Statistical framework for video decoding complexity modeling and prediction

Video decoding complexity modeling and prediction is an increasingly important issue for efficient resource utilization in a variety of applications, including task scheduling, receiver-driven complexity shaping, and adaptive dynamic voltage scaling. In this paper we present a novel view of this problem based on a statistical framework perspective. We explore the statistical structure (clustering) of the execution time required by each video decoder module (entropy decoding, motion compensation, etc.) in conjunction with complexity features that are easily extractable at encoding time (representing the properties of each module's input source data). For this purpose, we employ Gaussian mixture models (GMMs) and an expectation-maximization algorithm to estimate the joint execution-time - feature probability density function (PDF). A training set of typical video sequences is used for this purpose in an offline estimation process. The obtained GMM representation is used in conjunction with the complexity features of new video sequences to predict the execution time required for the decoding of these sequences. Several prediction approaches are discussed and compared. The potential mismatch between the training set and new video content is addressed by adaptive online joint-PDF re-estimation. An experimental comparison is performed to evaluate the different approaches and compare the proposed prediction scheme with related resource prediction schemes from the literature. The usefulness of the proposed complexity-prediction approaches is demonstrated in an application of rate-distortion-complexity optimized decoding

Pharmacogenetic & Pharmacokinetic Biomarker for Efavirenz Based ARV and Rifampicin Based Anti-TB Drug Induced Liver Injury in TB-HIV Infected Patients

BACKGROUND: Implication of pharmacogenetic variations and efavirenz pharmacokinetics in concomitant efavirenz based antiviral therapy and anti-tubercular drug induced liver injury (DILI) has not been yet studied. We performed a prospective case-control association study to identify the incidence, pharmacogenetic, pharmacokinetic and biochemical predictors for anti-tubercular and antiretroviral drugs induced liver injury (DILI) in HIV and tuberculosis (TB) co-infected patients. METHODS AND FINDINGS: Newly diagnosed treatment naïve TB-HIV co-infected patients (n = 353) were enrolled to receive efavirenz based ART and rifampicin based anti-TB therapy, and assessed clinically and biochemically for DILI up to 56 weeks. Quantification of plasma efavirenz and 8-hydroxyefaviernz levels and genotyping for NAT2, CYP2B6, CYP3A5, ABCB1, UGT2B7 and SLCO1B1 genes were done. The incidence of DILI and identification of predictors was evaluated using survival analysis and the Cox Proportional Hazards Model. The incidence of DILI was 30.0%, or 14.5 per 1000 person-week, and that of severe was 18.4%, or 7.49 per 1000 person-week. A statistically significant association of DILI with being of the female sex (p = 0.001), higher plasma efavirenz level (p = 0.009), efavirenz/8-hydroxyefavirenz ratio (p = 0.036), baseline AST (p = 0.022), ALT (p = 0.014), lower hemoglobin (p = 0.008), and serum albumin (p = 0.007), NAT2 slow-acetylator genotype (p = 0.039) and ABCB1 3435TT genotype (p = 0.001). CONCLUSION: We report high incidence of anti-tubercular and antiretroviral DILI in Ethiopian patients. Between patient variability in systemic efavirenz exposure and pharmacogenetic variations in NAT2, CYP2B6 and ABCB1 genes determines susceptibility to DILI in TB-HIV co-infected patients. Close monitoring of plasma efavirenz level and liver enzymes during early therapy and/or genotyping practice in HIV clinics is recommended for early identification of patients at risk of DILI

Can serum hyaluronic acid replace simple non-invasive indexes to predict liver fibrosis in HIV/Hepatitis C coinfected patients?

<p>Abstract</p> <p>Background</p> <p>Hyaluronic acid (HA) serum levels correlate with the histological stages of liver fibrosis in hepatitis C virus (HCV) monoinfected patients, and HA alone has shown very good diagnostic accuracy as a non-invasive assessment of fibrosis and cirrhosis. The aim of this study was to evaluate serum HA levels as a simple non-invasive diagnostic test to predict hepatic fibrosis in HIV/HCV-coinfected patients and to compare its diagnostic performance with other previously published simple non-invasive indexes consisting of routine parameters (HGM-1, HGM-2, Forns, APRI, and FIB-4).</p> <p>Methods</p> <p>We carried out a cross-sectional study on 201 patients who all underwent liver biopsies and had not previously received interferon therapy. Liver fibrosis was determined via METAVIR score. The diagnostic accuracy of HA was assessed by area under the receiver operating characteristic curves (AUROCs).</p> <p>Results</p> <p>The distribution of liver fibrosis in our cohort was 58.2% with significant fibrosis (F≥2), 31.8% with advanced fibrosis (F≥3), and 11.4% with cirrhosis (F4). Values for the AUROC of HA levels corresponding to significant fibrosis (F≥2), advanced fibrosis (F≥3) and cirrhosis (F4) were 0.676, 0.772, and 0.863, respectively. The AUROC values for HA were similar to those for HGM-1, HGM-2, FIB-4, APRI, and Forns indexes. The best diagnostic accuracy of HA was found for the diagnosis of cirrhosis (F4): the value of HA at the low cut-off (1182 ng/mL) excluded cirrhosis (F4) with a negative predictive value of 99% and at the high cut-off (2400 ng/mL) confirmed cirrhosis (F4) with a positive predictive value of 55%. By utilizing these low and high cut-off points for cirrhosis, biopsies could have theoretically been avoided in 52.2% (111/201) of the patients.</p> <p>Conclusions</p> <p>The diagnostic accuracy of serum HA levels increases gradually with the hepatic fibrosis stage. However, HA is better than other simple non-invasive indexes using parameters easily available in routine clinical practice only for the diagnosing of cirrhosis.</p

Panel 7: otitis media:treatment and complications

Objective: We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice. Data Sources: PubMed, Ovid Medline, the Cochrane Library, and Clinical Evidence (BMJ Publishing). Review Methods: All types of articles related to otitis media treatment and complications between June 2011 and March 2015 were identified. A total of 1122 potential related articles were reviewed by the panel members; 118 relevant articles were ultimately included in this summary. Conclusions: Recent literature and guidelines emphasize accurate diagnosis of acute otitis media and optimal management of ear pain. Watchful waiting is optional in mild to moderate acute otitis media; antibiotics do shorten symptoms and duration of middle ear effusion. The additive benefit of adenoidectomy to tympanostomy tubes in recurrent acute otitis media and otitis media with effusion is controversial and age dependent. Topical antibiotic is the treatment of choice in acute tube otorrhea. Symptomatic hearing loss due to persistent otitis media with effusion is best treated with tympanostomy tubes. Novel molecular and biomaterial treatments as adjuvants to surgical closure of eardrum perforations seem promising. There is insufficient evidence to support the use of complementary and alternative treatments. Implications for Practice: Emphasis on accurate diagnosis of otitis media, in its various forms, is important to reduce overdiagnosis, overtreatment, and antibiotic resistance. Children at risk for otitis media and its complications deserve special attention

Μερος δευτερο : οι επιγραφες

Publication des inscriptions inédites, gravées pour la plupart sur des bases d'hermès ou des plaques incluses dans l'appareil d'un mur, qui ont été découvertes pendant les fouilles des terrains occupant l'emplacement du bâtiment antique dont la présentation figure dans la première partie. Il s'agit de textes de palestre, avec mention des épistates des enfants, de leur secrétaire et du fournisseur d'huile. Ces inscriptions invitent à identifier l'édifice comme une palestre, mais ses dimensions imposantes (longueur de côté voisine d'un stade) plaident plutôt en faveur d'un gymnase, le second connu à Rhodes. Son rapprochement avec le Ptolémaion, témenos dont chaque côté était un portique long d'un stade (Diod., XX, 100, 3-4) soulève plusieurs problèmes. Selon l'A., c'est seulement après avoir obtenu confirmation de ce que ce bâtiment partiellement fouillé était vraiment à cour péristyle et seulement après l'étude des autres intéressantes trouvailles (timbres amphoriques p. ex.) que l'on pourra parvenir à des conclusions sûres.Kontorinis Vassa N. Μερος δευτερο : οι επιγραφες. In: L'antiquité classique, Tome 58, 1989. pp. 157-177

Le roi Hiempsal II de Numidie et Rhodes

L'auteur publie une inscription inédite de Rhodes par laquelle le peuple honore le roi de Numidie Hiempsal II (c. 88-60 avant J.-C). Elle étudie la généalogie de cette famille royale et reprend une inscription de Syracuse (Notizie degli Scavi, 1956, p. 96), qui, malgré ses mutilations, permet de mieux fixer la succession chronologique des différents rois.Kontorinis Vassa N. Le roi Hiempsal II de Numidie et Rhodes. In: L'antiquité classique, Tome 44, fasc. 1, 1975. pp. 89-99

Undiagnosed Myeloproliferative Disease in Cases of Intra-Abdominal Thrombosis: The Utility of the JAK2 617F Mutation

Background & Aims: Extrahepatic portal vein thrombosis and Budd-Chiari syndrome frequently result from multiple concurrent factors such as cirrhosis, intra-abdominal sepsis, procoagulant states, and underlying myeloproliferative disorders (MPDs). The JAK2 V617F mutation is a point mutation in the Janus kinase 2 (JAK2) tyrosine kinase that is variably present in MPDs. The incidence depends on the subclassification of the MPDs and the sensitivity of the assay used. This case series aimed to illustrate the diagnostic utility of JAK2 V617F mutation in atypical cases of MPD that otherwise may not have met traditional diagnostic criteria. Methods: Granulocytic DNA was obtained and real-time polymerase chain reaction was performed using allele-specific primer and probe to provide a quantitative expression of the V617F mutation. Results: The JAK2 V617F point mutation was found in 3 patients with extrahepatic portal vein thrombosis who had multiple thrombotic events but did not fulfill the traditional diagnostic criteria for MPDs. Conclusions: A sensitive assay for the JAK2 V617F mutation has the potential to diagnose atypical MPDs in multiple undiagnosed cases of intra-abdominal thrombosis and therefore alter the management and prognosis of these patients

Screening for hepatocellular carcinoma (HCC) in hepatitis/HIV co-infection using ultrasound imaging and alfa-feto protein levels

Hepatocellular carcinoma (HCC) is a serious complication of chronic viral hepatitis once cirrhosis has developed. Screening for HCC allows for early detection in HCV or HBV mono-infection and, if detected, possible treatment. Since HIV co-infection is associated with faster progression of liver disease in both HBV and HCV infection and non-AIDS cancers have recently been shown to be more common and occur earlier in the setting of HIV, it is likely that HIV co-infection increases not only the rapidity of hepatocarcinogenesis but also the overall risk of HCC. Screening for HCC by abdominal ultrasound and alfafeto protein (AFP) measurement is recommended at 6 to 12 month intervals for both HBV and HCV monoinfected patients. There are multiple treatment modalities currently available for HCC including radio-frequency ablation, percutaneous ethanol injection, trans-arterial chemo-embolisation, resection and liver transplantation. Treatment is a feasible option in those individuals with hepatitis/HIV co-infection who are successfully treated with HAART and otherwise healthy. Fifty-one hepatitis/HIV co-infected patients attending the Ambulatory HIV Service at Royal Perth Hospital (RPH) were identified and their medical records reviewed to identify uptake of HCC screening. Since 2000, 21 patients (41%) were screened at least once by abdominal ultrasound, 5 more had ultrasound requested for other reasons (e.g. renal failure). One patient was subsequently found to have a HCC as an incidental finding. Nine of the 21 patients (42%) screened since 2000 have had a second study performed and 8 more patients (31%) are awaiting further follow-up. The mean interval between ultrasound screenings was 1.0 year (range 0.5-2.2). Thirty patients (59%) have been screened for HCC with measurement of serum AFP. There has been poor uptake of initial and follow-up HCC screening with abdominal ultrasound and AFP in hepatitis/HIV co-infected patients at RPH and few patients have had regular follow-up scans. Improved drug treatments have resulted in decreased mortality from HIV in countries with access to HAART but co-infection with hepatitis poses a significant threat to those that might otherwise expect a normal lifespan. Improved screening protocols for HCC are warranted