Comparison of manual and semi-automated delineation of regions of interest for radioligand PET imaging analysis

BACKGROUND As imaging centers produce higher resolution research scans, the number of man-hours required to process regional data has become a major concern. Comparison of automated vs. manual methodology has not been reported for functional imaging. We explored validation of using automation to delineate regions of interest on positron emission tomography (PET) scans. The purpose of this study was to ascertain improvements in image processing time and reproducibility of a semi-automated brain region extraction (SABRE) method over manual delineation of regions of interest (ROIs). METHODS We compared 2 sets of partial volume corrected serotonin 1a receptor binding potentials (BPs) resulting from manual vs. semi-automated methods. BPs were obtained from subjects meeting consensus criteria for frontotemporal degeneration and from age- and gender-matched healthy controls. Two trained raters provided each set of data to conduct comparisons of inter-rater mean image processing time, rank order of BPs for 9 PET scans, intra- and inter-rater intraclass correlation coefficients (ICC), repeatability coefficients (RC), percentages of the average parameter value (RM%), and effect sizes of either method. RESULTS SABRE saved approximately 3 hours of processing time per PET subject over manual delineation (p 0.8) for both methods. RC and RM% were lower for the manual method across all ROIs, indicating less intra-rater variance across PET subjects' BPs. CONCLUSION SABRE demonstrated significant time savings and no significant difference in reproducibility over manual methods, justifying the use of SABRE in serotonin 1a receptor radioligand PET imaging analysis. This implies that semi-automated ROI delineation is a valid methodology for future PET imaging analysis

Kehidupan Waria Di Kota Manado

Waria dalam menjalani kehidupannya di Kota besar sering kali mendapat penolakan dari masyarakat, hal itu dikarenakan belum terbukanya masyarakat terhadap hal-hal yang dipandang tidak normal. Masyarakat Indonesia yang cenderung memiliki pikiran yang masih tradisional membuat kaum waria semakin terpojokan. Karena itu, penelitian inipun dilakukan untuk memahami serta mengkaji bagaimana waria dalam menjalani kehidupan mereka di Kota Manado. Penelitian ini menggunakan metode peneltian kualitatif dengan melibatkan 10 (sepuluh) informan waria. Dalam penelitian ini ditemukan bahwa kaum waria di Manado dalam menjalani kehidupan mereka tidak jarang mengalami penolakan dari masyarakat. Belum semua masyarakat yang ada di Manado boleh menerima waria disekitar mereka, ada masyarakat yang bisa menerima mereka namun tak sedikit pun yang menolak mereka. Hal itu dikarenakan stigma yang muncul dalam masyarakat dimana kalau kaum waria yaitu mereka yang bekerja sebagai seks komersial, padahal tidak semua waria bekerja seperti itu. Kurang mengertinya masyarakat tentang alasan atau latar belakang seorang laki-laki menjadi waria atau kenapa mereka memilih menjadi waria meruapakan salah satu penyebab mereka mendapat penolakan. Penolakan yang dialami kaum waria bukan hanya dari masyarakat saja, tetapi justru penolakan datang pertama kali dari keluarga, khususnya orangtua. Tidak ada orangtua yang menginginkan anggota keluarganya berperilaku yang tidak normal, untuk itulah waria mendapat tolakan keras dari keluarga. Padahal faktor keluarga jugalah yang menyebabkan perilaku mereka terbentuk, dimana perlakuan orangtua terhadap anak ketika mereka kecil dengan memperlakukan mereka (anak laki-laki) seperti perempuan. Sulitnya mencari pekerjaan di Kota Manado menjadi salah satu faktor seorang laki-laki mengubah atau memilih menjadi waria dengan alasan untuk memenuhi kebutuhan sehari-hari. para waria ingin menjalani kehidupan layaknya masyarakat normal pada umumnya, mereka hanya ingin berharga dimata masyarakat dan keluarga serta diterimanya mereka diantara masyarakat, agar supaya mereka dapat berinteraksi dengan baik bersama masyarakat

Kontribusi Ibu Rumah Tangga Sebagai Pemulung Sampah Dalam Meningkatkan Ekonomi Keluarga ( Di Tpa Kelurahan Sumompo Kecamatan Tuminting)

Metode penelitian yang di gunakan dalam penelitian ini adalah metode penelitian kualitatif. Dengan memanfaatkan informan sebagai sumber data penelitian. Lokasi penelitian ini adalah tempat pembuangan akhir Kelurahan Sumompo Kecamatan Tuminting Kota Manado. Hasil Penelitian adalah: (1) Latar belakang kehidupan sosial pemulung di kelurahan sumompo lingkungan III adalah yang paling banyak menjadi pemulung adalah kaum perempuan atau para ibu-ibu rumah tangga yang kodisi ekonominya dalam keluarganya lemah sehingga membuat mereka menjadi seorang pemulung. Pekerjaan sebagai pemulung bukan menjadi pilihan utama bagi mereka, dan hampir setiap hari waktu mereka hanya dihabiskan ditempat pembuangan sampah. (2)Faktor yang menyebabkan mereka ibu rumah tangga berprofesi sebagai pemulung di TPA dikelurahan sumompo yaitu karena faktor ekonomi yang pada umunya karena pekerjaan suami mereka yang tidak tetap dan pendapatan suami tidak dapat mencukupi kebutuhan dalam keluarga karena sebagian besar dari mereka suaminya hanya bekerja sebaga buruh sampah, sehingga tingkat ekonomi mereka lemah dan menyebakan mereka bekerja sehingga mereka mampu untuk memenuhi kebutuhan dan kehidupan mereka dan salah satu pekerjaan yang dapat mereka lakukan adalah menjadi pemulung, hal ini juga didukung oleh adanya TPA yang dekat dengan tempat tinggal mereka. Faktor keterbatasan sumber daya manusia (SDM) yang sangat diperlukan karena salah satu yang dihadapi oleh masyrakat pemulung adalah SDM yang rendah karena tingkat pendidikan mereka pada umumnya hanya sampai sekolah dasar sehingga para ibu-ibu rumah tangga terpaksa menjadi seorang pemulung agar dapat memberi kontribusi didalam keluarga mereka dengan bekerja menjadi pemulung sampah agar dapat membantu meningkatkan ekonomi dalam keluarga mereka

Striatal Acetylcholine-Dopamine Imbalance in Parkinson Disease:In Vivo Neuroimaging Study with Dual-Tracer PET and Dopaminergic PET-Informed Correlational Tractography

Previous studies of animal models of Parkinson disease (PD) suggest an imbalance between striatal acetylcholine and dopamine, although other studies have questioned this. To our knowledge, there are no previous in vivo neuroimaging studies examining striatal acetylcholine-dopamine imbalance in PD patients. Using cholinergic and dopaminergic PET (F-18-fluoroethoxybenzovesamicol [F-18-FEOBV] and C-11-dihydrotetrabenazine [C-11-DTBZ], respectively) and correlational tractography, our aim was to investigate the acetylcholine-dopamine interaction at 2 levels of dopaminergic loss in PD subjects: integrity loss of the nigrostriatal dopaminergic white matter tract and loss at the presynaptic-terminal level. Methods: The study involved 45 subjects with mild to moderate PD (36 men, 9 women; mean age, 66.3 +/- 6.3 y, disease duration, 5.8 +/- 3.6 y; Hoehn and Yahr stage, 2.2 +/- 0.6) and 15 control subjects (9 men, 6 women; mean age, 69.1 +/- 8.6 y). PET imaging was performed using standard protocols. We first estimated the integrity of the dopaminergic nigrostriatal white matter tracts in PD subjects by incorporating molecular information from striatal C-11-DTBZ PET into the fiber tracking process using correlational tractography (based on quantitative anisotropy [QA], a measure of tract integrity). Subsequently, we used voxel-based correlation to test the association of the mean QA of the nigrostriatal tract of each cerebral hemisphere with the striatal F-18-FEOBV distribution volume ratio (DVR) in PD subjects. The same analysis was performed for C-11-DTBZ DVR in 12 striatal subregions (presynaptic-terminal level). Results: Unlike C-11-DTBZ DVR in striatal subregions, the mean QA of the nigrostriatal tract of the most affected hemisphere showed a negative correlation with a striatal cluster of F-18-FEOBV DVR in PD subjects (corrected P = 0.039). We also found that the mean F-18-FEOBV DVR within this cluster was higher in the PD group than in the control group (P = 0.01). Cross-validation analyses confirmed these findings. We also found an increase in bradykinesia ratings associated with increased acetylcholine-dopamine imbalance in the most affected hemisphere (r = 0.41, P = 0.006). Conclusion: Our results provide evidence for the existence of striatal acetylcholine-dopamine imbalance in early PD and may provide an avenue for testing in vivo effects of therapeutic strategies aimed at restoring striatal acetylcholine-dopamine balance in PD

HIV-infected sex workers with beneficial HLA-variants are potential hubs for selection of HIV-1 recombinants that may affect disease progression

Cytotoxic T lymphocyte (CTL) responses against the HIV Gag protein are associated with lowering viremia; however, immune control is undermined by viral escape mutations. The rapid viral mutation rate is a key factor, but recombination may also contribute. We hypothesized that CTL responses drive the outgrowth of unique intra-patient HIV-recombinants (URFs) and examined gag sequences from a Kenyan sex worker cohort. We determined whether patients with HLA variants associated with effective CTL responses (beneficial HLA variants) were more likely to carry URFs and, if so, examined whether they progressed more rapidly than patients with beneficial HLA-variants who did not carry URFs. Women with beneficial HLA-variants (12/52) were more likely to carry URFs than those without beneficial HLA variants (3/61) (p < 0.0055; odds ratio = 5.7). Beneficial HLA variants were primarily found in slow/standard progressors in the URF group, whereas they predominated in long-term non-progressors/survivors in the remaining cohort (p = 0.0377). The URFs may sometimes spread and become circulating recombinant forms (CRFs) of HIV and local CRF fragments were over-represented in the URF sequences (p < 0.0001). Collectively, our results suggest that CTL-responses associated with beneficial HLA variants likely drive the outgrowth of URFs that might reduce the positive effect of these CTL responses on disease progression

The Use of Telehealth Technology in Assessing the Accuracy of Self-Reported Weight and the Impact of a Daily Immediate-Feedback Intervention among Obese Employees

Objective. To determine the accuracy of self-reported body weight prior to and following a weight loss intervention including daily self-weighing among obese employees. Methods. As part of a 6-month randomized controlled trial including a no-treatment control group, an intervention group received a series of coaching calls, daily self-weighing, and interactive telemonitoring. The primary outcome variable was the absolute discrepancy between self-reported and measured body weight at baseline and at 6 months. We used general linear mixed model regression to estimate changes and differences between study groups over time. Results. At baseline, study participants underreported their weight by an average of 2.06 (se = 0.33) lbs. The intervention group self-reported a smaller absolute body weight discrepancy at followup than the control group. Conclusions. The discrepancy between self-reported and measured body weight appears to be relatively small, may be improved through daily self-monitoring using immediate-feedback telehealth technology, and negligibly impacts change in body weight

Reproducibility of 2D and 3D Ramus Height Measurements in Facial Asymmetry

In our clinic, the current preferred primary treatment regime for unilateral condylar hyperactivity is a proportional condylectomy in order to prevent secondary orthognathic surgery. Until recently, to determine the indicated size of reduction during surgery, we used a 'panorex-free-hand' method to measure the difference between left and right ramus heights. The problem encountered with this method was that our TMJ surgeons measured differences in the amount to resect during surgery. Other 2D and 3D method comparisons were unavailable. The aim of this study was to determine the most reproducible ramus height measuring method. Differences in left/right ramus height were measured in 32 patients using three methods: one 3D and two 2D. The inter- and intra-observer reliabilities were determined for each method. All methods showed excellent intra-observer reliability (ICC > 0.9). Excellent inter-observer reliability was also attained with the panorex-bisection method (ICC > 0.9), while the CBCT and panorex-free-hand gave good results (0.75 < ICC < 0.9). However, the lower boundary of the 95% CI (0.06-0.97) of the inter-observer reliability regarding the panorex-free-hand was poor. Therefore, we discourage the use of the panorex-free-hand method to measure ramus height differences in clinical practice. The panorex-bisection method was the most reproducible method. When planning a proportional condylectomy, we advise applying the panorex-bisection method or using an optimized 3D-measuring method