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• Karyotype analysis has a great impact on the diagnosis, treatment and prognosis in hematologic neoplasms. • Identification and characterization of chromosomes is a challenging process and needs experienced personal. • The presented novel laboratory approach using a convolutional neural network (CNN) saves time and reduces mistakes in the karyotyping workflow. Karyotype analysis has a great impact on the diagnosis, treatment and prognosis in hematologic neoplasms. The identification and characterization of chromosomes is a challenging process and needs experienced personal. Artificial intelligence provides novel support tools. However, their safe and reliable application in diagnostics needs to be evaluated. Here, we present a novel laboratory approach to identify chromosomes in cancer cells using a convolutional neural network (CNN). The CNN identified the correct chromosome class for 98.8% of chromosomes, which led to a time saving of 42% for the karyotyping workflow. These results demonstrate that the CNN has potential application value in chromosome classification of hematologic neoplasms. This study contributes to the development of an automatic karyotyping platform. [ABSTRACT FROM AUTHOR]

Background: For the translation of noninvasive motor imagery (MI)-based brain-computer interfaces (BCIs) from the lab environment to end users at their homes, their handling must be improved. As a key component, the number of electroencephalogram (EEG)-recording electrodes has to be kept at a minimum. However, due to inter-individual anatomical and physiological variations, reducing the number of electrodes bares the risk of electrode misplacement, which will directly translate into a limited BCI performance of end users. The aim of the study is to evaluate the use of focal transcranial magnetic stimulation (TMS) as an easy tool to individually optimize electrode positioning for a MI-based BCI. For this, the area of MI-induced mu-rhythm modulation was compared with the motor hand representation area in respect to their localization and to the control performance of a MI-based BCI. Methods: Focal TMS was applied to map the motor hand areas and a 48-channel high-resolution EEG was used to localize MI-induced mu-rhythm modulations in 11 able-bodied, right-handed subjects (5 male, age: 23-31). The online BCI performances of the study participants were assessed with a single next-neighbor Laplace channel consecutively placed over the motor hand area and over the area of the strongest mu-modulation. Results: For most subjects, a consistent deviation between the position of the mu-modulation center and the corresponding motor hand areas well above the localization error could be observed in mediolateral and to a lesser degree in anterior-posterior direction. On an individual level, the MI-induced mu-rhythm modulation was at average found 1.6 cm (standard deviation (SD) = 1.30 cm) lateral and 0.31 cm anterior (SD = 1.39 cm) to the motor hand area and enabled a significantly better online BCI performance than the motor hand areas. Conclusion: On an individual level a trend towards a consistent average spatial distance between motor hand area and mu-rhythm modulation center was found indicating that TMS may be used as a simple tool for quick individual optimization of EEG-recording electrode positions of MI-based BCIs. The study results indicate that motor hand areas of the primary motor cortex determined by TMS are not the main generators of the cortical mu-rhythm. [ABSTRACT FROM AUTHOR]

Diel vertical migration (DVM) is a common behaviour and often relates with the diurnal feeding periodicity. Nonetheless, sprat feeding behaviour and daily ration (DR) estimation are usually based on daytime stomach contents from deeper layers. Our study provides a new approach for DR estimation, taking into consideration the DVM associated feeding periodicity. We analysed sprat DVM by hydroacoustics and collected stomach contents in the Central Baltic Sea at different depths. The main outcome is that feeding in the deep during the day represents only 16–39% of the DR. DRs were 1.4-times higher using our approach compared to the established approach. The underestimation by the established approach was mainly caused by ignoring the effect of higher temperatures from the upper layers on the gastric evacuation rate. Our results have major implications not only for DR estimates but also on the interpretation of prey selectivity. The study emphasizes the importance of adapting the sampling design to the vertical feeding dynamics to avoid a biased picture of predator prey interactions. [ABSTRACT FROM AUTHOR]

Aims: To determine the effect of the glucagon-like peptide-1 analogue liraglutide on left ventricular function in chronic heart failure patients with and without type 2 diabetes.Methods and Results: LIVE was an investigator-initiated, randomised, double-blinded, placebo-controlled multicentre trial. Patients (n = 241) with reduced left ventricular ejection fraction (LVEF ≤45%) were recruited (February 2012 to August 2015). Patients were clinically stable and on optimal heart failure treatment. Intervention was liraglutide 1.8 mg once daily or matching placebo for 24 weeks. The LVEF was similar at baseline in the liraglutide and the placebo group (33.7 ± 7.6% vs. 35.4 ± 9.4%). Change in LVEF did not differ between the liraglutide and the placebo group; mean difference (95% confidence interval) was -0.8% (-2.1, 0.5; P = 0.24). Heart rate increased with liraglutide [mean difference: 7 b.p.m. (5, 9), P < 0.0001]. Serious cardiac events were seen in 12 (10%) patients treated with liraglutide compared with 3 (3%) patients in the placebo group (P = 0.04).Conclusion: Liraglutide did not affect left ventricular systolic function compared with placebo in stable chronic heart failure patients with and without diabetes. Treatment with liraglutide was associated with an increase in heart rate and more serious cardiac adverse events, and this raises some concern with respect to the use of liraglutide in patients with chronic heart failure and reduced left ventricular function. More data on the safety of liraglutide in different subgroups of heart failure patients are needed. [ABSTRACT FROM AUTHOR]

Aims: Despite recent advances in the treatment of chronic heart failure (HF), mortality and hospitalizations still remain high. Additional therapies to improve mortality and morbidity are urgently needed. The efficacy of cardiac glycosides - although regularly used for HF treatment - remains unclear. DIGIT-HF was designed to demonstrate that digitoxin on top of standard of care treatment improves mortality and morbidity in patients with HF and a reduced ejection fraction (HFrEF).Methods: Patients with chronic HF, New York Heart Association (NYHA) functional class III-IV and left ventricular ejection fraction (LVEF) ≤ 40%, or patients in NYHA functional class II and LVEF ≤ 30% are randomized 1:1 in a double-blind fashion to treatment with digitoxin (target serum concentration 8-18 ng/mL) or matching placebo. Randomization is stratified by centre, sex, NYHA functional class (II, III, or IV), atrial fibrillation, and treatment with cardiac glycosides at baseline. A total of 2190 eligible patients will be included in this clinical trial (1095 per group). All patients receive standard of care treatment recommended by expert guidelines upon discretion of the treating physician. The primary outcome is a composite of all-cause mortality or hospital admission for worsening HF (whatever occurs first). Key secondary endpoints are all-cause mortality, hospital admission for worsening HF, and recurrent hospital admission for worsening HF.Conclusion: The DIGIT-HF trial will provide important evidence, whether the cardiac glycoside digitoxin reduces the risk for all-cause mortality and/or hospital admission for worsening HF in patients with advanced chronic HFrEF on top of standard of care treatment. [ABSTRACT FROM AUTHOR]

A recent increase in the construction of Offshore Wind Farms (OWFs) has initiated numerous environmental impact assessments and monitoring programs. These focus on sea mammals, seabirds, benthos or demersal fish, but generally ignore any potential effects OWFs may have on the pelagic ecosystem. The only work on the latter has been through modelling analyses, which predict localised impacts like enhanced vertical mixing leading to a decrease in seasonal stratification, as well as shelf-wide changes of tidal amplitudes. Here we provide for the first-time empirical bio-physical data from an OWF. The data were obtained by towing a remotely operated vehicle (TRIAXUS ROTV) through two non-operating OWFs in the summer stratified North Sea. The undulating TRIAXUS transects provided high-resolution CTD data accompanied by oxygen and chlorophyll- a measurements. We provide empirical indication that vertical mixing is increased within the OWFs, leading to a doming of the thermocline and a subsequent transport of nutrients into the surface mixed layer (SML). Nutrients were taken up rapidly because underwater photosynthetically active radiation (PAR) enabled net primary production in the entire water column, especially within submesoscale chlorophyll- a pillars that were observed at regular intervals within the OWF regions. Video Plankton Recorder (VPR) images revealed distinct meroplankton distribution patterns in a copepod-dominated plankton community. Hydroacoustic records did not show any OWF effects on the distribution of pelagic fish. The results of a pre-OWF survey show however, that it is difficult to fully separate the anthropogenic impacts from the natural variability. [ABSTRACT FROM AUTHOR]

Aims To determine the effect of the glucagon-like peptide-1 analogue liraglutide on left ventricular function in chronic heart failure patients with and without type 2 diabetes. Methods and results LIVE was an investigator-initiated, randomised, double-blinded, placebo-controlled multicentre trial. Patients (n=241) with reduced left ventricular ejection fraction (LVEF ≤45%) were recruited (February 2012 to August 2015). Patients were clinically stable and on optimal heart failure treatment. Intervention was liraglutide 1.8 mg once daily or matching placebo for 24weeks. The LVEF was similar at baseline in the liraglutide and the placebo group (33.7±7.6% vs. 35.4±9.4%). Change in LVEF did not differ between the liraglutide and the placebo group; mean difference (95% confidence interval) was -0.8% (-2.1, 0.5; P =0.24). Heart rate increased with liraglutide [mean difference: 7 b.p.m. (5, 9), P <0.0001]. Serious cardiac events were seen in 12 (10%) patients treated with liraglutide compared with 3 (3%) patients in the placebo group (P =0.04). Conclusion Liraglutide did not affect left ventricular systolic function compared with placebo in stable chronic heart failure patients with and without diabetes. Treatment with liraglutide was associated with an increase in heart rate and more serious cardiac adverse events, and this raises some concern with respect to the use of liraglutide in patients with chronic heart failure and reduced left ventricular function. More data on the safety of liraglutide in different subgroups of heart failure patients are needed. [ABSTRACT FROM AUTHOR]

Background: Maternal mental health conditions are prevalent across the world. For women, the perinatal period is associated with increased rates of depression and anxiety. At the same time, there is widespread documentation of disrespectful care for women by maternity health staff. Improving the empathic engagement skills of maternity healthcare workers may enable them to respond to the mental health needs of their clients more effectively. In South Africa, a participatory empathic training method, the "Secret History" has been used as part of a national Department of Health training program with maternity staff and has showed promising results. For this paper, we aimed to describe an adaptation of the Secret History empathic training method from the South African to the German setting and to evaluate the adapted training. Methods: The pilot study occurred in an academic medical center in Germany. A focus group (n = 8) was used to adapt the training by describing the local context and changing the materials to be relevant to Germany. After adapting the materials, the pilot training was conducted with a mixed group of professionals (n = 15), many of whom were trainers themselves. A pre-post survey assessed the participants' empathy levels and attitudes towards the training method. Results: In adapting the materials, the focus group discussion generated several experiences that were considered to be typical interpersonal and structural challenges facing healthcare workers in maternal care in Germany. These experiences were crafted into case scenarios that then formed the basis of the activities used in the Secret History empathic training pilot. Evaluation of the pilot training showed that although the participants had high levels of empathy in the pre-phase (100% estimated their empathic ability as high or very high), 69% became more aware of their own emotional experiences with patients and the need for self-care after the training. A majority, or 85%, indicated that the training was relevant to their work as clinicians and trainers, that it reflected the German situation, and that it may be useful ultimately to address emotional distress in mothers in the perinatal phase. Conclusions: Our study suggests that it is possible to adapt an empathic training method developed in a South African setting and apply it to a German setting, and that it is well received by participants who may be involved in healthcare worker training. More research is needed to assess adaptations with other groups of healthcare workers in different settings and to assess empathic skill outcomes for participants and women in the perinatal period. [ABSTRACT FROM AUTHOR]