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The distinction between tuberculosis and sarcoidosis presents sometimes a clinical challenge. Their sequential occurrence in the same patient is uncommon. We present the case of a 42-year-old female with a proven diagnosis of tuberculous lymphadenitis who has developed successively nasal tuberculosis and pulmonary and liver sarcoidosis.

Resume Objectif Etudier les reponses des mouvements verticaux obtenues par une faible prismation en fonction de la dominance oculaire a l’aide d’un nouveau videoculographe Gazelab. Methodes Les mouvements verticaux de vergence ont ete enregistres dans trois conditions, en fixation binoculaire sans prisme (VN), avec un prisme de 2 Δ base inferieure sur l’œil dominant (POD) et l’œil non dominant (POND) sur sept patients. Resultats Les resultats revelent que le mouvement induit par un prisme de 2 Δ base inferieure a une distance de 150 cm est plus significatif sur l’œil non dominant que sur l’œil dominant. En supraversion PPOD = 0,094 et PPOND = 0,004. En position primaire PPOD = 0,172 et PPOND = 0,045. En infraversion PPOD = 0,084 et PPOND = 0,038. Conclusion Les reponses oculomotrices de la vergence verticale sont modulees par la dominance oculaire.

Fucosylated chondroitin sulfate (FCScs) isolated from sea cucumber Cucumaria syracusana was characterized by Fourier Transform InfraRed spectroscopy (FT-IR), Nuclear Magnetic Resonance (NMR) spectroscopy and high performance size exclusion chromatograph, a multi-angle laser light scattering detector, a viscometer and a differential refractive index (dRI) detector (HPSEC-MALLS-dRI). The anticoagulant activities of FCScs were studied by the classical clotting time assays and the purified systems containing thrombin and antithrombin or heparin cofactor II. The effect on thrombin generation was investigated using calibrated automated thrombography (CAT). The results obtained showed that the FCS with high sulfate content 31 % and relatively low average molecular weight of 36.3 kDa was isolated from C. syracusana in amount of ∼ 35.6 mg/g dry body wall. Structural analysis of this polysaccharide revealed the presence backbone structure of chondroitin sulfate chain branched by two types of fucose 2,4-O-di and 3,4-O-disulfated residues in respective ratios of 57.5 and 42.5 %. The FCScs exhibited a high anticoagulant activity mediated essentially by heparin cofactor II (HCII) and to lesser extent by antithrombin (AT) with IC50 values of 0.05 μg/mL and 0.09 μg/mL, respectively. Furthermore, the results of CAT assay showed that the velocity index decreases 3-times at 50 μg/mL in comparison with normal plasma. The overall results showed high anticoagulant activity attributed to the high sulfate content and abundance of disulfated fucose branches of FCScs which made it a promising candidate of anticoagulation drug.

Background Although low oxygen saturations are generally regarded as deleterious, recent studies in ICU patients have shown that a liberal oxygen strategy increases mortality. However, the optimal oxygen saturation target remains unclear. The goal of this study was to determine the optimal range by using real-world data. Methods Replicate retrospective analyses were conducted of two electronic medical record databases: the eICU Collaborative Research Database (eICU-CRD) and the Medical Information Mart for Intensive Care III database (MIMIC). Only patients with at least 48 h of oxygen therapy were included. Nonlinear regression was used to analyze the association between median pulse oximetry-derived oxygen saturation (Spo2) and hospital mortality. We derived an optimal range of Spo2 and analyzed the association between the percentage of time within the optimal range of Spo2 and hospital mortality. All models adjusted for age, BMI, sex, and Sequential Organ Failure Assessment score. Subgroup analyses included ICU types, main diagnosis, and comorbidities. Results The analysis identified 26,723 patients from eICU-CRD and 8,564 patients from MIMIC. The optimal range of Spo2 was 94% to 98% in both databases. The percentage of time patients were within the optimal range of Spo2 was associated with decreased hospital mortality (OR of 80% vs 40% of the measurements within the optimal range, 0.42 [95% CI, 0.40-0.43] for eICU-CRD and 0.53 [95% CI, 0.50-0.55] for MIMIC). This association was consistent across subgroup analyses. Conclusions The optimal range of Spo2 was 94% to 98% and should inform future trials of oxygen therapy.

Comorbidity in patients, along with attendant operations and complications, is associated with reduced long-term survival probability and an increased need for healthcare facilities. This study proposes a user-friendly toolkit to design an adjusted case-mix model of the risk of comorbidity for use by the public for its incremental development. The proposed model, Temporal Comorbidity-Adjusted Risk of Emergency Readmission (T-CARER), introduces a generic method for generating a pool of features from re-categorised and temporal features to create a customised comorbidity risk index. Research on emergency admission has shown that demographics, temporal dimensions, length of stay, and time between admissions can noticeably improve statistical measures related to comorbidities. The model proposed in this study, T-CARER, incorporates temporal aspects, medical procedures, demographics, admission details, and diagnoses. And, it tries to address four weakness areas in popular comorbidity risk indices: robustness, temporal adjustment, population stratification, and inclusion of major associated factors. Three approaches to modelling, a logistic regression, a random forest, and a wide and deep neural network, are designed to predict the comorbidity risk index associated with 30- and 365-day emergency readmissions. The models were trained and tested using England’s Hospital Episode Statistics inpatient database for two time-frames: 1999–2004 and 2004–2009, and various risk cut-offs. Also, models are compared against implementations of Charlson and Elixhauser’s comorbidity indices from multiple aspects. Tests using k − f o l d cross-validation yielded stable and consistent results, with negative mean-squared error variance of -0.7 to -2.9. In terms of c-statistics, the wide and deep neural network and the random forest models outperformed Charlson’s and Elixhauser’s comorbidity indices. For the 30- and 365-day emergency readmission models, the c-statistics ranged from 0.772 to 0.804 across the timeframes. The wide and deep neural network model generated predictions with high precision, and the random forest model performed better than the regression model, in terms of the micro-average of the F1-score. Our best models yielded precision values in the range of 0.582–0.639, and an average F1-score of 0.730–0.790. The proposed temporal case-mix risk model T-CARER outperforms prevalent models, including Charlson’s and Elixhauser’s comorbidity indices, with superior precision, F1-score, and c-statistics. The proposed risk index can help monitor the temporal comorbidities of patients and reduce the cost of emergency admissions.

A new formulation of the interfacial momentum transfer in two-fluid model for bubbly flows is presented and implemented in a CFD code. The main feature of the interfacial momentum closure lies in an explicit formulation of the turbulent contribution of the added mass force. The two-fluid model with the proposed closure of the momentum interfacial transfer is used to predict vertical bubbly jets. The numerical results show that the turbulent contribution of the added mass force greatly affects the dynamics of the bubbles and the gas distribution. The turbulent contribution of the added mass force has two components: a non-linear turbulent term and a convective acceleration associated to the drift velocity. Each of these turbulent terms can oppose the gravity effect. The simultaneous effects of the two turbulent terms provide an explanation to the deceleration of the bubbles as well as the negative relative velocity reported in the experimental data obtained in vertical bubbly jets. The improvements of the slip velocity prediction appear to have a great effect on the prediction of the lateral void fraction distribution.