Assessment of Vessel Density on Non-Contrast Computed Tomography to Detect Basilar Artery Occlusion

Introduction: Basilar artery occlusion (BAO) may be clinically occult due to variable and non-specific symptomatology. We evaluated the qualitative and quantitative determination of a hyperdense basilar artery (HDBA) on non-contrast computed tomography (NCCT) brain for the diagnosis of BAO.Methods: We conducted a case control study of patients with confirmed acute BAO vs a control group of suspected acute stroke patients without BAO. Two EM attending physicians, one third-year EM resident, and one medical student performed qualitative and quantitative assessments for the presence of a HDBA on axial NCCT images. Our primary outcome measures were sensitivity and specificity for BAO. Our secondary outcomes were inter-rater and intra-rater reliability of the qualitative and quantitative assessments.Results: We included 60 BAO and 65 control patients in our analysis. Qualitative assessment of the hyperdense basilar artery sign was poorly sensitive (54%–72%) and specific (55%–89%). Quantitative measurement improved the specificity of hyperdense basilar artery assessment for diagnosing BAO, with a threshold of 61.0–63.8 Hounsfield units demonstrating relatively high specificity of 85%–94%. There was moderate inter-rater agreement for the qualitative assessment of HDBA (Fleiss’ kappa statistic 0.508, 95% confidence interval: 0.435–0.581). Agreement improved for quantitative assessments, but still fell in the moderate range (Shrout-Fleiss intraclass correlation coefficient: 0.635). Intra-rater reliability for the quantitative assessments of the two attending physician reviewers demonstrated substantial consistency.Conclusion: Our results highlight the importance of carefully examining basilar artery density when interpreting the NCCT of patients with altered consciousness or other signs and symptoms concerning for an acute basilar artery occlusion. If the Hounsfield unit density of the basilar artery exceeds 61 Hounsfield units, BAO should be highly suspected

Head-Neck Dual-energy CT Contrast Media Reduction Using Diffusion Models

Iodinated contrast media is essential for dual-energy computed tomography (DECT) angiography. Previous studies show that iodinated contrast media may cause side effects, and the interruption of the supply chain in 2022 led to a severe contrast media shortage in the US. Both factors justify the necessity of contrast media reduction in relevant clinical applications. In this study, we propose a diffusion model-based deep learning framework to address this challenge. First, we simulate different levels of low contrast dosage DECT scans from the standard normal contrast dosage DECT scans using material decomposition. Conditional denoising diffusion probabilistic models are then trained to enhance the contrast media and create contrast-enhanced images. Our results demonstrate that the proposed methods can generate high-quality contrast-enhanced results even for images obtained with as low as 12.5% of the normal contrast dosage. Furthermore, our method outperforms selected competing methods in a human reader study

Mount Malinao (Albay, Philippines) Revisited: Diversity and Ethnomedicinal Studies

Introduction:  This study provides information as to the diversity of plants in Mt. Malinao (Albay, Philippines) and their ethnomedicinal values. Methods:  Plants were collected by random sampling from three vegetation types, identified and measured for diversity indices.  The use reports and dosage preparations of medicinal plants sampled were confirmed by interview of local residents and forest guides. Results: The montane secondary dipterocarp forest gave the greatest plant diversity but recorded the lowest tree statistics.  Ethnomedicinal survey of the 70 plants collected have been qualified by generating information such as use values, fidelity levels, informant consensus factor and the modes by which dosage forms are prepared from these plants for use in various ailments. Conclusion:  This study gave important data on medicinal plants in Mt. Malinao which includes diversity, ethnomedicinal uses and dosage preparations.   Â

TLR7 gain-of-function genetic variation causes human lupus

Although circumstantial evidence supports enhanced Toll-like receptor 7 (TLR7) signalling as a mechanism of human systemic autoimmune disease evidence of lupus-causing TLR7 gene variants is lacking. Here we describe human systemic lupus erythematosus caused by a TLR7 gain-of-function variant. TLR7 is a sensor of viral RNA and binds to guanosine. We identified a de novo, previously undescribed missense TLR7Y264H variant in a child with severe lupus and additional variants in other patients with lupus. The TLR7Y264H variant selectively increased sensing of guanosine and 2',3'-cGMP1 and was sufficient to cause lupus when introduced into mice. We show that enhanced TLR7 signalling drives aberrant survival of B cell receptor (BCR)-activated B cells, and in a cell-intrinsic manner, accumulation of CD11c+ age-associated B cells and germinal centre B cells. Follicular and extrafollicular helper T cells were also increased but these phenotypes were cell-extrinsic. Deficiency of MyD88 (an adaptor protein downstream of TLR7) rescued autoimmunity, aberrant B cell survival, and all cellular and serological phenotypes. Despite prominent spontaneous germinal-centre formation in Tlr7Y264H mice, autoimmunity was not ameliorated by germinal-centre deficiency, suggesting an extrafollicular origin of pathogenic B cells. We establish the importance of TLR7 and guanosine-containing self-ligands for human lupus pathogenesis, which paves the way for therapeutic TLR7 or MyD88 inhibition

Role of Caustic Addition in Bitumen-Clay Interactions

Coating of bitumen by clays, known as slime coating, is detrimental to bitumen recovery from oil sands using the warm slurry extn. process. Sodium hydroxide (caustic) is added to the extn. process to balance many competing processing challenges, which include undesirable slime coating. The current research aims at understanding the role of caustic addn. in controlling interactions of bitumen with various types of model clays. The interaction potential was studied by quartz crystal microbalance with dissipation monitoring (QCM-D). After confirming the slime coating potential of montmorillonite clays on bitumen in the presence of calcium ions, the interaction of kaolinite and illite with bitumen was studied. To represent more closely the industrial applications, tailings water from bitumen extn. tests at different caustic dosage was used. At caustic dosage up to 0.5 wt % oil sands ore, a negligible coating of kaolinite on the bitumen was detd. However, at a lower level of caustic addn., illite was shown to attach to the bitumen, with the interaction potential decreasing with increasing caustic dosage. Increasing concn. of humic acids as a result of increasing caustic dosage was identified to limit the interaction potential of illite with bitumen. This fundamental study clearly shows that the crit. role of caustics in modulating interactions of clays with bitumen depends upon the type of clays. Thus, clay type was identified as a key operational variable

American Gut: an Open Platform for Citizen Science Microbiome Research

McDonald D, Hyde E, Debelius JW, et al. American Gut: an Open Platform for Citizen Science Microbiome Research. mSystems. 2018;3(3):e00031-18

A communal catalogue reveals Earth's multiscale microbial diversity

Our growing awareness of the microbial world's importance and diversity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community samples collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of diversity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth's microbial diversity.Peer reviewe

A communal catalogue reveals Earth’s multiscale microbial diversity

Our growing awareness of the microbial world’s importance and diversity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community samples collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of diversity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth’s microbial diversity