Brain Natriuretic Peptide is a Predictor of Cardiac Thrombus in Critically Ill Acute Ischemic Stroke Patients

CONTEXT: Plasma brain natriuretic peptide (BNP) levels are elevated in patients with acute ischemic stroke, particularly when accompanied by atrial fibrillation (AF). Plasma BNP might be a useful marker of vulnerability to thromboembolism in non-valvular AF patients. AIM: The aim of the present study was to assess whether the BNP level can serve as a biomarker of the left atrial (LA) thrombus in AF patients with acute ischemic stroke. SETTINGS AND DESIGN: This was a multicenter prospective cohort study. PATIENTS AND METHODS: Thirty AF patients with acute ischemic stroke were included in the study. Their transesophageal echocardiography (TEE) and BNP were assessed. RESULTS: There was a positive significant relation between serum BNP levels and LA thrombus detection by TEE. BNP with a cutoff value >498 pg/l can be used as a diagnostic biomarker for the presence of the LA thrombus. A significant positive correlation existed between serum BNP and LA diameter. Furthermore, a statistically significant positive correlation between serum BNP and AF rate and duration was found in all patients. In addition, a statistically significant inverse correlation was detected between serum BNP and direct bilirubin, international normalized ratio, and albumin. A statistically significant positive correlation existed between serum BNP and prothrombin concentration. CONCLUSION: BNP can be a good diagnostic biomarker for the detection of the LA thrombus in chronic AF patients with acute ischemic stroke

Diabetic foot ulcer classification using mapped binary patterns and convolutional neural networks

Diabetic foot ulcer (DFU) is a major complication of diabetes and can lead to lower limb amputation if not treated early and properly. In addition to the traditional clinical approaches, in recent years, research on automation using computer vision and machine learning methods plays an important role in DFU classification, achieving promising successes. The most recent automatic approaches to DFU classification are based on convolutional neural networks (CNNs), using solely RGB images as input. In this paper, we present a CNN-based DFU classification method in which we showed that feeding an appropriate feature (texture information) to the CNN model provides a complementary performance to the standard RGB-based deep models of the DFU classification task, and better performance can be obtained if both RGB images and their texture features are combined and used as input to the CNN. To this end, the proposed method consists of two main stages. The first stage extracts texture information from the RGB image using the mapped binary patterns technique. The obtained mapped image is used to aid the second stage in recognizing DFU as it contains texture information of ulcer. The stack of RGB and mapped binary patterns images are fed to the CNN as a tensor input or as a fused image, which is a linear combination of RGB and mapped binary patterns images. The performance of the proposed approach was evaluated using two recently published DFU datasets: the Part-A dataset of healthy and unhealthy (DFU) cases [17] and Part-B dataset of ischaemia and infection cases [18]. The results showed that the proposed methods provided better performance than the state-of-the-art CNN-based methods with 0.981% (AUC) and 0.952% (F-Measure) on the Part-A dataset, 0.995% (AUC) and 0.990% (F-measure) for the Part-B ischaemia dataset, and 0.820% (AUC) and 0.744% (F-measure) on the Part-B infection dataset

Oxygen sensing coordinates photomorphogenesis to facilitate seedling survival

Successful emergence from the soil is essential for plant establishment in natural and farmed systems. It has been assumed that the absence of light in the soil is the preeminent signal perceived during early seedling development, leading to a distinct morphogenic plan (skotomorphogenesis) [1], characterized by traits providing an adaptive advantage until emergence and photomorphogenesis. These traits include suppressed chlorophyll synthesis, promotion of hypocotyl elongation, and formation of a closed apical hook that protects the stem cell niche from damage [2, 3]. However, absence of light by itself is not a sufficient environmental signal for early seedling development [4, 5]. Reduced oxygen levels (hypoxia) can occur in water-logged soils [6-8]. We therefore hypothesized that below-ground hypoxia may be an important, but thus far undiscovered, ecological component regulating seedling development. Here, we show that survival and establishment of seedlings following darkness depend on their ability to sense hypoxia, through enhanced stability of group VII Ethylene Response Factor (ERFVII) transcription factors. Hypoxia is perceived as a positive environmental component in diverse taxa of flowering plants, promoting maintenance of skotomorphogenic traits. Hypoxia greatly enhances survival once light is perceived, while oxygen is necessary for the subsequent effective completion of photomorphogenesis. Together with light perception, oxygen sensing therefore allows an integrated response to the complex and changing physical microenvironment encountered during early seedling growth. We propose that plants monitor the soil's gaseous environment after germination, using hypoxia as a key external cue to protect the stem cell niche, thus ensuring successful rapid establishment upon emergence above ground

Common Genetic Variation at the IL1RL1 Locus Regulates IL-33/ST2 Signaling

The suppression of tumorigenicity 2/IL-33 (ST2/IL-33) pathway has been implicated in several immune and inflammatory diseases. ST2 is produced as 2 isoforms. The membrane-bound isoform (ST2L) induces an immune response when bound to its ligand, IL-33. The other isoform is a soluble protein (sST2) that is thought to be a decoy receptor for IL-33 signaling. Elevated sST2 levels in serum are associated with an increased risk for cardiovascular disease. We investigated the determinants of sST2 plasma concentrations in 2,991 Framingham Offspring Cohort participants. While clinical and environmental factors explained some variation in sST2 levels, much of the variation in sST2 production was driven by genetic factors. In a genome-wide association study (GWAS), multiple SNPs within IL1RL1 (the gene encoding ST2) demonstrated associations with sST2 concentrations. Five missense variants of IL1RL1 correlated with higher sST2 levels in the GWAS and mapped to the intracellular domain of ST2, which is absent in sST2. In a cell culture model, IL1RL1 missense variants increased sST2 expression by inducing IL-33 expression and enhancing IL-33 responsiveness (via ST2L). Our data suggest that genetic variation in IL1RL1 can result in increased levels of sST2 and alter immune and inflammatory signaling through the ST2/IL-33 pathway.Stem Cell and Regenerative Biolog

Meta-analysis of genome-wide association studies from the CHARGE consortium identifies common variants associated with carotid intima media thickness and plaque

Carotid intima media thickness (cIMT) and plaque determined by ultrasonography are established measures of subclinical atherosclerosis that each predicts future cardiovascular disease events. We conducted a meta-analysis of genome-wide association data in 31,211 participants of European ancestry from nine large studies in the setting of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. We then sought additional evidence to support our findings among 11,273 individuals using data from seven additional studies. In the combined meta-analysis, we identified three genomic regions associated with common carotid intima media thickness and two different regions associated with the presence of carotid plaque (P < 5 × 10 -8). The associated SNPs mapped in or near genes related to cellular signaling, lipid metabolism and blood pressure homeostasis, and two of the regions were associated with coronary artery disease (P < 0.006) in the Coronary Artery Disease Genome-Wide Replication and Meta-Analysis (CARDIoGRAM) consortium. Our findings may provide new insight into pathways leading to subclinical atherosclerosis and subsequent cardiovascular events

Prospective Associations of Coronary Heart Disease Loci in African Americans Using the MetaboChip: The PAGE Study

Background: Coronary heart disease (CHD) is a leading cause of morbidity and mortality in African Americans. However, there is a paucity of studies assessing genetic determinants of CHD in African Americans. We examined the association of published variants in CHD loci with incident CHD, attempted to fine map these loci, and characterize novel variants influencing CHD risk in African Americans. Methods and Results: Up to 8,201 African Americans (including 546 first CHD events) were genotyped using the MetaboChip array in the Atherosclerosis Risk in Communities (ARIC) study and Women's Health Initiative (WHI). We tested associations using Cox proportional hazard models in sex- and study-stratified analyses and combined results using meta-analysis. Among 44 validated CHD loci available in the array, we replicated and fine-mapped the SORT1 locus, and showed same direction of effects as reported in studies of individuals of European ancestry for SNPs in 22 additional published loci. We also identified a SNP achieving array wide significance (MYC: rs2070583, allele frequency 0.02, P = 8.1×10−8), but the association did not replicate in an additional 8,059 African Americans (577 events) from the WHI, HealthABC and GeneSTAR studies, and in a meta-analysis of 5 cohort studies of European ancestry (24,024 individuals including 1,570 cases of MI and 2,406 cases of CHD) from the CHARGE Consortium. Conclusions: Our findings suggest that some CHD loci previously identified in individuals of European ancestry may be relevant to incident CHD in African Americans

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

Prospective associations of coronary heart disease loci in African Americans using the MetaboChip

Background: Coronary heart disease (CHD) is a leading cause of morbidity and mortality in African Americans. However, there is a paucity of studies assessing genetic determinants of CHD in African Americans. We examined the association of publishe

Gaia Data Release 1. Astrometry: one billion positions, two million proper motions and parallaxes

Context. Gaia Data Release 1 (DR1) contains astrometric results for more than 1 billion stars brighter than magnitude 20.7 based on observations collected by the Gaia satellite during the first 14 months of its operational phase. Aims. We give a brief overview of the astrometric content of the data release and of the model assumptions, data processing, and validation of the results. Methods. For stars in common with the Hipparcos and Tycho-2 catalogues, complete astrometric single-star solutions are obtained by incorporating positional information from the earlier catalogues. For other stars only their positions are obtained, essentially by neglecting their proper motions and parallaxes. The results are validated by an analysis of the residuals, through special validation runs, and by comparison with external data. Results. For about two million of the brighter stars (down to magnitude ∼11.5) we obtain positions, parallaxes, and proper motions to Hipparcos-type precision or better. For these stars, systematic errors depending for example on position and colour are at a level of ±0.3 milliarcsecond (mas). For the remaining stars we obtain positions at epoch J2015.0 accurate to ∼10 mas. Positions and proper motions are given in a reference frame that is aligned with the International Celestial Reference Frame (ICRF) to better than 0.1 mas at epoch J2015.0, and non-rotating with respect to ICRF to within 0.03 mas yr−1 . The Hipparcos reference frame is found to rotate with respect to the Gaia DR1 frame at a rate of 0.24 mas yr−1 . Conclusions. Based on less than a quarter of the nominal mission length and on very provisional and incomplete calibrations, the quality and completeness of the astrometric data in Gaia DR1 are far from what is expected for the final mission products. The present results nevertheless represent a huge improvement in the available fundamental stellar data and practical definition of the optical reference frame

Whole-Exome Sequencing Identifies Loci Associated with Blood Cell Traits and Reveals a Role for Alternative GFI1B Splice Variants in Human Hematopoiesis

(The American Journal of Human Genetics 99, 481–488; August 4, 2016