Development of an automated screening tool for diabetic retinopathy using artificial intelligence

Diabetic retinopathy is the commonest cause of blindness in the working age population in the Western world. It is widely recognised that screening for this treatable condition is highly cost effective. However, there is a shortage in the number of trained personnel required to screen for sight threatening forms of the disease. It has been shown that many of the features of diabetic retinopathy such as microaneurysms, cotton wool spots, exudates and haemorrhages can be identified automatically with high levels of sensitivity and specificity. This work describes the development of an automated computerised system for the screening of diabetic retinopathy through the integration of an artificial intelligent system and the development of custom written software (Diabetic Retinopathy Image Classification Programme) to enable image acquisition, image processing, neural network training and testing to be performed in a structured manner. A combination of conventional image processing and neural network methods are utilised for the identification of the basic features associated with the normal and diabetic fundus image. Preliminary investigations into the identification of sight-threatening features are also described. Identification of normal retinal vasculature and diabetic associated features was performed using three separately trained back-propagtion neural networks. Localisation of the optic disc and macula was achieved by region of interest pixel intensity scanning. Assessment of the optic disc for sight-threatening new vessel growth was performed by comparing the variance in circular intensity profiles of normal optic discs to the variance of those with neovascularisation. Patients were classified as having maculopathy if hard exudates were identified within one disc diameter of the fovea. The overall aim of this project is to develop an automated screening programme for diabetic retinopathy. The initial phase details the development and comparison of a range of algorithms for the detection of features associated with diabetic retinopathy. The final phase details the clinical evaluation of the current screening system

Developmentally appropriate transitional care during the Covid-19 pandemic for young people with juvenile-onset rheumatic and musculoskeletal diseases: the rationale for a position statement

From Springer Nature via Jisc Publications RouterHistory: received 2021-03-26, accepted 2021-06-06, registration 2021-07-31, pub-electronic 2021-08-25, online 2021-08-25, collection 2021-12Publication status: PublishedAbstract: Background: The importance of developmentally appropriate transitional care in young people with juvenile-onset rheumatic and musculoskeletal disease is well recognised. The Paediatric Rheumatology European Society (PReS) / European League Against Rheumatism (EULAR) Taskforce has developed international recommendations and standards for transitional care and a growing evidence base supports the positive benefits of such care. However, there is also evidence that universal implementation has yet to be realised. In 2020, against this background the COVID-19 pandemic arrived with significant impact on all our lives, young and old, patient, public and professional alike. The unfortunate reality of the pandemic with potential for unfavourable outcomes on healthcare provision during transition was acknowledged by the PReS working groups in a position statement to support healthcare professionals, young people and their caregivers. Aim: The aim of this review is to present the literature which provides the rationale for the recommendations in the PReS Position Statement. Summary: The following areas are specifically addressed: the prime importance of care coordination; the impact of the pandemic on the various aspects of the transition process; the importance of ensuring continuity of medication supply; the pros and cons of telemedicine with young people; ensuring meaningful involvement of young people in service development and the importance of core adolescent health practices such as routine developmental assessment psychosocial screening and appropriate parental involvement during transitional care

Transjugular intrahepatic portosystemic stent-shunts: a new option in portal hypertension.

These guidelines on transjugular intrahepatic portosystemic stent-shunt (TIPSS) in the management of portal hypertension have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the Liver Section of the BSG. The guidelines are new and have been produced in collaboration with the British Society of Interventional Radiology (BSIR) and British Association of the Study of the Liver (BASL). The guidelines development group comprises elected members of the BSG Liver Section, representation from BASL, a nursing representative and two patient representatives. The quality of evidence and grading of recommendations was appraised using the GRADE system. These guidelines are aimed at healthcare professionals considering referring a patient for a TIPSS. They comprise the following subheadings: indications; patient selection; procedural details; complications; and research agenda. They are not designed to address: the management of the underlying liver disease; the role of TIPSS in children; or complex technical and procedural aspects of TIPSS.</jats:p

Quality standards for the management of alcohol-related liver disease: consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology ARLD special interest group

Objective Alcohol-related liver disease (ALD) is the most common cause of liver-related ill health and liver-related deaths in the UK, and deaths from ALD have doubled in the last decade. The management of ALD requires treatment of both liver disease and alcohol use; this necessitates effective and constructive multidisciplinary working. To support this, we have developed quality standard recommendations for the management of ALD, based on evidence and consensus expert opinion, with the aim of improving patient care.Design A multidisciplinary group of experts from the British Association for the Study of the Liver and British Society of Gastroenterology ALD Special Interest Group developed the quality standards, with input from the British Liver Trust and patient representatives.Results The standards cover three broad themes: the recognition and diagnosis of people with ALD in primary care and the liver outpatient clinic; the management of acutely decompensated ALD including acute alcohol-related hepatitis and the posthospital care of people with advanced liver disease due to ALD. Draft quality standards were initially developed by smaller working groups and then an anonymous modified Delphi voting process was conducted by the entire group to assess the level of agreement with each statement. Statements were included when agreement was 85% or greater. Twenty-four quality standards were produced from this process which support best practice. From the final list of statements, a smaller number of auditable key performance indicators were selected to allow services to benchmark their practice and an audit tool provided.Conclusion It is hoped that services will review their practice against these recommendations and key performance indicators and institute service development where needed to improve the care of patients with ALD

Spectrum of mutational signatures in T-cell lymphoma reveals a key role for UV radiation in cutaneous T-cell lymphoma

Funder: Galderma; doi: http://dx.doi.org/10.13039/501100009754Funder: NIHR-BRC Cambridge core grantFunder: National Institute for Health Research; doi: http://dx.doi.org/10.13039/501100000272Funder: NHS EnglandAbstract: T-cell non-Hodgkin’s lymphomas develop following transformation of tissue resident T-cells. We performed a meta-analysis of whole exome sequencing data from 403 patients with eight subtypes of T-cell non-Hodgkin’s lymphoma to identify mutational signatures and associated recurrent gene mutations. Signature 1, indicative of age-related deamination, was prevalent across all T-cell lymphomas, reflecting the derivation of these malignancies from memory T-cells. Adult T-cell leukemia-lymphoma was specifically associated with signature 17, which was found to correlate with the IRF4 K59R mutation that is exclusive to Adult T-cell leukemia-lymphoma. Signature 7, implicating UV exposure was uniquely identified in cutaneous T-cell lymphoma (CTCL), contributing 52% of the mutational burden in mycosis fungoides and 23% in Sezary syndrome. Importantly this UV signature was observed in CD4 + T-cells isolated from the blood of Sezary syndrome patients suggesting extensive re-circulation of these T-cells through skin and blood. Analysis of non-Hodgkin’s T-cell lymphoma cases submitted to the national 100,000 WGS project confirmed that signature 7 was only identified in CTCL strongly implicating UV radiation in the pathogenesis of cutaneous T-cell lymphoma

Frontend pro matematicky vyhledavac

Mathematical notation is becoming more important as software is more often used in day-to-day life. Schools are starting to support e-learning, science is penetrating WWW and search engines can handle more complex questions. In the present work, I summarise the state-of-art of available applications which support mathematical input and could be used for graphical user interface (UI) of a mathematical search engine - EgoMath. Since none of the evaluated UIs meet our requirements, I present the design and implementation of yet another mathematical user interface focusing on the identified issues. The main goal of the new mathematical UI is to help the user provide input which will be well understood by the underlying application. Input symbols can be selected from a large domain using a limited set of keys. This must be intuitive and the application should actively aid in this task by providing graphical hints based on the input expression in real time

Near Infrared Imaging for the Improved Detection of Fingermarks on Difficult Surfaces

The near infrared spectral region offers advantages over the visible region in the detection of latent fingermarks due to increased contrast and decreased background luminescence. In this work, a chemical imaging system was used to image latent fingermarks in the near-infrared (NIR) region. A variety of porous, non-porous and semi-porous surfaces were tested using standard chemical and physical enhancement techniques. NIR dyes were also used to enhance latent marks. Both absorption and luminescence properties of the treated marks were examined over the spectral range 650-1100nm. Significant NIR absorption was found for ninhydrin, iodine/benzoflavone, physical developer, and powdering. NIR luminescence emission was found for DFO, ninhydrin with zinc salt post treatment, 1,2-indanedione and genipin. Significant NIR luminescence emission was found for cyanoacrylate fuming followed by staining with NIR dyes. In addition, metal oxide powders coated with NIR dyes were able to enhance fingermarks on a patterned and highly luminescent surface

Emergence of canine parvovirus subtype 2b (CPV-2b) infections in Australian dogs

Tracing the temporal dynamics of pathogens is crucial for developing strategies to detect and limit disease emergence. Canine parvovirus (CPV-2) is an enteric virus causing morbidity and mortality in dogs around the globe. Previous work in Australia reported that the majority of cases were associated with the CPV-2a subtype, an unexpected finding since CPV-2a was rapidly replaced by another subtype (CPV-2b) in many countries. Using a nine-year dataset of CPV-2 infections from 396 dogs sampled across Australia, we assessed the population dynamics and molecular epidemiology of circulating CPV-2 subtypes. Bayesian phylogenetic Skygrid models and logistic regressions were used to trace the temporal dynamics of CPV-2 infections in dogs sampled from 2007 to 2016. Phylogenetic models indicated that CPV-2a likely emerged in Australia between 1973 and 1988, while CPV-2b likely emerged between 1985 and 1998. Sequences from both subtypes were found in dogs across continental Australia and Tasmania, with no apparent effect of climate variability on subtype occurrence. Both variant subtypes exhibited a classical disease emergence pattern of relatively high rates of evolution during early emergence followed by subsequent decreases in evolutionary rates over time. However, the CPV-2b subtype maintained higher mutation rates than CPV-2a and continued to expand, resulting in an increase in the probability that dogs will carry this subtype over time. Ongoing monitoring programs that provide molecular epidemiology surveillance will be necessary to detect emergence of new variants and make informed recommendations to develop reliable detection and vaccine methods