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Post-mortem culture of Balamuthia mandrillaris from the brain and cerebrospinal fluid of a case of granulomatous amoebic meningoencephalitis, using human brain microvascular endothelial cells

The first isolation in the UK of Balamuthia mandrillaris amoebae from a fatal case of granulomatous amoebic meningoencephalitis is reported. Using primary cultures of human brain microvascular endothelial cells (HBMECs), amoebae were isolated from the brain and cerebrospinal fluid (CSF). The cultures showed a cytopathic effect at 20–28 days, but morphologically identifiable B. mandrillaris amoebae were seen in cleared plaques in subcultures at 45 days. The identification of the organism was later confirmed using PCR on Chelex-treated extracts. Serum taken while the patient was still alive reacted strongly with slide antigen prepared from cultures of the post-mortem isolate, and also with those from a baboon B. mandrillaris strain at 1 : 10 000 in indirect immunofluorescence, but with Acanthamoeba castellanii (Neff) at 1 : 160, supporting B. mandrillaris to be the causative agent. If the presence of amoebae in the post-mortem CSF reflects the condition in life, PCR studies on CSF and on biopsies of cutaneous lesions may also be a valuable tool. The role of HBMECs in understanding the interactions of B. mandrillaris with the blood–brain barrier is discussed

Toxicological inhalation studies in rats to substantiate grouping of zinc oxide nanoforms

Background Significant variations exist in the forms of ZnO, making it impossible to test all forms in in vivo inhalation studies. Hence, grouping and read-across is a common approach under REACH to evaluate the toxicological profile of familiar substances. The objective of this paper is to investigate the potential role of dissolution, size, or coating in grouping ZnO (nano)forms for the purpose of hazard assessment. We performed a 90-day inhalation study (OECD test guideline no. (TG) 413) in rats combined with a reproduction/developmental (neuro)toxicity screening test (TG 421/424/426) with coated and uncoated ZnO nanoforms in comparison with microscale ZnO particles and soluble zinc sulfate. In addition, genotoxicity in the nasal cavity, lungs, liver, and bone marrow was examined via comet assay (TG 489) after 14-day inhalation exposure. Results ZnO nanoparticles caused local toxicity in the respiratory tract. Systemic effects that were not related to the local irritation were not observed. There was no indication of impaired fertility, developmental toxicity, or developmental neurotoxicity. No indication for genotoxicity of any of the test substances was observed. Local effects were similar across the different ZnO test substances and were reversible after the end of the exposure. Conclusion With exception of local toxicity, this study could not confirm the occasional findings in some of the previous studies regarding the above-mentioned toxicological endpoints. The two representative ZnO nanoforms and the microscale particles showed similar local effects. The ZnO nanoforms most likely exhibit their effects by zinc ions as no particles could be detected after the end of the exposure, and exposure to rapidly soluble zinc sulfate had similar effects. Obviously, material differences between the ZnO particles do not substantially alter their toxicokinetics and toxicodynamics. The grouping of ZnO nanoforms into a set of similar nanoforms is justified by these observations

A robust multi-watermarking algorithm for medical images based on DTCWT-DCT and Henon map

To resolve the contradiction between existing watermarking methods—which are not compatible with the watermark’s ability to resist geometric attacks—and robustness, a robust multi-watermarking algorithm suitable for medical images is proposed. First, the visual feature vector of the medical image was obtained by dual-tree complex wavelet transform and discrete cosine transform (DTCWT-DCT) to perform multi-watermark embedding and extraction. Then, the multi-watermark was pre-processed using the Henon map chaotic encryption technology to strengthen the security of watermark information, and combined with the concept of zero watermark to make the watermark able to resist both conventional and geometric attacks. Experimental results show that the proposed algorithm can effectively extract watermark information; it implements zero watermarking and blind extraction. Compared with existing watermark technology, it has good performance in terms of its robustness and resistance to geometric attacks and conventional attacks, especially in geometric attacks

Robust watermarking algorithm for medical volume data in internet of medical things

The advancement of 5G technology, big data and cloud storage has promoted the rapid development of the Internet of Medical Things (IoMT). Based on the strict security requirements and high level of accuracy required for disease diagnosis and pathological analysis, 3D medical volume data have been created in large numbers. The IoMT facilitates the rapid transfer of medical information and also makes the protection of pathological information and privacy information of patients increasingly prominent. To solve the security problem, a robust zero-watermarking algorithm based on 3D hyperchaos and 3D dual-tree complex wavelet transform is proposed according to the selected feature of medical volume data. The feature combines human visual features with improved perceptual hashing techniques. It is a robust and efficient binary sequence. When implementing the proposed algorithm, the watermark is first scrambled with 3D hyperchaos to enhance security. Then, 3D DTCWT-DCT transformation is applied to medical volume data, and the low-frequency coefficients that can represent the features are selected and binarized to generate the secret key to complete the watermark embedding and extraction. Zero embedding and blind extraction ensure that the original medical volume data is not altered in any form, which meets the special requirements for diagnosis. Simulation results show that the algorithm is robust and can effectively resist common attacks and geometric attacks. It used fewer robust features to effectively bound medical volume data and watermark information, saved bandwidth, and satisfied the security of transmission and storage of medical volume data in the Internet of medical things. In particular, compared with state-of-the-art technology, the proposed algorithm improves the average NC value by 46.67% under geometric attacks

Prevalence of depression among university students in low and middle income countries (LMICs): a systematic review and meta-analysis

Introduction Though university years are peak time for the onset of many mental health problems including depression, knowledge on the prevalence of depressive symptoms among university students in low and middle-income countries (LMICs) is limited. This study examined the prevalence of depressive symptoms among university students in LMICs. Methods We systematically searched PubMed, Web of Science, and WHO Global Health Library for studies published between January 1, 2009 and December 31, 2018. Cross-sectional and longitudinal studies conducted in LMICs (as defined by World Bank), having a sample size≥500 and published in English were identified. Data on study characteristics and prevalence of depressive symptoms was extracted by two investigators. Estimate of prevalence was pooled in meta-analysis using random-effects meta-analysis. Sub-group differences were estimated using mixed-effects meta-analysis and meta-regression. Results Depressive symptoms prevalence data were extracted from 37 studies involving 76,608 individuals in 20 countries. Studies on depression among university students in LMICs were limited, and most were based on non-representative and small study samples. The overall prevalence of depressive symptoms was 24.4% (95% CI, 19.2% -30.5%). Subgroup analysis revealed that the prevalence did not vary by study design, sampling technique, sample size, study major, educational level, economic regions, and screening instrument. Limitations Only English language studies were included. Included studies were diverse in design, screening tool, and sample size that introduced substantial heterogeneity. Conclusion Overall prevalence of depressive symptoms among university students in LMICs was 24.4%, however, finding should be interpreted with caution. Further research is needed to address the issue

Replication of LDL SWAs hits in PROSPER/PHASE as validation for future (pharmaco)genetic analyses

<p><b>Background:</b> The PHArmacogenetic study of Statins in the Elderly at risk (PHASE) is a genome wide association study in the PROspective Study of Pravastatin in the Elderly at risk for vascular disease (PROSPER) that investigates the genetic variation responsible for the individual variation in drug response to pravastatin. Statins lower LDL-cholesterol in general by 30%, however not in all subjects. Moreover, clinical response is highly variable and adverse effects occur in a minority of patients. In this report we first describe the rationale of the PROSPER/PHASE project and second show that the PROSPER/PHASE study can be used to study pharmacogenetics in the elderly.</p> <p><b>Methods:</b> The genome wide association study (GWAS) was conducted using the Illumina 660K-Quad beadchips following manufacturer's instructions. After a stringent quality control 557,192 SNPs in 5,244 subjects were available for analysis. To maximize the availability of genetic data and coverage of the genome, imputation up to 2.5 million autosomal CEPH HapMap SNPs was performed with MACH imputation software. The GWAS for LDL-cholesterol is assessed with an additive linear regression model in PROBABEL software, adjusted for age, sex, and country of origin to account for population stratification.</p> <p><b>Results:</b> Forty-two SNPs reached the GWAS significant threshold of p = 5.0e-08 in 5 genomic loci (APOE/APOC1; LDLR; FADS2/FEN1; HMGCR; PSRC1/CELSR5). The top SNP (rs445925, chromosome 19) with a p-value of p = 2.8e-30 is located within the APOC1 gene and near the APOE gene. The second top SNP (rs6511720, chromosome 19) with a p-value of p = 5.22e-15 is located within the LDLR gene. All 5 genomic loci were previously associated with LDL-cholesterol levels, no novel loci were identified. Replication in WOSCOPS and CARE confirmed our results.</p> <p><b>Conclusion:</b> With the GWAS in the PROSPER/PHASE study we confirm the previously found genetic associations with LDL-cholesterol levels. With this proof-of-principle study we show that the PROSPER/PHASE study can be used to investigate genetic associations in a similar way to population based studies. The next step of the PROSPER/PHASE study is to identify the genetic variation responsible for the variation in LDL-cholesterol lowering in response to statin treatment in collaboration with other large trials.</p&gt

Should physical activity recommendations be ethnicity-specific? Evidence from a cross-sectional study of south Asian and European men

Background Expert bodies and health organisations recommend that adults undertake at least 150 min.week−1 of moderate-intensity physical activity (MPA). However, the underpinning data largely emanate from studies of populations of European descent. It is unclear whether this level of activity is appropriate for other ethnic groups, particularly South Asians, who have increased cardio-metabolic disease risk compared to Europeans. The aim of this study was to explore the level of MPA required in South Asians to confer a similar cardio-metabolic risk profile to that observed in Europeans undertaking the currently recommended MPA level of 150 min.week−1.<p></p> Methods Seventy-five South Asian and 83 European men, aged 40–70, without cardiovascular disease or diabetes had fasted blood taken, blood pressure measured, physical activity assessed objectively (using accelerometry), and anthropometric measures made. Factor analysis was used to summarise measured risk biomarkers into underlying latent ‘factors’ for glycaemia, insulin resistance, lipid metabolism, blood pressure, and overall cardio-metabolic risk. Age-adjusted regression models were used to determine the equivalent level of MPA (in bouts of ≥10 minutes) in South Asians needed to elicit the same value in each factor as Europeans undertaking 150 min.week−1 MPA.<p></p> Findings For all factors, except blood pressure, equivalent MPA values in South Asians were significantly higher than 150 min.week−1; the equivalent MPA value for the overall cardio-metabolic risk factor was 266 (95% CI 185-347) min.week−1.<p></p> Conclusions South Asian men may need to undertake greater levels of MPA than Europeans to exhibit a similar cardio-metabolic risk profile, suggesting that a conceptual case can be made for ethnicity-specific physical activity guidance. Further study is needed to extend these findings to women and to replicate them prospectively in a larger cohort.<p></p&gt

A novel robust watermarking algorithm for encrypted medical image based on DTCWT-DCT and chaotic map

In order to solve the problem of patient information security protection in medical images, whilst also taking into consideration the unchangeable particularity of medical images to the lesion area and the need for medical images themselves to be protected, a novel robust watermarking algorithm for encrypted medical images based on dual-tree complex wavelet transform and discrete cosine transform (DTCWT-DCT) and chaotic map is proposed in this paper. First, DTCWT-DCT transformation was performed on medical images, and dot product was per-formed in relation to the transformation matrix and logistic map. Inverse transformation was undertaken to obtain encrypted medical images. Then, in the low-frequency part of the DTCWT-DCT transformation coefficient of the encrypted medical image, a set of 32 bits visual feature vectors that can effectively resist geometric attacks are found to be the feature vector of the encrypted medical image by using perceptual hashing. After that, different logistic initial values and growth parameters were set to encrypt the watermark, and zero-watermark technology was used to embed and extract the encrypted medical images by combining cryptography and third-party concepts. The proposed watermarking algorithm does not change the region of interest of medical images thus it does not affect the judgment of doctors. Additionally, the security of the algorithm is enhanced by using chaotic mapping, which is sensitive to the initial value in order to encrypt the medical image and the watermark. The simulation results show that the pro-posed algorithm has good homomorphism, which can not only protect the original medical image and the watermark information, but can also embed and extract the watermark directly in the encrypted image, eliminating the potential risk of decrypting the embedded watermark and extracting watermark. Compared with the recent related research, the proposed algorithm solves the contradiction between robustness and invisibility of the watermarking algorithm for encrypted medical images, and it has good results against both conventional attacks and geometric attacks. Under geometric attacks in particular, the proposed algorithm performs much better than existing algorithms