Identification of Possible Virulence Marker from Campylobacter jejuni Isolates

A novel protein translocation system, the type-6 secretion system (T6SS), may play a role in virulence of Campylobacter jejuni. We investigated 181 C. jejuni isolates from humans, chickens, and environmental sources in Vietnam, Thailand, Pakistan, and the United Kingdom for T6SS. The marker was most prevalent in human and chicken isolates from Vietnam.     

Novel Biologically Inspired Approaches to Extracting Online Information from Temporal Data

In this paper, we aim to develop novel learning approaches for extracting invariant features from time series. Specifically, we implement an existing method of solving the generalized eigenproblem and use this to firstly implement the biologically inspired technique of slow feature analysis (SFA) originally developed by Wiskott and Sejnowski (Neural Comput 14:715–770, 2002) and a rival method derived earlier by Stone (Neural Comput 8(7):1463–1492, 1996). Secondly, we investigate preprocessing the data using echo state networks (ESNs) (Lukosevicius and Jaeger in Comput Sci Rev 3(3):127–149, 2009) and show that the combination of generalized eigensolver and ESN is very powerful as a more biologically plausible implementation of SFA. Thirdly, we also investigate the effect of higher-order derivatives as a smoothing constraint and show the overall smoothness in the output signal. We demonstrate the potential of our proposed techniques, benchmarked against state-of-the-art approaches, using datasets comprising artificial, MNIST digits and hand-written character trajectories.     

Septic Coronary Artery Embolism Treated with Aspiration Thrombectomy: Case Report and Review of Literature

Coronary embolization is a potentially fatal sequela of endocarditis. We report a case of Candida endocarditis with septic embolism to the left anterior descending coronary artery. This embolism was successfully treated with aspiration thrombectomy followed by balloon angioplasty. The treatment of acute coronary syndrome in the presence of septic embolism is controversial. Aspiration thrombectomy has been performed in this situation before, and it appears to be safer and more feasible than is thrombolysis or percutaneous transluminal angioplasty.     

Refining amyloid complete hematological response: Quantitative serum free light chains superior to ratio

Response assessment in light chain (AL) amyloidosis is based on serum and urine monoclonal protein studies. Newly diagnosed patients (n = 373) who achieved very good partial response or complete response (CR) to first line therapy were assessed for the survival impact of each of the monoclonal protein studies. At end of therapy (EOT), negative serum/urine immunofixation (IFE) was achieved in 61% of patients, 72% achieved normal serum free light chain ratio (sFLCR), and the median involved free light chain (iFLC) and difference between involved to uninvolved light chain (dFLC) were 17 mg/L and 5 mg/L, respectively. Overall, 46% of patients achieved a CR at EOT. At EOT, iFLC ≤20 mg/L and dFLC ≤10 mg/L were additive in survival discrimination to negative serum/urine IFE and were independent predictors of overall survival. In contrast, normalization of sFLCR did not add survival discrimination to serum/urine IFE and was not independent predictor of survival. We propose a new definition for hematological CR to include serum/urine IFE negativity plus iFLC ≤20 mg/L or dFLC ≤10 mg/L, instead of the current definition of serum/urine IFE negativity and normal sFLCR. Complete response using dFLC ≤10 mg/L had the best performance in those with significant renal dysfunction and by light chain isotype, making it the preferred partner to IFE. Validation of these results in a multicenter cohort is warranted.     

A comparison of the diagnostic accuracy of MARS MRI and ultrasound of the painful metal-on-metal hip arthroplasty

Background and purpose

Metal artifact reduction sequence (MARS) MRI and ultrasound scanning (USS) can both be used to detect pseudotumors, abductor muscle atrophy, and tendinous pathology in patients with painful metal-on-metal (MOM) hip arthroplasty. We wanted to determine the diagnostic test characteristics of USS using MARS MRI as a reference for detection of pseudotumors and muscle atrophy.

Patients and methods

We performed a prospective cohort study to compare MARS MRI and USS findings in 19 consecutive patients with unilateral MOM hips. Protocolized USS was performed by consultant musculoskeletal radiologists who were blinded regarding clinical details. Reports were independently compared with MARS MRI, the imaging gold standard, to calculate predictive values.

Results

The prevalence of pseudotumors on MARS MRI was 68% (95% CI: 43–87) and on USS it was 53% (CI: 29–76). The sensitivity of USS in detecting pseudotumors was 69% (CI 39–91) and the specificity was 83% (CI: 36–97). The sensitivity of detection of abductor muscle atrophy was 47% (CI: 24–71). In addition, joint effusion was detected in 10 cases by USS and none were seen by MARS MRI.

Interpretation

We found a poor agreement between USS and MARS MRI. USS was inferior to MARS MRI for detection of pseudotumors and muscle atrophy, but it was superior for detection of joint effusion and tendinous pathologies. MARS MRI is more advantageous than USS for practical reasons, including preoperative planning and longitudinal comparison.Approximately 1.5 million metal-on-metal (MOM) hip arthroplasties have been implanted worldwide since 1996 (FDA 2012). A high early failure rate for these prostheses has recently been demonstrated (Smith et al. 2012). The pattern of failure appears to differ from other hip arthroplasty types, with adverse reactions to wear-related metal debris being a prominent feature (Pandit et al. 2008, Kwon et al. 2011). These solid or cystic lesions have been termed pseudotumors (Pandit et al. 2008). A wide spectrum of adverse tissue reactions have been described. Histologically, using their pseudocapsules, these have been termed aseptic lymphocytic vasculitis-associated lesions (ALVALs) (Willert et al. 2005).Health regulatory guidelines recommend investigation with cross-sectional imaging, using either metal artifact reduction sequence (MARS) MRI or ultrasound scanning (USS), to evaluate the periprosthetic soft tissues. A number of advantages and disadvantages have been reported (Sabah et al. 2011, Liddle et al. 2013). The high-resolution capability of USS allows detailed imaging of solid or cystic extra-articular lesions and also detection of muscle atrophy (Sofka et al. 2004), joint effusions, gluteal tendon avulsion, and iliopsoas or trochanteric bursitis (Long et al. 2012). USS is also commonly used during guided anesthetic injection or fluid aspiration.

Table 1.

A comparison of the advantages and disadvantages of MARS MRI and ultrasound imaging of metal-on-metal hips