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1.
IEEE Trans Med Imaging ; 40(5): 1363-1376, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33507867

RESUMO

To better understand early brain development in health and disorder, it is critical to accurately segment infant brain magnetic resonance (MR) images into white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF). Deep learning-based methods have achieved state-of-the-art performance; h owever, one of the major limitations is that the learning-based methods may suffer from the multi-site issue, that is, the models trained on a dataset from one site may not be applicable to the datasets acquired from other sites with different imaging protocols/scanners. To promote methodological development in the community, the iSeg-2019 challenge (http://iseg2019.web.unc.edu) provides a set of 6-month infant subjects from multiple sites with different protocols/scanners for the participating methods. T raining/validation subjects are from UNC (MAP) and testing subjects are from UNC/UMN (BCP), Stanford University, and Emory University. By the time of writing, there are 30 automatic segmentation methods participated in the iSeg-2019. In this article, 8 top-ranked methods were reviewed by detailing their pipelines/implementations, presenting experimental results, and evaluating performance across different sites in terms of whole brain, regions of interest, and gyral landmark curves. We further pointed out their limitations and possible directions for addressing the multi-site issue. We find that multi-site consistency is still an open issue. We hope that the multi-site dataset in the iSeg-2019 and this review article will attract more researchers to address the challenging and critical multi-site issue in practice.

2.
Postgrad Med J ; 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32917776

RESUMO

BACKGROUND: Ischaemic stroke and transient ischaemic attack (TIA) share a common cause. We aim to develop and validate a concise prognostic nomogram for patients with minor stroke and TIA. METHODS: A total of 994 patients with minor stroke and TIA were included. They were split into a derivation (n=746) and validation (n=248) cohort. The modified Rankin Scale (mRS) scores 3 months after onset were used to assess the prognosis as unfavourable outcome (mRS≥2) or favourable outcome (mRS<2). RESULT: The final model included seven independent predictors: gender, age, baseline National Institute of Health Stroke Scale (NIHSS), hypertension, diabetes mellitus, white blood cell and serum uric acid. The Harrell's concordance index (C-index) of the nomogram for predicting the outcome was 0.775 (95% CI 0.735 to 0.814), which was confirmed by the validation cohort (C-index=0.787 (95% CI 0.722 to 0.853)). The calibration curve showed that the nomogram-based predictions were consistent with actual observation in both derivation cohort and validation cohort. CONCLUSION: The proposed nomogram showed favourable predictive accuracy for minor stroke and TIA. This has the potential to contribute to clinical decision-making.

3.
Neurologist ; 25(3): 62-69, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358463

RESUMO

BACKGROUND: Baseline systolic blood pressure (SBP) is an important parameter that can significantly influence the outcome in ischemic stroke patients who received intravenous thrombolysis, but the target baseline SBP for optimal outcome is uncertain. This study aimed to assess the relationship between baseline SBP and outcome. MATERIALS AND METHODS: Studies that evaluated the association between the baseline SBP and the outcome of patients undergoing thrombolytic therapy were sought. Data were extracted according to a predefined data extraction form and then analyzed by STATA 12.0 software. The primary endpoint was the occurrence of good outcomes measured by a modified Rankin Scale score at 3 months, while the secondary endpoint was the occurrence of intracranial hemorrhage and death. RESULTS: Eleven studies involving a total of 33,263 patients were included. Pooled data suggested that the odds of good outcome was decreased by 7% per 10 mm Hg increase in baseline SBP (odds ratio=0.93; 95% confidence interval: 0.91-0.94; P<0.001). Patients with higher baseline SBP were more likely to have intracranial hemorrhage (odds ratio=1.12 per 10 mm Hg increase; 95% confidence interval: 1.08-1.16, P<0.001). CONCLUSIONS: This study suggested that lower baseline SBP may be positively associated with a greater chance of good outcome and less chance of intracranial hemorrhage. However, this effect was reliable only when the baseline SBP was within a certain range, which has not been explicitly stated. Therefore, more well-designed studies are needed to define the optimal baseline SBP.

4.
Front Neurol ; 11: 319, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32431660

RESUMO

In the present study, we investigated the genetic variation in a family with acute encephalopathy and retinitis pigmentosa. Nine of 25 people in this family underwent genetic testing. Three family members, namely, the proband and the proband's two sisters, showed symptoms resembling those of meningoencephalitis and simultaneously suffered from retinitis pigmentosa. Whole-exome sequencing and Sanger sequencing identified a heterozygous mutation, chr14: 73673106 c.881G>A (p.W294*), in the presenilin 1 (PSEN1) gene in these three family members, and the SWISS-MODEL server predicted the formation of a truncated protein. This mutation was not found in the asymptomatic family members. This mutation is a newly discovered nonsense mutation that results in a truncated protein. Although the current genetic evidences may indicate the likelihood of association, further investigations are needed to establish the genotype and phenotype relationship.

5.
PLoS One ; 15(5): e0232132, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32369517

RESUMO

A risk assessment was conducted to assess the risk of ASFV entry into Japan through pork products illegally brought in by air passengers from China and fed to pigs in Japan. Scenario tree modelling was used with the following entry and exposure pathway considered to be the most likely route of ASF entry: an ASFV infected pork product is illegally brought into Japan by air travellers from China; this pork product is then used in a restaurant where scrap waste is recycled for animal feed and subsequently fed to pigs without being heat-treated. Input parameter values were based on surveys conducted by the authors, scientific data gathered from the literature and official data published by government agencies. The annual probability of ASFV entry into Japan via this pathway was predicted to be 0.20 (90% prediction interval: 0.00-0.90). The wide prediction interval was mainly caused by the uncertainty regarding the dose response relation of ASFV, followed by the probability of an ASF infected pig dying on affected farms, the loading of ASFV in an infected pig and the probability of an illegally imported pork product being heat-treated in China and used in restaurants. The results of scenario analysis revealed that the annual probability of ASFV entry into Japan will increase with an increase in the number of ASF affected farms in China. The probability of ASFV entry will increase substantially even if only a small proportion of Ecofeed is not heat-treated during the production process. The probability will decrease if an increased proportion of farms that feed swill apply heat-treatment before feeding swill to their pigs. These findings indicate that stringent application of heat-treatment of Ecofeed and swill is key to protecting the Japanese pig industry from the introduction of ASFV.


Assuntos
Vírus da Febre Suína Africana , Febre Suína Africana/transmissão , Viagem Aérea , Carne de Porco/virologia , Suínos , Ração Animal/virologia , Criação de Animais Domésticos , Animais , China , Temperatura Alta , Japão , Probabilidade , Restaurantes , Medição de Risco
6.
Prev Vet Med ; 177: 104947, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32203815

RESUMO

With the aim of obtaining information to establish an import risk assessment on African swine fever (ASF) and other transboundary animal diseases (TADs) into Japan, a questionnaire survey was conducted between 1 August and 20 September 2019 on air travellers arriving into Japan from China. There were 248 responses with 2.8 % of respondents illegally importing pork products. The quantity imported per traveller varied between 250 g and 2 kg. Concerning the travellers' perception in regard to the difficulty of importing a pork product in their luggage, 32 respondents (12.9 %) considered it very easy or rather easy and 216 (87.1 %) very difficult or rather difficult. In regard to the recognition of respondents of the illegality of importing pork products into Japan, seven respondents (2.8 %) did not consider this practice to be illegal whilst 241 (97.2 %) had some idea of the illegal nature of this behaviour. The regression analysis revealed that the practice of illegal importation of pork products was significantly affected by the level of difficulty perception held by the traveller (P < 0.001) and that the difficulty perception is significantly affected by the level of recognition of illegality by the traveller (P < 0.001). The result of this study will not only provide useful data in developing a model to assess the probability of introduction of ASF and other TADs into Japan and other countries, but also in monitoring the effect of measures taken by the government to reduce the illegal importation of meat and meat products.

8.
Stroke Vasc Neurol ; 4(3): 115-122, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31709116

RESUMO

Prehospital delay is one of the major causes of low rate of intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis for acute ischaemic stroke in China. Regional emergency systems have been proven a successful approach to improve access to thrombolysis. Shenzhen is a high population density city with great geographical disparity of healthcare resources, leading to limited access to rt-PA thrombolysis for most patients with acute ischaemic stroke. To improve rapid access to rt-PA thrombolysis in Shenzhen, a Shenzhen stroke emergency map was implemented by Shenzhen healthcare administrations. This map comprised certification of qualified local hospitals, identification of patients with stroke, acute stroke transport protocol and maintenance of the map. We conducted a retrospective observational study to compare consecutive patients with acute stroke arriving at qualified local hospitals before and after implementation of the Shenzhen stroke emergency map. After implementation of the map, the rate of patients receiving rt-PA thrombolysis increased from 8.3% to 9.7% (p=0.003), and the rate of patients treated with endovascular thrombectomy increased from 0.9% to 1.6% (p<0.001). Sixteen of 20 hospitals have an increase in the number of patients with stroke treated with rt-PA thrombolysis. The median time between receipt of the call and arrival on the scene reduced significantly (17.0 min vs 9.0 min, p<0.001). In Shenzhen Second People's Hospital, the median onset-to-needle time and door-to-needle time were reduced (175.5 min vs 149.5 min, p=0.039; 71.5 min vs 51.5 min, p<0.001). No statistically significant differences were found in the proportion of rt-PA-treated patients within various geographical distances. Currently, there are more than 40 cities in China implementing a stroke emergency map. The Shenzhen stroke emergency map improves access to rt-PA thrombolysis for acute ischaemic stroke, and the novel model has been expanded to multiple areas in China. Future efforts should be conducted to optimise the stroke emergency map.

9.
Prev Vet Med ; 173: 104802, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675606

RESUMO

In Japan veterinary antimicrobials are used most in the pig production sector. However, there is a paucity of data on the quantity of antimicrobials used on pig farms in Japan. This study describes antimicrobial use on Japanese pig farms in 2015, 2016 and 2017 in terms of mg of active ingredient per kg of PCU (population correction unit). Data on antimicrobial use from a total of 72 farrow-to finish farms over these three years were used in the study. The results revealed that the average use of antimicrobials in 2015, 2016 and 2017 was 304.8 (SD = 226.3), 311.2 (SD = 241.0) and 342.9 (SD = 291.3) mg/kg PCU, respectively. Most (97%) of the antimicrobials were administered orally. The most commonly used antimicrobials were tetracyclines, followed by macrolides, penicillins and sulfonamides. Tohoku was the region in which the lowest quantities of antimicrobial were used whilst South Kanto was the region in which the largest amount was used. The use of antimicrobials was on the increase in the North Kanto, South Kanto and Kyushu regions.


Assuntos
Anti-Infecciosos/administração & dosagem , Uso de Medicamentos , Fazendas , Suínos , Animais , Japão
10.
Neurologist ; 24(4): 121-131, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31246721

RESUMO

BACKGROUND: The issue of whether serum uric acid (SUA) is associated with the outcome of acute ischemic stroke is controversial. This study aimed to evaluate the correlation between the SUA level and outcome of patients with ischemic stroke by performing a meta-analysis. MATERIALS AND METHODS: Studies were included by a systematic search of several databases through December 01, 2018, followed by reviewing reference lists of obtained articles. Studies that included odds ratios (ORs) for ischemic stroke outcome per unit SUA level with 95% confidence intervals (95% CIs) were eligible for the meta-analysis. A random-effects model was used to calculate the pooled risk estimate. Publication bias was detected by Begg's test. RESULTS: Fifteen studies with a total of 12,739 cases of stroke were included. Overall, higher SUA levels were associated with a significantly better outcome of ischemic stroke (OR, 1.13; 95% CI, 1.07-1.18; P<0.00001). For patients receiving thrombolytic therapy, a subgroup meta-analysis showed a positive association between SUA level and patient outcome (OR, 1.26; 95% CI, 1.14-1.40; P<0.00001). In addition, the pooled estimate of patients with a modified Rankin Scale score ≤2 at 90 days also showed a positive association (OR, 1.07; 95% CI, 1.01-1.133; P<0.00001). Furthermore, we found that the average SUA level in patients with a good outcome was higher than in those with a poor outcome (mean difference, 0.24 µmol/L; 95% CI, 0.16-0.32; P<0.00001). CONCLUSIONS: This meta-analysis suggested that there was a significant positive association between SUA level and the outcome of ischemic stroke.


Assuntos
Isquemia Encefálica/sangue , Acidente Vascular Cerebral/sangue , Terapia Trombolítica , Ácido Úrico/sangue , Biomarcadores/sangue , Isquemia Encefálica/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Humanos , Prognóstico , Acidente Vascular Cerebral/tratamento farmacológico , Ativador de Plasminogênio Tecidual/uso terapêutico , Resultado do Tratamento
11.
Postgrad Med J ; 95(1119): 46-47, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30696707

RESUMO

China has the largest stroke population and at-risk population in the world. However, it has a lower thrombolytic therapy rate and longer onset-to-needle time/door-to-needle time for patients who had an acute stroke compared with developed countries, which might be due to redundant procedures or inefficient systems. Things are changing due to some new initiatives. Two years ago, a new emergency system in China, Stroke Emergency Map, was first launched as a regional emergency system in Shenzhen, the bustling metropolis just north of Hong Kong. As a result of the Stroke Emergency Map in Shenzhen, the number of thrombolytic cases increased in the last 2 years, from 568 to 809 annually. The Stroke Emergency Map, first pioneered in Shenzhen and now spreading to the rest of China, is a comprehensive and interdisciplinary system. The benefits are not just the immediate improvements in the acute stroke care because the continuous data collection and audit allows for improvements in logistics and future strategies.


Assuntos
Fibrinolíticos/administração & dosagem , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica/métodos , China/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Acidente Vascular Cerebral/epidemiologia , Tempo para o Tratamento
12.
Neurol Res ; 41(1): 1-8, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30296199

RESUMO

Introduction: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a well-known risk factor of atherosclerotic vascular diseases. Nevertheless, its role in the acute phase of ischemic stroke is still unclear. The aim of this study is to identify the relationship between Lp-PLA2 levels and early neurological deterioration (END) in acute ischemic stroke patients with Trial of Org 10 172 in Acute Stroke Treatment (TOAST) subtype of large arterial atherosclerosis (LAA). Methods: We enrolled Chinese patients with first ever acute ischemic stroke admitted to Neurology Department of Shenzhen Second People's Hospital within 48 h from onset of symptoms during January - November 2015. Demographic and laboratory information were collected while END was defined as an increase in the National Institute of Health Stroke Scale score by ≥ 1 point in motor power, or ≥ 2 points in the total score within 10 days after admission. Results: Overall 181 patients were involved; END was diagnosed in 30 patients within 10 days after admission. The odds ratio for END increased with increasing levels of Lp-PLA2 (intermediate level, OR = 1.96, 95%CI 1.02-4.27, p = 0.041; high level, OR = 2.99, 95%CI 1.26-5.73, p = 0.023). Conclution: Intermediate and high level of Lp-PLA2 was identified as independent predictor of END in multivariate analysis. Lp-PLA2 could be valued as a risk factor of END in patients with acute ischemic stroke with TOAST subtype of LAA.


Assuntos
1-Alquil-2-acetilglicerofosfocolina Esterase/sangue , Isquemia Encefálica/sangue , Acidente Vascular Cerebral/sangue , Artérias , Aterosclerose/sangue , Aterosclerose/epidemiologia , Aterosclerose/terapia , Biomarcadores/sangue , Isquemia Encefálica/epidemiologia , Isquemia Encefálica/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapia
13.
PLoS One ; 11(9): e0163828, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27682422

RESUMO

Cattle are major reservoirs of the provisionally named influenza D virus, which is potentially involved in the bovine respiratory disease complex. Here, we conducted a serological survey for the influenza D virus in Japan, using archived bovine serum samples collected during 2010-2016 from several herds of apparently healthy cattle in various regions of the country. We found sero-positive cattle across all years and in all the prefectural regions tested, with a total positivity rate of 30.5%, although the positivity rates varied among regions (13.5-50.0%). There was no significant difference in positivity rates for Holstein and Japanese Black cattle. Positivity rates tended to increase with cattle age. The herds were clearly divided into two groups: those with a high positive rate and those with a low (or no) positive rate, indicating that horizontal transmission of the virus occurs readily within a herd. These data demonstrate that bovine influenza D viruses have been in circulation for at least 5 years countrywide, emphasizing its ubiquitous distribution in the cattle population of Japan.

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