To compare central visual field progression using mean deviation and pointwise linear regression analysis

Purpose

To compare central visual field progression using mean deviation and pointwise linear regression (PLR) analysis.

Methods

We analyzed the 10-2 Humphrey visual field (HVF) tests for moderate and advanced primary glaucoma who had undergone at least five reliable 10-2 visual field tests with a minimum follow-up of at least two years and best-corrected visual acuity better than 6/12. Regression slope less than -1 dB/year at P < 0.01 at a point was defined as an individual threshold point progression.

Results

Ninety-six eyes of 74 patients were included. The median follow-up duration was of 4 years (±1.97). Median 10-2 mean deviation (MD) at inclusion was -19.01 dB (interquartile range [IQR] -13.2, -24.14) and -21.90 (IQR - 13.4, -27.8) on 24-2 HVF. The median rate of MD change was -0.13 dB/year (IQR - 0.46, 0.08) for 10-2. The median rate for visual field index (VFI) change was 0.9% per year (IQR - 1.5, 0.4). Twenty-eight percent of eyes (27 eyes) showed progression. Twelve percent (12 eyes) showed progression of two or more points in the same hemifield on pointwise linear regression (PLR) analysis, and 16% of eyes (15 eyes) showed progression of one point. The median rate of MD change was significantly more in progressing eyes based on PLR analysis than eyes with no progression (-0.5 vs. -0.06 dB/year P < 0.001). One patient had likely and the second had possible progression on 24-2. In 24 eyes, event analysis did not show any change; the rest mean deviation was out of range.

Conclusion

Central visual field PLR analysis is useful in detecting progression in advanced glaucomatous damage.

ECG-NETS – A novel integration of capsule networks and extreme gated recurrent neural network for IoT based human activity recognition

Human Activity Recognition (HAR) has reached its new dimension with the support of Internet of Things (IoT) and Artificial Intelligence (AI). To observe human activities, motion sensors like accelerometer or gyroscope can be integrated with microcontrollers to collect all the inputs and send to the cloud with the help of IoT transceivers. These inputs give the characteristics such as, angular velocity of movements, acceleration and apply them for an effective HAR. But reaching high recognition rate with less complicated computational overhead still represents a problem in the research. To solve this aforementioned issue, this work proposes a novel ensembling of Capsule Networks (CN) and modified Gated Recurrent Units (MGRU) with Extreme Learning Machine (ELM) for an effective HAR classification based on data collected using IoT systems called Ensemble Capsule Gated (ECG)-Networks (NETS). The proposed system uses Capsule networks for spatio-feature extraction and modified (Gated Recurrent Unit) GRU for temporal feature extraction. The powerful feed forward training networks are then employed to train these features for human activity recognition. The proposed model is validated on real time IoT data and WISDM datasets. Experimental results demonstrates that proposed model achieves better results comparatively higher than existing (Deep Learning) DL models.

Data automated bag breathing unit for COVID-19 ventilator shortages

BACKGROUND

The COVID-19 pandemic has caused a global mechanical ventilator shortage for treatment of severe acute respiratory failure. Development of novel breathing devices has been proposed as a low cost, rapid solution when full-featured ventilators are unavailable. Here we report the design, bench testing and preclinical results for an 'Automated Bag Breathing Unit' (ABBU). Output parameters were validated with mechanical test lungs followed by animal model testing.

RESULTS

The ABBU design uses a programmable motor-driven wheel assembled for adult resuscitation bag-valve compression. ABBU can control tidal volume (200-800 ml), respiratory rate (10-40 bpm), inspiratory time (0.5-1.5 s), assist pressure sensing (- 1 to - 20 cm H2O), manual PEEP valve (0-20 cm H2O). All set values are displayed on an LCD screen. Bench testing with lung simulators (Michigan 1600, SmartLung 2000) yielded consistent tidal volume delivery at compliances of 20, 40 and 70 (mL/cm H2O). The delivered fraction of inspired oxygen (FiO2) decreased with increasing minute ventilation (VE), from 98 to 47% when VE was increased from 4 to 16 L/min using a fixed oxygen flow source of 5 L/min. ABBU was tested in Berkshire pigs (n = 6, weight of 50.8 ± 2.6 kg) utilizing normal lung model and saline lavage induced lung injury. Arterial blood gases were measured following changes in tidal volume (200-800 ml), respiratory rate (10-40 bpm), and PEEP (5-20 cm H2O) at baseline and after lung lavage. Physiological levels of PaCO2 (≤ 40 mm Hg [5.3 kPa]) were achieved in all animals at baseline and following lavage injury. PaO2 increased in lavage injured lungs in response to incremental PEEP (5-20 cm H2O) (p < 0.01). At fixed low oxygen flow rates (5 L/min), delivered FiO2 decreased with increased VE.

CONCLUSIONS

ABBU provides oxygenation and ventilation across a range of parameter settings that may potentially provide a low-cost solution to ventilator shortages. A clinical trial is necessary to establish safety and efficacy in adult patients with diverse etiologies of respiratory failure.

Combined efficacy of Vigna radiata (L.) R. Wilczek and Amorphophallus paeoniifolius (Dennst.) Nicolson on serum lipids in albino rats

Coronary Artery Disease (CAD) is a major killer disease throughout the world. Dyslipidemia is a major contributor to the risk of CAD. Several dietary articles traditionally used in India and other South Asian countries reduced dyslipidemia. The present study was undertaken to evaluate the combined effect of Mung bean (Vigna radiata) and Elephant foot yam (Amorphophallus paeoniifolius) on serum lipids and atherogenic indices in albino rats and to compare it with a standard drug Cholestyramine. Thirty healthy albino rats of both sexes (150-200 g) were randomized to 5 groups of 6 animals each. The grouping were done based on the following criteria: Group I: Normal Control Group, Group II: (Standard Group): Cholestyramine resin 5 mg/kg bw, Group III: (Half Dose Group): Drug powder at 540 mg/kg bw, Group IV: (Effective Dose Group): Drug powder at 1080 mg/kg bw, and Group V: (Double Dose Group): Drug powder at 2160 mg/kg bw. Lipid profile was estimated at the beginning and after 30 days of treatment. The Effective and Double doses of the drug reduced Total cholesterol along with levels of Triglycerides, Low density lipoprotein and Very low density lipoprotein levels significantly (p < 0.01) along with a significant (p < 0.01) increase in high density lipoproteins (HDL) in rats. There was also significant (p < 0.01) improvement in atherogenic indices like Castelli Risk Index I, Non HDL C/HDL, Castelli risk Index II, TG/HDL, Atherogenic coefficient and Atherogenic Index of Plasma. The combination of powdered sprouted mung bean and yam powder have excellent lipid lowering potential.

W-band sparse synthetic aperture for computational imaging

We present a sparse synthetic-aperture, active imaging system at W-band (75 - 110 GHz), which uses sub-harmonic mixer modules. The system employs mechanical scanning of the receiver module position, and a fixed transmitter module. A vector network analyzer provides the back end detection. A full-wave forward model allows accurate construction of the image transfer matrix. We solve the inverse problem to reconstruct scenes using the least squares technique. We demonstrate far-field, diffraction limited imaging of 2D and 3D objects and achieve a cross-range resolution of 3 mm and a depth-range resolution of 4 mm, respectively. Furthermore, we develop an information-based metric to evaluate the performance of a given image transfer matrix for noise-limited, computational imaging systems. We use this metric to find the optimal gain of the radiating element for a given range, both theoretically and experimentally in our system.

Discoid lupus erythematosus with squamous cell carcinoma: a case report and review of the literature in Indian patients

We report a case of a patient with localized discoid lupus erythematosus (DLE) who was found to have high-grade squamous dysplasia (carcinoma in situ) over the upper lip. This report also consists of a brief review of 16 other cases of DLE with squamous cell carcinoma (SCC) we came across while going through the literature in an Indian scenario.Incidence of SCC over DLE in the Indian population is found to be 0.98% to 3.4% with a male-to-female ratio of 1.6:1. The latent period between onset of DLE and development of SCC was 9.59 ± 5.6 years.There was history of chronic sun exposure in 81.8% of patients, which indicates a possible role of prolonged ultraviolet light exposure in malignant transformation. The lips were the most commonly affected area (28.57%), with the upper lip being more commonly involved than the lower lip. We also observed that the latent period (5 ± 2.7 years) in lip tumours was shorter than that in other sites (11.22 ± 6.78 years), indicating a more rapid transformation in lips (p value = 0.038). Well differentiated was the most common (46.2%) type of SCC noted. Lymph node involvement was found in three of 17 cases (25%) and one case (8.3%) had recurrence of lesions after excision.We conclude that in India though SCC is rare per se, its occurrence in the context of DLE is not uncommon and is aggressive in nature.

Effect of tonsillectomy on aso-titre

136 children below the age of 15 suffering from chronic tonsillitis were screened. 56 patients who showed a raised ASO titre above 200iu/ml were selected for this study. All of them underwent tonsillectomy. ASO titre estimation was done after 1 month;62% after 3 months;78% after 6 months and 88% after 1 year.

Skeletal muscle metastasis from malignant melanoma

Malignant melanomas commonly metastasise to skin, subcutaneous tissue and lymph nodes. Skeletal muscle metastases from malignant neoplasms are uncommon. There have been very few reports of malignant melanoma metastasising to skeletal muscle. We report a case of malignant melanoma metastasis in the thigh musculature in a young female patient.

Cutaneous T cell lymphoma with multiple oral lesions

Cutaneous T cell lymphoma is a type of non Hodgkins lymphoma occurring rarely (two-three percentage of NHL) and that with an ENT manifestation is much more rare. We present here a case of cutaneous T cell lymphoma presenting with multiple skin lesions and oral and oropharyngeal ulcerations.

A spontaneous compartment syndrome in a patient with diabetes

A compartment syndrome is an orthopaedic emergency which can result from a variety of causes, the most common being trauma. Rarely, it can develop spontaneously and several aetiologies for spontaneous compartment syndrome have been described. We describe a patient with diabetes who developed a spontaneous compartment syndrome. The diagnosis was delayed because of the atypical presentation.

Extensive and divergent circadian gene expression in liver and heart

Many mammalian peripheral tissues have circadian clocks; endogenous oscillators that generate transcriptional rhythms thought to be important for the daily timing of physiological processes. The extent of circadian gene regulation in peripheral tissues is unclear, and to what degree circadian regulation in different tissues involves common or specialized pathways is unknown. Here we report a comparative analysis of circadian gene expression in vivo in mouse liver and heart using oligonucleotide arrays representing 12,488 genes. We find that peripheral circadian gene regulation is extensive (> or = 8-10% of the genes expressed in each tissue), that the distributions of circadian phases in the two tissues are markedly different, and that very few genes show circadian regulation in both tissues. This specificity of circadian regulation cannot be accounted for by tissue-specific gene expression. Despite this divergence, the clock-regulated genes in liver and heart participate in overlapping, extremely diverse processes. A core set of 37 genes with similar circadian regulation in both tissues includes candidates for new clock genes and output genes, and it contains genes responsive to circulating factors with circadian or diurnal rhythms.

Maternal entrainment in the circadian activity rhythm of laboratory mouse (C57BL/6J)

Maternal entrainment of circadian activity rhythm was studied in the laboratory mouse (C57BL/6J). Pregnant mice gave birth in constant dim light and the mother raised the pups until Postnatal Day 18 (weaning). The wheel running activity of these pups was individually monitored from Day 18. It was found that the phases of pups' activity on the day of weaning were similar to the phases of their mother's rhythm (p < 0.001), indicating that maternal entrainment occurs in the C57BL/6J pups. When the mother mouse was cyclically presented to the pups for 12 h of a day, thereby creating presence-absence (PA) cycles of 12:12 h, it was found that the pups' activity rhythm entrained to the imposed cycles. The onset of activity of the pups coincided with the beginning of the mother's 12-h absence period. It is proposed that the social contact between the mother and the pups is taken by the pups as subjective day (rest time) and absence of the mother as subjective night (activity time). This maternal (nonphotic) entrainment, however, does not continue beyond Postnatal Days 23-26, despite ongoing PA cycles. These results indicate that the PA cycles of the mother are a transient zeitgeber, and are effective in entraining the rhythm of pups only for about 4 weeks after birth.

Free-running circadian period does not shorten with age in female Syrian hamsters

It has been reported that the free-running period of circadian rhythms shortens with age in mammals, including humans, and this shortening has been suggested to be the underlying cause of early morning awakening and difficulty maintaining sleep in older people. A recent study found that the free-running period of male hamsters does not change with age. The present study extends those findings to female hamsters. We studied the locomotor activity rhythm of 22 female hamsters kept in constant conditions from early adulthood until their death, and compared their data to those from male hamsters. We found no shortening of free-running period with age in the female hamsters, and no difference in free-running period between females and males. In contrast, mean activity level and amount of time per cycle spent running declined with age in females and males. These findings demonstrate that the free-running period in hamsters does not systematically shorten with age, and suggest that alternative explanations for the observed age-related advance of sleep-wake times in humans should be explored.

Stability of circadian timing with age in Syrian hamsters

The causes of age-related disruptions in the timing of human sleep and wakefulness are not known but may include changes in both the homeostatic and circadian regulation of sleep. In Syrian hamsters the free running period of the circadian activity/rest rhythm has been reported to shorten with age. Although this has been observed under a variety of experimental conditions, the changes have been small and their consistency uncertain. In the present study, the wheel running activity/rest rhythm was continuously measured in male Syrian hamsters (Mesocricetus auratus) in dim constant light (<1 lx) from 8 wk of age until death. Fifteen hamsters survived to at least 90 wk (28%). The average free running period of these hamsters did not change with age. In 18 hamsters that died between 50 and 88 wk, free running period also did not change before death. In contrast to free running period, other measures related to activity level changed significantly with age and before death. Despite changes in the expression of the activity/rest rhythm, the free running period of the hamster circadian pacemaker remained remarkably stable with age.

A screen for genes induced in the suprachiasmatic nucleus by light

The mechanism by which mammalian circadian clocks are entrained to light-dark cycles is unknown. The clock that drives behavioral rhythms is located in the suprachiasmatic nucleus (SCN) of the brain, and entrainment is thought to require induction of genes in the SCN by light. A complementary DNA subtraction method based on genomic representational difference analysis was developed to identify such genes without making assumptions about their nature. Four clones corresponded to genes induced specifically in the SCN by light, all of which showed gating of induction by the circadian clock. Among these genes are c-fos and nur77, two of the five early-response genes known to be induced in the SCN by light, and egr-3, a zinc finger transcription factor not previously identified in the SCN. In contrast to known examples, egr-3 induction by light is restricted to the ventral SCN, a structure implicated in entrainment.

Survival in cancer of the cervix: treatment in a population-based cancer registry in a developing country (Bangalore, India)

A survival analysis of treated cases of cervix cancer that were registered in the Bangalore (India) Population Based Cancer Registry between 1 January 1987 and 31 December 1989 was performed. Information on vital status of patients was obtained principally through follow-up visits to homes of patients. Follow-up information was available for 860 (92.7 percent) of 928 registered cases. Of the 860 cases, information on treatment was available for 559 patients, on whom the analysis of treatment outcome was performed. The overall five-year observed survival (5YS) was 41.1 percent with a relative survival of 46.3 percent. The 5YS was significantly (P = 0.01) influenced by clinical stage and by addition of brachytherapy (BT) to external radiotherapy (EXT) (5YS = 60.1 percent cf 27.4 percent, P < or = 0.001). In 343 patients who received EXT only, comparatively better survival was seen in the group who had received between 4,800 to 5,999 centigray (cGy) (5YS = 36.1 percent) when compared with those who received less than 3,000 and 3,000 to 4,799 cGy (5YS = 16.7 percent and 24.9 percent, respectively). Doses of EXT higher than 5,999 cGy (in patients who were not suitable for BT) did not have any benefit in the 5YS (27.4 percent). The study has generated a specific hypothesis about possible needless excess dose of external radiotherapy.

Single prenatal injections of melatonin or the D1-dopamine receptor agonist SKF 38393 to pregnant hamsters sets the offsprings' circadian rhythms to phases 180 degrees apart

Pregnant Syrian hamsters with lesions of the suprachiasmatic nucleus (SCN) received single injections of melatonin or the D1-dopamine receptor agonist, SKF 38393 on day 15 of gestation (1 day before birth). Pups were weaned on postnatal day 20 and their freerunning activity rhythms recorded for 3-4 weeks. The pups' phases on the day of weaning were significantly clustered in both of the treatment groups, but the average phases differed by approximately 180 degrees. The results demonstrate that a single prenatal stimulus is sufficient to set the phases of the hamsters' rhythms and that the phase established depends on the stimulus. Both c-fos mRNA and Fos protein were expressed in the fetal SCN after SKF 38393 injection but neither were expressed after melatonin injection. Simulations showed that a single stimulus could produce the observed synchrony from a population of uniformally distributed phases if the phase shifts were three to four times the magnitude of the adult hamster light phase response curve (PRC). A light pulse PRC mimicked the effect of an SKF 38393 injection and a dark-pulse PRC mimicked the effects of a melatonin injection. Together these results suggest that dopamine and melatonin either are, or mimic, maternal entraining signals that represent day and night.

The effect of transplanting one or two suprachiasmatic nuclei on the period of the restored rhythm

A fundamental property of circadian rhythms is the free-running period expressed by organisms when isolated from environmental periodicity. The physiological determinants of the free-running period, including variation among and within individuals and among species, are not known. The circadian rhythms of mammals are regulated by a circadian pacemaker within the suprachiasmatic nucleus (SCN) of the hypothalamus. To examine possible determinants of the free-running period, one or two SCNs were transplanted into hamsters that had their own SCNs ablated. Wheel-running behavior was measured to estimate the free-running period of restored rhythmicity. Hosts received grafts containing either the left or right SCN from a single fetus or both SCNs from a single fetus. In some cases, both the left and right SCNs from a single fetus restored rhythmicity in different hosts, demonstrating that each of the right and left SCN alone is a competent circadian pacemaker. The average free-running period of the restored rhythms was significantly longer in hamsters that received both of the SCNs from a single fetus. The sizes of grafts were estimated using immunoreactivity for vasoactive intestinal polypeptide as a marker of SCN tissue. Grafts never grew to be larger than an intact SCN, and a graft only 6.5% the size of the combined left and right intact SCNs restored rhythmicity. The average volume of grafted SCN in hamsters that received two SCNs was larger than that in hamsters that received a single SCN. The results demonstrate that SCN graft volume and/or the number of SCNs that comprise the graft influence the free-running period.

Suprachiasmatic nucleus grafts restore circadian function in aged hamsters

The regulation of circadian rhythms changes with age. In humans, changes in the timing of sleep and wakefulness are especially common. In Syrian hamsters Mesocricetus auratus the free running period of the activity/rest rhythm shortens with age. The present study tested the hypothesis that critical age-related changes occur within the hypothalamic suprachiasmatic nucleus (SCN), known to contain a circadian pacemaker. Fetal SCN were transplanted into the brains of younger (20 weeks) and older (81 weeks) hamsters which had had their own SCNs ablated. The restoration of rhythmicity and the free running period of the rhythmicity were determined from continuous records of wheel-running activity. Transplantation restored rhythmicity in hosts of both ages. In older hamsters, the mean free running period after transplantation was longer than that measured before SCN ablation, but a similar lengthening of period was not observed after transplantation to younger hamsters. In addition, the mean period after transplantation was the same for both younger and older hosts even when there was a difference between the groups before SCN ablation. When the grafts were allowed to age, the mean free running period of the restored rhythms became shorter, indicating that the grafts can also undergo age-related changes. The results indicate that age-related changes specifically in the SCN are responsible for an age-related change in free running period.

Entrainment of the fetal hamster circadian pacemaker by prenatal injections of the dopamine agonist SKF 38393

Prenatal treatment with the D1-dopamine receptor agonist SKF 38393 or cocaine induces expression of the immediate-early gene c-fos in the fetal rat suprachiasmatic nucleus (SCN) (Weaver et al., 1992). Because the induction of c-fos gene expression in the SCN has been implicated in the entrainment of circadian rhythms by light in mature animals, the present study investigated whether prenatal dopaminergic activation entrains the fetal circadian pacemaker. Injections of SKF 38393 (8 mg/kg) were given to pregnant, SCN-lesioned hamsters during the last 5 d of gestation and the phases of the offspring's wheel-running activity rhythms were measured on postnatal day 20. Pregnant hamsters were each given two injections/day 12 hr apart, but only one of the injections each day contained SKF 38393. One group of hamsters received the drug at 0800 hr while another group received the drug at 2000 hr. The offspring from these treatment groups showed average phases that differed by 11.3 hr, demonstrating that prenatal SKF 38393 set the phase of the offspring's circadian rhythms. These results suggest that the fetal circadian pacemaker can be entrained by dopaminergic activation. In situ hybridization using cRNA probes demonstrated that a single injection of SKF 38393 on the last day of gestation induced c-fos gene expression in the fetal hamster SCN and that mRNA for the D1-dopamine receptor was present in the SCN at that time. It is possible that maternal entrainment of the fetal circadian pacemaker, which normally occurs during development, is mediated by dopaminergic activation within the fetal hypothalamus.

The fetal circadian pacemaker is not involved in the timing of birth in hamsters

The role of the fetal circadian pacemaker in the timing of birth was examined in Syrian hamsters (Mesocricetus auratus). Two groups of pregnant hamsters with lesions of the suprachiasmatic nucleus received daily intraperitoneal injections of melatonin (25 micrograms) on Days 9-15 of gestation. One group was injected with melatonin in the evening and the other in the morning. After the last set of injections, the animals were observed every hour until they gave birth. The timing of birth was not significantly different in the two groups, indicating that it was not affected by the melatonin injections. In contrast, the average phases of the pups' activity rhythms at weaning were significantly different in the two groups; this difference, approximately 10 h, indicated that the prenatal melatonin injections set the phases of the pups' circadian pacemakers. These results suggest that the fetal pacemaker is not involved in the timing of birth, since the pacemaker could be set to different phases without affecting this timing. In a separate study, time of birth and length of gestation were measured for heterozygous tau mutant pups, which express a circadian rhythm with a period of approximately 22 h. The results were compared with similar measurements obtained from a previous study of wild-type pups that express a circadian rhythm with a period of approximately 24 h. In both cases, the pups had been born to wild-type mothers. The timing of birth was similar in the two groups, indicating that the tau mutation does not influence the length of gestation or the time of day when birth occurs.

The dose time relationship in the radiotherapy of carcinoma of the cervix--application of CRE formalism

A retrospective analysis of 291 patients with cancer of the uterine cervix treated with a combination of external and intracavitary radiotherapy was carried out. Patients were either treated with 45 Gy in 20 fractions by five fractions per week or with 42 Gy in 14 fractions by three fractions per week or with 42 Gy in 14 fractions by three fraction per week schedule by external radiotherapy. For brachytherapy the total dose was 24 to 32 Gy at a dose rate of 1.4 to 2.2 Gy per hour. Complication were correlated with total CRE values for point A (CRE TA) and for rectum CRE TR. Correlations of CRE TA with overall complication rate (p value < 0.05) and rectal complication rate (p value < 0.01) were excellent. Lack of correlation was observed between CRETR and overall complication rate (p value > 0.1) as well as rectal complication rate (p value > 0.1). In order to limit Grade II and III rectal and bladder complications to acceptable level, in combined external and intracavitary treatments, CRETA value of less than 2500 reu is suggested.

Timing of birth in Syrian hamsters

The effects of mating time and of LD cycles on the timing of birth and length of gestation were examined in Syrian hamsters (Mesocricetus auratus). Hamsters maintained on 14L:10D cycles were mated for 2 h either in the evening or in the morning, and groups of hamsters mated in the morning were subjected to either a 6-h advance shift or a 6-h delay shift of the LD cycle on Days 5-14 of gestation. For the last 2 days of gestation the hamsters were kept in constant dim light and observed every hour to determine the time of birth. Hamsters mated in the evening gave birth an average of 4.8 h before those mated in the morning, and the hamsters subjected to an advance shift gave birth an average of 8.1 h before those subjected to delay shift. The results show that 80-100% of births occur during the subjective day on Day 16 of gestation and that the minimum duration of gestation is 15 days and 2 h. The regulation of birth appears to involve two processes, an interval timer related to the time of conception and a circadian rhythm that is governed by the LD cycle.

Maternal entrainment of tau mutant hamsters

Maternal entrainment of the circadian wheel-running activity rhythm was examined in Syrian hamsters heterozygous for a single gene mutation (tau) that affects the free-running period of circadian rhythms. Heterozygous tau pups were born to and raised by wild-type mothers under constant dim light. The pups' wheel-running activity was recorded after weaning on postnatal day 18 or 24. Pups weaned on day 18 had an average free-running period of 21.70 hr, demonstrating that the tau phenotype was fully expressed at this age. Using the activity onset of the postnatal free-running rhythms as a phase reference, we estimated the phase relationships between the pups and their mothers on days 18 and 24. In contrast to results with wild-type pups, the activity rhythms of tau pups were not in phase with the rhythms of their wild-type mothers; that is, activity onsets of mothers and pups did not coincide. The pups did, however, show synchrony among themselves, indicating that they had been exposed to a synchronizing signal sometime during development. It is likely that this synchronizing signal was provided by the mothers, since pups from different litters showed phase relationships similar to those of their mothers. Thus the mothers provided a signal that was sufficient to cause entrainment, despite the 2-hr difference in free-running period between the mothers and pups. Although the pups' activity rhythms appeared to have been entrained by the mothers, they were clearly free-running by postnatal day 18. The mechanism for entrainment is lost during the course of development, despite continued interaction between the mothers and pups.

Prevalence of spontaneous bacterial peritonitis

To assess the prevalence of spontaneous bacterial peritonitis (SBP), ascitic fluid cell count, and ascitic fluid culture by conventional method and by bedside inoculation in blood culture bottles were performed in 31 consecutive patients of liver cirrhosis. Seven (22.58%) patients had ascitic fluid polymorphonuclear count (PMN) more than 500/mm. Ascitic fluid culture by conventional method was negative in all the patients, while in 4 patients culture was positive by bedside inoculation method. Six of 7 patients with SBP or its variant were in Child class C. Clinical features in these patients were abdominal pain (5 patients), fever (4) and encephalopathy (2); serum bilirubin level was 6.8 +/- 5.5 mg/dl, serum albumin 1.98 +/- 0.2 g/dl, prothrombin index 59.8 +/- 12.2%, ascitic fluid protein 0.78 +/- 0.24 g/dl. Three of 7 patients with SBP or its variant expired during hospital stay; the other 4 patients recovered after appropriate antibiotic therapy. We conclude that SBP is a serious complication in patients of liver cirrhosis with ascites. Ascitic fluid PMN count and bedside inoculation of blood culture bottles with ascitic fluid are sensitive indicators of SBP. Hence they should be performed routinely for early detection of SBP.

Application of radiation effect models in combined external and intracavitary radiotherapy of carcinoma of the uterine cervix

A retrospective analysis of 291 patients with cancer of the uterine cervix treated with a combination of external and intracavitary radiotherapy was carried out. Patients were treated with an external radiotherapy dose of 45 Gy in 20 fractions, 5 fractions per week, or 42 Gy in 14 fractions, 3 fractions per week. For brachytherapy the total dose was 24 to 32 Gy at a dose rate of 1.4 to 2.2 Gy per hour. Treatment results in terms of survival, local disease-free survival and complication rates were compared with cumulative radiation effect (CRE) and extrapolated response dose (ERD) values for point A (CRETA and ERDTA respectively) and for rectum (CRETr and ERDTr respectively). CRETA and ERDTA values did not significantly correlate with local disease-free and survival rates. Correlations of CRETA and ERDTA with overall complication rate and with rectal complication rate (p-value less than 0.025) were good. No significant correlation was observed between CRETr or ERDTr and overall complication rate and rectal complication rate. In order to limit grades II and III rectal complications to acceptable level, in combined external and intracavitary treatment, CRETA and ERDTA values of less than 2,500 and 93 respectively are suggested.

The time dose fractionation (TDF) relationship in the radiotherapy of carcinoma of the cervix

A retrospective analysis of 291 patients with cancer of the uterine cervix treated with a combination of external and intracavitary radiotherapy was carried out. Patients were either treated with 45 Gy in 20 fractions by five fractions per week or with 42 Gy in 14 fractions by three fractions per week schedule by external radiotherapy. For brachytherapy the total dose was 24 to 32 Gy at a dose rate of 1.4 to 2.2 Gy per hour. Treatment results in terms of response, survival, recurrence and complication were correlated with total TDF values for point A (TDFTA) and for rectum TDFTR. Correlations of TDFTA with overall complication rate (p value less than 0.05) and rectal complications rate (p value less than 0.01) were excellent. TDFTA values did not correlate with response, recurrence and survival rates (p value greater than 0.1). Lack of correlation was observed between TDFTR and overall complication rate (p value greater than 0.1) as well as rectal complication rate (p value greater than 0.1). In order to limit grade II and III rectal and bladder complications to acceptable level, in combined external and intracavitary treatments, TDFTA value of less than 150 is suggested.

Presence-absence cycles of the mother and not light-darkness are the zeitgeber for the circadian rhythm of newborn mice

The relative roles of conflicting zeitgebers [presence/absence (PA) cycles versus light/dark (LD) cycles] on entrainment of circadian rhythm of locomotor activity were tested in pups of the night active mouse Mus booduga. During the early days of the pups' life the PA cycles of the mother acted as a zeitgeber and entrained their activity rhythm, even though the LD cycles were available. Entrainment by LD cycles took place only when the pups' eyes opened and probably became functional.

Continuous light abolishes the maternal entrainment of the circadian activity rhythm of the pups in the field mouse

12:12-h cycles of presence and absence of mother mouse act as a 'zeitgeber' and entrain the circadian rhythm of locomotor activity in the pups of Mus booduga under continuous darkness or continuous dim light. Continuous higher illumination of 15-25 lx abolishes this impressive maternal entrainment.

Cycles of presence and absence of mother mouse entrain the circadian clock of pups

Recent findings on neural and endocrine rhythms in infant mice and rats show that maternal coordination has an important role in setting the phase of the developing circadian clock both in the fetus and soon after birth. However, less information is available about the influence of the mother on activity/rest cycles of infants. Separation of the mother from infants in guinea pigs, monkeys and rats results in an increase in sleep disturbance (enhanced activity?). In this context it may be a common feature that during the postnatal period there is enhanced activity of pups during the hours when the mother is not nearby. Conversely, the social influences exerted by the mother while present with her young possibly leads to a relative rest stage. We have now tested this assumption in the night-active mouse Mus booduga. Our study addressed the postulate that the circadian activity/rest cycles of the pups are controlled by cyclic(?) presence and absence of the mother. The results reported here clearly indicate that the circadian locomotor activity of pups kept under continuous illumination or continuous darkness do entrain them to a regime of imposed 12:12-h cyclic presence and absence of the mother. The characteristics of this entrainment confer on the mother mouse the role of zeitgeber.