Differences between capillary and venous blood counts in children-A data mining approach.

BACKGROUND: Capillary sampling of blood counts is a well-established alternative to venipuncture in paediatrics. However, the sampling method has to be considered when interpreting test results, as measurements differ. Ethical and practical considerations prevent simultaneous venous and capillary sample acquisition in comprehensive paediatric cohorts that span all ages for the purpose of a direct method comparison, resulting in uncertainty regarding the interpretation of capillary test results. METHODS: We applied a data mining method to calculate the differences between capillary and venous blood count analytes using laboratory data collected during patient care. We examined 486 401 blood counts performed between 2010 and 2017 in two German paediatric tertiary care centers in children from birth to 18 years analysed on SYSMEX XE-2100 and SYSMEX XE-5000 devices, and analysed the differences between capillary and venous test results in 15 218 paired samples performed within 24 h. RESULTS: We identified the mean systematic differences between capillary and venous (capillary-venous) test results for haemoglobin (+6.5 g/L), haematocrit (+2.38%), platelet count (-7.01 × 109 /l), red cell count (+0.18 × 1012 /L), white cell count (-0.64 × 109 /L), mean corpuscular cell volume (+2.07 fl), mean corpuscular haemoglobin (+0.33 pg), mean corpuscular haemoglobin concentration (-4.4 g/L) and red cell distribution width (+0.40%). The effect of age on these mean deltas is negligible, while the levels of test results influence the difference between capillary and venous test results in most analytes. CONCLUSIONS: Our results improve guidance regarding the interpretation of capillary test results for children of all ages and in both physiological and pathological ranges.

Action on Invasive Species: Control Strategies of Parthenium hysterophorus L. on Smallholder Farms in Kenya.

Parthenium hysterophorus L. (Asteraceae) is an invasive alien weed with detrimental effects on agricultural production, biodiversity, human and animal health, threating rural livelihoods in Asia and Africa. The problem emerged recently in the Kenyan Rift Valley, where it began to affect the landholdings of both agro-pastoralists and crop farmers. These vulnerable smallholders depend heavily on natural resources for their livelihoods. In this study, we assessed the severity of parthenium invasion and farmers' management responses using a sample of 530 agro-pastoralists in Baringo County, Kenya, in 2019. We hypothesise that the implementation of existing management strategies depends on the state of parthenium invasion and household socio-economic characteristics. The prevalence and severity of parthenium invasion differed greatly among field plots. To control weeds, farmers resort to either hand weeding, the use of synthetic herbicides, or intensive tillage, sometimes in combination with mulching. A multivariate probit regression model shows that households' characteristics determine the type of control strategies used as well as their complementarity and substitutability. Hand weeding is the most common option, adopted by almost 40% of farmers. The use of agrochemicals or soil-based control strategies appears to be related to knowledge and information characteristics such as access to extension services, membership in organisations and the educational level of household heads. While hand weeding and the use of synthetic herbicides depict significant substitutability, the latter strategy is limited to a few larger farms with market-oriented production. As parthenium invasion continues, policies need to improve farmer awareness and access to knowledge to enable pro-poor and environmentally sustainable control of parthenium on smallholder farms.

Invasive Alien Plants in Africa and the Potential Emergence of Mosquito-Borne Arboviral Diseases-A Review and Research Outlook.

The emergence of arthropod-borne viruses (arboviruses) as linked to land-use changes, especially the growing agricultural intensification and expansion efforts in rural parts of Africa, is of growing health concern. This places an additional burden on health systems as drugs, vaccines, and effective vector-control measures against arboviruses and their vectors remain lacking. An integrated One Health approach holds potential in the control and prevention of arboviruses. Land-use changes favour invasion by invasive alien plants (IAPs) and investigating their impact on mosquito populations may offer a new dimension to our understanding of arbovirus emergence. Of prime importance to understand is how IAPs influence mosquito life-history traits and how this may affect transmission of arboviruses to mammalian hosts, questions that we are exploring in this review. Potential effects of IAPs may be significant, including supporting the proliferation of immature and adult stages of mosquito vectors, providing additional nutrition and suitable microhabitats, and a possible interaction between ingested secondary plant metabolites and arboviruses. We conclude that aspects of vector biology are differentially affected by individual IAPs and that while some plants may have the potential to indirectly increase the risk of transmission of certain arboviruses by their direct interaction with the vectors, the reverse holds for other IAPs. In addition, we highlight priority research areas to improve our understanding of the potential health impacts of IAPs.

Stent-assisted coiling of broad-necked intracranial aneurysms with a new braided microstent (Accero): procedural results and long-term follow-up.

Intracranial stents have expanded endovascular therapy options for intracranial aneurysms. The braided Accero stent is available for clinical use since May 2015. To date, no clinical reports on the stent are available. Purpose of this study was the evaluation of the safety and efficacy of the Accero stent in stent-assisted coiling. All patients, in whom implantation of the stent was performed, were included. Primary endpoints were good clinical outcome (mRS ≤ 2) and aneurysm occlusion grades 1 and 2 (Raymond Roy Occlusion Classification). Secondary endpoints were procedural and device-related complications with permanent disability or death, complications in the course, and the recanalization rate. Between September 2015 and August 2018, thirty-four aneurysms were treated with stent-assisted coiling using the Accero. Sixteen aneurysms were untreated, four of these were ruptured. Mild neurological complications occurred in 2/34 (5.9%) treatments. Two stent occlusions occurred during follow-up. No patient had a poor procedure- or device-related outcome. After an average of 15 months of follow-up, 28/30 aneurysms were completely or near-completely occluded. The Accero stent proved to be safe and effective in the treatment of broad-based intracranial aneurysms. The complication rate and the rate of successful aneurysm occlusions are similar to those of other stents.

The role of attachment characteristics in dialectical behavior therapy for patients with borderline personality disorder.

Attachment characteristics play a key role in understanding borderline-specific problems with respect to childhood maltreatment. The aim of this study was to investigate how attachment representations may influence the trajectory of change in a 1-year outpatient dialectical behavior therapy (DBT) for patients with borderline personality disorder (BPD). Attachment representations were assessed in 26 BPD patients and 26 healthy controls (HC) using the Adult Attachment Projective Picture System (AAP) before treatment. Borderline and global symptom severity and interpersonal problems were examined before, during, and after completing the intervention. Analysis of variance and stepwise hierarchical regression analyses were used to explore the course of symptomatology. As expected, BPD patients displayed a predominance of unresolved attachment in the AAP compared with HC, by showing a lack of ability to integrate attachment related trauma. Whereas both resolved and unresolved attachment groups revealed significant improvement in symptom severity during treatment, dimensional AAP scores showed differences. Patients with higher scores in "synchrony" demonstrated more indicators of mutual care in their narratives to dyadic pictures and displayed a significantly stronger decrease of interpersonal problems than patients with lower synchrony scores. Assessing attachment representations prior to DBT might provide a helpful insight into individual attachment related resources or lack of these capacities. Responsiveness and synchrony in dyadic interactions with significant others are crucial for healthy interpersonal relations. A stronger therapeutic focus on the patient's capacity to show synchrony in dyadic attachment situations might improve the patient's interpersonal problems towards sensitive and mutual interaction.

HoloInjection: augmented reality support for CT-guided spinal needle injections.

The correct placement of needles is decisive for the success of many minimally-invasive interventions and therapies. These needle insertions are usually only guided by radiological imaging and can benefit from additional navigation support. Augmented reality (AR) is a promising tool to conveniently provide needed information and may thus overcome the limitations of existing approaches. To this end, a prototypical AR application was developed to guide the insertion of needles to spinal targets using the mixed reality glasses Microsoft HoloLens. The system's registration accuracy was attempted to measure and three guidance visualisation concepts were evaluated concerning achievable in-plane and out-of-plane needle orientation errors in a comparison study. Results suggested high registration accuracy and showed that the AR prototype is suitable for reducing out-of-plane orientation errors. Limitations, like comparatively high in-plane orientation errors, effects of the viewing position and missing image slices indicate potential for improvement that needs to be addressed before transferring the application to clinical trials.

Assessment of subjective emotional valence and long-lasting impact of life events: development and psychometrics of the Stralsund Life Event List (SEL).

BACKGROUND: Life events (LEs) are associated with future physical and mental health. They are crucial for understanding the pathways to mental disorders as well as the interactions with biological parameters. However, deeper insight is needed into the complex interplay between the type of LE, its subjective evaluation and accompanying factors such as social support. The "Stralsund Life Event List" (SEL) was developed to facilitate this research. METHODS: The SEL is a standardized interview that assesses the time of occurrence and frequency of 81 LEs, their subjective emotional valence, the perceived social support during the LE experience and the impact of past LEs on present life. Data from 2265 subjects from the general population-based cohort study "Study of Health in Pomerania" (SHIP) were analysed. Based on the mean emotional valence ratings of the whole sample, LEs were categorized as "positive" or "negative". For verification, the SEL was related to lifetime major depressive disorder (MDD; Munich Composite International Diagnostic Interview), childhood trauma (Childhood Trauma Questionnaire), resilience (Resilience Scale) and subjective health (SF-12 Health Survey). RESULTS: The report of lifetime MDD was associated with more negative emotional valence ratings of negative LEs (OR = 2.96, p < 0.0001). Negative LEs (b = 0.071, p < 0.0001, ß = 0.25) and more negative emotional valence ratings of positive LEs (b = 3.74, p < 0.0001, ß = 0.11) were positively associated with childhood trauma. In contrast, more positive emotional valence ratings of positive LEs were associated with higher resilience (b = - 7.05, p < 0.0001, ß = 0.13), and a lower present impact of past negative LEs was associated with better subjective health (b = 2.79, p = 0.001, ß = 0.05). The internal consistency of the generated scores varied considerably, but the mean value was acceptable (averaged Cronbach's alpha > 0.75). CONCLUSIONS: The SEL is a valid instrument that enables the analysis of the number and frequency of LEs, their emotional valence, perceived social support and current impact on life on a global score and on an individual item level. Thus, we can recommend its use in research settings that require the assessment and analysis of the relationship between the occurrence and subjective evaluation of LEs as well as the complex balance between distressing and stabilizing life experiences.

Comparison of gesture and conventional interaction techniques for interventional neuroradiology.

PURPOSE: Interaction with radiological image data and volume renderings within a sterile environment is a challenging task. Clinically established methods such as joystick control and task delegation can be time-consuming and error-prone and interrupt the workflow. New touchless input modalities may have the potential to overcome these limitations, but their value compared to established methods is unclear. METHODS: We present a comparative evaluation to analyze the value of two gesture input modalities (Myo Gesture Control Armband and Leap Motion Controller) versus two clinically established methods (task delegation and joystick control). A user study was conducted with ten experienced radiologists by simulating a diagnostic neuroradiological vascular treatment with two frequently used interaction tasks in an experimental operating room. The input modalities were assessed using task completion time, perceived task difficulty, and subjective workload. RESULTS: Overall, the clinically established method of task delegation performed best under the study conditions. In general, gesture control failed to exceed the clinical input approach. However, the Myo Gesture Control Armband showed a potential for simple image selection task. CONCLUSION: Novel input modalities have the potential to take over single tasks more efficiently than clinically established methods. The results of our user study show the relevance of task characteristics such as task complexity on performance with specific input modalities. Accordingly, future work should consider task characteristics to provide a useful gesture interface for a specific use case instead of an all-in-one solution.

[Influence and Change of Self-Directedness in Dialectical Behavior Therapy]. / Einfluss und Veränderung der Selbstlenkungsfähigkeit in der Dialektisch-Behavioralen Therapie (DBT).

Objective Investigate influence and change of self-directedness (SD) in Dialectical-Behavior Therapy (DBT) for 26 female outpatients with borderline personality disorder (BPS). Method Variance analyses are used to evaluate psychopathology and interpersonal problems in 2 subgroups (low vs. high SD) with questionnaires at 3 measuring times over the period of 1 year. Results Low SD was associated with higher psychopathology, more interpersonal problems and lower symptomreduction. Over time of intervention the SD of all patients improved significantly. Conclusion DBT strengthens the SD of patients with BPD. A screening of SD before intervention, and systematic support should be considered.

Bringing hemodynamic simulations closer to the clinics: a CFD prototype study for intracranial aneurysms.

Computational Fluid Dynamics enables the investigation of patient-specific hemodynamics for rupture predictions and treatment support of intracranial aneurysms. However, due to numerous simplifications to decrease the computations effort, clinical applicability is limited until now. To overcome this situation a clinical research software prototype was tested that can be easily operated by attending physicians. In order to evaluate the accuracy of this prototype, four patient-specific intracranial aneurysms were investigated using four different spatial resolutions. The results demonstrate that physicians were able to generate hemodynamic predictions within several minutes at low spatial resolution. However, depending on the parameter of interest and the desired accuracy, higher resolutions are required, which will lead to an increase of computational times that still look very attractive towards clinical usability. The study shows that the next step towards an applicable individualized therapy for patients harboring intracranial aneurysms can be done. However, further in vivo validations are required to guarantee realistic predictions in future studies.

Loci, genes, and mechanisms associated with tolerance to ferrous iron toxicity in rice (Oryza sativa L.).

KEY MESSAGE: A genome-wide association study in rice yielded loci and candidate genes associated with tolerance to iron toxicity, and revealed biochemical mechanisms associated with tolerance in contrasting haplotypes. Iron toxicity is a major nutrient disorder affecting rice. Therefore, understanding the genetic and physiological mechanisms associated with iron toxicity tolerance is crucial in adaptive breeding and biofortification. We conducted a genome-wide association study (GWAS) by exposing a population of 329 accessions representing all subgroups of rice to ferrous iron stress (1000 ppm, 5 days). Expression patterns and sequence polymorphisms of candidate genes were investigated, and physiological hypotheses related to candidate loci were tested using a subset of contrasting haplotypes. Both iron including and excluding tolerant genotypes were observed, and shoot iron concentrations explained around 15.5 % of the variation in foliar symptom formation. GWAS for seven traits yielded 20 SNP markers exceeding a significance threshold of -log10 P > 4.0, which represented 18 distinct loci. One locus mapped for foliar symptom formation on chromosome 1 contained two putative glutathione-S-transferases, which were strongly expressed under iron stress and showed sequence polymorphisms in complete linkage disequilibrium with the most significant SNP. Contrasting haplotypes for this locus showed significant differences in dehydroascorbate reductase activity, which affected the plants' redox status under iron stress. We conclude that maintaining foliar redox homeostasis under iron stress represented an important tolerance mechanism associated with a locus identified through GWAS.

The impact of childhood trauma on depression: does resilience matter? Population-based results from the Study of Health in Pomerania.

OBJECTIVE: Data suggests that traumatic experiences at early age contribute to the onset of major depressive disorder (MDD) in later life. This study aims at investigating the influence of dispositional resilience on this relationship. METHODS: Two thousand and forty-six subjects aged 29-89 (SD=13.9) from a community based sample who were free of MDD during the last 12 months prior to data collection were diagnosed for Lifetime diagnosis of MDD by the Munich-Composite International Diagnostic Interview (M-CIDI) according to DSM-IV criteria. Childhood maltreatment (CM) and resilience were assessed with the Childhood Trauma Questionnaire (CTQ) and the Resilience-Scale (RS-25). RESULTS: Both CM (OR=1.03, 95% CI [1.02, 1.04], P<.000) and resilience (OR=0.98, 95% CI [0.98, 0.99], P<.000) were associated with MDD later in life. The detrimental effects of low resilience on MDD were not only especially prominent in subjects with a history of CM (OR=3.18, 95% CI [1.84, 5.50], P<.000), but also effective in subjects without CM (OR=2.62, 95% CI [1.41, 4.88], P=.002). CONCLUSIONS: The findings support the clinical assumption that resilient subjects may be partly protected against the detrimental long-term effects of child abuse and neglect.

Genetic and physiological analysis of tolerance to acute iron toxicity in rice.

BACKGROUND: Fe toxicity occurs in lowland rice production due to excess ferrous iron (Fe(2+)) formation in reduced soils. To contribute to the breeding for tolerance to Fe toxicity in rice, we determined quantitative trait loci (QTL) by screening two different bi-parental mapping populations under iron pulse stresses (1,000 mg L(-1) = 17.9 mM Fe(2+) for 5 days) in hydroponic solution, followed by experiments with selected lines to determine whether QTLs were associated with iron exclusion (i.e. root based mechanisms), or iron inclusion (i.e. shoot-based mechanisms). RESULTS: In an IR29/Pokkali F8 recombinant inbred population, 7 QTLs were detected for leaf bronzing score on chromosome 1, 2, 4, 7 and 12, respectively, individually explaining 9.2-18.7% of the phenotypic variation. Two tolerant recombinant inbred lines carrying putative QTLs were selected for further experiments. Based on Fe uptake into the shoot, the dominant tolerance mechanism of the tolerant line FL510 was determined to be exclusion with its root architecture being conducive to air transport and thus the ability to oxidize Fe(2+) in rhizosphere. In line FL483, the iron tolerance was related mainly to shoot-based mechanisms (tolerant inclusion mechanism). In a Nipponbare/Kasalath/Nipponbare backcross inbred population, 3 QTLs were mapped on chromosomes 1, 3 and 8, respectively. These QTLs explained 11.6-18.6% of the total phenotypic variation. The effect of QTLs on chromosome 1 and 3 were confirmed by using chromosome segment substitution lines (SL), carrying Kasalath introgressions in the genetic background on Nipponbare. The Fe uptake in shoots of substitution lines suggests that the effect of the QTL on chromosome 1 was associated with shoot tolerance while the QTL on chromosome 3 was associated with iron exclusion. CONCLUSION: Tolerance of certain genotypes were classified into shoot- and root- based mechanisms. Comparing our findings with previously reported QTLs for iron toxicity tolerance, we identified co-localization for some QTLs in both pluse and chronic stresses, especially on chromosome 1.

Spatial and temporal variability of surface water pollution in the Mekong Delta, Vietnam.

Surface water pollution in the Vietnamese Mekong Delta (MD) could threaten human, animal and ecosystem health given the fact that this water source is intensively used for drinking, irrigation and domestic services. We therefore determined the levels of pollution by organic pollutants, salts, metals and microbial indicators by (bi)monthly monitoring of canals between November 2011 and July 2012 at 32 sampling locations, representing fresh and saline/brackish environments. The results were compared with national water quality guidelines, between the studied regions and with water quality data from main waterways. Key factors explaining the observed levels of pollution in surface water were identified through principal component analysis (PCA). Temporal variations due to tidal regime and seasonality were also assessed. Based on regression models, the spatial variability of five water quality parameters was visualized using GIS based maps. Results indicate that pH (max. 8.6), turbidity (max. 461 FTU), maximum concentrations of ammonium (14.7 mg L(-1)), arsenic (44.1 µg L(-1)), barium (157.5 µg L(-1)), chromium (84.7 µg L(-1)), mercury (45.5 µg L(-1)), manganese (1659.7 µg L(-1)), aluminum (14.5 mg L(-1)), iron (17.0 mg L(-1)) and the number of Escherichia coli (87,000 CFU 100 mL(-1)) and total coliforms (2,500,000 CFU 100 mL(-1)) in canals exceed the thresholds set by Vietnamese quality guidelines for drinking and domestic purposes. The PCA showed that i) urbanization; ii) metal leaching from soils; iii) aquaculture; and iv) tidal regime explain 85% of the variance of surface water quality attributes. Significant differences in water quality were found due to daily tidal regime and as a result of seasonality. Surface water quality maps for dissolved oxygen, ammonium, ortho-phosphate, manganese and total coliforms were developed to highlight hot-spot areas of pollution. The results of this study can assist policy makers in developing water management strategies and drinking water companies in selecting optimum water extraction locations.