Using Confocal Microscopy and Pigment Analyses to Detect Adverse Insecticide Effects in non-target Freshwater Diatom species - a proof-of-concept Using Nitzschia palea.

The persistence of insecticides in aquatic environments is a cause of concern and to date hardly any studies have focused on the effects that DDT and deltamethrin have on non-target freshwater diatom communities. The application of diatoms in ecotoxicological studies is well acknowledged and therefore this study used laboratory bioassays to determine the effects that DDT and deltamethrin have on a monoculture of a diatom indicator species, Nitzschia palea. The insecticides affected the morphology of chloroplasts at all exposure concentrations. These effects were a maximum reduction in chlorophyll concentrations (4.8% and 2.3%), cell viability (51% and 42%), and increases in cell deformities (3.6% and 1.6%) following exposure to DDT and deltamethrin respectively. Based on the results we propose that methods, such as confocal microscopy, chlorophyll-α analysis and cell deformities are useful tools in assessing the effects of insecticides on diatoms.

Fully automatic cardiac four chamber and great vessel segmentation on CT pulmonary angiography using deep learning.

Introduction: Computed tomography pulmonary angiography (CTPA) is an essential test in the work-up of suspected pulmonary vascular disease including pulmonary hypertension and pulmonary embolism. Cardiac and great vessel assessments on CTPA are based on visual assessment and manual measurements which are known to have poor reproducibility. The primary aim of this study was to develop an automated whole heart segmentation (four chamber and great vessels) model for CTPA. Methods: A nine structure semantic segmentation model of the heart and great vessels was developed using 200 patients (80/20/100 training/validation/internal testing) with testing in 20 external patients. Ground truth segmentations were performed by consultant cardiothoracic radiologists. Failure analysis was conducted in 1,333 patients with mixed pulmonary vascular disease. Segmentation was achieved using deep learning via a convolutional neural network. Volumetric imaging biomarkers were correlated with invasive haemodynamics in the test cohort. Results: Dice similarity coefficients (DSC) for segmented structures were in the range 0.58-0.93 for both the internal and external test cohorts. The left and right ventricle myocardium segmentations had lower DSC of 0.83 and 0.58 respectively while all other structures had DSC >0.89 in the internal test cohort and >0.87 in the external test cohort. Interobserver comparison found that the left and right ventricle myocardium segmentations showed the most variation between observers: mean DSC (range) of 0.795 (0.785-0.801) and 0.520 (0.482-0.542) respectively. Right ventricle myocardial volume had strong correlation with mean pulmonary artery pressure (Spearman's correlation coefficient = 0.7). The volume of segmented cardiac structures by deep learning had higher or equivalent correlation with invasive haemodynamics than by manual segmentations. The model demonstrated good generalisability to different vendors and hospitals with similar performance in the external test cohort. The failure rates in mixed pulmonary vascular disease were low (<3.9%) indicating good generalisability of the model to different diseases. Conclusion: Fully automated segmentation of the four cardiac chambers and great vessels has been achieved in CTPA with high accuracy and low rates of failure. DL volumetric biomarkers can potentially improve CTPA cardiac assessment and invasive haemodynamic prediction.

A lentic microcosm approach to determine the toxicity of DDT and deltamethrin on diatom communities.

Worldwide the use of pesticides has increased, especially in the industry and agriculture sector even though they contain highly toxic substances. The use of pesticides has various negative effects on the aquatic ecosystem and organisms within these ecosystems. The paper aimed to assess the effects of increased concentrations of malaria vector control insecticides (Dichlorodiphenyltrichloroethane (DDT) and Deltamethrin (DTM)) on the freshwater diatom community structure using a microcosm approach as well as determine whether a mixture (DDT 1:1 Deltamethrin) exposure will have a greater influence on the diatom community when compared to single exposures of these insecticides. Diatoms were exposed to a high and low concentration (based on LC50 data for freshwater Xenopus laevis from the USEPA Ecotox database) of DDT, DTM and a mixture in lentic microcosms over a total period of 28 days. Results indicated that irrespective of exposure concentrations, DDT, DTM and a mixture had negative effects on the diatom community including functionality and vitality as these insecticides induced changes to their chloroplasts. There was an increased percentage dead cells for all exposures compared to the control, with the insecticides having a phototoxic effect on the diatom community. Exposure to the selected insecticides caused a significant decrease in some diatom metrics indicating the negative effects these insecticides have on the diatom metrics. Therefore, diatoms may prove to be useful as bio-indicators in ecotoxicology studies when assessing the effects of any insecticide exposures.

On Sea Turtle-associated Craspedostauros (Bacillariophyta), with Description of Three Novel Species.

The current study focuses on four species from the primarily marine diatom genus Craspedostauros that were observed growing attached to numerous sea turtles and sea turtle-associated barnacles from Croatia and South Africa. Three of the examined taxa, C. danayanus sp. nov., C. legouvelloanus sp. nov., and C. macewanii sp. nov., are described based on morphological and, whenever possible, molecular characteristics. The new taxa exhibit characters not previously observed in other members of the genus, such as the presence of more than two rows of cribrate areolae on the girdle bands, shallow perforated septa, and a complete reduction of the stauros. The fourth species, C. alatus, itself recently described from museum sea turtle specimens, is reported for the first time from loggerhead sea turtles rescued in Europe. A 3-gene phylogenetic analysis including DNA sequence data for three sea turtle-associated Craspedostauros species and other marine and epizoic diatom taxa indicated that Craspedostauros is monophyletic and sister to Achnanthes. This study, being based on a large number of samples and animal specimens analyzed and using different preservation and processing methods, provides new insights into the ecology and biogeography of the genus and sheds light on the level of intimacy and permanency in the host-epibiont interaction within the epizoic Craspedostauros species.

Diatom type material in permanent slides does not need to be permanently unavailable for electron microscopy examination.

The inability to thoroughly examine diatom type material existing only in resin-mounted permanent slides is a common frustration for diatomologists. Here, we present an efficient, inexpensive, and straightforward technique to extract siliceous exoskeletons of diatoms from permanent slides prepared with commonly used mounting media. Van Heurck's slide constituting an isotype duplicate of Proschkinia bulnheimii var. belgica, an entity with an uncertain taxonomic status, was deconstructed to allow thorough examination using scanning electron microscopy. Numerous specimens of the taxon, including intact frustules and specimens with complete areola occlusions, were recovered and documented. The extracted diatom material was sufficient to prepare two scanning electron microscopy specimens and reconstruct the permanent slide. The proposed approach may help overcome many of the taxonomic bottlenecks associated with the low resolution of information provided by older diatom descriptions and permanent slide observations.

Benthic diatom-based indices and isotopic biomonitoring of nitrogen pollution in a warm temperate Austral river system.

Rivers are impacted by pollutants from anthropogenic activities such as urbanisation and agricultural practices. Whilst point source pollution has been widely studied and in some cases remediated, non-point pollutant sources remain pervasive, particularly in developing countries that lack economic and human specialist capacity. Monitoring of pollution levels in many regions is additionally challenged by a lack of robust indicators for nitrogen inputs, however, diatom community indices and analysis of variation in microphytobenthos (MBP) stable isotope analysis variations have potential. The present study investigates variations and utilities in benthic diatom indices and MPB δ15N along different river sections (n = 31) of an austral river between two seasons (wet and dry), testing for relationships with key environmental variables (physical, water and sediment), in the context of N monitoring. One hundred and eighteen diatom taxa belonging to 36 genera were identified, with physical (water flow), water (nitrate, P and total dissolved solids) and sediment (B, Ca, Cr, Na, N, P, SOM, Pb and Zn) variables correlating to one or more of the 12 diatom indices presented. In particular, Biological Diatom Index, Biological Index of Water Quality, Central Economic Community, Index of Artois-Picardie Diatom (IDAP) and Sládecek's Index were strongly explained by sediment variables, whilst Descy's Pollution Index and Schiefele and Schreiner's Index were explained by water and physical variables. Whilst MPB δ15N were within the "no impact" level in the wet and dry seasons at reference (i.e. unpolluted) sites, all sites located in agricultural or urban areas, and downstream of sewage discharges, had a wider range that encompassed increasing organic impacts ("inorganic impacts" to high "organic impacts"). Temperature and turbidity (negative), as well as dissolved oxygen, waterway width and depth (positive), significantly affected MPB δ15N, whilst effects of chemistry variables were less apparent. Overall, we found that MPB δ15N signatures were significantly correlated with Trophic Diatom Index, the Specific Pollution Sensitivity Index and the Artois-Picardie Diatom Index, suggesting the utility of diatoms and MPB δ15N in assessments of aquatic pollution. In turn, MPB δ15N values are strong indicators of N pollution across spatial and seasonal gradients. Thus, the results showed the effects of sediment variables on diatoms to be strong, indicating that sediment rather than water characteristics more strongly structure diatom communities. Thus, sediment variables should be sampled when conducting bioassessment studies.

2015 UK software audit of hepatobiliary scintigraphy.

INTRODUCTION: This audit investigated hepatobiliary function imaging in UK hospitals, reviewing protocol differences in acquisition and processing parameters and the effect on calculated gallbladder ejection fraction (GBEF). PARTICIPANTS AND METHODS: Two dynamic data sets were available: one continuous dynamic data set, and the other with a 5-min break to administer the fatty stimulus. Participants used a set of 12 anonymized patient data sets most similar to their standard protocol calculating GBEF using their routine method. RESULTS: Fifty-two UK centres responded. Across all centres for all data sets, there was large variability in GBEF quoted, mostly owing to variations in the calculation method, motion correction and imaging type/times. The largest contributor to GBEF variation was time acquired after stimulus which varied from 20 to 70 min. Only 48.1% centres acquired for 60 min after stimulus, which is the acquisition time stated in normal range references. Overall, 13.5% participating centres administered fatty stimuli that fell below the recommended 10 g. Widespread variations were found in GBEF normal ranges and fatty stimulus administration. Motion correction has a large effect on GBEF; in one data set, motion correction alone changed GBEF from 44 to 9%, but 25% of the participants stated motion correction was not used. CONCLUSION: The authors proposed gold standard is fat content of the stimulus should be at least 10 g; and images should be acquired for 60 min after stimulus. If GBEF is quoted, motion correction should be used, and if compared with a normal range, the stimulus used must fit with the reference.

The subresolution DaTSCAN phantom: a cost-effective, flexible alternative to traditional phantom technology.

The Alderson striatal phantom is frequently used to assess I-FP-CIT (Ioflupane) image quality and to test semi-quantification software. However, its design is associated with a number of limitations, in particular: unrealistic image appearances and inflexibility. A new physical phantom approach is proposed on the basis of subresolution phantom technology. The design incorporates thin slabs of attenuating material generated through additive manufacturing, and paper sheets with radioactive ink patterns printed on their surface, created with a conventional inkjet printer. The paper sheets and attenuating slabs are interleaved before scanning. Use of thin layers ensures that they cannot be individually resolved on reconstructed images. An investigation was carried out to demonstrate the performance of such a phantom in producing simplified I-FP-CIT uptake patterns. Single photon emission computed tomography imaging was carried out on an assembled phantom designed to mimic a healthy patient. Striatal binding ratio results and linear striatal dimensions were calculated from the reconstructed data and compared with that of 22 clinical patients without evidence of Parkinsonian syndrome, determined from clinical follow-up. Striatal binding ratio results for the fully assembled phantom were: 3.1, 3.3, 2.9 and 2.6 for the right caudate, left caudate, right putamen and right caudate, respectively. All were within two SDs of results derived from a cohort of clinical patients. Medial-lateral and anterior-posterior dimensions of the simulated striata were also within the range of values seen in clinical data. This work provides the foundation for the generation of a range of more clinically realistic, physical phantoms.

Effects of deployment on diet quality and nutritional status markers of elite U.S. Army special operations forces soldiers.

BACKGROUND: Special Operations Forces (SOF) Soldiers deploy frequently and require high levels of physical and cognitive performance. Nutritional status is linked to cognitive and physical performance. Studies evaluating dietary intake and nutritional status in deployed environments are lacking. Therefore, this study assessed the effects of combat deployment on diet quality and serum concentrations of nutritional status markers, including iron, vitamin D, parathyroid hormone (PTH), glucose, and lipids, among elite United States (U.S.) Army SOF Soldiers. METHODS: Changes from baseline to post-deployment were determined with a repeated measure within-subjects design for Healthy Eating Index-2010 (HEI-2010) scores, intake of foods, food groups, key nutrients, and serum nutritional status markers. Dietary intake was assessed with a Block Food Frequency Questionnaire. The association between post-deployment serum 25-hydroxy vitamin D (25-OH vitamin D) and PTH was determined. Analyses of serum markers were completed on 50 participants and analyses of dietary intake were completed on 33 participants. RESULTS: In response to deployment, HEI-2010 scores decreased for total HEI-2010 (70.3 ± 9.1 vs. 62.9 ± 11.1), total fruit (4.4 ± 1.1 vs. 3.7 ± 1.5), whole fruit (4.6 ± 1.0 vs. 4.2 ± 1.4), dairy (6.2 ± 2.7 vs. 4.8 ± 2.4), and empty calories (14.3 ± 3.2 vs. 11.1 ± 4.5) (P ≤ 0.05). Average daily intakes of foods and food groups that decreased included total dairy (P < 0.01), milk (P < 0.01), and non-juice fruit (P = 0.03). Dietary intake of calcium (P = 0.05) and vitamin D (P = 0.03) decreased. PTH increased from baseline (3.4 ± 1.6 vs. 3.8 ± 1.4 pmol/L, P = 0.04), while there was no change in 25-OH vitamin D. Ferritin decreased (385 ± 173 vs. 354 ± 161 pmol/L, P = 0.03) and soluble transferrin receptor increased (16.3 ± 3.7 vs. 17.1 ± 3.5 nmol/L, P = 0.01). There were no changes in glucose or lipids. Post-deployment, serum 25-OH vitamin D was inversely associated with PTH (r = -0.43, P < 0.01). CONCLUSIONS: HEI-2010 scores and dietary intake of milk, calcium, and vitamin D decreased following deployment. Serum PTH increased and iron stores were degraded. No Soldiers were iron deficient. Personnel that deploy frequently should maintain a high diet quality in the U.S. and while deployed by avoiding empty calories and consuming fruits, vegetables, and adequate sources of calcium, vitamin D, and iron. Improving availability and quality of perishable food during deployment may improve diet quality.

UK audit of quantitative thyroid uptake imaging.

AIM: A national audit of quantitative thyroid uptake imaging was conducted by the Nuclear Medicine Software Quality Group of the Institute of Physics and Engineering in Medicine in 2014/2015. The aims of the audit were to measure and assess the variability in thyroid uptake results across the UK and to compare local protocols with British Nuclear Medicine Society (BNMS) guidelines. PARTICIPANTS AND METHODS: Participants were invited through a combination of emails on a public mailbase and targeted invitations from regional co-ordinators. All participants were given a set of images from which to calculate quantitative measures and a spreadsheet for capturing results. The image data consisted of two sets of 10 anterior thyroid images, half of which were acquired after administration of Tc-pertechnetate and the other half after administration of I-iodide. Images of the administration syringes or thyroid phantoms were also included. RESULTS: In total, 54 participants responded to the audit. The median number of scans conducted per year was 50. A majority of centres had at least one noncompliance in comparison with BNMS guidelines. Of most concern was the widespread lack of injection-site imaging. Quantitative results showed that both intersite and intrasite variability were low for the Tc dataset. The coefficient of quartile deviation was between 0.03 and 0.13 for measurements of overall percentage uptake. Although the number of returns for the I dataset was smaller, the level of variability between participants was greater (the coefficient of quartile deviation was between 0.17 and 0.25). CONCLUSION: A UK-wide audit showed that thyroid uptake imaging is still a common test in the UK. It was found that most centres do not adhere to all aspects of the BNMS practice guidelines but that quantitative results are reasonably consistent for Tc-based scans.

Effects of Combat Deployment on Anthropometrics and Physiological Status of U.S. Army Special Operations Forces Soldiers.

INTRODUCTION: U.S. Army Special Operations Forces (SOF) soldiers deploy frequently and conduct military operations through special warfare and surgical strike capabilities. Tasks required to execute these capabilities may induce physical and mental stress and have the potential to degrade soldier physiological status. No investigations have longitudinally characterized whether combat deployment alters anthropometrics or biochemical markers of physiological status in a SOF population of frequent deployers. MATERIALS AND METHODS: Effects of modern combat deployment on longitudinal changes in anthropometrics and physiological status of elite U.S. Army SOF soldiers (n = 50) were assessed. Changes in measures of body composition, grip strength, physiological status, and health behaviors from baseline to postdeployment were determined with paired t test and McNemar's statistic. Baseline measures were obtained between 4 and 8 weeks before deployment. Deployment length was a uniform duration of time between 3 and 6 months (all soldiers completed the same length of deployment). Post hoc analyses determined change in body mass within quartiles of baseline body mass with paired t test and associations between change in sex hormone-binding globulin (SHBG) and change in body mass with correlation coefficient. The study was approved by the Human Use Review Committee at the U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts. RESULTS: In response to deployment, increases in lean mass (77.1 ± 7.6 to 77.8 ± 7.5 kg), maximum grip strength (57.9 ± 7.2 to 61.6 ± 8.8 kg), and conduct of aerobic (156 ± 106 to 250 ± 182 minutes/week) and strength training (190 ± 101 to 336 ± 251 minutes/week) exercise were observed (p < 0.05). Increases in serum SHBG (35.42 ± 10.68 to 38.77 ± 12.26 nmol/L) and decreases in serum cortisol (443.2 ± 79.3 to 381.9 ± 111.6 nmol/L) were also observed (p < 0.05). Body mass changes were dependent on baseline body mass. Soldiers in the lowest quartile of baseline body mass increased body mass (75.6 ± 2.6 vs. 76.6 ± 2.8 kg, p = 0.03), as did those in the second quartile (81.6 ± 2.0 vs. 83.7 ± 3.5 kg, p = 0.02). Those in the third quartile also tended to increase body mass (89.2 ± 2.6 vs. 90.9 ± 3.3 kg, p = 0.05), while those in the upper quartile tended to decrease body mass (98.5 ± 3.6 vs. 96.7 kg, p = 0.06). Change in SHBG was inversely correlated with change in body mass (r = -0.33, p = 0.02). There were no changes in fat mass, body fat percentage, waist circumference, neck circumference, total testosterone, calculated bioavailable or free testosterone, high-sensitivity C-reactive protein, tumor necrosis factor-α, interleukin-1ß, or interleukin-6. Inflammatory markers were skewed toward lower values. CONCLUSIONS: Overall, physiological status of elite SOF soldiers characterized by multiple prior deployments was minimally impacted by combat deployment, in the absence of major unit casualties. The majority experienced some adaptive changes, including increased lean mass, grip strength, time spent engaged in exercise, and decreased levels of the stress hormone cortisol. Mechanisms contributing to inverse correlations between change in SHBG and change in body mass may be further clarified. Future investigations may also more fully characterize the degradation and optimization of health and physiological status of SOF training and deployment cycles with in-theater data collection and repeated measures.

Commissioning of a new SeHCAT detector and comparison with an uncollimated gamma camera.

Measurements of SeHCAT (tauroselcholic [75selenium] acid) retention have been used to diagnose bile acid malabsorption for a number of years. In current UK practice the vast majority of centres calculate uptake using an uncollimated gamma camera. Because of ever-increasing demands on gamma camera time, a new 'probe' detector was designed, assembled and commissioned. To validate the system, nine patients were scanned at day 0 and day 7 with both the new probe detector and an uncollimated gamma camera. Commissioning results were largely in line with expectations. Spatial resolution (full-width 95% of maximum) at 1 m was 36.6 cm, the background count rate was 24.7 cps and sensitivity at 1 m was 720.8 cps/MBq. The patient comparison study showed a mean absolute difference in retention measurements of 0.8% between the probe and uncollimated gamma camera, and SD of ± 1.8%. The study demonstrated that it is possible to create a simple, reproducible SeHCAT measurement system using a commercially available scintillation detector. Retention results from the probe closely agreed with those from the uncollimated gamma camera.

Evaluation of elbow pain in adults.

The elbow is a complex joint designed to withstand a wide range of dynamic exertional forces. The location and quality of elbow pain can generally localize the injury to one of the four anatomic regions: anterior, medial, lateral, or posterior. The history should include questions about the onset of pain, what the patient was doing when the pain started, and the type and frequency of athletic and occupational activities. Lateral and medial epicondylitis are two of the more common diagnoses and often occur as a result of occupational activities. Patients have pain and tenderness over the affected tendinous insertion that are accentuated with specific movements. If lateral and medial epicondylitis treatments are unsuccessful, ulnar neuropathy and radial tunnel syndrome should be considered. Ulnar collateral ligament injuries occur in athletes participating in sports that involve overhead throwing. Biceps tendinopathy is a relatively common source of pain in the anterior elbow; history often includes repeated elbow flexion with forearm supination and pronation. Olecranon bursitis is a common cause of posterior elbow pain and swelling. It can be septic or aseptic, and is diagnosed based on history, physical examination, and bursal fluid analysis if necessary. Plain radiography is the initial choice for the evaluation of acute injuries and is best for showing bony injuries, soft tissue swelling, and joint effusions. Magnetic resonance imaging is the preferred imaging modality for chronic elbow pain. Musculoskeletal ultrasonography allows for an inexpensive dynamic evaluation of commonly injured structures.

Correlation of left ventricular count rate with patient weight in Tc-99m myocardial perfusion imaging.

OBJECTIVES: The aim of this retrospective investigation was to devise a protocol for obtaining consistent myocardial counts for patients attending myocardial perfusion imaging. METHODS: A total of 229 patients were included in the study sample. For each rest single-photon emission computed tomography data set, a three-dimensional ellipse was manually defined to isolate the left ventricle. The count rate per voxel was measured from a threshold region of interest covering the normally perfused myocardium (70-100% of maximum counts). Data were normalized for net administered activity and plotted against patient weight. The correlation between the variables was used to derive a protocol for adjusting injected activity or scan time to obtain consistent counts from patient to patient. RESULTS: There was a significant correlation between counts per second per voxel per MBq and patient weight. The best fit was achieved with an inverse model. A correlation equation was derived for patients weighing more than 60 kg (combined R=0.79): [CPS/voxel/MBq=(0.0163/weight(kg)]-3.68×10+A in which A, a sex-dependent constant, was 0 for men and -2.920×10 for women. CONCLUSION: There was a significant inverse correlation between patient weight and CPS per voxel per MBq.

Acute and overuse injuries of the abdomen and groin in athletes.

Abdominal and groin injuries are common problems encountered by athletes across a wide variety of sports. They range from benign but annoying, such as exercise-related transient abdominal pain (ETAP), to the activity-limiting and possibly career-ending condition of athletic hernia. This article covers ETAP, rectus abdominus injuries, osteitis pubis, athletic hernia, and abdominal/groin hernias to provide an update on the current pathophysiology and treatment of common abdominal and pelvic conditions in the athlete.