Visible Blood Research Articles

Differences in haemosporidian parasite prevalence and diversity in migratory and resident birds of prey species revealed by a non-invasive sampling method.

Avian haemosporidian parasites are widespread globally and infect numerous wild bird species. However, they have primarily been studied in passerine birds. Accordingly, the prevalence and diversity of these parasites in birds of prey remain understudied. This lack of research is primarily due to the international protection status of many of these species, their sparse distribution across ecosystems and difficulty to capture in the wild. The aim of this study was to examine the prevalence and diversity of haemosporidian parasites in two species of birds of prey, namely white-tailed eagle and lesser spotted eagle. To achieve this, a non-invasive approach was employed, involving the extraction of DNA from blood spots present in moulted feathers. Freshly moulted feathers were collected from the ground under nests or within the nests of these birds during the breeding season. A visible blood spot located at the junction of the calamus and rachis was removed and fixed in SET buffer for molecular analysis. The identification of haemosporidian parasites (Plasmodium, Haemoproteus and Leucocytozoon) was conducted using PCR-based methods. Overall, parasite DNA was successfully detected in shed feathers that were kept in their original form at least decade prior to analysis. Among the studied individuals, resident white-tailed eagles showed significantly lower infection rates of haemosporidian parasites compared to migratory lesser spotted eagles. A total of nine genetic lineages of haemosporidian parasites were detected, with seven of them being new to science based on partial sequences of the cytb gene. Additionally, the phylogenetic relationships among these new lineages and previously described ones were established. These findings highlight the suitability of non-invasive sampling for investigating the prevalence and diversity of haemosporidian parasites in wild birds of prey populations. Moreover, this approach holds promise for studying other challenging-to-reach and protected bird species. According to our research, there is a greater chance of finding haemosporidian parasites in freshly gathered feathers.

Pityriasis rosea: dermoscopic features in Uganda.

The study aimed to describe the dermoscopic features of pityriasis rosea among patients attending the skin clinic at Mbarara Regional Referral Hospital. A hospital-based cross-sectional descriptive study conducted for a 6-month period in the skin clinic of MRRH in Southwestern Uganda. Data were collected from consecutively recruited patients using structured questionnaires. Patients with a clinical diagnosis of pityriasis rosea were examined using a dermoscope and subsequently sent for KOH and TPHA tests to rule out fungal skin infection and secondary syphilis, respectively, and then received routine care at the skin clinic. There were 54 patients with pityriasis rosea seen. Dermoscopy was done on a total of 162 lesions of which 19 were herald patches, 51 were truncal lesions, 52 on the extremities while 40 were on the face and neck regions. Common dermoscopic features consisted of a violaceous background noted in 145 (89.51%), white scales in 161 (99.38%), diffuse scale distribution in 57 (35.19%), perifollicular scale type in 61 (37.65%), and brown-dotted pigmentary changes in 66 (40.74%). Other unique findings noted in a few lesions were cloudy structures, petechial spots, erosions, and punched out pits. Most prevalent dermoscopic features included: a violaceous background, white scales, diffuse scale distribution, perifollicular scale type, brown-dotted pigmentary changes with no visible blood vessels nor follicular changes. Other unique less frequently seen findings were cloudy structures, petechial spots, erosions, and punched out pits.

Synthetic optical coherence tomography angiographs for detailed retinal vessel segmentation without human annotations.

Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality that can acquire high-resolution volumes of the retinal vasculature and aid the diagnosis of ocular, neurological and cardiac diseases. Segmenting the visible blood vessels is a common first step when extracting quantitative biomarkers from these images. Classical segmentation algorithms based on thresholding are strongly affected by image artifacts and limited signal-to-noise ratio. The use of modern, deep learning-based segmentation methods has been inhibited by a lack of large datasets with detailed annotations of the blood vessels. To address this issue, recent work has employed transfer learning, where a segmentation network is trained on synthetic OCTA images and is then applied to real data. However, the previously proposed simulations fail to faithfully model the retinal vasculature and do not provide effective domain adaptation. Because of this, current methods are unable to fully segment the retinal vasculature, in particular the smallest capillaries. In this work, we present a lightweight simulation of the retinal vascular network based on space colonization for faster and more realistic OCTA synthesis. We then introduce three contrast adaptation pipelines to decrease the domain gap between real and artificial images. We demonstrate the superior segmentation performance of our approach in extensive quantitative and qualitative experiments on three public datasets that compare our method to traditional computer vision algorithms and supervised training using human annotations. Finally, we make our entire pipeline publicly available, including the source code, pretrained models, and a large dataset of synthetic OCTA images.

Role of Injection Tranexamic Acid in Reducing Blood Loss in Peri Trochanter Fracture Surgeries

Background: For patients undergoing surgery for peritrochanteric fractures, blood loss is a big issue. The purpose of this study was to see if tranexamic acid (TXA) could reduce postoperative blood loss in individuals who had hip surgery for peritrochanteric fracture. Methods: A total of 69 patients with intertrochanteric fractures were enrolled in this prospective study. Patients are randomly divided into two groups. Group A patients received 200 mL (1 g) of TXA intravenously before peritrochanter surgery and Group B patients did not receive an injection of TXA. Haemoglobin and hematocrit values were measured preoperatively and postoperatively at days 1 and 3. Visible and hidden blood loss volumes were calculated on postoperative day 3. Results: The blood transfusion rate was reduced significantly in patients by injecting tranexamic acid before surgery. However, mean haemoglobin and hematocrit levels were not significantly different between patients who received injection tranexamic acid and those who did not receive injection tranexamic acid. Conclusion: TXA significantly reduced postoperative blood loss in patients with Peritrochanteric fractures who underwent surgery.

182 Influence of Group Size on Performance and Tail Damage Caused by Tail Biting in Undocked Growing-Finishing Pigs

Abstract Tail biting is both an economic and welfare problem of grower-finishing pigs. This destructive chewing behavior of tails of pen-mates causes challenges for farmers who raise pigs with intact tails, resulting in the need to find management solutions. Our objective was to determine if group size influences growth performance and tail damage caused by biting behavior of undocked growing-finishing pigs. Pigs (n = 432; initial BW = 22 ± 3.8 kg) with intact tails were allocated to small pens or large pens on totally slatted floors, with equal ratio of barrows to gilts in each pen and balanced for average initial BW across pens. Small pens (SM; n = 24) housed 9 pigs/pen and large pens (LG; n = 12) held 18 pigs/pen. Floor space allowance (0.76 m2/pig) and feeder-space allowance (4 feeder spaces/9 pigs) were consistent across group sizes. Pigs were weighed individually and feed intake was recorded on a pen basis every 4 weeks for 16 weeks until market weight (120 kg ± 3.8 kg), from which ADG, ADFI, and Gain:Feed were calculated. Number of pigs that were dead (mortality) and removed (morbidity) from the study due to tail biting, lameness, and other health issues were recorded throughout the study period. Tail damage was evaluated using a 0 to 4 scale scoring system: 0 = no evidence of tail biting; 1 = evidence of chewing without visible blood; 2 = evidence of tail bitten with visible blood and no signs of infection; 3 = open wounds or abscesses with signs of infection; 4 = partial or total loss of the tail. Tail damage was assessed once weekly during the study period, and the maximum tail score (MTS) that each pig received over the entire 16 weeks was recorded. Data were analyzed using SAS software, with a mixed procedure for performance variables and a frequency procedure with chi-square test for mortality, morbidity, and MTS. Group size did not affect growth performance (all P > 0.70; Table 1), mortality, or morbidity (Chi-square = 2.33, df = 2; P = 0.31). However, group size affected MTS (chi-square = 10.78, df = 4; P = 0.03). Pigs in SM experienced a marginally lower prevalence of tail biting compared with LG (16% vs. 9% of pigs receiving an MTS of 0); but greater severity with 13.0% of pigs in SM vs. 7.4% of pigs in LG receiving an MTS of 4. These results suggest group size did not influence growth performance, mortality, or morbidity; but affect severity of tail damage caused by tail biting. Compared with LG, SM had more pigs that lost their tails due to tail biting, which seriously compromised pig welfare.

Design of a highly sensitive cascaded rectangular ring resonator embedded with gold nanorods and gratings for multipurpose application

This study introduces a sensor consisting of a metal-insulator-metal (MIM) structure, having an integration of gold nanorods and gratings, to perform various functions including sensing refractive index, detecting blood components, monitoring temperature, and measuring magnetic fields. The sensor's spectral properties are studied analytically in the MIR region implementing finite element method. Furthermore, the potential in the RI sensing is extensively examined by modulating the geometrical parameters, ultimately establishing a direct relationship with the transmittance profile. Following computational experiments, the best possible configuration exhibits the maximum sensitivity of 6118.685 nm/RIU. This research shows the biosensing applications by the detection of near-infrared and visible blood components such RBC, Hb, WBC, plasma, and water with a high sensitivity of 3185.05 nm/RIU. Moreover, ethanol is employed to evaluate the proffered sensor's temperature sensing feature and a maximum sensitivity 1.18 nm/°C was attained. Furthermore, this sensor can be used for magnetic field detection as it shows a high magnetic field sensitivity of 354.66 pm/Oe. The structural model is simple. Besides, this design has the potential to serve as a substitute for sensors that rely on silver. It is chemically stable and performs well in refractive index measurement, biosensing, temperature sensing and magnetic field detection.

SAT407 Hematospermia In Transgender Woman Revealing Occult Endometriosis

Abstract Disclosure: J.C. Coleman-Belin: None. T. Reisman: None. Background: While hematospermia (visible blood in ejaculate) is most frequently benign, etiology includes idiopathic, infection, prostate disease, iatrogenic, obstruction, systemic disorders, and (rarely) malignancy. The incidence and prevalence of hematospermia in transgender women is unknown. Clinical Course: A 35-year-old transgender woman treated with estradiol valerate and leuprolide presents with persistent hematospermia and two years of intermittent hematuria. She does not report dysuria, urgency, frequency, or gastrointestinal symptoms and is a lifetime nonsmoker. Chlamydia, gonorrhea, and HIV tests are negative. CT scan 4/2021, cytoscopy 5/2021, and MRI prostrate 7/2022 (with and without IV contrast) were unremarkable. Transrectal ultrasound 9/2022 reveals 17cc prostate and posterior cyst with hemorrhagic products. Two ultrasound-guided transperineal biopsy samples obtained from the cystic structure 11/2022 reveal benign prostatic tissue with a small focus of endometrial-type epithelium (positive immunostains for PAX 8 and ER in epithelium and CD10 in stroma). These findings may indicate endometriosis or a Müllerian cyst. Discussion: The prevalence of endometrial tissue in transgender woman has not been described. Risk factors for endometriosis in AMAB* individuals are hypothesized to include prolonged estrogen exposure, cirrhosis, or chronic post-procedural inflammation1. Because transgender women are routinely treated with extended estrogen-containing regimens, it is of interest to determine if the presence of endometrial tissue is more common than previously thought. Guidelines for management of benign endometrial-type epithelium in transgender women are lacking, including whether ectopic endometrial tissue should be excised due to concern for malignant transformation2. Conclusion: Hematospermia in transgender women on GAHT** may indicate occult Müllerian epithelial tissue growth. *AMAB: Assigned Male at Birth **GAHT: Gender-Affirming Hormone Therapy

Systematic review and meta-analysis of topical tranexamic acid in spine surgery.

Tranexamic acid (TXA) is an antifibrinolytic drug associated with reduced blood loss in a range of surgical specialties, including neurosurgery, orthopedic surgery, and cardiac surgery. Concerns about venous thromboembolism and seizures from intravenous (IV) TXA have led to increased use of topical TXA. Given the relative scarcity of the literature on topical TXA compared with that on IV TXA within neurosurgery, the authors aimed to conduct a systematic review and meta-analysis on the safety, efficacy, and optimal administration of topical TXA in a wide range of spinal procedures and pathologies. The PRISMA guidelines, Cochrane risk of bias tool, and Newcastle-Ottawa Scale were used to extract randomized controlled trials and high-quality case-control and cross-sectional/cohort studies (adult studies only) from PubMed, Web of Science, Cochrane Library, and Embase published between 2016 and 2023. Studies were analyzed by two independent reviewers for variables including dosage, TXA administration route, type of spine procedure, blood loss, adverse events including thromboembolism and infection, postoperative hemoglobin level, and hospitalization length. Pooled analysis comparing intraoperative and postoperative blood loss, postoperative hemoglobin levels, and hospitalization length of stay on the basis of route of TXA administration was conducted. Four cohort studies, 1 cross-sectional study, 1 case-control study, and 12 randomized controlled trials, together involving 2045 patients, were included. The most common route of topical TXA administration was via TXA in saline solution. Other routes of topical TXA included retrograde injection and TXA-soaked Gelfoam. In pooled analysis, topical TXA significantly reduced visible blood loss (standardized mean difference [SMD] -0.22, 95% CI -0.45 to -0.00001), postoperative blood loss (SMD -1.63, 95% CI -2.03 to -1.22), and length of hospital stay (SMD -1.02, 95% CI -1.42 to -0.61), as well as higher postoperative hemoglobin (SMD 0.59, 95% CI 0.34-0.83), compared with non-TXA controls. No significant differences in outcomes were found between topical and IV TXA or between combined (topical and IV) and IV TXA. Thromboembolism and infection rates did not significantly differ between any TXA administration group and non-TXA controls. In pooled analyses, topical TXA was associated with decreased perioperative blood loss in a wide range of scenarios, including cervical spine surgery and thoracolumbar trauma, as well as in patients with a thromboembolic history.

Colorectal Cancer Fast Tracks: Cancer Yield and the Predictive Value of Entry Criteria.

Fast-track pathways for diagnosing colorectal cancer (CRC) have been implemented in several European countries. In Sweden, a substantial number of CRC are diagnosed via the Swedish Standardized Course of Care for colorectal cancer (SCC-CRC). We evaluated the SCC-CRC in terms of CRC yield, and predictive values and odds ratios (OR) for the entry criteria. We retrospectively analyzed all 2539 patients referred for SCC-CRC colonoscopy between September 2016 and December 2020. Entry criteria and colonoscopy outcomes were analyzed. CRC yield was 16.4%. Highest positive predictive values (PPVs) were seen for abnormal radiology (PPV 30.5%, OR 4.7 (95% CI 3.4-6.4) p < 0.001), abnormal rectal examination (PPV 28%, OR 3.6 (95% CI 2.7-4.8) p < 0.001), and anemia (PPV 24.8%, OR 2.2 (95% CI 1.5-3.1) p < 0.001). Some entry criteria showed no significant risk increase, i.e., visible blood in stool/rectal bleeding, change in bowel habits, and the combination of changed bowel habits plus anemia. A positive fecal immunochemical test (FIT), although not part of the SCC-CRC, showed the highest OR: 9.9 (95% CI 4.5-21.7) p < 0.001) and PPV of 18.8%. CRC yield from the SCC-CRC is slightly higher compared to other European fast tracks. A number of entry criteria showed no benefit towards assessing CRC risk. FIT testing should be included in CRC fast tracks to increase diagnostic efficacy.

Atrial fibrillation as a risk factor for exercise-induced pulmonary haemorrhage following a standardised exercise test.

Atrial fibrillation (AF) has been proposed as a risk factor for exercise-induced pulmonary haemorrhage (EIPH) due to increased pressure in the left atrium. To evaluate if AF was associated with EIPH following a standardised exercise test (SET) to fatigue. Two-arm controlled experiment. Ten untrained Standardbred mares mean (standard deviation [SD]) age 6 (2) years performed a SET on the treadmill in sinus rhythm (SR) (SET1) and 25-44 days after induction of self-sustained AF (SET2). AF was induced by tachypacing using a pacing device. Endoscopy, including tracheal wash and bronchoalveolar lavage (BAL), was performed 48-72 h before and 24 h after the two SETs. In addition, endoscopic grading of tracheal blood was performed 2 h after each SET. After SET1, none of the horses showed blood in the trachea, and two horses showed erythrophagocytosis. Following SET2, two horses had grade 1 blood in the trachea and free erythrocytes and erythrophagocytosis in the BAL, while another two horses had erythrophagocytosis in the BAL. In SET2, the overall performance on the treadmill was decreased with a lower maximum velocity (SET1 10.3 ± 0.8 m/s vs. SET2 8.9 ± 0.9 m/s, p = 0.004), a higher heart rate (284 ± 21 vs. 221 ± 18 bpm, p = 0.003) and more abnormal QRS complexes (p < 0.001) compared with SET1. Two horses showed signs of EIPH, resulting in visible blood in the trachea, when exercising in AF compared with SR. However, a possible link between EIPH, pulmonary pressure and AF needs to be further elucidated.

Vacuum-assisted biopsy system for breast lesions: a potential therapeutic approach.

The primary objective is to optimize the population eligible for Mammotome Minimally Invasive Surgery (MIS) by refining selection criteria. This involves maximizing procedure benefits, minimizing malignancy risk, and reducing the rate of malignant outcomes. A total of 1158 female patients who came to our hospital from November 2016 to August 2021 for the Mammotome MIS were analyzed retrospectively. Following χ2 tests to screen for risk variables, binary logistic regression analysis was used to determine the independent predictors of malignant lesions. In addition, the correlation between age and lesion diameter was investigated for BI-RADS ultrasound (US) category 4a lesions in order to better understand the relationship between these variables. The malignancy rates of BI-RADS US category 3, category 4a and category 4b patients who underwent the Mammotome MIS were 0.6% (9/1562), 6.4% (37/578) and 8.3% (2/24) respectively. Malignant lesions were more common in patients over the age of 40, have visible blood supply, and BI-RADS category 4 of mammography. In BI-RADS US category 4a lesions, the diameter of malignant tumor was highly correlated with age, and this correlation was strengthened in patients over the age of 40 and with BI-RADS category 4 of mammography. The results of this study demonstrate that the clinical data and imaging results, particularly age, blood supply, and mammography classification, offer valuable insights to optimize patients' surgical options and decrease the incidence of malignant outcomes.

Is a Single Nephrographic Phase Computed Tomography Sufficient for Detecting Urothelial Carcinoma in Patients with Visible Haematuria? A Prospective Paired Noninferiority Comparison

BackgroundThere is uncertainty about the utility of multiphase computed tomography (CT) compared with single-phase CT in the routine examination of patients with visible haematuria (VH). ObjectiveTo compare the accuracies of single nephrographic phase (NP) CT and four-phase CT in detecting urothelial carcinoma (UC). Design, setting, and participantsThis was a single-centre, prospective, paired, noninferiority study of patients with painless VH referred for CT before cystoscopy between September 2019 and June 2021. Patients were followed up for 1 yr to ascertain UC diagnosis. InterventionAll patients underwent four-phase CT (control), from which single NP CT (experimental) was extracted. Both were independently assessed for UC. Outcome measurements and statistical analysisThe primary outcome was the difference in accuracy between the control and experimental CT using a 7.5% noninferiority limit. Histologically verified UC defined a positive reference standard. Secondary outcomes included differences in sensitivity, specificity, negative (NPV) and positive (PPV) predictive values, and area under the curve (AUC). All results are reported per patient. Results and limitationsOf the 308 patients included, UC was diagnosed in 45 (14.6%). The difference in accuracy between the control and experimental CT was 1.9% (95% confidence interval −2.8 to 6.7), demonstrating noninferiority. Sensitivity was 93.3% versus 91.1%, specificity was 83.7% versus 81.8%, NPV was 98.7% versus 98.2%, PPV was 49.4% versus 46.1%, and AUC was 0.96 versus 0.94 for the control versus experimental CT. Limitations included a low number of UC cases and no definite criteria for selecting a noninferiority limit. ConclusionsThe accuracy of NP CT is not inferior to that of four-phase CT for detecting UC. Patient summaryThis study shows that a computed tomography (CT) examination with only one contrast phase is no worse than a more complex CT examination for detecting cancer in the urinary tract among patients presenting with visible blood in the urine.

Epinephrine injection monotherapy shows similar hemostatic efficacy to epinephrine injection combined therapy in high-risk patients (Forrest Ib) with bleeding ulcers.

Whether combination therapy has higher hemostatic efficacy than epinephrine injection monotherapy in different Forrest classifications is not clear. This study aimed to compare hemostatic efficacy between epinephrine injection monotherapy (MT) and combination therapy (CT) based on different Forrest classifications. We retrospectively analyzed peptic ulcer bleeding (PUB) patients who underwent endoscopic epinephrine injections or epinephrine injections combined with a second therapy between March 2014 and June 2022 in our center, and the patients were divided into MT group or CT group. Subsequently, a propensity score matching analysis (PSM) was performed and rebleeding rates were calculated according to Forrest classifications via a stratified analysis. Overall, 605 patients who met the inclusion criteria were included, and after PSM, 173 patients in each of the CT and MT groups were included. For PUB patients with nonbleeding visible vessels (FIIa), the rebleeding rates by Days 3, 7, 14, and 30 after PSM were 8.8%, 17.5%, 19.3%, and 19.3% in the MT group, respectively, and rates were 0%, 4.1%, 5.5%, and 5.5% in the CT group, respectively, with significant differences observed between the two groups by Days 3, 7, 14, and 30 (P = 0.015, P = 0.011, P = 0.014, and P = 0.014, respectively). However, for PUB patients with oozing bleeding (FIb), the rebleeding rates by Days 3, 7, 14, and 30 after PSM were 14.9%, 16.2%, 17.6%, and 17.6% in the MT group, respectively, and rates were 13.2%, 14.7%, 14.7%, and 16.2% in the CT group, respectively, with no significant differences observed between the two groups by Days 3, 7, 14, and 30 (P = 0.78, P = 0.804, P = 0.644 and P = 0.825). Combined therapy has higher hemostatic efficacy than epinephrine injection monotherapy for PUB patients with visible blood vessel (FIIa) ulcers. However, epinephrine injection monotherapy is equally as effective as combined therapy for PUB patients with oozing blood (FIb) ulcers.

Renal Dysfunction as a Predictor of Slow-Flow/No-Reflow Phenomenon and Impaired ST-Segment Resolution after Percutaneous Coronary Intervention in ST- Elevation Myocardial Infarction. A Retrospective Analysis

Objective: The research aimed to examine the relationship between kidney dysfunction and the occurrence of slow blood flow or no-reflow phenomenon and insufficient ST-segment resolution after the percutaneous coronary intervention procedure in individuals suffering from ST-elevation myocardial infarction. Methods: In a retrospective analysis conducted at Hayatabad Medical Complex Peshawar, for six months, 210 consecutive patients have undergone percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). The term slow-flow/no-reflow referred to an angiogram result of TIMI Grade &lt;3 after the implantation of a stent, despite a residual stenosis of less than 50%, and with no major damage or visible blood clots. Results: The study included 210 patients, with 185 (88.0%) having normal flow and 25 (11.9%) having slow flow/no-reflow after PCI. Comparison between patients with normal flow and those with slow flow or no-reflow. Male sex was more common in the LVEF ≥50% group compared to the LVEF &lt;50% group (84.2% vs. 74.0%, p=0.043). Practical Implication: Overall, the practical implications of this study can positively impact the community by enhancing risk assessment, patient management, treatment approaches, communication, and future research in the context of renal dysfunction and PCI outcomes in STEMI patients. Conclusion: The study found that patients with STEMI who have renal dysfunction are more likely to experience SFR and ISR after undergoing PCI. We should regard renal dysfunction as a significant factor that increases the risk of these complications. Treatment may need to be more intensive to achieve better results in these patients. Keywords: Renal dysfunction, slow-flow/no-reflow phenomenon, inadequate ST-segment resolution,

Immunopathogenesis of Campylobacter jejuniinfection in a small animal model

Abstract We set out to develop and characterize a small animal model of Campylobacter jejuni(CJ) infection that recapitulates human campylobacteriosis. Adult C57BL/6J mice are rendered susceptible to colonization and disease by pre-treatment with a zinc deficient diet and a broad-spectrum antibiotic cocktail. We have established this model with four strains with diverse capsular serotypes and flagellar groups, two key virulence factors for CJ pathogenesis. We measured colonization, weight loss, diarrhea, fecal inflammatory markers, and cytokine production by mesenteric lymphocytes and splenocytes. Diarrhea containing visible mucous and/or blood and degree of weight loss vary in severity depending on the strain and dose. Interestingly, we identified an inverse relationship between inoculum dose and levels of fecal inflammatory markers, with lower inoculum doses inducing significantly higher inflammation. We also observed production of IFNγ and IL-17 at day 9 post infection and despite no decrease in CJ colonization, IFNγ and IL-17 levels decreased by day 21 with a subsequent increase in IL-10 production. We also observed higher levels of IFNγ and IL-17 in mice challenged with strain CG8486 relative to those challenged with strain 81–176 pointing to potential strain differences. These differences observed were more striking in mesenteric lymphocytes versus splenocytes, indicating that local cellular responses differed from systemic responses. We have developed a model of inflammatory diarrhea in adult mice that exhibits hallmarks of CJ infection and further identified significant shifts in cytokine expression associated with the duration of infection, bacterial strain utilized, and therapeutic treatment. Research reported in this presentation is supported by Navy work unit number: 6000.RAD1.DA3.A0308 and CARB-X. CARB-X’s funding for this project is sponsored by the Cooperative Agreement Number IDSEP160030 from ASPR/BARDA and by awards from Wellcome Trust, the UK Global Antimicrobial Resistance Innovation Fund (GAMRIF) funded by the UK Government Department of Health and Social Care (DHSC) and the Bill &amp; Melinda Gates Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of CARB-X or any of its funders. Disclaimers: The views expressed in this work are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government. F. Poly is an employee of the U.S. Government. This work was prepared as part of official duties. Title 17 U.S.C. §105 provides that ‘Copyright protection under this title is not available for any work of the United States Government.’ Title 17 U.S.C. §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties.The animal study protocol was reviewed and approved by the Naval Medical Research Center IACUC in compliance with all applicable Federal regulations governing the protection of animals in research.

A Diagnostic Test Combining Molecular Testing with Phenotypic Pooled Antibiotic Susceptibility Improved the Clinical Outcomes of Patients with Non-E. coli or Polymicrobial Complicated Urinary Tract Infections.

Complicated UTIs (cUTIs) cause significant morbidity and healthcare resource utilization and cost. Standard urine culture has limitations in detecting polymicrobial and non-E. coli infections, resulting in the under-diagnosis and under-treatment of cUTIs. In this study, patient-reported outcomes were compared between treated and untreated patients when an advanced diagnostic test combining multiplex-polymerase chain reaction (M-PCR) with a pooled antibiotic susceptibility method (P-AST) was incorporated into the patients' clinical management. Patients who had symptoms typical of cUTI and positive M-PCR/P-AST test results were recruited from urology clinics. Symptom reduction and clinical cure rates were measured from day 0 through day 14 using the American English Acute Cystitis Symptom Score (ACSS) Questionnaire. Clinical cure was defined based on the sum of the scores of four US Food and Drug Administration (FDA) symptoms and the absence of visible blood in the urine. Of 264 patients with suspected cUTI, 146 (55.4%) had exclusively non-E. coli infections (115 treated and 31 untreated) and 190 (72%) had polymicrobial infections (162 treated and 28 untreated). Treated patients exhibited greater symptom reduction compared to untreated ones on day 14 for those with exclusively non-E. coli organisms (3.18 vs 1.64, p = 0.006) and polymicrobial infections (3.52 vs 1.41, p = 0.002), respectively. A higher percentage of treated patients than of untreated patients achieved clinical cure for polymicrobial infections on day 14 (58.7% vs 36.4%, p = 0.049). Patients with cUTIs treated based on the M-PCR/P-AST diagnostic test had significantly improved symptom reduction and clinical cure rates compared to untreated patients among those with non-E. coli or polymicrobial infections.

Detection of fresh blood by luminol and DNA after walking over various substrates

ABSTRACT This preliminary research aimed to determine if a forensically useful human DNA profile could be obtained from latent blood past the point at which the blood could be visualized with luminol. Five participants with differing physical characteristics created shoeprints from fresh human blood over concrete, linoleum and carpet. The amount and distribution of both visible blood and chemiluminescence emanating from latent blood were documented. DNA analysis was performed on samples taken from the fifth last latent shoeprint to show chemiluminescence and the first and tenth steps after which chemiluminescence no longer occurred. DNA from the blood source was obtained past the point of visualization using luminol, with 2 of the 30 samples generating full STR DNA profiles, 18 generating partial profiles of 4 or more alleles, and 3 generating between 1 and 3 alleles. Of the 7 samples which did not generate a profile, 6 came from the concrete. Higher amounts of DNA, and more full and partial profiles, were obtained from linoleum compared to concrete or carpet. Participant effect was not observed. These findings demonstrate that it may be possible to obtain forensically useful DNA from crime scenes even when blood is not able to be visualized with chemiluminescence.

Introducing a Rapid DNA Analysis Procedure for Crime Scene Samples Outside of the Laboratory-A Field Experiment.

Technological innovations enable rapid DNA analysis implementation possibilities. Concordantly, rapid DNA devices are being used in practice. However, the effects of implementing rapid DNA technologies in the crime scene investigation procedure have only been evaluated to a limited extent. In this study a field experiment was set up comparing 47 real crime scene cases following a rapid DNA analysis procedure outside of the laboratory (decentral), with 50 cases following the regular DNA analysis procedure at the forensic laboratory. The impact on duration of the investigative process, and on the quality of the analyzed trace results (97 blood and 38 saliva traces) was measured. The results of the study show that the duration of the investigation process has been significantly reduced in cases where the decentral rapid DNA procedure was deployed, compared to cases where the regular procedure was used. Most of the delay in the regular process lies in the procedural steps during the police investigation, not in the DNA analysis, which highlights the importance of an effective work process and having sufficient capacity available. This study also shows that rapid DNA techniques are less sensitive than regular DNA analysis equipment. The device used in this study was only to a limited extent suitable for the analysis of saliva traces secured at the crime scene and can mainly be used for the analysis of visible blood traces with an expected high DNA quantity of a single donor.

The effect of intravenous unit-dose tranexamic acid on visible and hidden blood loss in posterior lumbar interbody fusion: a randomized clinical trial

There are few reports of intravenous unit-dose tranexamic acid (TXA) on the relationship between visible blood loss (VBL) and hidden blood loss (HBL) in posterior lumbar interbody fusion (PLIF). Therefore, the objective of this randomized, prospective, double-blind, single center study was to investigate the effect of intravenous unit-dose TXA on VBL and HBL in patients who underwent PLIF. Among 100 patients, 11 were excluded due to failue to comply with the study, 1 was excluded due to non-conpliance with the study, and 88 were eligible for inclusion in the study. 46 patients who treated with PLIF received unit-dose of TXA (1 g/100 mL) intravenously 15 min before skin incision after general anesthesia (observation group) and 42 patients were given 100 mL of normal saline (control group). The operation time, intraoperative blood loss, postoperative drainage, VBL, HBL, blood transfusion rate, and adverse events were recorded in the two groups. Besides, activated partial prothrombin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (FIB), platelets (PLT), red blood cells (RBC), hemoglobin (HB), hematocrit (HCT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) on the 1st postoperative day; and RBC, HB, HCT, CRP, ESR on the 4th postoperative day were recorded. All 88 patients successfully completed the operation, the incision healed well, and there was no deep vein thrombosis of the lower extremity after operation. The intraoperative blood loss, postoperative drainage, VBL, HBL, and blood transfusion rate in the observation group were lower than those in the control group, and the differences were statistically significant (p < 0.05). There was no significant difference in operation time between the two groups (p > 0.05). There was no significant difference in postoperative APTT, PT, TT, FIB, PLT, RBC, HB, HCT, CRP and ESR between the two groups (p > 0.05). Intravenous unit-dose TXA is safe and feasible in PLIF, and it can effectively reduce perioperative VBL and HBL.

Hidden blood loss between percutaneous pedicle screw fixation and the mini-open Wiltse approach with pedicle screw fixation for neurologically intact thoracolumbar fractures: a retrospective study

BackgroundThe aim of this study was to determine the proportion of hidden blood loss (HBL) in patients treated with minimally invasive surgery, and to compare the HBL between patients treated with percutaneous pedicle screw fixation (PPSF) and the mini-open Wiltse approach with pedicle screw fixation (MWPSF).MethodsFrom January 2017 to January 2019, a total of 119 patients with thoracolumbar fractures were included in the analysis, of which 58 cases received PPSF and 61 cases received MWPSF. The clinical information and demographic results were collected and compared. And the HBL of the patients is calculated by the combination formulas of Nadler, Gross and Sehat.ResultsCompared with the PPSF group, operation time of MWPSF is shorter. The fluoroscopy times are 13.6 ± 3.0 in PPSF group and 5.6 ± 1.6 in MWPSF group (p < 0.001). As shown in Table 3, the intraoperative blood loss in PPSF group is 31.9 ± 9.6 ml, which is significantly less than that in the MWPSF group (44.0 ± 14.9 ml). The HBL (445.7 ± 228.9 ml), and HBL% (91.2 ± 7.7%) of the PPSF group are significantly higher than that in the MWPSF group (P < 0.05). And the total blood loss (TBL) of the PPSF group (477.6 ± 228.8 ml) is also more than that in the MWPSF group (401.0 ± 171.3 ml).ConclusionsOur results suggest that in the minimally invasive surgical treatment of thoracolumbar fractures, the perioperative HBL is much higher than visible blood loss (VBL). Although PPSF has less intraoperative blood loss, it has higher TBL and HBL than those of MWPSF. Compared with MWPSF, we should pay more attention to the postoperative anemia status of patients with thoracolumbar fractures undergoing PPSF surgery.