemorrhage in the renal interstitium and meninges especially in IP followed by IC and IM. The immunolocalisation of the antigen described for the first time further explain the pathogenesis of streptococcosis in red tilapia.
The evaluation and selection of inappropriate open source software in learning management system (OSS-LMS) packages adversely affect the business processes and functions of an organization. Thus, comprehensive insights into the evaluation and selection of OSS-LMS packages are presented in this paper on the basis of three directions. First, available OSS-LMSs are ascertained from published papers. Second, the criteria for evaluating OSS-LMS packages are specified.according to two aspects: the criteria are identified and established, followed by a crossover between them to highlight the gaps between the evaluation criteria for OSS-LMS packages and the selection problems. Third, the abilities of selection methods that appear fit to solve the problems of OSS-LMS packages based on the multi-criteria evaluation and selection problem are discussed to select the best OSS-LMS packages. Results indicate the following: (1) a list of active OSS-LMS packages; (2) the gaps on the evaluation criteria used for LMS and other problems (consisting of main groups with sub-criteria); (3) use of multi-attribute or multi-criteria decision-making (MADM/MCDM) techniques in the framework of the evaluation and selection of the OSS in education as recommended solutions.
Recently, the study of the fractional formal (operators, polynomials and classes of special functions) has been increased. This study not only in mathematics but extended to another topics. In this effort, we investigate a generalized integro-differential operator [Formula: see text] defined by a fractional formal (fractional differential operator) and study some its geometric properties by employing it in new subclasses of analytic univalent functions.
A review on CMOS delay lines with a focus on the most frequently used techniques for high-resolution delay step is presented. The primary types, specifications, delay circuits, and operating principles are presented. The delay circuits reported in this paper are used for delaying digital inputs and clock signals. The most common analog and digitally-controlled delay elements topologies are presented, focusing on the main delay-tuning strategies. IC variables, namely, process, supply voltage, temperature, and noise sources that affect delay resolution through timing jitter are discussed. The design specifications of these delay elements are also discussed and compared for the common delay line circuits. As a result, the main findings of this paper are highlighting and discussing the followings: the most efficient high-resolution delay line techniques, the trade-off challenge found between CMOS delay lines designed using either analog or digitally-controlled delay elements, the trade-off challenge between delay resolution and delay range and the proposed solutions for this challenge, and how CMOS technology scaling can affect the performance of CMOS delay lines. Moreover, the current trends and efforts used in order to generate output delayed signal with low jitter in the sub-picosecond range are presented.
In the existing electroencephalogram (EEG) signals peak classification research, the existing models, such as Dumpala, Acir, Liu, and Dingle peak models, employ different set of features. However, all these models may not be able to offer good performance for various applications and it is found to be problem dependent. Therefore, the objective of this study is to combine all the associated features from the existing models before selecting the best combination of features. A new optimization algorithm, namely as angle modulated simulated Kalman filter (AMSKF) will be employed as feature selector. Also, the neural network random weight method is utilized in the proposed AMSKF technique as a classifier. In the conducted experiment, 11,781 samples of peak candidate are employed in this study for the validation purpose. The samples are collected from three different peak event-related EEG signals of 30 healthy subjects; (1) single eye blink, (2) double eye blink, and (3) eye movement signals. The experimental results have shown that the proposed AMSKF feature selector is able to find the best combination of features and performs at par with the existing related studies of epileptic EEG events classification.
Various peak models have been introduced to detect and analyze peaks in the time domain analysis of electroencephalogram (EEG) signals. In general, peak model in the time domain analysis consists of a set of signal parameters, such as amplitude, width, and slope. Models including those proposed by Dumpala, Acir, Liu, and Dingle are routinely used to detect peaks in EEG signals acquired in clinical studies of epilepsy or eye blink. The optimal peak model is the most reliable peak detection performance in a particular application. A fair measure of performance of different models requires a common and unbiased platform. In this study, we evaluate the performance of the four different peak models using the extreme learning machine (ELM)-based peak detection algorithm. We found that the Dingle model gave the best performance, with 72 % accuracy in the analysis of real EEG data. Statistical analysis conferred that the Dingle model afforded significantly better mean testing accuracy than did the Acir and Liu models, which were in the range 37-52 %. Meanwhile, the Dingle model has no significant difference compared to Dumpala model.
l-2-Haloacid dehalogenase (DehL) from Rhizobium sp. RC1 is a stereospecific enzyme that acts exclusively on l-isomers of 2-chloropropionate and dichloroacetate. The amino acid sequence of this enzyme is substantially different from those of other l-specific dehalogenases produced by other organisms. DehL has not been crystallised, and hence its three-dimensional structure is unavailable. Herein, we review what is known concerning DehL and tentatively identify the amino acid residues important for catalysis based on a comparative structural and sequence analysis with well-characterised l-specific dehalogenases.
There is currently no established bacteriological beach quality monitoring (BQM) program in place in Malaysia. To initiate cost-effective, sustainable bacteriological BQM schemes for the ultimate goal of protecting public health, policy decision makers need to be provided robust, indigenous empirical findings that validate appropriate water quality parameters for inclusion in such monitoring programs. This is the first study that assesses the validity of enterococci as an ideal indicator for bacteriological BQM in Malaysia using a multivariate approach. Beach water and sand samples from 7 beach locations were analyzed for a total of twenty-one microbial and non-microbial water quality parameters. A multivariate approach incorporating cluster analyses (CA), principal component analyses (PCA), and factor analysis (FA) was also adopted. Apart from the weak correlations of Staphylococcus aureus with concentrations of Vibro species (r = 0.302, p = 0.037) and total coliforms (r = 0.392, p = 0.006) in seawater, no correlation existed between S. aureus concentration and other parameters. Faecal coliforms failed to correlate with any of the tested parameters. Enterococci also correlated with more quality parameters than faecal coliforms or any other indicator. Multiple linear regressions highlighted a significant, best fit model that could predict enterococci concentrations in relation to other parameters with a maximum predictive success of 69.64%. PCA/FA clearly delineated enterococci and faecal coliforms as parameters that weighed strongly for BQM while Staphylococcus aureus, faecal coliforms and enterococci weighed strongly for beach sand quality monitoring. On the whole, higher correlations of enterococci levels with other parameters than was observed for faecal coliforms suggest that the former be considered a preferred parameter of choice for BQM in Malaysia. Our findings provide meaningful evidence particularly as it relates to the correlation of Enterococci with pathogens and other non-microbial parameters. It also provides empirical data to validate the applicability of the enterococci indicator paradigm for bacteriological beach quality monitoring in Malaysia. The current study thus provides policy decision makers evidenced based approach to parameter streamlining for optimized beach sampling and sustainable bacteriological quality monitoring.
The exp(-Ф(η))-expansion method is an ascending method for obtaining exact and solitary wave solutions for nonlinear evolution equations. In this article, we implement the exp(-Ф(η))-expansion method to build solitary wave solutions to the fourth order Boussinesq equation. The procedure is simple, direct and useful with the help of computer algebra. By using this method, we obtain solitary wave solutions in terms of the hyperbolic functions, the trigonometric functions and elementary functions. The results show that the exp(-Ф(η))-expansion method is straightforward and effective mathematical tool for the treatment of nonlinear evolution equations in mathematical physics and engineering.
The (G'/G)-expansion method is one of the most direct and effective method for obtaining exact solutions of nonlinear partial differential equations (PDEs). In the present article, we construct the exact traveling wave solutions of nonlinear evolution equations in mathematical physics via the (2 + 1)-dimensional breaking soliton equation by using two methods: namely, a further improved (G'/G)-expansion method, where G(ξ) satisfies the auxiliary ordinary differential equation (ODE) [G'(ξ)](2) = p G (2)(ξ) + q G (4)(ξ) + r G (6)(ξ); p, q and r are constants and the well known extended tanh-function method. We demonstrate, nevertheless some of the exact solutions bring out by these two methods are analogous, but they are not one and the same. It is worth mentioning that the first method has not been exercised anybody previously which gives further exact solutions than the second one. PACS numbers 02.30.Jr, 05.45.Yv, 02.30.Ik.
Over the years, (G'/G)-expansion method is employed to generate traveling wave solutions to various wave equations in mathematical physics. In the present paper, the alternative (G'/G)-expansion method has been further modified by introducing the generalized Riccati equation to construct new exact solutions. In order to illustrate the novelty and advantages of this approach, the (1+1)-dimensional Drinfel'd-Sokolov-Wilson (DSW) equation is considered and abundant new exact traveling wave solutions are obtained in a uniform way. These solutions may be imperative and significant for the explanation of some practical physical phenomena. It is shown that the modified alternative (G'/G)-expansion method an efficient and advance mathematical tool for solving nonlinear partial differential equations in mathematical physics.
In this article, we introduce an ansatz involving exact traveling wave solutions to nonlinear partial differential equations. To obtain wave solutions using direct method, the choice of an appropriate ansatz is of great importance. We apply this ansatz to examine new and further general traveling wave solutions to the (1+1)-dimensional modified Benjamin-Bona-Mahony equation. Abundant traveling wave solutions are derived including solitons, singular solitons, periodic solutions and general solitary wave solutions. The solutions emphasize the nobility of this ansatz in providing distinct solutions to various tangible phenomena in nonlinear science and engineering. The ansatz could be more efficient tool to deal with higher dimensional nonlinear evolution equations which frequently arise in many real world physical problems.
Breast cancer is the most frequent cancer and the second reason of cancer deaths among woman worldwide, including Malaysia. The objective of this paper is to assess the practice of breast self-examination (BSE) and identify the barriers of BSE practice among undergraduate female students in Malaysia.
Microbial degradation of lignin releases fermentable sugars, effective utilization of which could support biofuel production from lignocellulosic biomass. In the present study, a lignin-degrading bacterium was isolated from leaf soil and identified as Burkholderia sp. based on 16S rRNA gene sequencing. This strain was named CCA53, and its lignin-degrading capability was assessed by observing its growth on medium containing alkali lignin or lignin-associated aromatic monomers as the sole carbon source. Alkali lignin and at least eight lignin-associated aromatic monomers supported growth of this strain, and the most effective utilization was observed for p-hydroxybenzene monomers. These findings indicate that Burkholderia sp. strain CCA53 has fragmentary activity for lignin degradation.
Achievement of the optimal hydropower generation from operation of water reservoirs, is a complex problems. The purpose of this study was to formulate and improve an approach of a genetic algorithm optimization model (GAOM) in order to increase the maximization of annual hydropower generation for a single reservoir. For this purpose, two simulation algorithms were drafted and applied independently in that GAOM during 20 scenarios (years) for operation of Mosul reservoir, northern Iraq. The first algorithm was based on the traditional simulation of reservoir operation, whilst the second algorithm (Salg) enhanced the GAOM by changing the population values of GA through a new simulation process of reservoir operation. The performances of these two algorithms were evaluated through the comparison of their optimal values of annual hydropower generation during the 20 scenarios of operating. The GAOM achieved an increase in hydropower generation in 17 scenarios using these two algorithms, with the Salg being superior in all scenarios. All of these were done prior adding the evaporation (Ev) and precipitation (Pr) to the water balance equation. Next, the GAOM using the Salg was applied by taking into consideration the volumes of these two parameters. In this case, the optimal values obtained from the GAOM were compared, firstly with their counterpart that found using the same algorithm without taking into consideration of Ev and Pr, secondly with the observed values. The first comparison showed that the optimal values obtained in this case decreased in all scenarios, whilst maintaining the good results compared with the observed in the second comparison. The results proved the effectiveness of the Salg in increasing the hydropower generation through the enhanced approach of the GAOM. In addition, the results indicated to the importance of taking into account the Ev and Pr in the modelling of reservoirs operation.
A qualitative method using focus group discussions (FGDs) was applied in this study to identify people's perceptions on newspaper reporting pertaining to the Southern Separatist Movement (SSM) by different Yemeni newspapers. This paper also looked into the attitudes towards the movement and the popularity of the issue of Yemeni unification. Five FGD groups with a total of 30 participants discussed the subject and some other aspects related to it. The findings of the focu19 groups showed that the southern crisis and SSM had shaken the people's trust on the current form of the unity. The discussion with the groups revealed that media in general and the selected four papers from various political persuasions have no credibility and objectivity, but these papers are trying to instill democratic values which is consistent with their ideology, which have a serious impact on the value of liberal democracy. The participants assured that reporting on the southern cause and the SSM indicated the absence of professional journalism in the media and the political discourse in general.
Preservation of privacy in data mining has emerged as an absolute prerequisite for exchanging confidential information in terms of data analysis, validation, and publishing. Ever-escalating internet phishing posed severe threat on widespread propagation of sensitive information over the web. Conversely, the dubious feelings and contentions mediated unwillingness of various information providers towards the reliability protection of data from disclosure often results utter rejection in data sharing or incorrect information sharing. This article provides a panoramic overview on new perspective and systematic interpretation of a list published literatures via their meticulous organization in subcategories. The fundamental notions of the existing privacy preserving data mining methods, their merits, and shortcomings are presented. The current privacy preserving data mining techniques are classified based on distortion, association rule, hide association rule, taxonomy, clustering, associative classification, outsourced data mining, distributed, and k-anonymity, where their notable advantages and disadvantages are emphasized. This careful scrutiny reveals the past development, present research challenges, future trends, the gaps and weaknesses. Further significant enhancements for more robust privacy protection and preservation are affirmed to be mandatory.
A decrease in the lineage commitment of multipotent Mesenchymal stem cells (MSC) to the bone forming osteoblast lineage and an increase in the commitment to the fat forming adipocyte lineage is more common in bone marrow of elderly persons. A link between methylation status and MSC differentiation remains unclear. Therefore, we hypothesize that hypomethylation may decide the fate decisions of MSC. In the current study, murine bone marrow derived-C3H10T1/2 stem cell was used to examine the role of methylation mechanism on the differentiation potential of stem cells into osteoblasts or adipocytes. C3H10T1/2 cells were treated with Periodate oxidized adenosine (Adox), an inhibitor of S-adenosylhomocysteine-dependent hydrolase (SAHH), which in turn block the non-DNA methylation pathway. The effect of hypomethylation on C3H10T1/2 stem cell differentiation was determined by measuring the alkaline phosphates activity and the degree of mineralization as well as Oil-red O staining and lipid content. The ratio of S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) was determined as a metabolic indicator of cellular methylation potential. It was clearly observed that hypomethylation significantly (P