Magnetic Resonance Direct Thrombus Imaging (MRDTI) Can Distinguish Between Old and New Thrombosis in the Abdominal Aorta: a Case Report

A 43-year-old man complaining of abdominal angina for several months showed a large suprarenal aneurysm of the abdominal aorta with extensive circumferential wall thrombosis, complete occlusion of the right renal artery and a critically stenosed left renal artery on CT angiography. He suffered from severe hypertension and renal failure. A percutaneous transluminal angioplasty (PTA) was planned. After the PTA procedure, which was complicated by the development of left renal artery occlusion, successful rescue revascularization surgery was performed. Since we were hesitant to start anticoagulant treatment because of a high bleeding risk, magnetic resonance direct thrombus imaging was performed to assess the age of the extensive arterial thrombosis. The aortic thrombus showed a low signal intensity, which is indicative of chronic rather than acute thrombosis. Therefore, oral anticoagulant treatment was not started. The patient recovered without major complications

Genetic variants for head size share genes and pathways with cancer

The size of the human head is highly heritable, but genetic drivers of its variation within the general population remain unmapped. We perform a genome-wide association study on head size (N = 80,890) and identify 67 genetic loci, of which 50 are novel. Neuroimaging studies show that 17 variants affect specific brain areas, but most have widespread effects. Gene set enrichment is observed for various cancers and the p53, Wnt, and ErbB signaling pathways. Genes harboring lead variants are enriched for macrocephaly syndrome genes (37-fold) and high-fidelity cancer genes (9-fold), which is not seen for human height variants. Head size variants are also near genes preferentially expressed in intermediate progenitor cells, neural cells linked to evolutionary brain expansion. Our results indicate that genes regulating early brain and cranial growth incline to neoplasia later in life, irrespective of height. This warrants investigation of clinical implications of the link between head size and cancer.</p

ENIGMA and global neuroscience: A decade of large-scale studies of the brain in health and disease across more than 40 countries

This review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) Consortium, a global alliance of over 1400 scientists across 43 countries, studying the human brain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicated genetic loci associated with brain metrics, ENIGMA has diversified into over 50 working groups (WGs), pooling worldwide data and expertise to answer fundamental questions in neuroscience, psychiatry, neurology, and genetics. Most ENIGMA WGs focus on specific psychiatric and neurological conditions, other WGs study normal variation due to sex and gender differences, or development and aging; still other WGs develop methodological pipelines and tools to facilitate harmonized analyses of "big data" (i.e., genetic and epigenetic data, multimodal MRI, and electroencephalography data). These international efforts have yielded the largest neuroimaging studies to date in schizophrenia, bipolar disorder, major depressive disorder, post-traumatic stress disorder, substance use disorders, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism spectrum disorders, epilepsy, and 22q11.2 deletion syndrome. More recent ENIGMA WGs have formed to study anxiety disorders, suicidal thoughts and behavior, sleep and insomnia, eating disorders, irritability, brain injury, antisocial personality and conduct disorder, and dissociative identity disorder. Here, we summarize the first decade of ENIGMA's activities and ongoing projects, and describe the successes and challenges encountered along the way. We highlight the advantages of collaborative large-scale coordinated data analyses for testing reproducibility and robustness of findings, offering the opportunity to identify brain systems involved in clinical syndromes across diverse samples and associated genetic, environmental, demographic, cognitive, and psychosocial factors

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Co-developing an integrated modelling framework for the circular bioeconomy : Assessing technological, societal and policy implications

The circular bioeconomy is the intersection of bioeconomy and circular economy. It strives towards a more sustainable and resource efficient world with a low carbon footprint. The circular bioeconomy increases the resource efficiency of processes and the use of recycled materials. In addition, fossil carbon is substituted through renewable carbon from biomass produced with agriculture, forestry and the marine environment. As the above definition illustrates, several interlinked sectors, represented by different scientific disciplines, are involved in studying the bioeconomy. These disciplines use different vocabularies, principles and concepts, which must be aligned to enable a coherent and consistent assessment of future scenarios and potential policies. To this end, around fifteen individuals representing the disciplines engaged in a process of collaborative modelling during workshops and bilateral meetings. This report describes i) the co-production of the conceptual model of the circular bioeconomy and ii) the transfer of the conceptual model into a modelling framework of existing models, and; iii) the application of one of the computer models within the context of the circular bio-economy, i.e. iClue, in relation to the linked models of the modelling framewor

The Role of Spatialisation and Spatial Planning in Improving Food Systems: Insights from the Fast-Growing City of Dhaka, Bangladesh

Cities are growing rapidly. It takes a chain of activities to get food from farms to cities. This food system is largely driven by autonomous market development, seizing opportunities favourable to a stakeholder but unfavourable to society at large. Spatial planning is crucial along the chain of food system activities to improve food system outcomes, resilience, and limit negative trade-offs. To include the food system in spatial planning, it must first be mapped (i.e., spatialisation) to understand the functions. These maps inform the spatial planning process, which in turn influences spatial configuration of activities. This paper explores the role of spatialisation and spatial planning in the food system of the fast-growing Dhaka Metropolitan Area (DMA) using three different approaches: urban footprint, mapping, and semi-structured interviews. Stakeholders are unaware of spatial aspects that are present in DMA’s food system and therefore do not consider it while developing spatial plans. The analysis in this article, based on the Urban Food Footprint analysis, food system spatialisation, and interviews shows that spatial planning informed by descriptive spatial information can play an important role in guiding the transformation to a more robust, resilient, and inclusive food system

The Role of Spatialisation and Spatial Planning in Improving Food Systems: Insights from the Fast-Growing City of Dhaka, Bangladesh

Cities are growing rapidly. It takes a chain of activities to get food from farms to cities. This food system is largely driven by autonomous market development, seizing opportunities favourable to a stakeholder but unfavourable to society at large. Spatial planning is crucial along the chain of food system activities to improve food system outcomes, resilience, and limit negative trade-offs. To include the food system in spatial planning, it must first be mapped (i.e., spatialisation) to understand the functions. These maps inform the spatial planning process, which in turn influences spatial configuration of activities. This paper explores the role of spatialisation and spatial planning in the food system of the fast-growing Dhaka Metropolitan Area (DMA) using three different approaches: urban footprint, mapping, and semi-structured interviews. Stakeholders are unaware of spatial aspects that are present in DMA’s food system and therefore do not consider it while developing spatial plans. The analysis in this article, based on the Urban Food Footprint analysis, food system spatialisation, and interviews shows that spatial planning informed by descriptive spatial information can play an important role in guiding the transformation to a more robust, resilient, and inclusive food system

Detection of upper extremity deep vein thrombosis by magnetic resonance non-contrast thrombus imaging

Background Compression ultrasonography (CUS) is the first-line imaging test for diagnosing upper extremity deep vein thrombosis (UEDVT), but often yields inconclusive test results. Contrast venography is still considered the diagnostic standard but is an invasive technique. Objectives We aimed to determine the diagnostic accuracy of magnetic resonance noncontrast thrombus imaging (MR-NCTI) for the diagnosis of UEDVT. Methods In this international multicenter diagnostic study, we prospectively included patients with clinically suspected UEDVT who were managed according to a diagnostic algorithm that included a clinical decision rule (CDR), D-dimer test, and diagnostic imaging. UEDVT was confirmed by CUS or (computed tomography [CT]) venography. UEDVT was excluded by (1) an unlikely CDR and normal D-dimer, (2) a normal serial CUS or (3) a normal (CT) venography. Within 48 h after the final diagnosis was established, patients underwent MR-NCTI. MR-NCTI images were assessed post hoc by two independent radiologists unaware of the presence or absence of UEDVT. The sensitivity, specificity, and interobserver agreement of MR-NCTI for UEDVT were determined. Results Magnetic resonance noncontrast thrombus imaging demonstrated UEDVT in 28 of 30 patients with UEDVT and was normal in all 30 patients where UEDVT was ruled out, yielding a sensitivity of 93% (95% CI 78–99) and specificity of 100% (95% CI 88–100). The interobserver agreement of MR-NCTI had a kappa value of 0.83 (95% CI 0.69–0.97). Conclusions Magnetic resonance noncontrast thrombus imaging is an accurate and reproducible method for diagnosing UEDVT. Clinical outcome studies should determine whether MR-NCTI can replace venography as the second-line imaging test in case of inconclusive CUS

Dhaka Food Agenda 2041 Foresight and Scenario development : Workshop Report Dhaka Food Systems project

This report is a compilation of a workshop sessions held with stakeholders engaged in a foresight and scenario develop process to develop a Dhaka Food Agenda 2041. The report describes the rationale and the different steps undertaken in the process as well as its outputs. Stakeholders have interacted and explored the Dhaka Metropolitan food system and discussed the linkages between issues in the domain of food and nutrition security, food safety, food loss and waste, fresh markets and value chains. In terms of output they have deliberated that one of the major uncertainties is the shift in diets of citizens related to the uncertainty of having thriving small and sustainable businesses versus big- companies (supermarketisation). The participants developed different scenarios and their narratives that are varying from least to most desirable situation. The workshops have led to evidence and dialogue on the needs and opportunities to aim for a sustainable and inclusive food system in Dhaka in 2041. In conclusion, the report presents the steps that will follow the scoping, mapping, analysis of drivers and trends and the scenario development feeding into the further development of the Dhaka Food Agenda 2041