Localization and Segmentation of 3D Intervertebral Discs in MR Images by Data Driven Estimation

This paper addresses the problem of fully-automatic localization and segmentation of 3D intervertebral discs (IVDs) from MR images. Our method contains two steps, where we first localize the center of each IVD, and then segment IVDs by classifying image pixels around each disc center as foreground (disc) or background. The disc localization is done by estimating the image displacements from a set of randomly sampled 3D image patches to the disc center. The image displacements are estimated by jointly optimizing the training and test displacement values in a data-driven way, where we take into consideration both the training data and the geometric constraint on the test image. After the disc centers are localized, we segment the discs by classifying image pixels around disc centers as background or foreground. The classification is done in a similar data-driven approach as we used for localization, but in this segmentation case we are aiming to estimate the foreground/background probability of each pixel instead of the image displacements. In addition, an extra neighborhood smooth constraint is introduced to enforce the local smoothness of the label field. Our method is validated on 3D T2-weighted turbo spin echo MR images of 35 patients from two different studies. Experiments show that compared to state of the art, our method achieves better or comparable results. Specifically, we achieve for localization a mean error of 1.6-2.0 mm, and for segmentation a mean Dice metric of 85%-88% and a mean surface distance of 1.3-1.4 mm.

Evaluation and Comparison of Anatomical Landmark Detection Methods for Cephalometric X-Ray Images: A Grand Challenge

Cephalometric analysis is an essential clinical and research tool in orthodontics for the orthodontic analysis and treatment planning. This paper presents the evaluation of the methods submitted to the Automatic Cephalometric X-Ray Landmark Detection Challenge, held at the IEEE International Symposium on Biomedical Imaging 2014 with an on-site competition. The challenge was set to explore and compare automatic landmark detection methods in application to cephalometric X-ray images. Methods were evaluated on a common database including cephalograms of 300 patients aged six to 60 years, collected from the Dental Department, Tri-Service General Hospital, Taiwan, and manually marked anatomical landmarks as the ground truth data, generated by two experienced medical doctors. Quantitative evaluation was performed to compare the results of a representative selection of current methods submitted to the challenge. Experimental results show that three methods are able to achieve detection rates greater than 80% using the 4 mm precision range, but only one method achieves a detection rate greater than 70% using the 2 mm precision range, which is the acceptable precision range in clinical practice. The study provides insights into the performance of different landmark detection approaches under real-world conditions and highlights achievements and limitations of current image analysis techniques.

Lung Pattern Classification for Interstitial Lung Diseases Using a Deep Convolutional Neural Network

Automated tissue characterization is one of the most crucial components of a computer aided diagnosis (CAD) system for interstitial lung diseases (ILDs). Although much research has been conducted in this field, the problem remains challenging. Deep learning techniques have recently achieved impressive results in a variety of computer vision problems, raising expectations that they might be applied in other domains, such as medical image analysis. In this paper, we propose and evaluate a convolutional neural network (CNN), designed for the classification of ILD patterns. The proposed network consists of 5 convolutional layers with 2×2 kernels and LeakyReLU activations, followed by average pooling with size equal to the size of the final feature maps and three dense layers. The last dense layer has 7 outputs, equivalent to the classes considered: healthy, ground glass opacity (GGO), micronodules, consolidation, reticulation, honeycombing and a combination of GGO/reticulation. To train and evaluate the CNN, we used a dataset of 14696 image patches, derived by 120 CT scans from different scanners and hospitals. To the best of our knowledge, this is the first deep CNN designed for the specific problem. A comparative analysis proved the effectiveness of the proposed CNN against previous methods in a challenging dataset. The classification performance (~85.5%) demonstrated the potential of CNNs in analyzing lung patterns. Future work includes, extending the CNN to three-dimensional data provided by CT volume scans and integrating the proposed method into a CAD system that aims to provide differential diagnosis for ILDs as a supportive tool for radiologists.

Retention in care of HIV-infected pregnant and lactating women starting art under Option B+ in rural Mozambique.

OBJECTIVE In 2013, Mozambique adopted Option B+, universal lifelong antiretroviral therapy (ART) for all pregnant and lactating women, as national strategy for prevention of mother-to-child transmission of HIV. We analyzed retention in care of pregnant and lactating women starting Option B+ in rural northern Mozambique. METHODS We compared ART outcomes in pregnant ("B+pregnant"), lactating ("B+lactating") and non-pregnant-non-lactating women of childbearing age starting ART after clinical and/or immunological criteria ("own health") between July 2013 and June 2014. Lost to follow-up was defined as no contact >180 days after the last visit. Multivariable competing risk models were adjusted for type of facility (type 1 vs. peripheral type 2 health center), age, WHO stage and time from HIV diagnosis to ART. RESULTS Over 333 person-years of follow-up (of 243 "B+pregnant", 65″B+lactating" and 317 "own health" women), 3.7% of women died and 48.5% were lost to follow-up. "B+pregnant" and "B+lactating" women were more likely to be lost in the first year (57% vs. 56.9% vs. 31.6%; p<0.001) and to have no follow-up after the first visit (42.4% vs. 29.2% vs. 16.4%; p<0.001) than "own health" women. In adjusted analyses, risk of being lost to follow-up was higher in "B+pregnant" (adjusted subhazard ratio [asHR]: 2.77; 95% CI: 2.18-3.50; p<0.001) and "B+lactating" (asHR: 1.94; 95% CI: 1.37-2.74; p<0.001). Type 2 health center was the only additional significant risk factor for loss to follow-up. CONCLUSIONS Retaining pregnant and lactating women in option B+ ART was poor; losses to follow-up were mainly early. The success of Option B+ for prevention of mother-to-child transmission of HIV in rural settings with weak health systems will depend on specific improvements in counseling and retention measures, especially at the beginning of treatment. This article is protected by copyright. All rights reserved.

Desigualdades socioeconómicas en la mortalidad infantil en Mendoza (1996-2010)

Esta investigación propone determinar y describir patrones de desigualdades socioeconómicas en salud asociadas a la tasa de mortalidad infantil en la provincia de Mendoza y sus departamentos, planteando la hipótesis de que existe un vector socioeconómico asociado a la TMI que explicaría, en parte, las desigualdades observadas en la TMI entre departamentos.

Area-averaged mean seasonal cycles of chlorophyll-a concentration, sea surface temperature, alongshore wind stress, westward wind speed and dust component of the aerosol optical depth at 550 nm

Nutrient supply in the area off Northwest Africa is mainly regulated by two processes, coastal upwelling and deposition of Saharan dust. In the present study, both processes were analyzed and evaluated by different methods, including cross-correlation, multiple correlation, and event statistics, using remotely sensed proxies of the period from 2000 to 2008 to investigate their influence on the marine environment. The remotely sensed chlorophyll-a concentration was used as a proxy for the phytoplankton biomass stimulated by nutrient supply into the euphotic zone from deeper water layers and from the atmosphere. Satellite-derived alongshore wind stress and sea-surface temperature were applied as proxies for the strength and reflection of coastal upwelling processes. The westward wind and the dust component of the aerosol optical depth describe the transport direction of atmospheric dust and the atmospheric dust column load. Alongshore wind stress and induced upwelling processes were most significantly responsible for the surface chlorophyll-a variability, accounting for about 24% of the total variance, mainly in the winter and spring due to the strong north-easterly trade winds. The remotely sensed proxies allowed determination of time lags between biological response and its forcing processes. A delay of up to 16 days in the surface chlorophyll-a concentration due to the alongshore wind stress was determined in the northern winter and spring. Although input of atmospheric iron by dust storms can stimulate new phytoplankton production in the study area, only 5% of the surface chlorophyll-a variability could be ascribed to the dust component in the aerosol optical depth. All strong desert storms were identified by an event statistics in the time period from 2000 to 2008. The 57 strong storms were studied in relation to their biological response. Six events were clearly detected in which an increase of chlorophyll-a was caused by Saharan dust input and not by coastal upwelling processes. Time lags of <8 days, 8 days, and 16 days were determined. An increase in surface chlorophyll-a concentration of up to 2.4 mg m**3 after dust storms in which the dust component of the aerosol optical depth was up to 0.9 was observed.

Super-Resolution in Respiratory Synchronized Positron Emission Tomography

Respiratory motion is a major source of reduced quality in positron emission tomography (PET). In order to minimize its effects, the use of respiratory synchronized acquisitions, leading to gated frames, has been suggested. Such frames, however, are of low signal-to-noise ratio (SNR) as they contain reduced statistics. Super-resolution (SR) techniques make use of the motion in a sequence of images in order to improve their quality. They aim at enhancing a low-resolution image belonging to a sequence of images representing different views of the same scene. In this work, a maximum a posteriori (MAP) super-resolution algorithm has been implemented and applied to respiratory gated PET images for motion compensation. An edge preserving Huber regularization term was used to ensure convergence. Motion fields were recovered using a B-spline based elastic registration algorithm. The performance of the SR algorithm was evaluated through the use of both simulated and clinical datasets by assessing image SNR, as well as the contrast, position and extent of the different lesions. Results were compared to summing the registered synchronized frames on both simulated and clinical datasets. The super-resolution image had higher SNR (by a factor of over 4 on average) and lesion contrast (by a factor of 2) than the single respiratory synchronized frame using the same reconstruction matrix size. In comparison to the motion corrected or the motion free images a similar SNR was obtained, while improvements of up to 20% in the recovered lesion size and contrast were measured. Finally, the recovered lesion locations on the SR images were systematically closer to the true simulated lesion positions. These observations concerning the SNR, lesion contrast and size were confirmed on two clinical datasets included in the study. In conclusion, the use of SR techniques applied to respiratory motion synchronized images lead to motion compensation combined with improved image SNR and contrast, without any increase in the overall acquisition times.

Propagation of Cross-Section Uncertainties in Criticality Calculations in the Framework of UAM-Phase I Using MCNPX-2.7e and SCALE-6.1

In the framework of the OECD/NEA project on Benchmark for Uncertainty Analysis in Modeling (UAM) for Design, Operation, and Safety Analysis of LWRs, several approaches and codes are being used to deal with the exercises proposed in Phase I, “Specifications and Support Data for Neutronics Cases.” At UPM, our research group treats these exercises with sensitivity calculations and the “sandwich formula” to propagate cross-section uncertainties. Two different codes are employed to calculate the sensitivity coefficients of to cross sections in criticality calculations: MCNPX-2.7e and SCALE-6.1. The former uses the Differential Operator Technique and the latter uses the Adjoint-Weighted Technique. In this paper, the main results for exercise I-2 “Lattice Physics” are presented for the criticality calculations of PWR. These criticality calculations are done for a TMI fuel assembly at four different states: HZP-Unrodded, HZP-Rodded, HFP-Unrodded, and HFP-Rodded. The results of the two different codes above are presented and compared. The comparison proves a good agreement between SCALE-6.1 and MCNPX-2.7e in uncertainty that comes from the sensitivity coefficients calculated by both codes. Differences are found when the sensitivity profiles are analysed, but they do not lead to differences in the uncertainty.

Myocyte-specific enhancer factor 2 acts cooperatively with a muscle activator region to regulate Drosophila tropomyosin gene muscle expression.

MEF2 (myocyte-specific enhancer factor 2) is a MADS box transcription factor that is thought to be a key regulator of myogenesis in vertebrates. Mutations in the Drosophila homologue of the mef2 gene indicate that it plays a key role in regulating myogenesis in Drosophila. We show here that the Drosophila tropomyosin I (TmI) gene is a target gene for mef2 regulation. The TmI gene contains a proximal and a distal muscle enhancer within the first intron of the gene. We show that both enhancers contain a MEF2 binding site and that a mutation in the MEF2 binding site of either enhancer significantly reduces reporter gene expression in embryonic, larval, and adult somatic body wall muscles of transgenic flies. We also show that a high level of proximal enhancer-directed reporter gene expression in somatic muscles requires the cooperative activity of MEF2 and a cis-acting muscle activator region located within the enhancer. Thus, mef2 null mutant embryos show a significant reduction but not an elimination of TmI expression in the body wall myoblasts and muscle fibers that are present. Surprisingly, there is little effect in these mutants on TmI expression in developing visceral muscles and dorsal vessel (heart), despite the fact that MEF2 is expressed in these muscles in wild-type embryos, indicating that TmI expression is regulated differently in these muscles. Taken together, our results show that mef2 is a positive regulator of tropomyosin gene transcription that is necessary but not sufficient for high level expression in somatic muscle of the embryo, larva, and adult.

Efeito do treinamento muscular inspiratório com diferentes cargas na força e função de músculos respiratórios

Background: The inspiratory muscle training (IMT) has been considered an option in reversing or preventing decrease in respiratory muscle strength, however, little is known about the adaptations of these muscles arising from the training with charge. Objectives: To investigate the effect of IMT on the diaphragmatic muscle strength and function neural and structural adjustment of diaphragm in sedentary young people, compare the effects of low intensity IMT with moderate intensity IMT on the thickness, mobility and electrical activity of diaphragm and in inspiratory muscles strength and establish a protocol for conducting a systematic review to evaluate the effects of respiratory muscle training in children and adults with neuromuscular diseases. Materials and Methods: A randomized, double-blind, parallel-group, controlled trial, sample of 28 healthy, both sexes, and sedentary young people, divided into two groups: 14 in the low load training group (G10%) and 14 in the moderate load training group (G55%). The volunteers performed for 9 weeks a home IMT protocol with POWERbreathe®. The G55% trained with 55% of maximal inspiratory pressure (MIP) and the G10% used a charge of 10% of MIP. The training was conducted in sessions of 30 repetitions, twice a day, six days per week. Every two weeks was evaluated MIP and adjusted the load. Volunteers were submitted by ultrasound, surface electromyography, spirometry and manometer before and after IMT. Data were analyzed by SPSS 20.0. Were performed Student's t-test for paired samples to compare diaphragmatic thickness, MIP and MEP before and after IMT protocol and Wilcoxon to compare the RMS (root mean square) and median frequency (MedF) values also before and after training protocol. They were then performed the Student t test for independent samples to compare mobility and diaphragm thickness, MIP and MEP between two groups and the Mann-Whitney test to compare the RMS and MedF values also between the two groups. Parallel to experimental study, we developed a protocol with support from the Cochrane Collaboration on IMT in people with neuromuscular diseases. Results: There was, in both groups, increased inspiratory muscle strength (P <0.05) and expiratory in G10% (P = 0.009) increase in RMS and thickness of relaxed muscle in G55% (P = 0.005; P = 0.026) and there was no change in the MedF (P> 0.05). The comparison between two groups showed a difference in RMS (P = 0.04) and no difference in diaphragm thickness and diaphragm mobility and respiratory muscle strength. Conclusions: It was identified increased neural activity and diagrammatic structure with consequent increase in respiratory muscle strength after the IMT with moderate load. IMT with load of 10% of MIP cannot be considered as a placebo dose, it increases the inspiratory muscle strength and IMT with moderate intensity is able to enhance the recruitment of muscle fibers of diaphragm and promote their hypertrophy. The protocol for carrying out the systematic review published in The Cochrane Library.

Heart failure in sub-Saharan Africa: review of the aetiology of heart failure and the role of point-of-care biomarker diagnostics

Within Africa, the burden of heart failure is significant. This arises from the increase in cardiovascular disease and associated risk factors such as hypertension and diabetes, as well as causes of heart failure which are particular to sub-Saharan Africa, such as endomyocardial fibrosis. The lack of access to echocardiography and other imaging modalities, from a cost and technical perspective, combined with the predominantly rural nature of many countries with poor transport links, means that the vast majority of people never obtain an appropriate diagnosis. Similarly, research has been limited on the causes and treatment of heart failure in Africa and in particular endemic causes such as EMF and rheumatic heart disease. This review outlines the burden of heart failure in Africa and highlights the opportunity to expand diagnosis through the use of biomarkers, in particular natriuretic peptides. This builds on the success of point-of-care testing in human immunodeficiency virus and tuberculosis which have been extensively deployed in community settings in Africa.

Treino de músculos inspiratórios em indivíduos saudáveis: estudo randomizado controlado

Introdução – O treino dos músculos inspiratórios (TMI) surge como uma intervenção importante na população com doença pulmonar obstrutiva crónica (DPOC), mas com interesse crescente na população saudável. No entanto, não existem estudos suficientes que comprovem se o treino dos músculos inspiratórios se traduz também numa melhoria da capacidade aeróbia objetivada no consumo de oxigénio (VO2). Assim, a relação entre o TMI e os seus resultados no indivíduo saudável carece de estudo que comprove os efeitos reais do treino. Considerou-se, pelo anteriormente exposto, pertinente a realização de um estudo de investigação na população saudável que permitisse avaliar em que medida um programa de TMI induz alterações na força muscular inspiratória e na capacidade aeróbia. Métodos e análise – A amostra foi constituída por indivíduos saudáveis (n=19) com idades compreendidas entre os 18 e 21 anos que realizam exercício físico regularmente (≥3 vezes por semana ou ≥4h por semana). A capacidade aeróbia foi estimada através do Teste de Ebbeling e a força dos músculos inspiratórios foi medida pela pressão inspiratória máxima (PIM) obtida num dinamómetro específico (MicroRPM®), em dois momentos distintos (pré e pós-treino). A referida amostra foi dividida aleatoriamente em dois grupos (n=9 no grupo experimental e n=10 no grupo de controlo). O grupo experimental (GE) foi submetido a um TMI de alta intensidade (≥50% Pi,máx), enquanto o grupo de controlo (GC) não foi sujeito a qualquer intervenção. O TMI foi realizado através do PowerBreathe Classic® Level 1 e Level 2, que fornece uma pressão consistente e específica para a força muscular inspiratória, independentemente do fluxo inspiratório do indivíduo. Conclusões – Após o treino verificou-se um aumento de 37% na PIM do GE, enquanto o GC apresentou uma melhoria de 7%. Na comparação intragrupos, ambos os grupos aumentaram significativamente tanto a PIM como o VO2 (p<0,05). Já na comparação intergrupos, a diferença foi significativa para a PIM (p=0,000), mas não para o VO2. Serão necessários mais estudos no sentido de concluir e avaliar em que condições o TMI produz alterações na capacidade aeróbia.

Mapping freshwater snails in Angola: distribution, identity and molecular diversity of medically important taxa

Introduction - This study was designed to determine the presence and identity of potential intermediate snail hosts of schistosomiasis in Bengo, Luanda, Kwanza Norte and Malanje Provinces in NW Angola. This is an area where infection with Schistosoma haematobium, causing urogenital schistosomiasis, is common but little is known about transmission of the disease. Angola has had a varied past with regards to disease control and is revitalising efforts to combat Neglected Tropical Diseases.

New Possibilities for Geophysical Parameter Retrievals Opened by GCOM-W1 AMSR2

A new approach to retrieve sea surface wind speed (SWS) in tropical cyclones (TCs) from the Advanced Microwave Scanning Radiometer 2 (AMSR2) data is presented. Analysis of all six AMSR2 C- and X-band channel measurements over TCs is shown to efficiently help to separate the rain contribution. Corrected measurements at 6.9 and 10.65 GHz are then used to retrieve the SWS. Spatial and temporal collocation of AMSR2 and tropical rain measurement mission (TRMM) microwave instrument (TMI) data is then further used to empirically relate TMI rain rate (RR) product to RR estimates from AMSR2 in hurricanes. SWS estimates are validated with measurements from the stepped frequency microwave radiometer (SFMR). As further tested, more than 100 North Atlantic and North Pacific TCs are analyzed for the 2012–2014 period. Despite few particular cases, most SWS fields are in a very good agreement with TC center data on maximum wind speeds, radii of storm, and hurricane winds. As also compared, very high consistency between AMSR2 and L-band SMOS wind speed estimates are obtained, especially for the super typhoon Haiyan, to prove the high potential of AMSR2 measurements in TCs.

Modelo de gestión para priorizar los proyectos de fedepapa, bajo las condiciones del desarrollo integral sustentable en Colombia

Tesis (Maestria en Ingeniería).-- Universidad de La Salle. Facultad de Ingeniería. Maestría en Ingeniería, 2014