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B-mode ultrasound can be used to image musculoskeletal tissues, but one major bottleneck is analyses of muscle architectural parameters (i.e., muscle thickness, pennation angle and fascicle length), which are most often performed manually. In this study we trained two different neural networks (classic U-Net and U-Net with VGG16 pre-trained encoder) to detect muscle fascicles and aponeuroses using a set of labeled musculoskeletal ultrasound images. We determined the best-performing model based on intersection over union and loss metrics. We then compared neural network predictions on an unseen test set with those obtained via manual analysis and two existing semi/automated analysis approaches (simple muscle architecture analysis [SMA] and UltraTrack). DL_Track_US detects the locations of the superficial and deep aponeuroses, as well as multiple fascicle fragments per image. For single images, DL_Track_US yielded results similar to those produced by a non-trainable automated method (SMA; mean difference in fascicle length: 5.1 mm) and human manual analysis (mean difference: –2.4 mm). Between-method differences in pennation angle were within 1.5°, and mean differences in muscle thickness were less than 1 mm. Similarly, for videos, there was overlap between the results produced with UltraTrack and DL_Track_US, with intraclass correlations ranging between 0.19 and 0.88. DL_Track_US is fully automated and open source and can estimate fascicle length, pennation angle and muscle thickness from single images or videos, as well as from multiple superficial muscles. We also provide a user interface and all necessary code and training data for custom model development. [ABSTRACT FROM AUTHOR]

Abstract Skeletal muscle structural assembly (and its remodeling in response to loading–unloading states) can be investigated macroscopically by assessing muscle architecture, described as fascicle geometric disposition within the muscle. Over recent decades, various medical imaging techniques have been developed to facilitate the in vivo assessment of muscle architecture. However, the main advantages and limitations of these methodologies have been fragmentally discussed. In the present article, the main techniques used for the evaluation of muscle architecture are presented: conventional B-mode ultrasonography, extended-field-of-view ultrasound, 3-D ultrasound and magnetic resonance imaging-based diffusion tensor imaging. By critically discussing potentials and shortcomings of each methodology, we aim to provide readers with an overview of both established and new techniques for the in vivo assessment of muscle architecture. This review may serve as decision guidance facilitating selection of the appropriate technique to be applied in biomedical research or clinical routine. [ABSTRACT FROM AUTHOR]

Non-invasive criteria to identify patients with compensated hepatitis B virus (HBV) cirrhosis who can avoid esophagogastroduodenoscopy(EGD) and predict the progression of low-risk esophageal varices(EV) are lacking. To evaluate the diagnostic performance of RESIST criteria: 1)to rule out high-risk EV(HRV) in viremic patients with compensated HBV cirrhosis at baseline; 2)to predict progression to HRV after viral suppression with nucleos(t)idic analogues(NUCs) in patients without HRV at baseline. All consecutive patients observed at 2 Italian referral centers with compensated viremic HBV cirrhosis who received NUCs therapy during follow-up were classified as RESIST low-risk if platelets were>120 × 109/L and serum albumin>3.6 g/dL or RESIST high-risk if platelets were<120 × 109/L or albumin<3.6 g/dL, before and after viral suppression. Outcomes were the presence of HRV at baseline and the progression to HRV during follow-up after viral suppression. Area under the receiver operating characteristic curve(AUROC) and decision curve analysis(DCA) were calculated for RESIST and compared with elastography-based criteria (Baveno VI, Expanded Baveno VI, and Baveno VII). One-hundred-thirty-five Child-Pugh class A patients(mean age 50.8 years, 83.7% males) were included. At baseline, 35 patients(25.9%) had low-risk varices and 13(9.7%) had HRV. HRV were correctly classified in all 13 patients(100%) by Baveno VII and Baveno VI, in 12(92.3%) by RESIST and in 11(84.6%) by Expanded Baveno VI. Although RESIST missed 1 patient with HRV, they had the highest AUROC(0.73) and DCA demonstrates a higher net benefit compared to elastography-based criteria for ruling out HRV. After a median follow-up of 16.8 years, 9 out of 87(10.3%) patients without HRV at baseline developed HRV. RESIST showed higher specificity(85%) versus Baveno VII(59%) and VI(63%), avoiding a higher number(80%) of unnecessary endoscopies and showing the highest AUROC(0.90) and the highest net benefit in ruling out HRV compared to elastography-based scores. RESIST criteria are useful to accurately predict HRV at baseline and the development of HRV after viral suppression by NUCs in patients with compensated HBV cirrhosis. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Pressure ulcers are a common and debilitating form of chronic wounds that impose a considerable burden on individuals and healthcare systems. Colonisation by bacteria complicates the management of pressure ulcers and delays healing. Ionic silver has a well-established role as an antimicrobial agent, providing effective and sustained activity against a broad range of microorganisms, including antibiotic-resistant strains. Innovative silver-containing wound dressings have been designed to assist in the healing of moderate to highly-exuding chronic and acute wounds where there is infection or risk of infection, including ulcers of various causes. This study evaluated the efficacy and contribution to healing of a silver-containing hydrofibre dressing (SCHD; Aquacel® Ag) in the treatment of bedsores. Materials and methods: Twenty patients with bedsore pressure ulcers were treated with SCHD applications for one week. Wound bacterial load change, measured by three different biopsies during therapy, was evaluated for each patient. Results: Wound bioburden decreased by 80% over the treatment period, with 60% of wounds showing no bacterial burden at the end of the study. Conclusion: SCHD was a safe, effective and easy-to-apply treatment for patients with bedsores and eliminated the need for local or systemic antibiotic therapy. [Copyright &y& Elsevier]

Abstract: In this study, the possibility of manipulating biopolymer composition in mixed culture polyhydroxyalkanoate (PHA) production from fermented molasses was assessed by studying the effects of substrate volatile fatty acid (VFA) composition and feeding regime (pulse wise versus continuous). It was found that the use of a continuous feeding strategy rather than a pulse feeding strategy can not only help mitigate the process constraints of the pulse-feeding strategy (resulting in higher specific and volumetric productivities) but also be used as means to broaden the range of polymer structures. Continuous feeding increased the hydroxyvalerate content by 8% relatively to that obtained from the same feedstock using pulse wise feeding. Therefore, the feeding strategy can be used to manipulate polymer composition. Furthermore, the range of PHA compositions, copolymers of P(HB-co-HV) with HV fraction ranging from 15 to 39%, obtained subsequently resulted in different polymer properties. Increasing HV content resulted in a decrease of the average molecular weight, the glass transition and melting temperatures and also in a reduction in the crystallinity degree from a semi-crystalline material to an amorphous matrix. [ABSTRACT FROM AUTHOR]

Motor neuron degeneration, denervation, neuromuscular junction (NMJ) fragmentation and loss of motor units (MUs), play a key-role in the development of sarcopenia. The aim of the present study was to investigate the beneficial effects of regular practice of dancing in physically active elders on concentration of C-terminal Agrin fragment (CAF), a marker of NMJ instability, muscle mass, strength, and physical performance in a group of 16 recreationally active older dancers (AOD; 70.1 ± 3.4 yr) compared to 15 age-matched sedentary peers (OS; 70.9 ± 6.2 yr). Circulating concentration of CAF was measured in serum, while morphology of the vastus lateralis and multifidus muscles was assessed by ultrasound imaging. In addition, the participants underwent two functional performance tests, the Timed Up and Go (TUG) and the 10-meter walk test (10-MWT), a lower and upper limb isometric strength test, a static and a dynamic balance test. Although no statistically significant differences were detected for both muscle morphology and isometric strength, higher CAF concentration (20%, p < 0.01) was found in OS. AOD showed a better performance in TUG (22%, p < 0.001), 10-MWT (17%, p < 0.001) and dynamic balance (25%, p < 0.01) than OS. Notably, CAF concentration correlated with dynamic balance performance (r = 0.3711, p < 0.05). Our results provide evidence that the regular practice of dancing in older age, together with non-structured light aerobic physical activities, is associated to lower CAF concentration and improved walking and balance performance. Our findings also suggest that NMJ instability, as indicated by elevated CAF serum concentration, seems to precede the loss of muscle size and alterations in muscle architecture normally associated with sarcopenia. [ABSTRACT FROM AUTHOR]

Summary: Five Argentine medicinal plants selected according to folk traditional or ethnomedical use, references and primary pharmacological screening; were chosen to elucidate their immunomodulating properties. Dichloromethane, methanolic and aqueous extracts of the aerial parts of Achyrocline flaccida (A.flaccida), Eupatorium arnottianum (E. arnottianum) and Eupatorioum buniifolium (E. buniifolium), leaves of Lithraea molleoides (L. molleoides) and leaves and stems of Phyllanthus sellowianus (P. sellowianus) were analyzed to disclose their effects on murine normal and tumor cell growth as well as on complement hemolytic activity. Modulation of cell growth was evaluated by tritiated thymidine incorporation while inhibition of complement activity was measured on both classical and alternative complement pathways (CP and AP respectively). The results obtained show that most of the extracts exerted inhibitory effect on tumor as well as on mitogen activated normal spleen cell growth. On tumor cells, IC50 ranged between 1–75 g/ml for most of the extracts with the exception of dichloromethane of L. molleoides and P. sellowianus which required concentrations higher than 100 g/ml to produce the effect. On mitogenic activated splenocytes, IC50 ranged between &#60;1 to 85g/ml with the exception of methanolic extract of E. buniifolium or P. sellowianus which were not effective on ConA or LPS stimulated splenocytes respectively. Only E. buniifolium was active on murine normal splenocytes proliferation (IC50 0.5–1.5 g/ml). Finally, one (7%) of 15 extracts showed inhibition of complement activity on CP and 6 extracts (40%) presented moderate activity on CP. The dichloromethane extract of E. arnottianum was the most active (IC50 5 g/ml), although remarkable effect was also obtained with dichloromethane and methanolic extracts of P. sellowianus(IC50 11.2 and 17.3 g/ml respectively). Besides, 2 extracts (13%), dichloromethane extract of E. arnottianum and aqueous extract of P. sellowianus, showed moderate inhibition on AP. [Copyright &y& Elsevier]

La prévalence la stéatose hépatique non alcoolique (NAFLD) est importante en cas de rhumatisme inflammatoire chronique. Elle peut favoriser la progression de la fibrose hépatique, conduisant à la cirrhose et au carcinome hépatocellulaire. Le GRAPPA recommande d'éviter le méthotrexate en cas de NAFLD. L'évaluation non invasive à long terme de la progression de la fibrose hépatique fait toujours défaut avec les bDMARDs. Le but de cette étude était d'évaluer les variations du score Fib-4, un test non invasif de fibrose hépatique, après 2 ans de traitement par anti-TNF et anti-IL 17 en cas de spondyloarthrite. Cette étude observationnelle rétrospective monocentrique a inclut des patients atteints de spondylarthrite axiale (axSpA) répondant aux critères ASAS 2009 et de rhumatisme psoriasique (PsA) répondant aux critères CASPAR. Les patients ont débuté un traitement par anti-TNF ou anti-IL 17 entre 2015 et 2020 et ont été traités pendant au minimum 2 ans. Nous avons recueilli le statut HLA B27, le tabagisme actif, la consommation d'alcool, les antécédents de maladie hépatique chronique, les antécédents de traitement par AINS ou anti-TNF, les manifestations extra-articulaire, la durée de la maladie et les tests sanguins comprenant la numération globulaire complète, la CRP et les enzymes hépatiques (ASAT et ALAT). L'indice Fib-4 a été calculé selon la formule suivante : (âge [années] × ASAT[U/L]/plaquettes [PLT] [109/L] × √ALAT[U/L]) avec une valeur seuil inférieure de 1,45 et une valeur seuil supérieure de 3,25. Au total, 78 patients (45 axSpA et 33 PsA) ont été inclus. Dans le groupe axSpA, 80 % étaient HLA B27, 65 % d'hommes, avec un âge moyen de 41 ± 10,8 ans et une durée moyenne de la maladie de 7,7 ± 7,5 ans. La valeur moyenne du FIB-4 initial était de 0,76 (± 0,2). Quarante-quatre patients (98 %) avaient un score FIB-4 inférieur à 1,45. Les patients traités avec anti-TNF ont montré une légère diminution du score FIB4 (−0,05 ± 0,2) à 2 ans. Les patients traités par anti-IL17 ont montré une légère diminution du score FIB4 (−0,2 ± 0,2) (p < 0,05) à 2 ans. Dans le groupe PsA, 26 % étaient HLA B27, 36 % d'hommes, avec un âge moyen de 55 ± 14,6 ans et une durée moyenne de la maladie de 8,8 ± 8,6 ans. La valeur moyenne du FIB-4 initial était de 1,18 (± 0,92). Sept patients (21 %) avaient un score FIB-4 supérieur à 1,45, dont un patient avec un score FIB-4 > 3,25. Les patients traités par anti-TNF (n = 13) ont présenté une légère diminution du score FIB-4 (−0,17 ± 0,7) après 2 ans de traitement. Alors que ceux sous anti-IL17 ont montré une légère augmentation du score FIB4 (0,2 ± 0,3). Treize patients (4 axSpA [8 %] et 9 PsA [27 %]) présentaient une NAFLD histologiquement prouvée. Le score FIB4 est resté inchangé après 24 mois de traitement chez les patients atteints de NAFLD et aucun changement dans les catégories de risque de fibrose n'a été observé. Dans la spondyloarthrite, les traitements anti-TNF et anti-IL 17 ne sont pas associés à une augmentation significative du Fib-4 à deux ans (mais avec des différences entre les thérapies), même en cas de NAFLD. Ces résultats méritent d'être confirmés dans une plus grande cohorte avec un suivi plus long. [ABSTRACT FROM AUTHOR]

Physical inactivity (PI) is a major risk factor of chronic diseases. A major aspect of PI is loss of muscle mass and strength. The latter phenomenon significantly impacts daily life and represent a major issue for global health. Understandably, skeletal muscle itself has been the major focus of studies aimed at understanding the mechanisms underlying loss of mass and strength. Relatively lesser attention has been given to the contribution of alterations in somatomotor control, despite the fact that these changes can start very early and can occur at multiple levels, from the cortex down to the neuromuscular junction (NMJ). It is well known that exposure to chronic inactivity or immobilization causes a disproportionate loss of force compared to muscle mass, i.e. a loss of specific or intrinsic whole muscle force. The latter phenomenon may be partially explained by the loss of specific force of individual muscle fibres, but several other players are very likely to contribute to such detrimental phenomenon. Irrespective of the length of the disuse period, the loss of force is, in fact, more than two-fold greater than that of muscle size. It is very likely that somatomotor alterations may contribute to this loss in intrinsic muscle force. Here we review evidence that alterations of one component of somatomotor control, namely the neuromuscular junction, occur in disuse. We also discuss some of the novel players in NMJ stability (e.g., homer, bassoon, pannexin) and the importance of new established and emerging molecular markers of neurodegenerative processes in humans such as agrin, neural-cell adhesion molecule and light-chain neurofilaments. • Bassoon, pannexin & homer proteins participate in the E-C coupling. • Hemichannels expression could occur during disuse, making resting potential unstable. • Circulatory c-terminal agrin fragment and light-chain neurofilaments occur during disuse. [ABSTRACT FROM AUTHOR]

Aim To investigate the utility of multidetector CT (MDCT) in helping to establish the underlying cause of acute colitis. Methods and materials All patients who had acute colitis with a well-identified cause and underwent abdomen 64-MDCT were included in the study. MDCT images were retrospectively analysed in a blinded fashion and the CT findings were correlated with the eventual aetiological diagnosis. Results The study population included 105 patients. Acute colitis was related to inflammatory bowel disease in 43 cases. MDCT was used to identify six relevant signs of inflammatory colitis: the “comb” sign ( p < 0.001), enlarged lymph nodes ( p < 0.001), abscess ( p = 0.026), fibro-fatty infiltration ( p = 0.007), small bowel involvement ( p < 0.001), and the absence of an “empty colon” sign ( p = 0.045). Multivariate logistic regression analysis identified three independent signs of inflammatory colitis: the “comb” sign, small bowel involvement, and enlarged lymph nodes. Acute colitis was related to bacterial infection in 35 cases. Five signs were significantly associated with infectious colitis: continuous distribution ( p = 0.020), an “empty colon” sign ( p = 0.002), absence of fat stranding ( p = 0.013), and absence of a “comb” sign ( p = 0.010) and absence of enlarged lymph nodes ( p = 0.035). Multivariate analysis identified three independent signs: the “empty colon” sign and absence of fat stranding and of a “comb” sign. The remaining causes were ischaemic colitis ( n = 21) and drug-related colitis ( n = 6). MDCT examination provided five relevant signs of ischaemic colitis: fat stranding ( p = 0.002), discontinuous distribution ( p < 0.001), and absence of enlarged lymph node ( p < 0.001), a “comb” sign ( p = 0.006) and small bowel involvement ( p = 0.037). Conclusions MDCT provides certain suggestive signs that may be helpful in distinguishing the underlying aetiological cause of acute colitis. [ABSTRACT FROM AUTHOR]

Clin Microbiol Infect 2010; 16: 788–791 The present study aimed to identify a sub-group of inoperable alveolar echinococcosis (AE) patients undergoing long-term treatment with benzimidazole (BZM) who presented with an evolution suggestive of a parasitocidal effect. An evolution compatible with parasite death was observed in five patients. [ABSTRACT FROM AUTHOR]

Previous research suggests that hepatitis C detection is lower in rural than in urban areas and depends on geographic accessibility to care. To what extent differences in socioeconomic context could explain these disparities remains unknown. This study assessed the respective influence of the socioeconomic context and of the distance to primary care on the hepatitis C detection rates in a well-defined population of 1,005,817 inhabitants covered by a universal health insurance system in the Côte d'Or and the Doubs areas of France. The 1938 cases of hepatitis C newly diagnosed in the survey area between 1994 and 2001 were included. The patients' 'cantons' of residence were classified into six socioeconomic clusters according to 19 quantitative indicators. Age and sex-standardized hepatitis C detection rate ratios (DRR) for the six clusters were estimated and a multilevel Poisson model investigated whether detection rates varied across clusters after adjusting for distance to the nearest general practitioner. Standardized DRR (95% CI) were higher in both 'lower-income urban' and 'upper-income urban' clusters and lower in the following clusters: 'outer suburb', 'industrial rural' and economically 'dynamic rural'. Adjusting for distance to general practitioner reduced the rate difference between socioeconomic clusters: for a distance to general practitioner equalling 0km (practice in the municipality) and compared to the 'upper-income urban' cluster, only the 'lower-income urban' cluster had higher DRR. In the six clusters, detection rates decreased as the distance to general practitioner increased (DRR 0.89 95% CI 0.84-0.96 for a 1-km change) but the decrease was more marked in both urban clusters. In this population with good primary care affordability, geographic proximity to general practitioner, rather than socioeconomic context of neighborhood, appeared to be the main factor limiting hepatitis C detection. [ABSTRACT FROM AUTHOR]