An approach for automatic identification of fundamental and additional sounds from cardiac sounds recordings.

This paper presents an approach for automatic segmentation of cardiac events from non-invasive sounds recordings, without the need of having an auxiliary signal reference. In addition, methods are proposed to subsequently differentiate cardiac events which correspond to normal cardiac cycles, from those which are due to abnormal activity of the heart. The detection of abnormal sounds is based on a model built with parameters which are obtained following feature extraction from those segments that were previously identified as normal fundamental heart sounds. The proposed algorithm achieved a sensitivity of 91.79% and 89.23% for the identification of normal fundamental, S1 and S2 sounds, and a true positive (TP) rate of 81.48% for abnormal additional sounds. These results were obtained using the PASCAL Classifying Heart Sounds challenge (CHSC) database

Cost-effectiveness of noninvasive liver fibrosis tests for treatment decisions in patients with chronic hepatitis C

The cost-effectiveness of noninvasive tests (NITs) as alternatives to liver biopsy is unknown. We compared the cost-effectiveness of using NITs to inform treatment decisions in adult patients with chronic hepatitis C (CHC). We conducted a systematic review and meta-analysis to calculate the diagnostic accuracy of various NITs using a bivariate random-effects model. We constructed a probabilistic decision analytical model to estimate health care costs and outcomes (quality-adjusted life-years; QALYs) using data from the meta-analysis, literature, and national UK data. We compared the cost-effectiveness of four treatment strategies: testing with NITs and treating patients with fibrosis stage ≥F2; testing with liver biopsy and treating patients with ≥F2; treat none; and treat all irrespective of fibrosis. We compared all NITs and tested the cost-effectiveness using current triple therapy with boceprevir or telaprevir, but also modeled new, more-potent antivirals. Treating all patients without any previous NIT was the most effective strategy and had an incremental cost-effectiveness ratio (ICER) of £9,204 per additional QALY gained. The exploratory analysis of currently licensed sofosbuvir treatment regimens found that treat all was cost-effective, compared to using an NIT to decide on treatment, with an ICER of £16,028 per QALY gained. The exploratory analysis to assess the possible effect on results of new treatments, found that if SVR rates increased to >90% for genotypes 1-4, the incremental treatment cost threshold for the "treat all" strategy to remain the most cost-effective strategy would be £37,500. Above this threshold, the most cost-effective option would be noninvasive testing with magnetic resonance elastography (ICER=£9,189). Conclusions: Treating all adult patients with CHC, irrespective of fibrosis stage, is the most cost-effective strategy with currently available drugs in developed countries. © 2014 The Authors

Wall Climbing And Pipe Crawler Robots For Nozzle Weld Inspection Inside Nuclear Pressure Vessels

This paper describes the design and development of a NDT robotic solution to test circumferential welds located inside pipe nozzles at a distance of 700mm from the inside walls of nuclear pressure vessels. These welds are currently inspected using very large robot arms that are taken into the containment area and assembled. This is a time consuming operation that exposes operators to radiation. A preferred solution is to develop a light weight and compact robot that can be carried into the containment area and inserted into a pressure vessel using an overhead crane. The crane is then removed and used for other tasks. The robot must then be operated to accomplish the weld inspection task in all the pipe nozzles located in the pressure vessel

Accretion Discs with an Inner Spiral Density Wave

In Montgomery (2009a), we show that accretion discs in binary systems could retrogradely precess by tidal torques like the Moon and the Sun on a tilted, spinning, non-spherical Earth. In addition, we show that the state of matter and the geometrical shape of the celestial object could significantly affect the precessional value. For example, a Cataclysmic Variable (CV) Dwarf Novae (DN) non-magnetic system that shows negative superhumps in its light curve can be described by a retrogradely precessing, differentially rotating, tilted disc. Because the disc is a fluid and because the gas stream overflows the tilted disc and particles can migrate into inner disc annuli, coupled to the disc could be a retrogradely precessing inner ring that is located near the innermost annuli of the disc. However, numerical simulations by Bisikalo et al. (2003, 2004) and this work show that an inner spiral density wave can be generated instead of an inner ring. Therefore, we show that retrograde precession in non-magnetic, spinning, tilted CV DN systems can equally be described by a retrogradely precessing and differentially rotating disc with an attached retrogradely precessing inner spiral density wave so long as the wave appears at the same radius as the ring and within the plane of the tilted disc. We find that the theoretical results generated in this work agree well with the theoretical results presented in Montgomery (2009a) and thus with the numerical simulations and select CV DN systems in Montgomery (2009b) that may have a main sequence secondary. Therefore, pressure effects do need to be considered in CV DN systems that exhibit negative superhumps if the accretion discs are tilted and have an inner spiral density wave that is in the plane of the disc

Cytomegalovirus replication kinetics in solid organ transplant recipients managed by preemptive therapy.

After allotransplantation, cytomegalovirus (CMV) may be transmitted from the donor organ, giving rise to primary infection in a CMV negative recipient or reinfection in one who is CMV positive. In addition, latent CMV may reactivate in a CMV positive recipient. In this study, serial blood samples from 689 kidney or liver transplant recipients were tested for CMV DNA by quantitative PCR. CMV was managed using preemptive antiviral therapy and no patient received antiviral prophylaxis. Dynamic and quantitative measures of viremia and treatment were assessed. Median peak viral load, duration of viremia and duration of treatment were highest during primary infection, followed by reinfection then reactivation. In patients who experienced a second episode of viremia, the viral replication rate was significantly slower than in the first episode. Our data provide a clear demonstration of the immune control of CMV in immunosuppressed patients and emphasize the effectiveness of the preemptive approach for prevention of CMV syndrome and end organ disease. Overall, our findings provide quantitative biomarkers which can be used in pharmacodynamic assessments of the ability of novel CMV vaccines or antiviral drugs to reduce or even interrupt such transmission

Transcription of toll-like receptors 2, 3, 4 and 9, FoxP3 and Th17 cytokines in a susceptible experimental model of canine Leishmania infantum infection

Canine leishmaniosis (CanL) due to Leishmania infantum is a chronic zoonotic systemic disease resulting from complex interactions between protozoa and the canine immune system. Toll-like receptors (TLRs) are essential components of the innate immune system and facilitate the early detection of many infections. However, the role of TLRs in CanL remains unknown and information describing TLR transcription during infection is extremely scarce. The aim of this research project was to investigate the impact of L. infantum infection on canine TLR transcription using a susceptible model. The objectives of this study were to evaluate transcription of TLRs 2, 3, 4 and 9 by means of quantitative reverse transcription polymerase chain reaction (qRT-PCR) in skin, spleen, lymph node and liver in the presence or absence of experimental L. infantum infection in Beagle dogs. These findings were compared with clinical and serological data, parasite densities in infected tissues and transcription of IL-17, IL-22 and FoxP3 in different tissues in non-infected dogs (n = 10), and at six months (n = 24) and 15 months (n = 7) post infection. Results revealed significant down regulation of transcription with disease progression in lymph node samples for TLR3, TLR4, TLR9, IL-17, IL-22 and FoxP3. In spleen samples, significant down regulation of transcription was seen in TLR4 and IL-22 when both infected groups were compared with controls. In liver samples, down regulation of transcription was evident with disease progression for IL-22. In the skin, upregulation was seen only for TLR9 and FoxP3 in the early stages of infection. Subtle changes or down regulation in TLR transcription, Th17 cytokines and FoxP3 are indicative of the silent establishment of infection that Leishmania is renowned for. These observations provide new insights about TLR transcription, Th17 cytokines and Foxp3 in the liver, spleen, lymph node and skin in CanL and highlight possible markers of disease susceptibility in this model

Dendritic Spine Shape Analysis: A Clustering Perspective

Functional properties of neurons are strongly coupled with their morphology. Changes in neuronal activity alter morphological characteristics of dendritic spines. First step towards understanding the structure-function relationship is to group spines into main spine classes reported in the literature. Shape analysis of dendritic spines can help neuroscientists understand the underlying relationships. Due to unavailability of reliable automated tools, this analysis is currently performed manually which is a time-intensive and subjective task. Several studies on spine shape classification have been reported in the literature, however, there is an on-going debate on whether distinct spine shape classes exist or whether spines should be modeled through a continuum of shape variations. Another challenge is the subjectivity and bias that is introduced due to the supervised nature of classification approaches. In this paper, we aim to address these issues by presenting a clustering perspective. In this context, clustering may serve both confirmation of known patterns and discovery of new ones. We perform cluster analysis on two-photon microscopic images of spines using morphological, shape, and appearance based features and gain insights into the spine shape analysis problem. We use histogram of oriented gradients (HOG), disjunctive normal shape models (DNSM), morphological features, and intensity profile based features for cluster analysis. We use x-means to perform cluster analysis that selects the number of clusters automatically using the Bayesian information criterion (BIC). For all features, this analysis produces 4 clusters and we observe the formation of at least one cluster consisting of spines which are difficult to be assigned to a known class. This observation supports the argument of intermediate shape types.Comment: Accepted for BioImageComputing workshop at ECCV 201

Clustering Algorithms for Spatial Big Data

In our time people and devices constantly generate data. User activity generates data about needs and preferences as well as the quality of their experiences in different ways: i. e. streaming a video, looking at the news, searching for a restaurant or a an hotel, playing a game with others, making purchases, driving a car. Even when people put their devices in their pockets, the network is generating location and other data that keeps services running and ready to use. This rapid developments in the availability and access to data and in particular spatially referenced data in a different areas, has induced the need for better analysis techniques to understand the various phenomena. Spatial clustering algorithms, which groups similar spatial objects into classes, can be used for the identification of areas sharing common characteristics. The aim of this paper is to analyze the performance of three different clustering algorithms i.e. the Density-Based Spatial Clustering of Applications with Noise algorithm (DBSCAN), the Fast Search by Density Peak (FSDP) algorithm and the classic K-means algorithm (K-Means) as regards the analysis of spatial big data. We propose a modification of the FSDP algorithm in order to improve its efficiency in large databases. The applications concern both synthetic data sets and satellite images

Presence and Persistence of Ebola or Marburg Virus in Patients and Survivors: A Rapid Systematic Review

Background: The 2013-15 Ebola outbreak was unprecedented due to sustainedtransmission within urban environments and thousands of survivors. In 2014 the World Health Organization stated that there was insufficient evidence to give definitive guidance about which body fluids are infectious and when they pose a risk to humans. We report a rapid systematic review of published evidence on the presence of filoviruses in body fluids of infected people and survivors. Methods: Scientific articles were screened for information about filovirus in human body fluids. The aim was to find primary data that suggested high likelihood of actively infectious filovirus in human body fluids (viral RNA). Eligible infections were from Marburg virus (MARV or RAVV) and Zaire, Sudan, Taï Forest and Bundibugyo species of Ebola. [1] Cause of infection had to be laboratory confirmed (in practice either tissue culture or RT-PCR tests), or evidenced by compatible clinical history with subsequent positivity for filovirus antibodies or inflammatory factors. Data were extracted and summarized narratively. Results: 6831 unique articles were found, and after screening, 33 studies were eligible. For most body fluid types there were insufficient patients to draw strong conclusions, and prevalence of positivity was highly variable. Body fluids taken >16 days after onset were usually negative. In the six studies that used both assay methods RT-PCR tests for filovirus RNA gave positive results about 4 times more often than tissue culture. Conclusions: Filovirus was reported in most types of body fluid, but not in every sample from every otherwise confirmed patient. Apart from semen, most non-blood, RT-PCR positive samples are likely to be culture negative and so possibly of low infectious risk. Nevertheless, it is not apparent how relatively infectious many body fluids are during or after illness, even when culture-positive, not least because most test results come from more severe cases. Contact with blood and blood-stained body fluids remains the major risk for disease transmission because of the known high viral loads in blood

Heat in optical tweezers

Laser-induced thermal effects in optically trapped microspheres and single cells have been investigated by Luminescence Thermometry. Thermal spectroscopy has revealed a non-localized temperature distribution around the trap that extends over tens of microns, in agreement with previous theoretical models. Solvent absorption has been identified as the key parameter to determine laser-induced heating, which can be reduced by establishing a continuous fluid flow of the sample. Our experimental results of thermal loading at a variety of wavelengths reveal that an optimum trapping wavelength exists for biological applications close to 820 nm. This has been corroborated by a simultaneous analysis of the spectral dependence of cellular heating and damage in human lymphocytes during optical trapping. Minimum intracellular heating, well below the cytotoxic level (43 °C), has been demonstrated to occur for optical trapping with 820 nm laser radiation, thus avoiding cell damage