New Algorithms Improving PML Risk Stratification in MS Patients Treated With Natalizumab.

Overview: We assessed the role of age and disease activity as new factors contributing to establish the risk of progressive multifocal leucoencephalopathy in multiple sclerosis patients treated with natalizumab in 36 University Hospitals in Europe. We performed the study in 1,307 multiple sclerosis patients (70.8% anti-John Cunninghan virus positive antibodies) treated with natalizumab for a median time of 3.28 years. Epidemiological, clinical, and laboratory variables were collected. Lipid-specific IgM oligoclonal band status was available in 277 patients. Factors associated with progressive multifocal leucoencephalopathy onset were explored by uni- and multivariate logistic regression. Results: Thirty-five patients developed progressive multifocal leucoencephalopathy. The multivariate analysis identified anti-John Cunninghan virus antibody indices and relapse rate as the best predictors for the onset of this serious opportunistic infection in the whole cohort. They allowed to stratify progressive multifocal leucoencephalopathy risk before natalizumab initiation in individual patients [area under the curve (AUC) = 0.85]. The risk ranged from <1/3,300 in patients with anti-John Cunninghan virus antibody indices <0.9 and relapse rate >0.5, to 1/50 in the opposite case. In patients with lipid-specific IgM oligoclonal bands assessment, age at natalizumab onset, anti-John Cunninghan virus antibody indices, and lipid-specific IgM oligoclonal band status predicted progressive multifocal leucoencephalopathy risk (AUC = 0.92). The absence of lipid-specific IgM oligoclonal bands was the best individual predictor (OR = 40.94). The individual risk ranged from <1/10,000 in patients younger than 45 years at natalizumab initiation, who showed anti John Cunningham virus antibody indices <0.9 and lipid-specific IgM oligoclonal bands to 1/33 in the opposite case. Conclusions: In a perspective of personalized medicine, disease activity, anti-lipid specific IgM oligoclonal bands, anti Jonh Cunninghan virus antibody levels, and age can help tailor natalizumab therapy in multiple sclerosis patients, as predictors of progressive multifocal leucoencephalopathy.

Single-image rectification technique in forensic science.

Many researchers have been working in Spain to document the communal graves of those assassinated during the Spanish Civil War. This article shows the results obtained with two low-cost photogrammetric techniques for the basic documentation of forensic studies. These low-cost techniques are based on single-image rectification and the correction of the original photo displacement due to the projection and perspective distortions introduced by the lens of the camera. The capability of image rectification is tested in an excavation in the village of Loma de Montija (Burgos, Spain). The results of both techniques are compared with the more accurate data obtained from a laser scanner system RIEGL LMS-Z390i to evaluate the error in the lengths. The first technique uses a camera situated on a triangle-shaped pole at a height of 5 m and the second positions the camera over the grave using a linearly actuated device. The first technique shows measurement errors less than 6%, whereas the second shows greater errors (between 8% and 14%) owing to the positioning of the carbon-fiber cross on an uneven surface.

A refrigerated web camera for photogrammetric video measurement inside biomass boilers and combustion analysis.

This paper describes a prototype instrumentation system for photogrammetric measuring of bed and ash layers, as well as for flying particle detection and pursuit using a single device (CCD) web camera. The system was designed to obtain images of the combustion process in the interior of a domestic boiler. It includes a cooling system, needed because of the high temperatures in the combustion chamber of the boiler. The cooling system was designed using CFD simulations to ensure effectiveness. This method allows more complete and real-time monitoring of the combustion process taking place inside a boiler. The information gained from this system may facilitate the optimisation of boiler processes.

Uncertainty determination methodology, sampling maps generation and trend studies with biomass thermogravimetric analysis.

This paper investigates a method for the determination of the maximum sampling error and confidence intervals of thermal properties obtained from thermogravimetric analysis (TG analysis) for several lignocellulosic materials (ground olive stone, almond shell, pine pellets and oak pellets), completing previous work of the same authors. A comparison has been made between results of TG analysis and prompt analysis. Levels of uncertainty and errors were obtained, demonstrating that properties evaluated by TG analysis were representative of the overall fuel composition, and no correlation between prompt and TG analysis exists. Additionally, a study of trends and time correlations is indicated. These results are particularly interesting for biomass energy applications.

Biomass thermogravimetric analysis: uncertainty determination methodology and sampling maps generation.

The objective of this study was to develop a methodology for the determination of the maximum sampling error and confidence intervals of thermal properties obtained from thermogravimetric analysis (TG), including moisture, volatile matter, fixed carbon and ash content. The sampling procedure of the TG analysis was of particular interest and was conducted with care. The results of the present study were compared to those of a prompt analysis, and a correlation between the mean values and maximum sampling errors of the methods were not observed. In general, low and acceptable levels of uncertainty and error were obtained, demonstrating that the properties evaluated by TG analysis were representative of the overall fuel composition. The accurate determination of the thermal properties of biomass with precise confidence intervals is of particular interest in energetic biomass applications.

SUNCT and trigeminal neuralgia attributed to meningoencephalitis.

We describe a 46-year-old female with viral meningoencephalitis (likely varicella-zoster virus) who developed a SUNCT syndrome followed a few days later by trigeminal neuralgia. Both disorders resolved in parallel with the resolution of encephalitis, which suggests a causal link. In conclusion, headache attributed to intracranial infection may have the clinical features of SUNCT or TN.

The value of diffusion-weighted MRI in the diagnosis of cerebral fat embolism.

Fat embolism syndrome complicates open fractures involving long bones, although it occasionally follows nontraumatic conditions. Incomplete forms of the syndrome (ie, cerebral fat embolism) represent a challenge to diagnosis, and brain MRI represents a valuable diagnostic tool. We describe a patient who had a fat embolism to the brain after an isolated traumatic open fracture of the tibia. MRI with T2 and diffusion-weighted images revealed multiple, reversible brain lesions, suggesting vasogenic edema and consistent with this entity. At present, MR imaging is the most sensitive technique to evaluate cerebral fat embolism.