Osteoporotic and Neoplastic Compression Fracture Classification on Longitudinal CT

Classification of vertebral compression fractures (VCF) having osteoporotic or neoplastic origin is fundamental to the planning of treatment. We developed a fracture classification system by acquiring quantitative morphologic and bone density determinants of fracture progression through the use of automated measurements from longitudinal studies. A total of 250 CT studies were acquired for the task, each having previously identified VCFs with osteoporosis or neoplasm. Thirty-six features or each identified VCF were computed and classified using a committee of support vector machines. Ten-fold cross validation on 695 identified fractured vertebrae showed classification accuracies of 0.812, 0.665, and 0.820 for the measured, longitudinal, and combined feature sets respectively.Comment: Contributed 4-Page Paper to be presented at the 2016 IEEE International Symposium on Biomedical Imaging (ISBI), April 13-16, 2016, Prague, Czech Republi

Deep convolutional networks for automated detection of posterior-element fractures on spine CT

Injuries of the spine, and its posterior elements in particular, are a common occurrence in trauma patients, with potentially devastating consequences. Computer-aided detection (CADe) could assist in the detection and classification of spine fractures. Furthermore, CAD could help assess the stability and chronicity of fractures, as well as facilitate research into optimization of treatment paradigms. In this work, we apply deep convolutional networks (ConvNets) for the automated detection of posterior element fractures of the spine. First, the vertebra bodies of the spine with its posterior elements are segmented in spine CT using multi-atlas label fusion. Then, edge maps of the posterior elements are computed. These edge maps serve as candidate regions for predicting a set of probabilities for fractures along the image edges using ConvNets in a 2.5D fashion (three orthogonal patches in axial, coronal and sagittal planes). We explore three different methods for training the ConvNet using 2.5D patches along the edge maps of 'positive', i.e. fractured posterior-elements and 'negative', i.e. non-fractured elements. An experienced radiologist retrospectively marked the location of 55 displaced posterior-element fractures in 18 trauma patients. We randomly split the data into training and testing cases. In testing, we achieve an area-under-the-curve of 0.857. This corresponds to 71% or 81% sensitivities at 5 or 10 false-positives per patient, respectively. Analysis of our set of trauma patients demonstrates the feasibility of detecting posterior-element fractures in spine CT images using computer vision techniques such as deep convolutional networks.Comment: To be presented at SPIE Medical Imaging, 2016, San Dieg

Circadian Variation of Brain Histamine in Goldfish

Teleosts may make an excellent model to study brain histamine function. Fishes are phylogenetically closer to the basic vertebrate blueprint than higher vertebrates. They appear to have a simpler histaminergic system in terms of central nervous system distribution and, contrary to higher vertebrates, brain histamine appears to be strictly neuronal. In this preliminary study, we examined circadian variation of brain histamine in goldfish, Carassius auratus, as this neurotransmitter correlates with circadian behavior of some mammals. Two groups of juvenile goldfish were held in 24 60L aquaria, six fish per aquarium, on reversed photoperiods; L:D 12:12 with light onset either at 0700 or 1900 h. Fish were sampled every 4 h. At a sampling time, all the fish in a tank were taken; each sampling, for both groups, was done in replicate. Brain histamine was determined by immunoassay. There was a significant circadian variation in histamine on both photoperiod regimes with the highest levels during the photophase. These results support the hypothesis of an early phylogenic role for histamine in vertebrate circadian physiology

Type and Timing of Rehabilitation Following Acute and Subacute Spinal Cord Injury: A Systematic Review

Objectives: The objective of this study was to conduct a systematic review of the literature to address the following clinical questions: In adult patients with acute and subacute complete or incomplete traumatic SCI, (1) does the time interval between injury and commencing rehabilitation affect outcome?; (2) what is the comparative effectiveness of different rehabilitation strategies, including different intensities and durations of treatment?; (3) are there patient or injury characteristics that affect the efficacy of rehabilitation?; and (4) what is the cost-effectiveness of various rehabilitation strategies? Methods: A systematic search was conducted for literature published through March 31, 2015 that evaluated rehabilitation strategies in adults with acute or subacute traumatic SCI at any level. Studies were critically appraised individually and the overall strength of evidence was evaluated using methods proposed by the GRADE (Grades of Recommendation Assessment, Development and Evaluation) working group. Results: The search strategy yielded 384 articles, 19 of which met our inclusion criteria. Based on our results, there was no difference between body weight–supported treadmill training and conventional rehabilitation with respect to improvements in Functional Independence Measure (FIM) Locomotor score, Lower Extremity Motor Scores, the distance walked in 6 minutes or gait velocity over 15.2 m. Functional electrical therapy resulted in slightly better FIM Motor, FIM Self-Care, and Spinal Cord Independence Measure Self-Care subscores compared with conventional occupational therapy. Comparisons using the Toronto Rehabilitation Institute Hand Function Test demonstrated no differences between groups in 7 of 9 domains. There were no clinically important differences in Maximal Lean Test, Maximal Sidewards Reach Test, T-shirt Test, or the Canadian Occupational Performance Measure between unsupported sitting training and standard in-patient rehabilitation. Conclusion: The current evidence base for rehabilitation following acute and subacute spinal cord injury is limited. Methodological challenges have contributed to this and further research is still needed. © 2017, © The Author(s) 2017

Reliability of Peak Treadmill Exercise Tests in Mild Alzheimer Disease

This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Neuroscience on August 2011, available online: http://www.tandfonline.com/10.3109/00207454.2011.574762.The prevalence of Alzheimer disease (AD) doubles every 5 years after the age of 65, reaching nearly 50% after age 85 (Evans et al., 1989). This, along with an unprecedented growth in the elderly population, is leading to dramatic increases in the incidence of AD. Thus, effective strategies for promoting healthy brain aging and preventing AD are increasingly important. One strategy that appears promising in promoting healthy brain aging is exercise and physical activity. Evidence is accumulating that endurance exercise is beneficial to brain health (Laurin, Verreault, Lindsay, MacPherson, & Rockwood, 2001), and increased cardiorespiratory fitness is associated with increased brain volume in subjects with very mild to mild AD (Burns et al., 2008). While enhancing cardiorespiratory fitness may be a strategy for preventing cognitive decline in AD, there is limited information available on the validity and reliability of cardiorespiratory fitness measures in this population. The gold standard measure of cardiorespiratory fitness is maximum oxygen consumption (VO2max) (Frankin, 2001), the highest rate of oxygen uptake attainable during maximal or exhaustive exercise (American College of Sports Medicine, 2005). If the subject becomes exhausted and ends the test prior to reaching the physiologic VO2max, the end of the test is called peak oxygen consumption (VO2peak). It is unknown if advanced age and cognitive difficulties in people with AD would limit their ability to fully participate in a standard graded exercise test to reliably assess VO2max or VO2peak. Treadmill exercise testing has been found to be reliable in subjects with traumatic brain injury and mental retardation, although these subjects were very young (Fernhall, Millar, Tymeson, & Burkett, 1990; Mossberg & Greene, 2005). Traumatic brain injury and mental retardation are different disease processes than AD and would be expected to result in static rather than progressive cognitive symptoms. With AD, memory is impaired as is the ability to follow commands, however patients in the earliest stages of AD would be expected to respond to prompting and reminders to follow testing procedures. To our knowledge, no studies have assessed the reliability of peak treadmill exercise testing in subjects with AD. In our previous research on patients with very mild to mild AD (Burns, et al., 2008), we have found them to be capable of ambulating on a treadmill and completing peak treadmill exercise testing with 3 participants out of 74 (126 total peak exercise tests) identified as having EKG changes during testing. All 3 participants had negative follow-up testing in cardiology. The purpose of this study was to investigate the reliability of a graded peak treadmill exercise test in elderly people with early AD

On the Secular Behavior of Irregular Satellites

Although analytical studies on the secular motion of the irregular satellites have been published recently, these theories have not yet been satisfactorily reconciled with the results of direct numerical integrations. These discrepancies occur because in secular theories the disturbing function is averaged over orbital motions, whereas instead one should take into account some large periodic terms, most notably the so-called ``evection''. We demonstrate that such terms can be incorporated into the Kozai formalism, and that our synthetic approach produces much better agreement with results from symplectic integrations. Using this method, we plot the locations of secular resonances in the orbital-element space, and we note that the distribution of irregular satellite clusters appears to be non-random. We find that the large majority of irregular-satellite groups cluster close to the secular resonances, with several objects having practically stationary pericenters. None of the largest satellites belong to this class, so we argue that this dichotomy implies that the smaller near-resonant satellites might have been captured differently than the largest irregulars.Comment: 56 pages, 24 figures, accepted for publication in The Astronomical Journa

An inter-platform repeatability study investigating real-time amplification of plasmid DNA

BACKGROUND: The wide variety of real-time amplification platforms currently available has determined that standardisation of DNA measurements is a fundamental aspect involved in the comparability of results. Statistical analysis of the data arising from three different real-time platforms was conducted in order to assess inter-platform repeatability. On three consecutive days two PCR reaction mixes were used on each of the three amplification platforms – the LightCycler(®), ABI PRISM(® )7700 and Rotor Gene 3000™. Real-time PCR amplification using a fluorogenic 5' exonuclease assay was performed in triplicate on negative controls and DNA plasmid dilutions of 10(8)–10(2 )copies to give a total of 24 reactions per PCR experiment. RESULTS: The results of the statistical analyses indicated that the platform with the most precise repeatability was the ABI PRISM(® )7700 when coupled with the FastStart PCR reaction mix. It was also found that there was no obvious relationship between plasmid copy number and repeatability. An ANOVA approach identified the factors that significantly affected the results, in descending order of magnitude, as: plasmid copy number, platform, PCR reaction mix and day (on which the experiment was performed). CONCLUSION: In order to deliver useful, informative genetic tests, standardisation of real-time PCR detection platforms to provide repeatable, reliable results is warranted. In addition, a better understanding of inter-assay and intra-assay repeatability is required

Magnetization Reversal and Nanoscopic Magnetic Phase Separation in Doped La1-xSrxCoO3

The doped perovskite cobaltite La1-xSrxCoO3 (LSCO) has been advanced as a model system for studying intrinsic magnetic phase separation. We have employed a first-order reversal curve (FORC) method to probe the amount of irreversible switching in bulk polycrystalline LSCO as a function of Sr doping, field cooling procedure, and temperature. The value of the FORC distribution, rho, is used as a measure of the extent of irreversible switching. For x < 0.18, the small values of rho and its ridge-like distribution along local coercivity (Hc) and zero bias (Hb), are characteristic of non-interacting single domain particles. This is consistent with the formation of an array of isolated nanoscopic ferromagnetic clusters, as observed in previous work. For x >= 0.18, the much larger values of rho, the tilting of its distribution towards negative bias field, and the emergence of regions with negative rho, are consistent with increased long-range ferromagnetic ordering. The FORC distributions display little dependence on the cooling procedure. With increasing temperature, the fraction of irreversible switching determined from the FORC distribution follows closely the ferromagnetic phase fraction measured by La nuclear magnetic resonance. Our results furthermore demonstrate that the FORC method is a valuable first-pass characterization tool for magnetic phase separation.Comment: 30 pages, 8 figures, to appear in PR

Cardiorespiratory fitness and preserved medial temporal lobe volume in Alzheimer's Disease

This is not the final published version.Exercise and cardiorespiratory (CR) fitness may moderate age-related regional brain changes in nondemented older adults (ND). The relationship of fitness to Alzheimer's disease (AD) related brain change is understudied, particularly in the hippocampus which is disproportionately affected in early AD. The role of apolipoprotein E4 (apoE4) genotype in modulating this relationship is also unknown. Nondemented (n=56) and early-stage AD subjects (n=61) over age 65 had MRI and CR fitness assessments. Voxel-based morphometry (VBM) techniques were utilized to identify AD-related atrophy. We analyzed the relationship of CR fitness with white and gray matter within groups, assessed fitness-related brain volume change in areas most affected by AD-related atrophy, and then analyzed differential fitness-brain relationships between apoE4 carriers. Atrophy was present in the medial temporal, temporal, and parietal cortices in subjects with mild AD. There was a significant positive correlation of CR fitness with parietal and medial temporal volume in AD subjects. ND subjects did not have a significant relationship between brain volume and CR fitness in the global or SVC analyses. There was not a significant interaction for fitness × apoE4 genotype in either group. In early-stage AD, cardiorespiratory fitness is associated with regional brain volumes in the medial temporal and parietal cortices suggesting that maintaining cardiorespiratory fitness may modify AD-related brain atrophy