Image fusion using steerable dyadic wavelet transform

An image fusion algorithm based on multiscale analysis along arbitrary orientations is presented. After a steerable dyadic wavelet transform decomposition of multi-sensor images is carried out, the maximum local oriented energy is determined at each level of scale and spatial position. Maximum local oriented energy and local dominant orientation are used to combine transform coefficients obtained from the analysis of each input image. Reconstruction is accomplished from the modified coefficients, resulting in a fused image. Examples of multi-sensor fusion and fusion using different settings of a single sensor are demonstrated

Enhancement via Fusion of Mammographic Features

Image enhancement in mammography is typically concerned with either general visibility of all features or conspicuity of a specific sign of malignancy. We describe a synthesis of the two approaches through fusion of locally enhanced microcalcifications, circumscribed masses, and stellate lesions. Both local processing and image fusion are performed within a single wavelet transform framework which contributes to the computational efficiency of the method. The algorithm not only allows for efficient combination of specific features of importance, but also provides a flexible framework for incorporation of distinct enhancement methods and their independent optimization

Interactive wavelet processing and techniques applied to digital mammography

We present an interactive scheme for processing of digital mammograms relying upon a steerable dyadic wavelet transform. Coefficients of the translation and rotation-invariant transform are interactively processed before an inverse transform is applied. Analysis is carried out at dyadic scales and along arbitrary orientations. Local orientation is computed at each level of scale and spatial position and formulated into criteria for including or excluding specific orientations for contrast enhancement and enhancing locally radiating structures. Transform coefficients that were selected for contrast enhancement are modified by a piecewise linear enhancement function. The presented scheme is flexible enough to enable efficient position, scale, and orientation based interactive processing and analysis

Impact of Dronedarone Treatment on Healthcare Resource Utilization in Patients with Atrial Fibrillation/Flutter

BACKGROUND: The ATHENA (A Placebo-Controlled, Double-Blind, Parallel Arm Trial to Assess the Efficacy of Dronedarone 400 mg bid for the Prevention of Cardiovascular Hospitalization or Death from Any Cause in Patients with Atrial Fibrillation/Atrial Flutter) trial demonstrated a significant reduction (26%) in the rate of first cardiovascular (CV) hospitalization in dronedarone-treated patients with paroxysmal or persistent atrial fibrillation/flutter (AF/AFL). ATHENA was the first trial to demonstrate a CV outcomes benefit, specifically reduced CV hospitalizations, with an antiarrhythmic drug. The objective of this study was to assess the impact of dronedarone treatment on healthcare resource utilization among real-world patients with AF/AFL in United States clinical practice. METHODS: This retrospective cohort study used claims data from the MarketScan(®) databases (Truven Health, Durham, NC, USA) to identify patients with ≥2 concurrent de novo pharmacy claims for dronedarone (≥180 days’ total supply) between June 2009 and March 2011, and with an AF/AFL diagnosis and no heart failure-related hospitalization during the 12 months preceding the initial (index) dronedarone claim. Annualized inpatient and outpatient resource utilization were compared between the pre-index (baseline) and post-index (follow-up) periods. RESULTS: In total, 5,656 AF/AFL patients were prescribed dronedarone for ≥6 months and were followed for mean (standard deviation) 11.9 (4.7) months. Reductions in mean numbers of annualized all-cause, CV- and AF-related hospitalizations (~40–45%), and emergency department visits (~30–45%) were realized. These benefits were offset by increases in office visits (~10–30%) and AF-related prescription claims (74%) after dronedarone initiation. The sub-cohort of patients switching to dronedarone from Prior Rhythm-Control therapy (n = 2,080) showed similar reductions in hospital and emergency department events. CONCLUSIONS: This study suggests that dronedarone use in real-world practice, as in the ATHENA trial, results in substantial reductions in hospital admissions, both in first-line and second-line antiarrhythmic treatment settings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s12325-014-0108-x) contains supplementary material, which is available to authorized users

Edge detection in echocardiographic image sequences by 3-D multiscale analysis

Robust and reliable edge detection is an important step for accomplishing automatic detection of heart wall boundaries in echocardiograms. We present an edge detection algorithm that makes use of both spatial and temporal information. Our algorithm is comprised of (1) a 3-D discrete dyadic wavelet transform carried out on a sequence of images, (2) edge detection that is carried out by maxima detection and a search strategy for maxima curves within the transform space. Using detected edges and "a priori" knowledge of cardiographic features we demonstrate the performance of fully automatic detection of epicardial and endocardial boundaries along the posterior and anterior walls in 2-D short-axis echocardiographic image sequences

Visualization of mammograms via fusion of enhanced features

Image enhancement in mammography is typically concerned with either general visibility of all features or conspicuity of a specific sign of malignancy. We describe a synthesis of the two approaches through fusion of locally enhanced microcalcifications, circumscribed masses, and stellate lesions. Both local processing and image fusion are performed within a single wavelet transform framework which contributes to the computational efficiency of the method. The algorithm not only allows for efficient combination of specific features of importance, but also provides a flexible framework for incorporation of distinct enhancement methods and their independent optimization

A placebo-controlled, double-blind, randomized, multicenter study to assess the effects of dronedarone 400 mg twice daily for 12 weeks on atrial fibrillation burden in subjects with permanent pacemakers

Purpose Dronedarone is a benzofuran derivative with a pharmacological profile similar to amiodarone but has a more rapid onset of action and a much shorter half-life (13–19 h). Our goal was to evaluate the efficacy of dronedarone in atrial fibrillation (AF) patients using dual-chamber pacemakers capable of quantifying atrial fibrillation burden. Methods Pacemakers were adjusted to optimize AF detection. Patients with AF burden \u3e1 % were randomized to dronedarone 400 mg twice daily (BID) or placebo. Pacemakers were interrogated after 4 and 12 weeks of treatment. The primary endpoint was the change in AF burden from baseline over the 12-week treatment period. Patients with permanent AF, severe/recently decompensated heart failure, and current use of antiarrhythmic drugs were excluded. AF burden was assessed by a core laboratory blinded to treatment assignment. Results From 285 patients screened, 112 were randomized (mean age 76 years, 60 % male, 84 % hypertensive, 65 % with sick sinus syndrome, 26 % with diabetes mellitus type II, 15 % with heart failure). Baseline mean (SEM) AF burden was 8.77 % (0.16) for placebo and 10.14 % (0.17) for dronedarone. Over the 12-week study period, AF burden compared to baseline decreased by 54.4 % (0.22) (P = 0.0009) with dronedarone and trended higher by 12.8 % (0.16) (P = 0.450) with placebo. The absolute change in burden was decreased by 5.5 % in the dronedarone group and increased by 1.1 % in the placebo group. Heart rate during AF was reduced to approximately 4 beats/min with dronedarone (P = 0.285). Adverse events were higher with dronedarone compared to placebo (65 vs 56 %). Conclusions Dronedarone reduced pacemaker-assessed the relative AF burden compared to baseline and placebo by over 50 % during the 12-week observation period

Alirocumab in high-risk patients: Observations from the open-label expanded use program

BACKGROUND: The alirocumab expanded use program provided open-label access to alirocumab before its commercial availability to patients with severe hypercholesterolemia not controlled with maximally tolerated doses of standard-of-care lipid-lowering therapy. OBJECTIVE: To describe the safety and lipid-lowering efficacy of alirocumab in high-risk patients who were likely to be early users of proprotein convertase subtilisin/kexin type 9 inhibitors after approval. METHODS: Patients with heterozygous familial hypercholesterolemia (HeFH) and/or coronary heart disease (CHD) and baseline low-density lipoprotein cholesterol (LDL-C) of ≥160 mg/dL on maximally tolerated lipid-lowering therapy were enrolled and received alirocumab 150 mg every 2 weeks for 24 weeks. Patients were permitted use of all available statins; those not taking any dose of statin could also be enrolled. RESULTS: Of 100 enrolled patients, 93 were white, 62 were women, and overall mean age was 58 years; 61 had HeFH, 3 had unknown type of familial hypercholesterolemia, 66 had CHD, and 30 had both familial hypercholesterolemia and CHD. Sixty-four patients were identified by their providers to have some level of statin intolerance; of these, 47 were not on statin. Alirocumab reduced LDL-C on average from 221 mg/dL at baseline to 102 mg/dL by week 24 (-55%). Treatment-emergent adverse events were experienced in 61% of patients and treatment-emergent adverse events leading to permanent treatment discontinuation in 3% of patients; no deaths occurred. CONCLUSIONS: Safety and efficacy observations from the open-label alirocumab expanded use program of very high-risk patients with HeFH and/or CHD and baseline LDL-C of ≥160 mg/dL uncontrolled by maximally tolerated lipid-lowering therapy were consistent with those in the placebo/ezetimibe-controlled ODYSSEY trials

Is the relationship between binge eating episodes and personality attributable to genetic factors?

Aspects of disordered eating and personality traits, such as neuroticism are correlated and, individually, heritable. We examined the phenotypic correlation between binge eating episodes and indices of personality (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness and control/impulsivity). For correlations ≥ |0.20|, we estimated the extent to which genetic and environmental factors contributed to this correlation. Participants included 3446 European-American same-sex female twins from the Missouri Adolescent Female Twin Study (median age = 22 years). Binge eating episode was assessed via interview questions. Personality traits were assessed by self-report questionnaires. There was a significant moderate phenotypic correlation between binge eating episode and neuroticism (r = 0.33), as well as conscientiousness (r=−0.21) while other correlations were significant but smaller (r ranging from −0.14 to 0.14). Individual differences in binge eating episodes, neuroticism and conscientiousness were attributed to additive genetic influences (38% [95% confidence interval: 21%–53%], 45% [38%–52%], and 44% [0.33–0.55] respectively), with the remaining variance due to individual-specific environmental influences. Covariance was attributable to genetic (neuroticism r(g) = 0.37; conscientiousness r(g) = −0.22) and individual-specific environmental (neuroticism r(e) = 0.28; conscientiousness r(e) = −0.19) influences. Personality traits may be an early indicator of genetic vulnerability to a variety of pathological behaviors including binge eating episode. Furthermore, prior research documenting phenotypic correlations between eating disorder diagnoses and personality may stem from etiological overlap between these personality traits and aspects of disordered eating, such as binge eating episode