Prenatal ultrasound diagnosis of velamentous cord insertion: a case report and review of the literature

PURPOSE

The velamentous cord insertion is a rare pathology in which the umbilical blood vessels branch before reaching the placenta; by varying its structure, the cord becomes prone to spontaneous internal ruptures. This pathology is an obstetric emergency, so its early diagnosis is essential.

METHODS AND RESULTS

We present a 27-year-old pregnant woman who attends an antenatal check-up for a routine third-trimester examination. Ultrasound reveals grade I polyhydramnios and suggestive findings of a trivascular umbilical cord with velamentous insertion 35 mm from the nearest placental border. The ultrasound diagnosis allowed a term delivery by elective cesarean section, avoiding severe complications of the maternal-fetal binomial.

CONCLUSION

Velamentous cord insertion can and should have an early prenatal diagnosis, even from the second trimester, through imaging techniques such as transabdominal ultrasound or color Doppler. Early detection and appropriate peripartum management will highly reduce complications during labor.

Analysing spatio-temporal drought characteristics and copula-based return period in Indian Gangetic Basin (1901-2021)

Uncertainty and uneven distribution of monsoonal rainfall and its consequences on crop production is a matter of serious concern in India, specifically, in the Indo-Gangetic plain region. In this study, drought patterns were investigated through standardised precipitation index (SPI) of varying timescales, using the India Meteorological Department (IMD) precipitation data (1901-2021). We analysed the spatio-temporal pattern of different drought characteristics (frequency, duration, severity, intensity) of the Indian Gangetic basin using run theory. The bivariate copula method has been incorporated to combine two drought properties (severity and duration). Copula integrates multivariate distribution and considers the dependency rate among the variables. The five most widely used copulas from various copula families, elliptical (normal, t-copula) and Archimedean (Clayton, Gumbel, Frank), were estimated for modelling, and the best fit copula was selected. The study revealed that seasonal drought is more frequent and intense in the Upper and Middle Gangetic Plain, whereas annual drought is quite scattered in nature. It is worthy to mention that downward drought trends were observed in this agricultural belts significantly after 1965; specifically, in the Upper, Middle, and Trans Gangetic Plain regions. With increasing drought duration and severity, the drought return period raised, but the frequency decreased gradually. Most of the droughts characterised by less duration and severity occurred with a return period below 10 years for the whole region. The major 100 + years return period droughts were to be found after 1960 and their frequencies were significantly higher after 2000. The most recent remarkable droughts with more than 100 years of return occurred during 2008-2011 and 2016-2018 in the Upper and Middle Gangetic plains, whereas in the Lower Gangetic plain, a hundred-year return period drought was occurred during 2010-2013. This study provides agroclimatic-zones-wise significant information of drought characteristics and its nature of occurrence in the Indian Ganga Basin. The results enhance the understanding of drought management and formulation of adaptive strategies to mitigate the adverse impact of droughts.

Whole brain irradiation-induced endothelial dysfunction in the mouse brain

Whole brain irradiation (WBI), also known as whole brain radiation therapy (WBRT), is a well-established treatment for multiple brain metastases and as a preventive measure to reduce the risk of recurrence after surgical removal of a cerebral metastasis. However, WBI has been found to lead to a gradual decline in neurocognitive function in approximately 50% of patients who survive the treatment, significantly impacting their overall quality of life. Recent preclinical investigations have shed light on the underlying mechanisms of this adverse effect, revealing a complex cerebrovascular injury that involves the induction of cellular senescence in various components of the neurovascular unit, including endothelial cells. The emergence of cellular senescence following WBI has been implicated in the disruption of the blood-brain barrier and impairment of neurovascular coupling responses following irradiation. Building upon these findings, the present study aims to test the hypothesis that WBI-induced endothelial injury promotes endothelial dysfunction, which mimics the aging phenotype. To investigate this hypothesis, we employed a clinically relevant fractionated WBI protocol (5 Gy twice weekly for 4 weeks) on young mice. Both the WBI-treated and control mice were fitted with a cranial window, enabling the assessment of microvascular endothelial function. In order to evaluate the endothelium-dependent, NO-mediated cerebral blood flow (CBF) responses, we topically administered acetylcholine and ATP, and measured the resulting changes using laser Doppler flowmetry. We found that the increases in regional CBF induced by acetylcholine and ATP were significantly diminished in mice subjected to WBI. These findings provide additional preclinical evidence supporting the notion that WBI induces dysfunction in cerebrovascular endothelial cells, which in turn likely contributes to the detrimental long-term effects of the treatment. This endothelial dysfunction resembles an accelerated aging phenotype in the cerebrovascular system and is likely causally linked to the development of cognitive impairment. By integrating these findings with our previous results, we have deepened our understanding of the lasting consequences of WBI. Moreover, our study underscores the critical role of cerebromicrovascular health in safeguarding cognitive function over the long term. This enhanced understanding highlights the importance of prioritizing cerebromicrovascular health in the context of preserving cognitive abilities.

Agricultural drought in the Vietnamese Central Highlands at 1-km resolution: Monthly and annual datasets

Drought is a complex natural hazard which can create significant impacts on society and environment. Given that this phenomenon varies across space and changes over time dependent on various factors (e.g., physical conditions and human activities), the available of spatiotemporal drought data enables a better monitoring and assessment of drought severity This study introduced the integrated multivariate drought index (iMDI) data, a new regional drought index, at 1 km spatial and monthly temporal resolutions for the Vietnamese Central Highlands over a 20-years period. The iMDI was developed recently which is a combination of vegetation condition index (VCI), the temperature condition index (TCI), and the evaporative stress index (ESI) based on the feature of scaling algorithms (i.e., normalisations and standardisation). The data were processed using the median values of MODIS time-series imagery obtained from the Google Earth Engine (GEE) platform. The iMDI datasets are available for monthly and annual drought monitoring between 2001 and 2020. Additionally, the datasets of VCI, TCI, and ESI were provided so that users can apply for their own purposes even though these data can directly obtain from GEE or other sources. Users, especially those without technical expertise, can reap the advantages of having open access to iDMI data. By doing so, they can reduce their expenses and the time required to process data. As such, this accessibility can promote the use of data for diverse applications, such as evaluating the impact of droughts on the environment and human activities and monitoring droughts regionally.

Negative correlation between serum pyruvate kinase M2 and cognitive function in patients with cerebral small vessel disease

OBJECTIVE

Cerebral small vessel disease (CSVD) is one of the main contributing factors to vascular cognitive impairment (VCI), with an increasing incidence rate. However, the genesis of CSVD cognitive impairment remains unknown. Inflammation and metabolic disorders are considered important pathogenesis of CSVD. In addition to acting as the key regulator of aerobic glycolysis, pyruvate kinase muscle isozyme 2 (PKM2) is a proinflammatory mediator transcriptional activator that can promote an inflammatory response. This study explored whether serum PKM2 is associated with cognitive impairment in CSVD patients.

METHODS

The demographic data, history of risk factors, laboratory data, and cognitive function scale assessment of 219 CSVD patients were analyzed, and the correlation between the CSVD clinical data and neuroimaging parameters with serum PKM2 was further explored. The serum PKM2 level was determined by enzyme-linked immunosorbent assay using the collected serum samples. Insulin resistance (IR) was assessed with reference to the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). HOMA-IR was calculated using the formula HOMA-IR = fasting plasma glucose (FPG, mmol/L) × fasting insulin (FINS, μU/mL)/22.5. A binomial logistic regression model was referred to infer the risk factors for VCI, and the ability of serum PKM2 to diagnose VCI was assessed by using a ROC curve.

RESULTS

Serum PKM2 level was positively correlated with HOMA-IR (r = 0.206, P = 0.002), negatively correlated with MMSE and MOCA on the cognitive scale in CSVD patients, and higher in CSVD patients with white matter hyperintensities (WMH) (P < 0.001). When compared with patients without cognitive impairment, the serum PKM2 levels were elevated in cases with suspected dementia, mild dementia, mild to moderate dementia, and moderate to severe dementia, and the differences were statistically significant (P < 0.05). Serum PKM2 levels were correlated with cognitive screening test scores in CSVD.

CONCLUSION

The present findings indicated that the serum PKM2 level was positively correlated with HOMA-IR, WMH, and enlarged perivascular spaces and negatively correlated with cognitive function in CSVD patients.

Role of Vitamin D Deficiency in the Pathogenesis of Cardiovascular and Cerebrovascular Diseases

Deficiency in vitamin D (VitD), a lipid-soluble vitamin and steroid hormone, affects approximately 24% to 40% of the population of the Western world. In addition to its well-documented effects on the musculoskeletal system, VitD also contributes importantly to the promotion and preservation of cardiovascular health via modulating the immune and inflammatory functions and regulating cell proliferation and migration, endothelial function, renin expression, and extracellular matrix homeostasis. This brief overview focuses on the cardiovascular and cerebrovascular effects of VitD and the cellular, molecular, and functional changes that occur in the circulatory system in VitD deficiency (VDD). It explores the links among VDD and adverse vascular remodeling, endothelial dysfunction, vascular inflammation, and increased risk for cardiovascular and cerebrovascular diseases. Improved understanding of the complex role of VDD in the pathogenesis of atherosclerotic cardiovascular diseases, stroke, and vascular cognitive impairment is crucial for all cardiologists, dietitians, and geriatricians, as VDD presents an easy target for intervention.

Age-related decline in circulating IGF-1 associates with impaired neurovascular coupling responses in older adults

Impairment of moment-to-moment adjustment of cerebral blood flow (CBF) to the increased oxygen and energy requirements of active brain regions via neurovascular coupling (NVC) contributes to the genesis of age-related cognitive impairment. Aging is associated with marked deficiency in the vasoprotective hormone insulin-like growth factor-1 (IGF-1). Preclinical studies on animal models of aging suggest that circulating IGF-1 deficiency is causally linked to impairment of NVC responses. The present study was designed to test the hypotheses that decreases in circulating IGF-1 levels in older adults also predict the magnitude of age-related decline of NVC responses. In a single-center cross-sectional study, we enrolled healthy young (n = 31, 11 female, 20 male, mean age: 28.4 + / - 4.2 years) and aged volunteers (n = 32, 18 female, 14 male, mean age: 67.9 + / - 4.1 years). Serum IGF-1 level, basal CBF (phase contrast magnetic resonance imaging (MRI)), and NVC responses during the trail making task (with transcranial Doppler sonography) were assessed. We found that circulating IGF-1 levels were significantly decreased with age and associated with decreased basal CBF. Age-related decline in IGF-1 levels predicted the magnitude of age-related decline in NVC responses. In conclusion, our study provides additional evidence in support of the concept that age-related circulating IGF-1 deficiency contributes to neurovascular aging, impairing CBF and functional hyperemia in older adults.

Evaluation of Three Feature Dimension Reduction Techniques for Machine Learning-Based Crop Yield Prediction Models

Machine learning (ML) has been widely used worldwide to develop crop yield forecasting models. However, it is still challenging to identify the most critical features from a dataset. Although either feature selection (FS) or feature extraction (FX) techniques have been employed, no research compares their performances and, more importantly, the benefits of combining both methods. Therefore, this paper proposes a framework that uses non-feature reduction (All-F) as a baseline to investigate the performance of FS, FX, and a combination of both (FSX). The case study employs the vegetation condition index (VCI)/temperature condition index (TCI) to develop 21 rice yield forecasting models for eight sub-regions in Vietnam based on ML methods, namely linear, support vector machine (SVM), decision tree (Tree), artificial neural network (ANN), and Ensemble. The results reveal that FSX takes full advantage of the FS and FX, leading FSX-based models to perform the best in 18 out of 21 models, while 2 (1) for FS-based (FX-based) models. These FXS-, FS-, and FX-based models improve All-F-based models at an average level of 21% and up to 60% in terms of RMSE. Furthermore, 21 of the best models are developed based on Ensemble (13 models), Tree (6 models), linear (1 model), and ANN (1 model). These findings highlight the significant role of FS, FX, and specially FSX coupled with a wide range of ML algorithms (especially Ensemble) for enhancing the accuracy of predicting crop yield.

Network pharmacology-based strategy to investigate pharmacological mechanisms of Andrographolide for treatment of vascular cognitive impairment

Vascular cognitive impairment (VCI) is the second most common form of dementia. Andrographolide (Andro) shows potential effects in anti-inflammation, anti-oxidative stress, and anti-apoptosis. We have obtained 48 potential genes related to the effect of Andro on VCI through network pharmacology analysis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were used to reveal significant enriched pathway of potential genes, and the mitogen-activated protein kinase (MAPK) pathway was screened out. To verify the results of network pharmacology, we tested the effects of Andro in VCI model induced by bilateral common carotid artery occlusion (BCCAO) surgery. The results showed that Andro treatment ameliorated the cognitive impairment induced by BCCAO. Immunohistochemistry study revealed that Andro could reduce neuronal damage and activation of microglia in the cortex and hippocampus in BCCAO rats. To test the MAPK pathway changes, we analyzed the expression of JNK, p38 and ERK and found that Andro reduced the levels of phosphorylated-ERK (p-ERK) and phosphorylated-p38 (p-p38) in BCCAO rats. In conclusion, Andro could improve neuronal survival, reduce neuroinflammation and ameliorate cognitive impairment in VCI. The underlying mechanisms of Andro treatment may be through the inhibition of MAPK pathway.

Cerebral venous congestion exacerbates cerebral microhemorrhages in mice

Cerebral microhemorrhages (CMHs; microbleeds), which are small focal intracerebral hemorrhages, importantly contribute to the pathogenesis of cognitive decline and dementia in older adults. Although recently it has been increasingly recognized that the venous side of the cerebral circulation likely plays a fundamental role in the pathogenesis of a wide spectrum of cerebrovascular and brain disorders, its role in the pathogenesis of CMHs has never been studied. The present study was designed to experimentally test the hypothesis that venous congestion can exacerbate the genesis of CMHs. Increased cerebral venous pressure was induced by internal and external jugular vein ligation (JVL) in C57BL/6 mice in which systemic hypertension was induced by treatment with angiotensin II plus L-NAME. Histological analysis (diaminobenzidine staining) showed that mice with JVL developed multiple CMHs. CMHs in mice with JVL were often localized adjacent to veins and venules and their morphology was consistent with venous origin of the bleeds. In brains of mice with JVL, a higher total count of CMHs was observed compared to control mice. CMHs were distributed widely in the brain of mice with JVL, including the cortical gray matter, brain stem, the basal ganglia, subcortical white matter, cerebellum, and the hippocampi. In mice with JVL, there were more CMHs predominantly in cerebral cortex, brain stem, and cerebellum than in control mice. CMH burden, defined as total CMH volume, also significantly increased in mice with JVL. Thus, cerebral venous congestion can exacerbate CMHs. These observations have relevance to the pathogenesis of cognitive impairment associated with right heart failure as well as elevated cerebral venous pressure due to jugular venous reflux in older adults.

Endothelial deficiency of insulin-like growth factor-1 receptor (IGF1R) impairs neurovascular coupling responses in mice, mimicking aspects of the brain aging phenotype

Age-related impairment of neurovascular coupling (NVC; or "functional hyperemia") compromises moment-to-moment adjustment of regional cerebral blood flow to increased neuronal activity and thereby contributes to the pathogenesis of vascular cognitive impairment (VCI). Previous studies established a causal link among age-related decline in circulating levels of insulin-like growth factor-1 (IGF-1), neurovascular dysfunction and cognitive impairment. Endothelium-mediated microvascular dilation plays a central role in NVC responses. To determine the functional consequences of impaired IGF-1 input to cerebromicrovascular endothelial cells, endothelium-mediated NVC responses were studied in a novel mouse model of accelerated neurovascular aging: mice with endothelium-specific knockout of IGF1R (VE-Cadherin-Cre^ERT2/Igf1r^f/f). Increases in cerebral blood flow in the somatosensory whisker barrel cortex (assessed using laser speckle contrast imaging through a cranial window) in response to contralateral whisker stimulation were significantly attenuated in VE-Cadherin-Cre^ERT2/Igf1r^f/f mice as compared to control mice. In VE-Cadherin-Cre^ERT2/Igf1r^f/f mice, the effects of the NO synthase inhibitor L-NAME were significantly decreased, suggesting that endothelium-specific disruption of IGF1R signaling impairs the endothelial NO-dependent component of NVC responses. Collectively, these findings provide additional evidence that IGF-1 is critical for cerebromicrovascular endothelial health and maintenance of normal NVC responses.

VCI-Based Analysis on Spatiotemporal Variations of Spring Drought in China

The analysis of spatiotemporal variations in drought is important for environmental monitoring and agricultural production. In this study, the spring vegetative drought conditions in China were analyzed by using the vegetation condition index (VCI) as an indicator to reveal the drought characteristics in China from 1981–2015. The results suggest that spring vegetative drought (especially moderate drought) occurs frequently in China, and drought conditions have obvious geographical differences and are highly affected by monsoons. The frequency of spring vegetative drought is relatively high in the southern and northern regions, which are greatly affected by monsoons, and is relatively low in the northwestern and Qinghai-Tibet regions, which are less affected by monsoons. During 1981–2015, the spring VCI in China showed an overall upward trend. In addition, the trend was not a single change but a wave-like increasing trend that can be divided into four stages: (1) a stage of slow growth from 1981–1990, (2) a stage of intense fluctuations from 1991–2000, (3) a stage of steady growth from 2001–2010, and (4) a stage of slow descent after 2010. The Mann–Kendall test confirmed that the spring VCI in China was increasing, and the changes in the southern, northwestern, and Qinghai-Tibet regions reached significant levels. The time point of mutation in the southern region was 2000, and that in the northwestern and Qinghai-Tibet regions was 1992. Wavelet time series analysis showed that spring vegetation drought in China has a short-period oscillation of 5–7 years and a long-period oscillation of approximately 23–28 years. The northwestern and Qinghai-Tibet regions, which are less affected by the monsoons, are dominated by long-period oscillations, while the southern and northern regions, which are more affected by the monsoons, are dominated by short-period oscillations.

Drought disaster monitoring using MODIS derived index for drought years: A space-based information for ecosystems and environmental conservation

Drought disaster is one of the major factors restricting the development of vegetation across a wide variety of environments. Monitoring the temporal and spatial dynamics of drought episodes in the study area is crucial for environmental and ecosystem conservation. This study assesses drought disaster by utilising space-based data and R programming for drought years 2003, 2007, 2012 and 2019 in the Free State Province, South Africa. Results revealed that the study area witnessed drought events in the year 2003 where March, August, September, October, November and December were more affected by drought disaster events. It was further observed that February and March were affected by extreme drought conditions in the year 2007. In year 2012, January, October, November and December, there exist moderate to severe drought conditions in the study area where some regions were more affected than the other. Finally, year 2019 witnessed variations in drought event distributions across the months with January, October and November witnessing severe to extreme drought conditions from about 0 to 30% drought values. Overall, this study shows that the 16-day Terra-MODIS composite and EVI products are sensitive to stressors associated with drought. The Vegetation Condition Monitoring Index (VCI) based on MODIS is suited for monitoring drought disasters. The technique used in this study revealed the suitability of MODIS data for assessing drought conditions and their potential environmental impacts.

IGF1R signaling regulates astrocyte-mediated neurovascular coupling in mice: implications for brain aging

Aging is associated with a significant deficiency in circulating insulin-like growth factor-1 (IGF-1), which has an important role in the pathogenesis of age-related vascular cognitive impairment (VCI). Impairment of moment-to-moment adjustment of regional cerebral blood flow via neurovascular coupling (NVC) importantly contributes to VCI. Previous studies established a causal link between circulating IGF-1 deficiency and neurovascular dysfunction. Release of vasodilator mediators from activated astrocytes plays a key role in NVC. To determine the impact of impaired IGF-1 signaling on astrocytic function, astrocyte-mediated NVC responses were studied in a novel mouse model of astrocyte-specific knockout of IGF1R (GFAP-CreERT2/Igf1rf/f) and accelerated neurovascular aging. We found that mice with disrupted astrocytic IGF1R signaling exhibit impaired NVC responses, decreased stimulated release of the vasodilator gliotransmitter epoxy-eicosatrienoic acids (EETs), and upregulation of soluble epoxy hydrolase (sEH), which metabolizes and inactivates EETs. Collectively, our findings provide additional evidence that IGF-1 promotes astrocyte health and maintains normal NVC, protecting cognitive health.

Aerobic exercise improves VCI through circRIMS2/miR-186/BDNF-mediated neuronal apoptosis

BACKGROUND

Vascular cognitive impairment (VCI) is a common cognitive disorder caused by cerebrovascular disease, ranging from mild cognitive impairment to dementia. Studies have shown that aerobic exercise might alleviate the pathological development of VCI, and our previous study observed that aerobic exercise could alleviate VCI through NF-κB/miR-503/BDNF pathway. However, there are few studies on the mechanism. Therefore, it is of great significance to fill the gaps in the mechanism for the early diagnosis of VCI and the clinical prevention and treatment of vascular dementia.

METHODS

CircRNA microarray analysis and quantitative real-time PCR were used to detect the expression of circRNA regulating synaptic be exocytosis 2 (RIMS2) (circRIMS2). Cell apoptosis was determined by TdT-mediated dUTP nick-end labeling (TUNEL) assay. The dual-luciferase reporter assay was performed to verify the interaction between circRIMS2 and miR-186, as well as miR-186 and BDNF. RNA pull-down assay detected the binding between circRIMS2 and miR-186. A VCI mouse model was established by repeated ligation of bilateral common carotid arteries (2VO). The lentiviral interfering vector was injected into the VCI mice through the lateral ventricle. The mice in the aerobic exercise group performed 30 min (12 m/min) running for 5 days a week. A Morris water maze test was performed after 4 weeks.

RESULTS

The expression of circRIMS2 and BDNF in the serum of VCI patients was significantly reduced, miR-186 expression was increased, and the expression of circRIMS2 was increased in the 2VO group of mice undergoing aerobic exercise. The expression levels of circRIMS2 and BDNF in the oxygen and glucose deprivation-treated (OGD-treated) cells were decreased, the miR-186 expression and cell apoptosis were increased, while the effect was weakened after transfection with the lentiviral vector pLO-ciR-RIMS2. CircRIMS2 could bind to miR-186, and after interference with circRIMS2 in HT22 cells, the expression of miR-186 was increased. Besides, miR-186 could bind to BDNF, and BDNF expression was decreased because of the overexpression of miR-186 in HT22 cells. The expression level of BDNF in the pLO-ciR-RIMS2 group was increased, and apoptosis was decreased, but the miR-186 mimic weakened the effect of pLO-ciR-RIMS2. Aerobic exercise could shorten the average time that mice reached the platform in the Morris water maze, increase the expression level of circRIMS2 and BDNF, reduce miR-186 expression, and inhibit neuronal apoptosis. However, the interference with circRIMS2 weakened this effect.

CONCLUSION

The expression of circRIMS2 was down-regulated in VCI and aerobic exercise reduced neuronal apoptosis, and circRIMS2 improved VCI through the circRIMS2/miR-186/BDNF axis.

Path Integration Changes as a Cognitive Marker for Vascular Cognitive Impairment?-A Pilot Study

Path integration spatial navigation processes are emerging as promising cognitive markers for prodromal and clinical Alzheimer’s disease (AD). However, such path integration changes have been less explored in Vascular Cognitive Impairment (VCI), despite neurovascular change being a major contributing factor to dementia and potentially AD. In particular, the sensitivity and specificity of path integration impairments in VCI compared to AD is unclear. In the current pilot study, we explore path integration performance in early-stage AD and VCI patient groups and hypothesize that: (i) medial parietal mediated egocentric processes will be more affected in VCI; and (ii) medial temporal mediated allocentric processes will be more affected in AD. This cross-sectional study included early-stage VCI patients (n = 9), AD patients (n = 10) and healthy age-matched controls (n = 20). All participants underwent extensive neuropsychological testing, as well as spatial navigation testing. The spatial navigation tests included the virtual reality “Supermarket” task assessing egocentric (body-based) and allocentric (map-based) navigation as well as the “Clock Orientation” test assessing egocentric and path integration processes. Results showed that egocentric integration processes are only impaired in VCI, potentially distinguishing it from AD. However, in contrast to our prediction, allocentric integration was not more impaired in AD compared to VCI. These preliminary findings suggest limited specificity of allocentric integration deficits between VCI and AD. By contrast, egocentric path integration deficits emerge as more specific to VCI, potentially allowing for more specific diagnostic and treatment outcome measures for vascular impairment in dementia.

Evaluating the utility of various drought indices to monitor meteorological drought in Tropical Dry Forests

Even though existing remote-sensing-based drought indices are widely used in many different types of ecosystems, their utility has not been widely assessed in tropical dry forests (TDFs). The aim of this study is to evaluate the performance of three remote-sensing-based drought indices, the Vegetation Condition Index (VCI), Temperature Condition Index (TCI), and Vegetation Health Index (VHI), for meteorological drought monitoring in TDFs using the moderate-resolution imaging spectroradiometer (MODIS) products. The correlation between the VCI, TCI, and VHI and multiple time scales of the Standardized Precipitation Index (SPI) (1, 3, 6, 9, 12, 15, 18, 21, 24 months) for each month (January to December) and each season (dry season, dry-to-wet season, wet season and wet-to-dry season) were conducted using the Pearson correlation analysis. We also correlated year-to-year changes of satellite-based drought indices with the changes of the in situ annual SPI (A_SPI) which provides annual information on the mean meteorological drought. The analysis reveals that the ability of these remote-sensing-based drought indices for meteorological drought monitoring varies with timing, and the TCI outperforms the VCI and VHI in terms of seasonal and annual scale. These remote-sensing indices performed well in monitoring meteorological drought in the dry season, poorly in the in the dry-to-wet season, and moderately in the wet season. The TCI performed best in monitoring meteorological drought in the wet-to-dry period, followed by VHI, whereas the VCI performed worst. All of these remote-sensing-based drought indices failed to detect drought in May during the green-up period and in September, October, and November when the water content in the root regions was abundant. Our results indicate that the evapotranspiration of TDFs is more sensitive than canopy greenness to detect meteorological drought. Results from this study increase the ability to provide real-time drought monitoring and early warnings of drought in TDFs.

Consistency of agricultural drought characterization over Upper Greater Horn of Africa (1982-2013): Topographical, gauge density, and model forcing influence

The negative impact of Upper Greater Horn of Africa's (UGHA) complex topography on drought characterization exacerbated by gauge density and model forcing parameters has not been investigated. In order to fill this gap, this study employs a combination of remotely sensed, in situ, and model products (1982-2013); precipitation (CHIRPS, GPCC, and CHIRP), soil moisture (ERA-Interim, MERRA-2, CPC, GLDAS, and FLDAS), vegetation condition index (VCI), and total water storage products (GRACE and MERRA-2) to (i) characterize drought, (ii) explore the inconsistencies in areas under drought due to topographical variations, gauge density, and model forcing parameters, and (iii), assess the effectiveness of various drought indicators over Ethiopia (a selected UGHA region with unique topographical variation). A 3-month time scale that sufficiently captures agricultural drought is employed to provide an indirect link to food security situation in this rain-dependent region. The spatio-temporal drought patterns across all the products are found to be dependent on topography of the region, at the same time, the inconsistencies in characterizing drought is found to be mainly driven by topographical variability (directly) and gauge density (inversely) for precipitation products while for soil moisture products, precipitation forcing parameters plays a major role. In addition, the inconsistencies are found to be higher under extreme and moderate droughts than severe droughts. The mean differences in the percentage of areas under drought and different drought intensities over the region are on average 15.87% and 6.16% (from precipitation products) and 12.65% and 5.20% (from soil moisture products), respectively. On the effectiveness of various indicators, for the duration under study, the following were found to be most suitable over Ethiopia; VCI, GPCC, ERA, CPC, and FLDAS. These results are critical in putting into perspective drought analysis outcomes from various products.

Obesity in Aging Exacerbates Neuroinflammation, Dysregulating Synaptic Function-Related Genes and Altering Eicosanoid Synthesis in the Mouse Hippocampus: Potential Role in Impaired Synaptic Plasticity and Cognitive Decline

There is strong evidence that obesity has deleterious effects on cognitive function of older adults. Previous preclinical studies demonstrate that obesity in aging is associated with a heightened state of systemic inflammation, which exacerbates blood-brain barrier disruption, promoting neuroinflammation and oxidative stress. To test the hypothesis that synergistic effects of obesity and aging on inflammatory processes exert deleterious effects on hippocampal function, young and aged C57BL/6 mice were rendered obese by chronic feeding of a high-fat diet followed by assessment of learning and memory function, measurement of hippocampal long-term potentiation (LTP), assessment of changes in hippocampal expression of genes relevant for synaptic function and determination of synaptic density. Because there is increasing evidence that altered production of lipid mediators modulate LTP, neuroinflammation and neurovascular coupling responses, the effects of obesity on hippocampal levels of relevant eicosanoid mediators were also assessed. We found that aging exacerbates obesity-induced microglia activation, which is associated with deficits in hippocampal-dependent learning and memory tests, impaired LTP, decreased synaptic density, and dysregulation of genes involved in regulation of synaptic plasticity. Obesity in aging also resulted in an altered hippocampal eicosanoid profile, including decreases in vasodilator and pro-LTP epoxy-eicosatrienoic acids (EETs). Collectively, our results taken together with previous findings suggest that obesity in aging promotes hippocampal inflammation, which in turn may contribute to synaptic dysfunction and cognitive impairment.

Drought in Portugal: Current regime, comparison of indices and impacts on extreme wildfires

In Portugal, drought characterizes the climatic variability, contributes to the increase of fire risk and its duration and intensity are expected to increase in future climate. Surprisingly, the quantitative and objective analysis to characterize the drought regime in current climate conditions as well as its influence on the occurrence of large wildfires (LW) has never been done for Portugal, which are the main objectives of this study. We assessed drought regime for recent past climate conditions (1981-2017), using four different drought indices, namely SPI, SPEI, RDI and VCI, and assessed the influence of drought in LW occurrence. Results include the characterization of drought number, duration, severity, intensity, extension, intra- and inter-annual variability for different classes of severity and the space-time distribution of LW in drought periods and affected area. Our main findings include 67% of the study period were drought months; regions with higher drought duration and severity assessed with SPI and SPEI for general drought conditions evolves from north to south with the increase of drought assessment period; drought characteristics present low intra - annual and inter - annual variability but are clearly associated to the temporal and spatial distribution of LW. In fact, all LW occurred during drought assessed with SPI or SPEI, almost all LW (97% to 95%) and corresponding burnt area (98% to 97%) occurred during drought assessed with SPI and SPEI. The relationship between drought and fire incidence is statistical significant for 3 - month SPI, 3 - and 6 - month SPEI, and is particularly strong for Moderate and Severe drought. 85% and 87% of LW occurred in area affected by drought assessed with SPI or SPEI, respectively. It is not clear which is the best index, but drought plays a fundamental role in the occurrence of large wildfires in Portugal.

Assessment of age-related decline of neurovascular coupling responses by functional near-infrared spectroscopy (fNIRS) in humans

Preclinical studies provide strong evidence that age-related impairment of neurovascular coupling (NVC) plays a causal role in the pathogenesis of vascular cognitive impairment (VCI). NVC is a critical homeostatic mechanism in the brain, responsible for adjustment of local cerebral blood flow to the energetic needs of the active neuronal tissue. Recent progress in geroscience has led to the identification of critical cellular and molecular mechanisms involved in neurovascular aging, identifying these pathways as targets for intervention. In order to translate the preclinical findings to humans, there is a need to assess NVC in geriatric patients as an endpoint in clinical studies. Functional near-infrared spectroscopy (fNIRS) is a non-invasive neuroimaging technique that enables the investigation of local changes in cerebral blood flow, quantifying task-related changes in oxygenated and deoxygenated hemoglobin concentrations. In the present overview, the basic principles of fNIRS are introduced and the application of this technique to assess NVC in older adults with implications for the design of studies on the mechanistic underpinnings of VCI is discussed.

Cerebral venous congestion promotes blood-brain barrier disruption and neuroinflammation, impairing cognitive function in mice

Cognitive impairment is one of the most common co-occurring chronic conditions among elderly heart failure patients (incidence: up to ~ 80%); however, the underlying mechanisms are not completely understood. It is hypothesized that in addition to decreased cardiac output, increases in central-and consequentially, cerebral-venous pressure (backward failure) also contribute significantly to the genesis of cognitive impairment. To test this hypothesis and elucidate the specific pathogenic role of venous congestion in the brain, we have established a novel model of increased cerebral venous pressure: mice with jugular vein ligation (JVL). To test the hypothesis that increased venous pressure in the brain contributes to the development of cognitive deficits by causing blood-brain barrier disruption, dysregulation of blood flow, and/or promoting neuroinflammation, in C57BL/6 mice, the internal and external jugular veins were ligated. Cognitive function (radial arm water maze), gait function (CatWalk), and motor coordination (rotarod) were tested post-JVL. Neurovascular coupling responses were assessed by measuring changes in cerebral blood flow in the whisker barrel cortex in response to contralateral whisker stimulation by laser speckle contrast imaging through a closed cranial window. Blood-brain barrier integrity (IgG extravasation) and microglia activation (Iba1 staining) were assessed in brain slices by immunohistochemistry. Neuroinflammation-related gene expression profile was assessed by a targeted qPCR array. After jugular vein ligation, mice exhibited impaired spatial learning and memory, altered motor coordination, and impaired gait function, mimicking important aspects of altered brain function observed in human heart failure patients. JVL did not alter neurovascular coupling responses. In the brains of mice with JVL, significant extravasation of IgG was detected, indicating blood-brain barrier disruption, which was associated with histological markers of neuroinflammation (increased presence of activated microglia) and a pro-inflammatory shift in gene expression profile. Thus, cerebral venous congestion per se can cause blood-brain barrier disruption and neuroinflammation, which likely contribute to the genesis of cognitive impairment. These findings have relevance to the pathogenesis of cognitive decline associated with heart failure as well as increased cerebal venous pressure due to increased jugular venous reflux in elderly human patients.

Spatial and Temporal Variation of Drought Based on Satellite Derived Vegetation Condition Index in Nepal from 1982⁻2015

Identification of drought is essential for many environmental and agricultural applications. To further understand drought, this study presented spatial and temporal variations of drought based on satellite derived Vegetation Condition Index (VCI) on annual (Jan⁻Dec), seasonal monsoon (Jun⁻Nov) and pre-monsoon (Mar⁻May) scales from 1982⁻2015 in Nepal. The Vegetation Condition Index (VCI) obtained from NOAA, AVHRR (National Oceanic and Atmospheric Administration, Advanced Very High Resolution Radiometer) and climate data from meteorological stations were used. VCI was used to grade the drought, and the Mann⁻Kendall test and linear trend analysis were conducted to examine drought trends and the Pearson correlation between VCI and climatic factors (i.e., temperature and precipitation) was also acquired. The results identified that severe drought was identified in 1982, 1984, 1985 and 2000 on all time scales. However, VCI has increased at the rate of 1.14 yr^-1 (p = 0.04), 1.31 yr^-1 (p = 0.03) and 0.77 yr^-1 (p = 0.77) on the annual, seasonal monsoon and pre-monsoon scales, respectively. These increased VCIs indicated decreases in drought. However, spatially, increased trends of drought were also found in some regions in Nepal. For instance, northern areas mainly in the Trans-Himalayan regions identified severe drought. The foothills and the lowlands of Terai (southern Nepal) experienced normal VCI, i.e., no drought. Similarly, the Anomaly Vegetation Condition Index (AVCI) was mostly negative before 2000 which indicated deficient soil moisture. The exceedance probability analysis results on the annual time scale showed that there was a 20% chance of occurring severe drought (VCI ≤ 35%) and a 35% chance of occurring normal drought (35% ≤ VCI ≤ 50%) in Nepal. Drought was also linked with climates in which temperature on the annual and seasonal monsoon scales was significant and positively correlated with VCI. Drought occurrence and trends in Nepal need to be further studied for comprehensive information and understanding.

Repeated Valsalva maneuvers promote symptomatic manifestations of cerebral microhemorrhages: implications for the pathogenesis of vascular cognitive impairment in older adults

Multifocal cerebral microhemorrhages (CMHs, also known as "cerebral microbleeds"), which are associated with rupture of small intracerebral vessels, have been recognized as an important cause for cognitive decline in older adults. Although recent studies demonstrate that CMHs are highly prevalent in patients 65 and older, many aspects of the pathogenesis and clinical significance of CMHs remain obscure. In this longitudinal observational study, a case of a 77-year-old man with multifocal CMHs is described, in whom the rupture of intracerebral vessels could be linked to repeatedly performing extended Valsalva maneuvers. This patient was initially seen with acute aphasia after performing a prolonged Valsalva maneuver during underwater swimming. T2-weighted magnetic resonance imaging revealed a left acute frontal intracerebral hemorrhage (ICH) with multiple CMHs. The aphasia was resolved and no cognitive impairment was present. Two years later, he developed unsteadiness and confusion after performing two prolonged Valsalva maneuvers during underwater swimming separated by about 12 days. Repeat brain imaging revealed an acute right and a subacute left ICH, with a marked interval increase in the number of CMHs. The patient also exhibited manifest memory loss after the second admission and was diagnosed with dementia. These observations suggest that prolonged Valsalva maneuver is potentially a common precipitating cause of both CMHs and symptomatic ICHs. The Valsalva maneuver both increases the systolic arterial pressure and gives rise to a venous pressure wave transmitted to the brain in the absence of the competent antireflux jugular vein valves. This pressure increase is superimposed on existing hypertension and/or increases in blood pressure due to exercise and increased venous return due to immersion of the body in water. We advocate that further studies are needed to distinguish between CMHs with arterial and venous origins and their potential to lead to ICH induced by Valsalva maneuver as well as to determine whether these lesions have a predilection for a particular location.

Probabilistic assessment of phenophase-wise agricultural drought risk under different sowing windows: a case study with rainfed soybean

A new methodology for crop-growth stage-specific assessment of agricultural drought risk under a variable sowing window is proposed for the soybean crop. It encompasses three drought indices, which include Crop-Specific Drought Index (CSDI), Vegetation Condition Index (VCI), and Standardized Precipitation Evapotranspiration Index (SPEI). The unique features of crop-growth stage-specific nature and spatial and multi-scalar coverage provide a comprehensive assessment of agricultural drought risk. This study was conducted in 10 major soybean-growing districts of Madhya Pradesh state of India. These areas contribute about 60% of the total soybean production for the country. The phenophase most vulnerable to agricultural drought was identified (germination and flowering in our case) for each district across four sowing windows. The agricultural drought risk was quantified at various severity levels (moderate, severe, and very severe) for each growth stage and sowing window. Validation of the proposed new methodology also yielded results with a high correlation coefficient between percent probability of agricultural drought risk and yield risk (r = 0.92). Assessment by proximity matrix yielded a similar statistic. Expectations for the proposed methodology are better mitigation-oriented management and improved crop contingency plans for planners and decision makers.

Analysis of the spatial-temporal variation characteristics of vegetative drought and its relationship with meteorological factors in China from 1982 to 2010

Drought is a complex natural phenomenon that can cause reduced water supplies and can consequently have substantial effects on agriculture and socioeconomic activities. The objective of this study was to gain a better understanding of the spatial-temporal variation characteristics of vegetative drought and its relationship with meteorological factors in China. The Vegetation Condition Index (VCI) dataset calculated from NOAA/AVHRR images from 1982 to 2010 was used to analyse the spatial-temporal variation characteristics of vegetative drought in China. This study also examined the trends in meteorological factors and their influences on drought using monitoring data collected from 686 national ground meteorological stations. The results showed that the VCI appeared to slowly rise in China from 1982 to 2010. From 1982 to 1999, the VCI rose slowly. Then, around 2000, the VCI exhibited a severe fluctuation before it entered into a relatively stable stage. Drought frequencies in China were higher, showing a spatial distribution feature of "higher in the north and lower in the south". Based on the different levels of drought, the frequencies of mild and moderate drought in four geographical areas were higher, and the frequency of severe drought was higher only in ecologically vulnerable areas, such as the Tarim Basin and the Qaidam Basin. Drought was mainly influenced by meteorological factors, which differed regionally. In the northern region, the main influential factor was sunshine duration, while the other factors showed minimal effects. In the southern region and Tibetan Plateau, the main influential factors were sunshine duration and temperature. In the northwestern region, the main influential factors were wind velocity and station atmospheric pressure.

Impaired neurovascular coupling in aging and Alzheimer's disease: Contribution of astrocyte dysfunction and endothelial impairment to cognitive decline

The importance of (micro)vascular contributions to cognitive impairment and dementia (VCID) in aging cannot be overemphasized, and the pathogenesis and prevention of age-related cerebromicrovascular pathologies are a subject of intensive research. In particular, aging impairs the increase in cerebral blood flow triggered by neural activation (termed neurovascular coupling or functional hyperemia), a critical mechanism that matches oxygen and nutrient delivery with the increased demands in active brain regions. From epidemiological, clinical and experimental studies the picture emerges of a complex functional impairment of cerebral microvessels and astrocytes, which likely contribute to neurovascular dysfunction and cognitive decline in aging and in age-related neurodegenerative diseases. This overview discusses age-related alterations in neurovascular coupling responses responsible for impaired functional hyperemia. The mechanisms and consequences of astrocyte dysfunction (including potential alteration of astrocytic endfeet calcium signaling, dysregulation of eicosanoid gliotransmitters and astrocyte energetics) and functional impairment of the microvascular endothelium are explored. Age-related mechanisms (cellular oxidative stress, senescence, circulating IGF-1 deficiency) impairing the function of cells of the neurovascular unit are discussed and the evidence for the causal role of neurovascular uncoupling in cognitive decline is critically examined.

Drought trends based on the VCI and its correlation with climate factors in the agricultural areas of China from 1982 to 2010

Drought is a type of natural disaster that has the most significant impacts on agriculture. Regional drought monitoring based on remote sensing has become popular due to the development of remote sensing technology. In this study, vegetation condition index (VCI) data recorded from 1982 to 2010 in agricultural areas of China were obtained from advanced very high resolution radiometer (AVHRR) data, and the temporal and spatial variations in each drought were analyzed. The relationships between drought and climate factors were also analyzed. The results showed that from 1982 to 2010, the agricultural areas that experienced frequent and severe droughts were mainly concentrated in the northwestern areas and Huang-Huai Plain. Moreover, the VCI increased in the majority of agricultural areas, indicating that the drought frequency decreased over time, and the decreasing trend in the southern region was more notable than that in the northern region. A correlation analysis showed that temperature and wind velocity were the main factors that influenced drought in the agricultural areas of China. From a regional perspective, excluding precipitation, the climate factors had various effects on drought in different regions. However, the correlation between the VCI and precipitation was low, possibly due to the widespread use of artificial irrigation technology, which reduces the reliance of agricultural areas on precipitation.

Robert's uterus: modern imaging techniques and ultrasound-guided hysteroscopic treatment without laparoscopy or laparotomy

Robert's uterus is a unique malformation, described as a septate uterus with a non-communicating hemicavity, consisting of a blind uterine horn usually with unilateral hematometra, a contralateral unicornuate uterine cavity and a normally shaped external uterine fundus. The main symptom in affected young women is pelvic pain that becomes intensified near menses. We describe the case of a 22-year-old woman who was referred for diagnostic assessment and treatment of a congenital uterine anomaly. We used three-dimensional sonohysterography with volume-contrast imaging, HDLive rendering mode and automatic volume calculation (SonoHysteroAVC) for the diagnosis, surgical planning and postoperative evaluation. These imaging techniques provided a complete understanding of the internal and external uterine structures, enabling us to perform a minimally invasive hysteroscopic metroplasty, guided by transrectal ultrasound, and therefore avoiding the need for laparotomy/laparoscopy. The outcome of treatment was considered satisfactory; menstruation ceased to be painful and, after two hysteroscopic procedures, the communicating 0.3-cm³ hemicavity was visualized as a 3.6-cm³ normalized uterine cavity using the same imaging techniques. The findings of this case report raise questions about the embryological origin of Robert's uterus, the suitability of current classification systems, and the role of more invasive approaches (laparoscopy/laparotomy) and surgical procedures (horn resection/endometrectomy) that do not aim to improve uterine cavity shape and volume in women with this condition. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Vascular cognitive impairment: Modeling a critical neurologic disease in vitro and in vivo

BACKGROUND

Vascular contributions to cognitive impairment and dementia (VCID) is a complex form of dementia, combining aspects of vascular disease and other forms of dementia, such as Alzheimer's disease. VCID encompasses a wide spectrum of cerebrovascular-driven cognitive impairment, from mild cognitive impairment to fully developed dementia. This disease state is further complicated by metabolic disorders, such as type 2 diabetes and hypertension, and lifestyle factors, like obesity and high fat diets.

SCOPE OF REVIEW

This manuscript is meant to both define VCID and review the in vitro and in vivo models of the disease state. This includes in vitro models of the neurovascular unit, models of chronic cerebral hypoperfusion, animals with NOTCH3 mutations as a model of small vessel disease, large animals with cerebral amyloid angiopathy (CAA), and animal models of mixed dementia.

MAJOR CONCLUSIONS

Synthetic microvessels are a promising technique to study the neurovascular unit and canines, despite the cost, are an excellent model to study CAA. While there are several good models of individual aspects of VCID, the heterogeneity of the disease states prevents them from being a model of all aspects of the disease. Therefore, VCID needs to be further defined into disease states that exist within this umbrella term. This includes specific guidelines for stroke counts and stroke locations and further categorization of overlapping cerebrovascular and AD pathologies that contribute to dementia. This will allow for better models and a more thorough understanding of how vascular disease contributes to dementia.

GENERAL SIGNIFICANCE

VCID is the second most common form of dementia and is expected to increase in coming years. The heterogeneity of VCID makes it difficult to study, but without better definitions and models, VCID presents a major public health problem for our aging population. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia, edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock.

Three-dimensional ultrasound with volume contrast imaging for preoperative assessment of myometrial invasion and cervical involvement in women with endometrial cancer

OBJECTIVES

To evaluate the accuracy of transvaginal three-dimensional ultrasound with volume contrast imaging (VCI) for preoperative assessment of depth of myometrial invasion and cervical involvement in women with endometrial cancer.

METHODS

Transvaginal volume acquisition of the uterus was performed in 60 consecutive patients with histological diagnosis of endometrial cancer who were scheduled for primary surgical treatment. Depth of myometrial invasion and presence or absence of cervical involvement were assessed using VCI in multiplanar display mode. Results were compared to final postoperative histopathological findings. Patients with histological high-risk cell types, including Grade 3 endometrioid adenocarcinoma, clear cell carcinoma, papillary serous carcinoma and carcinosarcoma, were excluded.

RESULTS

Forty patients were included in the analysis. The accuracy of VCI in assessing single-stage myometrial invasion (superficial or deep) was 92.5%. In the prediction of deep myometrial invasion, sensitivity, specificity, PPV and NPV of VCI were 100%, 89.7%, 78.6% and 100%, respectively. The accuracy of VCI in assessing cervical involvement was 90.0%. Sensitivity, specificity, PPV and NPV of VCI in predicting the presence of cervical involvement were 100%, 86.2%, 73.3% and 100%, respectively.

CONCLUSION

Transvaginal VCI is an uncomplicated method that is able to predict with reasonable accuracy the depth of myometrial invasion and cervical involvement in women with endometrial cancer.