Hierarchical Cluster Analysis to Aid Diagnostic Image Data Visualization of MS and Other Medical Imaging Modalities

Perceiving abnormal regions in the images of different medical modalities plays a crucial role in diagnosis and subsequent treatment planning. In medical images to visually perceive abnormalities’ extent and boundaries requires substantial experience. Consequently, manually drawn region of interest (ROI) to outline boundaries of abnormalities suffers from limitations of human perception leading to inter-observer variability. As an alternative to human drawn ROI, it is proposed the use of a computer-based segmenta- tion algorithm to segment digital medical image data. Hierarchical Clustering-based Segmentation (HCS) process is a generic unsupervised segmentation process that can be used to segment dissimilar regions in digital images. HCS process generates a hierarchy of segmented images by partitioning an image into its constituent regions at hierarchical levels of allowable dissimilarity between its different regions. The hierarchy represents the continuous merging of similar, spatially adjacent, and/or disjoint regions as the allowable threshold value of dissimilarity between regions, for merging, is gradually increased. This chapter discusses in detail first the implementation of the HCS process, second the implementa- tion details of how the HCS process is used for the presentation of multi-modal imaging data (MALDI and MRI) of a biological sample, third the implementation details of how the process is used as a perception aid for X-ray mammogram readers, and finally the implementation details of how it is used as an interpreta- tion aid for the interpretation of Multi-parametric Magnetic Resonance Imaging (mpMRI) of the Prostate

Body mass index has a curvilinear relationship with the percentage of body fat among children

<p>Abstract</p> <p>Background</p> <p>Body Mass Index (BMI), which is defined as the ratio between weight (in kg) and height (in m²), is often used in clinical practice as well as in large scale epidemiological studies to classify subjects as underweight, normal weight, overweight or obese. Although BMI does not directly measure the percentage of Body Fat (BF%), it is widely applied because it is strongly related with BF%, it is easy to measure and it is an important predictor of mortality. Among children, age and sex-specific reference values of BMI, known as percentiles, are used. However, it is not clear how strong the relationship between BMI and BF% is among children and whether the association is linear. We performed a cross-sectional study aiming at evaluating the strength and shape of the relationship between BMI and BF% among school-aged children aged 6-12 years.</p> <p>Findings</p> <p>The study was conducted on a sample of 361 football-playing male children aged 6 to 12 years in Rome, Italy. Age, weight, height and skinfold thickness were collected. BF% was estimated using 4 skinfold equations whereas BMI was converted into BMI-for-age z-score. The relationship between these variables was examined using linear regression analyses. Mean BMI was 18.2 (± 2.8), whereas BF% was influenced by the skinfold equation used, with mean values ranging from 15.6% to 23.0%. A curvilinear relationship between BMI-for-age zscore and BF % was found, with the regression line being convex. The association between BMI-for-age zscore and BF% was stronger among overweight/obese children than among normal/underweight children. This curvilinear pattern was evident in all 4 skinfold equations used.</p> <p>Conclusions</p> <p>The association between BMI-for-age zscore and BF% is not linear among male children aged 6-12 years and it is stronger among overweight and obese subjects than among normal and underweight subjects. In this age group, BMI is a valid index of adiposity only among overweight and obese subjects.</p

Quantifying abundance and distribution of native and invasive oysters in an urbanised estuary

Human activities have modified the chemical, physical and biological attributes of many of the world’s estuaries. Natural foreshores have been replaced by artificial habitats and non-indigenous species have been introduced by shipping, aquaculture, and as ornamental pets. In south east Australia, the native Sydney rock oyster Saccostrea glomerata is threatened by pollution, disease and competition from the invasive Pacific oyster Crassostrea gigas. This study assessed the abundance (as number m-2), size, and distribution of both invasive and native oyster species at 32 sites in the heavily urbanised Port Jackson Estuary, Australia. We tested the hypotheses that there would be: (1) a difference in the proportion of C. gigas and S. glomerata among locations; (2) a greater proportion of C. gigas on artificial compared to natural substrates; (3) a greater numbers of all oysters, with differing size characteristics, on artificial compared to natural substrates; and (4) that the abundance and size of all oysters would vary among locations along an environmental gradient. Environmental variables included distance from the estuary mouth and salinity. We found the abundance and size of all oysters differed among locations; smaller oysters occurred at greater abundances near the mouth of the estuary. Abundance was also higher on artificial, than on natural substrate. Habitat type, however, had no effect on which species of oyster was present. In contrast, distance from the estuary mouth strongly influenced the relative proportion of the two species. The invasive C. gigas comprised 16% of the oysters sampled, and up to 85% at some of the upper estuary sites. As predicted, C. gigas was more abundant at locations in the bay ends and upper channel of the estuary; it was also larger in size than the native S. glomerata. This is the first assessment of oyster distribution in Port Jackson and provides a solid base for monitoring changes in the estuarine distribution of a globally invasive pest

Screening for pickiness - a validation study

Picky eating is prevalent in childhood and is associated with negative health outcomes. Therefore early detection of pickiness is pertinent. Because no psychometric measure of picky/fussy eating has been validated, we aimed to examine the screening efficiency of the 6-item ‘Food Fussiness’ (FF) scale from the Children’s Eating Behavior Questionnaire using structured psychiatric interviews (the Preschool Age Psychiatric Interview), providing meaningful cut-off values based on a large, representative sample of Norwegian 6 year olds (n = 752). Screening efficiency was evaluated using receiver operating characteristic curve analysis, revealing excellent discrimination. The cut-point maximizing the sum of sensitivity and specificity for the scale was found at a score of 3.33 for severe cases and 3.00 when both moderate and severe pickiness were included. The results suggest that the FF scale may provide a tool for identification of clinically significant picky eating, although further assessment may be needed to separate moderate from severe cases

Characterizing microplastic hazards: which concentration metrics and particle characteristics are most informative for understanding toxicity in aquatic organisms?

There is definitive evidence that microplastics, defined as plastic particles less than 5 mm in size, are ubiquitous in the environment and can cause harm to aquatic organisms. These findings have prompted legislators and environmental regulators to seek out strategies for managing risk. However, microplastics are also an incredibly diverse contaminant suite, comprising a complex mixture of physical and chemical characteristics (e.g., sizes, morphologies, polymer types, chemical additives, sorbed chemicals, and impurities), making it challenging to identify which particle characteristics might influence the associated hazards to aquatic life. In addition, there is a lack of consensus on how microplastic concentrations should be reported. This not only makes it difficult to compare concentrations across studies, but it also begs the question as to which concentration metric may be most informative for hazard characterization. Thus, an international panel of experts was convened to identify 1) which concentration metrics (e.g., mass or count per unit of volume or mass) are most informative for the development of health-based thresholds and risk assessment and 2) which microplastic characteristics best inform toxicological concerns. Based on existing knowledge, it is recommended that microplastic concentrations in toxicity tests are calculated from both mass and count at minimum, though ideally researchers should report additional metrics, such as volume and surface area, which may be more informative for specific toxicity mechanisms. Regarding particle characteristics, there is sufficient evidence to conclude that particle size is a critical determinant of toxicological outcomes, particularly for the mechanisms of food dilution and tissue translocation

Reliability of a 1-week recall period for the Medical Outcomes Study Sleep Scale (MOS-SS) in patients with fibromyalgia

<p>Abstract</p> <p>Objective</p> <p>To evaluate the reliability of a one-week versus a four-week recall period of the Medical Outcomes Study Sleep Scale (MOS-SS) in patients with fibromyalgia (FM).</p> <p>Methods</p> <p>The MOS-SS was administered by mail to patients with a confirmed diagnosis of FM and a current pain rating of > 2 (0–10 point numerical rating scale) recruited through newspapers, support groups, and the Internet. Reliability of MOS-SS subscale domains was evaluated using test-retest methodology separated by a 1–3 day interval for the 4-week recall period and a 7-day interval for the 1-week recall period. Patient Impression of Change was evaluated for sleep, and for patients with no change, the intraclass correlation coefficient (ICC) and the Pearson correlation coefficient was calculated for MOS-SS subscales.</p> <p>Results</p> <p>Of 129 patients enrolled, 91.3% were female, mean age was 49.4 ± 11.0 years; self-rated FM severity was moderate-to-severe in 88.1% of patients. MOS-SS subscale scores were similar for both recall periods with little variation between test-retest. The 9-item Sleep Problems Index scores ranged from 57.2 ± 14.5 to 61.9 ± 15.8 across all assessments and demonstrated high reliability which was similar for the 1-week (ICC 0.81) and 4-week (ICC 0.89) recall periods. For the other MOS-SS subscales, the 1-week recall period also showed good reliability, which was consistent for the ICC and Pearson correlation coefficients.</p> <p>Conclusion</p> <p>A 1-week recall period is adequately reliable for use of the MOS-SS in studies evaluating sleep disturbance in patients with FM.</p

Spontaneous and deliberate future thinking: A dual process account

© 2019 Springer Nature.This is the final published version of an article published in Psychological Research, licensed under a Creative Commons Attri-bution 4.0 International License. Available online at: https://doi.org/10.1007/s00426-019-01262-7.In this article, we address an apparent paradox in the literature on mental time travel and mind-wandering: How is it possible that future thinking is both constructive, yet often experienced as occurring spontaneously? We identify and describe two ‘routes’ whereby episodic future thoughts are brought to consciousness, with each of the ‘routes’ being associated with separable cognitive processes and functions. Voluntary future thinking relies on controlled, deliberate and slow cognitive processing. The other, termed involuntary or spontaneous future thinking, relies on automatic processes that allows ‘fully-fledged’ episodic future thoughts to freely come to mind, often triggered by internal or external cues. To unravel the paradox, we propose that the majority of spontaneous future thoughts are ‘pre-made’ (i.e., each spontaneous future thought is a re-iteration of a previously constructed future event), and therefore based on simple, well-understood, memory processes. We also propose that the pre-made hypothesis explains why spontaneous future thoughts occur rapidly, are similar to involuntary memories, and predominantly about upcoming tasks and goals. We also raise the possibility that spontaneous future thinking is the default mode of imagining the future. This dual process approach complements and extends standard theoretical approaches that emphasise constructive simulation, and outlines novel opportunities for researchers examining voluntary and spontaneous forms of future thinking.Peer reviewe

The effect of transmucosal 0.2mg/kg Midazolam premedication on dental anxiety, anaesthetic induction and psychological morbidity in children undergoing general anaesthesia for tooth extraction

&lt;b&gt;Background:&lt;/b&gt; The project aims were to evaluate the benefit of transmucosal Midazolam 0.2mg/kg pre-medication on anxiety, induction behaviour and psychological morbidity in children undergoing general anaesthesia (GA) extractions. &lt;b&gt;Method:&lt;/b&gt; 179 children aged 5-10 years (mean 6.53 years) participated in this randomised, double blind, placebo controlled trial. Ninety children had Midazolam placed in the buccal pouch. Dental anxiety was recorded pre operatively and 48 hours later using a child reported MCDAS-FIS scale. Behaviour at anaesthetic induction was recorded and psychological morbidity was scored by the parent using the Rutter Scale pre-operatively and again one-week later. Subsequent dental attendance was recorded at one, three and six months after GA. &lt;b&gt;Results:&lt;/b&gt; Whilst levels of mental anxiety did not reduce overall, the most anxious patients demonstrated a reduction in anxiety after receiving midazolam premedicationmay (p=0.01). Neither induction behaviour nor psychological morbidity improved. Irrespective of group, parents reported less hyperactive (p= 0.002) and more prosocial behaviour (p=0.002) after the procedure:;, older children improved most (p=0.048), Post GA Dental attendance was poor and unrelated to after the procedure and unaffected by premedication. &lt;b&gt;Conclusion:&lt;/b&gt; 0.2mg/kg buccal Midazolam provided some evidence for reducing anxiety in the most dentally anxious patients. However, induction behaviour, psychological morbidity and subsequent dental attendance were not found to alter between the premedication groups

Surfactant status and respiratory outcome in premature infants receiving late surfactant treatment.

BACKGROUND:Many premature infants with respiratory failure are deficient in surfactant, but the relationship to occurrence of bronchopulmonary dysplasia (BPD) is uncertain. METHODS:Tracheal aspirates were collected from 209 treated and control infants enrolled at 7-14 days in the Trial of Late Surfactant. The content of phospholipid, surfactant protein B, and total protein were determined in large aggregate (active) surfactant. RESULTS:At 24 h, surfactant treatment transiently increased surfactant protein B content (70%, p &lt; 0.01), but did not affect recovered airway surfactant or total protein/phospholipid. The level of recovered surfactant during dosing was directly associated with content of surfactant protein B (r = 0.50, p &lt; 0.00001) and inversely related to total protein (r = 0.39, p &lt; 0.0001). For all infants, occurrence of BPD was associated with lower levels of recovered large aggregate surfactant, higher protein content, and lower SP-B levels. Tracheal aspirates with lower amounts of recovered surfactant had an increased proportion of small vesicle (inactive) surfactant. CONCLUSIONS:We conclude that many intubated premature infants are deficient in active surfactant, in part due to increased intra-alveolar metabolism, low SP-B content, and protein inhibition, and that the severity of this deficit is predictive of BPD. Late surfactant treatment at the frequency used did not provide a sustained increase in airway surfactant