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Due to advances in automated image acquisition and analysis, whole-brain connectomes with 100,000 or more neurons are on the horizon. Proofreading of whole-brain automated reconstructions will require many person-years of effort, due to the huge volumes of data involved. Here we present FlyWire, an online community for proofreading neural circuits in a Drosophila melanogaster brain and explain how its computational and social structures are organized to scale up to whole-brain connectomics. Browser-based three-dimensional interactive segmentation by collaborative editing of a spatially chunked supervoxel graph makes it possible to distribute proofreading to individuals located virtually anywhere in the world. Information in the edit history is programmatically accessible for a variety of uses such as estimating proofreading accuracy or building incentive systems. An open community accelerates proofreading by recruiting more participants and accelerates scientific discovery by requiring information sharing. We demonstrate how FlyWire enables circuit analysis by reconstructing and analyzing the connectome of mechanosensory neurons.

International audience; Background and aimsTo evaluate the prevalence and prognostic value of metabolic syndrome (MetS) in patients admitted for coronavirus disease 2019 (COVID-19).Methods and resultsIn this monocentric cohort retrospective study, we consecutively included all adult patients admitted to COVID-19 units between April 9 and May 29, 2020 and between February 1 and March 26, 2021. MetS was defined when at least three of the following components were met: android obesity, high HbA1c, hypertension, hypertriglyceridemia, and low HDL cholesterol. COVID-19 deterioration was defined as the need for nasal oxygen flow ≥6 L/min within 28 days after admission.We included 155 patients (55.5% men, mean age 61.7 years old, mean body mass index 29.8 kg/m2). Fifty-six patients (36.1%) had COVID-19 deterioration. MetS was present in 126 patients (81.3%) and was associated with COVID-19 deterioration (no-MetS vs MetS: 13.7% and 41.2%, respectively, p < 0.01). Logistic regression taking into account MetS, age, gender, ethnicity, period of inclusion, and Charlson Index showed that COVID-19 deterioration was 5.3 times more likely in MetS patients (95% confidence interval 1.3–20.2) than no-MetS patients.ConclusionsOver 81.3% of patients hospitalized in COVID-19 units had MetS. This syndrome appears to be an independent risk factor of COVID-19 deterioration.

This article demonstrates how Jonathan Lyndon Chase utilizes a range of abstract images of flowers, seeds and even a cowboy aesthetic to reimagine the relationship between nature and queer men of colour in the contemporary United States. Chase uses flowers and seeds as multifaceted symbols, carefully shaped, to evoke the fragile and yet revitalizing joys of a messy human growth. These allusions to growth, plant and human, offer a specific challenge to falsely naturalized, too curtailed conceptions of gender, sexuality and race in America.

Background Standard therapy in gastric or gastro-esophageal junction (GOJ) adenocarcinoma is perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT regimen). FLOT offers significant histological response rates. The objective of our study was to evaluate the benefit of postoperative chemotherapy on recurrence free survival (RFS) in operated gastric or gastro-esophageal junction adenocarcinoma ypT0-3N0. Materials and Methods. This retrospective mulicenter study included patients with gastric or GOJ adenocarcinoma ypT0-3N0 treated with preoperative FLOT-type chemotherapy and operated between January 2017 and January 2022. Patients were divided into two groups: a group without postoperative chemotherapy (monitoring group) and a group with postoperative chemotherapy (chemotherapy group). Primary criterion was RFS. Secondary criterion was overall survival (OS). Results A total of 123 patients were included, 107 in the post chemotherapy group and 16 in the monitoring group. Patients in the chemotherapy group were younger (59 vs. 67 years) and had had less preoperative chemotherapy dose reduction (29 vs. 43,7%). There was no significant difference between the 2 groups concerning RFS (p = 0,87) and OS (p = 0,93). Conclusion Our study suggests that postoperative chemotherapy does not improve survival in gastric or GOJ adenocarcinoma following surgery and 4 cycles of preoperative FLOT. Our study paves the way for a prospective randomized trial focusing on the usefulness of 4 cycles of post operative FLOT. Publication type : MeSH : Academic Dissertation

Abdominal pain is a cardinal sign of functional bowel disorders (FBD), in favor of irritable bowel syndrome (IBS). However, the determinants of abdominal pain severity (APS) are unknown. The present study aimed to search the relationships between APS and demographic, psychological, and clinical parameters in tertiary care FBD outpatients. In this retrospective study, we included 2043 new outpatients with FBD or functional abdominal pain. They fulfilled the Rome III questionnaire, psychological evaluation, and four 10-points Likert scale for the perceived severity of constipation, diarrhea, bloating, and abdominal pain. Linear regression was performed for each phenotype to model the severity of abdominal pain with demographic, psychological parameters, and symptoms severity. APS was positively associated with bloating severity in all phenotypes, but APS was also associated with other variables according to gender and phenotype. APS was negatively associated with age and positively with depression, constipation severity, and diarrhea severity in female patients. In male patients, APS was associated with state anxiety, constipation severity, and diarrhea severity. APS severity was associated with bloating severity and transit severity in IBS patients, while in non-IBS patients, APS was only associated with bloating severity. Perceived abdominal pain severity is always associated with perceived bloating severity in FBD and FAP patients.

BACKGROUND/OBJECTIVES Suicidal ideation (SI), a symptom of depression, is known to be associated with irritable bowel syndrome (IBS) but is not known to be associated with other functional gastrointestinal disorders (FGIDs). However, the source of this association is discussed. It could be related to a possible abnormal biochemical pathway implicating neurotransmitters common to both disorders like serotonin or pain and an ill-being associated with a chronic disorder of unknown etiology. The present study aims to search for the FGIDs associated with suicidal ideation. DESIGN Observational study. METHODS A total of 1469 patients with FGIDs (71% of women) were included in the present study. They filled the Rome III questionnaire, Beck depression inventory, and state and trait anxiety questionnaires. Data were analyzed using analysis of variance with Bonferroni correction and logistic regression analysis. RESULTS Suicidal ideation was reported by 15% of patients, associated with increased scales of depression (P

Constipation is a frequent complaint of patients with functional bowel disorders. The present study aimed to evaluate the relationship between the perceived constipation severity with demographics, clinical, physiological, and psychological parameters in constipated patients. Four hundred seven constipated patients were included and had clinical, physiological, and psychological evaluation. The self-reported severity of constipation was analyzed using stepwise linear regression in the total population and within each clinical group. The patients were mainly of female gender (81%) and were 47.4 ± 16.5 years old. They complained of IBS (65%), and 62% had defecation disorders. The depression scale was abnormal in 200 patients (49%). The relationships of the constipation severity varied according to the Rome IV phenotype. In all phenotypes, it was positively associated with bloating severity, and negatively with Bristol stool form. In IBS patients, perceived constipation severity was also associated with abdominal pain severity. Our data support the hypothesis that perceived constipation severity is associated with clinical and physiological factors but not demographics and psychological factors. Besides, the relationships of perceived constipation severity with these factors vary according to clinical phenotypes.

Although idiopathic fecal incontinence (FI) patients have some psychological characteristics, the personality of FI patients was not described. The present study aims to describe the clinical and personality characteristics of FI patients. This retrospective observational study included 996 outpatients, 72 with fecal incontinence. They filled out the Rome III diagnostic questionnaire, the personality inventory MMPI-2, the questionnaires for urological and sexual disorders, and Likert scales for bowel disorders perceived symptom severity. The main outcome measures were the presence in FI patients of functional gastrointestinal disorders, the self-reported symptom severity, and the personality profile. Patients were mainly females (72%). FI patients were characterized by higher age (P = 0.015), and by a higher prevalence of functional diarrhea (P = 0.001), urological (P = 0.001), and sexual disorders (P = 0.005). These patients also report higher diarrhea severity (P < 0.001) and lower abdominal pain severity (P = 0.009). The personality of FI patients is distinguished by a higher score for psychopathic deviate (P = 0.006), social responsibility (P = 0.003), Mac Andrew revised scale (P = 0.005), and antisocial practice (P = 0.007), and a lower score for type A behavior (P = 0.005). FI patients are characterized not only by older age, and a high prevalence of diarrhea but also by a specific personality profile characterized by an unfavorable comparison with others.

Stressful events are frequently associated with functional gastrointestinal disorders (FGID). This study aims to determine if the severity of self-perceived stress is associated with specific FGID and personality characteristics in 822 patients with FGID who have filled a Rome III questionnaire, Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and a 10-point Likert scale for self-perceived stress. According to stress severity, the patients were divided into three groups: low (4; n = 183), moderate (4-6; n = 283), and severe stress (6; n = 356). Female sex was more frequent in the severe stress group than in the low stress group (p = 0.001). Stress severity was strongly correlated with the two MMPI-2 posttraumatic stress scales. Clinically, chest pain was more frequently reported by severe stress patients than moderate stress patients. MMPI-2 clinical scales vary significantly according to the severity of stress, and "mild stress" patients have increased hysteria and depression scales and showed a higher frequency of irritable bowel syndrome-diarrhea. This study shows that severe stress severity is associated with a higher frequency of noncardiac chest pain and correlated with most personality items.

Summary Background While all resources have been mobilized to fight COVID-19, this study aimed to analyze the consequences of lockdown and pandemic stress in participants with and without Irritable Bowel Syndrome (IBS). Methodology An online survey was proposed to people with or without IBS during the exponential phase of the pandemic in France. The questionnaire included questions about socio-demographic data, conditions of confinement , activities carried out, IBS characteristics, measurement of stress level, consequences on sleep, fatigue, anxiety and depression, and quality of life (both perceived non-specific and specific for IBS). Results/Discussion From March 31 to April 15, 2020, 304 participants, 232 with IBS and 72 without were included in the survey (mean age: 46.8 ± 16.8 years, female gender: 75.3%). Age, level of education, financial resources, living space per person and activities performed during confinement were identical in both groups. Stress linked to fear of COVID-19, lockdown and financial worries was at the same level in both groups, but the psychological consequences and deterioration of quality of life (QOL) were both higher in IBS participants. In a univariate analysis , teleworking, solitary confinement, and low household resources had a variable impact on the scores of depression, anxiety, fatigue and non-specific perceived QOL, but in a multivariate analysis , the only factor explaining a deterioration of non-specific QOL was the fact of suffering from IBS. Conclusion/Perspectives Stress linked to the COVID-19 pandemic and confinement is high and equivalent in both IBS and non-IBS participants, with higher psychological and QOL consequences in IBS patients who have altered coping capacities.

This essay argues for the prominence of angelic figures in queer post-WWII American literature. John Rechy in particular provides a useful starting point for understanding this proliferati...

Although direct oral anticoagulants (DOACs) are associated with an overall favourable safety profile, the risk of gastrointestinal bleeding with DOACs compared with vitamin K antagonists (VKAs) remains controversial. Accordingly, we aimed to provide a focused overview of the risk of gastrointestinal bleeding associated with dabigatran, rivaroxaban, apixaban and edoxaban and its management. We reviewed published studies reporting on DOACs with gastrointestinal bleeding as an outcome, including randomised controlled trials (RCTs), retrospective database studies and large-scale prospective cohort studies. Cumulative evidence confirms no notable difference in major gastrointestinal bleeding risk between DOACs and VKAs. Moreover, gastrointestinal bleeding in DOAC-treated patients seems less severe and requires less intensive management. The main cause of upper gastrointestinal bleeding in DOAC-treated patients appears to be gastroduodenal ulcers, whereas lower gastrointestinal bleedings are mainly due to diverticula followed by angiodysplasia and haemorrhoids. The lack of head-to-head RCTs with DOACs precludes drawing conclusions on the DOAC with the lowest gastrointestinal bleeding risk. Prescribing physicians should be aware of risk factors for DOAC-related gastrointestinal bleeding (e.g. age > 65, heavy alcohol use, uncontrolled hypertension, hepatic or renal dysfunction, active cancer, anaemia) and adopt preventive measures accordingly. Management of DOAC-associated major gastrointestinal bleeding involves temporary discontinuation of the DOAC, investigation of the bleeding source and treatment of bleeding with fluid resuscitation combined with transfusion and endoscopic haemostasis. DOACs as a class do not increase the risk of major gastrointestinal bleeding compared to VKAs, which supports their continued use for different anticoagulant indications.

BACKGROUND AND AIM Functional gastrointestinal disorders (FGIDs) are frequently overlapped. The present study was designed to (i) search the clinical differences between patients with single FGID and overlap FGIDs and (ii) define the most common FGIDs associations to identify homogenous subgroups of patients. METHODS A total of 3555 outpatients with FGID filled out the Rome III adult diagnostic questionnaire, Bristol stool form, and four 10-point Likert scales to report the severity of constipation, diarrhea, bloating, and abdominal pain. An unsupervised algorithm was used to estimate the number of groups directly from the data. A classification tree separated patients into different subgroups, according to FGIDs. Multinomial logistic regression was used to characterize the groups of patients with overlap disorders. RESULTS Patients reported 3.3 ± 1.9 FGIDs (range 1-10, median = 3); 736 reported only one FGID, while 2819 reported more than one FGID (3.8 ± 1.7). Patients with single FGID had higher body mass index (P

Previous studies have found a correlation between malnutrition and prognosis in respiratory infections. Our objectives were to determine (i) the percentage of malnutrition, and (ii) its prognosis in patients admitted for coronavirus disease 2019 (COVID-19). In this monocentric retrospective study, we consecutively included all adult patients presenting with acute COVID-19 between 9 April and 29 May 2020. Malnutrition was diagnosed on low body mass index (BMI) and weight loss &ge, 5% in the previous month and/or &ge, 10% in the previous six months. The Nutritional Risk Index (NRI) defined nutritional risk. Severe COVID-19 was defined as a need for nasal oxygen &ge, 6 L/min. We enrolled 108 patients (64 men, 62 &plusmn, 16 years, BMI 28.8 &plusmn, 6.2 kg/m2), including 34 (31.5%) with severe COVID-19. Malnutrition was found in 42 (38.9%) patients, and moderate or severe nutritional risk in 83 (84.7%) patients. Malnutrition was not associated with COVID-19 severity. Nutritional risk was associated with severe COVID-19 (p &lt, 0.01, p &lt, 0.01 after adjustment for C reactive protein), as were lower plasma proteins, albumin, prealbumin, and zinc levels (p &lt, 0.01). The main cause of malnutrition was inflammation. The high percentage of malnutrition and the association between nutritional risk and COVID-19 prognosis supports international guidelines advising regular screening and nutritional support when necessary.

Sustained changes in mood or action require persistent changes in neural activity, but it has been difficult to identify the neural circuit mechanisms that underlie persistent activity and contribute to long-lasting changes in behavior. Here, we show that a subset of Doublesex+ pC1 neurons in the Drosophila female brain, called pC1d/e, can drive minutes-long changes in female behavior in the presence of males. Using automated reconstruction of a volume electron microscopic (EM) image of the female brain, we map all inputs and outputs to both pC1d and pC1e. This reveals strong recurrent connectivity between, in particular, pC1d/e neurons and a specific subset of Fruitless+ neurons called aIPg. We additionally find that pC1d/e activation drives long-lasting persistent neural activity in brain areas and cells overlapping with the pC1d/e neural network, including both Doublesex+ and Fruitless+ neurons. Our work thus links minutes-long persistent changes in behavior with persistent neural activity and recurrent circuit architecture in the female brain.

Everett's relative-state construction in quantum theory has never been satisfactorily expressed in the Heisenberg picture. What one might have expected to be a straightforward process was impeded by conceptual and technical problems that we solve here. The result is a construction which, unlike Everett's one in the Schrödinger picture, makes manifest the locality of Everettian multiplicity, its inherently approximative nature and its origin in certain kinds of entanglement and locally inaccessible information. (By Everettian , we are referring not only to Everett's own work, but also to versions of quantum theory that elaborate and refine his. The notion of relative states first appeared in Everett (Everett 1973 In The many worlds interpretation of quantum mechanics (eds BS DeWitt, N Graham)). We are proposing a formalism for relative states that is more detailed and more illuminating than Everett's.) Our construction also allows us to give a more precise definition of an Everett ‘universe’, under which it is fully quantum, not quasi-classical, and we compare the Everettian decomposition of a quantum state with the foliation of a space–time.