Automated detection of regions of interest for tissue microarray experiments: an image texture analysis

BACKGROUND: Recent research with tissue microarrays led to a rapid progress toward quantifying the expressions of large sets of biomarkers in normal and diseased tissue. However, standard procedures for sampling tissue for molecular profiling have not yet been established. METHODS: This study presents a high throughput analysis of texture heterogeneity on breast tissue images for the purpose of identifying regions of interest in the tissue for molecular profiling via tissue microarray technology. Image texture of breast histology slides was described in terms of three parameters: the percentage of area occupied in an image block by chromatin (B), percentage occupied by stroma-like regions (P), and a statistical heterogeneity index H commonly used in image analysis. Texture parameters were defined and computed for each of the thousands of image blocks in our dataset using both the gray scale and color segmentation. The image blocks were then classified into three categories using the texture feature parameters in a novel statistical learning algorithm. These categories are as follows: image blocks specific to normal breast tissue, blocks specific to cancerous tissue, and those image blocks that are non-specific to normal and disease states. RESULTS: Gray scale and color segmentation techniques led to identification of same regions in histology slides as cancer-specific. Moreover the image blocks identified as cancer-specific belonged to those cell crowded regions in whole section image slides that were marked by two pathologists as regions of interest for further histological studies. CONCLUSION: These results indicate the high efficiency of our automated method for identifying pathologic regions of interest on histology slides. Automation of critical region identification will help minimize the inter-rater variability among different raters (pathologists) as hundreds of tumors that are used to develop an array have typically been evaluated (graded) by different pathologists. The region of interest information gathered from the whole section images will guide the excision of tissue for constructing tissue microarrays and for high throughput profiling of global gene expression

The global impact of the COVID-19 pandemic on the management and course of chronic urticaria

Introduction: The COVID-19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. Aim: To understand how CU patients are affected by the COVID-19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID-19. Materials and Methods: Our cross-sectional, international, questionnaire-based, multicenter UCARE COVID-CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. Results: The COVID-19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID-19 patient care, which negatively impacted on the care of urticaria patients. The rate of face-to-face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID-19, but COVID-19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID-19. Conclusions: The COVID-19 pandemic brings major changes and challenges for CU patients and their physicians. The long-term consequences of these changes, especially the increased use of remote consultations, require careful evaluation

MOBYL: MOdel-driven BYpassing of middleware Layers

The Layered architectural style presents a quandary for software architects. On the one hand, the style provides important advantages: separation of concerns, abstraction, ease of evolution, etc. Each layer can build on lower layers to add specific abstractions or services. On the other hand, the layers can become opaque, rigid barriers that inhibit the ability to adapt to new application needs. Consider, for example that some application functions may not need the services of all the layers; it may be more efficient to implement them in a lower layer. We refer to these as bypassing functions. In such situations, where changes to lower layers are needed, developers must resort to writing tricky, intricate, low-level code, which is time-consuming, error prone, and not portable. We address this phenomenon in the context of middleware, and extend the middleware notion of model-driven development with new modeling syntax, code generation tools, and development processes to make it easier to build bypassing implementations. We will describe our approach and provide several illustrative examples and performance data. We will use this data to argue that bypassing implementations can provide more efficient use of a server’s resources, leading to overall better client experience. Our core contribution is this idea: model-driven code generation can enable application developers to conveniently bypass middleware layers when they are not needed, thus improving the server’s performance

Nevus Sebaceous and Accompanying Lesions: A Clinicopathologic Review of Seven Patients

Purpose: Benign lesions are frequently develops in nevus sebaceous, while malignancies mayalso be seen rarely. We aimed to review the pathologies developed from nevus sebaceous in ourpatients. Material and method: Seven patients with nevus sebaceous, whose diagnoses andmanagements had been carried out in our department during the last six years, were reviewed.Diagnoses were verified by the examination of a pathologist. Results: In addition to the seven sebaceous nevi that were five in the scalp and two in the cheek,syringocystadenoma papilliferum in a patient, eccrine spiroadenoma in one patient, and bothsyringocystadenoma papilliferum and tubular apocrine adenoma in a patient were seen. Totalsurgical excision was performed for all patients. No recurrence was noticed in any of the tumorsin the follow-up. Conclusion: Prophylactic excision has been suggested because of the probable neoplastictransformations in elderly. In our series, early excision had been performed in almost all patientsand no malignant transformation was detected. Concerning the neoplastic changes are seenusually at the ages of 40-70 and aesthetically disturbing lesions rise in adolescent period, wesuggest that excision can be delayed to adolescent period