Femoral artery ultrasound examination: a new role in predicting cardiovascular risk

We compared intima-media thickness (IMT) and the prevalence of plaques in the common carotid artery (CCA) and common femoral artery (CFA) in apparently healthy participants. This multicenter study included 322 participants (59.9% female; age 20-78 years, mean 52.1 ± 15.3 years) who underwent Echo-color Doppler examination of the CCA and CFA bilaterally. Prevalence and composition of plaque were recorded. A significant ( P < .01) difference between mean CCA-IMT and mean CFA-IMT was detected (0.70 vs 0.73 mm). Plaque prevalence was significantly higher in the CFA compared to the CCA (40.7% vs 30.4%). Atherosclerotic plaques were found in both CFA and CCA in 46% of the cases, solely in CFA in 38%, and in CCA alone in 17%. The observed difference in plaque prevalence was even greater when only fibrolipid isolated plaques were considered (CFA 39.4% vs CCA 22.1%). In a healthy general population, atherosclerotic plaques were present in the CFA but not in the CCA in over one-third of the cases. Further studies must confirm whether ultrasonography of the CFA might be introduced in the screening protocols for cardiovascular risk assessment

Multiple Myeloma Treatment in Real-world Clinical Practice : Results of a Prospective, Multinational, Noninterventional Study

Funding Information: The authors would like to thank all patients and their families and all the EMMOS investigators for their valuable contributions to the study. The authors would like to acknowledge Robert Olie for his significant contribution to the EMMOS study. Writing support during the development of our report was provided by Laura Mulcahy and Catherine Crookes of FireKite, an Ashfield company, a part of UDG Healthcare plc, which was funded by Millennium Pharmaceuticals, Inc, and Janssen Global Services, LLC. The EMMOS study was supported by research funding from Janssen Pharmaceutical NV and Millennium Pharmaceuticals, Inc. Funding Information: The authors would like to thank all patients and their families and all the EMMOS investigators for their valuable contributions to the study. The authors would like to acknowledge Robert Olie for his significant contribution to the EMMOS study. Writing support during the development of our report was provided by Laura Mulcahy and Catherine Crookes of FireKite, an Ashfield company, a part of UDG Healthcare plc, which was funded by Millennium Pharmaceuticals, Inc, and Janssen Global Services, LLC. The EMMOS study was supported by research funding from Janssen Pharmaceutical NV and Millennium Pharmaceuticals, Inc. Funding Information: M.M. has received personal fees from Janssen, Celgene, Amgen, Bristol-Myers Squibb, Sanofi, Novartis, and Takeda and grants from Janssen and Sanofi during the conduct of the study. E.T. has received grants from Janssen and personal fees from Janssen and Takeda during the conduct of the study, and grants from Amgen, Celgene/Genesis, personal fees from Amgen, Celgene/Genesis, Bristol-Myers Squibb, Novartis, and Glaxo-Smith Kline outside the submitted work. M.V.M. has received personal fees from Janssen, Celgene, Amgen, and Takeda outside the submitted work. M.C. reports honoraria from Janssen, outside the submitted work. M. B. reports grants from Janssen Cilag during the conduct of the study. M.D. has received honoraria for participation on advisory boards for Janssen, Celgene, Takeda, Amgen, and Novartis. H.S. has received honoraria from Janssen-Cilag, Celgene, Amgen, Bristol-Myers Squibb, Novartis, and Takeda outside the submitted work. V.P. reports personal fees from Janssen during the conduct of the study and grants, personal fees, and nonfinancial support from Amgen, grants and personal fees from Sanofi, and personal fees from Takeda outside the submitted work. W.W. has received personal fees and grants from Amgen, Celgene, Novartis, Roche, Takeda, Gilead, and Janssen and nonfinancial support from Roche outside the submitted work. J.S. reports grants and nonfinancial support from Janssen Pharmaceutical during the conduct of the study. V.L. reports funding from Janssen Global Services LLC during the conduct of the study and study support from Janssen-Cilag and Pharmion outside the submitted work. A.P. reports employment and shareholding of Janssen (Johnson & Johnson) during the conduct of the study. C.C. reports employment at Janssen-Cilag during the conduct of the study. C.F. reports employment at Janssen Research and Development during the conduct of the study. F.T.B. reports employment at Janssen-Cilag during the conduct of the study. The remaining authors have stated that they have no conflicts of interest. Publisher Copyright: © 2018 The AuthorsMultiple myeloma (MM) remains an incurable disease, with little information available on its management in real-world clinical practice. The results of the present prospective, noninterventional observational study revealed great diversity in the treatment regimens used to treat MM. Our results also provide data to inform health economic, pharmacoepidemiologic, and outcomes research, providing a framework for the design of protocols to improve the outcomes of patients with MM. Background: The present prospective, multinational, noninterventional study aimed to document and describe real-world treatment regimens and disease progression in multiple myeloma (MM) patients. Patients and Methods: Adult patients initiating any new MM therapy from October 2010 to October 2012 were eligible. A multistage patient/site recruitment model was applied to minimize the selection bias; enrollment was stratified by country, region, and practice type. The patient medical and disease features, treatment history, and remission status were recorded at baseline, and prospective data on treatment, efficacy, and safety were collected electronically every 3 months. Results: A total of 2358 patients were enrolled. Of these patients, 775 and 1583 did and did not undergo stem cell transplantation (SCT) at any time during treatment, respectively. Of the patients in the SCT and non-SCT groups, 49%, 21%, 14%, and 15% and 57%, 20%, 12% and 10% were enrolled at treatment line 1, 2, 3, and ≥ 4, respectively. In the SCT and non-SCT groups, 45% and 54% of the patients had received bortezomib-based therapy without thalidomide/lenalidomide, 12% and 18% had received thalidomide/lenalidomide-based therapy without bortezomib, and 30% and 4% had received bortezomib plus thalidomide/lenalidomide-based therapy as frontline treatment, respectively. The corresponding proportions of SCT and non-SCT patients in lines 2, 3, and ≥ 4 were 45% and 37%, 30% and 37%, and 12% and 3%, 33% and 27%, 35% and 32%, and 8% and 2%, and 27% and 27%, 27% and 23%, and 6% and 4%, respectively. In the SCT and non-SCT patients, the overall response rate was 86% to 97% and 64% to 85% in line 1, 74% to 78% and 59% to 68% in line 2, 55% to 83% and 48% to 60% in line 3, and 49% to 65% and 36% and 45% in line 4, respectively, for regimens that included bortezomib and/or thalidomide/lenalidomide. Conclusion: The results of our prospective study have revealed great diversity in the treatment regimens used to manage MM in real-life practice. This diversity was linked to factors such as novel agent accessibility and evolving treatment recommendations. Our results provide insight into associated clinical benefits.publishersversionPeer reviewe

Studio e sperimentazione di tecniche di segmentazione semantica di immagini

L'apprendimento automatico, per definizione, si distingue per la realizzazione di programmi che migliorano le prestazioni in base all'esperienza. Il deep learning (apprendimento approfondito o profondo) è una sottoclasse di questi algoritmi, i quali hanno alcune caratteristiche particolari, ma fondamentalmente si basano su reti neurali artificiali. Le reti utilizzate in questa tesi sono le cosiddette convolutional neural networks (CNN), particolari in quanto hanno avuto risultati eccellenti nel area del riconoscimento e nella classificazione delle immagini. In particolare, in questa tesi si affronta ciò che viene definito come semantic segmentation, ovvero il tentativo di realizzare reti neurali in grado, ad esempio, non solo di capire che l'immagine contiene un cane, ma di disegnare, pixel per pixel, dove si trova quest'ultimo. Nel primo capitolo vengono introdotte le reti neurali, dandone una panoramica generale e soffermandosi sugli aspetti utili per questa tesi. Nel secondo capitolo viene fatto uno studio più approfondito su un particolare schema di reti, le Convolutional Neural Networks (CNN), osservandone i livelli interni e le operazioni fondamentali, con maggiore attenzione a quelle utili per questa tesi. Successivamente, viene fatta una panoramica dell'evoluzione nello studio dell'image processing che ha portato alla definizione del particolare ramo della segmentazione semantica. Nel terzo capitolo, vengono inoltre introdotte le due reti che sono state analizzate e sperimentate in questa tesi: Deconvnet e, in particolare, le Fully Convolutional Networks. Nel quarto ed ultimo capitolo, vengono presentati gli strumenti che sono stati utili per la sperimentazione e viene descritto il codice con cui sono state tradotte le reti studiate. Infine, vengono mostrati i risultati per le reti coinvolte nella sperimentazione ed esposti sia tramite le valutazioni standard, sia con alcune immagini esplicative

Deep learning-based segmentation of retinal layers in intraoperative Optical Coherence Tomography

This thesis studies the approaches for the segmentation of retinal layers in Optical Coherence Tomography (OCT) scans. It proposes an overview of the technology and the medical applications of these systems, with a focus on the advantages of intraoperative systems and, in particular, the added progress of having an automatic retinal layers' segmentation algorithm. It has been proved in these last years, that Deep Learning can deal efficiently computer vision tasks and there are examples in literature on using these recent methods to segment retinal layer on diagnostic OCT scans. In this thesis, it is presented a recap of the most recent and successful between these approaches and the technical ideas behind them. However, to the knowledge of the author, there are no segmentation algorithms applied to intraoperative systems. This study presents a model, specifically used for edge detection, in order to find two retinal layers, Inner Limiting Layer (ILM) and Retinal Pigment Epithelium (RPE), in intraoperative OCT B-scans. The task of segmenting retinal layers in intraoperative OCT scans is more challenging due to the noisy and (sometimes) unreliable nature of the images. Moreover, it is also presented an extension of the model with an adversarial extension, to avoid specific issues of the task and improve the outcome. Along with the results, the study shows a qualitative analysis for a more complete evaluation

Transformer Models for Question Answering at BioASQ 2019

We describe our experiments in building a system to tackle task B of the BioASQ 2019 challenge on semantic question answering. We built separate systems to handle the five different types of questions in the dataset. We explored using transformer-based models using both ELMo, BERT and BioBERT. For the yesno questions, the results of our submissions using BERT ranked first in batches 3 and 4, while second best in batch 5

Simultaneous distributed estimation and classification in sensor networks

In this work we consider the problem of simultaneously classifying sensor types and estimating hidden parameters in a network of sensors subject to gossip-like communication limitations. In particular, we consider a network of scalar noisy sensors which measure a common unknown parameter. We assume that a fraction of the nodes is subject to the same (but possibly unknown) offset. The goal for each node is to simultaneously identify the class the node belongs to and to estimate the common unknown parameter, only through local communication and computation. We propose a distributed estimator based on the maximum likelihood (ML) approach and we show that, in case the offset is known, this estimator converges to the centralized ML as the number N of sensor nodes goes to infinity. We also compare this strategy with a distributed implementation of estimationmaximization (EM) algorithm; we show tradeoffs via numerical simulations in terms of robustness, speed of convergence and implementation simplicity

Gossip algorithms for distributed ranking

Ranking a set of numbers plays a key role in many application areas such as signal processing, statistics, computer science and so on. Distributed algorithms for ranking have been proposed in the computer science literature first for tree networks. Extension to general networks has been performed by constructing a spanning tree, which can be done in a distributed manner. In this paper we propose and analyze a gossip algorithm for distributed ranking. The advantage of the proposed algorithm is, on the one hand, its inherent robustness to changes and/or failures in the network and, on the other, its implementation simplicity. The algorithm is proved to converge, in the sense of giving the correct ranking, in finite time with probability one

Elm breeding for DED resistance, the Italian clones and their wood properties

Mejora del olmo para resistencia a DED: clones italianos y características de su madera En Italia, el programa de mejora genética del olmo para la obtención de árboles resistentes a la grafiosis se ha desarrollado a partir del cruzamiento de olmos asiáticos con especies nativas, y tiene por objetivo producir individuos que combinen la resistencia de los primeros con las características vegetativas y el alto grado de adaptación al ambiente de los segundos. Por esta razón, se ha aprovechado la favorable adaptación de Ulmuspumila en Italia: "San Zenobi" y "Plinio" son dos resultados recientes de estas investigaciones, y otros muchos clones prometedores como "FLO9O", "FL146", "FL441", "FL568" y "FL634" están en las fases finales de las pruebas de campo. Los niveles de resistencia de todos estos clones fueron significativamente mayores, en diferentes ensayos. que los niveles de resistencia de "Lobel" y "Urhan". Los primeros ensayos tecnológicos han mostrado que las características de la madera de los clones "San Zenobí" y "FLO9O" son comparables a los de las maderas de olmo tradicionalmente presentes en el mercado, indicando que esos clones pueden probablemente satisfacerlas demandas de madera. La actual caracterización debe ser confirmada con nuevas evaluaciones en árboles maduros de mayores diámetros y mediante ensayos industriales aún no disponibles

Surgical treatment of gastric cancer liver metastases: systematic review and meta-analysis of long-term outcomes and prognostic factors

The prognosis of patients with metastatic gastric cancer remains dismal, with palliative treatment as standard of care. However, encouraging results have been reported for surgical resection of liver only metastatic gastric cancer in carefully selected patients. A systematic review of articles published from 2000 onwards was conducted according to PRISMA guidelines. Twenty-nine studies were included in qualitative and quantitative analysis. Meta-analysis of proportions pointed out 29.1% 5ySR (I 2 = 39%). The pooled weighted median of MSTs was 31.1 months. T stage > 2, metastasis greatest dimension ≥ 5 cm, the presence of multiple metastases and bilobar disease resulted among the strongest predictors of mortality. Funnel plots, Egger's tests, and P-curve analyses failed to show significant publication bias. Based on strict selection criteria and robust statistical analyses, our results show that, in very carefully selected patients without extrahepatic disease, surgical resection with curative intent may significantly improve overall survival

Rotator cuff degeneration: the role of genetics

Background: The literature is certain regarding the multifactorial etiology of rotator cuff degeneration. However, it remains unclear if rotator cuff degeneration exclusively depends on intrinsic and extrinsic factors or if it is also genetically determined. We compared the health status of cuff tendons, evaluated with a magnetic resonance imaging (MRI) study, between elderly monozygotic and dizygotic twins with the aim of separating the contributions of genetics from shared and unique environments.Methods: The rotator cuff tendon status was assessed using the Sugaya classification by MRI. Heritability, defined as the proportion of total variance of a specific characteristic in a particular population due to a genetic cause, was calculated as twice the difference between the intraclass correlation coefficients for monozygotic and dizygotic pairs. The influence of shared environment, which contributes to twin and sibling similarity, was calculated as the difference between the monozygotic correlation coefficient and the heritability index.Results: We identified 33 pairs of elderly twins: 17 monozygotic pairs and 16 dizygotic pairs, with a mean age (and standard deviation) of 64.62 +/- 3.32 years. The polychoric correlation was 0.62 in monozygotic twins and 0.53 in dizygotic twins. The calculated heritability index was 0.18 (18%), and the contribution was 0.44 (44%) for the shared environment and 0.38 (38%) for the unique environment.Conclusions: The role of genetics in rotator cuff degeneration is quantified by our study on elderly monozygotic and dizygotic twins; however, it is only partial with respect to the contribution of shared and unique environments