Standardized evaluation of algorithms for computer-aided diagnosis of dementia based on structural MRI: The CADDementia challenge

Algorithms for computer-aided diagnosis of dementia based on structural MRI have demonstrated high performance in the literature, but are difficult to compare as different data sets and methodology were used for evaluation. In addition, it is unclear how the algorithms would perform on previously unseen data, and thus, how they would perform in clinical practice when there is no real opportunity to adapt the algorithm to the data at hand. To address these comparability, generalizability and clinical applicability issues, we organized a grand challenge that aimed to objectively compare algorithms based on a clinically representative multi-center data set. Using clinical practice as the starting point, the goal was to reproduce the clinical diagnosis. Therefore, we evaluated algorithms for multi-class classification of three diagnostic groups: patients with probable Alzheimer's disease, patients with mild cognitive impairment and healthy controls. The diagnosis based on clinical criteria was used as reference standard, as it was the best available reference despite its known limitations. For evaluation, a previously unseen test set was used consisting of 354 T1-weighted MRI scans with the diagnoses blinded. Fifteen research teams participated with a total of 29 algorithms. The algorithms were trained on a small training set (n = 30) and optionally on data from other sources (e.g., the Alzheimer's Disease Neuroimaging Initiative, the Australian Imaging Biomarkers and Lifestyle flagship study of aging). The best performing algorithm yielded an accuracy of 63.0% and an area under the receiver-operating-characteristic curve (AUC) of 78.8%. In general, the best performances were achieved using feature extraction based on voxel-based morphometry or a combination of features that included volume, cortical thickness, shape and intensity. The challenge is open for new submissions via the web-based framework: http://caddementia.grand-challenge.org.

Preliminary leaf area index estimates from airborne small footprint full-waveform LiDAR data

This study has compared preliminary estimates of effective leaf area index (LAI) derived from fish-eye lens photographs to those estimated from airborne full-waveform small-footprint LiDAR data for a forest dataset in Australia. The full-waveform data was decomposed and optimized using a trust-region-reflective algorithm to extract denser point clouds. LAI LiDAR estimates were derived in two ways (1) from the probability of discrete pulses reaching the ground without being intercepted (point method) and (2) from raw waveform canopy height profile processing adapted to small-footprint laser altimetry (waveform method) accounting for reflectance ratio between vegetation and ground. The best results, that matched hemispherical photography estimates, were achieved for the waveform method with a study area-adjusted reflectance ratio of 0.4 (RMSE of 0.15 and 0.03 at plot and site level, respectively). The point method generally overestimated, whereas the waveform method with an arbitrary reflectance ratio of 0.5 underestimated the fish-eye lens LAI estimates.

Towards pain-free diagnosis of skin diseases through multiplexed microneedles: biomarker extraction and detection using a highly sensitive blotting method

Immunodiagnostic microneedles provide a novel way to extract protein biomarkers from the skin in a minimally invasive manner for analysis in vitro. The technology could overcome challenges in biomarker analysis specifically in solid tissue, which currently often involves invasive biopsies. This study describes the development of a multiplex immunodiagnostic device incorporating mechanisms to detect multiple antigens simultaneously, as well as internal assay controls for result validation. A novel detection method is also proposed. It enables signal detection specifically at microneedle tips and therefore may aid the construction of depth profiles of skin biomarkers. The detection method can be coupled with computerised densitometry for signal quantitation. The antigen specificity, sensitivity and functional stability of the device were assessed against a number of model biomarkers. Detection and analysis of endogenous antigens (interleukins 1α and 6) from the skin using the device was demonstrated. The results were verified using conventional enzyme-linked immunosorbent assays. The detection limit of the microneedle device, at ≤10 pg/mL, was at least comparable to conventional plate-based solid-phase enzyme immunoassays.

The case of pre-natal diagnosis

This chapter reconsiders critiques of pre-natal diagnosis in Disability Studies. Underlying assumptions about reproductive technologies are analysed to demonstrate that while many critiques of pre-natal diagnosis by Disability activists and theorists are concerned about children being the product of 'choice' through the selective effects of pre-natal diagnosis, the issue that reproductive technologies (such as IVF) themselves necessarily always already rely on 'choice' -- namely the choice for a 'biological' or 'own' child (different terms are used) -- is nowhere considered. The chapter considers several consequences of thinking through this issue and its implications.

Predictors of onset of depression and anxiety in the year after diagnosis of breast cancer

Background Depression and anxiety are common after diagnosis of breast cancer. We examined to what extent these are recurrences of previous disorder and, controlling for this, whether shame, self-blame and low social support after diagnosis predicted onset of depression and anxiety subsequently. Method Women with primary breast cancer who had been treated surgically self-reported shame, self-blame, social support and emotional distress post-operatively. Psychiatric interview 12 months later identified those with adult lifetime episodes of major depression (MD) or generalized anxiety disorder (GAD) before diagnosis and onset over the subsequent year. Statistical analysis examined predictors of each disorder in that year. Results Of the patients, two-thirds with episodes of MD and 40% with episodes of GAD during the year after diagnosis were experiencing recurrence of previous disorder. Although low social support, self-blame and shame were each associated with both MD and GAD after diagnosis, they did not mediate the relationship of disorder after diagnosis with previous disorder. Low social support, but not shame or self-blame, predicted recurrence after controlling for previous disorder. Conclusions Anxiety and depression during the first year after diagnosis of breast cancer are often the recurrence of previous disorder. In predicting disorder following diagnosis, self-blame and shame are merely markers of previous disorder. Low social support is an independent predictor and therefore may have a causal role.

The perception of support received from breast care nurses by depressed patients following a diagnosis of breast cancer

INTRODUCTION Due to their specialist training, breast care nurses (BCNs) should be able to detect emotional distress and offer support to breast cancer patients. However, patients who are most distressed after diagnosis generally experience least support from care staff. To test whether BCNs overcome this potential barrier, we compared the support experienced by depressed and non-depressed patients from their BCNs and the other main professionals involved in their care: surgeons and ward nurses. PATIENTS AND METHODS Women with primary breast cancer (n = 355) 2–4 days after mastectomy or wide local excision, self-reported perceived professional support and current depression. Analysis of variance compared support ratings of depressed and non-depressed patients across staff types. RESULTS There was evidence of depression in 31 (9%) patients. Depressed patients recorded less surgeon and ward nurse support than those who were not depressed but the support received by patients from the BCN was high, whether or not patients were depressed. CONCLUSIONS BCNs were able to provide as much support to depressed patients as to non-depressed patients, whereas depressed patients felt less supported by surgeons and ward nurses than did non-depressed patients. Future research should examine the basis of BCNs' ability to overcome barriers to support in depressed patients. Our findings confirm the importance of maintaining the special role of the BCN.

Living to die and dying to live: the survival strategy behind leaf senescence

Senescence represents the final developmental act of the leaf, during which the leaf cell is dismantled in a coordinated manner to remobilize nutrients and to secure reproductive success. The process of senescence provides the plant with phenotypic plasticity to help it adapt to adverse environmental conditions. Here, we provide a comprehensive overview of the factors and mechanisms that control the onset of senescence. We explain how the competence to senesce is established during leaf development, as depicted by the senescence window model. We also discuss the mechanisms by which phytohormones and environmental stresses control senescence, as well as the impact of source-sink relationships on plant yield and stress tolerance. In addition, we discuss the role of senescence as a strategy for stress adaptation and how crop production and food quality could benefit from engineering or breeding crops with altered onset of senescence.

Understanding 2H/1H systematics of leaf wax n-alkanes in coastal plants at Stiffkey saltmarsh, Norfolk, UK

Interpretation of sedimentary n-alkyl lipid d2H data is complicated by a limited understanding of factors controlling interspecies variation in biomarker 2H/1H composition. To distinguish between the effects of interrelated environmental, physical and biochemical controls on the hydrogen isotope composition of n-alkyl lipids, we conducted linked d2H analyses of soil water, xylem water, leaf water and n-alkanes from a range of C3 and C4 plants growing at a UK saltmarsh (i) across multiple sampling sites, (ii) throughout the 2012 growing season, and (iii) at different times of the day. Soil waters varied isotopically by up to 35& depending on marsh sub-environment, and exhibited site-specific seasonal shifts in d2H up to a maximum of 31 per mil. Maximum interspecies variation in xylem water was 38 per mil, while leaf waters differed seasonally by a maximum of 29 per mil. Leaf wax n-alkane 2H/1H, however, consistently varied by over 100 per mil throughout the 2012 growing season, resulting in an interspecies range in the ewax/leaf water values of -79 per mil to –227 per mil. From the discrepancy in the magnitude of these isotopic differences, we conclude that mechanisms driving variation in the 2H/1H composition of leaf water, including (i) spatial changes in soil water 2H/1H, (ii) temporal changes in soil water 2H/1H, (iii) differences in xylem water 2H/1H, and (iv) differences in leaf water evaporative 2H-enrichment due to varied plant life forms, cannot explain the range of n-alkane d2H values we observed. Results from this study suggests that accurate reconstructions of palaeoclimate regimes from sedimentary n-alkane d2H require further research to constrain those biological mechanisms influencing species-specific differences in 2H/1H fractionation during lipid biosynthesis, in particular where plants have developed biochemical adaptations to water-stressed conditions. Understanding how these mechanisms interact with environmental conditions will be crucial to ensure accurate interpretation of hydrogen isotope signals from the geological record.

Responses of leaf traits to climatic gradients: adaptive variation versus compositional shifts

Dynamic global vegetation models (DGVMs) typically rely on plant functional types (PFTs), which are assigned distinct environmental tolerances and replace one another progressively along environmental gradients. Fixed values of traits are assigned to each PFT; modelled trait variation along gradients is thus driven by PFT replacement. But empirical studies have revealed "universal" scaling relationships (quantitative trait variations with climate that are similar within and between species, PFTs and communities); and continuous, adaptive trait variation has been proposed to replace PFTs as the basis for next-generation DGVMs. Here we analyse quantitative leaf-trait variation on long temperature and moisture gradients in China with a view to understanding the relative importance of PFT replacement vs. continuous adaptive variation within PFTs. Leaf area (LA), specific leaf area (SLA), leaf dry matter content (LDMC) and nitrogen content of dry matter were measured on all species at 80 sites ranging from temperate to tropical climates and from dense forests to deserts. Chlorophyll fluorescence traits and carbon, phosphorus and potassium contents were measured at 47 sites. Generalized linear models were used to relate log-transformed trait values to growing-season temperature and moisture indices, with or without PFT identity as a predictor, and to test for differences in trait responses among PFTs. Continuous trait variation was found to be ubiquitous. Responses to moisture availability were generally similar within and between PFTs, but biophysical traits (LA, SLA and LDMC) of forbs and grasses responded differently from woody plants. SLA and LDMC responses to temperature were dominated by the prevalence of evergreen PFTs with thick, dense leaves at the warm end of the gradient. Nutrient (N, P and K) responses to climate gradients were generally similar within all PFTs. Area-based nutrients generally declined with moisture; Narea and Karea declined with temperature, but Parea increased with temperature. Although the adaptive nature of many of these trait-climate relationships is understood qualitatively, a key challenge for modelling is to predict them quantitatively. Models must take into account that community-level responses to climatic gradients can be influenced by shifts in PFT composition, such as the replacement of deciduous by evergreen trees, which may run either parallel or counter to trait variation within PFTs. The importance of PFT shifts varies among traits, being important for biophysical traits but less so for physiological and chemical traits. Finally, models should take account of the diversity of trait values that is found in all sites and PFTs, representing the "pool" of variation that is locally available for the natural adaptation of ecosystem function to environmental change.

Leaf trapping and retention of particles by holm oak and other common tree species in Mediterranean urban environments

Holm oak (Quercus ilex), a widespread urban street tree in the Mediterranean region, is widely used as biomonitor of persistent atmospheric pollutants, especially particulate-bound metals. By using lab- and field-based experimental approaches, we compared the leaf-level capacity for particles’ capture and retention between Q. ilex and other common Mediterranean urban trees: Quercus cerris, Platanus × hispanica, Tilia cordata and Olea europaea. All applied methods were effective in quantifying particulate capture and retention, although not univocal in ranking species performances. Distinctive morphological features of leaves led to differences in species’ ability to trap and retain particles of different size classes and to accumulate metals after exposure to traffic in an urban street. Overall, P. × hispanica and T. cordata showed the largest capture potential per unit leaf area for most model particles (Na+ and powder particles), and street-level Cu and Pb, while Q. ilex acted intermediately. After wash-off experiments, P. × hispanica leaves had the greatest retention capacity among the tested species and O. europaea the lowest. We concluded that the Platanus planting could be considered in Mediterranean urban environments due to its efficiency in accumulating and retaining airborne particulates; however, with atmospheric pollution being typically higher in winter, the evergreen Q. ilex represents a better year-round choice to mitigate the impact of airborne particulate pollutants.

Relative importance of transpiration rate and leaf morphological traits for the regulation of leaf temperature

Urban greening solutions such as green roofs help improve residents’ thermal comfort and building insulation. However, not all plants provide the same level of cooling. This is partially due to differences in plant structure and function, including different mechanisms that plants employ to regulate leaf temperature. Ranking of multiple leaf/plant traits involved in the regulation of leaf temperature (and, consequently, plants’ cooling ‘service’) is not well understood. We therefore investigated the relative importance of water loss, leaf colour, thickness and extent of pubescence for the regulation of leaf temperature, in the context of species for semi-extensive green roofs. Leaf temperature were measured with an infrared imaging camera in a range of contrasting genotypes within three plant genera (Heuchera, Salvia and Sempervivum). In three glasshouse experiments (each evaluating three or four genotypes of each genera) we varied water availability to the plants and assessed how leaf temperature altered depending on water loss and specific leaf traits. Greatest reductions in leaf temperature were closely associated with higher water loss. Additionally, in non-succulents (Heuchera, Salvia), lighter leaf colour and longer hair length (on pubescent leaves) both contributed to reduced leaf temperature. However, in succulent Sempervivum, colour/pubescence made no significant contribution; leaf thickness and water loss rate were the key regulating factors. We propose that this can lead to different plant types having significantly different potentials for cooling. We suggest that maintaining transpirational water loss by sustainable irrigation and selecting urban plants with favourable morphological traits is the key to maximising thermal benefits provided by applications such as green roofs.

Specific leaf area and leaf area index in developing stands of Fagus sylvatica L. and Picea abies Karst

European beech (Fagus sylvatica L.) and Norway spruce (Picea abies Karst.) are two of the most ecologically and economically important forest tree species in Europe. These two species co-occur in many locations in Europe, leading to direct competition for canopy space. Foliage characteristics of two naturally regenerated pure stands of beech and spruce with fully closed canopies were contrasted to assess the dynamic relationship between foliage adaptability to shading, stand LAI and tree growth. We found that individual leaf size is far more conservative in spruce than in beech. Individual leaf and needle area was larger at the top than at the bottom of the canopy in both species. Inverse relationship was found for specific leaf area (SLA), highest SLA values were found at lowest light availability under the canopy. There was no difference in leaf area index (LAI) between the two stands, however LAI increased from 10.8 to 14.6 m2m-2 between 2009 and 2011. Dominant trees of both species were more efficient in converting foliage mass or area to produce stem biomass, although this relationship changed with age and was species-specific. Overall, we found larger foliage plasticity in beech than in spruce in relation to light conditions, indicating larger capacity to exploit niche openings.

An LDA and probability-based classifier for the diagnosis of Alzheimer's Disease from structural MRI

In this paper a custom classification algorithm based on linear discriminant analysis and probability-based weights is implemented and applied to the hippocampus measurements of structural magnetic resonance images from healthy subjects and Alzheimer’s Disease sufferers; and then attempts to diagnose them as accurately as possible. The classifier works by classifying each measurement of a hippocampal volume as healthy controlsized or Alzheimer’s Disease-sized, these new features are then weighted and used to classify the subject as a healthy control or suffering from Alzheimer’s Disease. The preliminary results obtained reach an accuracy of 85.8% and this is a similar accuracy to state-of-the-art methods such as a Naive Bayes classifier and a Support Vector Machine. An advantage of the method proposed in this paper over the aforementioned state of the art classifiers is the descriptive ability of the classifications it produces. The descriptive model can be of great help to aid a doctor in the diagnosis of Alzheimer’s Disease, or even further the understand of how Alzheimer’s Disease affects the hippocampus.