SparseTracer: the Reconstruction of Discontinuous Neuronal Morphology in Noisy Images

Digital reconstruction of a single neuron occupies an important position in computational neuroscience. Although many novel methods have been proposed, recent advances in molecular labeling and imaging systems allow for the production of large and complicated neuronal datasets, which pose many challenges for neuron reconstruction, especially when discontinuous neuronal morphology appears in a strong noise environment. Here, we develop a new pipeline to address this challenge. Our pipeline is based on two methods, one is the region-to-region connection (RRC) method for detecting the initial part of a neurite, which can effectively gather local cues, i.e., avoid the whole image analysis, and thus boosts the efficacy of computation; the other is constrained principal curves method for completing the neurite reconstruction, which uses the past reconstruction information of a neurite for current reconstruction and thus can be suitable for tracing discontinuous neurites. We investigate the reconstruction performances of our pipeline and some of the best state-of-the-art algorithms on the experimental datasets, indicating the superiority of our method in reconstructing sparsely distributed neurons with discontinuous neuronal morphologies in noisy environment. We show the strong ability of our pipeline in dealing with the large-scale image dataset. We validate the effectiveness in dealing with various kinds of image stacks including those from the DIADEM challenge and BigNeuron project.     

Contribution of knee adduction moment impulse to pain and disability in Japanese women with medial knee osteoarthritis

Background

An increase in the knee adduction moment is one of the risk factors of medial knee osteoarthritis. This study examined the relationship between knee adduction moment and self-reported pain and disability. We also investigated the influence of pain on the relationships between knee adduction moment and gait performance and disability.

Methods

Thirty-eight Japanese women with medial knee osteoarthritis participated in this study (66.37 years (41–79 years)). Gait analysis involved the measurement of the external knee adduction moment impulse in the stance duration and during 3 subdivisions of stance. The total, pain and stiffness, and physical function Japanese Knee Osteoarthritis Measure scores were determined.

Findings

The pain and stiffness, physical function, and total scores were positively correlated with the knee adduction moment impulses in the stance duration, and initial and second double support interval, and single limb support interval. The knee adduction moment impulse during the stance duration was related to the pain and stiffness subscale and gait velocity. The pain and stiffness subscale was related to the physical function subscale.

Interpretation

Our results suggest that increasing in the knee adduction moment impulse, a proxy for loading on the medial compartment of the knee, is related to increased pain during weight-bearing activities such as walking, thereby restricting walking performance and causing disability by reducing gait velocity. Thus, the reduction in the knee adduction moment impulse during gait may result in pain relief and may serve as a conservative treatment option with disease-modifying potential.     

Pharmacists’ knowledge and attitudes toward medication therapy management service and the associated challenges and barriers for its implementation

BackgroundThe literature demonstrated a positive impact of medication therapy management (MTM) services provided by the pharmacists to improve the overall health outcomes. Nevertheless, limited data is available with regard to MTM service implementation by community pharmacists and its associated factors in Jordan.ObjectiveTo evaluate community pharmacists’ knowledge, attitude and practice of MTM service and to explore the challenges and barriers for its implementation.MethodsThe present cross-sectional study utilized a validated online survey which was filled by community pharmacists in different areas across Jordan. In addition to the socio-demographic variables, the study questionnaire evaluated pharmacists’ knowledge and attitudes towards MTM service, extent of MTM implementation and its associated challenges and barriers.ResultsA total of 250 pharmacists completed the survey. The study pharmacists showed moderate knowledge level (median of the total knowledge score = 6 (4–7) out of 10) and positive attitude (median of the attitude score was 23 (19–26) out of 30) towards MTM services. The participating pharmacists recognized performing or obtaining necessary assessments of patient’s health status as the most frequently provided MTM service (84.8%), while the least one was documenting the care delivered and communicating essential information to other healthcare providers (62%). Furthermore, collecting patient-related information was the most commonly recognized challenge to MTM service provision (36.8%), followed by referring the patient to a physician or consultant (36%) and collaboration with them (35.6%). The most reported barrier was negative physician attitudes (40.4%), followed by the lack of training on MTM provision (38.4%), and lack of adequate support staff (37.2%).ConclusionEfforts are needed to enhance collaboration between pharmacists and other health care professional, to develop documentation systems that would preserve and facilitate access to patient information, and to implement appropriate training programs which aim to overcome the challenges and barriers for MTM implementation.     

Clinical features of Wilson disease: Analysis of 10 cases

Aim: The diagnosis of Wilson disease is based on the results of several clinical and biochemical tests. This study aimed to clarify the clinical features and spectrum of Wilson disease, including severe Wilson disease. Methods: Between 1985 and 2009, 10 patients with clinical, biochemical or histological evidence of Wilson disease were either diagnosed or had a previously established diagnosis confirmed at Fukuoka University Hospital. Severe Wilson disease was defined by a serum prothrombin time ratio of more than 1.5 or serum prothrombin activity of less than 50%. The 10 Wilson disease patients were divided into two groups, one containing three non‐severe patients and the other containing seven severe patients, and the biochemical features of the patients in these two groups were compared. Results: The mean age at diagnosis was 21.5 ± 11.7 years (range, 7–39). Decreased serum ceruloplasmin, enhanced 24‐h urinary copper excretion, presence of Kayser–Fleischer rings and histological signs of chronic liver damage were confirmed in 100%, 100%, 66.7% and 100% of patients, respectively. Severe Wilson disease patients had higher levels of serum ceruloplasmin and serum copper (P < 0.05, P < 0.05, respectively) than non‐severe patients. Conclusion: In severe Wilson disease patients, the serum ceruloplasmin and serum copper levels were higher than those in non‐severe Wilson disease patients.     

Incidence,patterns, risk factors and clinical outcomes of intravenous acyclovir induced nephrotoxicity

ObjectivesAcyclovir is approved to treat herpes simplex virus (HSV) type 1, type 2 and varicella-zoster virus. It is mainly eliminated via the kidneys, for which drug crystals accumulation might lead to nephrotoxicity. This study aimed to determine the incidence, risk factors, preventive measures, and clinical outcomes of acyclovir induced-nephrotoxicity.MethodsThis is a retrospective cohort study of patients >12 years of age at Sultan Qaboos University Hospital (SQUH) receiving IV acyclovir therapy between January 2016 and December 2020.ResultsOut of 191 included patients, 40 (20.1%) developed acyclovir induced-nephrotoxicity. Age (per year older: OR 1.04, 95 %CI 1.01–1.07), total duration of treatment (per day OR1.19, 95 %CI 1.06–1.33), and concomitant use of vancomycin (OR 5.96, 95 %CI 1.87–19.01) were significant independent risk factors for acyclovir induced-nephrotoxicity development. Nine patients (4.5%) died during the same hospitalization, including those three patients who required renal replacement therapy (1.5%).ConclusionFrequent monitoring of kidney function for older patients with concurrent use of vancomycin and IV hydration is essential to prevent IV acyclovir induced-nephrotoxicity. Antimicrobial stewardship is a crucial method to reduce the duration of treatment with IV acyclovir as appropriate.     

Isoechoic axillary lymph node metastases of mucinous carcinoma of the Breast: A case report

We report a case of isoechoic axillary lymph node metastasis of mucinous carcinoma (so-called pure mucinous carcinoma) of the breast. A 47-year-old premenopausal woman was referred to our hospital with a 2 years history of mass and distortion of her left breast and with recent worsening of her symptoms. Ultrasonography demonstrated a well-circumscribed mass, about 5 cm in diameter, which was isoechoic compared to the surrounding fat tissue. Distal enhancement was also recognized. A left axillary ultrasonographic scan demonstrated four nodules, which were indistinct because of their isoechogenicity compared to the surrounding tissue. Based on a preoperative diagnosis of mucinous carcinoma of the left breast with left axillary lymph nodes metastases, left mastectomy and left axillary nodal dissection were performed. Mucinous carcinoma with axillary lymph node metastases was diagnosed histologically. The lymph node metastases showed histological findings identical to those of the primary tumor, which was considered to be the reason for their isoechogenicity. Although lymph node metastasis of mucinous carcinoma of the breast is rare, ultrasonographers should perform careful scanning when the primary breast mass is suspicious for mucinous carcinoma, because lymph node metastases of mucinous carcinoma can be more indistinct and difficult to detect than those of other types of breast cancer.     

"以史为鉴"——倡导当前胆囊结石个体化治疗策略

胆囊结石历史悠久,最早记录可以追溯到距今3000年前古埃及木乃伊身上所发现的结石,中国古代医书也有患者罹患胆囊结石的记载。胆囊内几颗“小小的石头”已折磨人类数千年。17世纪以前,受限于时代和技术的发展,胆囊结石以内科治疗为主;17至19世纪,由于疼痛、出血、感染等主要基本问题未解决,西医外科仍很落后,限制了胆囊结石手术的数量和范围;19世纪中期之后,解剖学进一步发展,麻醉法、消毒法和无菌术的应用使得外科学开始广泛而深入的发展起来,胆囊手术逐渐增多和成熟;20世纪后期,伴随以腹腔镜为代表的新技术诞生和熊去氧胆酸为代表的新药物出现,胆囊结石治疗出现了许多进展,微创技术在胆囊结石外科治疗上的应用尤其令人振奋。然而,纵观整个胆囊结石治疗的发展历程,进步主要聚焦在以“胆囊切除”为主的治疗技术改进上,这与良性疾病治疗的医学发展方向“预防为主、保护器官功能”仍相去甚远。