Relational Reasoning Network (RRN) for Anatomical Landmarking

Accurately identifying anatomical landmarks is a crucial step in deformation analysis and surgical planning for craniomaxillofacial (CMF) bones. Available methods require segmentation of the object of interest for precise landmarking. Unlike those, our purpose in this study is to perform anatomical landmarking using the inherent relation of CMF bones without explicitly segmenting them. We propose a new deep network architecture, called relational reasoning network (RRN), to accurately learn the local and the global relations of the landmarks. Specifically, we are interested in learning landmarks in CMF region: mandible, maxilla, and nasal bones. The proposed RRN works in an end-to-end manner, utilizing learned relations of the landmarks based on dense-block units and without the need for segmentation. For a given a few landmarks as input, the proposed system accurately and efficiently localizes the remaining landmarks on the aforementioned bones. For a comprehensive evaluation of RRN, we used cone-beam computed tomography (CBCT) scans of 250 patients. The proposed system identifies the landmark locations very accurately even when there are severe pathologies or deformations in the bones. The proposed RRN has also revealed unique relationships among the landmarks that help us infer several reasoning about informativeness of the landmark points. RRN is invariant to order of landmarks and it allowed us to discover the optimal configurations (number and location) for landmarks to be localized within the object of interest (mandible) or nearby objects (maxilla and nasal). To the best of our knowledge, this is the first of its kind algorithm finding anatomical relations of the objects using deep learning.Comment: 10 pages, 6 Figures, 3 Table

Reproducibility of the dynamics of facial expressions in unilateral facial palsy

The aim of this study was to assess the reproducibility of non-verbal facial expressions in unilateral facial paralysis using dynamic four-dimensional (4D) imaging. The Di4D system was used to record five facial expressions of 20 adult patients. The system captured 60 three-dimensional (3D) images per second; each facial expression took 3–4 seconds which was recorded in real time. Thus a set of 180 3D facial images was generated for each expression. The procedure was repeated after 30 min to assess the reproducibility of the expressions. A mathematical facial mesh consisting of thousands of quasi-point ‘vertices’ was conformed to the face in order to determine the morphological characteristics in a comprehensive manner. The vertices were tracked throughout the sequence of the 180 images. Five key 3D facial frames from each sequence of images were analyzed. Comparisons were made between the first and second capture of each facial expression to assess the reproducibility of facial movements. Corresponding images were aligned using partial Procrustes analysis, and the root mean square distance between them was calculated and analyzed statistically (paired Student ttest, P < 0.05). Facial expressions of lip purse, cheek puff, and raising of eyebrows were reproducible. Facial expressions of maximum smile and forceful eye closure were not reproducible. The limited coordination of various groups of facial muscles contributed to the lack of reproducibility of these facial expressions. 4D imaging is a useful clinical tool for the assessment of facial expressions

A Review of Meta-level Learning in the Context of Multi-component, Multi-level Evolving Prediction Systems.

The exponential growth of volume, variety and velocity of data is raising the need for investigations of automated or semi-automated ways to extract useful patterns from the data. It requires deep expert knowledge and extensive computational resources to find the most appropriate mapping of learning methods for a given problem. It becomes a challenge in the presence of numerous configurations of learning algorithms on massive amounts of data. So there is a need for an intelligent recommendation engine that can advise what is the best learning algorithm for a dataset. The techniques that are commonly used by experts are based on a trial and error approach evaluating and comparing a number of possible solutions against each other, using their prior experience on a specific domain, etc. The trial and error approach combined with the expert’s prior knowledge, though computationally and time expensive, have been often shown to work for stationary problems where the processing is usually performed off-line. However, this approach would not normally be feasible to apply on non-stationary problems where streams of data are continuously arriving. Furthermore, in a non-stationary environment the manual analysis of data and testing of various methods every time when there is a change in the underlying data distribution would be very difficult or simply infeasible. In that scenario and within an on-line predictive system, there are several tasks where Meta-learning can be used to effectively facilitate best recommendations including: 1) pre processing steps, 2) learning algorithms or their combination, 3) adaptivity mechanisms and their parameters, 4) recurring concept extraction, and 5) concept drift detection. However, while conceptually very attractive and promising, the Meta-learning leads to several challenges with the appropriate representation of the problem at a meta-level being one of the key ones. The goal of this review and our research is, therefore, to investigate Meta learning in general and the associated challenges in the context of automating the building, deployment and adaptation of multi-level and multi-component predictive system that evolve over time

The use of repeated blood pressure measures for cardiovascular risk prediction: a comparison of statistical models in the ARIC study.

Many prediction models have been developed for the risk assessment and the prevention of cardiovascular disease in primary care. Recent efforts have focused on improving the accuracy of these prediction models by adding novel biomarkers to a common set of baseline risk predictors. Few have considered incorporating repeated measures of the common risk predictors. Through application to the Atherosclerosis Risk in Communities study and simulations, we compare models that use simple summary measures of the repeat information on systolic blood pressure, such as (i) baseline only; (ii) last observation carried forward; and (iii) cumulative mean, against more complex methods that model the repeat information using (iv) ordinary regression calibration; (v) risk-set regression calibration; and (vi) joint longitudinal and survival models. In comparison with the baseline-only model, we observed modest improvements in discrimination and calibration using the cumulative mean of systolic blood pressure, but little further improvement from any of the complex methods. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.J.K.B. was supported by the Medical Research Council grant numbers G0902100 and MR/K014811/1. This work was funded by the UK Medical Research Council (G0800270), British Heart Foundation (SP/09/002), UK National Institute for Health Research Cambridge Biomedical Research Centre, European Research Council (268834) and European Commission Framework Programme 7 (HEALTH-F2-2012-279233). The ARIC study is carried out as a collaborative study supported by the National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C and HHSN268201100012C).This is the final version of the article. It first appeared from Wiley via https://doi.org/10.1002/sim.714

Articulated Statistical Shape Modelling of the Shoulder Joint

The shoulder joint is the most mobile and unstable joint in the human body. This makes it vulnerable to soft tissue pathologies and dislocation. Insight into the kinematics of the joint may enable improved diagnosis and treatment of different shoulder pathologies. Shoulder joint kinematics can be influenced by the articular geometry of the joint. The aim of this project was to develop an analysis framework for shoulder joint kinematics via the use of articulated statistical shape models (ASSMs). Articulated statistical shape models extend conventional statistical shape models by combining the shape variability of anatomical objects collected from different subjects (statistical shape models), with the physical variation of pose between the same objects (articulation). The developed pipeline involved manual annotation of anatomical landmarks selected on 3D surface meshes of scapulae and humeri and establishing dense surface correspondence across these data through a registration process. The registration was performed using a Gaussian process morphable model fitting approach. In order to register two objects separately, while keeping their shape and kinematics relationship intact, one of the objects (scapula) was fixed leaving the other (humerus) to be mobile. All the pairs of registered humeri and scapulae were brought back to their native imaged position using the inverse of the associated registration transformation. The glenohumeral rotational center and local anatomic coordinate system of the humeri and scapulae were determined using the definitions suggested by the International Society of Biomechanics. Three motions (flexion, abduction, and internal rotation) were generated using Euler angle sequences. The ASSM of the model was built using principal component analysis and validated. The validation results show that the model adequately estimated the shape and pose encoded in the training data. Developing ASSM of the shoulder joint helps to define the statistical shape and pose parameters of the gleno humeral articulating surfaces. An ASSM of the shoulder joint has potential applications in the analysis and investigation of population-wide joint posture variation and kinematics. Such analyses may include determining and quantifying abnormal articulation of the joint based on the range of motion; understanding of detailed glenohumeral joint function and internal joint measurement; and diagnosis of shoulder pathologies. Future work will involve developing a protocol for encoding the shoulder ASSM with real, rather than handcrafted, pose variation

Contemporary issues in static and dynamic prediction:some applications and evaluation in the clinical context

Prediction models that estimate the probabilities of developing a specific disease (diagnostic model) or a specific endpoint of disease (prognostic model) given a set of subject’s characteristics are closely connected to personalized medicine of which the key idea is to base medical decisions on individual patient characteristics rather than on population averages. Depending on decision point, prediction models can be divided into two categories: static prediction models (making one-off decision) and dynamic prediction models (making dynamically updated decisions). While multivariable logistic and Cox regression are commonly used to develop prediction models, they are not the master key to every situation. Various issues such as clustered data, competing risks and time-dependent variable may occur when a simple logistic or Cox model cannot estimate the risk correctly in static and dynamic prediction. Although adapted or more advanced approaches have been developed to address those issues in medical statistics field, they are not appropriately applied in clinical research. To fill this gap, this thesis illustrated how sophisticated statistical models can be appropriately applied to obtain better predictions using a series of clinical case studies