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Non-contrast head CT (NCCT) is extremely insensitive for early (< 3–6 h) acute infarct identification. We developed a deep learning model that detects and delineates suspected early acute infarcts on NCCT, using diffusion MRI as ground truth (3566 NCCT/MRI training patient pairs). The model substantially outperformed 3 expert neuroradiologists on a test set of 150 CT scans of patients who were potential candidates for thrombectomy (60 stroke-negative, 90 stroke-positive middle cerebral artery territory only infarcts), with sensitivity 96% (specificity 72%) for the model versus 61–66% (specificity 90–92%) for the experts; model infarct volume estimates also strongly correlated with those of diffusion MRI (r 2  > 0.98). When this 150 CT test set was expanded to include a total of 364 CT scans with a more heterogeneous distribution of infarct locations (94 stroke-negative, 270 stroke-positive mixed territory infarcts), model sensitivity was 97%, specificity 99%, for detection of infarcts larger than the 70 mL volume threshold used for patient selection in several major randomized controlled trials of thrombectomy treatment.

Stroke is a leading cause of death and disability. The ability to quickly identify the presence of acute infarct and quantify the volume on magnetic resonance imaging (MRI) has important treatment implications. We developed a machine learning model that used the apparent diffusion coefficient and diffusion weighted imaging series. It was trained on 6,657 MRI studies from Massachusetts General Hospital (MGH; Boston, USA). All studies were labelled positive or negative for infarct (classification annotation) with 377 having the region of interest outlined (segmentation annotation). The different annotation types facilitated training on more studies while not requiring the extensive time to manually segment every study. We initially validated the model on studies sequestered from the training set. We then tested the model on studies from three clinical scenarios: consecutive stroke team activations for 6-months at MGH, consecutive stroke team activations for 6-months at a hospital that did not provide training data (Brigham and Women’s Hospital [BWH]; Boston, USA), and an international site (Diagnósticos da América SA [DASA]; Brazil). The model results were compared to radiologist ground truth interpretations. The model performed better when trained on classification and segmentation annotations (area under the receiver operating curve [AUROC] 0.995 [95% CI 0.992–0.998] and median Dice coefficient for segmentation overlap of 0.797 [IQR 0.642–0.861]) compared to segmentation annotations alone (AUROC 0.982 [95% CI 0.972–0.990] and Dice coefficient 0.776 [IQR 0.584–0.857]). The model accurately identified infarcts for MGH stroke team activations (AUROC 0.964 [95% CI 0.943–0.982], 381 studies), BWH stroke team activations (AUROC 0.981 [95% CI 0.966–0.993], 247 studies), and at DASA (AUROC 0.998 [95% CI 0.993–1.000], 171 studies). The model accurately segmented infarcts with Pearson correlation comparing model output and ground truth volumes between 0.968 and 0.986 for the three scenarios. Acute infarct can be accurately detected and segmented on MRI in real-world clinical scenarios using a machine learning model.

Spermidine acts as an endogenous free radical scavenger and inhibits the action of reactive oxygen species. In this study, we examined the effects of spermidine on retinal ganglion cell (RGC) death in a mouse model of optic nerve injury (ONI). Daily ingestion of spermidine reduced RGC death following ONI and sequential in vivo retinal imaging revealed that spermidine effectively prevented retinal degeneration. Apoptosis signal-regulating kinase-1 (ASK1) is an evolutionarily conserved mitogen-activated protein kinase kinase kinase and has an important role in ONI-induced RGC apoptosis. We demonstrated that spermidine suppresses ONI-induced activation of the ASK1-p38 mitogen-activated protein kinase pathway. Moreover, production of chemokines important for microglia recruitment was decreased with spermidine treatment and, consequently, accumulation of retinal microglia is reduced. In addition, the ONI-induced expression of inducible nitric oxide synthase in the retina was inhibited with spermidine treatment, particularly in microglia. Furthermore, daily spermidine intake enhanced optic nerve regeneration in vivo. Our findings indicate that spermidine stimulates neuroprotection as well as neuroregeneration, and may be useful for treatment of various neurodegenerative diseases including glaucoma.

We evaluated the late-onset ocular hypotensive effect of ripasudil after long-term administration in real-world clinical data and investigated its associated factors in primary open-angle glaucoma (POAG). We reviewed the clinical patients with POAG who newly started ripasudil without changes of treatment. Enrolled eyes were assigned to two groups: positive group with the late-onset effect and negative group. Eyes that show the late-onset effect 6 months after starting ripasudil were defined as positive. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the late-onset effect. We enrolled 74 eyes of 74 patients with POAG (age, 67.5 ± 10.9 years; mean deviation, -11.2 ± 5.9 dB) and followed them for 14.2 ± 5.0 months. Among them, 12 (16.2%) eyes were assigned to the positive group. Retinal nerve fiber layer (RNFL) thickness (73.4 ± 12.9 vs 64.0 ± 9.8 μm, = 0.04) and primary IOP (18.8 ± 4.1 vs 15.8 ± 4.3 mmHg, = 0.01) before starting ripasudil were higher in the positive group than in the negative group. The late-onset effect was associated with higher IOP (OR, 1.22; 1.01-1.48) and thicker RNFL (2.76; 1.15-6.63). Some patients with POAG showed the late-onset IOP-lowering effect of ripasudil, and its associated factors were higher IOP and thicker RNFL. The addition of ripasudil may offer potential benefits particularly for early-stage glaucoma with thicker RNFL.

The virulence factors of avian pathogenic Escherichia coli (APEC) isolated in Japan were investigated. Serogroups O, serotypes K1 and K5, and genes cvaC, iss, iutA, papA, tsh, and usp, which have been thought to be related to virulence, were examined for their association with E. coli strains isolated from diseased and healthy chickens. The frequently recognized serogroups O1, O2, and O78 were found in 56 of 125 (44.8%) strains of diseased chickens (APEC) versus 13 of 100 (13.0%) strains of healthy chickens (commensal E. coli), a significant difference at risk ratio < 0.01. Although iss, iutA, and tsh were widely distributed in the APEC irrespective of O serogroup, papA, usp, and the K1 serotype were detected in serogroup O2 of APEC. The kfiD gene related to the K5 capsule and VT, LT, and ST genes related to exotoxins were not detected in any strains examined.

One hundred and twenty 30-day-old specific-pathogen-free chickens were inoculated with the liposomal inactivated avian pathogenic Escherichia coli (APEC) vaccine by eye drop or coarse spraying. All of the chickens produced anti-lipopolysaccharide antibodies of the IgG subclass in their sera as well as IgA antibodies in their oral mucus. The results demonstrated a rise in antibodies in the serum of chickens administered the APEC vaccine through nonparenteral mucosal routes. Bacterial counts in the blood decreased, and clinical signs were moderated in the vaccinated chickens after challenge with a strain of APEC. No harmful effects from the vaccination were observed. The liposomal inactivated APEC vaccine described in this paper would contribute to a practical method of control for avian colibacillosis.

Stomal prolapse is one of the common complications in transverse colostomy and can be managed conservatively in most cases; however, laparotomy and reconstruction of the stoma may sometimes be required, especially in case of irreducible colostomy prolapse. We have reported a simple local repair with reconstruction of the loop colostomy. We herein report a new more simple technique to avoid laparotomy and allow excision of the irreducible colostomy prolapse and complete closure of the distal limb of loop colostomy when no decompression is required in the distal limb of the stoma. In this procedure, the number of stapler and the time with blood loss for the operation can be saved.

The Ezo abaloneHaliotis discushannai is the only species of abalone inhabiting the coastal waters affected by the cold Oyashio current in the Pacific waters of northern Honshu, Japan. Overwinter mortality of young-of-the-year (YOY) Ezo abalone was examined for 2000, 2001, and 2003 to 2006 year classes in Kadonohama Bay, northern Japan, to test the hypothesis that winter seawater temperature controls recruitment fluctuation of this northernmost abalone and regulates their distribution limit. Eggs of Ezo abalone hatch between late summer and mid-autumn, and grow to a size of 2 to 8 mm in shell length by winter. Overwinter mortality rates varied among years (range: 0 to 97.4%), and there was a strong negative relationship between the instantaneous mortality rate and the winter temperature. High mortalities of YOY abalone were observed in February 2001 and March 2006, respectively. In both cases, the Oyashio current extended south to the study area, and the mean temperature fell to below 5°C. High mortalities were not observed in the other years when the minimum temperatures were higher than 6°C, as the Oyashio current did not extend to the study area. The differences in shell length between early winter and post-winter suggest that the low temperature tolerance of YOY abalone may be size-dependent. Although not conclusive, the winter seawater temperature is an important factor affecting the survival of YOY and is the principal factor for the variation in the recruitment of Ezo abalone and the limit of their northward distribution.

Abstract Differential cross sections of $p$–$\\mathrm{^6He}$ elastic scattering were measured in inverse kinematics at an incident energy of 200 $A \\mathrm{MeV}$, covering the high momentum transfer region of 1.7–2.7 $\\mathrm{fm^{-1}}$. The sensitivity of the elastic scattering at low and high momentum transfers to the density distribution was investigated quantitatively using relativistic impulse approximation calculations. In the high momentum transfer region, where the present data were taken, the differential cross section has an order of magnitude higher sensitivity to the inner part of the $\\mathrm{^6He}$ density relative to the peripheral part (15:1). This feature makes the obtained data valuable for the deduction of the inner part of the $\\mathrm{^6He}$ density. The data were compared to a set of calculations assuming different proton and neutron density profiles of $\\mathrm{^6He}$. The data are well reproduced by the calculation assuming almost the same profiles of proton and neutron densities around the center of $\\mathrm{^6He}$, and a proton profile reproducing the known point-proton radius of 1.94 fm. This finding is consistent with the assumption that the $\\mathrm{^6He}$ nucleus consists of a rigid $\\alpha$-like core with a two-neutron halo.

Cross sections of pd breakup reaction at E p = 250 MeV were measured systematically in single-proton detection and in two-proton coincidence detection. Measured cross section is up to two times higher than calculated ones. The enhancement of breakup cross section is similar to reported enhancement in pd elastic scattering cross section. Origins of this enhancement are discussed.