Renal function-adapted D-dimer cutoffs in combination with a clinical prediction rule to exclude pulmonary embolism in patients presenting to the emergency department.

D-dimer levels significantly increase with declining renal function and hence, renal function-adjusted D-dimer cutoffs to rule out pulmonary embolism were suggested. Aim of this study was to "post hoc" validate previously defined renal function-adjusted D-dimer levels to safely rule out pulmonary embolism in patients presenting to the emergency department. In this retrospective, observational analysis, all patients with low to intermediate pre-test probability receiving D-dimer measurement and computed tomography angiography (CTA) to rule out pulmonary embolism between January 2017 and December 2020 were included. Previously defined renal function-adjusted D-dimer cutoffs (1306 µg/l for moderate and 1663 µg/l for severe renal function impairment) were applied to determine sensitivity, specificity, negative and positive predictive values. One thousand, three hundred sixty-nine patients were included of which 229 (17%) were diagnosed with pulmonary embolism. The estimated glomerular filtration rate (eGFR) was ≥ 60 ml/min in 1079 (79%), 30-59 ml/min in 266 (19%) and < 30 ml/min in 24 (2%) patients. Only three patients (1.1%) with an eGFR < 60 ml/min had a D-dimer level < 500 µg/l. There was a significant correlation between D-dimer and eGFR (R = - 0.159, p < 0.001). Calculated on the standard D-dimer cutoff value of 500 µg/l, sensitivity of D-dimer testing was 97% for patients with an eGFR ≥ 60 ml/min and 100% for those with 30-60 ml/min, while specificity decreased in patients with renal function impairment. A negative predictive value of 0.99 as a premise to safely rule out pulmonary embolism was achieved by applying a D-dimer cutoff of 1480 µg/l for eGFR 30-59 ml/min and 1351 µg/l for eGFR < 30 ml/min. The findings of this study underline that application of renal function-adapted D-dimer levels in combination with a clinical prediction rule appears feasible to rule out pulmonary embolism. Out of the current dataset, renal function-adjusted D-dimer cutoffs to rule out pulmonary embolism were slightly different compared to previously defined cutoffs. Further studies on a larger scale are needed to validate possible renal function-adjusted D-dimer cutoffs

Deep-learning-based instrument detection for intra-operative robotic assistance

Purpose: Robotic scrub nurses have the potential to become an attractive solution for the operating room. Surgical instrument detection is a fundamental task for these systems, which is the focus of this work. We address the detection of the complete surgery set for wisdom teeth extraction, and propose a data augmentation technique tailored for this task. Methods: Using a robotic scrub nurse system, we create a dataset of 369 unique multi-instrument images with manual annotations. We then propose the Mask-Based Object Insertion method, capable of automatically generating a large amount of synthetic images. By using both real and artificial data, different Mask R-CNN models are trained and evaluated. Results: Our experiments reveal that models trained on the synthetic data created with our method achieve comparable performance to that of models trained on real images. Moreover, we demonstrate that the combination of real and our artificial data can lead to a superior level of generalization. Conclusion: The proposed data augmentation technique is capable of dramatically reducing the labelling work required for training a deep-learning-based detection algorithm. A dataset for the complete instrument set for wisdom teeth extraction is made available for the scientific community, as well as the raw information required for the generation of the synthetic data (https://github.com/Jorebs/Deep-learning-based-instrument-detection-for-intra operative-robotic-assistance)

Group 2 Innate Lymphoid Cells Are Redundant in Experimental Renal Ischemia-Reperfusion Injury.

Acute kidney injury (AKI) can be fatal and is a well-defined risk factor for the development of chronic kidney disease. Group 2 innate lymphoid cells (ILC2s) are innate producers of type-2 cytokines and are critical regulators of homeostasis in peripheral organs. However, our knowledge of their function in the kidney is relatively limited. Recent evidence suggests that increasing ILC2 numbers by systemic administration of recombinant interleukin (IL)-25 or IL-33 protects against renal injury. Whilst ILC2s can be induced to protect against ischemic- or chemical-induced AKI, the impact of ILC2 deficiency or depletion on the severity of renal injury is unknown. Firstly, the phenotype and location of ILC2s in the kidney was assessed under homeostatic conditions. Kidney ILC2s constitutively expressed high levels of IL-5 and were located in close proximity to the renal vasculature. To test the functional role of ILC2s in the kidney, an experimental model of renal ischemia-reperfusion injury (IRI) was used and the severity of injury was assessed in wild-type, ILC2-reduced, ILC2-deficient, and ILC2-depleted mice. Surprisingly, there were no differences in histopathology, collagen deposition or mRNA expression of injury-associated (Lcn2), inflammatory (Cxcl1, Cxcl2, and Tnf) or extracellular matrix (Col1a1, Fn1) factors following IRI in the absence of ILC2s. These data suggest the absence of ILC2s does not alter the severity of renal injury, suggesting possible redundancy. Therefore, other mechanisms of type 2-mediated immune cell activation likely compensate in the absence of ILC2s. Hence, a loss of ILC2s is unlikely to increase susceptibility to, or severity of AKI

Growth and Fatty Acid Composition of Marine Microalga Nannochloropsis SP in Medium Enriched with Magnesium

Micro-algae are to be an attractive way to produce bio-diesel due to high photosynthetic yields and lipid accumulation in cells. This high productivity combined with possibility to uptake CO2 stimulated its utilization as a biological mitigation method of CO2, at once as an alternative renewable source of energy. Growth characteristics and chemical composition of micro-algae can be altered by culture environment. Nutrient sufficiency,included magnesium element (Mg2+) is important factors on overall biochemical composition. In study, Nannochloropsis sp was cultivated in Erlenmeyer 250 ml containing 200 ml f/2 medium. There are three groups of treatment with different levelof magnesium (Mg2+), i.e. 0 (M0); 0.1mgL-1 (M1); and 1.0 mgL-1 (M2). All treatment was designed triplicate in batch system. Culture was then aerated continuously with sterile atmospheric air (1.5 L.min-1). Cells were harvested on 25th day after inoculation and analyzed. Data showed that Chlorophyll-a increased linearly with time and maximum at 18th days of growth period, i.e. 23.57; 26.44; and 27.74mgL-1, for M0; M1; and M2,respectively. Chlorophyll-a content decreased significantly when pH dropped to 5-6.Enrichment with Mg2+ increased the chlorophyll-a content 12.2-17.7%. Dry cell reached 375-400mgL-1 in all treatment. Lipid content of Nannochloropsis sp in control (M0) is 55.3%, higher than M1 and M2. Saturated fatty acid tends to increase from 80.70 (M0)to 96.70 (M1) and 94.53% (M2). Fatty acid of M0 and M1 was composed dominantly by palmitic acid (C16:0), i.e. 49.19-70.75% total fatty acids. Meanwhile, M2 treatment was dominantly by lauric acid (C12:0), i.e. 32.98%

Reconstructing the colonization history of Indo-Pacific bottlenose dolphins (Tursiops aduncus) in Northwestern Australia

Bottlenose dolphins (Tursiops spp.) are found in waters around Australia, with T. truncatus typically occupying deeper, more oceanic habitat, while T. aduncus occur in shallower, coastal waters. Little is known about the colonization history of T. aduncus along the Western Australian coastline; however, it has been hypothesized that extant populations are the result of an expansion along the coastline originating from a source in the north of Australia. To investigate the history of coastal T. aduncus populations in the area, we generated a genomic SNP dataset using a double-digest restriction-site-associated DNA (ddRAD) sequencing approach. The resulting dataset consisted of 103,201 biallelic SNPs for 112 individuals which were sampled from eleven coastal and two offshore sites between Shark Bay and Cygnet Bay, Western Australia. Our population genomic analyses showed a pattern consistent with the proposed source in the north with significant isolation by distance along the coastline, as well as a reduction in genomic diversity measures along the coastline with Shark Bay showing the most pronounced reduction. Our demographic analysis indicated that the expansion of T. aduncus along the coastline began around the last glacial maximum and progressed southwards with the Shark Bay population being founded only 13 kya. Our results are in line with coastal colonization histories inferred for Tursiops globally, highlighting the ability of delphinids to rapidly colonize novel coastal niches as habitat is released during glacial cycle-related global sea level and temperature changes

Testing the accuracy of feldspar single grains to date late Holocene cyclone and tsunami deposits

Quartz is the preferred dosimeter for luminescence dating of Holocene sediments as optically stimulated luminescence (OSL) signals reset rapidly upon light exposure, and are stable over time. However, feldspar is required where quartz luminescence properties are inappropriate for dating, as is often the case in geologically young mountain ranges and areas with young volcanism. Here we aim to evaluate the potential of single grain feldspar luminescence dating applied to late Holocene cyclone and tsunami deposits, for which complete signal resetting can a priori not be guaranteed. To address potential problems of feldspar dating of such deposits associated with heterogeneous bleaching, remnant doses and anomalous fading, we use a low-temperature post infrared infrared stimulated luminescence protocol (pIRIR150) on single grains. For most samples, good agreement between fading corrected IR50 and non-fading corrected pIRIR150 ages is observed. Both feldspar ages generally also show good agreement with age control provided by historical data and quartz luminescence ages. pIRIR150 remnant ages in modern analogue samples are shown to be 150, IR50 and quartz ages, indicates that a significant number of grains must have experienced relatively complete signal resetting during or immediately prior to transport, as the three signals are known to bleach at different rates. Since light exposure during the event is expected to be limited, we deduce that a significant portion of the grains in the cyclone and tsunami deposits was already bleached prior to the event of interest. These well-bleached grains were likely eroded at the beach, while other grains with larger remnant ages probably originate from the shallow subtidal, coastal barriers or even further inland sources. Additional signal resetting during storm and tsunami transport is indicated by slightly younger quartz than feldspar ages for grains with incomplete pre-transport resetting that were eroded at the Holocene coastal barrier.</p

Toward the systematic identification of microplastics in the environment: evaluation of a new independent software tool (siMPle) for spectroscopic analysis

Microplastics (MP) are ubiquitous within the environment, but the analysis of this contaminant is currently quite diverse, and a number of analytical methods are available. The comparability of results is hindered as even for a single analytical method such as Fourier transform infrared spectroscopy (FT-IR) the different instruments currently available do not allow a harmonized analysis. To overcome this limitation, a new free of charge software tool, allowing the systematic identification of MP in the environment (siMPle) was developed. This software tool allows a rapid and harmonized analysis of MP across FT-IR systems from different manufacturers (Bruker Hyperion 3000, Agilent Cary 620/670, PerkinElmer Spotlight 400, Thermo Fischer Scientific Nicolet iN10). Using the same database and the automated analysis pipeline (AAP) in siMPle, MP were identified in samples that were analyzed with instruments with different detector systems and optical resolutions, the results of which are discussed

Retrospective audit of antibiotic use in a university general pediatrics department using hospital pharmacy dispensing data

Antibiotics are among the most frequently prescribed drugs in children’s hospitals, which is why regular monitoring of antibiotic use in hospitals is of great importance. This retrospective audit (60 months, January 2014 – December 2018) analyzes the antibiotic consumption at a university inpatient department of general pediatrics including neonatal and pediatric intensive care based on pharmacy dispensing data in units of grams per 100 patient days and in Defined Daily Doses per 100 patient days. The results provide potential targets for Antibiotic Stewardship interventions. Conversely, this audit elicits methodological limitations of the method of antibiotic surveillance in pediatrics recommended by the Robert Koch Institute, Berlin