Prevalence, characteristics and mortality outcomes of obese, nonobese and lean NAFLD in the United States, 1999-2016

BACKGROUND

Updated prevalence and outcome data for nonobese NAFLD for the multi-ethnic US population is limited.

OBJECTIVES

We aimed to investigate the prevalence, clinical characteristics and mortality of obese and nonobese individuals with NAFLD in the United Sates.

METHODS

A retrospective study was conducted using the 1999-2016 NHANES databases. We determined hazard ratio stratified by obesity status in NAFLD individuals using Cox regression and log-rank test.

RESULTS

Overall NAFLD prevalence was 32.3%: 22.7% were obese and 9.6% were nonobese, with increasing trend over time for obese NAFLD, but not nonobese NAFLD. Amongst those with NAFLD, 29.7% (95% CI: 27.8%-31.7%) were nonobese, of which 13.6% had lean NAFLD. Nonobese NAFLD was more common in older (40.9% if ≥ 65 vs. 24.2% if < 65 years), male (34.0% vs. 24.2%) and foreign-born Asian people (39.8% vs. 11.4%) and uncommon in black (11.5% vs 30-35% in other ethnicities, P < 0.001). Metabolic comorbidities were common in nonobese NAFLD individuals who also had more advanced fibrosis. Nonobese NAFLD individuals had higher 15-year cumulative all-cause mortality (51.7%) than obese NAFLD (27.2%) and non-NAFLD (20.7%) (P < 0.001). However, DM and fibrosis, but neither obese nor nonobese NAFLD compared to non-NAFLD was independently associated with higher mortality.

CONCLUSION

Nonobese NAFLD makes up about one-third of the NAFLD in the United States (even higher in older, male and foreign-born individuals) and carries higher mortality than obese NAFLD. Screening for NAFLD should be considered in high-risk groups even in the absence of obesity.

Automatic Machine Learning to Differentiate Pediatric Posterior Fossa Tumors on Routine MR Imaging

BACKGROUND AND PURPOSE

Differentiating the types of pediatric posterior fossa tumors on routine imaging may help in preoperative evaluation and guide surgical resection planning. However, qualitative radiologic MR imaging review has limited performance. This study aimed to compare different machine learning approaches to classify pediatric posterior fossa tumors on routine MR imaging.

MATERIALS AND METHODS

This retrospective study included preoperative MR imaging of 288 patients with pediatric posterior fossa tumors, including medulloblastoma (n = 111), ependymoma (n = 70), and pilocytic astrocytoma (n = 107). Radiomics features were extracted from T2-weighted images, contrast-enhanced T1-weighted images, and ADC maps. Models generated by standard manual optimization by a machine learning expert were compared with automatic machine learning via the Tree-Based Pipeline Optimization Tool for performance evaluation.

RESULTS

For 3-way classification, the radiomics model by automatic machine learning with the Tree-Based Pipeline Optimization Tool achieved a test micro-averaged area under the curve of 0.91 with an accuracy of 0.83, while the most optimized model based on the feature-selection method χ2 score and the Generalized Linear Model classifier achieved a test micro-averaged area under the curve of 0.92 with an accuracy of 0.74. Tree-Based Pipeline Optimization Tool models achieved significantly higher accuracy than average qualitative expert MR imaging review (0.83 versus 0.54, P < .001). For binary classification, Tree-Based Pipeline Optimization Tool models achieved an area under the curve of 0.94 with an accuracy of 0.85 for medulloblastoma versus nonmedulloblastoma, an area under the curve of 0.84 with an accuracy of 0.80 for ependymoma versus nonependymoma, and an area under the curve of 0.94 with an accuracy of 0.88 for pilocytic astrocytoma versus non-pilocytic astrocytoma.

CONCLUSIONS

Automatic machine learning based on routine MR imaging classified pediatric posterior fossa tumors with high accuracy compared with manual expert pipeline optimization and qualitative expert MR imaging review.

Deep Learning to Distinguish Benign from Malignant Renal Lesions Based on Routine MR Imaging

PURPOSE

With increasing incidence of renal mass, it is important to make a pretreatment differentiation between benign renal mass and malignant tumor. We aimed to develop a deep learning model that distinguishes benign renal tumors from renal cell carcinoma (RCC) by applying a residual convolutional neural network (ResNet) on routine MR imaging.

EXPERIMENTAL DESIGN

Preoperative MR images (T2-weighted and T1-postcontrast sequences) of 1,162 renal lesions definitely diagnosed on pathology or imaging in a multicenter cohort were divided into training, validation, and test sets (70:20:10 split). An ensemble model based on ResNet was built combining clinical variables and T1C and T2WI MR images using a bagging classifier to predict renal tumor pathology. Final model performance was compared with expert interpretation and the most optimized radiomics model.

RESULTS

Among the 1,162 renal lesions, 655 were malignant and 507 were benign. Compared with a baseline zero rule algorithm, the ensemble deep learning model had a statistically significant higher test accuracy (0.70 vs. 0.56, P = 0.004). Compared with all experts averaged, the ensemble deep learning model had higher test accuracy (0.70 vs. 0.60, P = 0.053), sensitivity (0.92 vs. 0.80, P = 0.017), and specificity (0.41 vs. 0.35, P = 0.450). Compared with the radiomics model, the ensemble deep learning model had higher test accuracy (0.70 vs. 0.62, P = 0.081), sensitivity (0.92 vs. 0.79, P = 0.012), and specificity (0.41 vs. 0.39, P = 0.770).

CONCLUSIONS

Deep learning can noninvasively distinguish benign renal tumors from RCC using conventional MR imaging in a multi-institutional dataset with good accuracy, sensitivity, and specificity comparable with experts and radiomics.

A novel glaucomatous representation method based on Radon and wavelet transform

Background

Glaucoma is an irreversible eye disease caused by the optic nerve injury. Therefore, it usually changes the structure of the optic nerve head (ONH). Clinically, ONH assessment based on fundus image is one of the most useful way for glaucoma detection. However, the effective representation for ONH assessment is a challenging task because its structural changes result in the complex and mixed visual patterns.

Method

We proposed a novel feature representation based on Radon and Wavelet transform to capture these visual patterns. Firstly, Radon transform (RT) is used to map the fundus image into Radon domain, in which the spatial radial variations of ONH are converted to a discrete signal for the description of image structural features. Secondly, the discrete wavelet transform (DWT) is utilized to capture differences and get quantitative representation. Finally, principal component analysis (PCA) and support vector machine (SVM) are used for dimensionality reduction and glaucoma detection.

Results

The proposed method achieves the state-of-the-art detection performance on RIMONE-r2 dataset with the accuracy and area under the curve (AUC) at 0.861 and 0.906, respectively.

Conclusion

In conclusion, we showed that the proposed method has the capacity as an effective tool for large-scale glaucoma screening, and it can provide a reference for the clinical diagnosis on glaucoma.

Retinal vessel segmentation using dense U-net with multiscale inputs

A color fundus image is an image of the inner wall of the eyeball taken with a fundus camera. Doctors can observe retinal vessel changes in the image, and these changes can be used to diagnose many serious diseases such as atherosclerosis, glaucoma, and age-related macular degeneration. Automated segmentation of retinal vessels can facilitate more efficient diagnosis of these diseases. We propose an improved U-net architecture to segment retinal vessels. Multiscale input layer and dense block are introduced into the conventional U-net, so that the network can make use of richer spatial context information. The proposed method is evaluated on the public dataset DRIVE, achieving 0.8199 in sensitivity and 0.9561 in accuracy. Especially for thin blood vessels, which are difficult to detect because of their low contrast with the background pixels, the segmentation results have been improved.

[Imaging characteristics of patients with large vestibular aqueduct syndrome and its relationship with the acoustically evoked short latency negative response]

Objective: To explore the imaging characteristics of large vestibular aqueduct syndrome (LVAS) patients and their relationship with the acoustically evoked short latency negative response (ANSR), so as to provide reference for the diagnosis of LVAS. Methods: Clinical data of 174 patients(334 ears) with LVAS diagnosed and treated by the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Guangxi Medical University, from October 2009 to December 2017 were retrospectively analyzed, including 117 males and 57 females, aged from 5 months to 47 years old, with the median age of 4 years and 4 months. ABR and imaging data of patients were collected. Midpoint diameter and the outlet diameter of the vestibular aqueduct were measured on CT images, the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac(EES) were measured on MRI images. The correlation between the above measurements was analyzed by Pearson test using SPSS 17.0. According to whether ASNR was detected in ABR, the above data were divided into two groups, and the differences of the above imaging measurements were compared by the Independent-Sample Test. Results: The average midpoint diameter of the vestibular aqueduct was (1.87±0.58) mm (x±s, the following was the same), and the outlet diameter was (3.07±0.99) mm on CT; the average midpoint diameter of the intraosseous parts in enlarged endolymphatic sac(EES) was (2.39±1.37) mm, and the extraosseous parts was (2.50±2.18) mm on MRI. There was a correlation between the four measurements (P<0.05), among which the midpoint diameter of vestibular aqueduct was strongly positively correlated with the outlet diameter (r=0.760), and the remaining pairs were weakly correlated. ASNR was detected in 241 ears (72.16%,241/334) and undetected in 93 ears (27.84%, 93/334) of the 334 ears with LVAS. Midpoint diameter and the outlet diameter of the vestibular aqueduct in no ASNR group were smaller than the ASNR group, and the difference was statistically significant (t value was 2.814 and 2.754, P<0.05). There was no significant difference in the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac between the two groups, and the difference was no statistically significant(t value was 0.101 and 0.683, P>0.05). Conclusions: There is a strong positive correlation between the midpoint diameter of vestibular aqueduct and the outlet diameter in LVAS patients. There is a certain correlation between the size of vestibular aqueduct and the size of endolymphatic sac. The smaller the diameter of vestibular aqueduct, the lower the occurrence rate of ASNR.

Weakly-Supervised Simultaneous Evidence Identification and Segmentation for Automated Glaucoma Diagnosis

Evidence identification, optic disc segmentation and automated glaucoma diagnosis are the most clinically significant tasks for clinicians to assess fundus images. However, delivering the three tasks simultaneously is extremely challenging due to the high variability of fundus structure and lack of datasets with complete annotations. In this paper, we propose an innovative Weakly-Supervised Multi-Task Learning method (WSMTL) for accurate evidence identification, optic disc segmentation and automated glaucoma diagnosis. The WSMTL method only uses weak-label data with binary diagnostic labels (normal/glaucoma) for training, while obtains pixel-level segmentation mask and diagnosis for testing. The WSMTL is constituted by a skip and densely connected CNN to capture multi-scale discriminative representation of fundus structure; a well-designed pyramid integration structure to generate high-resolution evidence map for evidence identification, in which the pixels with higher value represent higher confidence to highlight the abnormalities; a constrained clustering branch for optic disc segmentation; and a fully-connected discriminator for automated glaucoma diagnosis. Experimental results show that our proposed WSMTL effectively and simultaneously delivers evidence identification, optic disc segmentation (89.6% TP Dice), and accurate glaucoma diagnosis (92.4% AUC). This endows our WSMTL a great potential for the effective clinical assessment of glaucoma.

Long-term efficacy and safety of ustekinumab for Crohn's disease through the second year of therapy

BACKGROUND

In Phase 3 studies of ustekinumab, a fully human monoclonal IL-12/23p40 antibody approved for moderate-to-severe Crohn's disease, patients entered a long-term extension after completing 8 weeks of induction and 44 weeks of maintenance treatment. Efficacy through 92 weeks and safety through 96 weeks of IM-UNITI maintenance are reported.

METHODS

UNITI-1 (TNF-antagonist failures) and UNITI-2 (conventional therapy failures) patients (N = 1281) entered IM-UNITI, including 397 ustekinumab intravenous induction responders randomised to subcutaneous ustekinumab 90 mg every 12 weeks, every 8 weeks, or placebo and 884 nonrandomised patients. Dose-adjustment to 90 mg every 8 weeks occurred in patients randomised to 90 mg every 12 weeks and placebo patients with loss of response (Weeks 8-32). All Week 44 completers could enter the long-term extension without further dose adjustment. Placebo patients discontinued following study unblinding.

RESULTS

A total of 718 patients (all treated) entered the long-term extension (298 randomised and 420 not randomised). Overall, 86.5% (621/718) completed Week 96. The proportions of randomised patients in clinical remission were generally maintained from Week 44 through 92 in ustekinumab 90 mg every 12 weeks (77.4% to 72.6%), every 8 weeks (84.1% to 74.4%), and prior dose adjustment groups (63.4% to 53.5%). At Week 92, the proportions of patients in clinical remission were similar in the ustekinumab 90 mg every 12 weeks and every 8 weeks groups and lower in patients with prior dose adjustment. Proportions of patients in clinical remission at Week 92 for all treated every 8 weeks (64.4%) and every 12 weeks (64.3%) groups were lower than randomised every 8 weeks (74.4%) and every 12 weeks (72.6%) groups, but similarly maintained. Safety events (per hundred patient-years) were similar among all placebo and ustekinumab patients (Week 0-96), including adverse events (484.39 vs 447.76), serious adverse events (19.24 vs 18.82), and serious infections (4.09 vs 4.02). No dose effect was observed.

CONCLUSIONS

Subcutaneous ustekinumab maintained clinical response and remission through Week 92. No new safety signals were observed. ClinicalTrials.gov number NCT01369355.

A frameshift mutation in the CHM gene causes choroideremia with acute angle‑closure glaucoma

Choroideremia is an X‑linked recessive chorioretinal degenerative disease that is characterized by progressive centripetal loss of the photoreceptor, retinal pigment epithelium (RPE), and choriocapillaris layers. The CHM gene [choroideremia (Rab escort protein 1)] has been identified as the pathogenic gene in choroideremia. The aim of the present study was to describe the clinical and genetic characteristics of a family with choroideremia family. In the present study, a family with choroideremia presenting with serious chorioretinal atrophy and pigment proliferation, shallow anterior chambers, angle closure and high intraocular pressure (IOP) were recruited. The affected family members underwent a complete ophthalmologic examination. DNA samples obtained from the proband II:1 and the patient II:2 were used for targeted exome sequencing of the CHM gene. PCR amplification and Sanger sequencing were used to validate the variations exhibited in family members and controls. A novel frameshift mutation c.280delA (p.Thr94LeufsTer32), in CHM was identified in the male proband, the normal carrier I:2 and the phenotyped carrier II:2, which was absent in the normal individual II:3 as well as in 200 normal controls. Comparing the amino acid sequences of CHM between multiple species through Clustal Omega indicated conserved amino acids in these mutant sites. Additionally, an X‑chromosome inactivation (XCI) assay was performed in the female carriers in the family, in which DNA of the abnormal carrier II:2 and normal carrier I:2 showed a random XCI pattern. To conclude, the present findings strongly indicate that the c.280delA mutation is a disease‑causing mutation in our choroideremia pedigree with acute angle‑closure glaucoma.

Systematic review with meta-analysis: effectiveness and tolerability of interferon-free direct-acting antiviral regimens for chronic hepatitis C genotype 1 in routine clinical practice in Asia

BACKGROUND

Direct-acting antiviral (DAA) regimens have shown high efficacy and tolerability for patients with HCV genotype 1/1b (GT1/1b) in clinical trials. However, robust real-world evidence of interferon (IFN)-free DAA treatment for HCV GT1-infected patients in Asia is still lacking.

AIM

To systematically review and meta-analyse the effectiveness and tolerability of IFN-free DAA therapy for HCV GT1 infection in Asia.

METHODS

We included studies that enrolled adult patients with HCV GT1 infection in routine clinical practice in Asia, using IFN-free DAA regimens, and reported sustained virological response (SVR) after 12/24 weeks end-of-treatment by 31 May 2017. The pooled SVR rates were computed with a random-effects model. Subgroup analysis and meta-regression as previously registered in PROSPERO were performed to determine how pre-planned variables might have affected the pooled estimates.

RESULTS

We included 41 studies from eight countries and regions, comprising of 8574 individuals. The pooled SVR rates for GT1 were 89.9% (95% CI 88.6-91.1, I²  = 55.1%) with daclatasvir/asunaprevir (DCV/ASV) and 98.1% (95% CI 97.0-99.0, I²  = 41.0%) with ledipasvir/sofosbuvir ± ribavirin (LDV/SOF ± RBV). Baseline cirrhosis but not prior treatment history and age, attenuated the effectiveness of both regimens. Baseline resistance associated substitutions (RASs) severely attenuated SVR of DCV/ASV (65.4% vs 94.3%, P < 0.001) and only minimally with LDV/SOF ± RBV (94.5% vs 99.2%, P = 0.003). Patients with renal dysfunction treated with DCV/ASV showed a higher SVR rate (93.9% vs 89.8%, P = 0.046). Patients with hepatocellular carcinoma (HCC) LDV/SOF ± RBV achieved a lower SVR than those without HCC (94.1% vs 98.7%, P = 0.001).

CONCLUSION

All oral DAA treatment of HCV GT1 resulted in high cure rates in Asian patients in routine clinical practice setting including elderly patients and those with end-stage renal disease.

Retinal Blood Vessel Segmentation Using Extreme Learning Machine

Extreme learning machine (ELM) is an effective machine learning technique that widely used in image processing. In this paper, a new supervised method for segmenting blood vessels in retinal images is proposed based on the ELM classifier. The proposed algorithm first constructs a 7-D feature vector using multi-scale Gabor filter, Hessian matrix and bottom-hat transformation. Then, an ELM classifier is trained on gold standard examples of vessel segmentation images to classify previous unseen images. The algorithm was tested on the publicly available DRIVE database – a digital image database for vessel extraction. Experimental results on both real-captured images and public database images demonstrate that our method shows comparative performance against other methods, which make the proposed algorithm a suitable tool for automated retinal image analysis.

Hierarchical Contour Closure-Based Holistic Salient Object Detection

Most existing salient object detection methods compute the saliency for pixels, patches, or superpixels by contrast. Such fine-grained contrast-based salient object detection methods are stuck with saliency attenuation of the salient object and saliency overestimation of the background when the image is complicated. To better compute the saliency for complicated images, we propose a hierarchical contour closure-based holistic salient object detection method, in which two saliency cues, i.e., closure completeness and closure reliability, are thoroughly exploited. The former pops out the holistic homogeneous regions bounded by completely closed outer contours, and the latter highlights the holistic homogeneous regions bounded by averagely highly reliable outer contours. Accordingly, we propose two computational schemes to compute the corresponding saliency maps in a hierarchical segmentation space. Finally, we propose a framework to combine the two saliency maps, obtaining the final saliency map. Experimental results on three publicly available datasets show that even each single saliency map is able to reach the state-of-the-art performance. Furthermore, our framework, which combines two saliency maps, outperforms the state of the arts. Additionally, we show that the proposed framework can be easily used to extend existing methods and further improve their performances substantially.

Automatic Retinal Image Registration Using Blood Vessel Segmentation and SIFT Feature

Automatic retinal image registration is still a great challenge in computer aided diagnosis and screening system. In this paper, a new retinal image registration method is proposed based on the combination of blood vessel segmentation and scale invariant feature transform (SIFT) feature. The algorithm includes two stages: retinal image segmentation and registration. In the segmentation stage, the blood vessel is segmented by using the guided filter to enhance the vessel structure and the bottom-hat transformation to extract blood vessel. In the registration stage, the SIFT algorithm is adopted to detect the feature of vessel segmentation image, complemented by using a random sample consensus (RANSAC) algorithm to eliminate incorrect matches. We evaluate our method from both segmentation and registration aspects. For segmentation evaluation, we test our method on DRIVE database, which provides manually labeled images from two specialists. The experimental results show that our method achieves 0.9562 in accuracy (Acc), which presents competitive performance compare to other existing segmentation methods. For registration evaluation, we test our method on STARE database, and the experimental results demonstrate the superior performance of the proposed method, which makes the algorithm a suitable tool for automated retinal image analysis.

Orientation Histogram-Based Center-Surround Interaction: An Integration Approach for Contour Detection

Contour is a critical feature for image description and object recognition in many computer vision tasks. However, detection of object contour remains a challenging problem because of disturbances from texture edges. This letter proposes a scheme to handle texture edges by implementing contour integration. The proposed scheme integrates structural segments into contours while inhibiting texture edges with the help of the orientation histogram-based center-surround interaction model. In the model, local edges within surroundings exert a modulatory effect on central contour cues based on the co-occurrence statistics of local edges described by the divergence of orientation histograms in the local region. We evaluate the proposed scheme on two well-known challenging boundary detection data sets (RuG and BSDS500). The experiments demonstrate that our scheme achieves a high [Formula: see text]-measure of up to 0.74. Results show that our scheme achieves integrating accurate contour while eliminating most of texture edges, a novel approach to long-range feature analysis.

Temporal-Spatial Filtering for Enhancement of Low-Light Surveillance Video

A new surveillance video enhancement method is proposed to improve the visual effect of videos captured in low-light conditions. The proposed technique, called temporal-spatial (TS) filtering, uses adaptive temporal filtering and nonlocal mean filtering to smooth the transmission map in the temporal and spatial dimensions and thus yields restored video sequences with significantly reduced noise, improved details and good spatial and temporal coherence. The main advantage of this work is that the performance of contrast enhancement, noise reduction and temporal-spatial coherence can be significantly improved using the proposed framework, which adopts a strategy that applies the same transmission map to a series of video frames. Comparative study and quantitative evaluation demonstrate that the proposed method is better than previous techniques in terms of reducing noise and improving contrast.

Systematic review with network meta-analysis: comparative effectiveness and safety of strategies for preventing NSAID-associated gastrointestinal toxicity

BACKGROUND

Many strategies are used to prevent nonsteroidal anti-inflammatory drug (NSAID)-associated gastrointestinal toxicity, but the comparative effectiveness remains unclear.

AIM

To evaluate the comparative effectiveness of clinical strategies for preventing gastrointestinal toxicity induced by NSAIDs.

METHODS

MEDLINE, EMBASE and the Cochrane Library (from their inception to May 2015) were searched for randomised controlled trials comparing the risk of gastrointestinal adverse events in patients taking nonselective NSAIDs, selective cyclooxygenase(COX)-2 inhibitors or nonselective NSAIDs/COX-2 inhibitors plus gastroprotective agents [proton pump inhibitors (PPIs), histamine-2 receptor antagonists, misoprostol]. Both pairwise meta-analysis and Bayesian network meta-analysis were performed.

RESULTS

Analyses were based on 82 trials including 125 053 participants. Network meta-analysis demonstrated that selective COX-2 inhibitors + PPIs [Risk ratio (RR), 95% Credible Interval (CrI): ulcer complications 0.07, 0.02-0.18], selective COX-2 inhibitors (RR, 95% CrI: ulcer complications 0.25, 0.15- 0.38; symptomatic ulcer 0.12, 0.04-0.30), nonselective NSAIDs + PPIs (RR, 95% CrI: ulcer complications 0.28, 0.18-0.41; symptomatic ulcer 0.11, 0.04-0.23), nonselective NSAIDs + misoprostol (RR, 95% CrI: ulcer complications 0.47, 0.24-0.81; symptomatic ulcer 0.41, 0.13-1.00) were associated with significantly lower risk of clinical gastrointestinal events compared with nonselective NSAIDs. For all effectiveness endpoints, selective COX-2 inhibitors + PPIs was associated with the lowest absolute event probability and the highest rank, followed by selective COX-2 inhibitors and thirdly by nonselective NSAIDs + PPIs.

CONCLUSION

The combination of selective COX-2 inhibitors plus PPIs provides the best gastrointestinal protection, followed by selective COX-2 inhibitors, and thirdly by nonselective NSAIDs plus PPIs.

Prenatal diagnosis of trisomy 21, 18 and 13 by quantitative pyrosequencing of segmental duplications

Chromosomal aberration mostly occurs in chromosomes 21, 18 and 13, with an incidence approximately 1 out of 160 live births in humans, therefore making prenatal diagnosis necessary in clinics. Current methods have drawbacks such as time consuming, high cost, complicated operations and low sensitivity. In this paper, a novel method for rapid and accurate prenatal diagnosis of aneuploidy is proposed based on pyrosequencing, which quantitatively detects the peak height ratio (PHR) of different bases of segmental duplication. A direct polymerase chain reaction (PCR) approach was undertaken, where a small volume of amniotic fluid was used as the starting material without DNA extraction. Single-stranded DNA was prepared from PCR products and subsequently analyzed using pyrosequencing. The PHR between target and reference chromosome of 2.2 for euploid and 3:2 for a trisomy fetus were used as reference. The reference intervals and z scores were calculated for discrimination of aneuploidy. A total of 132 samples were collected, within trisomy 21 (n = 11), trisomy 18 (n = 3), trisomy 13 (n = 2), and unaffected controls (n = 116). A set of six segmental duplications were chosen for analysis. This method had consistent results with karyotyping analysis, a correct diagnosis with 100% sensitivity and 99.9% specificity.

Motion-Based Depth Estimation for 2D to 3D Video Conversion

Recent advances in 3D have increased the importance of stereoscopic content creation and processing. Therefore, converting existing 2D videos into 3D videos is very important for growing 3D market. The most difficult task in 2D-to-3D video conversion is estimating depth map from single-view frame images. Thus, in this paper, we propose a novel motion-based 2D to 3D video conversion method. The method first determines the motion type using the optical flow estimation. Then, different depth estimation processes are performed based on the motion type. For global motion, the depth from motion parallax provides the final depth map. For local motion, the depth from template together with the bilateral filter is used to produce the depth map. Finally, the left- and right-view images are synthesized to generate realistic stereoscopic results for viewers. During the process, the visual artifacts of the synthesized virtual views are effectively eliminated by recovering the separation and loss of foreground objects. A comparative study and quantitative evaluation with other conversion methods are carried out, which demonstrate that better overall quality results may be obtained using the proposed method.

Effects of potassium diformate on the gastric function of weaning piglets

Potassium diformate (KDF), as an acidifier, has been shown to improve growth performance in pigs, but it is not yet known whether KDF regulates gastric function. Thus, the objective of the present study was to investigate the effects of dietary KDF on gastric function in weaning piglets. One hundred and eighty Landrace × Large White piglets (bodyweight = 5.80 ± 0.15 kg) were weaned at 28 days old and randomly allocated into two groups, with six pens in each group and 15 piglets in each pen. Piglets in the control group were fed the basal diet, whereas the KDF-treated group was fed the basal diet supplemented with 10 g/kg KDF. After 35 days of feeding, the KDF treatment improved the bodyweight (P = 0.034) and reduced the relative weight of stomach (P = 0.050), decreased the hydrochloric acid concentration (P = 0.016) in the gastric digesta and the pepsin activity in the gastric oxyntic mucosa (P = 0.001) and increased the lactic acid concentration (P = 0.001) in the gastric digesta. Furthermore, KDF treatment increased the level of somatostatin (SS) (P = 0.009), but did not change the concentration of gastrin (P = 0.497) and the activity of H+-K+-ATPase (P = 0.575) in the gastric oxyntic mucosa. However, KDF treatment downregulated the expression of SS mRNA in the gastric oxyntic mucosa (P = 0.031) and upregulated the mRNA expression of gastrin (P < 0.001) and H+-K+-ATPase (P < 0.001) in the gastric oxyntic mucosa. These results suggest that the effects of KDF on weaning piglets may be related to the regulation of gastric function gene expression.

[Rapid 2D-3D medical image registration based on CUDA]

The medical image registration between preoperative three-dimensional (3D) scan data and intraoperative two-dimensional (2D) image is a key technology in the surgical navigation. Most previous methods need to generate 2D digitally reconstructed radiographs (DRR) images from the 3D scan volume data, then use conventional image similarity function for comparison. This procedure includes a large amount of calculation and is difficult to archive real-time processing. In this paper, with using geometric feature and image density mixed characteristics, we proposed a new similarity measure function for fast 2D-3D registration of preoperative CT and intraoperative X-ray images. This algorithm is easy to implement, and the calculation process is very short, while the resulting registration accuracy can meet the clinical use. In addition, the entire calculation process is very suitable for highly parallel numerical calculation by using the algorithm based on CUDA hardware acceleration to satisfy the requirement of real-time application in surgery.

Spectroscopic ellipsometry as an optical probe of strain evolution in ferroelectric thin films

Heteroepitaxial strain in ferroelectric thin films is known to have a significant impact on both their low and high frequency dielectric properties. In this paper, we use ex-situ spectroscopic ellipsometry to study the strain evolution with film thickness, and strain relaxation in ferroelectric Ba0.5Sr0.5<TiO3 epitaxial films grown on single crystal substrates. For films grown on MgO substrates, a critical thickness for strain relaxation is observed. In addition, studies of Ba0.5Sr0.5<TiO3 films grown on different single crystal substrates reveal that the strain relaxation rate can be inferred from changes in the optical properties. Using this information, we show that the optical constants of Ba0.5Sr0.5<TiO3 can be readily tuned via strain engineering.

Glucose stimulates human beta cell replication in vivo in islets transplanted into NOD-severe combined immunodeficiency (SCID) mice

AIMS/HYPOTHESIS

We determined whether hyperglycaemia stimulates human beta cell replication in vivo in an islet transplant model

METHODS

Human islets were transplanted into streptozotocin-induced diabetic NOD-severe combined immunodeficiency mice. Blood glucose was measured serially during a 2 week graft revascularisation period. Engrafted mice were then catheterised in the femoral artery and vein, and infused intravenously with BrdU for 4 days to label replicating beta cells. Mice with restored normoglycaemia were co-infused with either 0.9% (wt/vol.) saline or 50% (wt/vol.) glucose to generate glycaemic differences among grafts from the same donors. During infusions, blood glucose was measured daily. After infusion, human beta cell replication and apoptosis were measured in graft sections using immunofluorescence for insulin, and BrdU or TUNEL.

RESULTS

Human islet grafts corrected diabetes in the majority of cases. Among grafts from the same donor, human beta cell proliferation doubled in those exposed to higher glucose relative to lower glucose. Across the entire cohort of grafts, higher blood glucose was strongly correlated with increased beta cell replication. Beta cell replication rates were unrelated to circulating human insulin levels or donor age, but tended to correlate with donor BMI. Beta cell TUNEL reactivity was not measurably increased in grafts exposed to elevated blood glucose.

CONCLUSIONS/INTERPRETATION

Glucose is a mitogenic stimulus for transplanted human beta cells in vivo. Investigating the underlying pathways may point to mechanisms capable of expanding human beta cell mass in vivo.

Heavy metal contamination in soils and food crops around Dabaoshan mine in Guangdong, China: implication for human health

This study was designed to investigate heavy metal (Cu, Zn, Pb, and Cd) contamination levels of soils, vegetables, and rice grown in the vicinity of the Dabaoshan mine, south China. The concentration of Cu, Zn, Pb, and Cd in paddy soil exceeded the maximum allowable concentrations for Chinese agricultural soil. The heavy metal concentrations (mg kg(-1), dry weight basis) in vegetables ranged from 5.0 to 14.3 for Cu, 34.7 to 170 for Zn, 0.90 to 2.23 for Pb, and 0.45 to 4.1 for Cd. The concentrations of Pb and Cd in rice grain exceeded the maximum permissible limits in China. Dietary intake of Pb and Cd through the consumption of rice and certain vegetable exceeded the recommended dietary allowance levels. The status of heavy metal concentrations of food crops grown in the vicinity of Dabaoshan mine and their implications for human health should be further investigated.

Gefitinib versus platinum contained doublet chemotherapy in chemotherapy-naive patients with stage IIIb or IV non-small cell lung cancer of adenocarcinoma histology: A retrospective case control study

e19070

Background: The results of the ISEL study in non-small cell lung cancer (NSCLC) suggest greater benefit of gefitinib among Asian patients and non-smokers compared with the overall trial population. Methods: We conducted a retrospective case-control study to compare outcomes for gefitinib versus platinum doublet chemotherapy as first line treatment in selected NSCLC patients (stage IIIB/IV adenocarcinoma, PS 0–2). Patient receiving platinum chemotherapy were selected on the basis of disease stage (IIIB or IV), gender, smoking history, WHO performance status (PS) (0–1, or 2) and age (< 60ys or ≥ 60ys) being matched to patients receiving gefitinib. Gefitinib and chemotherapy arm patients were selected by 1:2 ratio in order to increase statistical power. The study was approved by local institute review board. Results: 99 chemo-naïve adenocarcinoma patients treated in our institute from January 2006 to December 2007 were collected: 33 received gefitinib and 66 received chemotherapy. The baseline characteristics are listed in table 1 . The median duration of follow-up was 10 months. Patients receiving gefitinib experienced significantly higher ORR and DCR, and prolonged PFS ( table 1 ). Patients receiving chemotherapy experienced more frequent grade 3–4 neutropenia (42.4% vs 0%), thrombocytopenia (21.2% Vs 0%), febrile neutropenia (7.5% vs 0%) and nausea (24.2% vs 3.0%). The most commonly recorded adverse events in the gefitinib arm were rash/acne (9.1%), diarrhea (3.0%), nausea (3.0%) and anemia (3.0%). Conclusions: The limitations of case-control studies are acknowledged, yet these results were supported by IPASS. Gefitinib as first-line treatment confers clinically relevant benefit in Asian NSCLC patients with adenocarcinoma histology versus platinum based chemotherapy.

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Dendritic plasticity of CA1 pyramidal neurons after transient global ischemia

Dendrites and spines undergo dynamic changes in physiological conditions, such as learning and memory, and in pathological conditions, such as Alzheimer's disease and epilepsy. Long-term dendritic plasticity has also been reported after ischemia/hypoxia, which might be compensatory effects of surviving neurons for the functional recovery after the insults. However, the dendritic changes shortly after ischemia, which might be associated with the pathogenesis of ischemic cell death, remain largely unknown. To reveal the morphological changes of ischemia-vulnerable neurons after ischemia, the present study investigated the alteration of dendritic arborization of CA1 pyramidal neurons in rats after transient cerebral ischemia using intracellular staining technique in vivo. The general appearance of dendritic arborization of CA1 neurons within 48 h after ischemia was similar to that of control neurons. However, a dramatic increase of dendritic disorientation was observed after ischemia with many basal dendrites coursed into the territory of apical dendrites and apical dendrites branched into the region of basal dendrites. In addition, a significant increase of apical dendritic length was found 24 h after ischemia. The increase of dendritic length after ischemia was mainly due to the dendritic sprouting rather than the extension of individual dendrites, which mainly occurred in the middle segment of the apical dendrites. These results reveal a plasticity change in dendritic arborization of CA1 neurons shortly after cerebral ischemia.

The contribution of cardiorespiratory fitness and visceral fat to risk factors in Japanese patients with impaired glucose tolerance and type 2 diabetes mellitus

It is still unclear as to how cardiorespiratory fitness and visceral fat accumulation contribute to coronary heart disease (CHD) risk factors in patients with diabetes mellitus. The purpose of the present study was to investigate whether cardiorespiratory fitness contributes to such risk factors independently of visceral fat accumulation. Two hundred Japanese patients (137 men and 63 women, aged 22 to 81 years) with impaired glucose tolerance (IGT) and type 2 diabetes mellitus (type 2 DM) without any intervention and pharmacological therapy participated in a cross-sectional study. The levels of fasting insulin, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and resting blood pressure were assessed. Maximal oxygen uptake (V.o(2max)), an index of cardiorespiratory fitness, was predicted by a graded exercise test using a cycle ergometer. Visceral fat area (VFA) was measured by computed tomography scan. The criteria for abnormalities of the risk factors were determined according to the standard values for Japanese. All subjects were divided equally into the following 3 groups according to their fitness level: low-fit (V.o(2max) < 32 mL/kg/min in men, V.o(2max) < 26 mL/kg/min in women), mid-fit (32 < or = V.o(2max) < 36 in men, 26 < or = V.o(2max) < 30 in women), and high-fit (V.o(2max) > or = 36 in men, V.o(2max) > or = 30 in women). The association between fitness level and the prevalence of abnormal values for these parameters was analyzed by a multiple logistic regression model adjusted for age and VFA. The odds ratio (OR) and 95% confidence interval (CI) for the prevalence of hyperinsulinemia were significantly lower in the mid-fit (OR = 0.35, 95% CI, 0.16 to 0.78) and in the high-fit groups (OR = 0.40, 95% CI, 0.16 to 0.98) compared with the low-fit group. In addition, ORs for the prevalence of low HDL-C in the mid-fit and high-fit groups were significantly lower (OR = 0.35, 95% CI, 0.14 to 0.86; and OR = 0.19; 95% CI, 0.08 to 0.60, respectively) than in the low-fit group. These results suggested that cardiorespiratory fitness might be one of the predictors of metabolic abnormalities, especially in patients with hyperinsulinemia and low HDL-C, independent of visceral fat accumulation in Japanese patients with IGT and type 2 DM.