Search results for: nerves

Authors: Anucha Taiwong, Nirobol Kanogsunthornrat

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This predictive research aimed to investigate the symptom clusters that influence the quality of life among patients with chronic kidney disease, as indicated in the Theory of Unpleasant Symptoms. The purposive sample consisted of 150 patients with stage 3-4 chronic kidney disease who received care at an outpatient chronic kidney disease clinic of a tertiary hospital in Roi-Et province. Data were collected from January to March 2016 by using a patient general information form, unpleasant symptom form, and quality of life (SF-36) and were analyzed by using descriptive statistics, factor analysis, and multiple regression analysis. Findings revealed six core symptom clusters including symptom cluster of the mental and emotional conditions, peripheral nerves abnormality, fatigue, gastro-intestinal tract, pain and, waste congestion. Significant predictors for quality of life were the two symptom clusters of pain (Beta = -.220; p < .05) and the mental and emotional conditions (Beta=-.204; p<.05) which had predictive value of 19.10% (R2=.191, p<.05). This study indicated that the symptom cluster of pain and the mental and emotional conditions would worsen the patients’ quality of life. Nurses should be attentive in managing the two symptom clusters to facilitate the quality of life among patients with chronic kidney disease.

Keywords: chronic kidney disease, symptom clusters, predictors of quality of life, pre-dialysis

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Authors: Sarah Sayed El- Tawab, Emmanuel Kamal Azix Saba

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Objectives: Somatosensory blink reflex (SBR) is an eye blink response obtained from electrical stimulation of peripheral nerves or skin area of the body. It has been studied in various neurological diseases as well as among healthy subjects in different population. We designed this study to detect SBR positivity in patients with facial palsy and patients with post facial syndrome, to relate the facial palsy severity and the presence of SBR, and to associate between trigeminal BR changes and SBR positivity in peripheral facial palsy patients. Methods: 50 patients with peripheral facial palsy and post-facial syndrome 31 age and gender matched healthy volunteers were enrolled to this study. Facial motor conduction studies, trigeminal BR, and SBR were studied in all. Results: SBR was elicited in 67.7% of normal subjects, in 68% of PFS group, and in 32% of PFP group. On the non-paralytic side SBR was found in 28% by paralyzed side stimulation and in 24% by healthy side stimulation among PFP patients. For PFS group SBR was found on the non- paralytic side in 48%. Bilateral SBR elicitability was higher than its unilateral elicitability. Conclusion: Increased brainstem interneurons excitability is not essential to generate SBR. The hypothetical sensory-motor gating mechanism is responsible for SBR generation.

Keywords: somatosensory evoked blink reflex, post facial syndrome, blink reflex, enchanced gain

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Authors: Anusha Bhardwaj, Shekhar Shinde

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Nitric oxide (NO•) has been documented in research papers as one of the most versatile player in the therapeutics. It is identified as a biological multifunctional messenger molecule which is synthesized by the action of nitric oxide synthase (NOS) enzyme from L-arginine. The protective and the toxic effect in conjunction form the complete picture of the biological function of nitric oxide in humans. The dual nature is because of various factors such as concentration of NO, the isoform of NOS involved, type of cells in which it is synthesized, reaction partners like proteins, reactive oxygen intermediates, prosthetic groups, thiols etc., availability of the substrate L-arginine, intracellular environment in which NO is produced and generation of guanosine 3, 5’- cyclic monophosphate (cGMP). Activation of NOS through infection or trauma leads to one or more systemic effects including enhanced immune activity against invading pathogens, vaso/bronchodilatation in the cardiovascular and respiratory systems and altered neurotransmission which can be protective or toxic. Hence, NO affects the balance between healthy signaling and neurodegeneration in the brain. In lungs, it has beneficial effects on the function of airways as a bronchodilator and acts as the neurotransmitter of bronchodilator nerves. Whereas, on the other hand, NO may have deleterious effects by amplifying the asthmatic inflammatory response and also act as a vasodilator in the airways by increasing plasma exudation. But NOS Inhibitors and NO donors hamper the signalling pathway and hence a therapeutic application of NO is compromised.

Keywords: nitric oxide, multifunctional, dual nature, therapeutic applications

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Authors: Fagner Luiz P. Salles, Janaina C. Oliveira, Ivair P. Cesar

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Statement of the Problem: Auriculotherapy (AT) is a TCM technique, which uses seeds instead of needles, based physiologically on the mechanical stimulation of the cranial nerves. In the context of understanding the new concept of health of the WHO, the AT is an integrative approach for achieving Global Health Care so as to achieve the global health care concerns. This study aimed to evaluate the effect of auriculotherapy on pain and sleep quality in patients with chronic pain. Methodology and Theoretical Orientation: This study was performed between February and March 2017 at the Faculdade Estácio de Sá de Vitória, Brazil. The pain evaluation was through VAS in 4 periods: maximum, minimum, average and at the time of evaluation; the evaluation of sleep quality was used the Pittsburgh Sleep Quality Index. Socio-demographic data included: gender, age, use of medication and BMI. All data are presented as mean (standard deviation), Teste Mann-Whitney and T-student with P-values < 0.05 were regarded as significant. Findings: Participated in this study thirty-two individuals with age (M = 43.18, SD = 17.86), the time with pain in years (M = 3.67, SD = 3.68), 81.7% were female, 75% of the individuals used medication and BMI (M = 26.67; SD = 6.20). The pain presented improvement in the maximum level and the average of the pain and sleep quality before did not have statistically significant results. Conclusion and Significance: This study showed that TA is efficacy for reduction levels of pain. However, AT was not effective in improving sleep quality.

Keywords: auriculotherapy, chronic pain, sleep quality, integrative approach

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Authors: Murat Durucu

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Glaucoma is a condition of irreversible blindness, early diagnosis and appropriate interventions to make the patients able to see longer time. In this study, it addressed that the importance of developing a decision support system for glaucoma diagnosis. Glaucoma occurs when pressure happens around the eyes it causes some damage to the optic nerves and deterioration of vision. There are different levels ranging blindness of glaucoma disease. The diagnosis at an early stage allows a chance for therapies that slows the progression of the disease. In recent years, imaging technology from Heidelberg Retinal Tomography (HRT), Stereoscopic Disc Photo (SDP) and Optical Coherence Tomography (OCT) have been used for the diagnosis of glaucoma. This better accuracy and faster imaging techniques in response technique of OCT have become the most common method used by experts. Although OCT images or HRT precision and quickness, especially in the early stages, there are still difficulties and mistakes are occurred in diagnosis of glaucoma. It is difficult to obtain objective results on diagnosis and placement process of the doctor's. It seems very important to develop an objective decision support system for diagnosis and level the glaucoma disease for patients. By using OCT images and pattern recognition systems, it is possible to develop a support system for doctors to make their decisions on glaucoma. Thus, in this recent study, we develop an evaluation and support system to the usage of doctors. Pattern recognition system based computer software would help the doctors to make an objective evaluation for their patients. It is intended that after development and evaluation processes of the software, the system is planning to be serve for the usage of doctors in different hospitals.

Keywords: decision support system, glaucoma, image processing, pattern recognition

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Authors: Ravi Kiran Pothamsetty, Radha Rani Ghosh, Baby Paul Thaliath

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Radiation therapy has undergone many advancements and evloved from 2D to 3D. Recently, with rapid pace of drug discoveries, cutting edge technology, and clinical trials has made innovative advancements in computer technology and treatment planning and upgraded to intensity modulated radiotherapy (IMRT) which delivers in homogenous dose to tumor and normal tissues. The present study was a hospital-based experience comparing two different conformal radiotherapy techniques for brain tumors. This analytical study design has been conducted at Regional Cancer Centre, India from January 2014 to January 2015. Ten patients have been selected after inclusion and exclusion criteria. All the patients were treated on Artiste Siemens Linac Accelerator. The tolerance level for maximum dose was 6.0 Gyfor lenses and 54.0 Gy for brain stem, optic chiasm and optical nerves as per RTOG criteria. Mean and standard deviation values of PTV98%, PTV 95% and PTV 2% in IMRT were 93.16±2.9, 95.01±3.4 and 103.1±1.1 respectively; for 3DCRT were 91.4±4.7, 94.17±2.6 and 102.7±0.39 respectively. PTV max dose (%) in IMRT and 3D-CRT were 104.7±0.96 and 103.9±1.0 respectively. Maximum dose to the tumor can be delivered with IMRT with acceptable toxicity limits. Variables such as expertise, location of tumor, patient condition, and TPS influence the outcome of the treatment.

Keywords: brain tumors, intensity modulated radiotherapy (IMRT), three dimensional conformal radiotherapy (3D-CRT), radiation therapy oncology group (RTOG)

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Authors: Geetanjali Sharma

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Guillain Barre’ syndrome (GBS) is an auto-immune mediated demyelination poly-radiculo-neuropathy. Clinical features include progressive symmetrical ascending muscle weakness of more than two limbs, areflexia with or without sensory, autonomic and brainstem abnormalities, the purpose of this study was to determine subclinical neurological changes of CNS with GBS and to establish the presence of central demyelination in GBS. The study was prospective and conducted in the Department of Physiology, Pt. B. D. Sharma Post-graduate Institute of Medical Sciences, University of Health Sciences, Rohtak, Haryana, India to find out early central demyelination in clinically diagnosed patients of GBS. These patients were referred from the department of Medicine of our Institute to our department for electro-diagnostic evaluation. The study group comprised of 40 subjects (20 clinically diagnosed GBS patients and 20 healthy individuals as controls) aged between 6-65 years. Brain Stem evoked Potential (BAEP) were done in both groups using RMS EMG EP mark II machine. BAEP parameters included the latencies of waves I to IV, inter peak latencies I-III, III-IV & I-V. Statistically significant increase in absolute peak and inter peak latencies in the GBS group as compared with control group was noted. Results of evoked potential reflect impairment of auditory pathways probably due to focal demyelination in Schwann cell derived myelin sheaths that cover the extramedullary portion of auditory nerves. Early detection of the sub-clinical abnormalities is important as timely intervention reduces morbidity.

Keywords: brainstem, demyelination, evoked potential, Guillain Barre’

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Authors: Sanjeev K. Singh, Maloy B. Mandal, Revand R.

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The physiology of baroreceptors and chemoreceptors present in large blood vessels of the heart is well known in regulation of cardiorespiratory functions. Since large blood vessels and peripheral blood vessels are of same mesodermal origin, therefore, involvement of the latter in regulation of cardiorespiratory system is expected. Role of perivascular nerves in mediating cardiorespiratory alterations produced after intra-arterial injection of a nociceptive agent (bradykinin) was examined in urethane anesthetized male rats. Respiratory frequency, blood pressure, and heart rate were recorded for 30 min after the retrograde injection of bradykinin/saline in the femoral artery. In addition, paw edema was determined and water content was expressed as percentage of wet weight. Injection of bradykinin produced immediate tachypnoeic, hypotensive and bradycardiac responses of shorter latency (5-8 s) favoring the neural mechanisms involved in it. Injection of equi-volume of saline did not produce any responses and served as time matched control. Paw edema was observed in the ipsilateral hind limb. Pretreatment with diclofenac sodium significantly attenuated the bradykinin-induced responses and also blocked the paw edema. Ipsilateral femoral and sciatic nerve sectioning attenuated bradykinin-induced responses significantly indicating the origin of responses from the local vascular bed. Administration of bradykinin in the segment of an artery produced reflex cardiorespiratory changes by stimulating the perivascular nociceptors involving prostaglandins. This is a novel study exhibiting the role of peripheral blood vessels in regulation of cardiorespiratory system.

Keywords: vasosensory reflex, cardiorespiratory changes, nociceptive agent, bradykinin, VR1 receptors

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Authors: Suchana Marahatta, Sabina Bhattarai, Bishnu Hari Paudel, Dilip Thakur

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Background: Every year thousands of patients develop nerve damage and disabilities as a result of leprosy which can be prevented by early detection and treatment. So, early detection and treatment of nerve function impairment is of paramount importance in leprosy. Objectives: To assess the electrophysiological pattern of the peripheral nerves in leprosy patients and to compare it with clinical assessment tools. Materials and Methods: In this comparative cross-sectional study, 74 newly diagnosed leprosy patients without reaction were enrolled. They underwent thorough evaluation for peripheral nerve function impairment using clinical tests [i.e. nerve palpation (NP), monofilament (MF) testing, voluntary muscle testing (VMT)] and nerve conduction study (NCS). Clinical findings were compared with that of NCS using SPSS version 11.5. Results: NCS was impaired in 43.24% of leprosy patient at the baseline. Among them, sensory NCS was impaired in more patients (32.4%) in comparison to motor NCS (20.3%). NP, MF, and VMT were impaired in 58.1%, 25.7%, and 9.4% of the patients, respectively. Maximum concordance of monofilament testing and sensory NCS was found for sural nerve (14.7%). Likewise, the concordance of motor NP and motor NCS was the maximum for ulnar nerve (14.9%). When individual parameters of the NCS were considered, amplitude was found to be the most frequently affected parameter for both sensory and motor NCS. It was impaired in 100% of cases with abnormal NCS findings. Conclusion: Since there was no acceptable concordance between NCS findings and clinical findings, we should consider NCS whenever feasible for early detection of neuropathy in leprosy. The amplitude of both sensory nerve action potential (SNAP) and compound nerve action potential (CAMP) could be important determinants of the abnormal NCS if supported by further studies.

Keywords: leprosy, nerve function impairment, neuropathy, nerve conduction study

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Authors: Seyed Ali Hossein Zahraei, Iman Dianat

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The role of midwives and healthcare providers in applying pain relief methods to female patients is very important. different therapies like hydropathy, flavorer remedies, and respiratory techniques for pain relief do not work properly as what we expected. Lack of recognition of the physiological property of birth, despite findings that coming will attenuate the consequences of hurting, suggests the necessity for bigger awareness among expectant oldsters, educators, and health professionals of the potential of coming as a way of pain relief. Method: In our method we have 5 steps to achieve activation of oxytocin and dopamine pathways in order to reduce pain in all possible fields and reasons instead of using other treatments such as chemical painkillers. Step 1: First of all the patient should start by rubbing the clitoris up and down till occurring first clitoral orgasm. Step 2: Without stop rubing clitoris the patient must continue stimulate the clitoris in different way like circular motion in clock pathway until occurring second clitoral orgasm. Step 3: Immedietly the patient can change the position from clitoris to urethral opening where vestibular glands located. In this step the patient nock the urethral area very slowly without pressure and just like touching the area till feeling want to pee. But because of activation of sympathic nerves the gi tract is inactive. Step 4: In this step the patient should apply more pressure and change the motion to circular on urethral area in which the pee sensation increase but actually it is vestibular gland fluid. The patient should release it in small amount in this step. Step 5: The last step is combination of clitoral and urethral stimulation in up and down motion that cause more pee feeling and after clitoral orgasm occurred the amount of released fluid can be about 400ml.

Keywords: female, natural, method, pain

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Authors: Dan Yan, Yunuo Zhang, Yuhan Huang, Weijie Ouyang

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The cornea serves as a vital protective barrier for the eye; however, it is prone to injury and damage that can disrupt corneal epithelium and nerves, triggering inflammation. Therefore, understanding the biological effects and molecular mechanisms involved in corneal wound healing and identifying drugs targeting these pathways is crucial for researchers in this field. This study aimed to investigate the therapeutic potential of progranulin (PGRN) in treating corneal injuries. Our findings demonstrated that PGRN significantly enhanced corneal wound repair by accelerating corneal re-epithelialization and re-innervation. In vitro experiments with cultured epithelial cells and trigeminal ganglion cells further revealed that PGRN stimulated corneal epithelial cell proliferation and promoted axon growth in trigeminal ganglion cells. Through RNA-sequencing (RNA-seq) analysis and other experimental techniques, we discovered that PGRN exerted its healing effects by modulating the Wnt signaling pathway, which played a critical role in repairing epithelial cells and promoting axon regeneration in trigeminal neurons. Importantly, our study highlighted the anti-inflammatory properties of PGRN by inhibiting the NF-κB signaling pathway, leading to decreased infiltration of macrophages. In conclusion, our findings underscored the potential of PGRN in facilitating corneal wound healing by promoting corneal epithelial cell proliferation, trigeminal ganglion cell axon regeneration, and suppressing ocular inflammation. These results suggest that PGRN could potentially expedite the healing process and improve visual outcomes in patients with corneal injuries.

Keywords: cornea, wound healing, progranulin, corneal epithelial cells, trigeminal ganglion cells

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Authors: Sylwia K. Naliwajko, Justyna Moskwa, Patryk Nowakowski, Renata Markiewicz-Zukowska, Krystyna Gromkowska-Kepka, Anna Puscion-Jakubik, Maria H. Borawska

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Amygdalin is found in many fruit seeds, including apricot, peach, quince, apples, and almonds. Amygdalin (also named vitamin B17), as well as its sources, are commonly used as an alternative therapy or prevention of cancer. The potential activity of amygdalin is related to its enzymatic degradation to the hydrogen cyanide. Hydrogen cyanide is a toxic substance that causes liver and nerves damage, fever, coma or even death. Amygdalin is much better tolerated after intravenous than oral administration. The aim of this study was to examine the influence of amygdalin on glioblastoma multiforme cell lines. Three glioblastoma multiforme cell lines – U87MG, T98, LN18 were incubated (48 h) with amygdalin in concentrations 100, 250, 500, 1000 and 2000 µg/mL. The MTT (Thiazolyl Blue Tetrazolium Bromide) test and DNA binding test by [3H]-thymidine incorporation were used to determine the anti-proliferative activity of amygdalin. The secretion of metalloproteinases (MMP2 and MMP-9) from U87MG cells was estimated by gelatin zymography. The statistical analysis was performed using Statistica v. 13.0 software. The data was presented as a % of control. Amygdalin did not show significant inhibition of viability of all the glioblastoma cells in concentrations 100, 250, 500, 1000 µg/mL. In 2000 µg/mL there were significant differences compared to the control, but inhibition of viability was less than 20% (more than 80% of control). The average viability of U87MG cells was 92,0±4%, T98G: 85,8±3% and LN18: 94,7±2% of the control. There was no dose-response viability, and IC50 value was not recognized. DNA binding in U87MG cells was not inhibited (109,0±3 % of control). After treatment with amygdalin, we observed significantly increased secretion of MMP2 and MMP9 in U87MG cells (130,3±14% and 112,0±5% of control, respectively). Our results suggest that amygdalin has no anticancer activity in glioblastoma cell lines.

Keywords: amygdalin, anticancer, cell line, glioblastoma

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Authors: Nitin Kumar

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Purpose: The current research work focuses mainly on evolving a delivery system for ginseng extract (GE), which in turn will ameliorate the neuroprotective potential by means of enhancing the ginsenoside (Rb1) bio-availability (BA). For more noteworthy enhancement in oral bioavailability (OBA) along with pharmacological properties, the drug carriers’ performance can be strengthened by utilizing phytosomes-loaded microspheres (PM) delivery system. Methods: For preparing the disparate phytosome complexes (F1, F2, and F3), an aqueous extract of ginseng roots (GR) along with phospholipids were reacted in disparate ratio. Considering the outcomes, F3 formulation (spray-dried) was chosen for preparing the phytosomes powder (PP), PM, and extract microspheres (EM). PM was made by means of loading of F3 into Gum Arabic (GA) in addition to maltodextrin polymer mixture, whereas EM was prepared by means of the addition of extract directly into the same polymer mixture. For investigating the neuroprotective effect (NPE) in addition to their pharmacokinetic (PK) properties, PP, PM, and EM formulations were assessed. Results: F3 formulation gave enhanced entrapment efficiency (EE) (i.e., 50.61%) along with good homogeneity of spherical shaped particle size (PS) (42.58 ± 1.4 nm) with least polydispersity index (PDI) (i.e., 0.193 ± 0.01). The sustained release (up to 24 h) of ginsenoside Rb1 (GRb1) is revealed by the dissolution study of PM. A significantly (p < 0.05) greater anti-oxidant (AO) potential of PM can well be perceived as of the diminution in the lipid peroxidase level in addition to the rise in the glutathione superoxide dismutase (SOD) in addition to catalase levels. It also showed a greater neuroprotective potential exhibiting significant (p < 0.05) augmentation in the nociceptive threshold together with the diminution in damage to nerves. A noteworthy enhancement in the relative BA (157.94%) of GRb1 through the PM formulation can well be seen in the PK studies. Conclusion: It is exhibited that the PM system is an optimistic and feasible strategy to enhance the delivery of GE for the effectual treatment of neuropathic pain.

Keywords: ginseng, neuropathic, phytosome, pain

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Authors: Narupon Kunbootsri, Patpiya Sirasaporn

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Low back pain is the most common of chief complaints in chronic pain. Low back pain directly affect to activities daily living and also has high socioeconomic costs. The prevalence of low back pain is high in both genders in all populations. The symptoms of low back pain including, pain at low back area, muscle spasm, tenderness points and stiff back. Trancutanous Electrical Nerve Stimulation (TENS) is one of modalities mainly use for control pain. There was indicated that TENS is wildly use in low back pain, but no scientific data about the flexibility of muscle after TENS in low back pain. Thus the aim of this study was to investigate immediate effect of TENS on flexibility and health status in patients with chronic nonspecific low back pain. Eight chronic nonspecific low back pain patients 1 male and 7 female employed in this study. Participants were diagnosed by a doctor based on history and physical examination. Each participant received treatment at physiotherapy unit. Participants completed Roland Morris Disability Questionnaire (RMDQ), numeric rating scale (NRS) and trunk flexibility before treatment. Each participant received low frequency TENS set at asymmetrical, 10 Hz, 20 minutes per point. Immediately after treatment, participants completed RNS, RMDQ and trunk flexibility again. All participants were treated by only one physiotherapist. There was a statistically significant increased in flexibility immediately after low frequency TENS [mean difference -6.37 with 95%CI were (-8.35)-(-4.39)]. There was a statistically significant decreased in numeric rating scale [mean difference 2.13 with 95%CI were 1.08-3.16]. Roland Morris Disability Questionnaire showed improvement of health status average 44.8% immediately after treatment. In conclusion, the results of the present study indicate that immediately effect after low frequency TENS can decrease pain and improve flexibility of back muscle in chronic nonspecific low back pain patients.

Keywords: low back pain, flexibility, TENS, chronic

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Authors: Jiping Cai, Ningzhi Wangyang, Jun Shao

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Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality that leads to structural and functional damage in several parts of the brain, such as cranial nerves, optic nerve tract or other circuitry involved in vision and occipital lobe, depending on its location and severity. As a result, the function associated with vision processing and perception are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. Here two cases complaining of monocular vision loss (actually temporal hemianopia) due to traumatic chiasmal syndrome after frontal head injury were reported, and were compared the findings with individual case reports published in the literature. Reported cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. The degree of bitemporal hemianopia and visual loss acuity have a variable presentation and was not necessarily related to the severity of the craniocerebral trauma. Chiasmal injury may occur even in the absence bony chip impingement. Isolated bitemporal hemianopia is rare and clinical improvement usually may not occur. Mechanisms of damage to the optic chiasm after trauma include direct tearing, contusion haemorrhage and contusion necrosis, and secondary mechanisms such as cell death, inflammation, edema, neurogenesis impairment and axonal damage associated with TBI. Beside visual field test, MRI evaluation of optic pathways seems to the strong objective evidence to demonstrate the impairment of the integrity of visual systems following TBI. Therefore, traumatic chiasmal syndrome should be considered as a differential diagnosis by both neurosurgeons and ophthalmologists in patients presenting with visual impairment, especially bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.

Keywords: bitemporal hemianopia, brain injury, optic chiasma, traumatic chiasmal syndrome.

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Authors: Sehrish Qayyum

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In this age of constant technology, asymmetrical warfare could not be won. Attuned psychometric study confirms that screaming sometimes is more productive than active retaliation against strong adversaries. Asymmetric warfare is a game of nerves and thoughts with least vigorous participation for large anticipated losses. It creates the condition of paraplegia with partial but permanent immobility, which effects the core warfare operations, being screams rather than active retaliation. When one’s own power is doubted, it gives power to one’s own doubt to ruin all planning either done with superlative cost-benefit analysis. Strategically calculated estimation of asymmetric warfare since the early WWI to WWII, WWII-to Cold War, and then to the current era in three chronological periods exposits that courage makes nations win the battle of warriors to battle of comrades. Asymmetric warfare has been most difficult to fight and survive due to unexpectedness and being lethal despite preparations. Thoughts before action may be the best-assumed strategy to mix Regional Security Complex Theory and OODA loop to develop the Paraplegic Resilience Policy Plan (PRPP) to win asymmetric warfare. PRPP may serve to control and halt the ongoing wave of terrorism, guerilla warfare, and insurgencies, etc. PRPP, along with a strategic work plan, is based on psychometric analysis to deal with any possible war condition and tactic to save millions of innocent lives such that lost in Christchurch New Zealand in 2019, November 2015 Paris attacks, and Berlin market attacks in 2016, etc. Getting tangled into self-imposed epistemic dilemmas results in regret that becomes the only option of performance. It is a descriptive psychometric analysis of war conditions with generic application of probability tests to find the best possible options and conditions to develop PRPP for any adverse condition possible so far. Innovation in technology begets innovation in planning and action-plan to serve as a rheostat approach to deal with asymmetric warfare.

Keywords: asymmetric warfare, psychometric analysis, PRPP, security

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Authors: Rita Alfattal, Maryam Alfarhan, Adeeb M. Algaith, Buthaina Albash, Reem M. Elshafie, Asma Alshammari, Ahmad Alahmad, Fatima Dashti, Rasha Alsafi, Hind Alsharhan

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Defects of respiratory chain complex III (CIII) result in characteristic but rare mitochondrial disorders associated with distinct neuroradiological findings. The underlying molecular defects affecting mitochondrial CIII assembly factors are few and yet to be identified. LYRM7 assembly factor is required for proper CIII assembly where it acts as a chaperone for the Rieske iron‐sulfur (UQCRFS1) protein in the mitochondrial matrix and stabilizing it. We present here the seventeenth individual with LYRM7-associated mitochondrial leukoencephalopathy harboring a previously reported rare pathogenic homozygous LYRM 7 variant, c.2T>C, (p.Met1?). Like previously reported individuals, our 4-year-old male proband presented with recurrent metabolic and lactic acidosis, encephalopathy, and myopathy. Further, he has additional, previously unreported features, including an acute stroke like episode with bilateral central blindness and optic neuropathy, recurrent hyperglycemia and hypertension associated with metabolic crisis. However, he has no signs of psychomotor regression. He has been stable clinically with residual left-sided reduced visual acuity and amblyopia, and no more metabolic crises for 2-year-period while on the mitochondrial cocktail. Although the reported brain MRI findings in other affected individuals are homogenous, it is slightly different in our index, revealing evidence of bilateral almost symmetric multifocal periventricular T2 hyperintensities with hyperintensities of the optic nerves, optic chiasm, and corona radiata but with no cavitation or cystic changes. This report describes new clinical and radiological findings of LYRM7-associated disease. The report also summarizes the clinical and molecular data of previously reported individuals describing the full phenotypic spectrum.

Keywords: LYRM7 gene defect, mitochondrial disease, , lactic acidosis, , genetic disorder

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Authors: Marina Shurupova, Victor Anisimov, Alexander Latanov

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Background: The cerebellar lesions inevitably provoke oculomotor impairments in patients of different age. Symptoms of subtentorial tumors, particularly medulloblastomas, include static and dynamic coordination disorders (ataxia, asynergia, imbalance), hypo-muscle tonus, disruption of the cranial nerves, and within the oculomotor system - nystagmus (fine or gross). Subtentorial tumors can also affect the areas of cerebellum that control the oculomotor system. The noninvasive eye-tracking technology allows obtaining multiple oculomotor characteristics such as the number of fixations and their duration, amplitude, latency and velocity of saccades, trajectory and scan path of gaze during the process of the visual field navigation. Eye tracking could be very useful in clinical studies serving as convenient and effective tool for diagnostics. The aim: We studied the dynamics of oculomotor system functioning in patients undergoing remission from cerebellar tumors removal surgeries and following neurocognitive rehabilitation. Methods: 38 children (23 boys, 15 girls, 9-17 years old) that have recovered from the cerebellar tumor-removal surgeries, radiation therapy and chemotherapy and were undergoing course of neurocognitive rehabilitation participated in the study. Two tests were carried out to evaluate oculomotor performance - gaze stability test and counting test. The monocular eye movements were recorded with eye tracker ArringtonResearch (60 Hz). Two experimental sessions with both tests were conducted before and after rehabilitation courses. Results: Within the final session of both tests we observed remarkable improvement in oculomotor performance: 1) in the gaze stability test the spread of gaze positions significantly declined compared to the first session, and 2) the visual path in counting test significantly shortened both compared to the first session. Thus, neurocognitive rehabilitation improved the functioning of the oculomotor system in patients following the cerebellar tumor removal surgeries and subsequent therapy. Conclusions: The experimental data support the effectiveness of the utilization of the eye tracking technique as diagnostic tool in the field of neurooncology.

Keywords: eye tracking, rehabilitation, cerebellar tumors, oculomotor system

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Authors: Mostafa Sarabzadeh, Masoumeh Helalizadeh, Seyyed Mahmoud Hejazi

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Multiple Sclerosis is considered as diseases related to central nerve system, the chronic and progressive disease impress on sensory and motor function of people. Due to equilibrium problems in this patients that related to disorder of nerve conduction transmission from central nerve system to organs and the nature of elastic bands that can make changes in neuromuscular junctions and momentary actions, the aim of this research is evaluate elastic training effect by reactionary ropes on nerve conduction velocity (in lower and upper limb) and functional balance in female patients with Multiple Sclerosis. The study was a semi-experimental study that was performed based on pre and post-test method, The statistical community consisted of 16 women with MS in the age mean 25-40yrs, at low and intermediate levels of disease EDSS 1-4 (Expanded Disability Status Scale) that were divided randomly into elastic and control groups, so the training program of experimental group lasted six weeks, 3 sessions per week of elastic exercises with reactionary ropes. Electroneurography parameters (nerve conduction velocity- latency) of Upper and lower nerves (Median, Tibial, Sural, Peroneal) along with balance were investigated respectively by the Electroneurography system (ENG) and Timed up and go (TUG) functional test two times in before and after the training period. After that, To analyze the data were used of Dependent and Independent T-test (with sig level p<0.05). The results showed significant increase in nerve conduction velocity of Sural (p=0.001), Peroneal (p=0.01), Median (p=0.03) except Tibial and also development Latency Time of Tibial (p= 0), Peroneal (p=0), Median (p=0) except Sural. The TUG test showed significant decreases in execution time too (p=0.001). Generally, based on what the obtained data can indicate, modern training with elastic bands can contribute to enhanced nerve conduction velocity and balance in neurosis patients (MS) so lead to reduce problems, promotion of mobility and finally more life expectancy in these patients.

Keywords: balance, elastic bands, multiple sclerosis, nerve conduction, velocity

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Authors: Ji Jiazheng, Wang Jingrao, Jin Xin, Zhang Hong

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Diabetes mellitus is a metabolic disease characterized by high blood sugar. A long-standing hyperglycemic state can lead to various tissue damage. Diabetic retinopathy is the most common and widely studied ocular complication and has become the leading cause of blindness in my country. At the same time, diabetes has profound clinically relevant effects on the cornea, leading to keratopathy and vision-threatening. The cornea is an avascular tissue and is sensitive to hyperglycemia, Keratopathy caused by diabetes is usually chronic, they are called diabetic keratopathy or diabetic neurotrophic keratopathy, leading to several diabetic corneal complications including delayed epithelial wound healing, recurrent erosions, neuropathy, loss of sensitivity. Corneal stem cell dysfunction in diabetic patients as an important influencing factor of diabetic keratopathy. The consequences of this condition are often underestimated. The limbus is located between the cornea and the sclera tissue. The limbal stroma consists of a series of radial elevations with fibrovascular centers known as palisades of Vogt (POV). Previous studies have shown that palisades of Vogt (POV), as the main site of limbal stem cells, plays an important role in the homeostasis of the corneal epithelium. Therefore, POV plays a vital role in the healing of corneal epithelial surgery and postoperative evaluation. IVCM can observe the condition of the corneal epithelium at the cellular level. It has profound significance and guidance for the evaluation of limbal and limbal stem cells. We have previously observed structural changes in POV in HSK and HZO patients on IVCM. At present, there have been reports involving limbal stem cell dysfunction in diabetic patients, but the specific pathogenesis is still unclear. However, there are no studies on POV morphological changes in patients with DM. Therefore, we performed statistics and compared the correlation between POV morphological changes and corneal epithelial basal cell density, corneal nerves, and length of disease in DM patients and normal humans using IVCM studies. At the same time, fundoscopy was used to observe the correlation between the thickness of RNFL and the thickness of GCC and POV in diabetic patients. And to observe the correlation between SVD, DVD and POV for research.

Keywords: confocal microscopy, fundus, limbal stem cells, diabetes

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Authors: Allyson Augusta Shrikhande, Alexa Rains, Tayyaba Ahmed, Marjorie Mamsaang, Rakhi Vyas, Janaki Natarajan, Erika Moody, Christian Reutter, Kimberlee Leishear, Yogita Tailor, Sandra Sandhu-Restaino, Lora Liu, Neha James, Rosemarie Filart

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Characterized by consistent difficulty getting and keeping an erection firm enough for intercourse, Erectile Dysfunction may affect up to 15% of adult men. Although awareness and access to treatment have improved in recent years, many patients do not actively seek diagnosis or treatment due to the stigma surrounding this condition. Patients who do seek treatment are often dissatisfied by the efficacy of the medication. The condition inhibits patients’ quality of life by worsening mental health and relationships. The purpose of this study was to test the effectiveness of an outpatient neuromuscular treatment protocol in treating the symptoms of Chronic Pelvic Pain and Erectile Dysfunction, improving pain and function. 56 patients ages 20-79 presented to an outpatient clinic for treatment of pelvic pain and Erectile Dysfunction symptoms. These symptoms had persisted for an average of 4 years. All patients underwent external ultrasound-guided hydro-dissection technique targeted at pelvic peripheral nerves in combination with pelvic floor musculature trigger-point injections. To measure the effects of this treatment, a five question Erectile Dysfunction questionnaire was completed by each patient at their first visit to a clinic and three months after treatment began. Answers were summed for a total score of 5-25, with a higher score indicating optimal function. The average score before treatment was 14.125 (SD 5.411) (a=0.05; CI 12.708-15.542), which increased by 18% to an average of 16.625 (SD 6.423) (a=0.05; CI 14.943-18.307) after treatment (P=0.0004). Secondary outcome variables included a Visual Analogue Scale (VAS) to measure pelvic pain intensity and the Functional Pelvic Pain Scale (FPPS) to measure function across multiple areas. VAS scores reduced by 51% after three months. Before treatment, the mean VAS score was 5.87, and the posttreatment mean VAS score was 2.89. Pelvic pain functionality improved by 34% after three months. Pretreatment FPPS scores averaged at 7.48, decreasing to 4.91 after treatment. These results indicate that this unique treatment was very effective at relieving pain and increasing function for patients with Erectile Dysfunction.

Keywords: chronic pelvic pain, erectile dysfunction, nonsurgical, outpatient, trigger point injections

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Authors: Vishwanath Mali, Hemant Warhatkar, Raju Pawade

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Drilling of bone has been always challenging for surgeons due to the adverse effect it may impart to bone tissues. Force has to be applied manually by the surgeon while performing conventional bone drilling which may lead to permanent death of bone tissues and nerves. During bone drilling the temperature of the bone tissues increases to higher values above 47 ⁰C that causes thermal osteonecrosis resulting into screw loosening and subsequent implant failures. An attempt has been made here to study the input drilling parameters and surgical drill bit geometry affecting bone health during bone drilling. A One Factor At a Time (OFAT) method is used to plan the experiments. Input drilling parameters studied include spindle speed and feed rate. The drill bit geometry parameter studied include point angle and helix angle. The output variables are drilling thrust force and bone temperature. The experiments were conducted on goat femur bone at room temperature 30 ⁰C. For measurement of thrust forces KISTLER cutting force dynamometer Type 9257BA was used. For continuous data acquisition of temperature NI LabVIEW software was used. Fixture was made on RPT machine for holding the bone specimen while performing drilling operation. Bone specimen were preserved in deep freezer (LABTOP make) under -40 ⁰C. In case of drilling parameters, it is observed that at constant feed rate when spindle speed increases, thrust force as well as temperature decreases and at constant spindle speed when feed rate increases thrust force as well as temperature increases. The effect of drill bit geometry shows that at constant helix angle when point angle increases thrust force as well as temperature increases and at constant point angle when helix angle increase thrust force as well as temperature decreases. Hence it is concluded that as the thrust force increases temperature increases. In case of drilling parameter, the lowest thrust force and temperature i.e. 35.55 N and 36.04 ⁰C respectively were recorded at spindle speed 2000 rpm and feed rate 0.04 mm/rev. In case of drill bit geometry parameter, the lowest thrust force and temperature i.e. 40.81 N and 34 ⁰C respectively were recorded at point angle 70⁰ and helix angle 25⁰ Hence to avoid thermal necrosis of bone it is recommended to use higher spindle speed, lower feed rate, low point angle and high helix angle. The hard nature of cortical bone contributes to a greater rise in temperature whereas a considerable drop in temperature is observed during cancellous bone drilling.

Keywords: bone drilling, helix angle, point angle, thrust force, temperature, thermal necrosis

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Authors: Wei-Ju Huang, Hung-Pin Hsu

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[Background] In congestive heart failure (CHF), it has always been the principle of clinical treatment to control the water retention mechanism in the body to prevent excessive fluid retention. Early control of sympathetic nerves, Renin-Angiotensin-Aldosterone system (RAA system, RAAS), or strengthening of Atrial Natriuretic Peptide (ANP) was the point. In RAA system, related hormones, such as angiotensin, or enzymes in the pathway, such as ACE-I, can be used with corresponding inhibitors to reduce water content.[Aim] In recent years, clinical studies have pointed out that if different mechanisms are combined, the control effect seems to be better. For example, recent studies showed that ENTRESTO, a combination of Sacubitril and Valsartan, is a good new drug for CHF. Sacubitril is a prodrug. After activation, it can inhibit neprilysin and act as a neprilysin inhibitor (ARNI) to reduce the breakdown of natriuretic peptides(ANP). Valsartan is a kind of angiotensin receptor blocker (ARB), both of which are used to treat heart failure at the same time, have excellent curative effects.[Materials and Methods] Considering the side effects of this drug, coughing and a few cases of diarrhea were observed. However, the effect of this drug on the patient's intestinal tract has not been confirmed. On the other hand, studies have pointed out that ANP supplement can improve the CHF and increase the inhibitory effect on cancer cells. Therefore, the purpose of this study is to use a special microbial detection method to prove that whether oral drugs have an effect on microorganisms.The experimental method uses Nissui Compact Dry to observe the situation in different types of microorganisms. After the drug is dissolved in water, it is implanted in a petri dish, and the presence of different microorganisms is detected through different antibody reactions to confirm whether the drug has some toxicology in the gut.[Results and Discussion]From the above experimental results, it can be known that among the effects of Sacubitril and Valsartan on the basic microbial flora of the human body, low doses had no significant effect on Escherichia coli or intestinal bacteria. If Sacubitril or Valsartan with a high concentration of 3mg/ml is used alone or under the stimulation of a high concentration of the two drugs, it has a significant inhibitory effect on Escherichia coli. However, in terms of the effect on intestinal bacteria, high concentration of Sacubitril has a more significant inhibitory effect on intestinal bacteria, while high concentration of Valsartan has a less significant inhibitory effect on intestinal bacteria. The inhibitory effect of the combination of the two drugs on intestinal bacteria is also less significant.[Conclusion]The results of this study can be used as a further reference for the possible side effects of the clinical use of Sacubitril and Valsartan on the intestinal tract of patients,

Keywords: sacubitril, valsartan, entresto, congestive heart failure (CHF)

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Authors: Arjun Prakash, Vinutha H., Karthik N.

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BACKGROUND: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy with an estimated prevalence of 0.6 - 5.8% in the general adult population. It is caused by compression of the Median Nerve (MN) at the wrist as it passes through a narrow osteofibrous canal. Presently, the diagnosis is established by the clinical symptoms and physical examination and Nerve conduction study (NCS) is used to assess its severity. However, it is considered to be painful, time consuming and expensive, with a false-negative rate between 16 - 34%. Ultrasonography (USG) is now increasingly used as a diagnostic tool in CTS due to its non-invasive nature, increased accessibility and relatively low cost. Elastography is a newer modality in USG which helps to assess stiffness of tissues. However, there is limited available literature about its applications in peripheral nerves. OBJECTIVES: Our objectives were to measure the Cross-Sectional Area (CSA) and elasticity of MN at the carpal tunnel using Grey scale Ultrasonography (USG), Strain Elastography (SE) and Shear Wave Elastography (SWE). We also made an attempt to independently evaluate the role of Gray scale USG, SE and SWE in grading the severity of CTS, keeping NCS as the gold standard. MATERIALS AND METHODS: After approval from the Institutional Ethics Review Board, we conducted a comparative cross sectional study for a period of 18 months. The participants were divided into two groups. Group A consisted of 54 patients with clinically diagnosed CTS who underwent NCS, and Group B consisted of 50 controls without any clinical symptoms of CTS. All Ultrasound examinations were performed on SAMSUNG RS 80 EVO Ultrasound machine with 2 - 9 Mega Hertz linear probe. In both groups, CSA of the MN was measured on Grey scale USG, and its elasticity was measured at the carpal tunnel (in terms of Strain ratio and Shear Modulus). The variables were compared between both groups by using ‘Independent t test’, and subgroup analyses were performed using one-way analysis of variance. Receiver operating characteristic curves were used to evaluate the diagnostic performance of each variable. RESULTS: The mean CSA of the MN was 13.60 + 3.201 mm2 and 9.17 + 1.665 mm2 in Group A and Group B, respectively (p < 0.001). The mean SWE was 30.65 + 12.996 kPa and 17.33 + 2.919 kPa in Group A and Group B, respectively (p < 0.001), and the mean Strain ratio was 7.545 + 2.017 and 5.802 + 1.153 in Group A and Group B respectively (p < 0.001). CONCLUSION: The combined use of Gray scale USG, SE and SWE is extremely useful in grading the severity of CTS and can be used as a painless and cost-effective alternative to NCS. Early diagnosis and grading of CTS and effective treatment is essential to avoid permanent nerve damage and functional disability.

Keywords: carpal tunnel, ultrasound, elastography, nerve conduction study

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Authors: Merilin Ivanova Ivanova, Kalin Dimitrov Atanasov, Stefan Petrov Enchev

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Backgroud: Neuromyelitis optica spectrum disorder, also known as Devic’s disease, is a relapsing demyelinating autoimmune inflammatory disorder of the central nervous system associated with anti-aquaporin 4 (AQP4) antibodies that can manifest with devastating secondary neurological deficits. Most commonly affected are the optic nerves and the spinal cord-clinically this is often presented with optic neuritis (loss of vision), transverse myelitis(weakness or paralysis of extremities),lack of bladder and bowel control, numbness. APS is a core clinical entity of NMOSD and adds to the clinical representation the following symptoms: intractable nausea, vomiting and hiccup, it usually occurs isolated at onset, and can lead to a significant delay in the diagnosis. The condition may have features similar to multiple sclerosis (MS) but the episodes are worse in NMO and it is treated differently. It could be relapsing or monophasic. Possible complications are visual field defects and motor impairment, with potential blindness and irreversible motor deficits. In severe cases, myogenic respiratory failure ensues. The incidence of reported cases is approximately 0.3–4.4 per 100,000. Paediatric cases of NMOSD are rare but have been reported occasionally, comprising less than 5% of the reported cases. Objective: The case serves to show the difficulty when it comes to the diagnostic processes regarding a rare autoimmune disease with non- specific symptoms, taking large interval of rimes to reveal as complete clinical manifestation of the aforementioned syndrome, as well as the necessity of multidisciplinary approach in the setting of а general paediatric department in аn emergency hospital. Methods: itpatient's history, clinical presentation, and information from the used diagnostic tools(MRI with contrast of the central nervous system) lead us to the conclusion .This was later on confirmed by the positive results from the anti-aquaporin 4 (AQP4) antibody serology test. Conclusion: APS is a common symptom of NMOSD and is considered a challenge in a differential-diagnostic plan. Gaining an increased awareness of this disease/syndrome, obtaining a detailed patient history, and performing thorough physical examinations are essential if we are to reduce and avoid misdiagnosis.

Keywords: neuromyelitis, devic's disease, hiccup, autoimmune, MRI

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Authors: Raveendranath Veeramani, Sunil Jonathan Holla, Parkash Chand, Sunil Chumber

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Gray’s Anatomy for Students has been a well-appreciated book among undergraduate students of anatomy in Asia. However, the current curricular requirements of anatomy require a more focused and organized approach. The editors of the first South Asia edition of Gray’s Anatomy for Students hereby highlight the modifications and importance of this edition. There is an emphasis on active learning by making the clinical relevance of anatomy explicit. Learning anatomy in context has been fostered by the association between anatomists and clinicians in keeping with the emerging integrated curriculum of the 21st century. The language has been simplified to aid students who have studied in the vernacular. The original illustrations have been retained, and few illustrations have been added. There are more figure numbers mentioned in the text to encourage students to refer to the illustrations while learning. The text has been made more student-friendly by adding generalizations, classifications and summaries. There are useful review materials at the beginning of the chapters which include digital resources for self-study. There are updates on imaging techniques to encourage students to appreciate the importance of essential knowledge of the relevant anatomy to interpret images, due emphasis has been laid on dissection. Additional importance has been given to the cranial nerves, by describing their relevant details with several additional illustrations and flowcharts. This new edition includes innovative features such as set inductions, outlines for subchapters and flowcharts to facilitate learning. Set inductions are mostly clinical scenarios to create interest in the need to study anatomy for healthcare professions. The outlines are a modern multimodal facilitating approach towards various topics to empower students to explore content and direct their learning and include learning objectives and material for review. The components of the outline encourage the student to be aware of the need to create solutions to clinical problems. The outlines help students direct their learning to recall facts, demonstrate and analyze relationships, use reason to explain concepts, appreciate the significance of structures and their relationships and apply anatomical knowledge. The 'structures to be identified in a dissection' are given as Level I, II and III which represent the 'must know, desirable to know and nice to know' content respectively. The flowcharts have been added to get an overview of the course of a structure, recapitulate important details about structures, and as an aid to recall. There has been a great effort to balance the need to have content that would enable students to understand concepts as well as get the basic material for the current condensed curriculum.

Keywords: Grays anatomy, South Asia, human anatomy, students anatomy

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Authors: Erico Da Silva Lima, Tiago Neves Pereira Valente, Roberto De Oliveira Roça

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Introduction: Over the last few years the market has increased its demand for high quality meat. Based on this premise some producers have continuously improved their efficiency in breeding beef cattle with the purpose to support this demand. It is well recognized that final quality of beef is intimately linked to animal’s diet. The key objective of this study is to evaluate the influence of feeding animals with cottonseed and its lipids and the final results in terms of pH and shear forces of the meat. Materials and Methods: The study was carried out in the Chapéu de Couro Farm in Aguaí/SP, Brazil. A group of 39 uncastrated Nellore cattle. Mean age of the animals was 36 months and initial mean live weight was 494.1 ± 10.1. Animals were randomly assigned to one of three treatments, based on dry matter: feed with control diet 2.50% cottonseed, feed with 11.50% cottonseed, and feed with 3.13% cottonseed added of 1.77% protected lipid. Forage:concentrate ratio was 50:50 on a dry matter basis. Sugar cane chopped was used as forage. After slaughter, carcasses were identified and divided into two halves that were kept in a cold chamber for 24 h at 2°C. Using pH meter was determined post-mortem pH in Longissimus thoracis muscle between the 12th and 13th rib of the left half carcass. After, part of each animal was removed, and divided in three samples (steaks). Steaks were 2.5 cm thick and were identified and stored individually in plastic bags under vacuum. Samples were frozen in a freezer at -18°C. The same samples cooked were refrigerated by 12 h the 4°C, and then cut into cylinders 1.10 Øcm with the support of a drill press avoiding fats and nerves. Shear force was calculated in these samples cut into cylinders through the Brookfield texture CT3 Texture Analyzer 25 k equipped with a set of blade Warner-Bratzler. Results and Discussion: No differences (P > 0.05) in pH 24 h after slaughter were observed in the meat of Nellore cattle fed different sources of fat, and mean value for this variable was 5.59. However, for the shear force differences (P < 0.05) were founded. For diet with 2,50% cottonseed the lowest value found 5.10 (kg) while for the treatment with 11.50% cottonseed the great value found was 6.30 (kg). High shear force values mean greater texture of meat that indicates less tenderness. The texture of the meat can be influenced by age, weight to the slaughter of animals. For cattle breed Nellore Bos taurus indicus more high value of shear force. Conclusions: The add the cottonseed or protected lipid in diet is not affected pH values in meat. The whole cottonseed does not contribute to the improvement of tenderness of the meat. Acknowledgments: IFGoiano, FAPEG and CNPq (Brazil).

Keywords: beef quality, cottonseed, protected fat, shear force

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Authors: Saori Iwatsuka

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In The Member of the Wedding, Carson McCullers starts with the words, “It happened,” without telling the reader what happens to a twelve-year-old protagonist, Frankie Adams. The reader feels confused and incomprehensible. However, he or she later realizes that the confusing phrase is connected to the scene where Frankie feels “the thing happened” after listening to the melodic lines of jazz and blues. Yet, the reader cannot really comprehend what happens to Frankie and feels puzzled till the end. And the story ends with Frankie’s words, “I am simply mad about . . .” Implying her queer desire for her new friend Mary Littlejohn, McCullers never tells the reader whom Frankie is mad about. Despite McCullers’s ambiguous way of depicting Frankie’s sexuality, recent critics and reviewers have come to discuss her sexuality as anti-heterosexual because Frankie expresses her hatred for Barney, whom she has had some type of sexual encounter, and feels wrong with her brother Jarvis’s wedding. After giving up her sexual desire for Jarvis’s bride, Janice, Frankie changes her name to Frances, becomes engrossed with Michelangelo, and enjoys reading Tennyson’s poetry with Mary. Michelangelo and Tennyson are well-known homosexual artists, which suggests that Frankie has an anti-heterosexual orientation. As McCullers does not precisely describe Frankie’s sexuality, the reader can only assume it by connecting fragmentary descriptions. However, this discussion is more clarified to show Frankie’s sexuality because analyzing the musical references of jazz and blues and interpreting them from a musicological viewpoint will illuminate it. In her works, McCullers frequently uses musical references and descriptions, which have a significant and psychological impact on the protagonists and portrays their bodily reactions to the impact to reveal what the reader cannot see on the surface. Thus, in this story, too, Frankie’s bodily reaction to music is portrayed to cue her feelings. After seeing the chimney swifts, known as monogamous birds, Frankie feels “a jazz sadness,” quivers her nerves and stiffens her heart. After listening to Berenice’s “dark jazz voice,” Frankie feels dizzy and throws a knife because Berenice’s voice jazzes (excites) her heart that beats in her head. Calming herself, she fantasizes that Jarvis, Jarvis’s bride, Janice, and herself are members of “the we of me.” Then in the evening, listening to the blues and jazz being played by a black horn player somewhere in her neighborhood, Frankie realizes “the thing happened” and discovers “a new feeling.” Following the musical references “jazz” and “blues” and examining them from the viewpoint of musicology and terminology leads the reader to explore what “it” is in “it happened” and what her “new feeling” is when “the thing happened” with the blues tune breaking off. Those discussions will illuminate Frankie’s sexuality. As McCullers does not clearly name her sexuality, this paper uses the word queer to express Frankie’s anti-sexual orientation.

Keywords: jazz and blues, musical references, queer sexuality, “we of me”

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Authors: Agbana Olaseinde Julius, Opadere Olaolu Stephen

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The concept of cross carpeting is as old as politics itself. Basically, it entails an individual leaving a political party/group, to join another. The reasons for which cross carpeting is embarked upon are diverse: ideological differences; ethnic and/or religious differences; access to actual or perceived better political opportunities; liberty of association; rancor; etc. The current democratic dispensation in Nigeria has experienced renewed and rather alarming rate of cross carpeting, for reasons including those enumerated above and others. Right to cross carpet is inherent in a democratic setting as well as the political stakeholder; so does it also comprise of the constitutional right of ‘freedom of association’. However, the current species of cross carpeting in Nigeria requires scrutiny, in view of some potential legal and moral challenges it poses for both the present and the future. Cross carpeting is considered both legal and constitutional, but the current spate raises the question of expediency, particularly in a nascent democracy. It is considered to have a propensity of negatively impacting political stability in a polity with fragile nerves. Importantly too, cross carpeting is considered a potential damage to the psyche of posterity with regards to a warped disposition to promises, honour and integrity. The perceived peculiar dimension of cross carpeting in Nigeria raises questions on the quality of leadership presently obtainable in the country, vis-à-vis greed, self-centeredness, disregard for the concern and interest of avowed followers/fans, entrenchment of distrust, etc. Thus, the study made use of primary and secondary sources of information. The primary sources included the Constitutions of the Federal Republic of Nigeria 1999 (as amended); judicial decisions; and the Electoral Act, 2010 (as Amended). The secondary sources comprised of information from books, journals, newspapers, magazines and Internet documents. Data obtained from these sources were subjected to content analysis. Findings of this study show that though the act of cross carpeting may not be in breach of any Statute or Law, it however, in most cases, breaches the morals of expediency. The morality thereof is far from justifiable, and should be condemned in the interest of the present and posterity. There is a great and urgent need to embark on a re-entrenchment of the culture of political ideology in the Nigerian polity, as obtainable in developed democracies. In conclusion, the need to exercise the right of cross carpeting with caution cannot be overemphasized. Membership of a political group/party should be backed by commitment to well defined ideologies and values. Commitment to them should be regarded akin to that found in the family, which is not easily or flippantly jettisoned.

Keywords: cross-carpeting, Nigeria, legal, moral issues, politics

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Authors: Ippei Torii, Kaoruko Ohtani, Takahito Niwa, Naohiro Ishii

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This paper shows developing an objectivity index using the measurement of subtle eyeball movement to diagnose autism. The developmentally disabled assessment varies, and the diagnosis depends on the subjective judgment of professionals. Therefore, a supplementary inspection method that will enable anyone to obtain the same quantitative judgment is needed. The diagnosis are made based on a comparison of the time of gazing an object in the conventional autistic study, but the results do not match. First, we divided the pupil into four parts from the center using measurements of subtle eyeball movement and comparing the number of pixels in the overlapping parts based on an afterimage. Then we developed the objective evaluation indicator to judge non-autistic and autistic people more clearly than conventional methods by analyzing the differences of subtle eyeball movements between the right and left eyes. Even when a person gazes at one point and his/her eyeballs always stay fixed at that point, their eyes perform subtle fixating movements (ie. tremors, drifting, microsaccades) to keep the retinal image clear. Particularly, the microsaccades link with nerves and reflect the mechanism that process the sight in a brain. We converted the differences between these movements into numbers. The process of the conversion is as followed: 1) Select the pixel indicating the subject's pupil from images of captured frames. 2) Set up a reference image, known as an afterimage, from the pixel indicating the subject's pupil. 3) Divide the pupil of the subject into four from the center in the acquired frame image. 4) Select the pixel in each divided part and count the number of the pixels of the overlapping part with the present pixel based on the afterimage. 5) Process the images with precision in 24 - 30fps from a camera and convert the amount of change in the pixels of the subtle movements of the right and left eyeballs in to numbers. The difference in the area of the amount of change occurs by measuring the difference between the afterimage in consecutive frames and the present frame. We set the amount of change to the quantity of the subtle eyeball movements. This method made it possible to detect a change of the eyeball vibration in numerical value. By comparing the numerical value between the right and left eyes, we found that there is a difference in how much they move. We compared the difference in these movements between non-autistc and autistic people and analyzed the result. Our research subjects consists of 8 children and 10 adults with autism, and 6 children and 18 adults with no disability. We measured the values through pasuit movements and fixations. We converted the difference in subtle movements between the right and left eyes into a graph and define it in multidimensional measure. Then we set the identification border with density function of the distribution, cumulative frequency function, and ROC curve. With this, we established an objective index to determine autism, normal, false positive, and false negative.

Keywords: subtle eyeball movement, autism, microsaccade, pursuit eye movements, ROC curve

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