To develop a fully automated, high-throughput white matter hyperintensity (WMH) analysis pipeline for clinical fluid-attenuated inversion recovery (FLAIR) images.
ABSTRACT Background and Aims Stroke is a leading cause of mortality and morbidity in Bangladesh. It is estimated that genetic determinants account for around 40%–60% of its etiology, similar to environmental factors. This study aimed to provide a better understanding of the genetic, environmental, and clinical risk factors in stroke patients from Bangladesh. Methods The MAGPIE (Multidimensional Approach of Genotype and Phenotype In Stroke Etiology) study is a population‐based case‐control study that will allow a hypothesis‐free genome‐wide association study (GWAS) to identify genetic risk factors associated with adult stroke (age ≥ 18 years) in Bangladesh. This study will collect detailed phenotypic data as well as blood samples from stroke patients and control subjects. High‐molecular‐weight genomic DNA will be isolated and archived using Qiagen DNA isolation kits. Results We will utilize SPSS v28.0, vR‐4.3.2 and gPLINK v2.0 software to analyse the study variables, as appropriate. Further, appropriate statistical tests will be applied to test the significance level between study groups. As applicable, data will be presented in tables and graphs, such as Manhattan plots and Quantile‐Quantile (QQ) plots. A p < 0.05 will be considered as statistical significance. Conclusion This will be the first large‐scale carefully phenotyped biobank of Bangladeshi stroke patients which will enable a GWAS enabling an understanding of the association between gene‐phenotype risk factors which has the potential to revise and refine national stroke guidelines.
Introduction: White matter hyperintensity volume (WMHv) is an important and highly heritable cerebrovascular phenotype; however, manual or semi-automated approaches to clinically acquired MRI analysis hinder large-scale studies in acute ischemic stroke (AIS). In this work, we develop a high-throughput, fully automated WMHv analysis pipeline for clinical fluid-attenuated inversion recovery (FLAIR) images to facilitate rapid genetic discovery in AIS. Methods: Automated WMHv extraction from multiple subjects relies on significant pre-processing of medical scans, including co-registration of the images. To reduce the effects of anisotropic voxel sizes, each FLAIR image is upsampled using bi-cubic interpolation. Brain extraction is performed using RObust Brain EXtraction (ROBEX). Images are then registered to an in-house FLAIR template using Advanced Normalization Tools (ANTs). The spatial covariation of WMH is learned through principal component analysis (PCA) of manual outlines from 100 subjects. Areas of leukoaraiosis are identified and separated from other lesions using the PCA modes. Volumes are then computed using non-interpolated slices for each subject. Standard deviation (SD) in WMHv (9 subjects; 6 raters each) is calculated as a measure of variability. Good agreement between automated and manual outlines is assessed in 358 subjects (automated WMHv within 3SD of manual WMHv). Results: As part of the MRI - Gen etics I nterface E xploration (MRI-GENIE) study, WMHv were calculated on a set of 2703 FLAIR images of patients from 12 independent AIS cohorts (sites). Results are shown in Figure 1. Comparing manual and automated WMHv shows that 88% of the automated WMHv fall within 3 SD from the manual WMHv, suggesting good agreement. Conclusion: WMHv segmentation using a fully-automated pipeline for analysis of clinical MRIs is both feasible and accurate. Ongoing analysis of the extracted WMHv is expected to advance current knowledge of risks and outcomes in AIS.
Abstract Background There is increasing interest in the management of stroke in ethnic minorities but few studies have considered this issue. This study investigated if differences in acute stroke management exist between a white European and Bangladeshi populations living in London, England. Methods All stroke surviving patients discharged over a five year period in a major London teaching hospital based in an ethnically diverse area of inner city London were recruited. Cerebrovascular risk factors, their management, and investigation for acute stroke syndromes were recorded and comparison between white and Bangladeshi cohorts was made. Categorical data were analysed using Fisher's exact test. Results Measurement of cholesterol concentrations are undertaken less often in those from a Bangladeshi background (25%) compared with white Europeans (76%) (p<0.0001). Statin therapy tends to be given less often to Bangladeshis. However, neuroimaging (p<0.05) and echocardiography (p<0.0001) is performed more often in Bangladeshis compared with white Europeans. Conclusion There are variations in the management of acute stroke because of ethnicity and these variations could have substantial consequences on secondary rates of cerebrovascular and cardiovascular disease. Whether the reasons for this disparity are attributable to inequity or iniquity of care need to be further investigated perhaps along with the development of ethnicity specific protocols. Overall the management of stroke and its risk factors in either racial group remains lamentable.
An attempt has been made to explore the wild edible plants (WEPs) of Spiti Valley, a cold desert region in Trans Himalaya. The Spiti Valley is inhabited by the Bhotia or Bhot tribal community and largely depends on wild resources to meet day-to-day needs. During the study, extensive field surveys were conducted from 2012 to 2017 in different localities of the valley. A total of 65 plant species belonging to 45 genera and 21 families were collected. A questionnaire was developed and first-hand information was gathered by conducting interviews of native people. These plants were consumed either raw and/or cooked. Leaves were the most harvested parts (37 sps.) followed by fruits (11 each sps.), roots (10 each sps.), seeds (6 sps.), inflorescence (4 sps.), aerial part (3 sps.), whole plant (3 sps.), bulb (2 sps. each). The habitat of most of the plant species has shrunk due to environmental degradation primarily due to heavy livestock grazing, the uncontrolled and unscientific harvest of species, unregulated tourism, and the construction of roads etc. Thus, community participation is the suggested solution for the conservation and sustainable use of the wild edible plants in the study area.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
