Exposure of insects and host plants to different concentrations of CO2 affects the performance of Mahanarva spectabilis (Hemiptera: Cercopidae) in successive insect generations.

The performance of three successive generations of Mahanarva spectabilis (Distant) (Hemiptera: Cercopidae) fed on four forages exposed to environments with different CO2 concentrations was evaluated. In the first bioassay, we utilized the following scenarios: A) plants and insects were kept at high and constant CO2 (700 ppm) and B) the insects were kept at CO2 700 ppm and fed on plants from the greenhouse (average of 390 ppm). In the second bioassay, we utilized the following scenarios: C) plants and insects were kept in a greenhouse and D) the insects were kept in the greenhouse and fed on plants kept at CO2 700 ppm. The survival and duration of the nymphal and adult stages and the number of eggs/female of M. spectabilis were evaluated. It was only possible to evaluate the cumulative effects of the increase of CO2 on three successive generations of M. spectabilis kept in a greenhouse, due to the reduced survival of the insects in the first generation in the laboratory. A greater direct than indirect effect of the CO2 level on the performance of M. spectabilis was observed. Furthermore, it should be considered that the effect of CO2 elevation on the survival, periods of development, and fecundity, when taken together, can significantly impact the population dynamics of M. spectabilis in future climate scenarios.

Patients' perspectives of the skills and competencies of therapy radiographers/radiation therapists (TRs/RTTs) in the UK, Portugal and Malta; a qualitative study from the SAFE Europe project.

INTRODUCTION: The role of the Therapy Radiographer/Radiation Therapist (TR/RTT) is to provide radiotherapy to patients with a cancer diagnosis. This includes, not only administration of treatment, but also management of side-effects and provision of support/care. Despite this role being consistent throughout Europe, there is currently no standardisation of education for TRs/RTTs. The SAFE EUROPE project aims to standardize TR/RTT education to enable 'safe and free exchange' of TRs/RTTs across Europe. Consequently, this study aims to explore patients' perspectives regarding the current skills and competencies of TRs/RTTs. METHODS: From May 2021 to February 2022, semi-structured interviews were conducted with patients who had recently received radiotherapy in the UK, Malta and Portugal. Ethical approval for this study was granted by the NHS Research Ethics Committee with additional local approvals obtained. RESULTS: Forty-eight participants from the UK (n = 18), Portugal (n = 19), and Malta (n = 11) completed interviews. Participants described high satisfaction with TRs'/RTTs' competence and skills in all three countries. The main theme arising from the analysis was the importance of trust building with TRs/RTTs. Six factors were identified as influencing levels of trust: communication; side-effect management; team consistency; relational skills; patient dignity; and competence. A small number of patients reported feeling rushed and not having their physical and emotional needs met by TRs/RTTs. CONCLUSION: This multicentre study demonstrated that patients perceive TRs/RTTs in the UK, Malta and Portugal as highly competent and skilled. Practical recommendations are provided to address identified deficits in practice, which can be addressed through adaptation of TR/RTT education/training and clinical practice. IMPLICATIONS FOR PRACTICE: Recommendations arising from this study are important to ensure that TRs/RTTs have transferable skills that provide consistently high quality care to patients throughout Europe.

Fibrotic alterations in human annulus fibrosus correlate with progression of intervertebral disc herniation.

BACKGROUND: Intervertebral disc (IVD) herniation is characterized by annulus fibrosus failure (AF) in containing the nucleus pulposus (NP). IVD herniation involves cellular and extracellular matrix (ECM) alterations that have been associated with tissue fibrosis, although still poorly investigated. METHODS: Here, fibrotic alterations in human AF were evaluated, by characterizing the herniated ECM. Human AF samples (herniated lumbar IVD (n = 39, age 24-83) and scoliosis controls (n = 6, age 15-21)) were processed for transmission electron microscopy and histological/immunohistochemical analysis of fibrotic markers. Correlations between the fibrotic markers in AF ECM and the degree of NP containment (protused, contained and uncontained) and patients' age were conducted. RESULTS: Our results demonstrate that with herniation progression, i.e. loss of NP containment, human AF presents less stained area of sulphated glycosaminoglycans and collagen I, being collagen I fibres thinner and disorganized. On the other hand, fibronectin stained area and percentage of α-smooth muscle actin+ cells increase in human AF, while matrix metalloproteinase-12 (MMP12) production and percentage of macrophages (CD68+ cells) remain constant. These structural and biochemical fibrotic alterations observed in human AF with herniation progression occur independently of the age. CONCLUSIONS: The characterization of human AF here conducted evidence the presence of fibrosis in degenerated IVD, while highlighting the importance of considering the herniation progression stage, despite the patients' age, for a better understanding of the mechanisms behind AF failure and IVD herniation.

Pratylenchus Araucensis (Rhabditida: Pratylenchidae) a Widely Distributed Nematode in Musa Spp. from Colombia.

Pratylenchus is one of the most limiting nematodes of Musaceae production in the world. Knowledge of the nematode species is one of the requirements for its management in the field. This study aimed to identify up to the species level Pratylenchus populations associated with plantain and banana crops in the states of Caldas, Quindío, and Valle del Cauca in Colombia. In these regions, Pratylenchus has been reported to affect these crops in the past, but with records of the nematode only up to the genus level. For this purpose, five populations of Pratylenchus extracted from samples composed of roots and rhizospheric soil, four from plantain and one from banana, were identified through morphological, morphometric, and molecular analysis (sequencing of the D2-D3 of rRNA and cytochrome oxidase subunit I of mtDNA). All populations were identified as P. araucensis, a species reported previously in eastern Colombia, and one that the present study found in the center and southwest of the country, indicating that this species of nematode is widely distributed in the Musaceae-producing areas of Colombia. The present study reports the first COI mtDNA sequences for this species of nematode.

Occurrence of Meloidogyne Arenaria in Black Pepper (Piper Nigrum L.) in the Extreme South of the State of Bahia, Brazil.

Samples of black pepper root with the presence of galls from the most southern region of the State of Bahia, Brazil, were characterized biochemically and morphologically using three criteria: i) observation of the anterior region of the males; ii) analysis of female perineal configuration and iii) polyacrylamide gel electrophoresis technique. Meloidogyne arenaria was found. This is the first report of this pathosystem in the State.

Pathogenicity of Aphelenchoides Pseudogoodeyi on the Ornamental Plants Asplenium Nidus and Lilium Speciosum in Brazil.

Aphelenchoides pseudogoodeyi has recently been reported in association with seeds of forage grasses and rice in Brazil and senescent strawberry plants, in the United States. This nematode is likely a mycophagous species; however, so far, its pathogenicity potential to plants is unclear. This study aimed to verify the pathogenicity of A. pseudogoodeyi to two species of ornamental plants. The experiments were conducted by inoculating A. pseudogoodeyi onto Bird's-Nest Fern (Asplenium nidus) and Oriental Lily (Lilium speciosum) leaves, using two inoculation methods (with and without injury). After 40 days of inoculation (DAI) in Bird's-Nest Fern and 5, 10, 20 and 40 DAI in Oriental Lily, the pathogenicity and the host efficiency were evaluated by symptoms observation and by severity, final nematode population and reproductive factor (RF), respectively. Additionally, a histopathological study was performed by inoculating A. pseudogoodeyi onto Bird's-Nest Fern for observing anatomical alterations. A. pseudogoodeyi was able to cause local necrotic lesions on both Bird's-Nest Fern and Oriental Lily leaves. However, the presence of injury was essential to enable A. pseudogoodeyi to penetrate and cause those symptoms in both plant species. Also, the total population of A. pseudogoodeyi decreased drastically over time and RF was <1, which characterized these species as poor-host or resistant plants. A. pseudogoodeyi penetrated into the foliar tissue and induced a total destruction of the mesophyll and collapse of the cells, with the formation of large intercellular spaces. It is concluded that A. pseudogoodeyi is an opportunistic pathogen as injury was required to induce symptoms in Bird's-Nest Fern and Oriental Lily.

The interaction of a thiosemicarbazone derived from R - (+) - limonene with lipid membranes.

As a potential drug, 2-nitrobenzaldehyde-thiosemicarbazone (2-TSC), a thiosemicarbazone derived from the terpene R-(+)-limonene, was studied through calorimetric and spectroscopic techniques. Differential Scanning Calorimetry (DSC) data showed that 2-TSC causes structural changes in a 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DMPC) membrane, strongly decreasing the cooperativity of the bilayer gel-fluid thermal transition. Optical absorption spectroscopy showed that 2-TSC is more soluble in ethanol and lipids than in water medium, and that the drug displays different structures in the different environments. Though 2-TSC displays no fluorescence, time resolved fluorescence showed that the drug is an effective quencher of the fluorescent probe 6-dodecanoyl-2-dimethylaminonaphthalene (Laurdan). As it is well accepted that Laurdan is positioned into the bilayer close to the membrane surface, that is possibly the localization of 2-TSC in a bilayer. Electron spin resonance (ESR) of the probe 1-palmitoyl-2-stearoyl-(14-doxyl)-sn-glycero-3-phosphocholine (14-PCSL) revealed that 2-TSC is inserted into the hydrocarbon part of the bilayer, fluidizing the lipid bilayer gel phase and rigidifying or organizing the bilayer fluid phase. Similar effects are found for other lipophilic molecules, including cholesterol. These results are useful to improve the understanding of the processes that govern the interaction of thiosemicarbazones with cell membranes, related to the activity of the drugs and their cytotoxicity.

On the First Occurrence of Xiphinema Santos in Brazil.

Based on morphology, measurements of juveniles and female specimens and sequences of the D2/ D3 expansion 28S rDNA gene and ITS1 analysis by DNA barcode technique, a Xiphinema americanum group species associated with olive trees from state of Sao Paulo, Brazil was identifi ed as X. santos. This is the first report of X. santos in Southern Hemisphere and outside the European and African continents, thus extending its geographic range.

Publisher Correction: A large intragenic deletion in the CLCN1 gene causes Hereditary Myotonia in pigs.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

A large intragenic deletion in the CLCN1 gene causes Hereditary Myotonia in pigs.

Mutations in the CLCN1 gene are the primary cause of non-dystrophic Hereditary Myotonia in several animal species. However, there are no reports of Hereditary Myotonia in pigs to date. Therefore, the objective of the present study was to characterize the clinical and molecular findings of Hereditary Myotonia in an inbred pedigree. The clinical, electromyographic, histopathological, and molecular findings were evaluated. Clinically affected pigs presented non-dystrophic recessive Hereditary Myotonia. Nucleotide sequence analysis of the entire coding region of the CLCN1 gene revealed the absence of the exons 15 and 16 in myotonic animals. Analysis of the genomic region flanking the deletion unveiled a large intragenic deletion of 4,165 nucleotides. Interestingly, non-related, non-myotonic pigs expressed transcriptional levels of an alternate transcript (i.e., X2) that was identical to the deleted X1 transcript of myotonic pigs. All myotonic pigs and their progenitors were homozygous recessive and heterozygous, respectively, for the 4,165-nucleotide deletion. This is the first study reporting Hereditary Myotonia in pigs and characterizing its clinical and molecular findings. Moreover, to the best of our knowledge, Hereditary Myotonia has never been associated with a genomic deletion in the CLCN1 gene in any other species.

Coffee berry borer in conilon coffee in the Brazilian Cerrado: an ancient pest in a new environment.

The aim of this study was to verify the occurrence of the coffee berry borer, Hypothenemus hampei (Ferrari), and to evaluate the population fluctuation of the pest in the Brazilian Cerrado (Federal District). The study was conducted, between November 2014 and October 2015, at Embrapa Cerrados (Planaltina/DF, Brazil) in an irrigated conilon coffee production area. In November 2014, 120 samples (ten berries/sample) were collected from berries that had fallen on the ground from the previous harvest. Between November 2014 and October 2015, insects were collected weekly, using traps (polyethylene terephthalate bottles) baited with ethyl alcohol (98 GL), ethyl alcohol (98 GL) with coffee powder, or molasses. Between January and July 2015, samples were collected fortnightly from 92 plants (12 berries per plant). All samples were evaluated for the presence of adult coffee berry borers. Samples from the previous harvest had an attack incidence of 72.4%. The baited traps captured 4062 H. hampei adults, and showed no statistical difference in capture efficiency among the baits. Pest population peaked in the dry season, with the largest percentage of captured adults occurring in July (31.0%). An average of 18.6% of the collected berries was attacked by the borer and the highest percentage incidence was recorded in July (33.2%). Our results suggest that the coffee berry borer, if not properly managed, could constitute a limiting factor for conilon coffee production in the Brazilian Cerrado.

Vitrification of bovine embryos followed by in vitro hatching and expansion.

The objective of this study was to assess the effects of bovine embryo vitrification by applying three different vitrification solutions containing ethylene glycol (EG) and dimethylsulphoxide (DMSO) at different concentrations (10, 20 or 25% each) combined with 1.0 M glucose or 1.0 M sucrose, on the in vitro hatching and expansion rates. Healthy oocytes were selected for in vitro maturation and fertilization from 200 bovine ovaries, and subsequently cultured up to the blastocyst stage (n = 800). Control (n = 200) and vitrified cells (n = 100 per treatment; 600 in total) were cultured for an extra 24 or 48 h to evaluate hatching and expansion, respectively. Vitrification significantly decreased embryonic re-expansion and hatching rates independently of the tested solution when compared with control embryos, but solutions with 25% EG + 25% DMSO resulted in the highest re-expansion (75%) and hatching (70%) rates, independently of the added sugar. The addition of sucrose resulted in higher rates of re-expanded and hatched embryos when compared with glucose addition. We concluded that the combination of 25% EG + 25% DMSO and 1.0 M sucrose allowed hatching and expansion of vitrified-warmed bovine embryos produced in vitro.

Chikungunya Infection in Solid Organ Transplant Recipients.

BACKGROUND: Chikungunya virus (CHIKV) is an emerging mosquito-borne disease that causes acute febrile polyarthralgia and arthritis. CHIKV has spread rapidly to the Americas and, in Brazil, autochthonous cases are increasingly been reported. Solid organ transplant (SOT) recipients who travel to or live in CHIKV endemic areas are under high risk of acquiring the disease. Few data exist regarding the clinical characteristics of CHIKV infections in this population. We report the first case series of CHIKV infection in SOT recipients. METHODS: We retrospectively evaluated 13 cases of CHIKV infection in SOT recipients between January 2016 and December 2016 confirmed by laboratory tests and transplanted in the Renal and Liver Transplant Units of Walter Cantídio University Hospital from Federal University of Ceará. RESULTS: Positive CHIKV serology (enzyme-linked immunosorbent assay immunoglobulin M) was found in all patients (9 kidney and 4 liver transplant recipients). All of these patients had been living in endemic areas for dengue and CHIKV in the past months before the illness. The mean time between transplantation and CHIKV infection was of 7.2 years. Fever presented in 11 (84.6%) patients and 5 (38.5%) presented with a maculopapular rash. All cases had joint symptoms: 11 (84.6%) with symmetrical and peripheral polyarthralgia/polyarthritis and 2 (15.3%) with monoarthralgia/monoarthritis. Six (46%) patients had a joint complaint that lasted 3 months. Two patients had concomitant positive dengue serology (enzyme-linked immunosorbent assay immunoglobulin M). There were no cases of complications or deaths. CONCLUSION: SOT with CHIKV infection seems to have a clinical presentation and evolution similar to those seen in the general population, with no apparent damage to the graft.

Kidney Transplantation Using Gonadal Vein for Venous Anastomosis in Patients With Iliac Vein Thrombosis or Stenosis: A Series of Cases.

BACKGROUND: Kidney transplantation is the treatment of choice for patients with end-stage renal disease. The standard surgery uses the recipient's iliac vessels for vascular anastomosis. Thrombosis and/or stenosis of the iliac vein, which are possible complications of multiple vascular access points for dialysis, can be detected intraoperatively, constituting a surgical challenge. An infrequently reported option is the use of the gonadal vein. OBJECTIVES: This study aims to evaluate the outcomes of venous anastomosis in the gonadal vein in patients with iliac vein thrombosis and/or stenosis submitted to kidney transplantation. METHODS: We reviewed the records of five adult recipients with iliac vein thrombosis and/or stenosis detected intraoperatively during emergency kidney transplantation with deceased donor due to vascular access failure from February 2013 to December 2014. Antithrombotic prophylaxis was not performed. We evaluated the postoperative complications, length of stay, early graft echo-Doppler, and renal function during the first year postoperatively. RESULTS: Delayed graft function occurred in three cases. Two patients developed postoperative infection requiring antibiotics. One patient required reoperation due to post-renal biopsy complications. The mean length of stay was 31.2 days and the mean serum creatinine levels at discharge, at 6 months, and at 12 months postoperatively were 1.42 mg/dL, 0.86 mg/dL, and 0.82 mg/dL, respectively. All patients had normal ultrasonography. There were no losses of graft or deaths during follow-up. CONCLUSION: Venous anastomosis using the gonadal vein in kidney transplantation for patients with iliac vein thrombosis and/or stenosis showed good clinical and surgical results, showing this method to be a viable alternative to venous drainage in these complex patients.

Influence of Select Antibiotics on Vibrio fischeri and Desmodesmus subspicatus at µg L-1 Concentrations.

The presence of pharmaceuticals in the aquatic environment is a contemporary reality and it is necessary to understand more about the effects of this presence on organisms. The purpose of this work was to assess the ecotoxicity of antibiotics metronidazole, nitrofurantoin, trimethoprim, and sulphamethoxazole (single and mixture) in Vibrio fischeri and Desmodesmus subspicatus at µg L-1 concentrations. The evaluation of the toxic effect of the antibiotics on V. fischeri and D. subspicatus was based on fluorescence and bioluminescence tests, respectively, using nominal concentrations. When tested individually, the four antibiotics gave rise to a toxic effect on the evaluated organisms. Sulphamethoxazole caused a higher toxic effect on V. fischeri and D. subspicatus from 7.81 to 500 µg L-1. Trimethoprim and sulphamethoxazole showed hormesis for the concentrations, which ranged from 7.81 to 62.5 µg L-1. The mixture of antibiotics induced a toxic effect on the V. fischeri and D. subspicatus organisms (from 0.03 to 1 µg L-1 concentrations) than when the antibiotics were evaluated individually. These results were significant since water quality problems are widespread all over the word, and emerging pollutants such as antibiotics have been detected in the aquatic environment in very low concentrations.

Measuring population fluctuation of jatropha stem-borer [Cophes notaticeps (Marshall)] in the Brazilian Cerrado using a new trap.

This study aimed to monitor the population fluctuation of Cophes notaticeps (Marshall) (Coleoptera: Curculionidae) in a jatropha (Jatropha curcas L.) plantation in the Federal District, Brazil, through the use of a new trap, combined with different attractive lures and trap colors. The study was conducted at Embrapa Cerrados (Planaltina/DF) in a field trial with 720 plants. The new trap, named CPAC16, was made with PVC pipes (100 mm in diameter) of about 40 cm in length, with a window (8 × 10 cm2) in its center to enable insect access. A lure compartment was fixed on the inside of the trap`s top, and a pot, containing water and detergent, was placed at its bottom to collect the insects. The traps were painted in red, yellow, blue and green. Molasses, ethanol and pineapple were used as attractive lures. The traps were in the field trial area between May 2013 and April 2014 and the insects were collected weekly. The incidence of plants presenting damage caused by C. notaticeps was evaluated in the beginning and at the end of the study. The CPAC16 trap proved efficient in monitoring C. notaticeps. About 3494 of C. notaticeps adults were collected during the study. There were no significant differences among traps painted with different colors. The most attractive lure was molasses collecting 75.2% (n = 2627) of the specimens. Although the population peak occurred in December (n = 1162), C. notaticeps were collected throughout the year. The incidence of plants attacked by C. notaticeps ranged from 66.4% (start) to 100% (end).

Torção esplênica primária em um cão: relato de caso / Primary splenic torsion in a dog: case report

A torção esplênica isolada ou primária é uma enfermidade de ocorrência rara em cães, caracterizada pela torção do pedículo esplênico, sem que haja outra enfermidade concomitante. Os sinais clínicos e os exames laboratoriais são inespecíficos, porém a ultrassonografia, juntamente com o uso de Doppler colorido, tem sido importante para sugerir o diagnóstico, que é confirmado por meio de laparotomia exploratória. Este estudo relata o caso de um cão da raça Bulldog campeiro, cinco anos de idade, muito ativo, que recebia alimentação apenas uma vez ao dia. Este foi atendido no Hospital Veterinário da Universidade Luterana do Brasil (HV-Ulbra), com histórico de prostração, emagrecimento e anorexia intermitente havia 10 dias. Neste caso relatado, o exame ultrassonográfico com Doppler colorido foi imprescindível para o diagnóstico, que pôde ser confirmado posteriormente pela laparotomia exploratória. Na celiotomia, observou-se o baço aumentado e rotacionado, envolto com o omento, e ambos encontravam-se desvitalizados. Por essa razão, foram realizados os procedimentos de esplenectomia total e omentectomia parcial da porção acometida.(AU)

The individual or primary splenic torsion is a rare disease occurrence in dogs characterized by twisting the splenic pedicle, without any other concomitant disease. Clinical signs and laboratory tests are nonspecific, however, ultrasonography, along with the use of color Doppler, has been important to suggest the diagnosis is confirmed through exploratory laparotomy. This study reports the case of a 5-year-old very active male Bulldog Campeiro, who received food once a day, which was attended at the Veterinary Hospital of Universidade Luterana do Brasil (HV ULBRA) with a history of prostration, weight loss and intermittent anorexia during 10 days. Ultrasonography with color Doppler exam was essential for the diagnosis, which could be confirmed later by exploratory laparotomy. In celiotomy it was observed the spleen increased in size and rotated, wrapped with omentum and both were found devitalized. For this reason, the procedures of total splenectomy and partial omentectomy of the affected portion were performed.(AU)

Urinary Tract Infections and Surgical Site Infections due to Carbapenem-Resistant Enterobacteriaceae in Renal Transplant.

BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) are emerging pathogens. Recent publications have shown that renal transplant recipients are a population at risk for CRE infections. Management of these infections in this population is complex, requiring frequent use of nephrotoxic antimicrobial agents. Differentiating between urinary tract infection (UTI) and surgical site infection (SSI) in renal transplant recipients is sometimes difficult. The aim of this study was to describe CRE UTIs and SSIs in renal transplant recipients and to evaluate the impact of these infections on renal graft and patient survival. RESULTS: Between January 2010 and October 2015, a total of 428 renal transplants were performed; 25 UTIs and 9 SSIs were identified. Median time between transplantation and diagnosis of CRE infection was 26 days; 29 cases (85.29%) were considered early infections. Of the 34 CRE isolates, 100% were sensitive to amikacin and colistin. Polymyxins were the most commonly used antimicrobial agent (27 cases [79.41%]). Nephrotoxicity was found in 4 (15.38%) of 26 cases. Combination therapy was used in 19 cases (55.88%), with a cure rate of 74%; monotherapy was used in 15 cases (44.11%), with a cure rate of 86%. Among the 25 cases of UTI, the cure rate was 100%, and recurrence occurred in 4 cases (16%). Among the 9 cases of SSI, 7 (77.7%) had negative outcomes (nephrectomy or death). CONCLUSIONS: We observed that CRE UTIs had a high therapeutic success rate, low recurrence, and low mortality. However, CRE SSIs were associated with high morbidity and mortality, with high graft loss. Polymyxins and aminoglycosides, despite the risk of nephrotoxicity, had little impact on renal graft function, and are thus a safe therapeutic alternative to treat these infections.

Artery Stenosis of the Renal Graft: Experience of a Center of Northeastern Brazil.

BACKGROUND: Transplant renal artery stenosis (TRAS), the most common vascular complication after transplant (Tx), leads to resistant hypertension, impaired renal function, and even loss of the graft. The purpose of the study was to investigate the prevalence and factors associated with TRAS in northeastern Brazil. METHODS: The study was conducted as a retrospective case-control study in a population of Tx recipients in a renal Tx center in northeastern Brazil. Demographic and clinical characteristics of the recipients and donors, data related to the surgery, laboratory data, and number of anti-hypertensive drugs were assessed. Statistical analysis was performed with the use of SPSS 17.0. RESULTS: A total of 494 of 529 recipients were assessed, of which 24 had TRAS. The prevalence of TRAS was 4.8%. Twelve patients (50%) were men with a mean age of 46.7 ± 13.5 years. The mean time of diagnosis was 89.9 days after Tx. The risk factors associated with TRAS were number of anti-hypertensive drugs ≥2 (odds ratio, 17.0; confidence interval, 4.1 to 70.4; P = .001) and grafting with 2 or more arteries (odds ratio, 8.9; confidence interval, 1.4 to 56.6; P = .021). There was a significant reduction in mean systolic blood pressure (147.1 ± 23.7 to 127.8 ± 15.2 mm Hg, P = .001) and diastolic blood pressure (86.6 ± 13.0 to 77.6 ± 9.4 mm Hg, P = .001) after TRAS repair and in serum creatinine (2.8 ± 2.4 to 1.9 ± 1.8 mg/dL, P = .04). CONCLUSIONS: Grafts with 2 or more arteries are associated with TRAS, as well as patients who use a higher number of anti-hypertensive drugs. TRAS repair was associated with improved blood pressure control and renal function.

Automated lesion detectors in retinal fundus images.

Diabetic retinopathy (DR) is a sight-threatening condition occurring in persons with diabetes, which causes progressive damage to the retina. The early detection and diagnosis of DR is vital for saving the vision of diabetic persons. The early signs of DR which appear on the surface of the retina are the dark lesions such as microaneurysms (MAs) and hemorrhages (HEMs), and bright lesions (BLs) such as exudates. In this paper, we propose a novel automated system for the detection and diagnosis of these retinal lesions by processing retinal fundus images. We devise appropriate binary classifiers for these three different types of lesions. Some novel contextual/numerical features are derived, for each lesion type, depending on its inherent properties. This is performed by analysing several wavelet bands (resulting from the isotropic undecimated wavelet transform decomposition of the retinal image green channel) and by using an appropriate combination of Hessian multiscale analysis, variational segmentation and cartoon+texture decomposition. The proposed methodology has been validated on several medical datasets, with a total of 45,770 images, using standard performance measures such as sensitivity and specificity. The individual performance, per frame, of the MA detector is 93% sensitivity and 89% specificity, of the HEM detector is 86% sensitivity and 90% specificity, and of the BL detector is 90% sensitivity and 97% specificity. Regarding the collective performance of these binary detectors, as an automated screening system for DR (meaning that a patient is considered to have DR if it is a positive patient for at least one of the detectors) it achieves an average 95-100% of sensitivity and 70% of specificity at a per patient basis. Furthermore, evaluation conducted on publicly available datasets, for comparison with other existing techniques, shows the promising potential of the proposed detectors.