Nasal lysine aspirin challenge in the diagnosis of aspirin - exacerbated respiratory disease

Background Aspirin-exacerbated respiratory disease is under-diagnosed and therefore effective and inexpensive therapy with aspirin desensitization is rarely performed. Methods We present an audit of 150 patients with difficult to treat nasal polyposis, 132 of whom also had asthma, 131 of whom underwent challenge with the only soluble form of aspirin, lysine aspirin (LAS), to confirm or exclude the diagnosis of aspirin-exacerbated respiratory disease (AERD). Results One hundred patients proved positive on nasal challenge, 31 who were negative went onto oral LAS challenge and a further 14 gave positive results, leaving 17 who were negative to a dose equivalent to over 375 mg of aspirin. Nineteen were not challenged because of contraindications. With the exception of one patient who developed facial angioedema and two patients with > 20% drop in FEV1 (following nasal plus oral challenge) no other severe adverse events occurred. No hospitalization was required for these three patients. Nasal inspiratory peak flow monitoring was less sensitive to obstruction caused by aspirin than was acoustic rhinometry – which should be employed when aspirin challenge is an outpatient procedure. Conclusions Provided patients are carefully chosen and monitored LAS challenge is suitable for ENT day case practice where respiratory physician help with asthma is available and should reduce the under-diagnosis of this condition

Citizen science and wildlife disease surveillance

Achieving effective wildlife disease surveillance is challenging. The incorporation of citizen science (CS) in wildlife health surveillance can be beneficial, particularly where resources are limited and cost-effectiveness is paramount. Reports of wildlife morbidity and mortality from the public facilitate large-scale surveillance, both in time and space, which would otherwise be financially infeasible, and raise awareness of incidents occurring on privately-owned land. CS wildlife disease surveillance schemes benefit scientists, the participating public and wildlife alike. CS has been employed for targeted, scanning and syndromic surveillance of wildlife disease. Whilst opportunistic surveillance is most common, systematic observations enable the standardization of observer effort and, combined with wildlife population monitoring schemes, can allow evaluation of disease impacts at the population level. Near-universal access to digital media has revolutionized reporting modalities and facilitated rapid and economical means of sharing feedback with participants. Here we review CS schemes for wildlife disease surveillance and highlight their scope, benefits, logistical considerations, financial implications and potential limitations. The need to adopt a collaborative and multidisciplinary approach to wildlife health surveillance is increasingly recognized and the general public can make a significant contribution through CS

Herschel and Odin observations of H2O, CO, CH, CH+, and NII in the barred spiral galaxy NGC 1365. Bar-induced activity in the outer and inner circumnuclear tori

The Odin satellite is now into its twentieth year of operation, much surpassing its design life of two years. One of its major pursuits was the search for and study of H2O in the Solar System and the Milky Way galaxy. Herschel has observed the central region of NGC 1365 in two positions, and both its SPIRE and PACS observations are available in the Herschel Science Archive. Herschel PACS images have been produced of the 70 and 160 micron infrared emission from the whole galaxy, and also of the cold dust distribution as obtained from the ratio of the 160 to 70 micron images. The Herschel SPIRE observations have been used to produce maps of the 557 GHz o-H2O, 752 GHz p-H2O, 691 GHz CO(6-5), 1037 GHz CO(9-8), 537 GHz CH, 835 GHz CH+, and the 1461 GHz NII lines; however, these observations have no effective velocity resolution. Odin has recently observed the 557 GHz o-H2O ground state line in the central region with high (5 km/s) spectral resolution. The emission and absorption of H2O at 557 GHz, with a velocity resolution of 5 km/s, has been marginally detected in NGC 1365 with Odin. The H2O is predominantly located in a shocked 15" (1.3 kpc) region near some central compact radio sources and hot-spot HII regions, close to the northeast component of the molecular torus surrounding the nucleus. An analysis of the H2O line intensities and velocities indicates that a shock-region is located here. This is corroborated by a statistical image deconvolution of our SEST CO(3-2) observations, yielding 5" resolution, and a study of our VLA HI absorption observations. Additionally, an enticing 20" HI ridge is found to extend south-southeast from the nucleus, coinciding in position with the southern edge of an OIII outflow cone, emanating from the nucleus. The molecular chemistry of the shocked central region is analyzed with special emphasis on the CO, H2O and CH, CH+ results.Comment: 25 pages, 11 figure

A new straightforward method for semi-automated segmentation of trabecular bone from cortical bone in diverse and challenging morphologies

Many physiological, biomechanical, evolutionary and clinical studies that explore skeletal structure and function require successful separation of trabecular from cortical compartments of a bone that has been imaged by X-ray micro-computed tomography (micro-CT) prior to analysis. Separation often involves manual subdivision of these two similarly radio-opaque compartments, which can be time-consuming and subjective. We have developed an objective, semi-automated protocol which reduces user bias and enables straightforward, user-friendly segmentation of trabecular from the cortical bone without requiring sophisticated programming expertise. This method can conveniently be used as a ‘recipe’ in commercial programmes (Avizo herein) and applied to a variety of datasets. Here, we characterize and share this recipe, and demonstrate its application to a range of murine and human bone types, including normal and osteoarthritic specimens, and bones with distinct embryonic origins and spanning a range of ages. We validate the method by testing inter-user bias during the scan preparation steps and confirm utility in the architecturally challenging analysis of growing murine epiphyses. We also report details of the recipe, so that other groups can readily re-create a similar method in open access programmes. Our aim is that this method will be adopted widely to create a reproducible and time-efficient method of segmenting trabecular and cortical bone

Improving the Segmentation of Anatomical Structures in Chest Radiographs using U-Net with an ImageNet Pre-trained Encoder

Accurate segmentation of anatomical structures in chest radiographs is essential for many computer-aided diagnosis tasks. In this paper we investigate the latest fully-convolutional architectures for the task of multi-class segmentation of the lungs field, heart and clavicles in a chest radiograph. In addition, we explore the influence of using different loss functions in the training process of a neural network for semantic segmentation. We evaluate all models on a common benchmark of 247 X-ray images from the JSRT database and ground-truth segmentation masks from the SCR dataset. Our best performing architecture, is a modified U-Net that benefits from pre-trained encoder weights. This model outperformed the current state-of-the-art methods tested on the same benchmark, with Jaccard overlap scores of 96.1% for lung fields, 90.6% for heart and 85.5% for clavicles.Comment: Presented at the First International Workshop on Thoracic Image Analysis (TIA), MICCAI 201

Electrodiagnostic evaluation of median nerve conduction in Type II diabetes mellitus patients that were asymptomatic for peripheral neuropathy: a case control study

Background: Diabetic neuropathy (DN) is a potentially debilitating complication of diabetes mellitus but many of the diabetic patients are often asymptomatic of DN, thereby, placing them at high risk of developing debilitating complications like diabetic hand and foot.Aim: The study was designed to evaluate median nerve conduction of T2DM patients that were asymptomatic for neuropathy and compare their findings with age and sex-matched healthy individuals.Methods: The median motor and sensory nerve conduction study was conducted on 100 type 2 diabetic (T2DM) patients and 100 healthy volunteers, matched for age and sex-matched control. Median nerve motor and sensory proximal and Distal latency (DL), Amplitude and Conduction Velocity (CV) as well as motor f-reponse were measured using Nihoen Kohden EMG Machine and standardized techniques of measurement in the course of the study were adhered to.Results: On comparison of the median nerve motor and sensory parameters, the median nerve (motor and sensory) distal latencies and f-responses were significantly lower in the control group while the median nerve conduction velocities and amplitudes were significantly higher in the T2DM group. Conclusion: The study showed significant impairment of median nerve conduction parameters in T2DM patients who did not have any feature suggestive of peripheral neuropathy when compared with apparently healthy individuals. Thus high index of suspicion as well as early screening for peripheral neuropathy in diabetes is further emphasized.Keywords: Median nerve, diabetic neuropathy, electrodiagnostic evaluation, conduction velocity, latenc

Mortality associated with avian reovirus infection in a free-living magpie (Pica pica) in Great Britain

Avian reoviruses (ARVs) cause a range of disease presentations in domestic, captive and free-living bird species. ARVs have been reported as a cause of significant disease and mortality in free-living corvid species in North America and continental Europe. Until this report, there have been no confirmed cases of ARV-associated disease in British wild birds

"Wink to grasp" – comparing eye, voice & EMG gesture control of grasp with soft-robotic gloves

The ability of robotic rehabilitation devices to support paralysed end-users is ultimately limited by the degree to which human-machine-interaction is designed to be effective and efficient in translating user intention into robotic action. Specifically, we evaluate the novel possibility of binocular eye-tracking technology to detect voluntary winks from involuntary blink commands, to establish winks as a novel low-latency control signal to trigger robotic action. By wearing binocular eye-tracking glasses we enable users to directly observe their environment or the actuator and trigger movement actions, without having to interact with a visual display unit or user interface. We compare our novel approach to two conventional approaches for controlling robotic devices based on electromyo-graphy (EMG) and speech-based human-computer interaction technology. We present an integrated software framework based on ROS that allows transparent integration of these multiple modalities with a robotic system. We use a soft-robotic SEM glove (Bioservo Technologies AB, Sweden) to evaluate how the 3 modalities support the performance and subjective experience of the end-user when movement assisted. All 3 modalities are evaluated in streaming, closed-loop control operation for grasping physical objects. We find that wink control shows the lowest error rate mean with lowest standard deviation of (0.23 ± 0.07, mean ± SEM) followed by speech control (0.35 ± 0. 13) and EMG gesture control (using the Myo armband by Thalamic Labs), with the highest mean and standard deviation (0.46 ± 0.16). We conclude that with our novel own developed eye-tracking based approach to control assistive technologies is a well suited alternative to conventional approaches, especially when combined with 3D eye-tracking based robotic end-point control

The left anterior right temporal (LART) placement for electroconvulsive therapy: A computational modelling study

Electrode placement in electroconvulsive therapy (ECT) has a major impact on treatment efficacy and cognitive side effects. Left Anterior Right Temporal (LART) is a lesser utilised bilateral montage which may produce more optimal clinical outcomes relative to standard bitemporal ECT. In this study we used computational modelling to explore how stimulation effects from LART and two novel variants (LART – F3 and LART – Frontal) compared to the more common bilateral placements of bitemporal and bifrontal ECT. High resolution finite element human head models were generated from MRI scans of three subjects with Major Depressive Disorder. Differences in regional stimulation were examined through parametric tests for regions of interest and subtraction maps. Compared to bitemporal ECT, LART – Original resulted in significantly greater stimulation of the left cingulate gyrus (hypothesised to be associated with treatment efficacy), and relatively reduced stimulation of the bilateral hippocampi (potentially associated with cognitive side effects). No additional clinical benefit was suggested with the novel LART placements compared to the original LART. The original LART placement is a promising montage for further clinical investigation