Machine Learning Approach for the Outcome Prediction of Temporal Lobe Epilepsy Surgery

Epilepsy surgery is effective in reducing both the number and frequency of seizures, particularly in temporal lobe epilepsy (TLE). Nevertheless, a significant proportion of these patients continue suffering seizures after surgery. Here we used a machine learning approach to predict the outcome of epilepsy surgery based on supervised classification data mining taking into account not only the common clinical variables, but also pathological and neuropsychological evaluations. We have generated models capable of predicting whether a patient with TLE secondary to hippocampal sclerosis will fully recover from epilepsy or not. The machine learning analysis revealed that outcome could be predicted with an estimated accuracy of almost 90% using some clinical and neuropsychological features. Importantly, not all the features were needed to perform the prediction; some of them proved to be irrelevant to the prognosis. Personality style was found to be one of the key features to predict the outcome. Although we examined relatively few cases, findings were verified across all data, showing that the machine learning approach described in the present study may be a powerful method. Since neuropsychological assessment of epileptic patients is a standard protocol in the pre-surgical evaluation, we propose to include these specific psychological tests and machine learning tools to improve the selection of candidates for epilepsy surgery.     

Essential tremor.

Essential tremor, including the juvenile and senile variations, may be a result of a disorder of the servomechanism that controls physiologic tremor. Hands and arms are affected most commonly, and the tremor can vary in amplitude as well as frequency. Long-term treatment with propranolol has been helpful for some patients, although older patients are less likely to benefit. Other drugs and behaviour modification therapy have been less successful. Surgical treatment is effective but should probably be reserved for severe cases. An effective instrument for measuring the subjective and objective aspects of the tremor is still needed, as is an effective long-term method of treatment.     

Evaluation of mouse brain-derived, inactivated Japanese encephalitis vaccine

Japanese encephalitis (JE) is a serious encephalitis caused by JE virus. Approximately 20% of JE patients die and 50% patients recover with neuro-psychiatric sequelae. In Japan, the number of JE patients was over 1000 per year in 1960s; however, the number decreased dramatically and has been less than 10 since 1990. Ministry of Health, Labour and Welfare suspended the strong recommendation for vaccination with the mouse brain-derived JE vaccine, because of cases who developed acute disseminated encephalomyelitis (ADEM) after vaccination with JE vaccine. However, it has not been fully confirmed on scientific bases that ADEM was caused by mouse brain-derived JE vaccine. Tissue culture derived-JE vaccine is under development. It is expected that this new vaccine will come to the market soon and that the recommendation of universal vaccination with JE vaccine will be implemented at the earliest occasion.     

腹腔镜胆囊切除术治疗高龄患者急性胆囊炎的临床观察

目的：探讨腹腔镜胆囊切除术治疗高龄患者急性胆囊炎的应用价值。方法：回顾性分析2005年1月．2011年12月我院收治的210例65岁以上因急性胆囊炎实施胆囊切除术的老年患者的临床资料,按手术方式分为腹腔镜组（LC组）和剖腹胆囊切除术组（OC组）,分析和比较两组患者的手术时间、术后肠功能恢复时间及住院时间,术中出血、腹腔引流量和术后并发症的发生情况。结果：与OC组比较,LC组的手术时间、术后肠功能恢复时间及住院时间均显著缩短,差异有统计学意义（P〈0．01）;但两组之间术中出血、腹腔引流量和术后并发症的发生率差异均无统计学意义（P〉0．05）。LC组中转开腹10例,占7_35％;其中粘连严重导致胆囊三角解剖不清6例,无法控制的出血2例,结石嵌顿胆囊管2例。结论：老年急性胆囊炎患者在条件合适的情况下行腹腔镜胆囊切除术治疗有助于患者更快地恢复．具有较强的临床应用价值。     

Food Intake and Circadian Rhythms of Activity of Red-Winged Blackbirds (Agelaius phoeniceus). A Time-Course Study on the Effects of Alpha-Chloralose and Secobarbital

Anesthetic drugs like alpha-chloralose and secobarbital are used to capture wild birds. The doses are usually chosen on the basis of low mortality rates and high capture success. However, little information is available on the time necessary for the birds to fully recover from the drugs' effects after they have regained consciousness. In this work, we used circadian rhythms of activities to study the long-term effects of a mixture of alpha-chloralose and secobarbital on adult male Red-winged Blackbirds. The birds were housed individually in sound-proof boxes for 30 days, during which they received alpha-chloralose and secobarbital mixed with corn, either on day 3 or on day 15. On the day of treatment, the birds experienced a significant decrease in activity level, including feeding activities, which lasted more than 22 days for the birds treated on day 3, compared to about 8 days for the birds treated on day 15. Moreover, typical circadian distribution of activity was lost and many birds became aperiodic. Two weeks were needed for the birds treated on day 3 to recover normal rhythms, compared to less than 9 days for those treated on day 15. These results indicate that circadian parameters can be used to detect after-effects of intoxication long after the birds have regained consciousness.     

Proprioceptive Interaction between the Two Arms in a Single-Arm Pointing Task

Proprioceptive signals coming from both arms are used to determine the perceived position of one arm in a two-arm matching task. Here, we examined whether the perceived position of one arm is affected by proprioceptive signals from the other arm in a one-arm pointing task in which participants specified the perceived position of an unseen reference arm with an indicator paddle. Both arms were hidden from the participant’s view throughout the study. In Experiment 1, with both arms placed in front of the body, the participants received 70–80 Hz vibration to the elbow flexors of the reference arm (= right arm) to induce the illusion of elbow extension. This extension illusion was compared with that when the left arm elbow flexors were vibrated or not. The degree of the vibration-induced extension illusion of the right arm was reduced in the presence of left arm vibration. In Experiment 2, we found that this kinesthetic interaction between the two arms did not occur when the left arm was vibrated in an abducted position. In Experiment 3, the vibration-induced extension illusion of one arm was fully developed when this arm was placed at an abducted position, indicating that the brain receives increased proprioceptive input from a vibrated arm even if the arm was abducted. Our results suggest that proprioceptive interaction between the two arms occurs in a one-arm pointing task when the two arms are aligned with one another. The position sense of one arm measured using a pointer appears to include the influences of incoming information from the other arm when both arms were placed in front of the body and parallel to one another.     

USE AND ABUSE OF NASOGASTRIC INTUBATION

The value of nasogastric intubation in the treatment of paralytic ileus and in some cases of mechanical obstruction, as well as in the preparation of obstructed patients for operation, cannot be denied. However, it is felt that intubation is oftentimes employed unnecessarily, and that the complications of this procedure are not fully appreciated. Fluid and electrolyte loss, sinusitis, parotitis, laryngeal obstruction, esophagitis, knotting and difficulty in withdrawing tubes and perforations of the gastrointestinal tract are complications that can occur when nasogastric intubation is employed.Two hundred consecutive operations on the gallbladder and bile ducts were reviewed, and the need for intubation in these cases was evaluated. It was needed in only 7.5 per cent of the cases in the series. In light of the hazards and the rather rare necessity for nasogastric intubation, “routine” use should be eschewed.     

Activity of upper limb muscles during human walking

The EMG activity of upper limb muscles during human gait has rarely been studied previously. It was examined in 20 normal volunteers in four conditions: walking on a treadmill (1) with unrestrained natural arm swing (Normal), (2) while volitionally holding the arms still (Held), (3) with the arms immobilized (Bound), and (4) with the arms swinging in phase with the ipsilateral legs, i.e. opposite-to-normal phasing (Anti-Normal). Normal arm swing involved weak rhythmical lengthening and shortening contractions of arm and shoulder muscles. Phasic muscle activity was needed to keep the unrestricted arms still during walking (Held), indicating a passive component of arm swing. An active component, possibly programmed centrally, existed as well, because some EMG signals persisted when the arms were immobilized during walking (Bound). Anti-Normal gait involved stronger EMG activity than Normal walking and was uneconomical. The present results indicate that normal arm swing has both passive and active components.     

One-pot synthesis of star-shaped macromolecules containing polyglycidol and poly(ethylene oxide) arms

Synthesis of fully hydrophilic star-shaped macromolecules with different kinds of arms (A(x)B(y)C(z)) based on polyglycidol (PGL, A(x)) and poly(ethylene oxide) (PEO, C(z)) arms and diepoxy compounds (diglycidyl ethers of ethylene glycol (DGEG) or neopentyl glycol (DGNG) in the core, B(y)) forming the core is described. Precursors of arms were prepared by polymerization of glycidol with protected -OH groups. The first-generation stars were formed in the series of consecutive-parallel reactions of arms A(x) with diepoxy compounds (B). These first-generation stars (A(x)B(y)), having approximately O-, Mt+ groups on the cores, were used as multianionic initiators for the second generation of arms (C(z)) built by polymerization of ethylene oxide. The products with M(n) up to 10(5) and having up to approximately 40 arms were obtained. The number of arms (f) was determined by direct measurements of M(n) of the first-generation stars (M(n) of arms A(x) is known), compared with f calculated from the branching index g, determined from R(g) measured with size-exclusion chromatography (SEC) triple detection with TriSEC software. The progress of the star formation was monitored by 1H NMR and SEC. These novel water-soluble stars, having a large number of hydroxyl groups, both at the ends of PEO arms as well as within the PGL arms, can be functionalized and further used for attaching compounds of interest. This approach opens, therefore, a new way of "multiPEGylation".     

Heterosynapsis in two fertile but hypoprolific boars carriers of reciprocal translocations.

The authors report here two new cases of reciprocal translocations in two fertile and hypoprolific boars. Silver stained synaptonemal complexes in surface-spread pachytene nuclei from a boar heterozygous for a reciprocal translocation, and from another one carrying two different reciprocal translocations, were analyzed by electron microscopy. In such heterozygotes, cross-shaped quadrivalent configurations are expected to form in order to allow homologous pairing. In the same boar, the lengths of the fully synapsed arms of the quadrivalent varies from one quadrivalent to the other and heterosynapsis was obvious. Heterosynapsis was also observed with asymmetrical pairing of the non-homologous partners of the quadrivalent. This heterosynapsis is assumed to be a mechanism preventing spermatocyte loss, but inducing a secondary segregational type of impairment of fertility due to foetal wastage leading to reduced prolificacy.     

Food Intake and Circadian Rhythms of Activity of Red-Winged Blackbirds (Agelaius phoeniceus). A Time-Course Study on the Effects of Alpha-Chloralose and Secobarbital

Anesthetic drugs like alpha-chloralose and secobarbital are used to capture wild birds. The doses are usually chosen on the basis of low mortality rates and high capture success. However, little information is available on the time necessary for the birds to fully recover from the drugs' effects after they have regained consciousness. In this work, we used circadian rhythms of activities to study the long-term effects of a mixture of alpha-chloralose and secobarbital on adult male Red-winged Blackbirds. The birds were housed individually in sound-proof boxes for 30 days, during which they received alpha-chloralose and secobarbital mixed with corn, either on day 3 or on day 15. On the day of treatment, the birds experienced a significant decrease in activity level, including feeding activities, which lasted more than 22 days for the birds treated on day 3, compared to about 8 days for the birds treated on day 15. Moreover, typical circadian distribution of activity was lost and many birds became aperiodic. Two weeks were needed for the birds treated on day 3 to recover normal rhythms, compared to less than 9 days for those treated on day 15. These results indicate that circadian parameters can be used to detect after-effects of intoxication long after the birds have regained consciousness.     

Canine distemper virus in wild ferret-badgers of Taiwan

Canine distemper is an acute or subacute, highly contagious, febrile disease that is caused by canine distemper virus (CDV). Two CDV-infected wild Taiwan ferret-badgers (Melogale moschata subauantiaca) were found in Kaohsiung County, southern Taiwan, in 2005. Each case was confirmed by detecting CDV RNA in lung and brain tissues. A suspected third case was detected based on clinical signs and histology. These cases are the first record of wildlife infected by CDV in Taiwan. It is believed that domestic dogs or coexisting wild carnivores infected with the virus were the most likely source, and a serologic survey is needed to fully understand the host range of this virus in Taiwan. In addition, further genetic sequencing is needed to determine the source of these CDV cases.     

Twist limits for late twisting double somersaults on trampoline

An angle-driven computer simulation model of aerial movement was used to determine the maximum amount of twist that could be produced in the second somersault of a double somersault on trampoline using asymmetrical movements of the arms and hips. Lower bounds were placed on the durations of arm and hip angle changes based on performances of a world trampoline champion whose inertia parameters were used in the simulations. The limiting movements were identified as the largest possible odd number of half twists for forward somersaulting takeoffs and even number of half twists for backward takeoffs. Simulations of these two limiting movements were found using simulated annealing optimisation to produce the required amounts of somersault, tilt and twist at landing after a flight time of 2.0 s. Additional optimisations were then run to seek solutions with the arms less adducted during the twisting phase. It was found that 3½ twists could be produced in the second somersault of a forward piked double somersault with arms abducted 8° from full adduction during the twisting phase and that three twists could be produced in the second somersault of a backward straight double somersault with arms fully adducted to the body. These two movements are at the limits of performance for elite trampolinists.     

Conservation of whole arms during chromosomal divergence of phyllotine rodents

The assumption of simple fusion in a group showing a constant number of chromosome arms was tested by comparison of the G-band patterns of chromosomes of three Phyllotis species. The karyotypes, each of which has 40 chromosome arms, have a 2n of 38, 38, and 40 and are made up of mostly metacentric chromosomes. Operational concepts describing the amount of matching in G-band patterns are proposed, separating chromosomes or arms into those with total correspondence, partial correspondence, or unique cases. Seven chromosomes and 21 arms out of the total were identical in the three species, denoting a conservation of whole-arm band sequences in this group. A greater number of identical arms than of identical chromosomes were observed, giving some support to the simple fusion hypothesis. An unexpected chromosomal divergence was detected, including chromosomal variation in the C-banded sex chromosomes.     

Hypoglossia-hypodactyly syndrome: report of 2 patients

Hypoglossia-hypodactyly syndrome: report of 2 patients: Two newborns with severe limb deformities and hypoglossia, with micro- and retrognathia are reported. The first patient had a transverse agenesia just below the knee of both legs and below the elbow of both arms. A Krukenberg phalangisation was performed and rehabilitation of march with prosthetics at an early age. The second child had less severe deformities and needed no corrective surgery till now.     

Widespread absence of outer dynein arms in the spermatozoids of lower plants

Transverse sections of flagellar axonemes from a variety of lower plant spermatozoids were examined by electron microscopy. Motile sperm of four ferns (Marsilea, Pteridium, Lygodium and Aneimia), a horsetail (Equisetum) and a liverwort (Marchantia) were fixed in the presence of tannic acid to visualise the dynein arms. In all cases the inner dynein arms were clearly resolved but the outer arms were absent. Absence of outer arms therefore appears to be a common feature of the archegoniate plants. The implications of these findings to our understanding of the evolution of the land plants and the role of the dynein arms in flagellar beating is discussed.     

Abnormalities in mutual influences of upper and lower limbs in patients with stroke

Previously, in healthy subjects the common pattern of muscle activation and specifics of interlimb neuron connections during performance of rhythmic separate and simultaneous movements of arms and legs in the lying position, which reflect functional meaningful of interlimb interactions, were shown. The aim of this research was to investigate such mutual influences of upper and lower limbs during the execution of similar motor tasks by patients with stroke. In sixteen poststroke patients with different stage of hemiparesis arms movements together with or without legs movements were performed, while lying supine. It was demonstrated that the common pattern of muscle activity distribution under the execution of voluntary cyclic movements by both arms was disordered. Passive rhythmic movements of each arm caused the phased EMG activity in shoulder muscles in patients with mild hemiparesis, but no activation was observed in patients with severe paresis. The loading of nonparetic arm resulted in an increasing of activity in shoulder flexor muscles of paretic arm in patients with weak paresis (which was typical for healthy subjects), while it not exerted essential influences in patients with severe paresis. Under connecting the cyclic movements of arms with stepping movements of legs in diagonal synergy the activity in proximal muscles of both arms was decreased irrespective of the paresis degree, as it was seeing in healthy subjects. Simultaneous arms and legs movements did not change the muscle activity in non-paretic leg in both groups of patients, but in some muscles of paretic leg the activity even decreased. The results obtained revealed important features of poststroke motor disturbances, which caused the changes of interlimb interaction and in great degree depended on the level of paresis. The data of investigation can be of a great importance for developing the new methods for rehabilitative procedure in patients with stroke.     

Regenerative ability of double-half and half upper arms in the newt, Notophthalmus viridescens

The upper arms of adult newts (Notophthalmus viridescens) were surgically manipulated to create double-half dorsal, double-half ventral, double-half anterior, and double-half posterior upper arms, and longitudinal half-dorsal, half-ventral, half-anterior, and half-posterior upper arms. Amputation through the double-half upper arms usually failed to elicit normal distal regeneration, despite the fact that an apparently normal regeneration blastema was initially formed. Instead, regeneration in these cases was limited to the formation of a variable number of small cartilage elements. On the basis of these results it is concluded that a complete limb circumference is required for distal transformation in newts, in addition to the well-established requirements for a wound epidermis, adequate innervation and dedifferentiation leading to blastema formation. A model for the sequential generation of new parts of the limb pattern during distal transformation from a complete circumference is presented. This model can also account for the occurrence of normal early stages of regeneration in double-half upper arms. Half upper arms which were amputated immediately were shown to develop single, complete regenerates. If amputation of half upper arms was delayed three or more weeks to permit complete wound healing, a supernumerary limb from the lateral wound surface sometimes developed in addition to a complete, single limb from the distal amputation surface.     

Xkid, a chromokinesin required for chromosome alignment on the metaphase plate

Metaphase chromosome alignment is a key step of animal cell mitosis. The molecular mechanism leading to this equatorial positioning is still not fully understood. Forces exerted at kinetochores and on chromosome arms drive chromosome movements that culminate in their alignment on the metaphase plate. In this paper, we show that Xkid, a kinesin-like protein localized on chromosome arms, plays an essential role in metaphase chromosome alignment and in its maintenance. We propose that Xkid is responsible for the polar ejection forces acting on chromosome arms. Our results show that these forces are essential to ensure that kinetochores and chromosome arms align on a narrow equatorial plate during metaphase, a prerequisite for proper chromosome segregation.     

DOES YOUR HOSPITAL NEED A RECOVERY ROOM?

In a survey made to estimate the need for a special room in which patients could recover from anesthesia after operation, it was found that of 475 cases in which this service might have been used, it would have been desirable in 296; that recovery room care would probably have relieved ward nurses of the duty of special care during their busiest hours; that recovery room care was indicated in a high percentage of cases in which certain anesthetics were employed, and that the need for recovery room care appeared to increase in proportion to the amount of pre-sedation given.