Letter to the editor : likelihood of tetraplegia after CT clearance of the cervical spine in obtunded blunt trauma patients

...the probabilistic computer simulation study by Dunham and colleagues evaluating the impact of different cervical spine management (CSM) strategies on tetraplegia and brain injury outcomes.1 Based on literature findings, expert opinion and with use of advances programming techniques the authors conclude that early collar removal without cervical spine magnetic resonance imaging (MRI) is a preferable CSM strategy for comatose, blunt trauma patients with extremity movement and a negative cervical spine computed tomography(CT) scan. Although we do not have the required expertise to comment on the applied statistical approach, we would like to comment on one of the medical assumptions raised by the authors, namely the likelihood of tetraplegia in this specific population....

Discovering the best feature extraction and selection algorithms for spontaneous facial expression recognition

Feature extraction and selection are critical processes in developing facial expression recognition (FER) systems. While many algorithms have been proposed for these processes, direct comparison between texture, geometry and their fusion, as well as between multiple selection algorithms has not been found for spontaneous FER. This paper addresses this issue by proposing a unified framework for a comparative study on the widely used texture (LBP, Gabor and SIFT) and geometric (FAP) features, using Adaboost, mRMR and SVM feature selection algorithms. Our experiments on the Feedtum and NVIE databases demonstrate the benefits of fusing geometric and texture features, where SIFT+FAP shows the best performance, while mRMR outperforms Adaboost and SVM. In terms of computational time, LBP and Gabor perform better than SIFT. The optimal combination of SIFT+FAP+mRMR also exhibits a state-of-the-art performance.

Towards spontaneous facial expression recognition in real-world video

Facial expression is an important channel of human social communication. Facial expression recognition (FER) aims to perceive and understand emotional states of humans based on information in the face. Building robust and high performance FER systems that can work in real-world video is still a challenging task, due to the various unpredictable facial variations and complicated exterior environmental conditions, as well as the difficulty of choosing a suitable type of feature descriptor for extracting discriminative facial information. Facial variations caused by factors such as pose, age, gender, race and occlusion, can exert profound influence on the robustness, while a suitable feature descriptor largely determines the performance. Most present attention on FER has been paid to addressing variations in pose and illumination. No approach has been reported on handling face localization errors and relatively few on overcoming facial occlusions, although the significant impact of these two variations on the performance has been proved and highlighted in many previous studies. Many texture and geometric features have been previously proposed for FER. However, few comparison studies have been conducted to explore the performance differences between different features and examine the performance improvement arisen from fusion of texture and geometry, especially on data with spontaneous emotions. The majority of existing approaches are evaluated on databases with posed or induced facial expressions collected in laboratory environments, whereas little attention has been paid on recognizing naturalistic facial expressions on real-world data. This thesis investigates techniques for building robust and high performance FER systems based on a number of established feature sets. It comprises of contributions towards three main objectives: (1) Robustness to face localization errors and facial occlusions. An approach is proposed to handle face localization errors and facial occlusions using Gabor based templates. Template extraction algorithms are designed to collect a pool of local template features and template matching is then performed to covert these templates into distances, which are robust to localization errors and occlusions. (2) Improvement of performance through feature comparison, selection and fusion. A comparative framework is presented to compare the performance between different features and different feature selection algorithms, and examine the performance improvement arising from fusion of texture and geometry. The framework is evaluated for both discrete and dimensional expression recognition on spontaneous data. (3) Evaluation of performance in the context of real-world applications. A system is selected and applied into discriminating posed versus spontaneous expressions and recognizing naturalistic facial expressions. A database is collected from real-world recordings and is used to explore feature differences between standard database images and real-world images, as well as between real-world images and real-world video frames. The performance evaluations are based on the JAFFE, CK, Feedtum, NVIE, Semaine and self-collected QUT databases. The results demonstrate high robustness of the proposed approach to the simulated localization errors and occlusions. Texture and geometry have different contributions to the performance of discrete and dimensional expression recognition, as well as posed versus spontaneous emotion discrimination. These investigations provide useful insights into enhancing robustness and achieving high performance of FER systems, and putting them into real-world applications.

Birth outcomes after spontaneous or assisted conception among infertile Australian women aged 28 to 36 years: A prospective, population-based study

Objective To examine the extent to which the odds of birth, pregnancy, or adverse birth outcomes are higher among women aged 28 to 36 years who use fertility treatment compared with untreated women. Design Prospective, population-based. Setting Not applicable. Patient(s) Participants in the ALSWH born in 1973 to 1978 who reported on their infertility and use of in vitro fertilization (IVF) or ovulation induction (OI). Intervention(s) Postal survey questionnaires administered as part of ALSWH. Main Outcome Measure(s) Among women treated with IVF or OI and untreated women, the odds of birth outcomes estimated by use of adjusted logistic regression modeling. Result(s) Among 7,280 women, 18.6% (n = 1,376) reported infertility. Half (53.0%) of the treated women gave birth compared with 43.8% of untreated women. Women with prior parity were less likely to use IVF compared with nulliparous women. Women using IVF or OI, respectively, were more likely to have given birth after treatment or be pregnant compared with untreated women. Women using IVF or OI were as likely to have ectopic pregnancies, stillbirths, or premature or low birthweight babies as untreated women. Conclusion(s) More than 40% of women aged 28–36 years reporting a history of infertility can achieve births without using treatment, indicating they are subfertile rather than infertile.

Next-generation sequencing of cervical DNA detects human papillomavirus types not detected by commercial kits

Background Human papillomavirus (HPV) is the aetiological agent for cervical cancer and genital warts. Concurrent HPV and HIV infection in the South African population is high. HIV positive (+) women are often infected with multiple, rare and undetermined HPV types. Data on HPV incidence and genotype distribution are based on commercial HPV detection kits, but these kits may not detect all HPV types in HIV + women. The objectives of this study were to (i) identify the HPV types not detected by commercial genotyping kits present in a cervical specimen from an HIV positive South African woman using next generation sequencing, and (ii) determine if these types were prevalent in a cohort of HIV-infected South African women. Methods Total DNA was isolated from 109 cervical specimens from South African HIV + women. A specimen within this cohort representing a complex multiple HPV infection, with 12 HPV genotypes detected by the Roche Linear Array HPV genotyping (LA) kit, was selected for next generation sequencing analysis. All HPV types present in this cervical specimen were identified by Illumina sequencing of the extracted DNA following rolling circle amplification. The prevalence of the HPV types identified by sequencing, but not included in the Roche LA, was then determined in the 109 HIV positive South African women by type-specific PCR. Results Illumina sequencing identified a total of 16 HPV genotypes in the selected specimen, with four genotypes (HPV-30, 74, 86 and 90) not included in the commercial kit. The prevalence's of HPV-30, 74, 86 and 90 in 109 HIV positive South African women were found to be 14.6 %, 12.8 %, 4.6 % and 8.3 % respectively. Conclusions Our results indicate that there are HPV types, with substantial prevalence, in HIV positive women not being detected in molecular epidemiology studies using commercial kits. The significance of these types in relation to cervical disease remains to be investigated.