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Soft tissue infections due to gram negative microorganism are very rare. Sphingobacterium multivorum related respiratory tract infections, cellulitis, necrotizing fasciitis and septic shock have been reported in literature mostly in immunosuppressed population. We present an interesting and rare case of neck abscess due to sphingobacterium multivorum in an immunocompetent patient, diagnosed by abscess fluid culture and neck imaging and treated with course of oral antibiotics.

Percutaneous coronary artery intervention (PCI) for unprotected left main coronary artery (LMCA) has emerged as a viable option with outcomes comparable to coronary artery bypass grafting in certain patient populations. Intravascular ultrasound has played an important role in optimizing PCI results

Femoral artery pseudoaneurysm (FAP) is a common complication associated with left heart cardiac catheterization. FAP is a pulsatile encapsulated mass usually formed three to seven days after removal of the arterial sheath post cardiac catheterization. Usually, FAP is asymptomatic. Groin pain and swelling are the most common complaints in symptomatic patients. It can be associated with multiple different complications including rupture, bleeding, and vascular compression leading to venous thrombosis, limb ischemia, and neuropathy. Deep vein thrombosis (DVT) resulting from FAP is an unusual complication with very few cases reported in the literature. We present a case of right-sided DVT secondary to the compression of femoral vein resulting in venous outflow obstruction due to iatrogenic FAP post cardiac catheterization that was successfully managed conservatively.

Angioedema is a localized, non-pitting, non-dependent, submucosal, and subcutaneous swelling resulting from the extravasation of fluid into the interstitium due to the increased production of plasma kinins and histamine. It can present with urticaria or anaphylaxis and is usually associated with angiotensin-converting enzyme inhibitors (ACEis), complement deficiencies, or the side effects of tissue plasminogen activator (tPA). Orolingual angioedema following tPA for acute ischemic stroke is a transient, self-resolving hemifacial swelling contralateral to neurological deficits that can rarely progress to the airway, compromising it and leading to a life-threatening situation if not managed promptly.

Background Catheter-related bloodstream infections (CRBSIs) cause morbidity and mortality in hemodialysis (HD) patients. Cathasept (tetra-sodium EDTA) solution has antimicrobial and anticoagulant activities. Study Design Multicenter prospective randomized controlled study. Setting & Participants 117 maintenance HD patients with confirmed uncolonized tunneled HD catheters from 4 HD centers. Intervention Patients were randomly assigned to receive Cathasept 4% locks (Cathasept group) or stayed with heparin 5,000 U/mL locks (heparin group), filled thrice weekly according to catheter lumen volume until the catheter was removed or for a maximum of 8 months. Outcomes Primary outcome was clinically significant microbial colonization of the catheter, defined as a through-catheter quantitative blood culture yielding ≥ 1,000 colony-forming units/mL of bacteria or yeast. Secondary outcomes included CRBSI rate, catheter patency, and biomarkers of inflammation and anemia. Measurements Weekly through-catheter quantitative blood culture, high-sensitivity C-reactive protein fortnightly, and full blood count and ferritin monthly. Results Incidence rates of catheter colonization were 0.14/1,000 catheter-days in the Cathasept group and 1.08/1,000 catheter-days in the heparin group (incidence rate ratio [IRR], 0.13; 95% CI, 0.003-0.94; P =0.02). CRBSI rates were 0.28/1,000 catheter-days in the Cathasept group and 0.68/1,000 catheter days in the heparin group (IRR, 0.40; 95% CI, 0.08-2.09; P =0.3). The proportion of dialysis sessions with achieved prescribed blood flow rate was significantly lower in the Cathasept group (66.8% vs 75.3%; P P =0.01). Mean high-sensitivity C-reactive protein level was 11.6±5.3 (SE) mg/L lower for patients in the heparin group ( P =0.03). Anemia marker levels were similar in both groups. Limitations Study was underpowered to assess effect on CRBSI, terminated early due to slow recruitment, and not double blinded. Conclusions Cathasept significantly reduced tunneled hemodialysis catheter colonization, but the reduction in CRBSIs was not statistically significant, and it was associated with more thrombotic complications. Its safety profile was comparable to heparin lock solution.

In this work, a new scheme of image encryption based on chaos and Fast Walsh Transform (FWT) has been proposed. We used two chaotic logistic maps and combined chaotic encryption methods to the two-dimensional FWT of images. The encryption process involves two steps: firstly, chaotic sequences generated by the chaotic logistic maps are used to permute and mask the intermediate results or array of FWT, the next step consist in changing the chaotic sequences or the initial conditions of chaotic logistic maps among two intermediate results of the same row or column. Changing the encryption key several times on the same row or column makes the cipher more robust against any attack. We tested our algorithms on many biomedical images. We also used images from data bases to compare our algorithm to those in literature. It comes out from statistical analysis and key sensitivity tests that our proposed image encryption scheme provides an efficient and secure way for real-time encryption and transmission biomedical images.

The objective of this thesis is to gain knowledge in tuberculosis in children and adolescent for ten years period from 01.01.05- 31.12.14 at the University Hospital of North Norway. The study was to answer the following questions: the number patients treated for latent and active tuberculosis in 10 years period of, the debut age for symptoms and treatment, the diagnostic methods the choice of treatment and follow-ups. Retrospective study method is used. Data is collected for 24 variables designed to answer the relevant question. There were 240 patient journals were studied. 13 of them 240 were excluded because of the age limit. Results: The main findings were (1) Most to tuberculosis among children in North Norway is latent tuberculosis. (2) The majority of the children with tuberculosis are born foreign-born Children (3) Patients with tuberculosis disease were treated adequately (4) IGRA used diagnostic methods. Conclusion: A futher study is needed to change the current practice of tuberculosis management at UNN and future study should have access to DIPS patient electronic journals at other hospitals in the region and get the access of contacting the local primary care when needed. Some modifications of the variables are also necessary

Tunnelled haemodialysis catheters (t-HDC) are prone to colonization by microorganisms, resulting in increased morbidity and mortality. A previous study concluded that all culture-negative catheters removed from cancer patients were colonized by microbial biofilms when examined by scanning electron microscopy (SEM). Examination of t-HDC by SEM has not been published before. A total of 44 segments (0.5 cm each) from 11 ex-vivo t-HDC were examined by SEM prior to endoluminal brushing and quantitative culture to determine their colonization status. Endoluminal brushing yielded a -positive culture from two catheters. Methicillin-sensitive Staphylococcus aureus was grown from one catheter and a Streptococcus species was cultured from the second. SEM examination revealed universal endoluminal coverage by adherent biological material (ABM), which was composed of fibrin, platelets and other host-derived products. However, bacterial cells were visible on the two culture–positive catheters and on two out of nine culture-negative catheters, and were possibly present on one culture-negative catheter. In conclusion, in this study the prevalence of microbial colonization of ex vivo t-HDC was 18% using the endoluminal brushing technique and 36% when examined by SEM. The previously reported universal microbial colonization of central venous catheters is likely to represent coverage by ABM rather than by microbial biofilms.

We explore recurrent encoder multi-decoder neural network architectures for semi-supervised sequence classification and reconstruction. We find that the use of multiple reconstruction modules helps models generalize in a classification task when only a small amount of labeled data is available, which is often the case in practice. Such models provide useful high-level representations of motions allowing clustering, searching and faster labeling of new sequences. We also propose a new, realistic partitioning of a well-known, high quality motion-capture dataset for better evaluations. We further explore a novel formulation for future-predicting decoders based on conditional recurrent generative adversarial networks, for which we propose both soft and hard constraints for transition generation derived from desired physical properties of synthesized future movements and desired animation goals. We find that using such constraints allow to stabilize the training of recurrent adversarial architectures for animation generation., IVC Journal Submission

The heat shock response maintains cellular homeostasis following sublethal injury. Heat shock proteins (Hsps) are induced by thermal, oxyradical, and inflammatory stress, and they chaperone denatured intracellular proteins. Hsps also chaperone signal transduction proteins, modulating signaling cascades during repeated stress. Gastroesophageal reflux disease (GERD) affects 7% of the US population, and it is linked to prolonged esophageal acid exposure. GERD is characterized by enhanced and selective leukocyte recruitment from esophageal microvasculature, implying activation of microvascular endothelium. We investigated whether phosphatidylinositol 3-kinase (PI3K)/Akt and MAPK regulate Hsp induction in primary cultures of human esophageal microvascular endothelial cells (HEMEC) in response to acid exposure (pH 4.5). Inhibitors of signaling pathways were used to define the contribution of PI3K/Akt and MAPKs in the heat shock response and following acid exposure. Acid significantly enhanced phosphorylation of Akt and MAPKs in HEMEC as well as inducing Hsp27 and Hsp70. The PI3K inhibitor LY-294002, and Akt small interfering RNA inhibited Akt activation and Hsp70 expression in HEMEC. The p38 MAPK inhibitor (SB-203580) and p38 MAPK siRNA blocked Hsp27 and Hsp70 mRNA induction, suggesting a role for MAPKs in the HEMEC heat shock response. Thus acidic pH exposure protects HEMEC through induction of Hsps and activation of MAPK and PI3 kinase pathway. Acidic exposure increased HEMEC expression of VCAM-1 protein, but not ICAM-1, which may contribute to selective leukocyte (i.e., eosinophil) recruitment in esophagitis. Activation of esophageal endothelial cells exposed to acidic refluxate may contribute to GERD in the setting of a disturbed mucosal squamous epithelial barrier (i.e., erosive esophagitis, peptic ulceration).

The biggest challenge in the underwater communication and target locating is to reduce the effect of underwater acoustic noise (UWAN). An experimental model is presented in this paper for the diurnal variability of UWAN of the acoustic underwater channel in tropical shallow water. Different segments of data are measured diurnally at various depths located in the Tanjung Balau, Johor, Malaysia. Most applications assume that the noise is white and Gaussian. However, the UWAN is not just thermal noise but a combination of turbulence, shipping and wind noises. Thus, it is appropriate to assume UWAN as colored rather than white noise. Site-specific noise, especially in shallow water often contains significant non-Gaussian components. The real-time noise segments are analyzed to determine the statistical properties such as power spectral density (PSD), autocorrelation function and probability density function (pdf). The results show the UWAN has a non-Gaussian pdf and is colored. Moreover, the difference in UWAN characteristics between day and night is studied and the noise power at night is found to be more than at the day time by around (3-8dB).

Nitric oxide (·NO) generation from conversion of l-arginine to citrulline by nitric oxide synthase isoforms plays a critical role in vascular homeostasis. Loss of ·NO is linked to vascular pathophysiology and is decreased in chronically inflamed gut blood vessels in inflammatory bowel disease (IBD; Crohn's disease and ulcerative colitis). Mechanisms underlying decreased ·NO production in IBD gut microvessels are not fully characterized. Loss of ·NO generation may result from increased arginase (AR) activity, which enzymatically competes with nitric oxide synthase for the common substrate l-arginine. We characterized AR expression in IBD microvessels and endothelial cells and its contribution to decreased ·NO production. AR expression was assessed in resected gut tissues and human intestinal microvascular endothelial cells (HIMEC). AR expression significantly increased in both ulcerative colitis and Crohn's disease microvessels and submucosal tissues compared with normal. TNF-α/lipopolysaccharide increased AR activity, mRNA and protein expression in HIMEC in a time-dependent fashion. RhoA/ROCK pathway, a negative regulator of ·NO generation in endothelial cells, was examined. The RhoA inhibitor C3 exoenzyme and the ROCK inhibitor Y-27632 both attenuated TNF-α/lipopolysaccharide-induced MAPK activation and blocked AR expression in HIMEC. A significantly higher AR activity and increased RhoA activity were observed in IBD submucosal tissues surrounding microvessels compared with normal control gut tissue. Functionally, inhibition of AR activity decreased leukocyte binding to HIMEC in an adhesion assay. Loss of ·NO production in IBD microvessels is linked to enhanced levels of AR in intestinal endothelial cells exposed to chronic inflammation in vivo.

Aim To compare the efficacy of 2% lidocaine and 4% articaine both with 1:100,000 adrenaline in anaesthetising the pulps of mandibular incisors. Methods Thirty-one healthy adult volunteers received the following local anaesthetic regimens adjacent to a mandibular central incisor: 1) buccal infiltration of 1.8 mL lidocaine plus dummy lingual injection (LB), 2) buccal plus lingual infiltrations of 0.9 mL lidocaine (LBL), 3) buccal infiltration of 1.8 mL articaine plus dummy lingual injection (AB), 4) buccal plus lingual infiltrations of 0.9 mL articaine (ABL). Pulp sensitivities of the central incisor and contralateral lateral incisor were assessed electronically. Anaesthetic efficacy was determined by two methods: 1) Recording the number of episodes with no responses to maximal electronic pulp tester stimulation during the course of the study period, 2) recording the number of volunteers with no response to maximal pulp tester stimulation within 15 min and maintained for 45 min (defined as sustained anaesthesia). Data were analysed by McNemar, chi-square, Mann-Whitney and paired t–tests. Results For both test teeth, the number of episodes of no sensation on maximal stimulation was significantly greater after articaine than lidocaine for both techniques. The split buccal plus lingual dose was more effective than the buccal injection alone for both solutions (p