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OBJECTIVES/GOALS: The correction of spinopelvic parameters is associated with better outcomes in patients with adult spinal deformity (ASD). This study presents a novel artificial intelligence (AI) tool that automatically predicts spinopelvic parameters from spine x-rays with high accuracy and without need for any manual entry. METHODS/STUDY POPULATION: The AI model was trained/validated on 761 sagittal whole-spine x-rays to predict the following parameters: Sagittal Vertical Axis (SVA), Pelvic Tilt (PT), Pelvic Incidence (PI), Sacral Slope (SS), Lumbar Lordosis (LL), T1-Pelvic Angle (T1PA), and L1-Pelvic Angle (L1PA). A separate test set of 40 x-rays was labeled by 4 reviewers including fellowship-trained spine surgeons and a neuroradiologist. Median errors relative to the most senior reviewer were calculated to determine model accuracy on test and cropped-test (i.e. lumbosacral) images. Intraclass correlation coefficients (ICC) were used to assess inter-rater reliability RESULTS/ANTICIPATED RESULTS: The AI model exhibited the following median (IQR) parameter errors: SVA[2.1mm (8.5mm), p=0.97], PT [1.5° (1.4°), p=0.52], PI[2.3° (2.4°), p=0.27], SS[1.7° (2.2°), p=0.64], LL [2.6° (4.0°), p=0.89], T1PA [1.3° (1.1°), p=0.41], and L1PA [1.3° (1.2°), p=0.51]. The parameter errors on cropped lumbosacral images were: LL[2.9° (2.6°), p=0.80] and SS[1.9° (2.2°), p=0.78]. The AI model exhibited excellent reliability at all parameters in both whole-spine (ICC: 0.92-1.0) and lumbosacral x-rays: (ICC: 0.92-0.93). DISCUSSION/SIGNIFICANCE: Our AI model accurately predicts spinopelvic parameters with excellent reliability comparable to fellowship-trained spine surgeons and neuroradiologists. Utilization of predictive AI tools in spine-imaging can substantially aid in patient selection and surgical planning.
A total of 108 diverse sorghum (Sorghum bicolor) accessions were characterized for quantitative and qualitative fodder-related traits and zonate leaf spot (ZLS) (Gloeocercospora sorghi) disease during two successive wet seasons of 2019 and 2020 in augmented randomized block design. The Shannon's diversity index and analysis of variance showed the existence of significant variability among qualitative and quantitative traits. K-mean clustering showed strong relationship between green fodder yield (GFY) and other yield-contributing traits. The dendrogram constructed based on morphological traits classified accessions into four diverse groups and most of genotype fall under cluster II. The principal component analysis bi-plot analysis showed a total variation of 68.96%, where GFY, stem weight per plant, panicle length and dry matter yield (DMY) contributed significantly. From the experimental results, three sorghum genotypes viz., IG-03-424, IG-01-436 and IG-03-438 were identified as promising for higher GFY (808.66 g/plant) and DMY (238.0 g/plant), respectively. Further, based on disease reactions under natural condition, five genotypes viz., EC-512397, EC512393, EC512394, EC512399 and IG-02-437 were identified as potential donor for resistance to ZLS disease. These selected lines could be used as promising sources for high biomass and disease resistance in forage sorghum breeding programme.
14CO2 activity in air samples collected at Kakrapar Gujarat Site, India, was measured, and site-specific dilution factor for 14CO2 has been evaluated. 14CO2 activity in air samples was monitored for 72 different sampling events at onsite stack of Nuclear Power Plant (NPP) and at ESL meteorology laboratory (at 1.6 km from NPP stack). 14CO2 activity in air at stack of NPP and at ESL meteorology laboratory was observed to 0.10–0.18 TBq (GWe.year)–1, with mean value 0.12 TBq (GWe.year)–1 and ≤0.04–0.13 Bq m–3, with mean value 0.08 Bq m–3 respectively. The results were correlated with meteorological parameters. Site specific dilution factor for 14CO2 in air was evaluated at 1.6 km and was found to be in the range of 4.6E-05 to 21E-05 s m–3. Inter angle (degree) between plume direction and fixed sampling location and rainfall (mm) are found to be the important influencing parameters for dilution factor of 14CO2 in air.
Mental health and psychosocial support (MHPSS) staff in humanitarian settings have limited access to clinical supervision and are at high risk of experiencing burnout. We previously piloted an online, peer-supervision program for MHPSS professionals working with displaced Rohingya (Bangladesh) and Syrian (Turkey and Northwest Syria) communities. Pilot evaluations demonstrated that online, peer-supervision is feasible, low-cost, and acceptable to MHPSS practitioners in humanitarian settings.
Objectives
This project will determine the impact of online supervision on i) the wellbeing and burnout levels of local MHPSS practitioners, and ii) practitioner technical skills to improve beneficiary perceived service satisfaction, acceptability, and appropriateness.
Methods
MHPSS practitioners in two contexts (Bangladesh and Turkey/Northwest Syria) will participate in 90-minute group-based online supervision, fortnightly for six months. Sessions will be run on zoom and will be co-facilitated by MHPSS practitioners and in-country research assistants. A quasi-experimental multiple-baseline design will enable a quantitative comparison of practitioner and beneficiary outcomes between control periods (12-months) and the intervention. Outcomes to be assessed include the Kessler-6, Harvard Trauma Questionnaire and Copenhagen Burnout Inventory and Client Satisfaction Questionnaire-8.
Results
A total of 80 MHPSS practitioners will complete 24 monthly online assessments from May 2022. Concurrently, 1920 people receiving MHPSS services will be randomly selected for post-session interviews (24 per practitioner).
Conclusions
This study will determine the impact of an online, peer-supervision program for MHPSS practitioners in humanitarian settings. Results from the baseline assessments, pilot evaluation, and theory of change model will be presented.
Ketamine is a rapidly-acting antidepressant treatment with robust response rates. Previous studies have reported that serial ketamine therapy modulates resting state functional connectivity in several large-scale networks, though it remains unknown whether variations in brain structure, function, and connectivity impact subsequent treatment success. We used a data-driven approach to determine whether pretreatment multimodal neuroimaging measures predict changes along symptom dimensions of depression following serial ketamine infusion.
Methods
Patients with depression (n = 60) received structural, resting state functional, and diffusion MRI scans before treatment. Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HDRS-17), the Inventory of Depressive Symptomatology (IDS-C), and the Rumination Response Scale (RRS) before and 24 h after patients received four (0.5 mg/kg) infusions of racemic ketamine over 2 weeks. Nineteen unaffected controls were assessed at similar timepoints. Random forest regression models predicted symptom changes using pretreatment multimodal neuroimaging and demographic measures.
Results
Two HDRS-17 subscales, the HDRS-6 and core mood and anhedonia (CMA) symptoms, and the RRS: reflection (RRSR) scale were predicted significantly with 19, 27, and 1% variance explained, respectively. Increased right medial prefrontal cortex/anterior cingulate and posterior insula (PoI) and lower kurtosis of the superior longitudinal fasciculus predicted reduced HDRS-6 and CMA symptoms following treatment. RRSR change was predicted by global connectivity of the left posterior cingulate, left insula, and right superior parietal lobule.
Conclusions
Our findings support that connectivity of the anterior default mode network and PoI may serve as potential biomarkers of antidepressant outcomes for core depressive symptoms.
This study aimed to evaluate the effect of resident involvement and the ‘July effect’ on peri-operative complications after parotidectomy.
Method
The American College of Surgeons National Surgical Quality Improvement Program database was queried for parotidectomy procedures with resident involvement between 2005 and 2014.
Results
There were 11 733 cases were identified, of which 932 involved resident participation (7.9 per cent). Resident involvement resulted in a significantly lower reoperation rate (adjusted odds ratio, 0.18; 95 per cent confidence interval, 0.05–0.73; p = 0.02) and readmission rate (adjusted odds ratios 0.30; 95 per cent confidence interval, 0.11–0.80; p = 0.02). However, resident involvement was associated with a mean 24 minutes longer adjusted operative time and 23.5 per cent longer adjusted total hospital length of stay (respective p < 0.01). No significant difference in surgical or medical complication rates or mortality was found when comparing cases among academic quarters.
Conclusion
Resident participation is associated with significantly decreased reoperation and readmission rates as well as longer mean operative times and total length of stay. Resident transitions during July are not associated with increased risk of adverse peri-operative outcomes after parotidectomy.
Deriving glacier outlines from satellite data has become increasingly popular in the past decade. In particular when glacier outlines are used as a base for change assessment, it is important to know how accurate they are. Calculating the accuracy correctly is challenging, as appropriate reference data (e.g. from higher-resolution sensors) are seldom available. Moreover, after the required manual correction of the raw outlines (e.g. for debris cover), such a comparison would only reveal the accuracy of the analyst rather than of the algorithm applied. Here we compare outlines for clean and debris-covered glaciers, as derived from single and multiple digitizing by different or the same analysts on very high- (1 m) and medium-resolution (30 m) remote-sensing data, against each other and to glacier outlines derived from automated classification of Landsat Thematic Mapper data. Results show a high variability in the interpretation of debris-covered glacier parts, largely independent of the spatial resolution (area differences were up to 30%), and an overall good agreement for clean ice with sufficient contrast to the surrounding terrain (differences ∼5%). The differences of the automatically derived outlines from a reference value are as small as the standard deviation of the manual digitizations from several analysts. Based on these results, we conclude that automated mapping of clean ice is preferable to manual digitization and recommend using the latter method only for required corrections of incorrectly mapped glacier parts (e.g. debris cover, shadow).
Monitoring the glacier mass balance of summer-accumulation-type Himalayan glaciers is critical to not only assess the impact of climate change on the volume of such glaciers but also predict the downstream water availability and the global sea-level change in future. To better understand the change in meteorological parameters related to glacier mass balance and runoff in a glacierized basin and to assess the highly heterogeneous glacier responses to climate change in the Nepal Himalaya and nearby ranges, the Cryosphere Monitoring Project (CMP) carries out meteorological observations in Langtang Valley and mass-balance measurements on Yala Glacier, a debris-free glacier in the same valley. A negative annual mass balance of –0.89m w.e. and the rising equilibrium-line altitude of Yala Glacier indicate a continuation of a secular trend toward more negative mass balances. Lower temperature lapse rate during the monsoon, the effect of convective precipitation associated with mesoscale thermal circulation in the local precipitation and the occurrence of distinct diurnal cycles of temperature and precipitation at different stations in the valley are other conclusions of this comprehensive scientific study initiated by CMP which aims to yield multi-year glaciological, hydrological and meteorological observations in the glacierized Langtang River basin.
Assaultive violence events are associated with increased risk for adverse psychiatric outcomes, including post-traumatic stress (PTS), depression, and generalized anxiety. Prior research has indicated that economic, legal, and social stressors that could follow assaultive events may explain the increased risk for adverse psychiatric outcomes, yet longitudinal studies have not adequately examined this pathway. In the current study, we aimed to address this limitation.
Methods
Participants (N = 1360) were part of a longitudinal population-based study of adults living in Detroit. At three waves, participants indicated their exposure to assaultive violence and economic, legal, and social stressors, and completed inventories of PTS, depression, and generalized anxiety. Longitudinal mediation models were used to test the hypothesized pathway from assaultive violence to each psychiatric outcome.
Results
The hypothesized models evidenced good fit with the data and, in each, the paths from Wave 1 (W1) assaultive violence to W2 stressors, and from W2 stressors to W3 symptoms were significant (range of Standardized Estimates: 0.09–0.15, all p < 0.01). Additionally, the indirect paths from W1 assaultive violence to W3 symptoms were significant (range of Standardized Estimates: 0.01–0.02, all p < 0.05).
Conclusions
The findings illustrate that the economic, legal, and social stressors that could follow assaultive violence increase risk for a range of psychiatric symptoms. Although future research is needed, the results suggest that investment in interventions that prevent and mitigate assaultive violence survivors’ exposure to such stressors may be an effective way to prevent mental illness in the aftermath of violent assaults.
Growth and reproductive potential with respect to season and photosynthetic gas exchange behavior under elevated (short-term) CO2 at varying temperature, relative humidity (RH), and irradiance levels were investigated in ragweed parthenium (also known as carrot grass and congress grass), a noxious weed in India. Lower values of biomass, relative growth rate, net assimilation rate, crop growth rate, leaf area duration, leaf area index, and numbers of flowers and seeds in winter compared with summer stands showed that ragweed parthenium is greatly suppressed by low temperatures during winter. This was due to constrained vegetative growth, seedling emergence, and seed to flower ratio. The species showed maximum photosynthetic response to temperature at 25 to 35 C, and the net photosynthetic rate was reduced considerably at a low temperature (7 C). These temperatures approximately corresponded to the normal temperatures experienced by summer (25–35 C) and winter (7 C) stands of ragweed parthenium. Elevated CO2 enhanced leaf net photosynthetic efficiency, maximum photosynthetic rate, and water use efficiency (WUE) but decreased the light compensation point for net photosynthesis, stomatal conductance, and transpiration rate. The interactive effects of elevated CO2 and temperature resulted in a decrease in light-limited and light-saturated net photosynthetic rates and WUE. The interactive effects also reduced an elevated CO2-induced decrease in light compensation point relative to elevated CO2 alone. Stomatal conductance was insensitive to photosynthetic photon flux but was greatly influenced by RH. Leaves of the species may show increasing rates of net photosynthesis with a rise in CO2 and temperature. However, excessive increase in transpiration with temperature, especially at 47 C (noon temperature during summer in the plains of northern India), appears to be disadvantageous for the leaves when conservation of water is of prime importance.
Docetaxel, cisplatin plus 5-fluorouracil is an efficacious induction regimen but is more toxic than cisplatin plus 5-fluorouracil. This study aimed to determine whether docetaxel and cisplatin without 5-fluorouracil maintains efficacy while decreasing toxicity.
Methods:
A multicenter non-comparative pilot study of locally advanced squamous cell carcinoma of the head and neck was performed. Patients received primary therapy comprising three cycles of 75 mg/m2 docetaxel and 75 mg/m2 cisplatin followed by concurrent chemoradiotherapy. The primary endpoint was the response rate to the docetaxel and cisplatin induction regimen.
Results:
A total of 26 patients were enrolled: of these, 23 (88.5 per cent) received all three docetaxel and cisplatin cycles. Common grade 3–4 adverse events were febrile neutropenia (19.2 per cent of patients), diarrhoea (19.2 per cent) and non-neutropenic infection (15.4 per cent). The overall response rate to docetaxel and cisplatin induction chemotherapy was 65.4 per cent. A total of 23 patients (88.5 per cent) subsequently received chemoradiotherapy with a median radiotherapy dose of 70 Gy. The response rate to chemoradiotherapy was 73 per cent. At a median follow up of 44 months, the 3-year progression-free survival and overall survival rates were 62 per cent and 69 per cent, respectively.
Conclusion:
Docetaxel and cisplatin induction chemotherapy is a feasible induction regimen with comparable efficacy to docetaxel, cisplatin and 5-fluorouracil induction chemotherapy.
A regional, multistate investigation into a June–August 2013 cyclosporiasis outbreak was conducted in Nebraska, Iowa, and neighbouring states. Cases were confirmed on the basis of laboratory and clinical findings. Of 227 cases in Iowa (n = 140) and Nebraska (n = 87) residents, 162 (71%) reported dining at chain A/B restaurants – 96% reported house salad consumption. A case-control study identified chain A/B house salad as the most likely vehicle. Traceback was conducted to ascertain production lot codes of bagged salad mix (iceberg and romaine lettuce, red cabbage, and carrots) served as house salad in implicated restaurants. A single production lot code of salad mix supplied by both a common producer and distributor was linked to the majority of confirmed cases in persons reporting regional chain A/B exposure. The salad mix linked to illnesses contained imported romaine lettuce from two separate single-grower fields-of-origin and ⩾1 additional field from another grower.
This study assessed the utility of current sialendoscopes in the paranasal sinuses in a cadaveric model and evaluated novel uses for sialendoscopes.
Methods:
Currently available sialendoscopes were used for visualisation and performing interventions in the paranasal sinuses. Ten cadaver heads were studied before and after dissection. Outcomes included ostia identification, sinus cannulation, success of mucosal biopsy collection and image clarity.
Results:
Marchal and Erlangen sialendoscopes were found to be effective for both visualising and cannulating the sphenoid sinuses before and after dissection. Both types demonstrated poor maxillary ostia visualisation without dissection, but did allow treatment after antrostomy. Larger diameter sialendoscopes were associated with the lowest image distortion during maxillary ostia assessment. Mucosal biopsy collection within the sphenoid sinus, but not in the maxillary sinus, was possible before dissection.
Conclusion:
Sialendoscopes can be used for visualisation and performing interventions in the sinonasal cavity, but their utility is mainly limited to the sphenoid sinus. They may be considered a minimally invasive method for drug delivery and/or biopsy collection in the post-operative setting for all sinuses. Design improvements are suggested.
We present a complete spatial and dynamical study of the poorly populated stellar system ESO65SC03. The radial distribution of the system gives a core and cluster radii of 1.10±0.63 and 5.36±0.24 arcmin, respectively. The SNDP does not show any clear enhancement of the surface stellar number density between the stars of the system and the field regions. We derive the optimum isochrone solution for a particular grid size in the CMD using the statistical cleaning procedure. Using the statistically cleaned CMDs, we find the distance modulus, (m − M)0, and reddening, E(B − V), of the system to be 11.8±0.2 and 0.45 mag, respectively. The mean proper motion of this system is − 5.37±0.81 mas yr−1 and 0.31±0.40 in RA and DEC directions, respectively. The mean proper motion of this system is found to be almost similar to the field region. The mass function for the brighter stars is found to be too high for the system to be an open cluster. These combined results place constraints on whether stellar system ESO65SC03 is a POCR or an Asterism. Our understanding is that the ESO65SC03 is in a stage of POCR by losing their main-sequence stars in the dynamic evolution processes.
Pregnancy is a special condition where many metabolic changes may occur because of increased requirement of essential micronutrients such as iron and iodine. Foetal thyroid starts producing its own thyroid hormones after 12 weeks of gestation. Therefore, the first trimester is very crucial for meeting thyroid hormone requirements of the mother and foetus. Iodine deficiency and iron deficiency may affect mental and physical growth of the foetus. Hence, it is very important to establish a programme on the screening of pregnant women for thyroid dysfunction tests along with established iron status assessment. Thus, the study was aimed to screen the pregnant women for iodine deficiency disorders and iron deficiency during early gestation, situational analysis on thyroid insufficiency and iron deficiency in pregnant women (gestational age <15 weeks) in urban Vadodara, Gujarat. n = 256 healthy pregnant women with uncomplicated singleton pregnancy were selected. The thyroid hormone was estimated by RIA, UIE using simple microplate technique and haemoglobin (Hb) concentration by acid hematin method. Median thyrotropin (TSH), free thyroxine (FT4), total thyroxine (TT4) and UIE concentrations were 1.88 μIU/ml, 0.83 ng/dl, 10.24 μg/dl and 297.14 mcg/l, respectively. There was a significant correlation between TSH, FT4 and month of gestation. Mean Hb concentration was 9.27 ± 1.09 g/dl. The prevalence of iodine insufficiency (based on UI) was 16.79% and iron deficiency was 91%. Screening programme for iodine deficiency during early gestation should be implemented along with the existing programme of haemoglobin estimation at first prenatal visit. This would help prevent damage to the developing brain and growth of the foetus and also to trace at-risk pregnant women.
The generation of 1–5 MeV protons from the interaction of a 3 ps TW CO2 laser pulse with a gas target with a peak density around the critical plasma density has been studied by 2D particle-in-cell simulations. The proton acceleration in the preformed plasma with a symmetric, linearly ramped density distribution occurs via formation of sheath of the hot electrons on the back surface of the target. The maximum energy of the hot electrons and, hence, net acceleration of protons is mainly defined by Forward Raman scattering instability in the underdense part of the plasma. Forward directed ion beams from a debris free gaseous target can find an application as a high-brightness ion source-injector to a conventional accelerator operating up to kHz pulse repetition frequency.
Insufficiency of vitamin B12 (B12) and folate during pregnancy can result in low concentrations in the fetus and have adverse effects on brain development. We investigated the relationship between maternal B12 and folate nutrition during pregnancy and offspring motor, mental and social development at two years of age (2 y). Mothers (n = 123) and their offspring (62 girls, 61 boys) from rural and middle-class urban communities in and around Pune city were followed through pregnancy up to 2 y. Maternal B12 and folate concentrations were measured at 28 and 34 weeks of gestation. At 2 y, the Developmental Assessment Scale for Indian Infants was used to determine motor and mental developmental quotients and the Vineland Social Maturity Scale for the social developmental quotient. Overall, 62% of the mothers had low B12 levels (<150 pmol/l) and one mother was folate deficient during pregnancy. Maternal B12 at 28 and 34 weeks of gestation was associated with offspring B12 at 2 y (r = 0.29, r = 0.32, P < 0.001), but folate was not associated with offspring folate. At 2 y, motor development was associated with maternal folate at 28 and 34 weeks of gestation. Mental and social development quotients were associated positively with head circumference and negatively with birth weight. In addition, pregnancy B12 and folate were positively associated with mental and social development quotients. Maternal B12 and folate during intrauterine life may favorably influence brain development and function. Pregnancy provides a window of opportunity to enhance fetal psychomotor (motor and mental) development.
Longitudinal studies investigating vitamin B12 and folate status of mothers and their offspring will provide a better understanding of intergenerational nutrition. During pregnancy and 2 years (2y) after delivery, we measured plasma vitamin B12 and folate concentrations in 118 women [aged (mean ± s.d.) 22.9 ± 3.9y] who attended a rural (n = 68) or an urban (n = 50) antenatal clinic in Pune, India. Cord blood vitamin B12 and folate were measured, and when the child was 2y total homocysteine (tHcy) was also measured. Demographic and diet measurements were recorded using standard methods.
Pregnancy plasma vitamin B12 concentration at 34 weeks was low [median (25th, 75th), 115 (95, 147) pm]; 75% had low status (<150 pm). Plasma folate was high (mean ± s.d., 33 ± 21 nm); one had a folate concentration <7 pm. Cord plasma vitamin B12 and folate concentrations were higher than and positively associated with maternal concentrations. In stepwise regression, higher child vitamin B12 at 2y was predicted (total R2 15.7%) by pregnancy vitamin B12 (std β 0.201, R2 7.7%), current consumption of cow's milk (std β 0.194, R2 3.3%) and whether breast feeding was stopped before 2y (std β −0.234 R2 7.2%). Child's 2y tHcy concentration was high (11.4 ± 3.6 μm) and predicted by lower pregnancy vitamin B12 (std β −0.206, R2 4.1%), lack of vitamin supplementation (std β −0.256, R2 5.6%) in pregnancy and whether currently breastfed (std β 0.268, R2 8.4%).
Low maternal vitamin B12 status in pregnancy and prolonged breast-feeding results in disturbed one-carbon metabolism in offspring at 2y. Supplementation of women of child-bearing age, particularly during pregnancy and lactation, may improve the homocysteine status of these children.