ARTICLE | doi:10.20944/preprints202004.0438.v1
Online: 24 April 2020 (10:53:36 CEST)
COVID-19 breakout in Italy has caused a huge number of severely ill patients with a serious increase in mortality. Although lungs seem to be the main target of the infection very few information are available about liver involvement in COVID-19 infection, that could possibly evocate a systemic disease targeting a lot of organs. Since now there are no reports of large series of histological evaluation of liver morphology in this setting. Knowledge of histological liver findings connected to clinical data is crucial in management of this disease.Post-mortem wedge liver biopsies from 48 patients died for COVID-19 infection were available from two main hospitals located in northern Italy, Lombardy; all sample were obtained during autopsies. No patient has a significant clinical complain of liver disease or signs of liver failure before and during hospitalization; for each of them laboratory data focused on liver were available. All liver samples showed minimal inflammation features; on the other side, many histological pictures compatible with vascular alterations were observed, characterized by portal vein braches number increase associated with lumen massive dilatation, partial or complete recent luminal thrombosis of portal and sinusoidal vessels, fibrosis of portal tract, focally severely enlarged and fibrotic. Our preliminary results concerning histological liver involvement in COVID-19 infection confirm the clinical impression that liver failure is not a main concern and this organ is not the target of significant inflammatory damage; histopatological findings are highly suggestive for marked alteration of intrahepatic blood vessel network secondary to systemic alterations induced by virus that could target, besides lung parenchyma, cardiovascular system, coagulation cascade or endothelial layer of blood vessels.
ARTICLE | doi:10.20944/preprints202002.0220.v2
Subject: Medicine & Pharmacology, Pathology & Pathobiology Keywords: coronavirus; COVID-19 pneumonia; pathology; SARS-CoV-2
Online: 2 March 2020 (01:34:58 CET)
There is currently a lack of pathologic data on the novel coronavirus (SARS-CoV-2) pneumonia, or COVID-19, from autopsy or biopsy. Two patients who recently underwent lung lobectomies for adenocarcinoma were retrospectively found to have had COVID-19 at the time of surgery. These two cases thus provide important first opportunities to study the pathology of COVID-19. Pathologic examinations revealed that, apart from the tumors, the lungs of both patients exhibited edema, proteinaceous exudate, focal reactive hyperplasia of pneumocytes with patchy inflammatory cellular infiltration, and multinucleated giant cells. Hyaline membranes were not prominent. Since both patients did not exhibit symptoms of pneumonia at the time of surgery, these changes likely represent an early phase of the lung pathology of COVID-19 pneumonia.
ARTICLE | doi:10.20944/preprints202208.0080.v1
Subject: Engineering, Biomedical & Chemical Engineering Keywords: gastric cancer; deep learning; digital pathology; lymph node metastasis
Online: 3 August 2022 (08:48:02 CEST)
Histologically poor differentiation is associated with lymph node metastasis. Thus, pathological evaluation of biopsy specimens is crucial when treating stomach cancers. Deep learning of WSIs is challenging because the images are enormous. Given the computing limitations, patch-level supervised learning methods have been proposed. However, valuable information is lost when dividing WSIs into smaller patches. Another drawback is the need for pixel-level annotation by a pathologist. It is acceptable to differentiate, i.e., grade, gastric cancer at the holistic tissue level (i.e., under low magnification). We developed a weakly supervised learning technique for tissue-level gastric adenocarcinoma histological differentiation (well-to-moderately or poorly differentiated) and applied global reasoning to tissue-level features. The tissue-level AUROCs of the histological differentiation classifiers were 0.953, 0.969, and 0.943, respectively when data from five hospitals were subjected to threefold cross-validation. Comparison of the Grad-CAM heatmaps of the trained classifier and the pathologists’ annotations confirmed that our weakly supervised model exhibited performed well.
REVIEW | doi:10.20944/preprints202207.0224.v1
Subject: Life Sciences, Other Keywords: meningioma; hemangioma; cranial pathology; porotic hyperostosis; differential diagnosis; osteosarcoma
Online: 14 July 2022 (12:29:05 CEST)
Background: The reliability of a recent review of meningiomas in the archeologic record was difficult to assess, given the inverted sex ratio of the report and other contents apparently at variance with anatomical/medical findings in scientifically-identified cases. It therefore seemed appropriate to reexamine the nature of meningiomas and derive improve criteria for their recognition in the archeologic record and distinguish them from hemangiomas and bone marrow hyperplasia (recognized in the form of porotic hyperostosis). Methods: Medically-documented cases of meningiomas, hemangiomas and cranial bone marrow hyperplasia were examined to establish a macroscopic standard that distinguishing among them. Alleged cases in the archeologic record were examined for conformity with those criteria. Results: An en face pattern of uniform mesh with contained whorls appears pathognomonic for meningiomas. This contrasts with the non-uniform marrow expansion displacement of trabeculae in porotic hyperostosis and non-uniform vascular displacement of trabeculae in hemangiomas. Reassessment of past attributions revealed few cases of meningiomas that could be confidently diagnosed. Those identified has sex ratios parsimonious with medical literature reports. Conclusions: Criteria suggested for identifying meningiomas permits distinguishing from hemangiomas, bone marrow hyperplasia (porotic hyperostosis) and from the macroscopically-observable surface spicules characteristic of osteosarcomas. Examination for fulfillment of criteria for meningiomas and hemangiomas seems to provide a picture (including sex ratios) more parsimonious with the clinical literature, concluding that Cook and Danforth’s disparate ratios were related to less fastidious case selection. Additionally, confidence in recognizing porotic hyperostosis may be compromised because of apparent similar macroscopic alterations to those seen with hemangiomas.
REVIEW | doi:10.20944/preprints202010.0041.v1
Subject: Keywords: Coronavirus, SARS-CoV-2, Pandemics, Molecular biology, Immunity, Pathology
Online: 2 October 2020 (13:24:16 CEST)
In humans, coronaviruses can cause infections of the respiratory system, with damage of varying severity depending on the virus examined: ranging from mild or moderate upper respiratory tract diseases, such as the common cold, to pneumonia, severe acute respiratory syndrome, kidney failure and even death. Human coronaviruses known to date, common throughout the world, are seven. The most common - and least harmful - ones were discovered in the 1960s and cause a common cold. Others, more dangerous, were identified in the early 2000s and cause more severe respiratory tract infections. Among these the SARS-CoV, isolated in 2003 and responsible for the Severe Acute Respiratory Syndrome (the so-called SARS), which appeared in China in November 2002, the Coronavirus 2012 (2012-nCoV) cause of the Middle Eastern Respiratory Syndrome from Coronavirus (MERS), which exploded in June 2012 in Saudi Arabia, and actually SARS-CoV-2. On December 31, 2019, a new Coronavirus strain was reported in Wuhan, China, identified as a new Coronavirus beta strain ß-CoV from Group 2B, with a genetic similarity of approximately 70% to SARS-CoV, the virus responsible. of SARS. In the first half of February, the International Committee on Taxonomy of Viruses (ICTV), in charge of the designation and naming of the viruses (i.e., species, genus, family, etc.), thus definitively named the new coronavirus as SARS-CoV-2. This article highlights the main knowledge we have about the biomolecular and pathophysiologic mechanisms of SARS-CoV-2.
REVIEW | doi:10.20944/preprints202003.0348.v1
Subject: Medicine & Pharmacology, Other Keywords: SARS-COV-2; COVID-19; clinical pathology; pathogenesis; immunopathology
Online: 23 March 2020 (07:51:17 CET)
Coronavirus Disease 2019 (COVID-19), caused by a novel coronavirus named Severe Acute Respiratory Syndrome - Coronavirus-2 (SARS-CoV-2), emerged in early December 2019 in China and attained a pandemic situation worldwide by its rapid spread to nearly 167 countries with 287.239 confirmed cases and 11.921 human deaths with a case fatality rate (CFR) of around 4 per cent. Bats were considered as the reservoir host, and the search of a probable intermediate host is still going on. Animals have anticipated culprit of SARS-CoV-2 as of now. The disease is mainly manifested by pneumonia and related respiratory signs and symptoms, but the involvement of the gastrointestinal system and nervous system is also suggested. The severe form of the disease associated with death is mainly reported in older and immune-compromised patients with pre-existing disease history. Death in severe cases is attributed to respiratory failure associated with hyperinflammation. Cytokine storm syndrome associated with rampant inflammation in response to SARS-CoV-2 infection is considered as the leading killer of COVID-19 patients. COVID-19 patients were reported with higher levels of many pro-inflammatory cytokines and chemokines like IFN-g, IL-1b, IP-10, and MCP-1. Furthermore, severe cases of COVID-19 revealed higher levels of TNF-α, G-CSF, and MIP-1A. Blood profile of the COVID-19 patients exhibits lymphopenia, leucopenia, thrombocytopenia and RNAaemia along with increased levels of aspartate aminotransferase. SARS-CoV-2 infection in pregnant women does not lead to fetus mortalities unlike other zoonotic coronaviruses like SARS-CoV and MERS-CoV, with no evidence of intrauterine transmission to neonates. Rapid and confirmatory diagnostics have been developed, and high efforts are being made to develop effective vaccines and therapeutics. In the absence of any virus-specific therapeutic, internationally health care authorities are recommending adoption of effective prevention and control measures to counter and contain this pandemic virus. This paper is an overview of this virus and the disease with a particular focus on SARS-COV-2 / COVID-19 clinical pathology, pathogenesis and immunopathology along with a few recent research developments.
ARTICLE | doi:10.20944/preprints202003.0311.v1
Subject: Medicine & Pharmacology, Pathology & Pathobiology Keywords: SARS-CoV-2; COVID-19; pathology; post-mortem biopsy
Online: 20 March 2020 (09:24:10 CET)
Data on pathologic changes of the 2019 novel coronavirus disease (COVID-19) are scarce. To gain knowledge about the pathology that may contribute to disease progression and fatality, we performed post-mortem needle core biopsies of lung, liver, and heart in four patients who died of COVID-19 pneumonia. The patients’ ages ranged from 59 to 81, including 3 males and 1 female. Each patient had at least one underlying disease, including immunocompromised status (chronic lymphocytic leukemia and renal transplantation) or other conditions (cirrhosis, hypertension, and diabetes). Time from disease onset to death ranged from 15 to 52 days. All patients had elevated white blood cell counts, with significant rise toward the end, and all had lymphocytopenia except for the patient with leukemia. Histologically, the main findings are in the lungs, including injury to the alveolar epithelial cells, hyaline membrane formation, and hyperplasia of type II pneumocytes, all components of diffuse alveolar damage. Consolidation by fibroblastic proliferation with extracellular matrix and fibrin forming clusters in airspaces is evident. In one patient, the consolidation consists of abundant intra-alveolar neutrophilic infiltration, consistent with superimposed bacterial bronchopneumonia. The liver exhibits mild lobular infiltration by small lymphocytes, and centrilobular sinusoidal dilation. Patchy necrosis is also seen. The heart shows only focal mild fibrosis and mild myocardial hypertrophy, changes likely related to the underlying conditions. In conclusion, the post-mortem examinations show advanced diffuse alveolar damage, as well as superimposed bacterial pneumonia in some patients. Changes in the liver and heart are likely secondary or related to the underlying diseases.
ARTICLE | doi:10.20944/preprints201704.0078.v1
Subject: Medicine & Pharmacology, Pathology & Pathobiology Keywords: Ochratoxin A, insulin, glucagon, glucose, rat plasma, pathology, immunohistochemistry
Online: 13 April 2017 (11:46:19 CEST)
In this study, diabetogenic effects of long term Ochratoxin A (OTA) administration in rats were investigated and its role in the etiology of diabetes mellitus (DM) was examined utilizing 42 female Wistar rats for these purposes. The rats were divided into 3 different study and control groups according to the duration of the OTA administration. Rats received 45 μg OTA daily in their feed for 6, 9 and 24 weeks study groups. Three control groups without any treatment were also used in the same periods. Blood and pancreatic tissue samples were collected during the necropsy at the end of 6, 9 and 24 weeks. Plasma values of insulin, glucagon and glucose in study and control groups were determined. Pancreatic lesions were evaluated by histopathological examination; then insulin and glucagon expression in these lesions were determined by immunohistochemical methods. Statistically significant decrease in insulin levels in contrast to increases in glucagon and glucose levels in blood were observed. Slight degeneration in Langerhans islet cells were observed at the histopathological examination in all OTA treated groups. Immunohistochemistry of pancreatic tissue revealed decreased insulin and increased glucagon expression. This study demonstrated that OTA may cause pancreatic damage in Langerhans islet and predispose rats to DM.
COMMUNICATION | doi:10.20944/preprints202201.0462.v1
Subject: Biology, Animal Sciences & Zoology Keywords: roe deer; Tick-Borne Encephalitis; neurologic disease; pathology; genetic characterization
Online: 31 January 2022 (13:21:18 CET)
Tick borne encephalitis virus (TBEV) is the causative agent of Tick borne encephalitis in humans, a severe zoonosis occurring in the Paleartic region mainly transmitted through ticks belonging to the genus Ixodes. In Italy, TBEV is restricted to few foci in the north-eastern part of the country. This report describes for the first time a case of clinical TBE in a roe deer, occurred in the Belluno province, Veneto region, an area highly endemic for the presence of the virus. The affected roe deer showed ataxia, staggering movements, muscle tremors and persistent teeth grinding causing hypersalivation. At necropsy, the macroscopic picture was inconclusive. RNA of TBEV was detected by real-time RT-PCR. Phylogenetic analysis revealed a close relationship to TBEV of the European subtype, and 100% similarity with a virus from the bordering Trento Province. The histological examination of the midbrain confirmed the viral etiology and specific immunofluorescence indicated the presence of a Flavivirus infection and characterized the pattern of infection in the neurons. This report underlines for the first time the occurrence of clinical encephalitic manifestations due to TBEV in a roe deer, thussuggesting to include this pathogen in the frame of differential diagnosis in this species.
REVIEW | doi:10.20944/preprints202011.0019.v1
Subject: Biology, Anatomy & Morphology Keywords: aging; biomass conversion; C. elegans; reproductive death; semelparity; senescent pathology
Online: 2 November 2020 (10:45:56 CET)
In some species of salmon, reproductive maturity triggers the development of massive pathology resulting from reproductive effort, leading to rapid post-reproductive death. Such reproductive death, which occurs in many semelparous organisms (with a single bout of reproduction), can be prevented by blocking reproductive maturation, and this can increase lifespan dramatically. Reproductive death is often viewed as distinct from senescence in iteroparous organisms (with multiple bouts of reproduction) such as humans. Here we review the evidence that reproductive death occurs in C. elegans and discuss what this means for its use as a model organism to study aging. Inhibiting insulin/IGF-1 signaling and germline removal suppresses reproductive death and greatly extends lifespan in C. elegans, but can also extend lifespan to a small extent in iteroparous organisms. We argue that mechanisms of senescence operative in reproductive death exist in a less catastrophic form in iteroparous organisms, particularly those involving costly resource reallocation, and exhibiting endocrine-regulated plasticity. Thus, mechanisms of senescence in semelparous organisms (including plants) and iteroparous ones form an etiological continuum. Therefore understanding mechanisms of reproductive death in C. elegans can teach us about some mechanisms of senescence that are operative in iteroparous organisms.
ARTICLE | doi:10.20944/preprints201904.0166.v1
Subject: Biology, Entomology Keywords: antimicrobial peptides; cellular defense; insect pathology; phenoloxidae; phospholipase A2; protease
Online: 15 April 2019 (11:45:11 CEST)
Xenorhabdus nematophila and Photorhabdus luminescens are entomopathogenic symbionts that produce several toxic proteins that can interfere with the immune system of insects. Here, we showed that outer membrane proteins (OMPs) could be involved as virulence factors during bacterial symbiont pathogenesis. Purified OMPs from bacterial culture were injected fifth instar larvae of Spodoptera exigua Hübner. Larvae were surveyed for fluctuations in total haemocyte counts (THC), granulocyte percentage (cellular defence), protease, phospholipase A2 (PLA2), and phenoloxidase (PO) activities (humoral defence) at specific time intervals. Changes in the expression of the three antimicrobial peptides (AMPs), cecropin, attacin, and spodoptericin, were also measured. Larvae treated with both types of OMPs had more haemocytes than did the negative controls. OMPs of X. nematophila caused more haemocyte destruction than did the OMPs of P. luminescens. The OMPs of both bacterial species initially activated insect defensive enzymes post-injection, their activating fluctuated in different ways. Attacin, cecropin and spodoptericin were up-regulated by OMP injections more than in normal larvae. The expression of these three AMPs was maximal at four hpi with P. luminescens OMPs treatment. Expression of the three AMPs in X. nematophila treatment was irregular and lower than in the P. luminescens OMPs treatment. These findings provide insights into the role of OMPs of entomopathogenic nematode bacterial symbionts in countering the physiological defenses of insects.
Subject: Medicine & Pharmacology, Pathology & Pathobiology Keywords: Novel coronavirus pneumonia; COVID-19; SARS-CoV-2; Pathology; Critical patient
Online: 9 March 2020 (10:31:10 CET)
Background Critical patients with novel coronavirus pneumonia ( COVID-19) have worse outcome and high mortality. However, the histopathology of critical patient with COVID-19 remains undisclosed. Methods We performed the whole lung biopsy, and described the pathological changes of critical COVID-19 patient done with transplant by HE staining, immunohistochemistry and special staining observed under the microscopy. Findings The whole lungs displayed diffuse congestive appearance and partly haemorrhagic necrosis on gross examination. The haemorrhagic necrosis was prominently present in outer edge of the right lower lung. The cut surfaces of the lung displayed severe congestive and haemorrhagic changes. The main pathological changes showed massive pulmonary interstitial fibrosis, and partly hyaline degeneration, variable degrees of hemorrhagic pulmonary infarction. Small vessels hyperplasia, vessel wall thickening, lumen stenosis, occlusion and microthrombosis formation. Focal monocytes, lymphocytes and plasma cells infiltrating into pulmonary interstitium. Bronchiolitis and alveolitis with proliferation, atrophy, desquamation and squamous metaplasia of epithelial cells. Atrophy, vacuolar degeneration, proliferation, desquamation and squamous metaplasia in alveolar epithelial cells. Alveolar cavity congestion was prominent, and contained mucus, edema fluid, desquamated epithelial cells, and inflammatory cells. We also found several multinucleate giant cells and intracytoplasmic viral inclusion bodies. Special stains including Masson stain, sirius red staining, reticular fibers staining indicated massive pulmonary interstitial fibrosis. Immunohistochemistry showed positive for immunity cells including CD3, CD4, CD8, CD20, CD79a, CD5, CD38 and CD68. Interpretation We demonstrate the pathological findings of critical patient with COVID-19, which might provide a deep insight of the pathogenesis and severity of this disease.
REVIEW | doi:10.20944/preprints201807.0478.v1
Subject: Medicine & Pharmacology, Pathology & Pathobiology Keywords: pheochromocytoma; paraganglioma; GAPP; metastasis; prognosis; catecholamine; gene mutation; immunohistochemistry; pathology; diagnosis
Online: 25 July 2018 (11:41:52 CEST)
Pheochromocytoma and sympathetic paraganglioma (PPGL) are rare neuroendocrine tumors characterized by catecholamine production in the adrenal medulla and extra-adrenal paraganglia. PPGL with metastasis was termed malignant PPGL. However, the distinction between “benign” and “malignant” PPGLs has been debated. Currently, all PPGLs are believed to have some metastatic potential and are assigned malignant tumors (ICD-O/3) by the WHO Classification of Endocrine Organs (2017, 4th edition). Therefore, the previous categories benign and malignant PPGL have been eliminated in favor of a risk stratification approach. The Grading of Adrenal Pheochromocytoma and Paraganglioma (GAPP) is a tool for risk stratification for predicting metastasis and the prognosis of patients. At least 30% of PPGLs are hereditary, with 20 genes identified and genotype-phenotype correlations clarified. Of these, VHL, RET, and NF1 have been well investigated and are the primary cause of bilateral PCC. In addition, succinate dehydrogenase gene subunits SDHB and SDHD are strongly correlated with extra-adrenal location, younger age, multiple tumors, metastasis, and poor prognosis. Disease stratification by catecholamine phenotype and molecular profiling correlates with histological grading by GAPP. PPGLs should be understood comprehensively based on clinical, biochemical, molecular, and pathological data for patient care. A flow chart for pathological diagnosis is included.
REVIEW | doi:10.20944/preprints202208.0519.v1
Subject: Life Sciences, Microbiology Keywords: prehistory; history; archeobiology; paleovirology; EVEs; ancient DNA; paleogenomics; pathology collections; historic publications
Online: 30 August 2022 (10:29:39 CEST)
Since life on earth developed, parasitic microbes have thrived. Increases in host numbers, or the conquest of a new species, provides an opportunity for such a pathogen to enjoy, before host defense systems kick in, a similar upsurge in reproduction. Outbreaks ‒ caused by ‘endemic’ pathogens ‒ and epidemics ‒ caused by ‘novel’ pathogens ‒ have thus been creating chaos and destruction since prehistorical times. To study such (pre)historic epidemics, recent advances in the ancient DNA field, applied to both archeological and historical remains, have helped tremendously to elucidate the evolutionary trajectory of pathogens. These studies offered new and unexpected insights in the evolution of, for instance, smallpox virus, hepatitis B virus and the plague-causing bacterium Yersinia pestis. Furthermore, burial patterns and historical publications can help in tracking down ancient pathogens. Another source of information is our genome, where selective sweeps in immune-related genes relate to past pathogen attacks, while multiple viruses have left their genomes behind for us to study.
BRIEF REPORT | doi:10.20944/preprints202112.0327.v1
Subject: Medicine & Pharmacology, Pathology & Pathobiology Keywords: keyword; histopathology; deep learning; machine learning; cancer; lung adenocarcinoma; immune; computational pathology
Online: 21 December 2021 (12:28:44 CET)
Studies have shown that STK11 mutation plays a critical role in affecting the lung adenocarcinoma (LUAD) tumor immune environment. By training an Inception-Resnet-v2 deep convolutional neural network model, we were able to classify STK11-mutated and wild type LUAD tumor histopathology images with a promising accuracy (per slide AUROC=0.795). Dimensional reduction of the activation maps before the output layer of the test set images revealed that fewer immune cells were accumulated around cancer cells in STK11-mutation cases. Our study demonstrated that deep convolutional network model can automatically identify STK11 mutations based on histopathology slides and confirmed that the immune cell density was the main feature used by the model to distinguish STK11-mutated cases.
ARTICLE | doi:10.20944/preprints202111.0049.v1
Subject: Life Sciences, Molecular Biology Keywords: Huntington’s disease; YAC128; HdhQ150; strain background; C57BL/6; synaptic pathology; extrasynaptic NMDAR
Online: 2 November 2021 (12:11:26 CET)
Mouse models are frequently used to study Huntington’s disease (HD). Onset and severity of neuronal and behavioral pathologies vary greatly between HD mouse models, which results from different huntingtin expression levels and different CAG repeat length. HD pathology appears to depend also on strain background of mouse models. Thus, behavioral deficits of HD mice are more severe in the FVB than in the C57BL/6 background. Alterations in medium spiny neuron (MSN) morphology and function has been well documented in young YAC128 mice in the FVB background. We here tested the relevance of strain background for mutant huntingtin (mHTT) toxicity on the cellular level by investigating HD pathologies in YAC128 mice in the C57BL/6 background (YAC128/BL6). Morphology, spine density, synapse function and membrane properties were not or only subtly altered in MSNs of 12-month-old YAC128/BL6 mice. Despite the mild cellular phenotype, YAC128/BL6 mice showed deficits in motor performance. More pronounced alterations in MSN function were found in the HdhQ150 mouse model in the C57BL/6 background (HdhQ150/BL6). Consistent with the differences in HD pathology, the number of inclusion bodies was considerably lower in YAC128/BL6 mice than HdhQ150/BL6 mice. This study highlights the relevance of strain background for mHTT toxicity in HD mouse models.
ARTICLE | doi:10.20944/preprints202101.0207.v1
Subject: Life Sciences, Biochemistry Keywords: severe fever with thrombocytopenia syndrome; cat; companion animals; viral hemorrhagic fever; pathology
Online: 11 January 2021 (17:48:51 CET)
ABSTRACT: A woman in her 50s showed symptoms of fever, loss of appetite, vomiting, and general fatigue 2 days after she was bitten by a sick cat, which had later died, in Yamaguchi prefecture, western Japan, in June 2016. She subsequently died of multiorgan failure, and an autopsy was performed to determine the cause of death. However, the etiological pathogens were not quickly identified. The pathological features of the patient were retrospectively re-examined, and the pathology of the regional lymph node at the site of the cat bite was found to show necrotizing lymphadenitis with hemophagocytosis. The pathological features were noticed to be similar to those of patients reported to have severe fever with thrombocytopenia syndrome (SFTS). Therefore, the lymph node section was retrospectively tested immunohistochemically for SFTSV antigen, which revealed the presence of SFTSV antigen. The sick cat also showed similar symptoms and laboratory findings similar to those shown in human SFTS cases. It is highly possible that the patient was infected with SFTSV through the sick cat’s bite. If a patient gets sick in an SFTS-endemic region after a cat bite, SFTS should be considered in the differential diagnosis.
BRIEF REPORT | doi:10.20944/preprints202209.0063.v1
Subject: Life Sciences, Virology Keywords: SARS-CoV-2; Placental Pathology; Apgar Scores; Gestational Age; Under-resourced Patient Population
Online: 5 September 2022 (13:17:10 CEST)
Abstract. Babies born to severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) infected mothers are at greater risk for perinatal morbidity and more likely to receive a neurodevelopmental diagnosis in the first year of life. However, the effect of maternal infection on placental function and neonatal outcomes varies depending upon the patient population. We set out to test our hypothesis that maternal SARS-CoV-2 infection in our underserved, socioeconomically disadvantaged, predominantly African American and Latina population in the Bronx, NY would have effects evident at birth. Fifty-five SARS-CoV-2 positive and 61 negative third trimester patients were randomly selected from Montefiore Medical Center (MMC), Bronx, NY. In addition, two positive cases from Yale New Haven Hospital, CT were included as controls. All 55 placentas delivered by SARS-CoV-2 positive mothers were uninfected by the virus, based on immunohistochemistry, in-situ hybridization, and qPCR analysis. However, placental villous infarcts, mild preeclampsia, shortened gestational periods and lower Apgar scores were observed in the infected cases. These findings suggest that even without entering the placenta, SARS-CoV-2 can affect various systemic pathways culminating in altered placental development and function, which may adversely affect the fetus, especially in a high-risk patient population such as ours. These results underline the importance of vaccination among pregnant women, particularly in low resource areas.
ARTICLE | doi:10.20944/preprints202201.0338.v1
Subject: Life Sciences, Other Keywords: disease incidence; emerging disease; Cultivated forage crops; plant pathology; disease incidence; emerging disease
Online: 24 January 2022 (09:57:58 CET)
Alfalfa (Medicago sativa L.) is one of the most important forage crops in the world. In Bolivia it is cultivated in different parts of the High Andes and in the Interandean Valleys. The species is affected by several fungal diseases which reduce production, but before 2016 hardly any mention had been made of virus disease in the region. The aims of the present work were: 1) to describe the symptomology of this apparent viral disease, and ii) determine its effects on the yield of different alfalfa cultivars available from the CIF-UMSS. In 2016, a plot was established at Tiquipaya (Dept. of Cochabamba) (altitude 2480 m) was planted with 12 alfalfa cultivars. Disease incidence values were estimated and the area under the disease progress curves (AUDPC) calculated. The disease progress curves themselves were analyzed using logit functions for polycyclic diseases, and yields were determined. Disease symptoms included deformation of the folioles, thickened veins, the presence of vein enations and papillae on the abaxial leaves, reduced plant size - all symptoms of infection apparently caused by Alfalfa Dwarf Virus. The different cultivars returned different incidence values. They also returned different apparent infection rates ranging from 0.072/day for Cóndor, to 0.113/day for Tamborada. The different cultivars returned different dry weight yields, with yields inversely related to the AUDPC. In conclusion, based on the foliar symptoms registered, the viral disease is associated with the Alfalfa Dwarf Virus. The twelve cultivars evaluated presented different incidence levels of the viral disease.
REVIEW | doi:10.20944/preprints202201.0224.v1
Subject: Mathematics & Computer Science, Artificial Intelligence & Robotics Keywords: deep learning; machine learning; histopathology; computational pathology; convolutional neural networks; generative adversarial networks
Online: 17 January 2022 (12:31:25 CET)
Deep learning techniques, such as convolutional neural networks (CNN), generative adversarial networks (GAN), and graph neural networks (GNN), have over the past decade changed the ac-curacy of prediction in many diverse fields. In recent years, the application of deep learning tech-niques in computer vision tasks in pathology demonstrated extraordinary potential in assisting clinicians, automating diagnosis, and reducing costs for patients. Formerly unknown pathologi-cal evidence, such as morphological features related to specific biomarkers, copy number varia-tions, and other molecular features, were also able to be captured by deep learning models. In this paper, we review popular deep learning methods and some recent publications about their appli-cations in pathology.
ARTICLE | doi:10.20944/preprints202106.0613.v1
Subject: Mathematics & Computer Science, Algebra & Number Theory Keywords: LRTI; URTI; Asthma; Cough Classification; Respiratory Pathology Classification; MFCCs; BiLSTM; Deep Neural Networks
Online: 25 June 2021 (09:45:00 CEST)
Intelligent systems are transforming the world, as well as our healthcare system. We propose a deep learning-based cough sound classification model that can distinguish between children with healthy versus pathological coughs such as asthma, upper respiratory tract infection (URTI), and lower respiratory tract infection (LRTI). In order to train a deep neural network model, we collected a new dataset of cough sounds, labelled with clinician's diagnosis. The chosen model is a bidirectional long-short term memory network (BiLSTM) based on Mel Frequency Cepstral Coefficients (MFCCs) features. The resulting trained model when trained for classifying two classes of coughs -- healthy or pathology (in general or belonging to a specific respiratory pathology), reaches accuracy exceeding 84\% when classifying cough to the label provided by the physicians' diagnosis. In order to classify subject's respiratory pathology condition, results of multiple cough epochs per subject were combined. The resulting prediction accuracy exceeds 91\% for all three respiratory pathologies. However, when the model is trained to classify and discriminate among the four classes of coughs, overall accuracy dropped: one class of pathological coughs are often misclassified as other. However, if one consider the healthy cough classified as healthy and pathological cough classified to have some kind of pathologies, then the overall accuracy of four class model is above 84\%. A longitudinal study of MFCC feature space when comparing pathologicial and recovered coughs collected from the same subjects revealed the fact that pathological cough irrespective of the underlying conditions occupy the same feature space making it harder to differentiate only using MFCC features.
ARTICLE | doi:10.20944/preprints202007.0747.v1
Subject: Life Sciences, Virology Keywords: African swine fever virus; virulence; pathology; wild boar; domestic pig; macroscopy; histopathology; immunology
Online: 31 July 2020 (13:01:32 CEST)
Endemically infected European wild boar are considered a major reservoir of African swine fever virus in Europe. While high lethality was observed in the majority of field cases, strains of moderate virulence occurred in the Baltic States. One of these, “Estonia 2014”, led to a higher number of clinically healthy, antibody-positive animals in the hunting bag of North-Eastern Estonia. Experimental characterization showed high virulence in wild boar but moderate virulence in domestic pigs. Putative pathogenic differences between wild boar and domestic pigs are unresolved and comparative pathological studies are limited. We here report on a kinetic experiment in both subspecies. Three animals each were euthanized at 4, 7 and 10 days post infection (dpi). Clinical data confirmed higher virulence in wild boar although macroscopy and viral genome load in blood and tissues were comparable in both subspecies. The percentage of viral antigen positive myeloid cells tested by flow cytometry did not differ significantly in most tissues. Only immunohistochemistry revealed consistently higher viral antigen loads in wild boar tissues in particular 7 dpi, whereas domestic pigs already eliminated the virus. The moderate virulence in domestic pigs could be explained by a more effective viral clearance.
REVIEW | doi:10.20944/preprints202210.0483.v1
Subject: Medicine & Pharmacology, Urology Keywords: Clear cell carcinoma, molecular pathology, biomarkers, gene and protein signatures, machine learning, treatment decision.
Online: 31 October 2022 (10:21:51 CET)
Renal clear cell carcinoma (ccRCC) comprises over 75% of all renal tumors and arises in the epithelial cells of the proximal convoluted tubule. Molecularly ccRCC is characterized by copy number alterations (CNAs) such as the loss of chromosome 3p and VHL inactivation. Additional driver mutations (SETD2, PBRM1, BAP1, and others) promote genomic instability and tumor cell metastasis through the dysregulation of various metabolic and immune-response pathways. Many researchers identified mutation, gene expression, and proteomic signatures for early diagnosis and prognostics for ccRCC. Despite a tremendous influx of data regarding DNA alterations, gene expression, and protein expression, the incorporation of these analyses for diagnosis and prognosis of RCC into the clinical application has not been implemented yet. In this review, we focused on the molecular changes associated with ccRCC development, along with gene expression and protein signatures, to emphasize the utilization of these molecular profiles in clinical practice. These findings, in the context of machine learning and precision medicine, may help to overcome some of the barriers encountered for implementing molecular profiles of tumors into the diagnosis and treatment of ccRCC.
ARTICLE | doi:10.20944/preprints201801.0196.v1
Subject: Medicine & Pharmacology, Urology Keywords: comorbid diseases; erectile dysfunction; penile duplex doppler ultrasound; penile pathology; phosphodiesterase type 5 inhibitors
Online: 22 January 2018 (09:03:17 CET)
Relationship between the results of penile duplex doppler ultrasound (PDDU) and response to vardenafil was investigated in patients diagnosed with erectile dysfunction (ED). Data of 148 patients with ED were analysed retrospectively. Patients who did not respond to therapy were classified as Group I (n = 32), those responded partially were classified as Group II (n = 40) and complete responders were classified as Group III (n = 76). Age, comorbid diseases, vascular and penile pathology were compared among the three groups. While diabetes mellitus (DM) and dyslipedimia positivity adversely affect the response to treatment, the presence of hypertension (HT), peyronie's disease and priapism increase the therapeutic response to the treatment (p < 0.05). Arterial insufficiency was present in 20(30.3%), 25(37,9%) and 21(31.8%) of the patients in Group I, Group II and Group III, respectively (p = 0.001). Venous insufficiency was observed in 3(14.3%) patients in Group I and in 8(85.7%) patients in Group III (p = 0.001). Arterial/venous insufficiency was seen in 9(30%), 14(46.7%) and 7(23.3%) of the patients in Group I, Group II and Group III, respectively (p = 0.001). Response rate to treatment was highest in normal patients according to PDDU, followed by patients with venous insuffiency. Besides, it was found that DM decreased the response to treatment, whereas response was increased in cases with HT, priapism and Peyronie’s disease.
REVIEW | doi:10.20944/preprints202210.0226.v3
Subject: Medicine & Pharmacology, Oncology & Oncogenics Keywords: Nasopharyngeal carcinoma ecology; Unity of ecology and evolution; Pathological ecosystem; Tumor microenvironment; Tumor host interface; Tumor budding; Ecological pathology; Ecological radiology; Multidimensional tumoriecology; Medical ecology tree
Online: 29 December 2022 (09:19:56 CET)
Nasopharyngeal carcinoma (NPC) is a particular entity of head neck cancer that is generally regarded as a genetic disease with diverse extent of intertumor and intratumor heterogeneity. Here, we declare that, NPC is not only a genetic disease; it could be better conceptualized as a multidimensional spatiotemporal “unity of ecology and evolution” pathological ecosystem. Subsequently, we discuss NPC cells as invasive species and its metastasis as a multidirectional ecological dispersal. We then interpreter the foundational ecological principles to understand NPC progression. The model of “mulberry-fish-ponds” can well illustrate the dynamic reciprocity of cancer ecosystem. We propose that tumor-host interface is the ecological transition zone in cancers, and tumor buddings should be recognized as ecological islands separated from the mainland. It should be noted that the invasive edge has a significantly molecular and functional edge effect because of its curvature and irregularity. Selection driving factors and ecological therapy including hyperthermia for NPC patients, and future perspectives of “ecological pathology”, “multidimensional spatiotemporal tumoriecology” are also pointed out. We advance that “nothing in cancer evolution or ecology makes sense except in the light of the other”. Medical ecology tree is unprecedentedly constructed to demonstrate that the initiation and progression of human diseases could be a multidimensional spatiotemporal ecological process. The establishment of “NPC ecology” and “medical ecology tree” might provide a new paradigm and conceptual framework for our understanding of the complex progression of human diseases and development of potential preventive and therapeutic strategies for patients.
REVIEW | doi:10.20944/preprints202009.0649.v1
Subject: Medicine & Pharmacology, Allergology Keywords: Infertile women; Hysteroscopy; Clinical pregnancy rate; Live birth rate; No Intrauterine pathology; endometrial stimulation; Systematic review
Online: 26 September 2020 (16:39:39 CEST)
(1) Background: The aim of this work was to systematically review existing studies on whether hysteroscopy improves the reproductive outcomes of women with infertility even in the absence of intrauterine pathologies when compared to women who did not receive a hysteroscopy. (2) Methods: We established the Participant-Intervention-Comparison-Outcome strategy and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to conduct a systematic review of 11 studies which were retrieved from 3 electronic databases: Ovid-Medline, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data from the included studies and used the Cochrane risk-of-bias tool to assess their quality. (3) Results: The primary outcome measures were the clinical pregnancy rates (CPRs) and live birth rates (LBRs) in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Hysteroscopy in infertile women without intrauterine pathologies showed higher CPRs and LBRs than those in the same population who did not receive hysteroscopy in cases of recurrent implantation failure and IVF (odds ratio: 1.79 and 1.46, 95% confidence interval: 1.46-2.30 and 1.08-1.97 for CPR and LBR, respectively); however, the degree of significance was not as high for LBR. (4) Conclusions: Hysteroscopy before IVF/ICSI in infertile women without intrauterine pathologies may potentially be effective in improving the CPRs and LBRs in patients with RIF. Robust and high-quality randomized trials are warranted to confirm this finding.
ARTICLE | doi:10.20944/preprints202211.0205.v1
Subject: Engineering, Biomedical & Chemical Engineering Keywords: lung cancer; digital pathology; whole slide imaging; artificial intelligence; deep learning; convolutional neural networks; computer-aided diagnosis
Online: 10 November 2022 (15:06:51 CET)
Lung cancer is the leading cause of cancer mortality worldwide, and it is urgently necessary to diagnose it as early as possible. Usually, the diagnostic process begins with a radiological examination which, when a possible tumour is present, is followed by a biopsy to extract tissue samples from the patient's lungs. Therefore, the purpose of this study is the development of an artificial intelligence algorithm that will analyse the Whole Slide Image (WSI) generated by the digitisation of the glass slides obtained from the extracted samples and detect if there is a tumour. The developed learning algorithms as well as the tested neural networks (NNs) were trained on a dataset composed of previously annotated WSI tiles, classified as Tumour or Non-Tumour. From these, four developed convolutional neural networks stood out and were selected to be compared with each other and with the tested NNs. When the best result of each of the developed architectures was compared to the highest result of the tested NNs, it was possible to denote that version 4 of CancerDetecNN achieved an average accuracy of 89.749 \% and an average loss of 0.220. Furthermore, the results for the four selected versions are in agreement with the results reported in the literature, however, the limited size of the given dataset must be considered. Given the results obtained, the fourth version has the potential to optimise the lung cancer diagnosis process.
ARTICLE | doi:10.20944/preprints202004.0418.v1
Subject: Medicine & Pharmacology, Pathology & Pathobiology Keywords: Diagnosis; Health sensing system; Nocturnal perspiration; Parameter; Pathology; Predictor; Q-strip; Subjective measurement; Sweat pattern; Symptoms; Prodromal; biomarker
Online: 23 April 2020 (15:26:39 CEST)
One third of a person’s life is spent on sleep, therefore the quality and habit of sleep affects health. A single case study indicated that perspiration could serve as a prognostic marker. Diagnosing nocturnal perspiration is common clinical practice, since this serves as a major symptom in many pathologies. Till this day no specific evidence-based approach for diagnosing nocturnal perspiration exists. By introducing the Q-strip, a device which quantitatively measures nocturnal perspiration, this could be acquired. The Q-strip could serve a purpose in diagnosing nocturnal perspiration more efficient without being intrusive. In addition to its health sensing potentials, the Q-strip makes it possible to visualise perspiration patterns. This introduces the possibility to examine the quality of sleep. Future research is recommended to investigate this.
ARTICLE | doi:10.20944/preprints202105.0246.v1
Subject: Biology, Agricultural Sciences & Agronomy Keywords: agriculture 4.0; chlorophyll; early diagnosis; fungal tree pathogens; mycology; plant disease; plant pathology; smart viticulture; vegetation indices; wine grapes
Online: 11 May 2021 (14:21:25 CEST)
The Armillaria genus represents one of the most common causes of chronic root rot disease in woody plants. The disease damage prompt assessment is crucial for pest management. However, the disease detection current methods are limited at the field scale. Therefore, an alternative approach that can enhance or supplement traditional techniques is needed. In this study, we investigated the potential of hyperspectral methods to identify the changes between fungi-infected and uninfected plants of Vitis vinifera in early detecting the Armillaria disease. The hyperspectral imaging sensor Specim-IQ was used to acquire images of leaves of the Teroldego Rotaliano grapevine cultivar. We analysed three groups of plants: healthy, asymptomatic, and diseased. Highly significant differences were found in the Near infrared (NIR) spectral region with a decreasing pattern from healthy to diseased plants attributable to internal leaf structure changes. Asymptomatic plants emerged from the other groups due to a smaller reflectance in the red-edge spectrum (around 705nm). Hypothetically associated with the presence of secondary metabolites involved in plant defence strategy. Furthermore, significant differences were observed in the wavelengths close to 550 nm in diseased plants versus asymptomatic. We used linear discriminant analysis from a machine learning context to classify the leaves based on the most significant variables (vegetation indices and single bands), with resulting overall accuracies of 85% and 84% respectively in healthy vs. diseased and healthy vs. asymptomatic. To our knowledge, this study represents the first report on the possibility of using hyperspectral data for root rot disease diagnosis on woody plants. Although further validation studies are required, it appears that the spectral reflectance technique, possibly implemented on unmanned aerial vehicles (UAV), could be a promising tool for a cost-effective, non-destructive method of Armillaria disease early diagnosis and mapping in the field, contributing to a significant step forward in precision viticulture.
REVIEW | doi:10.20944/preprints202201.0351.v1
Subject: Biology, Forestry Keywords: Ash; ash dieback; disease management; Fraxinus excelsior; fungal plant pathogen; Hymenoscyphus fraxineus; mycology; plant pathology; plant pathogen; plant science; tree disease
Online: 24 January 2022 (11:50:43 CET)
Ash trees have considerable economic, cultural and environmental value on the island of Ireland. However, European ash (Fraxinus excelsior L.) is currently under threat from the invasive ascomycete pathogen Hymenoscyphus fraxineus. This pathogen is the causal agent of ash dieback disease, which was initially reported in Poland in 1992. Hymenoscyphus fraxineus has since spread across Europe and the first recorded case of the disease on the island of Ireland was in 2012 at a forestry plantation in Co. Leitrim. The pathogen is now present in all 26 counties in Ireland and 6 counties in Northern Ireland, and it is considered unfeasible to eradicate. The spread of ash dieback disease is reflected in recent policy changes, which focus on management rather than eradication strategies. Since the first formal description of H. fraxineus in 2006, considerable research efforts have been made by the international scientific community to understand the biology of the pathogen and to develop management strategies against it. This review provides an update of current knowledge of H. fraxineus biology and infection. We then explore examples of mitigation techniques that have been trialled in Europe, in order to identify strategies that are feasible for disease management at a local level on the island of Ireland. Finally, we outline five key avenues of research that have the potential to provide breakthroughs in methods to protect valuable F. excelsior resources.
ARTICLE | doi:10.20944/preprints202110.0359.v2
Subject: Mathematics & Computer Science, Artificial Intelligence & Robotics Keywords: brain; pituitary adenoma; Dysembryoplastic neuroepithelial tumor; DNET; Ganglioglioma; deep learning; digital pathology; convolutional neural network; computer vision; machine learning; convolutional neural network; CNN
Online: 26 October 2021 (14:10:11 CEST)
Background: Processing whole-slide images (WSI) to train neural networks can be intricate and laborious. We developed an open-source library covering recurrent tasks in processing of WSI and in evaluating the performance of the trained networks for classification tasks. Methods: Two histopathology use-cases were selected. First we aimed to train a CNN to distinguish H&E-stained slides obtained from neuropathologically classified low-grade epilepsy-associated dysembryoplastic neuroepithelial tumor (DNET) and ganglioglioma (GG). The second project we trained a convolutional neural network (CNN) to predict the hormone expression of pituitary adenoms only from hematoxylin and eosin (H&E) stained slides. In the same approach, we addressed the issue to also predict clinically silent corticotroph adenoma. We included four clinico-pathological disease conditions in a multilabel approach. Results: Our best performing CNN achieved an area under the curve (AUC) of 0.97 for the receiver operating characteristic (ROC) for corticotroph adenoma, 0.86 for silent corticotroph adenoma and 0.98 for gonadotroph adenoma. Our DNET-GG classifier achieved an AUC of 1.00 for the ROC curve. All scores were calculated with the help of our library on predictions on a case basis. Conclusions: Our comprehensive library is most helpful to standardize the work-flow and minimize the work-burden in training CNN. It is also compatible with fastai. Indeed, our new CNNs reliably extracted neuropathologically relevant information from the H&E staining only. This approach will supplement the clinico-pathological diagnosis of brain tumors, which is currently based on cost-intense microscopic examination and variable panels of immunohistochemical stainings.