SPECTRAL CLUSTERING BASED PARCELLATION OF FETAL BRAIN MRI

Many neuroimaging studies are based on the idea that there are distinct brain regions that are functionally or micro-anatomically homogeneous. Obtaining such regions in an au-tomatic way is a challenging task for fetal data due to the lack of strong and consistent anatomical features at the early stages of brain development. In this paper we propose the use of an automatic approach for parcellating fetal cerebral hemi-spheric surfaces into K regions via spectral clustering. Unlike previous methods, our technique has the crucial advantage of only relying on intrinsic geometrical properties of the corti-cal surface and thus being unsupervised. Results on a data-set of fetal brain MRI acquired in utero demonstrated a convinc-ing parcellation reproducibility of the cortical surfaces across fetuses with varying gestational ages and folding magnitude

White matter maturation of normal human fetal brain. An in vivo diffusion tensor tractography study

We demonstrate for the first time the ability to determine in vivo and in utero the transitions between the main stages of white matter (WM) maturation in normal human fetuses using magnetic resonance diffusion tensor imaging (DTI) tractography. Biophysical characteristics of water motion are used as an indirect probe to evaluate progression of the tissue matrix organization in cortico-spinal tracts (CSTs), optic radiations (OR), and corpus callosum (CC) in 17 normal human fetuses explored between 23 and 38 weeks of gestation (GW) and selected strictly on minimal motion artifacts. Nonlinear polynomial (third order) curve fittings of normalized longitudinal and radial water diffusivities (Z-scores) as a function of age identify three different phases of maturation with specific dynamics for each WM bundle type. These phases may correspond to distinct cellular events such as axonal organization, myelination gliosis, and myelination, previously reported by other groups on post-mortem fetuses using immunostaining methods. According to the DTI parameter dynamics, we suggest that myelination (phase 3) appears early in the CSTs, followed by the OR and by the CC, respectively. DTI tractography provides access to a better understanding of fetal WM maturation

MR imaging of adult acute infectious encephalitis

International audienceBackground. – Imaging is a key tool for the diagnosis of acute encephalitis. Brain CT scan must be urgently performed to rule out a brain lesion with mass effect that would contraindicate lumbar puncture. Brain MRI is less accessible than CT scan, but can provide crucial information with patients presenting with acute encephalitis.Method. – We performed a literature review on PubMed on April 1, 2015 with the search terms " MRI " and " encephalitis ".Results. – We first described the various brain MRI abnormalities associated with each pathogen of acute encephalitis (HSV, VZV, other viral agents targeting immunocompromised patients or travelers; tuberculosis, listeriosis, other less frequent bacterial agents). Then, we identified specific patterns of brain MRI abnomalies that may suggest a particular pathogen. Limbic encephalitis is highly suggestive of HSV; it also occurs less frequently in encephalitis due to HHV6, syphillis, Whipple's disease and HIV primary infection. Rhombencephalitis is suggestive of tuberculosis and listeriosis. Acute ischemic lesions can occur in patients presenting with severe bacterial encephalitis, tuberculosis, VZV encephalitis, syphilis, and fungal infections. Conclusion. – Brain MRI plays a crucial role in the diagnosis of acute encephalitis. It detects brain signal changes that reinforce the clinical suspicion of encephalitis, especially when the causative agent is not identified by lumbar puncture; it can suggest a particular pathogen based on the pattern of brain abnormalities and it rules out important differential diagnosis (vascular, tumoral or inflammatory causes).Introduction. – L'imagerie cérébrale est essentielle au diagnostic d'encéphalite aiguë. Le scanner cérébral doit être réalisé en urgence afin d'exclure une lésion cérébrale avec effet de masse qui contre-indiquerait la ponction lombaire. L'IRM cérébrale est moins accessible que le scanner, mais peut apporter des informations importantes en cas d'encéphalite aiguë.Méthode. – Revue de la littérature sur PubMed le 1 er avril 2015 avec les mots clés « IRM » et « encéphalite ».Résultats. – Nous décrivons les différentes anomalies IRM associées à chaque agent pathogène de l'encéphalite aiguë (HSV, VZV, autres virus ciblant les patients immunodéprimés ou voyageurs ; tuberculose, listériose, autres agents bactériens moins fréquents). Nous identifions des patterns spécifiques d'anomalies IRM qui peuvent orienter vers un pathogène particulier. L'encéphalite limbique est très évocatrice de l'HSV ; elle survient aussi moins fréquemment dans les encéphalites dues au HHV6, à la syphilis, à la maladie de Whipple et à la primo-infection par le VIH. Une rhombencéphalite doit fait rechercher la tuberculose et la listériose. Des lésions ischémiques aiguës peuvent survenir chez des patients atteints d'encéphalite bactérienne grave, de tuberculose, d'encéphalite à VZV, de syphilis et d'infections fongiques

Comparative studies on water governance: a systematic review

Governance is key to tackle water challenges and transform water management under the increasing pressures of competing water uses and climate change. Diverse water governance regimes have evolved in different countries and regions to regulate the development and management of water resources and the provision of water services. Scholars and policy analysts have been comparing these water governance regimes to analyze elements and processes, to assess performance, or to draw lessons. While the number of such studies has increased over the past decades, no comprehensive synthesis exists. This paper aims to present such a synthesis through conducting a systematic review of the emerging field of comparative water governance studies, and critically reflecting on how water governance is defined, conceptualized and assessed in different contexts. Based on the insights that this review brings about, we identify four areas for future research: 1) improving the balance between small-N, medium-N and large-N studies that are applied for comparative studies on water governance, 2) conducting longitudinal comparisons of water governance in order to identify temporal governance trends and patterns 3) expanding the geographical coverage of the comparisons to include underrepresented countries and regions, focusing more broadly on the Global South 4) addressing the issues of justice, equity and power, which are becoming increasingly important in tackling the water governance challenges that are exacerbated by the impacts of climate change, industrialization and urbanization

European recommendations on practices in pediatric neuroradiology: consensus document from the European Society of Neuroradiology (ESNR), European Society of Paediatric Radiology (ESPR) and European Union of Medical Specialists Division of Neuroradiology (UEMS)

Pediatric neuroradiology is a subspecialty within radiology, with possible pathways to train within the discipline from neuroradiology or pediatric radiology. Formalized pediatric neuroradiology training programs are not available in most European countries. We aimed to construct a European consensus document providing recommendations for the safe practice of pediatric neuroradiology. We particularly emphasize imaging techniques that should be available, optimal site conditions and facilities, recommended team requirements and specific indications and protocol modifications for each imaging modality employed for pediatric neuroradiology studies. The present document serves as guidance to the optimal setup and organization for carrying out pediatric neuroradiology diagnostic and interventional procedures. Clinical activities should always be carried out in full agreement with national provisions and regulations. Continued education of all parties involved is a requisite for preserving pediatric neuroradiology practice at a high level

Differential impact of drugs on the outcome of ETV6-RUNX1 positive childhood B-cell precursor acute lymphoblastic leukaemia : results of the EORTC CLG 58881 and 58951 trials

info:eu-repo/semantics/publishe

Early formation and recent starburst activity in the nuclear disk of the Milky Way

The nuclear disk is a dense stellar structure at the centre of the Milky Way, with a radius of ~150 pc (ref. 1). It has been a place of intense star formation in the past several tens of millions of years1-3, but its overall formation history has remained unknown2. Here, we report that the bulk of its stars formed at least 8 Gyr ago. After a long period of quiescence, a starburst event followed about 1 Gyr ago that formed roughly 5% of its mass within ~100 Myr, in what may arguably have been one of the most energetic events in the history of the Milky Way. Star formation continued subsequently on a lower level, creating a few per cent of the stellar mass in the past ~500 Myr, with an increased rate up to ~30 Myr ago. Our findings contradict the previously accepted paradigm of quasi-continuous star formation at the Galactic Centre4. The long quiescent phase agrees with the overall quiescent history of the Milky Way2,5 and suggests that our Galaxy's bar may not have existed until recently, or that gas transport through the bar was extremely inefficient during a long stretch of the Milky Way's life. Consequently, the central black hole may have acquired most of its mass already in the early days of the Milky Way

Genome-Wide Interrogation of Mammalian Stem Cell Fate Determinants by Nested Chromosome Deletions

Understanding the function of important DNA elements in mammalian stem cell genomes would be enhanced by the availability of deletion collections in which segmental haploidies are precisely characterized. Using a modified Cre-loxP–based system, we now report the creation and characterization of a collection of ∼1,300 independent embryonic stem cell (ESC) clones enriched for nested chromosomal deletions. Mapping experiments indicate that this collection spans over 25% of the mouse genome with good representative coverage of protein-coding genes, regulatory RNAs, and other non-coding sequences. This collection of clones was screened for in vitro defects in differentiation of ESC into embryoid bodies (EB). Several putative novel haploinsufficient regions, critical for EB development, were identified. Functional characterization of one of these regions, through BAC complementation, identified the ribosomal gene Rps14 as a novel haploinsufficient determinant of embryoid body formation. This new library of chromosomal deletions in ESC (DelES: http://bioinfo.iric.ca/deles) will serve as a unique resource for elucidation of novel protein-coding and non-coding regulators of ESC activity

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Apport des techniques avancées d'IRM dans le diagnostic des masses intracérébrales de l'enfant

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-Bib. Serv.Santé Armées (751055204) / SudocSudocFranceF