Concentrations of total arsenic and individual arsenic compounds were determined in livers of cetaceans (Dall's porpoise and short-finned pilot whale), pinnipeds (harp and ringed seals), sirenian (dugong), and sea turtles (green and loggerhead turtles) to characterize arsenic accumulation profiles in higher trophic marine animals. Hepatic arsenic concentrations in sea turtles were highest among the species examined. Chemical speciation of arsenic revealed that arsenobetaine was the major arsenic compound in almost all the species. In contrast, arsenobetaine was a minor constituent in dugong. Dimethylarsinic acid, methylarsonic acid, arsenocholine, tetramethylarsonium ion, arsenite, and an unidentified arsenic compound were also detected as minor constituents. However, the composition of arsenic compounds was different among these species. These results might reflect the differences in the metabolism of arsenic and/or the compositions of arsenic compounds in their preys. To our knowledge, this is the first report on the large variation in the composition of arsenic species in liver of marine mammals and sea turtles.

The metabolic rate of harp (Pagophilus groenlandicus), harbor (Phoca vitulina), and ringed seals (Pusa hispida) was measured at various temperatures in air and water to estimate basal metabolic rates (BMRs) in these species. The basal rate and body composition of three harp seals were also measured throughout the year to examine the extent to which they vary seasonally. Marine mammalian carnivores generally have BMRs that are over three times the rates expected from body mass in mammals generally, both as a response to a cold-water distribution and to carnivorous food habits with the basal rates of terrestrial carnivores averaging about 1.8 times the mean of mammals. Phocid seals, however, have basal rates of metabolism that are 30% lower than other marine carnivores. Captive seals undergo profound changes in body mass and food consumption throughout the year, and after accounting for changes in body mass, the lowest rate of food intake occurs in summer. Contrary to earlier observations, harp seals also have lower basal rates during summer than during winter, but the variation in BMR, relative to mass expectations, was not associated with changes in the size of fat deposits. The summer reduction in energy expenditure and food consumption correlated with a reduction in BMR. That is, changes in BMR account for a significant portion of the seasonal variation in energy expenditure in the harp seal. Changes in body mass of harp seals throughout the year were due not only to changes in the size of body fat deposits, but also to changes in lean body mass. These results suggest that bioenergetics models used to predict prey consumption by seals should include time-variant energy requirements.

Laparoscopic donor nephrectomy (LDN) is less traumatic and painful than the open approach, with shorter convalescence time. Hand-assisted retroperitoneoscopic (HARP) donor nephrectomy may have benefits, particularly in left-sided nephrectomy, including shorter operation and warm-ischemia time (WIT) and improved safety. We evaluated outcomes of HARP alongside LDN. From July 2006 to May 2008, 20 left-sided HARP procedures and 40 left-sided LDNs were performed. Intra and postoperative data were prospectively collected and analysis on outcome of both techniques was performed. More female patients underwent HARP compared to LDN (75% vs. 40%, P = 0.017). Other baseline characteristics were not significantly different. Median operation time and WIT were shorter in HARP (180 vs. 225 min, P = 0.002 and 3 vs. 5 min, P = 0.007 respectively). Blood loss did not differ (200 ml vs.150 ml, P = 0.39). Intra and postoperative complication rates for HARP and LDN (respectively 10% vs. 25%, P = 0.17 and 5% vs. 15%, P = 0.25) were not significantly different. During median follow-up of 18 months estimated glomerular filtration rates in donors and recipients and graft- and recipient survival did not differ between groups. Hand-assisted retroperitoneoscopic donor nephrectomy reduces operation and warm ischemia times, and provides at least equal safety. Hand-assisted retroperitoneoscopic may be a valuable alternative for left-sided LDN.

Automatic segmentation of the hippocampus from 3D magnetic resonance imaging mostly relied on multi-atlas registration methods. In this work, we exploit recent advances in deep learning to design and implement a fully automatic segmentation method, offering both superior accuracy and fast result. The proposed method is based on deep Convolutional Neural Networks (CNNs) and incorporates distinct segmentation and error correction steps. Segmentation masks are produced by an ensemble of three independent models, operating with orthogonal slices of the input volume, while erroneous labels are subsequently corrected by a combination of Replace and Refine networks. We explore different training approaches and demonstrate how, in CNN-based segmentation, multiple datasets can be effectively combined through transfer learning techniques, allowing for improved segmentation quality. The proposed method was evaluated using two different public datasets and compared favorably to existing methodologies. In the EADC-ADNI HarP dataset, the correspondence between the method's output and the available ground truth manual tracings yielded a mean Dice value of 0.9015, while the required segmentation time for an entire MRI volume was 14.8 seconds. In the MICCAI dataset, the mean Dice value increased to 0.8835 through transfer learning from the larger EADC-ADNI HarP dataset.

BACKGROUND

Seal reproductive systems are surrounded by thermogenic muscle and insulating blubber, suggesting elevated temperatures at the gonads and uterus. In the limbs of terrestrial mammals, cooled blood returning from superficial veins is mixed proximally with warm blood returning from deep veins. Thus, mixed cool-superficial and warm-deep venous blood from the hind limbs is returned to the central circulation.

METHODS

We describe structures observed in salvaged carcasses of harbor (Phoca vitulina), gray (Haliochoerus gryphus), harp (Phoca groendlandica), hooded (Cystophora cristata), and ringed (Phoca hispida) seals. Vessels were identified by dissection of injected and uninjected material.

RESULTS

In contrast to terrestrial mammals, phocid seals have anastomoses between the veins of the distal hind limb and the pelvis which allow large volumes of cool blood returning from the skin surface of the flipper to enter the gluteal, pelvic, or pudendo-epigastric veins. This provides a cool-superficial venous return that remains separate from the warm-deep venous return of the femoral veins. The cooled venous blood from the hind flippers supplies venous plexuses lining the inguinal region and the abdominal and pelvic cavities.

CONCLUSIONS

Cooled blood may prevent hyperthermic insult to seal reproductive systems.

Sera (n = 328) collected from phocids (1995-97) from the east coast of Canada, including harp seals (Phoca groenlandica), hooded seals (Cystophora cristata), grey seals (Halichoerus grypus), and harbor seals (Phoca vitulina), were diluted 1:25, 1:50, and 1:500 and tested by a modified agglutination test for antibodies to Toxoplasma gondii. Titers equal to or greater than 1:25 were considered evidence of exposure. Grey seal (11/122, 9%), harbor seal (3/34, 9%), and hooded seal (1/60, 2%) had titers of 1:25 and 1:50. Harp seals (n = 112) were seronegative. Probable maternal antibody transfer was observed in one harbor and one grey seal pup at 10 and 14 day of age, respectively. Transmission of T gondii in the marine environment is not understood. The discovery of T. gondii in marine mammals might indicate natural infections unknown because of lack of study or might indicate recent contamination of the marine environment from the terrestrial environment by natural or anthropogenic activities.

UNASSIGNED

Patients with chronic kidney disease (CKD) are at risk of progression to end-stage renal disease and cardiovascular disease. Data from other populations and animal experiments suggest that neprilysin inhibition (which augments the natriuretic peptide system) may reduce these risks, but clinical trials among patients with CKD are required to test this hypothesis.

UNASSIGNED

UK Heart and Renal Protection III (HARP-III) is a multicentre, double-blind, randomized controlled trial comparing sacubitril/valsartan 97/103 mg two times daily (an angiotensin receptor-neprilysin inhibitor) with irbesartan 300 mg one time daily among 414 patients with CKD. Patients ≥18 years of age with an estimated glomerular filtration rate (eGFR) of ≥45 but <60 mL/min/1.73 m2 and urine albumin:creatinine ratio (uACR) >20 mg/mmol or eGFR ≥20 but <45 mL/min/1.73 m2 (regardless of uACR) were invited to be screened. Following a 4- to 7-week pre-randomization single-blind placebo run-in phase (during which any current renin-angiotensin system inhibitors were stopped), willing and eligible participants were randomly assigned either sacubitril/valsartan or irbesartan and followed-up for 12 months. The primary aim was to compare the effects of sacubitril/valsartan and irbesartan on measured GFR after 12 months of therapy. Important secondary outcomes include effects on albuminuria, change in eGFR over time and the safety and tolerability of sacubitril/valsartan in CKD.

UNASSIGNED

Between November 2014 and January 2016, 620 patients attended a screening visit and 566 (91%) entered the pre-randomization run-in phase. Of these, 414 (73%) participants were randomized (mean age 63 years; 72% male). The mean eGFR was 34.0 mL/min/1.73 m2 and the median uACR was 58.5 mg/mmol.

UNASSIGNED

UK HARP-III will provide important information on the short-term effects of sacubitril/valsartan on renal function, tolerability and safety among patients with CKD.

BACKGROUND

Stressful life events (SLEs) are associated with the onset of psychiatric disorders but little is known about the effects of SLEs on individuals already diagnosed with an anxiety disorder, particularly generalized anxiety disorder (GAD) in which worry about life events is a defining characteristic. This study examined the impact of SLEs on relapse in adults already diagnosed with GAD.

METHODS

Data are obtained from the Harvard/Brown Anxiety Research Project (HARP), a naturalistic longitudinal study of adults with a current or past history of anxiety disorders. One hundred and twelve adults recovered from an episode of GAD and 27 subsequently relapsed during the study. Eight categories of SLEs were assessed via interview and were examined as predictors of GAD relapse.

RESULTS

An increased total number of SLEs was associated with a higher cumulative probability of relapse into episode of GAD and there was a nonsignificant statistical trend indicating specific categories of SLEs including health, death, and family/friends/household were related to an increased probability of relapse into episodes of GAD.

CONCLUSIONS

SLEs impact the course of GAD and certain types of stressors may be more relevant to symptomatology than others. The change and uncertainty associated with SLEs may exacerbate existing worry tendencies even among those who have recovered from GAD.

Progressive left ventricular hypertrophy is the hallmark of cardiac manifestations in patients with Fabry disease. Cardiovascular magnetic resonance with tissue tagging allows detailed assessment of the cardiac motion pattern. The aim was to test the hypothesis that not only Fabry patients with severe left ventricular hypertrophy exhibit changes in myocardial motion, but also Fabry patients with normal left ventricular mass. Magnetic resonance tagging using slice following complementary spatial modulation of magnetization (CSPAMM) combined with harmonic phase analysis (HARP) was applied to measure left ventricular shortening and contraction. Additionally, left ventricular rotation and global left ventricular torsion were examined. Twenty-nine Fabry patients grouped in patients with (n = 13) and without (n = 16) left ventricular hypertrophy were compared with 29 age and sex matched healthy volunteers. Long axis shortening and circumferential contraction showed reduced peak values with increasing left ventricular mass and were significantly reduced in Fabry patients with left ventricular hypertrophy (p < 0.001 and p < 0.05, respectively). Torsional deformation and apical rotation were increased both in Fabry patients with left ventricular hypertrophy as well as in patients with normal left ventricular mass (p < 0.001 for torsion) compared with controls. Applying the magnetic resonance tagging acquisition and analysis methods, myocardial motion abnormalities could not only be measured in Fabry patients with left ventricular hypertrophy but also in patients without macroscopic cardiac involvement.

Giardia and Cryptosporidium are protozoan parasites known to cause enteric disease in terrestrial wildlife species (mammals, reptiles and birds). Few surveys for Giardia and Cryptosporidium in marine wildlife species, such as pinnipeds, have been reported. The objective of this study was to determine the prevalence and genotype of Giardia and Cryptosporidium in two species of pinnipeds, harp seal (Phoca groenlandica) and hooded seal (Cystophora cristata), from the Gulf of St. Lawrence, Canada. Faecal samples were collected from pup and adult seals and examined for the presence of cysts of Giardia and oocysts of Cryptosporidium using microscopy and immunofluorescent staining. Tissues from the small intestine of adult seals were also collected and examined for infections using the polymerase chain reaction (PCR) technique. Giardia cysts were found in the faeces of 42% (16/38) of adult harp seals, but in none of the harp seal pups (0/20). Although Giardia cysts were not detected in faeces of adult hooded seals (0/10) using microscopy, 80% tested positive for Giardia using PCR of intestinal tissue indicative of a true replicating infection. Both harp and hooded seals harboured infections with the zoonotic strain, Giardia duodenalis Assemblage A, as determined using a nested-PCR technique to amplify a small subunit ribosomal (SSU-rRNA) gene of Giardia. Cryptosporidium was not detected by microscopy, nor using the PCR technique on intestinal tissues from any of the 68 seals examined.

Music thanatology represents an emerging area in which the raw materials of music, usually harp and/or voice, assist and comfort the dying patient. During prescriptive "music vigils, " the clinician-musician carefully observes physiological changes, cues, and breathing patterns, thereby synchronizing the music to reflect or support the patient's physiology and overall condition. Using data collected from 65 patients, this study was designed to assess the effectiveness of prescriptive harp music on selected palliative care outcomes using a sample of de-identified data forms from past music vigils. Patients were administered a 25- to 95-minute intervention of prescriptive harp music. Data collected included vital signs and observational indicators before (Ti) and after (T2) the vigil. Patients were more likely to experience decreased levels of agitation and wakefulness while also breathing more slowly and deeply with less effort at the conclusion of the music vigil. Results from this study suggest that a prescriptive vigil conducted by a trained music thanatologist could provide an effective form of palliative care for dying patients.

A study of the bat diversity was conducted in Hulu Terengganu dipterocarp forest and Setiu Wetland Beach Ridges Interspersed with Swales (BRIS) forest in Terengganu, to study the species diversity, composition and stratification of fruit bats from the understorey to the forest canopy. Mist nets were set up at the understorey, sub-canopy and canopy layer while harp traps were set up at the understorey layer. We recorded 170 individuals from six families' compromised 21 species from Hulu Terengganu dipterocarp forests and four species from Setiu Wetland BRIS forests throughout the sampling period. Megaerops ecaudatus and Cynopterus brachyotis were the most dominant species in Hulu Terengganu dipterocarp forest and Setiu Wetland BRIS forests. Our study also recorded two species with new distributional records for the east coast of Peninsular Malaysia, namely, Rhinolophus chiewkweeae and Chaerephon johorensis in Hulu Terengganu dipterocarp forests. Potential factors that might influence the results were in terms of the canopy covers, the structural complexity of canopy, food availability and spatial characteristics. This study was able to increase the knowledge on the species diversity and composition of bats in Hulu Terengganu dipterocarp forest and Setiu Wetland BRIS forest, thus, further aid in the effort of bat conservation in both areas.

Male crickets produce stridulatory songs using engaged tegmina (forewings): a plectrum on the left sweeps along a tooth row on the right. During stridulation, the plectrum moves across the teeth and vibrations are amplified by the surrounding cells and veins, resonating at the frequency of tooth impacts. The advance of the plectrum on the file is controlled by an escapement mechanism so that passing each single tooth generates one wave of a highly tonal signal. Both tegmina must oscillate in phase to avoid destructive interference. But as each plectrum-tooth contact begins, the right and left tegmina react in opposite oscillatory directions. A mechanical phase shifter is part of the left tegmen and compensates to achieve wing oscillation synchrony. We use a new technique to simulate plectrum-on-file interactions: in combination with laser vibrometry, this technique assessed plectrum mechanics in the cricket Gryllus bimaculatus. Using an excised teneral file, shaped like a partial gear and moved by a motor, and a microscan Doppler laser vibrometer, plectrum and left-tegmen mechanics were explored. The results show that plectrum and harp oscillate with a phase difference of ca. 156 deg., a shift rather than a complete phase inversion (180 deg.). This phase shift occurs at the site of a large wing vein (possibly A3). Plectrum and harp vibrate with similar fundamental frequency, therefore, plectrum torsion resonant frequency is important for maintaining vibration coherence. The mechanical aspects involved in this partial phase inversion are discussed with respect to the escapement mechanism. The plectrum mechanics and its implications in katydid stridulation are also considered.

A juvenile female hooded seal (Cystophora cristata) and a juvenile male harp seal (Phoca groenlandica) stranded separately on the New Jersey (USA) coast and were taken to a marine mammal rehabilitation center. Both were lethargic and emaciated, had dermatitis, and died. Histologic skin lesions in the seals were similar and consisted of epidermal and follicular epithelial hyperplasia, hyperkeratosis, degeneration, and necrosis. The most distinctive finding was extensive syncytial zones bounded superficially by hyperkeratosis and deeply by hyperplastic basal cells. Eosinophilic intracytoplasmic inclusion bodies were present in epithelial cells. Morbilliviral antigen was demonstrated in the skin lesions by immunohistochemistry. Phocine distemper virus was detected in the skin by reverse transcription polymerase chain reaction and a phocine distemper virus-specific probe using the Southern blot technique. This is the first report of morbilliviral dermatitis in marine mammals.

The weights of harp seal pups quadruple during 13 days of suckling while hooded seal pups double in weight in a lactation period of just 4 days. Pups of both species then fast for a month or longer. As a first measure of tissue responses to this 'feast and famine' pattern, we weighted the body, sculp (blubber and attached skin), core (carcass including viscera) and major internal organs of seal pups at birth, at the end of suckling, and at the end of the fast. When expressed as a percentage of body weight, the weights of the internal organs of newborn harp and hooded seals were within the range reported for newborn land mammals. During suckling, harp and hooded seals gained 2.3 and 6.5 kg/day body weight, respectively, but a large part (64-73%) of this gain was blubber and skin rather than core. Even though pups were ingesting great quantities of fat, their digestive organs (stomach, small and large intestines, pancreas) were neither particularly large at birth nor did these organs gain in weight or length unusually rapidly. Most organs increased in weight in proportion to the increase in core weight, but the liver and spleen increased proportionately more than the core, and the stomach, heart and kidneys increased proportionately less. At the end of suckling, sculp accounted for more than half of the body weight in both species. The subsequent 4-week fast resulted in weight loss from both the sculp and core, and the liver and spleen decreased in weight by about 70%. The net effect of sequential suckling and fasting was particularly striking in the hooded seal pup, which has a lighter core, heart, liver and spleen at 1 month postpartum than at birth. These data illustrate a remarkable cycle of nutrient deposition and depletion which is undoubtedly central to the survival of young seals in the harsh pack-ice environment.

BACKGROUND

Live kidney donation has a clear economical benefit over dialysis and deceased-donor transplantation. Compared with mini-incision open donor nephrectomy, laparoscopic donor nephrectomy (LDN) is considered cost-effective. However, little is known on the cost-effectiveness of hand-assisted retroperitoneoscopic donor nephrectomy (HARP). This study evaluated the cost-effectiveness of HARP versus LDN.

METHODS

Alongside a randomized controlled trial, the cost-effectiveness of HARP versus LDN was assessed. Eighty-six donors were included in the LDN group and 82 in the HARP group. All in-hospital costs were recorded. During follow-up, return-to-work and other societal costs were documented up to 1 year. The EuroQol-5D questionnaire was administered up to 1 year postoperatively to calculate quality-adjusted life years (QALYs).

RESULTS

Mean total costs from a healthcare perspective were $8935 for HARP and $8650 for LDN (P = 0.25). Mean total costs from a societal perspective were $16,357 for HARP and $16,286 for LDN (P = 0.79). On average, donors completely resumed their daytime jobs on day 54 in the HARP group and on day 52 in the LDN group (P = 0.65). LDN resulted in a gain of 0.005 QALYs.

CONCLUSIONS

Absolute costs of both procedures are very low and the differences in costs and QALYs between LDN and HARP are very small. Other arguments, such as donor safety and pain, should determine the choice between HARP and LDN.

The circumnutation of a rice root under dark conditions was observed using a highly sensitive camera, a new super-HARP camera. A rice root showed regular rhythmic movement with fixed angle. When treated with Al (5 microM AlCl3), the rotation angle of the root tip was drastically decreased and then the movement was resumed again, whereas the root elongation rate was constant. With the increase of Al concentration, the cycle-fading period became shorter. This is the first report to show that an Al treatment ceased the rotation movement of the root but not elongation.

Tagged magnetic resonance imaging (tMRI) is a well-known noninvasive method for studying regional heart dynamics. It offers great potential for quantitative analysis of a variety of kine(ma)tic parameters, but its clinical use has so far been limited, in part due to the lack of robustness and accuracy of existing tag tracking algorithms in dealing with low (and intrinsically time-varying) image quality. In this paper, we evaluate the performance of four frequently used concepts found in the literature (optical flow, harmonic phase (HARP) magnetic resonance imaging, active contour fitting, and non-rigid image registration) for cardiac motion analysis in 2D tMRI image sequences, using both synthetic image data (with ground truth) and real data from preclinical (small animal) and clinical (human) studies. In addition we propose a new probabilistic method for tag tracking that serves as a complementary step to existing methods. The new method is based on a Bayesian estimation framework, implemented by means of reversible jump Markov chain Monte Carlo (MCMC) methods, and combines information about the heart dynamics, the imaging process, and tag appearance. The experimental results demonstrate that the new method improves the performance of even the best of the four previous methods. Yielding higher consistency, accuracy, and intrinsic tag reliability assessment, the proposed method allows for improved analysis of cardiac motion.

OBJECTIVE

To validate a method called bi-ventricular strain unwrapped phase (BiSUP) for reconstructing three-dimensional plus time (3D+t) biventricular strain maps from phase-unwrapped harmonic phase (HARP) images derived from tagged cardiac magnetic resonance imaging (MRI).

METHODS

A set of 30 human subjects were imaged with tagged MRI. In each study, HARP phase was computed and unwrapped in each short-axis and long-axis image. Inconsistencies in unwrapped phase were resolved using branch cuts manually placed with a graphical user interface. The 3D strain maps were computed independently in each imaged time frame through systole and mid diastole in each study. The BiSUP strain and displacements were compared with those estimated by a 3D feature-based (FB) technique and a 2D+t HARP technique.

RESULTS

The standard deviation of the difference between strains measured by the FB and the BiSUP methods was less than 4% of the average of the strains from the two methods. The correlation between peak minimum principal strain measured using the BiSUP and HARP techniques was over 83%.

CONCLUSIONS

The BiSUP technique can reconstruct full 3D+t strain maps from tagged MR images through the cardiac cycle in a reasonable amount of time and user interaction compared with other 3D analysis methods.

MR tagging is considered as a valuable technique to evaluate regional myocardial function quantitatively and noninvasively, however the cumbersome and time-consuming post-processing procedures for cardiac motion tracking still hinder its application to routine clinical examination. We present a fast and semiautomatic method for tracking 3D cardiac motion from short-axis (SA) and long-axis (LA) tagged MRI images. The technique, called 3D-HARP (HARmonic Phase), is based on the HARP method and extends this method to track 3D motion. A material mesh model is built to represent a collection of material points inside the left ventricle (LV) wall. The phase time-invariance property of material points is used to track the mesh points. For a series of 9 timeframe MRI images, the total time required for initializing settings, building the mesh, and tracking 3D cardiac motion is approximately 10 minutes. Further analysis of Langrangian strain and twist angle demonstrates that during systole, the lateral LV wall shows a greater strain values than the septum and the SA slices from the base to the apex show a gradual change in twist pattern.