Gene Ontology curation of the blood-brain barrier to improve the analysis of Alzheimer's and other neurological diseases.

Funder: National Institute for Health Research University College London Hospitals Biomedical Research CentreThe role of the blood-brain barrier (BBB) in Alzheimer's and other neurodegenerative diseases is still the subject of many studies. However, those studies using high-throughput methods have been compromised by the lack of Gene Ontology (GO) annotations describing the role of proteins in the normal function of the BBB. The GO Consortium provides a gold-standard bioinformatics resource used for analysis and interpretation of large biomedical data sets. However, the GO is also used by other research communities and, therefore, must meet a variety of demands on the breadth and depth of information that is provided. To meet the needs of the Alzheimer's research community we have focused on the GO annotation of the BBB, with over 100 transport or junctional proteins prioritized for annotation. This project has led to a substantial increase in the number of human proteins associated with BBB-relevant GO terms as well as more comprehensive annotation of these proteins in many other processes. Furthermore, data describing the microRNAs that regulate the expression of these priority proteins have also been curated. Thus, this project has increased both the breadth and depth of annotation for these prioritized BBB proteins. Database URLhttps://www.ebi.ac.uk/QuickGO/

The value of decision making methodology in increasing the diagnostic accuracy of endometrial cytology

OBJECTIVE: Endometrial cytology could be an alternative perspective for the diagnosis of endometrial cancer. Objective of this study is to investigate the potential of an Artificial Neural Network (ANN) based on Multi Layer Perceptron (MPL), for the discrimination of benign from malignant endometrial nuclei and lesions. Secondary it is examined the potential risk factors for strenuousness in endometrial cytology sampling. STUDY DESIGN: 416 histological confirmed liquid based cytological smears were collected, specifically: 117 within normal limits cases, 66 malignant cases, 37 hyperplasias without atypia and 8 cases of hyperplasia with atypia. From each case were extracted nuclear morphometric features from about 90 nuclei using a custom image analysis system. Subsequently nuclei from 50% of the cases were used to train an MPL ANN model that classified each nucleus as benign or malignant. The remaining data from the 50% of the cases were used to evaluate the ANN performance and stability on unknown data. Based on the results of nucleus classification process are proposed two algorithms to discriminate endometrium cases as benign or malignant. A subgroup of 181 women participated in the secondary study. Strenuousness in obtaining the sample was graded into a five-level scale-score. Various parameters were assessed in association with the strenuousness score. Multivariate ordinal logistic regression analysis was performed. RESULTS: The ANN-MPL had an overall accuracy for the classification of endometrial nuclei equal to 83.02%, specificity 85.09% and sensitivity 77.01%. For the case classification the overall accuracy was 92.98%, specificity 92.86% and sensitivity 93.24%. As far as the secondary study is concerned, postmenopausal status (adjusted OR=2.63, 95%CI: 1.52-4.56, p=0.001) and previous invasive/surgical procedures in the cervix (adjusted OR=2.15, 95%CI: 1.10-4.24, p=0.026) were associated with higher strenuousness score. Participants’ age at sampling, phase of the menstrual cycle, endometrial thickness, obesity, current hormonal use and the reproductive history of women were not significantly associated with the strenuousness of the procedure. CONCLUSION: Computerized systems based on ANNs have the potential to be used for the classification of endometrial nuclei and lesions. Increased difficulty during endometrial sampling is noted in postmenopausal women, and in patients with previous surgical procedures in the cervix.ΣΚΟΠΟΣ: H κυτταρολογία του ενδομητρίου θα μπορούσε να είναι μια εναλλακτική μέθοδος για τη διάγνωση του καρκίνου του ενδομητρίου. Στόχος της παρούσας μελέτης είναι να διερευνήσει τις δυνατότητες ενός Πολυστρωματικού Τεχνητού Νευρωνικού Δικτύου με Νευρώνες Perceptron (ΤΝΔ- MPL), για τη διάκριση μεταξύ καλοήθων από κακοήθων πυρήνες ενδομητρικών κυττάρων και τις συνοδές αλλοιώσεις. Δευτερευόντως εξετάζονται οι πιθανοί παράγοντες κινδύνου για τη δυσκολία στη δειγματοληψία της ενδομητρίου κυτταρολογίας. ΣΧΕΔΙΑΣΜΟΣ ΜΕΛΕΤΗΣ: 416 ιστολογικά επιβεβαιωμένα δείγματα συλλέχθηκαν με κυτταρολογία υγρής φάσης και συγκεκριμένα: 117 περιπτώσεις εντός των φυσιολογικών ορίων, 66 περιπτώσεις κακοήθειας, 37 με υπερπλασία χωρίς ατυπία και 8 περιπτώσεις υπερπλασίας με ατυπία. Από κάθε περίπτωση εξήχθησαν πυρηνικά μορφομετρικά χαρακτηριστικά από περίπου 90 πυρήνες χρησιμοποιώντας ένα προσαρμοσμένο σύστημα ανάλυσης εικόνας. Στη συνέχεια, οι πυρήνες από το 50% των περιπτώσεων χρησιμοποιήθηκαν για την κατάρτιση ενός μοντέλου ΤΝΔ-MPL που ταξινομεί τον κάθε πυρήνα ως καλοήθη ή κακοήθη. Τα υπόλοιπα δεδομένα από το 50% των περιπτώσεων χρησιμοποιήθηκαν για την αξιολόγηση της απόδοσης του ΤΝΔ-MPL και τη σταθερότητα της απόδοσής του σε άγνωστα δεδομένα. Με βάση τα αποτελέσματα της διαδικασίας ταξινόμησης των πυρήνων προτάθηκαν δύο αλγόριθμοι για την ταξινόμηση των ενδομητρικών κυττάρων ως καλοήθη ή κακοήθη. Μία υποομάδα 181 γυναίκες συμμετείχε στη δευτερεύουσα μελέτη. Η δυσκολία στη λήψη του δείγματος βαθμολογήθηκε σε πέντε επίπεδα της κλίμακας βαθμολογίας. Διάφορες παράμετροι αξιολογήθηκαν σε συνδυασμό με το βαθμό δυσκολίας. Κατά την πολυμεταβλητή ανάλυση, τελέστηκε λογιστική παλινδρόμηση για διατάξιμες μεταβλητές (ordinal logistic regression), με την κλίμακα δυσκολίας να τίθεται ως εξαρτημένη μεταβλητή. ΑΠΟΤΕΛΕΣΜΑΤΑ: Το ΤΝΔ-MPL είχε μια συνολική ακρίβεια για την κατάταξη των πυρήνων του ενδομητρίου ίση με 83,02%, ειδικότητα 85,09% και 77,01% ευαισθησία. Για την περίπτωση ταξινόμησης, η συνολική ακρίβεια ήταν 92,98%, 92,86% ειδικότητα και ευαισθησία 93,24%. Όσον αφορά στη δευτερεύουσα μελέτη, η μετεμμηνοπαυσιακή κατάσταση (προσαρμογή OR = 2,63, 95% CI: 1,52-4,56, p = 0,001) και οι προηγηθείσες παρεμβάσεις και χειρουργικές επεμβάσεις στον τράχηλο της μήτρας (προσαρμογή OR = 2,15, 95% CI: 1,10- 4,24, p = 0,026) συσχετίστηκαν με την υψηλότερη βαθμολογία δυσκολίας. Η ηλικία των συμμετεχουσών κατά τη δειγματοληψία, η φάση του κύκλου της εμμήνου ρύσεως, το πάχος του ενδομητρίου, η παχυσαρκία, η τρέχουσα χρήση ορμονών και το μαιευτικό αναμνηστικό των γυναικών δεν σχετίστηκαν σημαντικά με τη δυσκολία της διαδικασίας. ΣΥΜΠΕΡΑΣΜΑ: Τα ηλεκτρονικά συστήματα που βασίζονται σε ΤΝΔ έχουν τη δυνατότητα να χρησιμοποιούνται για την κατάταξη των πυρήνων του ενδομητρίου και των σχετικών βλαβών. Αυξημένη δυσκολία κατά τη διάρκεια της δειγματοληψίας κυτταρολογίας του ενδομητρίου σημειώνεται σε μετεμμηνοπαυσιακές γυναίκες και σε ασθενείς με προηγούμενες χειρουργικές επεμβάσεις στον τράχηλο της μήτρας

Community-Associated Staphylococcus aureus Infections: Pneumonia

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging health problem with distinct epidemiology. CA-MRSA colonization and infection is associated with risk factors different from healthcare-associated methicillin-resistant S. aureus infection. CA-MRSA strains pre­sent different characteristics to healthcare associated strains in terms of microbiology as well. Moreover, infection as a result of CA-MRSA may be associated with severe infections, in particular necrotizing pneumonia. CA-MRSA strains may produce Panton-Valentine leukocidin, a protein that available data suggest to be associated with the severity of the infection. Although the incidence of CA-MRSA pneumonia is relatively low, it affects mostly young, immunocompetent individuals, and in this respect constitutes a serious and potentially lethal form of community-acquired pneumonia. Current treatment suggested by international consensus guidelines includes linezolid or vancomycin often combined with clindamycin and/or rifampicin. However, clinical studies are required to clarify further therapeutic issues on timing, dosing, and choice of optimum treatment, and whether new therapeutic strategies such as vaccination and immunoglobulins could be useful. In the present review we discuss the microbiology, epidemiology, pathogenesis, and clinical aspects of community-acquired pneumonia as a result of CA-MRSA in respect of management and prevention

Traumatic spinal cord and spinal column injuries: A bibliometric analysis of the 200 most cited articles

Study Design: Bibliometric analysis. Objectives: This study aimed to highlight the 200 most influential articles related to traumatic spinal cord and spinal column injuries and provide an insight of past and current global trends in spinal trauma research. Methods: The Web of Science database was used to identify the top 200 most cited articles on the topic of traumatic spinal cord injury (SCI) and spinal column injuries between using a prespecified algorithm. The articles were manually reviewed; bibliometrics were collected on title, first and corresponding authors' country, institution, journal, publication year, and citation data. Results: The search string yielded 30,551 articles during 1977–2019. The average time from the publication was 19.5 years. A total of 1356 authors contributed to 67 different journals, the top 200 most cited articles amassing a total of 88,115 citations and an average 440.6 citations. The United States of America (USA) contributed the most with 110 articles; the top institution was the University of Toronto with 34 publications. Most studies focused on basic science research on SCI. Keyword analysis revealed the most commonly used keywords: SCI, inflammation, apoptosis, incidence/prevalence, and regeneration; four word-clusters were identified. Institutions from the USA and Canada collaborated the most and two major and two minor institutional collaboration subnetworks were identified. Co-citation analysis detected three main clusters of authors. Conclusion: This overview of the most cited articles on traumatic spinal cord and spinal column injuries provides insight into the international spinal trauma community and the terrain in this field, potentially acting as a springboard for further collaboration development

Giving Birth After Fertility Sparing Treatment for a Yolk Sac Tumour: Case Report

Yolk Sac Tumours (YSTs) of the ovary, also called Endodermal Sinus Tumours (ESTs), are the second most common Malignant Ovarian Germ Cell Tumours (MOGCTs), after dysgerminomas. YSTs occur primarily in children and young women. We present a case report of a 20-year-old woman who had been diagnosed with YST (tumour diameter of 29 cm). The patient underwent fertility sparing surgery and was subsequently treated with adjuvant chemotherapy (four cycles of bleomycin, etoposide and cisplatin). Two years after the diagnosis of YST, she successfully gave birth to a healthy girl (birth weight 3,500 g, Apgar score of 9-10 and a spontaneous vaginal delivery). During pregnancy, she had microscopic hematuria and bilateral nephrolithiasis, was ultrasonographically diagnosed. The conception after fertility sparing treatment of YST is possible and the birth of a healthy child is feasible. There are no current guidelines for surveillance of such patients during pregnancy; however, structured pregnancy surveillance in such survivors seems necessary

Abdominal Tumor in a 14-Year-Old Adolescent: Imperforate Hymen, Resulting in Hematocolpos—A Case Report and Review of the Literature

Background. Abdominal masses in female adolescents are uncommon. A rare cause of this condition is hematocolpos due to imperforate hymen. Case. We present a case of an unusually massive asymptomatic abdominal bulk in a 14-year-old female patient, who sought for medical advice after unusual abdominal pain lasting for few weeks. The patient was otherwise asymptomatic, apart from an unusual dramatic expansion of her abdominal wall during the last month. We describe the surgical management and the follow-up of the patient. Summary and Conclusion. Clinicians should keep in mind that an imperforate hymen can cause abdominal growth due to hematocolpos and include it in the differential diagnosis of such a clinical entity in female adolescents. 2D ultrasound is usually efficient for the confirmation of the diagnosis of hematocolpos, but 3D ultrasound is more accurate. Wide excision should be undertaken, as an initial approach, to avoid recurrence

Seasonal variations of allergenic pollen in a Mediterranean region – Alexandroupolis, north-east Greece

[b]Objectives.[/b] The aim of this study was to describe the aerobiological characteristics of NE Greece, identify the most prevalent taxa, define the duration of the main pollen season and correlate allergen records with meteorological parameters. [b]Materials and method.[/b] A 7-day volumetric trap, running continuously throughout the year, was used to collect circulating pollen. Pollen taxa were characterized by standard protocols and counted as grains/m[sup]3[/sup] . The main pollen season was deduced from these data and running means (10-day averages) were plotted against time. Correlations with climatic factors (temperature, rain, humidity, wind velocity) were assessed by single linear regression analysis. [b]Results.[/b] In total, 11 pollen families were identified, including 6 arboreal and 5 non-arboreal taxa. The 5 most prevalent taxa were Oleaceae, Fagaceae, Poaceae, Cupressaceae and Pinaceae. Peak pollen concentrations were detected in April and May, with daily averages exceeding 410 grains/m[sup]3[/sup] . Compositeae had the longest pollen season of 135 days and Oleaceae the shortest, extending to only 27 days. Correlations with meteorological parameters showed variable associations among different taxa, with mean temperature (p<0.001), relative humidity (p=0.015), and wind speed (p=0.042) emerging as the most significant determinants as regards total pollen counts. [b]Conclusions[/b]. Describing the aerobiological characteristics of NE Greece enabled the identification of allergenic risks that are specific for this region. Records generated in this study can be used to alert sensitized individuals of prevailing seasonal patterns, in order to take necessary precautions against imminent exposures. The monitoring system established here can serve as a reference guide for future epidemiological research focusing on allergic asthma and rhinitis