An Open-Source Deep Learning Algorithm for Efficient and Fully Automatic Analysis of the Choroid in Optical Coherence Tomography.

Purpose: To develop an open-source, fully automatic deep learning algorithm, DeepGPET, for choroid region segmentation in optical coherence tomography (OCT) data. Methods: We used a dataset of 715 OCT B-scans (82 subjects, 115 eyes) from three clinical studies related to systemic disease. Ground-truth segmentations were generated using a clinically validated, semiautomatic choroid segmentation method, Gaussian Process Edge Tracing (GPET). We finetuned a U-Net with the MobileNetV3 backbone pretrained on ImageNet. Standard segmentation agreement metrics, as well as derived measures of choroidal thickness and area, were used to evaluate DeepGPET, alongside qualitative evaluation from a clinical ophthalmologist. Results: DeepGPET achieved excellent agreement with GPET on data from three clinical studies (AUC = 0.9994, Dice = 0.9664; Pearson correlation = 0.8908 for choroidal thickness and 0.9082 for choroidal area), while reducing the mean processing time per image on a standard laptop CPU from 34.49 ± 15.09 seconds using GPET to 1.25 ± 0.10 seconds using DeepGPET. Both methods performed similarly according to a clinical ophthalmologist who qualitatively judged a subset of segmentations by GPET and DeepGPET, based on smoothness and accuracy of segmentations. Conclusions: DeepGPET, a fully automatic, open-source algorithm for choroidal segmentation, will enable researchers to efficiently extract choroidal measurements, even for large datasets. As no manual interventions are required, DeepGPET is less subjective than semiautomatic methods and could be deployed in clinical practice without requiring a trained operator. Translational Relevance: DeepGPET addresses the lack of open-source, fully automatic, and clinically relevant choroid segmentation algorithms, and its subsequent public release will facilitate future choroidal research in both ophthalmology and wider systemic health.

Neurite outgrowth inhibitory levels of organophosphates induce tissue transglutaminase activity in differentiating N2a cells: evidence for covalent adduct formation.

Organophosphate compounds (OPs) induce both acute and delayed neurotoxic effects, the latter of which is believed to involve their interaction with proteins other than acetylcholinesterase. However, few OP-binding proteins have been identified that may have a direct role in OP-induced delayed neurotoxicity. Given their ability to disrupt Ca2+ homeostasis, a key aim of the current work was to investigate the effects of sub-lethal neurite outgrowth inhibitory levels of OPs on the Ca2+-dependent enzyme tissue transglutaminase (TG2). At 1-10 µM, the OPs phenyl saligenin phosphate (PSP) and chlorpyrifos oxon (CPO) had no effect cell viability but induced concentration-dependent decreases in neurite outgrowth in differentiating N2a neuroblastoma cells. The activity of TG2 increased in cell lysates of differentiating cells exposed for 24 h to PSP and chlorpyrifos oxon CPO (10 µM), as determined by biotin-cadaverine incorporation assays. Exposure to both OPs (3 and/or 10 µM) also enhanced in situ incorporation of the membrane permeable substrate biotin-X-cadaverine, as indicated by Western blot analysis of treated cell lysates probed with ExtrAvidin peroxidase and fluorescence microscopy of cell monolayers incubated with FITC-streptavidin. Both OPs (10 µM) stimulated the activity of human and mouse recombinant TG2 and covalent labelling of TG2 with dansylamine-labelled PSP was demonstrated by fluorescence imaging following SDS-PAGE. A number of TG2 substrates were tentatively identified by mass spectrometry, including cytoskeletal proteins, chaperones and proteins involved protein synthesis and gene regulation. We propose that the elevated TG2 activity observed is due to the formation of a novel covalent adduct between TG2 and OPs.

Chorioretinal thinning in chronic kidney disease links to inflammation and endothelial dysfunction.

BACKGROUND. Chronic kidney disease (CKD) is strongly associated with cardiovascular disease and there is an established association between vasculopathy affecting the kidney and eye. Optical coherence tomography (OCT) is a novel, rapid method for high-definition imaging of the retina and choroid. Its use in patients at high cardiovascular disease risk remains unexplored. METHODS. We used the new SPECTRALIS OCT machine to examine retinal and retinal nerve fiber layer (RNFL) thickness, macular volume, and choroidal thickness in a prospective cross-sectional study in 150 subjects: 50 patients with hypertension (defined as a documented clinic BP greater than or equal to 140/90 mmHg (prior to starting any treatment) with no underlying cause identified); 50 with CKD (estimated glomerular filtration rate (eGFR) 8-125 ml/min/1.73 m2); and 50 matched healthy controls. We excluded those with diabetes. The same, masked ophthalmologist carried out each study. Plasma IL-6, TNF-α , asymmetric dimethylarginine (ADMA), and endothelin-1 (ET-1), as measures of inflammation and endothelial function, were also assessed. RESULTS. Retinal thickness, macular volume, and choroidal thickness were all reduced in CKD compared with hypertensive and healthy subjects (for retinal thickness and macular volume P < 0.0001 for CKD vs. healthy and for CKD vs. hypertensive subjects; for choroidal thickness P < 0.001 for CKD vs. healthy and for CKD vs. hypertensive subjects). RNFL thickness did not differ between groups. Interestingly, a thinner choroid was associated with a lower eGFR (r = 0.35, P <0.0001) and, in CKD, with proteinuria (r = -0.58, P < 0.001) as well as increased circulating C-reactive protein (r = -0.57, P = 0.0002), IL-6 (r = -0.40, P < 0.01), ADMA (r = -0.37, P = 0.02), and ET-1 (r = -0.44, P < 0.01). Finally, choroidal thinning was associated with renal histological inflammation and arterial stiffness. In a model of hypertension, choroidal thinning was seen only in the presence of renal injury. CONCLUSIONS. Chorioretinal thinning in CKD is associated with lower eGFR and greater proteinuria, but not BP. Larger studies, in more targeted groups of patients, are now needed to clarify whether these eye changes reflect the natural history of CKD. Similarly, the associations with arterial stiffness, inflammation, and endothelial dysfunction warrant further examination. TRIAL REGISTRATION. Registration number at www.clinicalTrials.gov: NCT02132741. SOURCE OF FUNDING. TR was supported by a bursary from the Erasmus Medical Centre, Rotterdam. JJMHvB was supported by a bursary from the Utrecht University. JRC is supported by a Rowling Scholarship. SB was supported by a Wellcome Trust funded clinical research fellowship from the Scottish Translational Medicine and Therapeutics Initiative, and by a Rowling Scholarship, at the time of this work. ND is supported by a British Heart Foundation Intermediate Clinical Research Fellowship (FS/13/30/29994).

Free-range layer chickens as a source of Campylobacter bacteriophage.

Bacteriophage specific for Campylobacter were isolated from chicken excreta collected from established free-range layer breed stock. Bacteriophage were either propagated on a Campylobacter jejuni host with broad susceptibility to bacteriophage (NCTC 12662) or on Campylobacter isolates from the same samples. Campylobacters were confirmed as being C. jejuni and or C. coli, using a combination of standard biochemical tests and PCR analysis with genus and species specific primers. The bacteriophage displayed differential patterns of susceptibility against reference NCTC strains and contemporary C. jejuni /C. coli isolates from chicken excreta. Electron microscopy demonstrated that the phage possessed icosahedral heads and rigid contractile tails. Pulsed-field gel electrophoresis revealed the bacteriophage genomes to be double stranded DNA in the range of 140 kb in size and the restriction enzyme patterns of the DNAs indicate they are genetically related members of the Myoviridae family. This study showed that Campylobacter bacteriophage could easily be isolated from free-range chickens and form part of their normal microbiological biota of environmentally exposed birds.

Imaging and automated detection of Sitophilus oryzae (Coleoptera: Curculionidae) pupae in hard red winter wheat.

Computed tomography, an imaging technique commonly used for diagnosing internal human health ailments, uses multiple x-rays and sophisticated software to recreate a cross-sectional representation of a subject. The use of this technique to image hard red winter wheat, Triticum aestivm L., samples infested with pupae of Sitophilus oryzae (L.) was investigated. A software program was developed to rapidly recognize and quantify the infested kernels. Samples were imaged in a 7.6-cm (o.d.) plastic tube containing 0, 50, or 100 infested kernels per kg of wheat. Interkernel spaces were filled with corn oil so as to increase the contrast between voids inside kernels and voids among kernels. Automated image processing, using a custom C language software program, was conducted separately on each 100 g portion of the prepared samples. The average detection accuracy in the five infested kernels per 100-g samples was 94.4 +/- 7.3% (mean +/- SD, n = 10), whereas the average detection accuracy in the 10 infested kernels per 100-g sample was 87.3 +/- 7.9% (n = 10). Detection accuracy in the 10 infested kernels per 100-g samples was slightly less than the five infested kernels per 100-g samples because of some infested kernels overlapping with each other or air bubbles in the oil. A mean of 1.2 +/- 0.9 (n = 10) bubbles (per tube) was incorrectly classed as infested kernels in replicates containing no infested kernels. In light of these positive results, future studies should be conducted using additional grains, insect species, and life stages.

Cost/benefit analysis of a benthic monitoring programme of organic benthic enrichment using different sampling and analysis methods.

To investigate the combined effects of decreasing taxonomic resolution (i.e. species, family, phylum), the use of different mesh-size (1.0 mm and 0.5 mm) and the type of samplers used (van Veen vs. corers taken by divers) on the quality of data obtained, a comparative study was undertaken with the overall aim of identifying cost efficient methods for routinely monitoring the ecological change caused by Mediterranean fish farming. The results clearly showed that information loss was relatively low as data were aggregated at higher taxonomic levels, particularly up to the level of family or even order. It was also found that the extra information gained by sieving samples through a 0.5 mm sieve did not improve the ability to distinguish the potentially impacted sites from the control stations. Finally, it was found that a relatively large proportion of the available information concerning the community structure such as abundance, biomass or diversity is lost when sampling is carried out with corers. A cost/benefit ratio analysis for the two sampling and the two sieving methods showed minimal values for the van Veen samples (for both sieve fractions) at the family level, indicating that analysis at this level gives the best balance between precision of the results and decrease in taxonomic effort. However, if the time needed to sort the samples is included in the analysis, then samples taken with corers using a 0.5 mm sieve and identified to families seems like a good compromise between precision and cost.

Percutaneous endoscopic colostomy in patients with chronic intestinal pseudo-obstruction.

BACKGROUND: Percutaneous endoscopic colostomy was used successfully to treat 3 patients with chronic intestinal pseudo-obstruction whose symptoms were not controlled by conservative measures. METHODS: Percutaneous endoscopic colostomy tubes were placed to allow intermittent decompression of the colon in response to the occurrence of symptoms. The technique and the equipment are the same as for PEG and are described herein. OBSERVATIONS: Symptom improvement was observed in 3 patients, and, to date, surgery has been avoided for all. CONCLUSIONS: Percutaneous endoscopic colostomy is a safe and effective management option for selected patients with chronic intestinal pseudo-obstruction.