The Birthday Party Test (BPT); A new picture description test to support the assessment of simultanagnosia in patients with acquired brain injury

There is broad consensus on the utility of complex pictures in the assessment of simultanagnosia in patients with acquired brain injury (ABI). To overcome various shortcomings of current instruments, we have developed the Birthday Party Test (BPT); a picture description test that contains a neutral scene, a balanced representation of events, and provides clear instructions and a scoring-aid. We have applied the BPT in a large group of patients with ABI (n = 502) and in an age-matched healthy control group (n = 194). Our results show that performance on the BPT was associated with a range of descriptive, neuropsychological and clinical characteristics and that poor test performance appeared to be more common in patients with etiologies that have an increased risk of bilateral damage. Furthermore, we assume a high correspondence between test performance on the BPT and the assessor’s clinical judgment of likely having simultanagnosia in preliminary analyses. This study shows the potential usefulness of the BPT to support diagnostic decision making in simultanagnosia. The BPT is made freely available to facilitate its broad application in the clinical assessment of patients with visual impairment and to enable a further evaluation of its utility and validity in future studies

Уникальные ресурсы Крыма как основа для развития мистического туризма

Целью статьи является рассмотрение возможности развития мистического туризма в Крыму на основе его уникальных природных и культурно-исторических ресурсов

High-throughput confocal imaging of differentiated 3D liver-like spheroid cellular stress response reporters for identification of drug-induced liver injury liability

Adaptive stress response pathways play a key role in the switch between adaptation and adversity, and are important in drug-induced liver injury. Previously, we have established an HepG2 fluorescent protein reporter platform to monitor adaptive stress response activation following drug treatment. HepG2 cells are often used in high-throughput primary toxicity screening, but metabolizing capacity in these cells is low and repeated dose toxicity testing inherently difficult. Here, we applied our bacterial artificial chromosome-based GFP reporter cell lines representing Nrf2 activation (Srxn1-GFP and NQO1-GFP), unfolded protein response (BiP-GFP and Chop-GFP), and DNA damage response (p21-GFP and Btg2-GFP) as long-term differentiated 3D liver-like spheroid cultures. All HepG2 GFP reporter lines differentiated into 3D spheroids similar to wild-type HepG2 cells. We systematically optimized the automated imaging and quantification of GFP reporter activity in individual spheroids using high-throughput confocal microscopy with a reference set of DILI compounds that activate these three stress response pathways at the transcriptional level in primary human hepatocytes. A panel of 33 compounds with established DILI liability was further tested in these six 3D GFP reporters in single 48 h treatment or 6 day daily repeated treatment. Strongest stress response activation was observed after 6-day repeated treatment, with the BiP and Srxn1-GFP reporters being most responsive and identified particular severe-DILI-onset compounds. Compounds that showed no GFP reporter activation in two-dimensional (2D) monolayer demonstrated GFP reporter stress response activation in 3D spheroids. Our data indicate that the application of BAC-GFP HepG2 cellular stress reporters in differentiated 3D spheroids is a promising strategy for mechanism-based identification of compounds with liability for DILI

Cross‐scale intercomparison of climate change impacts simulated by regional and global hydrological models in eleven large river basins

Ideally, the results from models operating at different scales should agree in trend direction and magnitude of impacts under climate change. However, this implies that the sensitivity to climate variability and climate change is comparable for impact models designed for either scale. In this study, we compare hydrological changes simulated by 9 global and 9 regional hydrological models (HM) for 11 large river basins in all continents under reference and scenario conditions. The foci are on model validation runs, sensitivity of annual discharge to climate variability in the reference period, and sensitivity of the long-term average monthly seasonal dynamics to climate change. One major result is that the global models, mostly not calibrated against observations, often show a considerable bias in mean monthly discharge, whereas regional models show a better reproduction of reference conditions. However, the sensitivity of the two HM ensembles to climate variability is in general similar. The simulated climate change impacts in terms of long-term average monthly dynamics evaluated for HM ensemble medians and spreads show that the medians are to a certain extent comparable in some cases, but have distinct differences in other cases, and the spreads related to global models are mostly notably larger. Summarizing, this implies that global HMs are useful tools when looking at large-scale impacts of climate change and variability. Whenever impacts for a specific river basin or region are of interest, e.g. for complex water management applications, the regional-scale models calibrated and validated against observed discharge should be used

Esophageal tumor segmentation in CT images using a Dilated Dense Attention Unet (DDAUnet)

Manual or automatic delineation of the esophageal tumor in CT images is known to be very challenging. This is due to the low contrast between the tumor and adjacent tissues, the anatomical variation of the esophagus, as well as the occasional presence of foreign bodies (e.g. feeding tubes). Physicians therefore usually exploit additional knowledge such as endoscopic findings, clinical history, additional imaging modalities like PET scans. Achieving his additional information is time-consuming, while the results are error-prone and might lead to non-deterministic results. In this paper we aim to investigate if and to what extent a simplified clinical workflow based on CT alone, allows one to automatically segment the esophageal tumor with sufficient quality. For this purpose, we present a fully automatic end-to-end esophageal tumor segmentation method based on convolutional neural networks (CNNs). The proposed network, called Dilated Dense Attention Unet (DDAUnet), leverages spatial and channel attention gates in each dense block to selectively concentrate on determinant feature maps and regions. Dilated convolutional layers are used to manage GPU memory and increase the network receptive field. We collected a dataset of 792 scans from 288 distinct patients including varying anatomies with air pockets, feeding tubes and proximal tumors. Repeatability and reproducibility studies were conducted for three distinct splits of training and validation sets. The proposed network achieved a DSC value of 0.79 +/- 0.20, a mean surface distance of 5.4 +/- 20.2mm and 95% Hausdorff distance of 14.7 +/- 25.0mm for 287 test scans, demonstrating promising results with a simplified clinical workflow based on CT alone. Our code is publicly available via https://github.com/yousefis/DenseUnet_Esophagus_Segmentation.Biological, physical and clinical aspects of cancer treatment with ionising radiatio

Comparing projections of future changes in runoff and water resources from hydrological and ecosystem models in ISI-MIP

Projections of future changes in runoff can have important implications for water resources and flooding. In this study, runoff projections from ISI-MIP (Inter-sectoral Impact Model Intercomparison Project) simulations forced with HadGEM2-ES bias-corrected climate data under the Representative Concentration Pathway 8.5 have been analysed. Projections of change from the baseline period (1981–2010) to the future (2070–2099) from a number of different ecosystems and hydrological models were studied. The differences between projections from the two types of model were looked at globally and regionally. Typically, across different regions the ecosystem models tended to project larger increases and smaller decreases in runoff than the hydrological models. However, the differences varied both regionally and seasonally. Sensitivity experiments were also used to investigate the contributions of varying CO2 and allowing vegetation distribution to evolve on projected changes in runoff. In two out of four models which had data available from CO2 sensitivity experiments, allowing CO2 to vary was found to increase runoff more than keeping CO2 constant, while in two models runoff decreased. This suggests more uncertainty in runoff responses to elevated CO2 than previously considered. As CO2 effects on evapotranspiration via stomatal conductance and leaf-area index are more commonly included in ecosystems models than in hydrological models, this may partially explain some of the difference between model types. Keeping the vegetation distribution static in JULES runs had much less effect on runoff projections than varying CO2, but this may be more pronounced if looked at over a longer timescale as vegetation changes may take longer to reach a new state