Cardiovascular disease in Hajj pilgrims

The changing pattern of hospital admissions during Hajj, the Muslims yearly pilgrimage attracting millions of pilgrims from all around the globe, has gradually seen infectious causes of hospital admission replaced by cardiovascular diseases as a leading cause of both intensive care unit admission and death. While this trend is partly associated with the high quality of medical services and awareness programs targeted at reducing the spread of infections, at the same time it underscores an urgent need to establish a pragmatic system to manage the challenge of cardiovascular morbidities and mortality during Hajj.Search strategy and inclusion criteriaA PubMed Central (PMC) literature search without date restrictions was performed for articles reporting on the medical experience during Hajj. There were 109 articles were returned using “Hajj” and “mortality” as search terms. After determining relevance to the current theme based on both direct and indirect reference to the pattern hospital admission during Hajj, 20 articles reporting on conducted studies were obtained. Data from these studies reporting on the pattern and outcome of hospitalization during Hajj were examined and helped in arriving at the conclusions presented in this review.     

Brain–computer interfaces increase whole-brain signal to noise

Brain–computer interfaces (BCIs) can convert mental states into signals to drive real-world devices, but it is not known if a given covert task is the same when performed with and without BCI-based control. Using a BCI likely involves additional cognitive processes, such as multitasking, attention, and conflict monitoring. In addition, it is challenging to measure the quality of covert task performance. We used whole-brain classifier-based real-time functional MRI to address these issues, because the method provides both classifier-based maps to examine the neural requirements of BCI and classification accuracy to quantify the quality of task performance. Subjects performed a covert counting task at fast and slow rates to control a visual interface. Compared with the same task when viewing but not controlling the interface, we observed that being in control of a BCI improved task classification of fast and slow counting states. Additional BCI control increased subjects’ whole-brain signal-to-noise ratio compared with the absence of control. The neural pattern for control consisted of a positive network comprised of dorsal parietal and frontal regions and the anterior insula of the right hemisphere as well as an expansive negative network of regions. These findings suggest that real-time functional MRI can serve as a platform for exploring information processing and frontoparietal and insula network-based regulation of whole-brain task signal-to-noise ratio.     

Four cases of distinctive meningiomas with Zellballen growth pattern

Dong Y, Zhou X, Wu B, Wang J, Ma H, Zhou H, Jiang S, Lu G, Hu Q. Four cases of distinctive meningiomas with Zellballen growth pattern. APMIS 2009; 117: 936–40. Meningiomas are attributed to those tumours with slow‐growing pattern occurring predominantly in middle‐aged or elderly patients. Fifteen histological variants have been described based on the variable histomorphological features. Herein we report four cases with specific Zellballen growth pattern, giving the tumours a ‘paraganglioma‐like’ general aspect. The diagnosis of meningiomas was confirmed by immunohistochemical and ultrastructural findings. Histopathologists should be aware of this specific morphology which can lead to misdiagnosis.     

Prevalence of coagulase-positive staphylococci in the skin of dogs; antibacterial resistance and plasmid profile of the isolates

This study was designed to understand the prevalence of coagulase-positive staphylococci in the skin of dogs and the role of dogs as reservoirs of pathogenic and antimicrobial-resistant staphylococci. Swab samples were taken from the surface of the skin at muzzle sites of 100 clinically normal dogs. Antibiotic susceptibility of coagulase-positive staphylococci isolates was assessed by antibiotic disc diffusion method using filter paper discs and plasmid DNAs were extracted from the isolates. Staphylococci were isolated from 79 of the 100 dogs sampled and of these 51 were coagulase positive. All coagulase-positive staphylococci isolates were resistant to penicillin G, amoxicillin, cefazolin, streptomycin, erythromycin, ampicillin, tetracycline, gentamicin, trimethoprim-sulfamethoxazole, and enrofloxacine at 100%, 100%, 72%, 48%, 44%, 44%, 12%, 4%, 8%, and 4% respectively. Characterization of plasmid DNAs by agarose gel electrophoresis showed that 22 out of the 51 coagulase-positive staphylococci isolates harbored a single plasmid. The results of the present study indicate that pathogenic and resistant staphylococci are located in the skin of the dogs and may transfer to human and other hosts. It is important to establish reliable antibiotic sensitivity data regarding these bacteria to select suitable antibacterial treatment.     

430名产褥期妇女的膳食模式及分布

目的了解产褥期妇女的膳食状况,初步建立产褥期妇女的膳食模式。方法采用方便抽样,在北京、济南、长沙等地抽取430名产褥期妇女进行膳食调查,膳食调查采用膳食频率法。采用主成分分析提取不同的膳食模式。结果 4种膳食模式分别是"薯豆水果"模式、"高蔬菜低肉"模式、"高肉低蔬菜"模式、"粗粮面"模式。"高肉低蔬菜"膳食模式与产褥期妇女的年龄分布有差异;"粗粮面"膳食模式与产褥期妇女家庭人均月收入有差异。多因素结果分析显示,产褥期妇女的家庭经济情况是"高蔬菜低肉"膳食模式、"高肉低蔬菜"膳食模式及"粗粮面"膳食模式的影响因素。结论产褥期妇女膳食模式多样化,且与多种因素有关,应进一步加强对产褥期妇女的知识教育,选择最科学合理的膳食模式。     

Long-term gait pattern assessment using a tri-axial accelerometer

In this article, we present a pervasive solution for gait pattern classification that uses accelerometer data retrieved from a waist-mounted inertial sensor. The proposed algorithm has been conceived to operate continuously for long-term applications. With respect to traditional approaches that use a large number of features and sophisticated classifiers, our solution is able to assess four different gait patterns (standing, level walking, stair ascending and descending) by using three features and a decision tree. We assess the algorithm detection performances using data that we retrieved from a validation group composed by nine young and healthy volunteers, for a total number of 36 tests and 12.5?h of recorded acceleration data. Experimental results show that in continuous applications the proposed algorithm is able to effectively discriminate between standing (100%), level walking (～99%), stair ascending (～84%), and descending (～85%), with an average classification accuracy for the four patterns that exceeds 92% in continuous, long-lasting applications.     

Factors associated with early mortality after cervical spinal cord injury

Abstract

Background

A relatively high early mortality rate (<30 days post-injury) for cervical spinal cord injury (SCI) has been observed.

Objective

To investigate this early mortality rate observed after cervical SCI and analyze the associated influential factors.

Methods

Medical records for 1163 patients with cervical SCI were reviewed, and the number of patients with early mortality was documented. Through logistic regression analysis, the effects of age, gender, occupation, cause of injury, severity of injury, highest involved spinal cord segment, nutritional condition during hospitalization, surgical treatment, tracheotomy, etc., on early mortality were assessed. Implementation of early treatment (i.e. surgery, tracheotomy, and nutritional support) and its effect on patient prognosis were also analyzed.

Results

Early mortality occurred in 109 of 1163 patients (9.4%). Four factors affected the early mortality rate, including level and severity of SCI, whether or not surgery was performed, the time interval between SCI and surgery, malnutrition, and tracheotomy. Patients with an American Spinal Injury Association grade of A, a high cervical SCI (C1–C3), and/or no surgical intervention were statistically more likely to have early mortality (P < 0.001).

Conclusion

Severe cervical SCI, upper-level cervical cord injury, malnutrition, and inappropriate tracheotomy are risk factors for early mortality in patients with cervical SCI. Surgery can reduce early mortality. Early tracheotomy should be performed in patients with complete upper-level cervical SCI, but patients with incomplete cervical SCI or complete low-level cervical SCI should initially be treated surgically to maintain smooth airway flow.     

Assessment of four statistical pattern recognition techniques to assist in obstructive sleep apnoea diagnosis from nocturnal oximetry

The aim of this study is to assess the utility of traditional statistical pattern recognition techniques to help in obstructive sleep apnoea (OSA) diagnosis. Classifiers based on quadratic (QDA) and linear (LDA) discriminant analysis, K-nearest neighbours (KNN) and logistic regression (LR) were evaluated. Spectral and nonlinear input features from oxygen saturation (SaO₂) signals were applied. A total of 187 recordings from patients suspected of suffering from OSA were available. This initial dataset was divided into training set (74 subjects) and test set (113 subjects). Twelve classification algorithms were developed by applying QDA, LDA, KNN and LR with spectral features, nonlinear features and combination of both groups. The performance of each algorithm was measured on the test set by means of classification accuracy and receiver operating characteristic (ROC) analysis. QDA, LDA and LR showed better classification capability than KNN. The classifier based on LDA with spectral features provided the best diagnostic ability with an accuracy of 87.61% (91.05% sensitivity and 82.61% specificity) and an area under the ROC curve (AROC) of 0.925. The proposed statistical pattern recognition techniques could be applied as an OSA screening tool.