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This study investigated whether the individual and combined effects of using biomass energy and living in the neighborhood of a cement plant were associated with the risk of COPD and respiratory symptoms among Congolese women. A total of 235 women from two neighborhood communities of a cement plant participated in this cross-sectional study. Participants were classified into the more exposed group (MEG = 137) and a less exposed group (LEG = 98), as well as into biomass users (wood = 85, charcoal = 49) or electricity users (101 participants). Participants completed a questionnaire including respiratory symptoms, sociodemographic factors, medical history, lifestyle, and household characteristics. In addition to spirometry performance, outdoor PM2.5 (μg/m3) was measured. Afternoon outdoor PM2.5 concentration was significantly higher in MEG than LEG (48.8 (2.5) μg/m3 vs 42.5 (1.5) μg/m3). Compared to electricity users, wood users (aOR: 2.6, 95%CI 1.7; 5.9) and charcoal users (aOR: 2.9, 95%CI 1.4; 10.7) were at risk of developing airflow obstruction. Combined effects of biomass use and living in the neighborhood of a cement plant increased the risk of COPD in both wood users (aOR: 4, 95%CI 1.3; 12.2) and charcoal users (aOR: 3.1, 95%CI 1.7; 11.4). Exposure to biomass energy is associated with an increased risk of COPD. In addition, combined exposure to biomass and living near a cement plant had additive effects on COPD.

Objective Given the recent advent in machine learning and artificial intelligence on medical data analysis, we hypothesized that the deep learning algorithm can classify resting needle electromyography (n-EMG) discharges. Methods Six clinically observed resting n-EMG signals were used as a dataset. The data were converted to Mel-spectrogram. Data augmentation was then applied to the training data. Deep learning algorithms were applied to assess the accuracies of correct classification, with or without the use of pre-trained weights for deep-learning networks. Results While the original data yielded the accuracy up to 0.86 on the test dataset, data-augmentation up to 200,000 training images showed significant increase in the accuracy to 1.0. The use of pre-trained weights (fine tuning) showed greater accuracy than “training from scratch”. Conclusions Resting n-EMG signals were successfully classified by deep-learning algorithm, especially with the use of data augmentation and transfer learning techniques. Significance Computer-aided signal identification of clinical n-EMG testing might be possible by deep-learning algorithms.

Objective To elucidate the mechanism of focal conduction slowing in the median nerve in ALS. Methods The patients with ALS and CTS and normal control subjects were tested with sonography of the median and ulnar nerves. The cross-sectional areas (CSAs) and the wrist–forearm CSA ratios were compared with the parameters of nerve conduction study. Results The median motor distal latency was frequently prolonged in ALS and CTS. CSA and the wrist–forearm ratio of the median nerve were smaller in ALS than in CTS. The ulnar nerve sonography was similar in all the groups. Conclusions Selective conduction slowing of the median nerve at the wrist in ALS is unlikely due to secondary compressive neuropathy, as seen in carpal tunnel syndrome. Significance Unique vulnerability of the median nerve in ALS may explain the selective conduction slowing.

Muscle sonography may show high densities in various myopathic conditions. Further classification among myopathic conditions could be possible by texture analysis, which analyzes relationships between the neighboring pixel densities. The following groups of subjects were assessed: (1) 19 patients with myotonic dystrophy type 1 (MD1), (2) 11 patients with inflammatory myopathy (IM), and (3) 16 normal control. A LOGIQe ultrasonography and an 11-MHz linear probe were used to obtain muscle images of medial gastrocnemius. Texture parameters were obtained by MaZda software. Linear Discriminant Analysis (LDA) was performed for texture-based classification. The mean echodensities of MD1 and IM were higher than those of the control, which yielded high areas under curve (AUC) >0.95. However, MD1 and IM were poorly discriminated by any of the histogram-related parameters (AUC

Antiphospholipid antibody syndrome (APS) has been widely recognized to be associated with various neurological complications. In addition to the classical notion of APS as a thrombotic disorder, APS has been suggested to be an autoinflammatory disease as well. We present a previously healthy 46-year-old man who concurrently developed transverse myelitis and polymyositis whose laboratory studies were significant for the elevated antiphospholipid antibodies such as anti-cardiolipin (CL)/beta2-glycoprotein I (beta 2GPI) antibody. This report further enhances the recognized clinical phenotypes of the neurological complications of APS and the understanding of its pathomechanism.

This study aimed to characterize the excitability changes in peripheral motor axons caused by hindlimb unloading, which is a model of disuse neuromuscular atrophy. Hindlimb unloading was performed in normal 6-week-old male mice by fixing the proximal tail by a clip connected to the top of the animal’s cage for 3 weeks. Axonal excitability studies were performed by stimulating the sciatic nerve at the ankle and recording the compound muscle action potential from the foot. The amplitudes of the motor responses of the unloading group were 51% of the control amplitudes (2.2 ± 1.3 mV [HLU] vs. 4.3 ± 1.2 mV [Control], P = 0.03). Multiple axonal excitability analysis showed that the unloading group had a smaller strength-duration time constant (SDTC) and late subexcitability (recovery cycle) than the controls (0.075 ± 0.01 [HLU] vs. 0.12 ± 0.01 [Control], P < 0.01; 5.4 ± 1.0 [HLU] vs. 10.0 ± 1.3 % [Control], P = 0.01, respectively). Three weeks after releasing from HLU, the SDTC became comparable to the control range. Using a modeling study, the observed differences in the waveforms could be explained by reduced persistent Na+ currents along with parameters related to current leakage. Quantification of RNA of a SCA1A gene coding a voltage-gated Na+ channel tended to be decreased in the sciatic nerve in HLU. The present study suggested that axonal ion currents are altered in vivo by hindlimb unloading. It is still undetermined whether the dysfunctional axonal ion currents have any pathogenicity on neuromuscular atrophy or are the results of neural plasticity by atrophy.

Objectives:(1) Compare longitudinal changes of Varicella-zoster virus (VZV)-specific cell-mediated immunity (CMI) in Hunt syndrome with Bell’s palsy using IFN-γ enzyme-linked immunospot (ELISPOT). (2) Examine the role of VZV-specific CMI for VZV reactivation in the facial nerve in Hunt syndrome.Methods:This prospective study was conducted in our tertiary referral hospital between 2010 and 2013. Nineteen Hunt syndrome and 59 Bell’s palsy patients were enrolled. Mononuclear cells isolated from whole blood were incubated with VZV antigen in culture plates for 40 hours. Anti IFN-γ antibody was added and the ELISPOT system counted immunostained spots indicating VZV-specific CMI. The relationship between the spots and days from the onset of palsy were compared between Hunt syndrome and Bell’s palsy patients.Results:Immediately after the onset, the number of spots in the Hunt syndrome group was much lower than in the Bell’s palsy group, indicating low VZV-specific CMI. However, it increased rapidly and showed a ...

Objectives:(1) Estimate the degree of postoperative aeration in the middle ear after canal wall down tympanoplasty with soft-wall reconstruction (CWD tympanoplasty with SWR) for cholesteatoma. (2) Characterize the relationship between postoperative middle ear aeration and hearing outcome. (3) Propose an ideal state of middle ear aeration in order to obtain satisfactory hearing outcome after CWD tympanoplasty with SWR.Methods:This retrospective study was conducted in our tertiary referral hospital between 2001 and 2013. Seventy-eight ears with cholesteatoma treated surgically at our hospital by planned two-stage CWD tympanoplasty and SWR were included. Postoperative middle ear aeration was scored one year after second-stage surgery by computed tomography (CT). The patients were divided into 4 bins according to postoperative audiometric air-bone (A-B) gaps: 0-10, 11-20, 21-30, and >30 dB.Results:Postoperative middle ear aeration was significantly greater in the smaller A-B gap bins (0-10 and 11-20 dB) compa...

Wet-only event-basis precipitation data at Nagasaki, the border area between the Asian Continent and Japan, with high non-sea-salt (nss-) SO 2- 4 and NO - 3 concentrations from November 1983 through March 1988 were analyzed in terms of wind conditions at upper and surface levels to assess both long-distant and local sources. In order to investigate the high nss-SO 2- 4 concentration events occurring with similar transport patterns, the wind conditions were grouped into the following three types: type 1, the upper air flow from the Asian Continent and the surface wind from the sea; type 2, the stagnant upper air and the surface wind from the land at and around Nagasaki; and type 3, the upper air flow from the Continent and the surface wind from the land. In the case of high NO - 3 concentration events, their wind-condition types were similar to those for high nss-SO 2- 4 concentration events. These three types for both ions were discussed to estimate their sources as follows: type 1, long-distant sources in the Asian Continent; type 2, local sources at and around Nagasaki; and type 3, both long-distant and local sources. From the viewpoint of precipitation chemistry, the ratios of H + /(nss-SO 2- 4 +NO - 3 ) were evaluated for the high concentration events so as to examine the degree of neutralization of acidic input, H 2 SO 4 and HNO 3 . High ratios events corresponded to wind-condition type 2 whereas low ratios were associated with types 1. This suggested that the acidic input from local sources were little neutralized to cause much higher acidity in precipitation than those from long-distant sources.

A regression model of wet deposition on rainfall amount for non-seasalt sulfate (nss-SO 4 2-) and nitrate (NO 3 -) was applied to a data set obtained through a nationwide survey from April 1989 to March 1993. Wet-only samples on a biweekly basis were collected at 29 sites over Japan. Reparameterized bivariate lognormal distribution was employed to describe the joint distribution of concentration (C) and rainfall amount (R) for each site. Ranges of geometric mean (μ D ) of biweekly deposition (D = CR) for each site were 0.54-2.90 meq m-2 for nss-SO 4 2-, and 0.21-1.36 meq m-2 for NO 3 -; that of biweekly rainfall amount (μ R ) was 24.1-78.0 mm. Urban or industrialized areas had high values of μ D for these ions. Ranges of estimates of the slope of the regression equation of log(D/μ D ) on log(R/μ R ), were 0.45-0.99 for nss-SO 4 2- , and 0.35-0.86 for NO 3 -; thus estimates of the slope for nss-SO 4 2- tend to be larger than those for NO 3 -. The present analysis, consequently, statistically clarified some differences between the two ions in deposition processes which is understood in the light of current knowledge of atmospheric chemistry.