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Evolutionary trends may underlie some aspects of the risk for common, non-communicable disorders, including psychiatric disease. We analyzed whole exome sequencing data from 80 unique individuals from India coming from families with two or more individuals with severe mental illness. We used Population Branch Statistics (PBS) to identify variants and genes under positive selection and identified 75 genes as candidates for positive selection. Of these, 20 were previously associated with Schizophrenia, Alzheimer’s disease and cognitive abilities in genome wide association studies. We then checked whether any of these 75 genes were involved in common biological pathways or related to specific cellular or molecular functions. We found that immune related pathways and functions related to innate immunity such as antigen binding were over-represented. We also evaluated for the presence of Neanderthal introgressed segments in these genes and found Neanderthal introgression in a single gene out of the 75 candidate genes. However, the introgression pattern indicates the region is unlikely to be the source for selection. Our findings hint at how selection pressures in individuals from families with a history of severe mental illness may diverge from the general population. Further, it also provides insights into the genetic architecture of severe mental illness, such as schizophrenia and its link to immune factors.

Human breath analysis of volatile organic compounds has gained significant attention recently because of its rapid and noninvasive potential to detect various metabolic diseases. The detection of ketones in the breath and blood is key to diagnosing and managing diabetic ketoacidosis (DKA) in patients with type 1 diabetes. It may also be of increasing importance to detect euglycemic ketoacidosis in patients with type 1 or type 2 diabetes or heart failure, treated with sodium-glucose transporter-2 inhibitors (SGLT2-i). The present research evaluates the efficiency of colorimetry for detecting acetone and ethanol in exhaled human breath with the response time, pH effect, temperature effect, concentration effect, and selectivity of dyes. Using the proposed multidye system, we obtained a detection limit of 0.0217 ppm for acetone and 0.029 ppm for ethanol in the detection range of 0.05-50 ppm. A smartphone-assisted unit consisting of a portable colorimetric device was used to detect relative red/green/blue values within 60 s of the interface for practical and real-time application. The developed method could be used for rapid, low-cost detection of ketones in patients with type 1 diabetes and DKA and patients with type 1 or type 2 diabetes or heart failure treated with SGLT2-I and euglycemic ketoacidosis.

The handshake is the most acceptable gesture of greeting in many cultures throughout many centuries. To date, robotic arms are not capable of fully replicating this typical human gesture. Using multiple sensors that detect contact forces and displacements, we characterized the movements that occured during handshakes. A typical human-to-human handshake took around 3.63 s (SD = 0.45 s) to perform. It can be divided into three phases: reaching (M = 0.92 s, SD = 0.45 s), contact (M = 1.96 s, SD = 0.46 s), and return (M = 0.75 s, SD = 0.12 s). The handshake was further investigated to understand its subtle movements. Using a multiphase jerk minimization model, a smooth human-to-human handshake can be modelled with fifth or fourth degree polynomials at the reaching and return phases, and a sinusoidal function with exponential decay at the contact phase. We show that the contact phase (1.96 s) can be further divided according to the following subphases: preshake (0.06 s), main shake (1.31 s), postshake (0.06 s), and a period of no movement (0.52 s) just before both hands are retracted. We compared these to the existing handshake models that were proposed for physical human-robot interaction (pHRI). From our findings in human-to-human handshakes, we proposed guidelines for a more natural handshake movement between humanoid robots and their human partners.

Autism spectrum disorder is a neurodevelopmental disorder that is characterized by patterns of behaviours and difficulties with social communication and interaction. Children on the spectrum exhibit atypical, restricted, repetitive, and challenging behaviours. In this study, we investigate the feasibility of integrating wearable sensors and machine learning techniques to detect the occurrence of challenging behaviours in real-time. A session of a child with autism interacting with different stimuli groups that included social robots was annotated with observed challenging behaviors. The child wore a wearable device that captured different motion and physiological signals. Different features and machine learning configurations were investigated to identify the most effective combination. Our results showed that physiological signals in addition to typical kinetic measures led to more accurate predictions. The best features and learning model combination achieved an accuracy of 97%. The findings of this work motivate research toward methods of early detection of challenging behaviours, which may enable the timely intervention by caregivers and possibly by social robots.

Gingival hyperplasia is a rare finding in clinical practice. Nevertheless, when it occurs, it is a finding of great value as it can lead to definite clinical diagnosis. The present case is a 19-year-old male who was referred for further management of stage 5 chronic kidney disease. On evaluation, he was found to have gingival hyperplasia. He was evaluated for reversible causes of kidney disease, and since none were found, renal replacement therapy was advised. He had been taking amlodipine for blood pressure control. As this was presumed to be the cause of gingival hyperplasia, it was stopped and replaced by a combination of beta-blocker and prazosin. At six-month follow-up, he had complete resolution of gingival hyperplasia. Amlodipine as a cause of gingival hyperplasia is a rare occurrence. However, it is crucial to keep in mind such a possible side effect of this commonly prescribed antihypertensive drug.

Aim Heart failure is a global problem that is increasing in prevalence. We undertook the initiative to compile the Vellore Heart Failure Registry (VHFR) to assess the clinical profile, mortality, risk factors and economic burden of heart failure by conducting a prospective, observational, hospital-based cohort study in Vellore, Tamil Nadu. Methods and results This study was a prospective observational cohort study conducted at the Christian Medical College and Hospital, Vellore, between January 2014 and December 2016. A total of 572 patients who satisfied the Boston criteria for “definite heart failure” were included and the primary outcome was all-cause mortality. The median duration of hospital stay was eight days and the in-hospital, one, three and six month mortalities were 13.25%, 27.3%, 32.53% and 38.15%, respectively. The median duration of survival was 921 days. Readmission for heart failure constituted 42%, and the most common cause of decompensation was an infection(31.5%). The presence of cyanosis at admission, history of previous stroke or transient ischemic attack, and American College of Cardiology (ACC)/American Heart Association (AHA) stage D at the time of discharge were independently associated with mortality at six months. The median total direct cost of admission was INR 84,881.00 ($ 1232.34) Conclusion The VHFR cohort had younger, more diabetic, and fewer hypertensive subjects than most cohorts. Admission for heart failure is a catastrophic health expenditure. Attempts should be made to ensure a reduction in readmission rates by targeting goal-directed therapy. As the most common cause of acute decompensation is pneumonia, vaccinating all patients before discharge may also help in this regard.

Robotic manipulators face significant challenges when handling objects of different sizes and shapes. Incorporating a sense of touch into these devices has the potential to improve performance and dexterity. In this paper, a bio-inspired approach is presented for slip detection and suppression during object manipulation. The method was inspired by the behavior of FA-I afferents located in the glabrous skin that encode sliding motion of objects over the skin. The proposed slip detection method encodes object motion captured by a slip sensor into spikes, following principles of neuromorphic sensing. The spikes are used as the feedback signal for an event-based closed-loop control system. The controller behaves in a reflex-like manner and actively engages the robotic fingers to increase grip force and suppress slip. A Dynamic Adaptive Threshold method was designed to improve slip detection for different surface properties of grasped objects. The performance of the method was evaluated following situations of dynamic slip caused by a sudden or gradual increase in object weight. The results demonstrated the feasibility of the proposed method. Slip events were suppressed before complete object slippage in 80% of all experimental trials. The response time ( Delta {\text {t}} < 85$ ms) was compatible with the time for grip force adjustments in humans. This paper explored event-based touch applicable to the problem of manipulation, which is less explored than event-based tactile perception and shows promising prospects for both robotics and prosthetics. - 2001-2012 IEEE. Scopus

Medan sangat kaya dengan berbagai jenis kuliner, di mana jenis makanan dari berbagai daerah ada di sana. Namun untuk kemasan produk makanan tersebut masih tidak semuanya memilikinya. Kemasan adalah salah satu yang dibutuhkan untuk bersaing dan menarik minat konsumen, dimana desain kemasan produk selain berfungsi sebagai pelindung produk tetapi juga sebagai sarana komunikasi untuk menyampaikan citra suatu perusahaan (usaha). Rumah Makan Patinku yang berada di Kota Medan adalah rumah makan yang memiliki ciri khas makanan tradisional dengan produk unggulan rumah makan tersebut adalah ikan patin. Oleh karena itu perancangan desain kemasan produk sangat berpengaruh untuk berkomunikasi dengan masyarakat dalam menyampaikan citra Rumah Makan Patinku. Konsep utama yang digunakan Rumah Makan Patinku adalah daun pisang sebagai ide kreatif mendesain kemasan. Desain kemasan menggunakan penelitian ilmiah yaitu studi literatur, observasi, dan juga teknik analis SWOT, sehingga dihasilkan rancangan yang sesuai dengan citra dan ciri khas Rumah Makan Patinku. Desain kemasan yang diciptakan adalah pembungkus nasi, kotak nasi, kotak ikan patin bakar, kantong kertas (paper bag), stiker pack plastik kontainer, cup jus minuman, dan kantong plastik.

Background Amyloidosis is caused by the deposition of abnormal proteins in the extracellular space of various organs. The clinical features of amyloidosis depend on the type of amyloid protein and the organ system involved. Case summary A 51-year-old woman developed complete heart block which warranted a permanent pacemaker insertion. She was referred for evaluation of chronic pericardial effusion. The patient had stable vital signs and muffled heart sounds on examination of the cardiovascular system. Her chest X-ray film showed a permanent pacemaker in situ, and echocardiogram showed a chronic pericardial effusion without features of tamponade. On further evaluation, she was found to have an M band on serum electrophoresis, elevated free light chain ratio and amyloid deposits in bone marrow biopsy. Technetium pyrophosphate (Tc-PYP) scintigraphy was consistent with cardiac amyloidosis. Discussion Cardiac amyloidosis can have diverse clinical presentations. Chronic pericardial effusion and conduction block can be a rare presentation of cardiac amyloidosis and needs to be considered while evaluating the same. Cardiac magnetic resonance imaging and Tc-PYP imaging can be used in establishing the diagnosis of cardiac amyloidosis, if endomyocardial biopsy is not feasible.

Neural Arterial Gingival Simplex is a common systemic disease linked to an invasive periodontal pathogen, Porphyromonas gingivalis as the key initiator. Instead of considering separate pathologic conditions as separate diseases, the health community should view this disease as a single entity, to diagnose and treat accordingly. We discuss the evidence for this hypothesis and the need for definitive research. A strategy to maintain a healthy, resilient microbiome with adjunctive support by probiotics and polyols is warranted. Newer diagnostic and monitoring technologies along with many possible therapeutic agents and protocols are readily available to prevent and treat Neural Arterial Gingival Simplex.

Background Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional ‘high-acuity' beds capable of managing high-risk patients outside the ICU/HDU environment. Methods We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ. Hospital- and ward-level data were collected, including bed numbers, tertiary services offered, presence of an emergency department, ward staffing levels, and the availability of critical care facilities. Results We received responses from 257 UK (response rate: 97.7%), 35 Australian (response rate: 32.7%), and 17 NZ (response rate: 94.4%) hospitals (total 309). Of these hospitals, 91.6% reported on-site ICU or HDU facilities. UK hospitals reported fewer critical care beds per 100 hospital beds (median=2.7) compared with Australia (median=3.7) and NZ (median=3.5). Additionally, 31.1% of hospitals reported having high-acuity beds to which high-risk patients were admitted for postoperative management, in addition to standard ICU/HDU facilities. The estimated numbers of critical care beds per 100 000 population were 9.3, 14.1, and 9.1 in the UK, Australia, and NZ, respectively. The estimated per capita high-acuity bed capacities per 100 000 population were 1.2, 3.8, and 6.4 in the UK, Australia, and NZ, respectively. Conclusions Postoperative critical care resources differ in the UK, Australia, and NZ. High-acuity beds may have developed to augment the capacity to deliver postoperative critical care.

In this article, a data generated from impacts of objects with different shapes, masses, and impact velocities on a developed dummy head. The mass considered was in the range of 0.3-0.5 kg while the shapes considered were cube, wedge, and cylinder. The impact velocities levels were in the range of 1-3 m/s. A total of 144 experiments were conducted and the corresponding videos and raw data were analyzed for impact velocity, peak head linear acceleration, 3 ms criterion, and the Head Injury Criterion (HIC). This dataset includes the raw acceleration data and a summary of the overall processed data. The data is available on Harvard Dataverse: https://doi.org/10.7910/DVN/AVC8GG. The work is supported by a research grant from Qatar University under the Grant no. QUST-1-CENG-2018-7 . Scopus

Nosocomial infections pose an imminent challenge to hospitalized Coronavirus disease-19 (COVID-19) patients due to complex interplay of dysregulated immune response combined with immunomodulator therapy. In the pre-pandemic era, immunomodulatory therapy has shown benefit in certain autoimmune conditions with untamed inflammatory response. Efforts to recapitulate these immunomodulatory effects in COVID-19 patients has gained impetus and were followed by NIH COVID-19 expert panel recommendations. The current NIH guideline recommends interleukin-6 inhibitors (tocilizumab and sarilumab) and Janus kinase inhibitors (baricitinib and tofacitinib). Several landmark research trials like COVAVTA, EMPACTA, REMDACTA, STOP-COVID and COV BARRIER have detailed the various effects associated with administration of immunomodulators. The historical evidence of increased infection among patients receiving immunomodulators for autoimmune conditions, raised concerns regarding administration of immunomodulators in COVID-19 patients. The aim of this review article is to provide a comprehensive update on the currently available literature surrounding this issue. We reviewed 40 studies out of which 37 investigated IL-6 inhibitors and 3 investigated JAK inhibitors. Among the studies reviewed, the reported rates of nosocomial infections among the COVID-19 patients treated with immunomodulators were similar to patients receiving standard of care for COVID-19. However, these studies were not powered to assess the side effect profile of these medications. Immunomodulators, by dampening the pyrogenic response and inflammatory markers may delay detection of infections among the patients. This underscores the importance of long-term surveillance which are necessary to discover the potential risks associated with these agents.