Design and Comparison of Low-Cost Urine Level Detection Systems for Critical Patients

With the rise in size of the elderly population suffering from urinary incontinence and the number of bedridden patients, individuals providing assistance to the aforementioned groups suffer from the “caregiving burden” due to the time-demanding nature of home health care. The current study proposes a low-cost Internet of Things (IoT)-based urine monitoring system for detecting a critical urine level in a urine collection container and sending an SMS text message to alert the caregiver. Remotely informing the caregiver of the patient’s urine level provides freedom of mobility. The proposed system consists of an Arduino microcontroller connected to a sensor measuring system and a SIM800L module with a SIM card. Three sensor measuring systems are suggested: Water Level Sensor, Ultrasonic Distance Sensor, and Weighing Scale Sensor. To compare the performance of the systems, 110 detection recordings from each system are used to construct a confusion matrix. The accuracy, precision, specificity, recall, and F-measure are computed for each system. Numerical and graphical analysis of the measurements show that the Water Level Sensor measurement system (accuracy: 0.96, precision: 0.98, specificity: 0.98, recall: 0.95, F-measure: 0.96) is the most reliable system, followed by the Weighing Scale Sensor (accuracy: 0.93, precision: 1, specificity: 0.936, recall: 0.88, F-measure: 0.93)

Nonhemolytic, Nonmotile Gram-Positive Rods Indicative of Bacillus anthracis

We report a 40-year-old female patient who was admitted to the hospital because of a left ovarian mass torsion. A nonhemolytic, nonmotile Bacillus, suspicious of Bacillus anthracis, was isolated from a blood culture. We discuss the evaluation that led to the final identification of the bacterium as B. megaterium

Recommendations for the management of rheumatoid arthritis in the Eastern Mediterranean region:an adolopment of the 2015 American College of Rheumatology guidelines

Clinical practice guidelines can assist rheumatologists in the proper prescription of newer treatment for rheumatoid arthritis (RA). The objective of this paper is to report on the recommendations for the management of patients with RA in the Eastern Mediterranean region. We adapted the 2015 American College of Rheumatology guidelines in two separate waves. We used the adolopment methodology, and followed the 18 steps of the “Guidelines 2.0” comprehensive checklist for guideline development. For each question, we updated the original guidelines’ evidence synthesis, and we developed an Evidence Profile (EP) and an Evidence to Decision (EtD) table. In the first wave, we adoloped eight out of the 15 original questions on early RA. The strength changed for five of these recommendations from strong to conditional, due to one or more of the following factors: cost, impact on health equities, the balance of benefits, and harms and acceptability. In the second wave, we adoloped eight out of the original 44 questions on established RA. The strength changed for two of these recommendations from strong to conditional, in both cases due to cost, impact on health equities, balance of benefits and harms, and acceptability. The panel also developed a good practice recommendation. We successfully adoloped 16 recommendations for the management of early and established RA in the Eastern Mediterranean region. The process proved feasible and sensitive to contextual factors.</p

Regulatory modules function in a non-autonomous manner to control transcription of the mbp gene

Multiple regulatory modules contribute to the complex expression programs realized by many loci. Although long thought of as isolated components, recent studies demonstrate that such regulatory sequences can physically associate with promoters and with each other and may localize to specific sub-nuclear transcription factories. These associations provide a substrate for putative interactions and have led to the suggested existence of a transcriptional interactome. Here, using a controlled strategy of transgenesis, we analyzed the functional consequences of regulatory sequence interaction within the myelin basic protein (mbp) locus. Interactions were revealed through comparisons of the qualitative and quantitative expression programs conferred by an allelic series of 11 different enhancer/inter-enhancer combinations ligated to a common promoter/reporter gene. In a developmentally contextual manner, the regulatory output of all modules changed markedly in the presence of other sequences. Predicted by transgene expression programs, deletion of one such module from the endogenous locus reduced oligodendrocyte expression levels but unexpectedly, also attenuated expression of the overlapping golli transcriptional unit. These observations support a regulatory architecture that extends beyond a combinatorial model to include frequent interactions capable of significantly modulating the functions conferred through regulatory modules in isolation

Functional analysis of the Myelin Basic Protein gene regulation

Through this investigation I hoped to illuminate and characterize any combinatorial relationships that might exist amongst the regulatory sequences that drive expression of the myelin basic protein gene. With such insight, I expected to learn more of the mechanism/s regulating myelin sheath formation, maintenance and repair. In the search for regulatory regions within the mbp gene, four highly conserved non-protein-coding modules were found in its 5' flanking sequence. In the context of reporter constructs in transgenic mice, these regulatory modules confer distinct cell specificity and developmental expression programs. M1 and M3 drive expression in oligodendrocytes while M4 drives Schwann cell expression. However, the expression programs realized by these reporter constructs also exposed higher levels of regulatory organization; e.g., when M3 is dissociated from neighboring flanking sequences it acquires the ability to drive transient expression in Schwann cells. To further understand how the four known mbp regulatory modules orchestrate the expression of the mbp gene, I first generated reporter constructs designed to contain most module combinations. These were inserted in single copy in a common orientation at a common site 5' of the HPRT locus and their qualitative and quantitative regulatory potential was analyzed. Based on the expression programming of reporter genes, M3 is critical for achieving high levels of mbp expression in myelinating oligodendrocytes. To determine if the expression phenotypes of reporter genes accurately reflected the activity of enhancers in the context of the endogenous locus, I used gene targeting to delete M3 in the endogenous mbp locAu cours de ma recherche j'ai voulu mettre en évidence les combinatoires existantes parmi les séquences régulatrices qui gouvernent l'expression du gène de la Protéine Basique de la Myéline (MBP). Ces connaissances devraient pouvoir me permettre de mieux comprendre les mécanismes régulant la formation, la maintenance et la réparation de la gaine de myéline. Lors de l'étude de la régulation du gène de la MBP, quatre modules non codant extrêmement conservés ont été trouvés en amont du gène de la MBP. Dans des souris transgéniques, ces modules confèrent des propriétés d'expression temporelle et tissu spécifique aux constructions. Les modules M1 et M3 gouvernent l'expression dans les oligodendrocytes alors que le module M4 gouverne l'expression dans les cellules de Schwann. Cependant, les programmes d'expression de ces constructions révèlent une organisation de plus haut niveau : Quand M3 est dissocié des séquences flanquantes du gène de la MBP il acquière la capacité de gouverner une expression transitoire dans les cellules de Schwann. Pour comprendre comment les quatre modules régulateurs de la MBP orchestrent l'expression du gène, j'ai d'abord généré des constructions présentant la plupart des combinaisons de modules. Ces constructions ont été insérées en copie unique de même orientation et dans un locus commun en 5' du gène HPRT afin de pouvoir comparer qualitativement et quantitativement leur expression. L'analyse de ces résultats montrent que le module M3 est critique pour obtenir un haut niveau d'expression durant la myélination des oligodendrocytes. Pour déterminer si l'expression des constructions reflète correctemen

Gene targeting of mouse Tardbp negatively affects Masp2 expression.

Amyotrophic Lateral Sclerosis (ALS) is a devastating adult onset neurodegenerative disease affecting both upper and lower motor neurons. TDP-43, encoded by the TARDBP gene, was identified as a component of motor neuron cytoplasmic inclusions in both familial and sporadic ALS and has become a pathological signature of the disease. TDP-43 is a nuclear protein involved in RNA metabolism, however in ALS, TDP-43 is mislocalized to the cytoplasm of affected motor neurons, suggesting that disease might be caused by TDP-43 loss of function. To investigate this hypothesis, we attempted to generate a mouse conditional knockout of the Tardbp gene using the classical Cre-loxP technology. Even though heterozygote mice for the targeted allele were successfully generated, we were unable to obtain homozygotes. Here we show that although the targeting vector was specifically designed to not overlap with Tardbp adjacent genes, the homologous recombination event affected the expression of a downstream gene, Masp2. This may explain the inability to obtain homozygote mice with targeted Tardbp

Strategy and validation of the conditional deletion of <i>Tardbp</i> gene.

<p>A) To delete exons 2 and 3 in the endogenous <i>Tardbp</i> we used a targeting vector with 6 Kb and 4 Kb homology arms, shown as black bars. The neomycin resistance was used for positive selection in embryonic stem cells and was flanked by two FRT sites to allow its removal upon FLP mediated recombination. A DTA cassette allowed negative selection of ES cells bearing random integration of the targeting vector. Upon homologous recombination in ES cells (Xs) the endogenous gene was replaced with the targeted cassette. FLP mediated recombination generated a conditional knockout where exons 2 and 3 were flanked by loxP sites. B) Southern Blot analysis of control (+/+) and targeted ES clones. A HindIII digest produced fragments of 7.3 Kb for the WT and 9.1 Kb for the targeted allele. C) Confirmation of neomycin cassette excision by PCR amplification.</p

Analysis of <i>Tardbp</i> and Masp2 expression in Tardbp^2Lox/+mice.

<p>A) Quantification of mRNA in mouse lumbar spinal cord by Real-Time PCR. No significant difference was found between <i>Tardbp</i> transcripts between WT and Tardbp^+/2lox mice (n = 4). B) Immunoblot analysis of TDP-43 protein expression in mouse brain, spinal cord, and liver shows no reduction in expression in <i>Tardbp</i>^+/2lox mice compared to wildtype littermates. Actin was used to normalize the amount of protein loaded. C) Quantification of <i>Masp</i>2 splicing variants mRNA in mouse liver by quantitative Real-Time PCR. <i>Masp2</i> long variant was significantly reduced in <i>Tardbp</i>^+/2lox compared to WT (p = 0.03, n = 3). No significant difference was found for <i>MAp19</i> transcript levels between WT and Tardbp^+/2lox mice. D) Analysis of total protein extracts from mouse liver by Western blot. Masp2 is clearly reduced in Tardbp^+/2lox mice livers when compared to WT, while MAp19 expression is marginally reduced.</p

Separate proteolipid protein/DM20 enhancers serve different lineages and stages of development

The gene encoding DM20 emerged in cartilaginous fish, descending from a bilaterian ancestor of the M6 proteolipid gene family. Its proteolipid protein (PLP) isoform appeared in amphibians, contains an additional 35 amino acids, and, in the mammalian CNS, is the dominant myelin protein in which it confers an essential neuroprotective function. During development, the DM20 isoform is prominent in a number of tissues, and plp/DM20 transcripts are detected in multiple progenitor populations, including those that continue to express plp/DM20 as they differentiate into myelinating oligodendrocytes. The locus also encodes isoforms with extended leader sequences that accumulate in the cell bodies of several types of neurons. Here, to locate and characterize regulatory sequences controlling the complex plp/DM20 transcription program, putative regulatory sequences, suggested by interspecies conservation, were ligated individually to a minimally promoted eGFPlacZ reporter gene. These constructs were inserted in single copy at a common site adjacent to the hypoxanthine-guanine phosphoribosyltransferase locus in embryonic stem cells and their in vivo expression programs were compared in transgenic mice. Most expressed developmental and cell-specific subprograms accommodated within the known expression phenotype of the endogenous plp/DM20 locus, thus defining multiple components of the combinatorial mechanism controlling its normal temporal and cell-specific program. Along with previously characterized nervous system enhancers, those described here should help expose the content and configuration of elements that are operational in multiple glial and neuronal lineages. The transgenic lines derived here also provide effective markers for multiple stages of glial and neuronal lineage progression

Obsessive&ndash;Compulsive Disorder with a Religious Focus: An Observational Study

Background: Obsessive&ndash;compulsive disorder (OCD) is a psychiatric disorder with poorly detailed subtypes/dimensions, such as religious OCD (ROCD). To date, little is known about ROCD characteristics. This work aimed to describe the sociodemographic and clinical characteristics, along with the religiosity and spirituality, of Lebanese Muslim citizens diagnosed with OCD and exhibiting religious symptoms. Methods: Participants were Lebanese Muslims, outpatients with OCD and religious symptoms, aged 18 or above, who could complete a questionnaire. Exclusion criteria were as follows: other psychiatric disorders and cognitive or physical impairments preventing participation. They completed a questionnaire including the 25-item Arabic Scale of Obsessions and Compulsions (10 questions addressing obsessions, 10 questions addressing compulsions, and 5 filler items, all of which were rated on a 4&ndash;point Likert scale, with higher total scores indicating increasing severity), the 26-item Spiritual Involvement and Beliefs Scale (rated on a 5-point Likert scale, with higher scores indicating higher spirituality), and questions assessing sociodemographic, clinical, and religiosity variables. Results: Fifty adults (62% females, 52% aged between 18 and 29 years) completed the study. They had mild (26%), moderate (48%), and severe (26%) OCD symptoms. The majority attended religious school at least at one point in their life and described a moderate to very high degree of self-religiosity and parental religiosity. Group comparisons (patients with mild vs. moderate vs. severe OCD symptoms) showed significant differences with regard to a family history of psychiatric disorders (p = 0.043), the frequency of self-questioning if they prayed correctly (p = 0.005), a higher rating of partial ablution repetition (p = 0.006), and the frequency of partial ablution repetitions (p = 0.041). No significant group differences were noted with regard to sociodemographic or spirituality outcomes. The prevalence of religious doubts (i.e., self-questioning if praying correctly) and specific rituals (partial ablution repetition) among severe OCD patients were 100% (13/13) and 77% (10/13), respectively. Conclusions: The results suggest a link between specific religious practices and OCD severity, underscoring the need for culturally sensitive approaches in diagnosing and treating ROCD