Development of automated image stitching system for radiographic images

Standard X-ray images using conventional screen-film technique have a limited field of view that is insufficient to show the full bone structure of large hands on a single frame. To produce images containing the whole hand structure, digitized images from the X-ray films can be assembled using image stitching. This paper presents a new medical image stitching method that utilizes minimum average correlation energy filters to identify and merge pairs of hand X-ray medical images. The effectiveness of the proposed method is demonstrated in the experiments involving two databases which contain a total of 40 pairs of overlapping and non-overlapping hand images. The experimental results are compared with that of the normalized cross-correlation (NCC) method. It is found that the proposed method outperforms the NCC method in classifying and merging the overlapping and non-overlapping medical images. The efficacy of the proposed method is further indicated by its average execution time, which is about five times shorter than that of the other method.

Good clinical laboratory practices improved proficiency testing performance at clinical trials centers in Ghana and Burkina Faso

Background

The recent drive towards accreditation of clinical laboratories in Africa by the World Health Organization – Regional Office for Africa (WHO-AFRO) and the U.S Government is a historic step to strengthen health systems, provide better results for patients and an improved quality of results for clinical trials. Enrollment in approved proficiency testing (PT) programs and maintenance of satisfactory performance is vital in the process of accreditation. Passing proficiency testing surveys has posed a great challenge to many laboratories across sub-Saharan Africa. Our study was aimed at identifying the causes of unsatisfactory PT results in clinical research laboratories conducting or planning to conduct malaria vaccine trials sponsored by the National Institutes of Health (NIH).

Methodology

PT reports for 2009 and 2010 from the College of American Pathologists (CAP) for the laboratories were reviewed as part of the process. Errors accounting for unsatisfactory results were classified into clerical, methodological, technical, problem with PT materials, and random errors. A training program on good clinical laboratory practices (GCLP) was developed for each center to address areas for improvement.

Results

The major cause of PT failure in the four centers was methodological. The application of GCLP improved the success rate in the PT surveys from 58% in 2009 to 88% in 2010. It also decreased the error rate on PT by 35%.

Conclusion

A previous report from the CAP- PT participating laboratories indicated that the major causes of error were clerical. These types of errors were predominantly made in laboratories in the US, with much more experience in quality control, and varied significantly from what we found. In our centers in sub-Saharan Africa, methodological errors, and not clerical errors, accounted for the vast majority of errors. A process was started for continuous improvement which has decreased methodological errors by 35%, but more improvement is needed.

Reactive oxygen species and nitric oxide effect on the steroid hormone binding with serum albumin

The interaction of a series of steroid hormones (DHEA, progesterone, testosterone, estradiol) with serum albumin immobilized on porous silica particles and the effect of reactive oxygen species and nitric oxide on this interaction were studied using a biochromatographic approach. The determination of enthalpy and entropy changes of this binding indicated that van der Waals interactions and hydrogen bonds predominated the hormone association with albumin. Reactive oxygen species (H(2)O(2) and OH*) increased the hormone binding affinity to albumin. On the other hand, this binding was decreased with the presence of NO*. This variation was due to conformational changes in the binding region explained by the oxidation of some residues such as free thiol and arginine. The thermodynamic analysis showed that free radical affects the van der Waals forces and/or a hydrogen bond of the hormone binding with albumin. These results explained the role of reactive oxygen species and nitric oxide in the hormone free fraction level in the blood.

Development of a kidney TeleUltrasound consultation system

This paper presents the development of kidney TeleUltrasound consultation system. The TeleUltrasound system provides an innovative design that aids the acquisition, archiving, and dissemination of medical data and information over the internet as its backbone. The system provides data sharing to allow remote collaboration, viewing, consultation, and diagnosis of medical data. The design is layered upon a standard known as Digital Imaging and Communication in Medicine (DICOM). The DICOM standard defines protocols for exchanging medical images and their associated data. The TeleUltrasound system is an integrated solution for retrieving, processing, and archiving images and providing data storage management using Structured Query Language (SQL) database. Creating a web-based interface is an additional advantage to achieve global accessibility of experts that will widely open the opportunity of greater examination and multiple consultations. This system is equipped with a high level of data security and its performance has been tested with white, black, and gray box techniques. And the result was satisfactory. The overall system has been evaluated by several radiologists in Malaysia, United Arab Emirates, and Sudan, the result is shown within this paper.

Non-invasive diagnosis of risk in dengue patients using bioelectrical impedance analysis and artificial neural network

This paper presents a new approach to diagnose and classify early risk in dengue patients using bioelectrical impedance analysis (BIA) and artificial neural network (ANN). A total of 223 healthy subjects and 207 hospitalized dengue patients were prospectively studied. The dengue risk severity criteria was determined and grouped based on three blood investigations, namely, platelet (PLT) count (less than or equal to 30,000 cells per mm(3)), hematocrit (HCT) (increase by more than or equal to 20%), and either aspartate aminotransferase (AST) level (raised by fivefold the normal upper limit) or alanine aminotransferase (ALT) level (raised by fivefold the normal upper limit). The dengue patients were classified according to their risk groups and the corresponding BIA parameters were subsequently obtained and quantified. Four parameters were used for training and testing the ANN which are day of fever, reactance, gender, and risk group's quantification. Day of fever was defined as the day of fever subsided, i.e., when the body temperature fell below 37.5°C. The blood investigation and the BIA data were taken for 5 days. The ANN was trained via the steepest descent back propagation with momentum algorithm using the log-sigmoid transfer function while the sum-squared error was used as the network's performance indicator. The best ANN architecture of 3-6-1 (3 inputs, 6 neurons in the hidden layer, and 1 output), learning rate of 0.1, momentum constant of 0.2, and iteration rate of 20,000 was pruned using a weight-eliminating method. Eliminating a weight of 0.05 enhances the dengue's prediction risk classification accuracy of 95.88% for high risk and 96.83% for low risk groups. As a result, the system is able to classify and diagnose the risk in the dengue patients with an overall prediction accuracy of 96.27%.

Clinical presentation and initial management of black men and white men with prostate cancer in the United Kingdom: the PROCESS cohort study

Background:

In the United States, Black men have a higher risk of prostate cancer and worse survival than do White men, but it is unclear whether this is because of differences in diagnosis and management. We re-examined these differences in the United Kingdom, where health care is free and unlikely to vary by socioeconomic status.

Methods:

This study is a population-based retrospective cohort study of men diagnosed with prostate cancer with data on ethnicity, prognostic factors, and clinical care. A Delphi panel considered the appropriateness of investigations and treatments received.

Results:

At diagnosis, Black men had similar clinical stage and Gleason scores but higher age-adjusted prostate-specific antigen levels (geometric mean ratio 1.41, 95% confidence interval (95% CI): 1.15–1.73). Black men underwent more investigations and were more likely to undergo radical treatment, although this was largely explained by their younger age. Even after age adjustment, Black men were more likely to undergo a bone scan (odds ratio 1.37, 95% CI: 1.05–1.80). The Delphi analysis did not suggest differential management by ethnicity.

Conclusions:

This UK-based study comparing Black men with White men found no evidence of differences in disease characteristics at the time of prostate cancer diagnosis, nor of under-investigation or under-treatment in Black men.