Decision Support for Intoxication Prediction Using Graph Convolutional Networks

Every day, poison control centers (PCC) are called for immediate classification and treatment recommendations if an acute intoxication is suspected. Due to the time-sensitive nature of these cases, doctors are required to propose a correct diagnosis and intervention within a minimal time frame. Usually the toxin is known and recommendations can be made accordingly. However, in challenging cases only symptoms are mentioned and doctors have to rely on their clinical experience. Medical experts and our analyses of a regional dataset of intoxication records provide evidence that this is challenging, since occurring symptoms may not always match the textbook description due to regional distinctions, inter-rater variance, and institutional workflow. Computer-aided diagnosis (CADx) can provide decision support, but approaches so far do not consider additional information of the reported cases like age or gender, despite their potential value towards a correct diagnosis. In this work, we propose a new machine learning based CADx method which fuses symptoms and meta information of the patients using graph convolutional networks. We further propose a novel symptom matching method that allows the effective incorporation of prior knowledge into the learning process and evidently stabilizes the poison prediction. We validate our method against 10 medical doctors with different experience diagnosing intoxication cases for 10 different toxins from the PCC in Munich and show our method's superiority in performance for poison prediction.Comment: 10 pages, 3 figure

New coil concept for endoluminal MR imaging: Initial results in staging of gastric carcinoma in correlation with Histopathology

Our aim was to conduct a prospective study to evaluate staging accuracy of a new coil concept for endoluminal magnetic resonance imaging (MRI) on ex vivo gastric carcinomas. Twenty-eight consecutive patients referred to surgery with a clinically proven primary gastric malignancy were included. Surgical specimens were examined with a foldable and self-expanding loop coil (8-cm diameter) at 1.5 Tesla immediately after total gastrectomy. T1- and T2-weighted and opposed-phase sequences (axial, frontal sections; 3- to 4-mm slice thickness) were acquired. Investigators blinded to any patient information analyzed signal intensity of normal gastric wall, gastric tumor, and lymph nodes. Findings were compared with histopathological staging. On surgical specimens, 2–5 gastric wall layers could be visualized. All gastric tumors (26 carcinomas, two lymphomas) were identified on endoluminal MR data (100%). Overall accuracy for T staging was 75% (18/24); sensitivity to detect serosal involvement was 80% and specificity 89%. N staging correlated in 58% (14/24) with histopathology (N+ versus N−). The endoluminal coil concept is feasible and applicable for an ex vivo setting. Endoluminal MR data provided sufficient detail for gastric wall layer differentiation, and therefore, identification of T stages in gastric carcinoma is possible. Further investigations in in vivo settings should explore the potential of our coil concept for endoluminal MR imaging

Reduction of anxiety-like and depression-like behaviors in rats after one month of drinking Aronia melanocarpa berry juice

The treatment of mood and anxiety disorders by nutraceuticals is gaining growing awareness. Berries of Aronia melanocarpa (Black chokeberry) and their extracts, exceptionally abundant in diverse phenolic compounds, have become famous for the highest in vitro antioxidant activity among fruits and notable health benefits (e.g. anti-diabetic, anti-inflammatory, cardioprotective). This study was designed to investigate the behavioral effects of month-long unlimited consumption of Aronia master juice (AJ) and/or juice reconstruct without polyphenols (RJ), in young male rats. AJ was initially evaluated for its content of phenolic compounds by spectrophotometric assays and HPLC-DAD. Rats that were supplied with three various water concentrations of AJ and RJ, respectively: 20% + 0% (ARO group), 5% + 15% (RAJ) and 0 + 20% (PLC), were compared with those which consumed only water (CTL). Daily drinking of AJ solution was significantly elevated from the second or third week onward, which was most expressed in the ARO group. Only this group displayed behavioral variations, manifested by certain hyperactivity in open field tests and prominent reductions of anxiety-like behaviors in the elevated plus maze. The ARO rats also expressed an alleviation of depression-like behavior in forced swimming tests. These findings demonstrate the beneficial behavioral effects of the one-month-long free drinking of phenolic-rich AJ in rats ( gt 20 ml per kg b. mass daily) that may be recognized as stimulating, anxiolytic-like and antidepressant-like. The in vitro assays suggested that MAO-A/MAO-B inhibitions by the phenolic compounds of AJ might be the possible in vivo mechanisms for such behavioral actions

Combining traditional dietary assessment methods with novel metabolomics techniques: present efforts by the Food Biomarker Alliance

FFQ, food diaries and 24 h recall methods represent the most commonly used dietary assessment tools in human studies on nutrition and health, but food intake biomarkers are assumed to provide a more objective reflection of intake. Unfortunately, very few of these biomarkers are sufficiently validated. This review provides an overview of food intake biomarker research and highlights present research efforts of the Joint Programming Initiative 'A Healthy Diet for a Healthy Life' (JPI-HDHL) Food Biomarkers Alliance (FoodBAll). In order to identify novel food intake biomarkers, the focus is on new food metabolomics techniques that allow the quantification of up to thousands of metabolites simultaneously, which may be applied in intervention and observational studies. As biomarkers are often influenced by various other factors than the food under investigation, FoodBAll developed a food intake biomarker quality and validity score aiming to assist the systematic evaluation of novel biomarkers. Moreover, to evaluate the applicability of nutritional biomarkers, studies are presently also focusing on associations between food intake biomarkers and diet-related disease risk. In order to be successful in these metabolomics studies, knowledge about available electronic metabolomics resources is necessary and further developments of these resources are essential. Ultimately, present efforts in this research area aim to advance quality control of traditional dietary assessment methods, advance compliance evaluation in nutritional intervention studies, and increase the significance of observational studies by investigating associations between nutrition and health. Keywords: Dietary assessment; Food intake biomarkers; Food metabolome; Metabolomics

Antioxidative protection of dietary bilberry, chokeberry and Lactobacillus plantarum HEAL19 in mice subjected to intestinal oxidative stress by ischemia-reperfusion

<p>Abstract</p> <p>Background</p> <p>Ischemia-reperfusion (I/R) in the intestines is an inflammatory condition which activates leukocytes and reactive oxygen species (ROS) and leads to lipid peroxidation and DNA damage. Bilberry and chokeberry fruits are rich sources of polyphenols which may act as antioxidants and prevent lipid peroxidation. Lactic acid bacteria (LAB) may improve microbial status in the intestines and increase the metabolic activity towards polyphenolic degradation. The aim of the study was to clarify antioxidative effects of bilberry and chokeberry fruits alone and with addition of a LAB-strain, <it>Lactobacillus plantarum </it>HEAL19, in an I/R-model in mice.</p> <p>Methods</p> <p>Male BALB/cJ mice were fed the experimental diets for 10 days. Diets consisted of standard chow supplemented with either bilberry (<it>Vaccinium myrtillus</it>) or chokeberry (<it>Aronia × prunifolia</it>) powder alone or in combination with the LAB-strain <it>Lactobacillus plantarum </it>HEAL19. I/R-injury was induced by holding superior mesenteric artery clamped for 30 minutes followed by reperfusion for 240 minutes. Thereafter, colonic and caecal tissues and contents were collected. Malondialdehyde (MDA) was used as indicator of lipid peroxidation and was measured by a calorimetric assay, lactobacilli were cultured on Rogosa agar plates and <it>Enterobacteriaceae </it>on VRBG agar plates, anthocyanins and phenolic acids were analysed by HPLC-DAD-ESI-MSn.</p> <p>Results</p> <p>MDA was significantly decreased in the colon of groups fed bilberry alone (p = 0.030) and in combination with <it>L. plantarum </it>HEAL19 (p = 0.021) compared to the IR-control but not in chokeberry-fed groups. Supplementation with bilberry or chokeberry alone reduced the total number of lactobacilli on the mucosa. Higher concentrations of anthocyanins were found in the colon than in the caecum content of mice. A more varied composition of different anthocyanins was also observed in the colon content compared to the caecum of bilberry-fed mice. Phenolic acids formed by microbial degradation of the dietary polyphenols in the gut could be detected. More phenolic metabolites were found in the intestines of bilberry-fed mice than in the chokeberry-fed ones.</p> <p>Conclusions</p> <p>Bilberry alone and in combination with <it>L. plantarum </it>HEAL19 exerts a better protection against lipid peroxidation than chokeberry. These dietary supplements may be used to prevent or suppress oxidative stress.</p