A multiscript gaze-based assistive virtual keyboard

The recent development of inexpensive and accurate eye-trackers allows the creation of gazed based virtual keyboards that can be used by a large population of disabled people in developing countries. Thanks to eye-tracking technology, gaze-based virtual keyboards can be designed in relation to constraints related to the gaze detection accuracy and the considered display device. In this paper, we propose a new multimodal multiscript gaze-based virtual keyboard where it is possible to change the layout of the graphical user interface in relation to the script. Traditionally, virtual keyboards are assessed for a single language (e.g. English). We propose a multiscript gaze based virtual keyboard that can be accessed for people who communicate with the Latin, Bangla, and/or Devanagari scripts. We evaluate the performance of the virtual keyboard with two main groups of participants: 28 people who can communicate with both Bangla and English, and 24 people who can communicate with both Devanagari and English. The performance is assessed in relation to the information transfer rate when participants had to spell a sentence using their gaze for pointing to the command, and a dedicated mouth switch for commands selection. The results support the conclusion that the system is efficient, with no difference in terms of information transfer rate between Bangla and Devanagari. However, the performance is higher with English, despite the fact it was the secondary language of the participants.

Dental Factors Influencing Treatment Choice For Maxillary Lateral Incisor Agenesis: A Retrospective Study

OBJECTIVES

Maxillary Lateral Incisor Agenesis (MLIA) pose significant orthodontic and restorative challenges. The aim of this study was to evaluate dental factors and their effect on decision making for MLIA.

METHODS

This is a retrospective study of patients who attended the Edinburgh Dental Institute between 2007 and 2016. Patients with unilateral or bilateral MLIA were included. Excusion criteria: inadequate pre-treatment records, hypodontia of additional teeth as well as MLIA, a craniofacial syndrome, previous orthodontic treatment. Archived records were used to record relevant dental features and treatment decisions. The independent variables were age, gender, overjet, molar relationship, space availability for lateral incisors, and canine aesthetics. The dependent variable was treatment outcome (orthodontic space opening or closing). Multiple regression models were used to identify predictors of treatment outcome.

RESULTS

44 patients were included in the study (30 female and 14 male). Mean age was 13.7 (SD 2.3) years. Fifteen patients (34.1%) had space closure and 29 patients (65.9%) received space opening. Space availability was the only significant predictor of treatment outcome within the regression model (p=0.02).

CONCLUSIONS

Presence of adequate space in the maxillary arch is associated with orthodontic space opening for MLIA.

P1708Therapeutic hypothermia in cardiac arrest survivors with pre-existing heart failure is nephroprotective

Introduction

The impact of therapeutic hypothermia on kidneys in cardiac arrest survivors with known congestive heart failure (CHF) is not known. Weak evidence suggests higher risk of acute kidney injury with hypothermia.

Purpose

The effect of hypothermia on organ function in cardiac arrest patients with preexisting CHF

Methods

This analysis includes 1417 comatose cardiac arrest survivors that achieved achieved return of spontaneous circulation on hospitalization and had a previous left ventricular ejection fraction (LVEF) assessment within last 1 year. Detailed chart review of these patients was performed. CHF was defined as either prior episode of congestive heart failure or presence of LVEF <50%. Odds ratio (OR) and 95% confidence intervals (CI) for association of hypothermia and acute kidney injury as well as hemodialysis at discharge among patients with and without CHF were computed using multivariable adjusted logistic regression.

Results

Overall, 1417 cardiac arrest patients (mean age 62.5±14.6 years, 60.2% males, 67.2% white and 29.7% black) were included in this analysis, out of which 467 (33.0%) were treated with therapeutic hypothermia and known CHF was present in 624 (44%). AKI developed in 25.2% of CHF patients that were not treated with hypothermia while, only in 18.0% among CHF patients treated with hypothermia (OR 0.56; 95% CI 0.32–0.96, p=0.03). There was an decrease in trend of requiring hemodialysis at discharge among CHF patients treated with hypothermia compared with CHF patients that were not treated with hypothermia (8.1% vs. 19.62%, p=0.019) among CHF patients not treated with hypothermia. However, there was no significant result.

Conclusions

Hypothermia is associated with nephroprotective effects among patients with cardiac survivors with pre-existing CHF. Future research is needed to identify subgroups that derive benefit from therapeutic hypothermia after cardiac arrest.

P1710Risk of Mortality associated with use of mechanical support devices among comatose cardiac arrest patients

Background

The impact of mechanical circulatory assist devices (MCS) has not been well studied in cardiac arrest survivors. We examined that association of MCS with risk of mortality among comatose cardiac arrest survivors

Purpose

Compare the survival between different MCS and non MCS groups

Methods

This is a retrospective cohort study of 1417 comatose adult cardiac arrest survivors that survived for at least 1 day post cardiopulmonary resuscitation. Cox proportional hazard models adjusted for demographics, resuscitation parameters, comorbidities and medications were used to compute hazard ratios for extracorporeal membrane oxygenation (ECMO), ECMO + Impella/intraaortic balloon pump (IABP), IABP and Impella associated with risk of short term 60 day mortality. Kaplan meier's curves were used to demonstrate cumulative survival rate.

Results

Among 1417 cardiac arrest survivors, MCS was used among 553 (39.1%) patients. After 60 days of follow up, mortality rate was 49.4% in non MCS group, 58.6% in IABP group, 22.9% in Impella group, 40.0% in ECMO only group, 50.0% in ECMO + Impella/IABP group. When compared with no MCS use, only Impella use was associated with decrease risk of short term mortality (HR 0.37; 95% CI 0.16–0.83, p=0.02) while there was no significant association of other forms of MCS with short term mortality. There was no significant association of any MCS with long term mortality. Kaplan-Meier curves demonstrate early benefit of Impella and very early benefit of ECMO (figure 1).

Conclusions

This is the first large study to report various types of MCS use among comatose cardiac arrest survivors and has shown an indication of benefit with Impella use only in first 60 days post cardiac arrest. Future prospective study may be needed to validate this association

Acknowledgement/Funding

None

Comprehensive case management of malaria: Operational research informing policy

In 2013, the Odisha state Vector Borne Disease Control Programme led a five year operational research project, under programmatic conditions, in close collaboration with several partners. This Comprehensive Case Management Project covered a population of 900,000 across paired control and intervention blocks in four districts, each with different transmission intensities. Key gaps in access to malaria services were identified through household surveys and a detailed situation analysis. The interventions included ensuring adequate stocks of rapid diagnostic tests and antimalarial drugs at the village level, the capacity building of health workers and ASHAs, setting up microscopy centres at the primary health care level, and conducting mass screening and treatment in poorly accessible areas. The programme strengthened the routine health system, and improved malaria surveillance as well as the access to and quality of care. Initially, the programme led to increased case reporting due to improved detection, followed by a decline in malaria incidence. Lessons from the project were then scaled up statewide in the form of a new initiative-Durgama Anchalare Malaria Nirakaran (DAMaN).

Experimental and numerical study of mechanical properties of multi-phase medium-Mn TWIP-TRIP steel: influences of strain rate and phase constituents

In the current work we investigate the room temperature tensile properties of a medium-Mn twinning- and transformation-induced plasticity (TWIP-TRIP) steel from quasi-static to low-dynamic strain rates ( ε ˙ = 10 - 4 s - 1 to ε ˙ = 10 2 s - 1 ). The multi-phase microstructure consists of coarse-grained recovered α' -martensite (inherited from the cold-rolled microstructure), multiple morphologies of ultrafine-grained (UFG) austenite (equiaxed, rod-like and plate-like), and equiaxed UFG ferrite. The multi-phase material exhibits a positive strain-rate sensitivity for yield and ultimate tensile strengths. Thermal imaging and digital image correlation allow for in situ measurements of temperature and local strain in the gauge length during tensile testing, but Lüders bands and Portevin Le Chatelier bands are not observed. A finite-element model uses empirical evidence from electron backscatter diffraction (EBSD) and transmission electron microscopy (TEM), plus constitutive equations to dissect the microstructural influences of grain size, dislocation density and TWIP-TRIP driving forces on tensile properties. Calibration of tensile properties not only captures the strain rate sensitivity of the multi-phase TWIP-TRIP steel, but also provides opportunity for a complete parametric analysis by changing one variable at a time (phase fraction, grain size, strain-induced twin fraction and strain-induced ε-martensite fraction). An equivalent set of high-rate mechanical properties can be matched by changing either the austenite phase fraction or the ratio of twinning vs. transformation to ε-martensite. This experimental-computational framework enables the prediction of mechanical properties in multi-phase steels beyond the experimental regime by tuning variables that are relevant to the alloy design process.

Comparative study of bone marrow and blood plasma levels of IL-2 in aplastic anaemia and their relationship with disease severity

OBJECTIVES

Interleukin-2 (alias: IL-2, TCGF, Lymphokine), a type of interleukin, is also a potent signalling molecule in the signalling cascade of the immune-mediated activation of T Lymphocytes leading to the destruction of haematopoietic stem cell (HSC) which is the basis of acquired aplastic anaemia (AAA). The objective was to study the association of IL-2 in the bone marrow plasma (BMP) and peripheral blood plasma (PBP) in AAA patients.

METHODS

A total of 52 BMP and PBP-paired samples (both from the same patients) was collected from the confirmed AAA patients and 10 healthy individuals. The level of IL-2 was measured by the quantitative enzyme-linked immunosorbent assay (ELISA). The Mann-Whitney U test was used for statistical analysis.

RESULTS

Significantly increased level of IL-2 was observed in the BMP than PBP of AAA patients. The level of IL-2 in PBP and BMP was found to be very low in the control cases. Considerably increased levels of IL-2 were found in the PBP and BMP of AAA patients as compared to controls (48.54 ± 21.89 vs. 1.99 ± 1.25 p-value < 0.00001) and (75.33 ± 41.9 vs. 3.12 ± 1.82; p-value < 0.00001) respectively. Among these patients, the IL-2 levels were higher in patients with Very Severe Aplastic Anaemia (VSAA) and Severe Aplastic Anaemia (SAA) than those with Non-severe Aplastic Anaemia (NSAA) in the PBP (65.6 ± 23.61 vs. 31.72 ± 7.64; p-value 0.00338) and (45.37 ± 16.25 vs. 31.72 ± 7.64; p-value 0.01468) respectively. Again the IL-2 levels were higher in patients with VSAA and SAA than those with NSAA in the BMP (115.01 ± 38.91 vs. 38.32 ± 19.49; p-value < 0.00001) and (66.44 ± 23.34 vs. 38.32 ± 19.49; p-value 0.0006). The IL-2 level was higher in VSAA than SAA in PBP (65.6 ± 23.61vs. 45.37 ± 16.25; p-value 0.0114) and BMP (115.01 ± 38.91 vs. 66.44 ± 23.34; p-value 0.00044).

CONCLUSION

This study emphasized on the bone marrow and blood plasma levels of IL-2 in aplastic anaemia and their relationship with disease severity. The results indicate towards the fact that IL-2 may have an important association with the marrow failure of AAA patients and thus can help in disease development. Further study is necessary for better understanding.

Incidence of Fanconi anaemia in phenotypically normal aplastic anaemia patients in West Bengal

OBJECTIVES

Fanconi anaemia (FA) is a rare inherited bone marrow failure and autosomal recessive blood disorder. FA patients have a higher risk of cancer, including acute myeloid leukaemia and squamous cell carcinoma. Maximum, but not all, affected individuals have one or more somatic abnormalities, including skin, skeletal, genitourinary, gastrointestinal, cardiac and neurological anomalies, etc. Positive stress cytogenetics has immense implications for the treatment and management of FA. The aim of our study was to find out the incidence of FA in the population of phenotypically normal aplastic anaemia (AA) patients in West Bengal.

METHODS

Ethical clearances were obtained from the corresponding institutional committees. A total of 117 AA cases was selected. Stress cytogenetics was performed from peripheral venous blood (PVB) samples of 63 AA patients (age ≤ 50 years) and 63 age- and sex-matched healthy individual (control) using Mitomycin C (MMC).

RESULTS

Out of 63 AA patients, 6 (9.25%) cases showed positive stress cytogenetics suggestive of FA, which is statistically significant (p-value - 0.000532), analysed by chi-square test.

DISCUSSION

A considerable percentage of patients showing sensitivity towards MMC, even if they are phenotypically normal and did not have any distinguishable features which are generally found in FA.

CONCLUSION

This observation may indicate that stress cytogenetics analysis of phenotypically normal AA patients (≤50 years) is essential for the improvement of the treatment procedure.

Cytogenetic study is not essential in patients with aplastic anemia

Depending on contemporary treatment approach of aggressive immunosuppression, Aplastic Anemia (AA) is caused by immunological destruction of otherwise normal hematopoietic stem cells. The aim was to summarize the cytogenetic abnormalities in AA patients and the frequency of Fanconi Anemia (FA) in morphologically normal AA patients in eastern India. Ethical clearances were obtained from both institutions involved in this study. Out of 72800 patients attending the outpatient department, 520 pancytopenia patients were screened for AA after Bone marrow (BM) aspiration and biopsy. Samples were collected from 117 cases in 3 phases. 51 peripheral venous blood (PVB) samples in the first phase, 19 BM & PVB paired samples in the second phase and 47 BM samples in third phase were collected followed by leukocyte and/or BM stem cell culture. Next GTG banding and karyotyping were performed. PVB was collected from 63 (< 50 years) AA patients and stress cytogenetics was done to diagnose FA. In the first phase of the study, out of 51 PVB samples, 1 (1.96%) showed a unique chromosomal abnormality, i.e. 45,XY,rob(14:21)(p10:q10)[20]. In the second phase of study, among 19 BM & PVB paired samples, 1 (5.26%) showed abnormal karyotype i.e. 45,X,-Y[3]/46,XY[47]. In the third phase of the study, 47 BM samples showed normal karyotype. Only 6 (9.52%) cases were found positive for stress cytogenetics. A negligible percentage showing cytogenetic abnormality in such a considerable number of AA cases indicates that routine cytogenetic analysis of AA patient is not essential. A significant percentage was positive for stress cytogenetics; suggestive for FA, even the patients were morphologically normal.

Identification of a suitable promoter for the sigma factor of Mycobacterium tuberculosis

Promoter binding specificity is one of the important characteristics of transcription by Mycobacterium tuberculosis (Mtb) sigma (σ) factors, which remains unexplored due to limited structural evidence. Our previous study on the structural features of Mtb-SigH, consisting of three alpha helices, and its interaction with core RNA polymerase has been extended herein to determine the little known DNA sequence recognition pattern involving its cognate promoters. Herein, high resolution X-ray crystallographic structures of the protein-DNA complexes were inspected to determine the tentative DNA-binding helix of the σ factor. The binding interface in the available crystal structures is found to be populated mainly with specific residues such as Arg, Asn, Lys, Gln, and Ser. We uncovered the helix 3 of Mtb-SigH containing most of these amino acids, which ranged from Arg 64 to Arg 75, forming the predicted active site. The complex of Mtb-SigH:DNA is modelled with 20 promoter sequences. The binding affinity is predicted by scoring these protein-DNA complexes through proximity and interaction parameters obtained by molecular dynamics simulations. The promoters are ranked considering hydrogen bonding, energy of interaction, buried surface area, and distance between centers of masses in interaction with the protein. The ranking is validated through in vitro transcription assays. The trends of these selected promoter interactions have shown variations parallel to the experimental evaluation, emphasizing the success of the active site determination along with screening of the promoter strength. The promoter interaction of Mtb-SigH can be highly beneficial for understanding the regulation of gene expression of a pathogen and also extends a solid platform to predict promoters for other bacterial σ factors.

Cytogenetic analysis of patients with primary amenorrhea in Eastern India

Amenorrhea is the absence of menstruation in women of reproductive age. Previous reports suggest that chromosomal abnormality is the second most common cause of amenorrhoea. Early referral for cytogenetic evaluation is recommended for the identification of underlying chromosomal aberrations in amenorrhoea patients. This was an observational study which was conducted in Vivekananda Institute of Medical sciences, Kolkata, during January 2013-December 2015. This study aims to estimate the frequency and types of chromosomal abnormalities in primary amenorrhoea (PA) patients in Eastern India and correlate their hormonal profile with chromosomal reports. Clinical features of 150 patients were recorded with clinical expertise. Peripheral venous blood was taken following informed consent, followed by karyotyping for chromosomal analysis. Results revealed 76.1% of PA with normal female karyotype (46, XX) and 23.9% with different abnormal karyotypes. Among the abnormal karyotype constituents, 50% numerical abnormalities, most frequent being Turner syndrome, pure (n = 12, 8%) and mosaic (n = 5, 3.3%). Three cases (2%) showed male (XY) karyotype. The other cases showed X structural abnormalities. This study emphasises the need for cytogenetic analysis as integral part of the diagnostic protocol in case of PA for precise identification of chromosomal abnormalities and for appropriate management and counselling of these patients.

Incidental finding of a persistent median artery (palmar type) during a routine carpal tunnel decompression: a case report

Carpal tunnel syndrome is characterised by compression of the median nerve. The mainstay of treatment is surgical decompression. This case report highlights the occurrence of a persistent median artery, which could complicate surgery. A 55-year-old woman underwent carpal tunnel decompression. An incidental finding of a large-calibre persistent median artery, which was superficial to the flexor sheath, could have been damaged. This was carefully retracted and the procedure was completed, without any complications. Several studies have shown the prevalence of persistent median artery to range from 1.1-27.1%. It is usually found deep to the flexor retinaculum but in this case it was found to be just beneath the palmar fascia. There is increased chance of iatrogenic injury with this particular variant. Surgeons performing the procedure should be mindful of this variation, because accidental damage could result in devastating consequences to the hand.

A review on thermal and catalytic pyrolysis of plastic solid waste (PSW)

Plastic plays an important role in our daily lives due to its versatility, light weight and low production cost. Plastics became essential in many sectors such as construction, medical, engineering applications, automotive, aerospace, etc. In addition, economic growth and development also increased our demand and dependency on plastics which leads to its accumulation in landfills imposing risk on human health, animals and cause environmental pollution problems such as ground water contamination, sanitary related issues, etc. Hence, a sustainable and an efficient plastic waste treatment is essential to avoid such issues. Pyrolysis is a thermo-chemical plastic waste treatment technique which can solve such pollution problems, as well as, recover valuable energy and products such as oil and gas. Pyrolysis of plastic solid waste (PSW) has gained importance due to having better advantages towards environmental pollution and reduction of carbon footprint of plastic products by minimizing the emissions of carbon monoxide and carbon dioxide compared to combustion and gasification. This paper presents the existing techniques of pyrolysis, the parameters which affect the products yield and selectivity and identify major research gaps in this technology. The influence of different catalysts on the process as well as review and comparative assessment of pyrolysis with other thermal and catalytic plastic treatment methods, is also presented.

THE DECADE OF THE RABiT (2005-15)

The RABiT (Rapid Automated Biodosimetry Tool) is a dedicated Robotic platform for the automation of cytogenetics-based biodosimetry assays. The RABiT was developed to fulfill the critical requirement for triage following a mass radiological or nuclear event. Starting from well-characterized and accepted assays we developed a custom robotic platform to automate them. We present here a brief historical overview of the RABiT program at Columbia University from its inception in 2005 until the RABiT was dismantled at the end of 2015. The main focus of this paper is to demonstrate how the biological assays drove development of the custom robotic systems and in turn new advances in commercial robotic platforms inspired small modifications in the assays to allow replacing customized robotics with 'off the shelf' systems. Currently, a second-generation, RABiT II, system at Columbia University, consisting of a PerkinElmer cell::explorer, was programmed to perform the RABiT assays and is undergoing testing and optimization studies.

Elucidating Kinetic, Adsorption and Partitioning Phenomena from a Single Well Tracer Method: Laboratory and Bench Scale Studies

This study is aimed at giving some insights on kinetics, adsorption and partitioning of ethyl acetate during a single well tracer test. Synthetic formation water, an specific crude oil and a silicate-dolomite rock were used during experiments performed in laboratory and bench scale systems. Independent sets of experiments were designed to calculate the partition coefficient of ethyl acetate between the formation water and the oil, to develop a kinetic model for the hydrolysis of ethyl acetate, and to derive isotherm and kinetic models for the adsorption of ethyl acetate on the rock. These tracer experiments were evaluated at a concentration range (100–300 mmol.L−1) similar to that supposed to be used in the single well tracer method. All parameters determined from these experiments were validated describing observations from stirred batch and column systems, in which kinetic, adsorption and partitioning phenomena occurred at the same time. Pseudo-heterogeneous models, accounting for three phases namely the formation water, the rock and the oil, were applied to elucidate the interaction of the different mechanisms involved in these set-ups. Main results are summarized as follows: (i) partition coefficients (KEA) were apparent varying from ca. 5–8 because of thermodynamic constraints; (ii) kinetic models for the hydrolysis of ethyl acetate were developed under acid and basic conditions since at neutral ones there were negligible conversions; (iii) the combined Langmuir-Freundlich isotherm and the Langmuir kinetics were the most suitable models describing equilibrium and adsorption rate observations, respectively; (iv) the studied rock adsorbed significant amounts of ethyl acetate, leading to a maximum adsorption capacity (qEAm) of ca. 7.0 mmol.g−1 at studied operating conditions; (v) the adsorption kinetic model rather than the simplified isotherm model seems necessary to describe this phenomenon from the single well test evaluating ethyl acetate as the tracer; and (vi) partition, hydrolysis and adsorption parameters evaluated from independent experiments allowed us to describe observations from both stirred batch and column systems. These results disclose the importance of accounting for partition, hydrolysis and adsorption mechanisms in a single well method using ethyl acetate as the tracer.