Hereditary thrombophilia

Thrombophilia can be defined as a predisposition to form clots inappropriately. Thrombotic events during infancy and childhood are increasingly recognized as a significant source of mortality and morbidity. The predisposition to form clots can arise from genetic factors, acquired changes in the clotting mechanism, or, more commonly, an interaction between genetic and acquired factors. Since the turn of the last century, there has been extensive research focusing on both the genetic and acquired causes of thrombophilia, with particular focus on clotting events in the venous circulation. This review describes clinically relevant aspects of genetic venous thrombophilia, which include well-established, lesser known, and suggested causes of inherited thrombophilias

3D Indoor Instance Segmentation in an Open-World

Existing 3D instance segmentation methods typically assume that all semantic classes to be segmented would be available during training and only seen categories are segmented at inference. We argue that such a closed-world assumption is restrictive and explore for the first time 3D indoor instance segmentation in an open-world setting, where the model is allowed to distinguish a set of known classes as well as identify an unknown object as unknown and then later incrementally learning the semantic category of the unknown when the corresponding category labels are available. To this end, we introduce an open-world 3D indoor instance segmentation method, where an auto-labeling scheme is employed to produce pseudo-labels during training and induce separation to separate known and unknown category labels. We further improve the pseudo-labels quality at inference by adjusting the unknown class probability based on the objectness score distribution. We also introduce carefully curated open-world splits leveraging realistic scenarios based on inherent object distribution, region-based indoor scene exploration and randomness aspect of open-world classes. Extensive experiments reveal the efficacy of the proposed contributions leading to promising open-world 3D instance segmentation performance.Comment: Accepted at NeurIPS 202

University Clinical Media Resource: Best Practices to Create, Maintain, and Maximize Visibility on a Social Media Platform

This paper reviews the need for social media platforms as a tool for healthcare facilities to provide resources, market their business, and interact directly with clients. Steps to creating a social media platform will be discussed, in addition to how healthcare facilities should frequently review competing healthcare providers’ social media pages to stay competitive with the target population. Special considerations for the audiology and speech-language pathology programs at Illinois State University will be explored, and ethical considerations for engaging in healthcare on a social media platform will also be analyzed in this paper. The Eckelmann-Taylor Speech and Hearing Clinic at Illinois State University (ETSHC) will benefit from the information and implementation of social media usage provided within this paper because it will allow the clinic to create a professional social media platform. This social media platform will improve patient outreach within the community to increase and diversify the clientele attending that clinic, and allow for the opportunity of interprofessional collaboration between the ETSHC and other speech-language pathology and audiology providers. Undergraduate students and graduate students in the programs of speech-language pathology and audiology will benefit from the ETSHC executing a social media platform to expand the opportunities and experiences provided throughout their education

Gender and other factors influencing the specialty choice among postgraduate medical students in Bangladesh, 2016-2020

Background: Over the last two decades, there has been a gender shift in undergraduate medical education in Bangladesh with different influencing factors in specialty choice as a career. We aimed to determine the gender and other influencing factors in specialty choice among post-graduate medical students of Bangladesh. Methods: This cross-sectional study was carried out at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Secondary data regarding students’ enrollment from 2016 to 2020 were acquired from the registry of the Information Technology Cell of BSMMU. Face-to-face interviews were conducted with 118 postgraduate medical students to learn about the motivation behind their specialty selections. Results: From 2016 to 2020, 9,112 postgraduate medical students were enrolled in 73 post-graduate medical programmes across the five faculties (Surgery, Medicine, Basic Science and Para Clinical Science, Pediatrics, and Preventive and Social Medicine) of BSMMU. There was a gradual increase in female students from 41.6% in 2016 to 49.3% in 2020. Male dominancy was found in the faculties of Surgery (61.2%) and Medicine (69.7%), whereas the faculties of Basic Science and Paraclinical Science (74.6%), Pediatrics (53.7%), and Preventive and Social Medicine (66.9%) were dominated by female students. Significant differences in the sex distribution among postgraduate medical students were observed in the faculties of Surgery and Pediatrics. The most frequently mentioned influencing factors for medical students\u27 choice of specialization were \u27personal interest\u27 (86.3%), followed by \u27future career potential\u27 (74.6%) and \u27demand for the specialty\u27 (73.7%). Significant gender variations in these influencing factors existed. Conclusion: Over the years, the percentage of female postgraduate medical students has increased in all five faculties of BSMMU. Gender differences in specialty choice can assist policymakers in making equitable distributions of the healthcare workforce. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(3): 152-159  

Tracklet and Signature Representation for Multi-shot Person Re-Identification.

International audienceVideo surveillance has become more and more important in many domains for their security andsafety. Person Re-Identification (Re-ID) is one of the most interesting subjects in this area. The Re-ID systemis divided into two main stages: i) extracting feature representations to construct a person’s appearance sig-nature and ii) establishing the correspondence/matching by learning similarity metrics or ranking functions.However, appearance based person Re-ID is a challenging task due to similarity of human’s appearance andvisual ambiguities across different cameras. This paper provides a representation of the appearance descriptors,called signatures, for multi-shot Re-ID. First, we will present the tracklets, i.e trajectories of persons. Then,we compute the signature and represent it based on the approach of Part Appearance Mixture (PAM). Anevaluation of the quality of this signature representation is also described in order to essentially solve the problemsof high variance in a person’s appearance, occlusions, illumination changes and person’s orientation/pose. Todeal with variance in a person’s appearance, we represent it as a set of multi-modal feature distributions modeledby Gaussian Mixture Model (GMM). Experiments and results on two public datasets and on our own datasetshow good performance

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Akkermansia muciniphila and improved metabolic health during a dietary intervention in obesity: relationship with gut microbiome richness and ecology

Objective: Individuals with obesity and type 2 diabetes differ from lean and healthy individuals in their abundance of certain gut microbial species and microbial gene richness. Abundance of Akkermansia muciniphila, a mucin-degrading bacterium, has been inversely associated with bodyfat mass and glucose intolerance in mice, but more evidence is needed in humans. The impact of diet and weight loss on this bacterial species is unknown. Our objective was to evaluate the association between fecal A. muciniphila abundance, fecal microbiome gene richness, diet, host characteristics, and their changes after calorie restriction (CR). Design: The intervention consisted of a 6-week CR period followed by a 6-week weight stabilization (WS) diet in overweight and obese adults (N=49, including 41 women). Fecal A. muciniphila abundance, fecal microbial gene richness, diet and bioclinical parameters were measured at baseline and after CR and WS. Results: At baseline A. muciniphila was inversely related to fasting glucose, waist-to-hip ratio, and subcutaneous adipocyte diameter. Subjects with higher gene richness and A. muciniphila abundance exhibited the healthiest metabolic status, particularly in fasting plasma glucose, plasma triglycerides and body fat distribution. Individuals with higher baseline A. muciniphila displayed greater improvement in insulin sensitivity markers and other clinical parameters after CR. A. muciniphila was associated with microbial species known to be related to health. Conclusion: A. muciniphila is associated with a healthier metabolic status and better clinicaloutcomes after CR in overweight/obese adults, however the interaction between gut microbiota ecology and A. muciniphila has to be taken into account

Identification and characterization of antibacterial compound(s) of cockroaches (Periplaneta americana)

Infectious diseases remain a significant threat to human health, contributing to more than 17 million deaths, annually. With the worsening trends of drug resistance, there is a need for newer and more powerful antimicrobial agents. We hypothesized that animals living in polluted environments are potential source of antimicrobials. Under polluted milieus, organisms such as cockroaches encounter different types of microbes, including superbugs. Such creatures survive the onslaught of superbugs and are able to ward off disease by producing antimicrobial substances. Here, we characterized antibacterial properties in extracts of various body organs of cockroaches (Periplaneta americana) and showed potent antibacterial activity in crude brain extract against methicillin-resistant Staphylococcus aureus and neuropathogenic E. coli K1. The size-exclusion spin columns revealed that the active compound(s) are less than 10 kDa in molecular mass. Using cytotoxicity assays, it was observed that pre-treatment of bacteria with lysates inhibited bacteria-mediated host cell cytotoxicity. Using spectra obtained with LC-MS on Agilent 1290 infinity liquid chromatograph, coupled with an Agilent 6460 triple quadruple mass spectrometer, tissues lysates were analyzed. Among hundreds of compounds, only a few homologous compounds were identified that contained isoquinoline group, chromene derivatives, thiazine groups, imidazoles, pyrrole containing analogs, sulfonamides, furanones, flavanones, and known to possess broad-spectrum antimicrobial properties, and possess anti-inflammatory, anti-tumour, and analgesic properties. Further identification, characterization and functional studies using individual compounds can act as a breakthrough in developing novel therapeutics against various pathogens including superbugs