Automated detection of parenchymal changes of ischemic stroke in non-contrast computer tomography: a fuzzy approach

The detection of ischemic changes is a primary task in the interpretation of brain Computer Tomography (CT) of patients suffering from neurological disorders. Although CT can easily show these lesions, their interpretation may be difficult when the lesion is not easily recognizable. The gold standard for the detection of acute stroke is highly variable and depends on the experience of physicians. This research proposes a new method of automatic detection of parenchymal changes of ischemic stroke in Non-Contrast CT. The method identifies non-pathological cases (94 cases, 40 training, 54 test) based on the analysis of cerebral symmetry. Parenchymal changes in cases with abnormalities (20 cases) are detected by means of a contralateral analysis of brain regions. In order to facilitate the evaluation of abnormal regions, non-pathological tissues in Hounsfield Units were characterized using fuzzy logic techniques. Cases of non-pathological and stroke patients were used to discard/confirm abnormality with a sensitivity (TPR) of 91% and specificity (SPC) of 100%. Abnormal regions were evaluated and the presence of parenchymal changes was detected with a TPR of 96% and SPC of 100%. The presence of parenchymal changes of ischemic stroke was detected by the identification of tissues using fuzzy logic techniques. Because of abnormal regions are identified, the expert can prioritize the examination to a previously delimited region, decreasing the diagnostic time. The identification of tissues allows a better visualization of the region to be evaluated, helping to discard or confirm a stroke.Peer ReviewedPostprint (author's final draft

Active ecological restoration of cold-water corals: techniques, challenges, costs and future directions

Cold-water coral (CWC) habitats dwell on continental shelves, slopes, seamounts, and ridge systems around the world's oceans from 50 to 4000 m depth, providing heterogeneous habitats which support a myriad of associated fauna. These highly diverse ecosystems are threatened by human stressors such as fishing activities, gas and oil exploitation, and climate change. Since their life-history traits such as long lifespan and slow growth rates make CWCs very vulnerable to potential threats, it is a foremost challenge to explore the viability of restoration actions to enhance and speed up their recovery. In contrast to terrestrial and shallow-water marine ecosystems, ecological restoration in deep marine environments has received minimal attention. This review, by means of a systematic literature search, aims to identify CWC restoration challenges, assess the most suitable techniques to restore them, and discuss future perspectives. Outcomes from the few restoration actions performed to date on CWCs, which have lasted between 1 to 4 years, provide evidence of the feasibility of coral transplantation and artificial reef deployments. Scientific efforts should focus on testing novel and creative restoration techniques, especially to scale up to the spatial and temporal scales of impacts. There is still a general lack of knowledge about the biological, ecological and habitat characteristics of CWC species exploration of which would aid the development of effective restoration measures. To ensure the long-term viability and success of any restoration action it is essential to include holistic and long-term monitoring programs, and to ideally combine active restoration with natural spontaneous regeneration (i.e., passive restoration) strategies such as the implementation of deep-sea marine protected areas (MPAs). We conclude that a combination of passive and active restoration approaches with involvement of local society would be the best optimal option to achieve and ensure CWC restoration success

Serum free light chain measurement aids the diagnosis of myeloma in patients with severe renal failure

<p>Abstract</p> <p>Background</p> <p>Monoclonal free light chains (FLCs) frequently cause rapidly progressive renal failure in patients with multiple myeloma. Immunoassays which provide quantitative measurement of FLCs in serum, have now been adopted into screening algorithms for multiple myeloma and other lymphoproliferative disorders. The assays indicate monoclonal FLC production by the presence of an abnormal κ to λ FLC ratio (reference range 0.26–1.65). Previous work, however, has demonstrated that in patients with renal failure the FLC ratio can be increased above normal with no other evidence of monoclonal proteins suggesting that in this population the range should be extended (reference range 0.37–3.1). This study evaluated the diagnostic sensitivity and specificity of the immunoassays in patients with severe renal failure.</p> <p>Methods</p> <p>Sera from 142 patients with new dialysis-dependent renal failure were assessed by serum protein electrophoresis (SPE), FLC immunoassays and immunofixation electrophoresis. The sensitivity and specificity of the FLC ratio's published reference range was compared with the modified renal reference range for identifying patients with multiple myeloma; by receiver operating characteristic curve analysis.</p> <p>Results</p> <p>Forty one patients had a clinical diagnosis of multiple myeloma; all of these patients had abnormal serum FLC ratios. The modified FLC ratio range increased the specificity of the assays (from 93% to 99%), with no loss of sensitivity. Monoclonal FLCs were identified in the urine from 23 of 24 patients assessed.</p> <p>Conclusion</p> <p>Measurement of serum FLC concentrations and calculation of the serum κ/λ ratio is a convenient, sensitive and specific method for identifying monoclonal FLC production in patients with multiple myeloma and acute renal failure. Rapid diagnosis in these patients will allow early initiation of disease specific treatment, such as chemotherapy plus or minus therapies for direct removal of FLCs.</p

Renal amyloidosis in children

Renal amyloidosis is a detrimental disease caused by the deposition of amyloid fibrils. A child with renal amyloidosis may present with proteinuria or nephrotic syndrome. Chronic renal failure may follow. Amyloid fibrils may deposit in other organs as well. The diagnosis is through the typical appearance on histopathology. Although chronic infections and chronic inflammatory diseases used to be the causes of secondary amyloidosis in children, the most frequent cause is now autoinflammatory diseases. Among this group of diseases, the most frequent one throughout the world is familial Mediterranean fever (FMF). FMF is typically characterized by attacks of clinical inflammation in the form of fever and serositis and high acute-phase reactants. Persisting inflammation in inadequately treated disease is associated with the development of secondary amyloidosis. The main treatment is colchicine. A number of other monogenic autoinflammatory diseases have also been identified. Among them cryopyrin-associated periodic syndrome (CAPS) is outstanding with its clinical features and the predilection to develop secondary amyloidosis in untreated cases. The treatment of secondary amyloidosis mainly depends on the treatment of the disease. However, a number of new treatments for amyloid per se are in the pipeline

Fractional integrodifferential boundary control of the Euler-Bernoulli beam

Absorbing boundary conditions are generally associated to long-range memory behaviors. In the case of the Euler-Bernoulli beam, they are naturally based on Abel-Volterra operators of order 1/2. Diffusive realizations of them are introduced and used for the construction of an original and efficient boundary dynamic feedback control. 1 Introduction In the context of force and torque boundary control of the Euler-Bernoulli beam, we consider wave absorbing feedbacks based upon the reduction of reflected waves. Due to the specific propagative properties of the beam, such feedbacks involve fractional integrator and derivator of order 1/2 which make the closed-loop system non standard with long range memory convolution operators. The analysis and the numerical approximation of the system under consideration are considerably simplified by using diffusive input-output realizations of Abel fractional integral operators which allows the representation of the closed-loop system under the traditio..

Fuzzy histograms: a statistical analysis

Fuzzy histograms are a fuzzy generalization of ordinary crisp histograms. In this paper, fuzzy histograms are analyzed statistically and are compared with other nonparametric density estimators. It turns out that fuzzy histograms can be used to combine a high level of statistical efficiency with a high level of computational efficiency

Identification of dynamic nonlinear thermal transfers for precise correction of bias induced by temperature variations

International audienceWe present a least squares method for dynamic correction of biases induced by temperature variations when very high precision is required. This method is based on a simple dynamic model allowing to take into account the macroscopic effects of complex underlying thermal phenomena inside the devic

Very slow chiral inversion of clopidogrel in rats: a pharmacokinetic and mechanistic investigation

Clopidogrel hydrogen sulfate, a thienopyridine derivative, is an ADP receptor antagonist that inhibits platelet aggregation. Clopidogrel is an enantiopure carboxylic ester of S-configuration. The R-enantiomer is devoid of antithrombotic activity and can provoke convulsions at high doses in animals. During preclinical safety evaluation, the possible chiral inversion of clopidogrel has, therefore, been investigated in vivo after repeated oral administration of different dose levels of clopidogrel to male and female rats. Due to rapid metabolism in the liver and low plasma levels of unchanged drug, possible chiral inversion was assessed by monitoring the plasma concentrations of the carboxylic acid metabolites, i.e., the (S)- and (R)-acid, by means of a stereoselective assay. The production of 4 to 8% of (R)-acid was observed. This could be the result of chiral inversion of either clopidogrel or its main metabolite, the (S)-acid. Thus, the possibility of nonenzymatic and enzymatic inversion of clopidogrel and its carboxylic acid metabolite was studied in vitro by chiral HPLC and (1)H NMR. Nonenzymatic chiral inversion of clopidogrel at 37 degrees C in 0.1 M phosphate buffers could be observed but was found to be slow, with estimated half-lives of 7 to 12 days, depending on the pH. The (S)-acid was configurationally fully stable up to 45 days in phosphate buffers. Neither clopidogrel nor its carboxylic acid metabolites were subject to enzymatic chiral inversion in isolated rat hepatocyte suspensions. We conclude that the nonenzymatic inversion of clopidogrel accounts for the 4 to 8% of chiral inversion seen in vivo in the rat