Automated Detection of Malarial Retinopathy in Digital Fundus Images for Improved Diagnosis in Malawian Children with Clinically Defined Cerebral Malaria

Cerebral malaria (CM), a complication of malaria infection, is the cause of the majority of malaria-associated deaths in African children. The standard clinical case definition for CM misclassifies ~25% of patients, but when malarial retinopathy (MR) is added to the clinical case definition, the specificity improves from 61% to 95%. Ocular fundoscopy requires expensive equipment and technical expertise not often available in malaria endemic settings, so we developed an automated software system to analyze retinal color images for MR lesions: retinal whitening, vessel discoloration, and white-centered hemorrhages. The individual lesion detection algorithms were combined using a partial least square classifier to determine the presence or absence of MR. We used a retrospective retinal image dataset of 86 pediatric patients with clinically defined CM (70 with MR and 16 without) to evaluate the algorithm performance. Our goal was to reduce the false positive rate of CM diagnosis, and so the algorithms were tuned at high specificity. This yielded sensitivity/specificity of 95%/100% for the detection of MR overall, and 65%/94% for retinal whitening, 62%/100% for vessel discoloration, and 73%/96% for hemorrhages. This automated system for detecting MR using retinal color images has the potential to improve the accuracy of CM diagnosis

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Sexual Dimorphism of the Adult Human Retina Assessed by Optical Coherence Tomography

Sexual dimorphism in the human visual system is a well-established phenomenon, and recent research has unveiled possible connections between gonadal hormones and the retina status. In the literature, the findings are quite diverse and inconclusive results have been reported as well. In the study herein, texture analysis was applied to computed optical coherence tomography (OCT) fundus images to identify differences between female and male healthy adult controls at the six neuroretinal layers. Furthermore, younger and older groups were formed to assess differences across the adult lifespan. Besides local and global texture features, the thickness of each retinal layer at study was also analysed. The vast majority of the differences between female and male groups were found from the ganglion cell layer (GCL) to the outer plexiform layer (OPL), with the retinal nerve fibre layer (RNFL) layer being the least distinct one. For the sub-study by age, the younger group show similar results as those for the entire population, except for the RNFL. On the other hand, the older group presents minute differences between female and male subjects. These findings suggest that studies should be well balanced by sex, and particular care should be taken in the age span of the study groups. In the present study, we also demonstrate that texture and thickness are independent, for the most part, that thickness conveys the least information, and that texture is a strong candidate biomarker of eye and central nervous system status in health and disease.This study was supported by The Portuguese Foundation for Science and Technology (PEst-ID/NEU/04539/2019) and UID/04950/2017, by FEDER-COMPETE (POCI-01-0145-FEDER-007440 and POCI01-0145-FEDER-16428), and by Centro 2020 FEDERCOMPETE (BIGDATIMAGE, CENTRO-01-0145-FEDER-000016).info:eu-repo/semantics/publishedVersio

Deep learning for marine species recognition

Research on marine species recognition is an important part of the actions for the protection of the ocean environment. It is also an under-exploited application area in the computer vision community. However, with the developments of deep learning, there has been an increasing interest about this topic. In this chapter, we present a comprehensive review of the computer vision techniques for marine species recognition, mainly from the perspectives of both classification and detection. In particular, we focus on capturing the evolution of various deep learning techniques in this area. We further compare the contemporary deep learning techniques with traditional machine learning techniques, and discuss the complementary issues between these two approaches. This chapter examines the attributes and challenges of a number of popular marine species datasets (which involve coral, kelp, plankton and fish) on recognition tasks. In the end, we highlight a few potential future application areas of deep learning in marine image analysis such as segmentation and enhancement of image quality