Multiple myeloma presenting with external ear canal mass

The manifestations of multiple myeloma are protean and related to bony osteolytic lesions, and to medullar and renal insufficiency. We report a patient who presented with otalgia as the inaugural symptom of multiple myeloma. Local irradiation combined with systemic chemotherapy led to the disappearance of the temporal bone mass and the accompanying symptoms. To date, 24 months after the diagnosis, the patient is still in remission. The literature on otological involvement in multiple myeloma is reviewed. Symptoms are non-specific and include hearing loss, tinnitus, dizziness, facial paralysis, and otalgia. The diagnosis of multiple myeloma should be considered in the presence of a temporal bone mas

Towards Blood Flow in the Virtual Human: Efficient Self-Coupling of HemeLB

Many scientific and medical researchers are working towards the creation of a virtual human - a personalised digital copy of an individual - that will assist in a patient's diagnosis, treatment and recovery. The complex nature of living systems means that the development of this remains a major challenge. We describe progress in enabling the HemeLB lattice Boltzmann code to simulate 3D macroscopic blood flow on a full human scale. Significant developments in memory management and load balancing allow near linear scaling performance of the code on hundreds of thousands of computer cores. Integral to the construction of a virtual human, we also outline the implementation of a self-coupling strategy for HemeLB. This allows simultaneous simulation of arterial and venous vascular trees based on human-specific geometries.Comment: 30 pages, 10 figures, To be published in Interface Focus (https://royalsocietypublishing.org/journal/rsfs

Increased sensitivity of p53-deficient cells to anticancer agents due to loss of Pms2

A large fraction of human tumours carries mutations in the p53 gene. p53 plays a central role in controlling cell cycle checkpoint regulation, DNA repair, transcription, and apoptosis upon genotoxic stress. Lack of p53 function impairs these cellular processes, and this may be the basis of resistance to chemotherapeutic regimens. By virtue of the involvement of DNA mismatch repair in modulating cytotoxic pathways in response to DNA damaging agents, we investigated the effects of loss of Pms2 on the sensitivity to a panel of widely used anticancer agents in E1A/Ha-Ras-transformed p53-null mouse fibroblasts either proficient or deficient in Pms2. We report that lack of the Pms2 gene is associated with an increased sensitivity, ranging from 2–6-fold, to some types of anticancer agents including the topoisomerase II poisons doxorubicin, etoposide and mitoxantrone, the platinum compounds cisplatin and oxaliplatin, the taxanes docetaxel and paclitaxel, and the antimetabolite gemcitabine. In contrast, no change in sensitivity was found after treatment with 5-fluorouracil. Cell cycle analysis revealed that both, Pms2-deficient and -proficient cells, retain the ability to arrest at the G2/M upon cisplatin treatment. The data indicate that the concomitant loss of Pms2 function chemosensitises p53-deficient cells to some types of anticancer agents, that Pms2 positively modulates cell survival by mechanisms independent of p53, and that increased cytotoxicity is paralleled by increased apoptosis. Tumour-targeted functional inhibition of Pms2 may be a valuable strategy for increasing the efficacy of anticancer agents in the treatment of p53-mutant cancers

Multidisciplinary Consensus on Assessment of Unruptured Intracranial Aneurysms Proposal of an International Research Group

Peer reviewe

The unruptured intracranial aneurysm treatment score A multidisciplinary consensus

Objective: We endeavored to develop an unruptured intracranial aneurysm (UIA) treatment score (UIATS) model that includes and quantifies key factors involved in clinical decision-making in the management of UIAs and to assess agreement for this model among specialists in UIA management and research. Methods: An international multidisciplinary (neurosurgery, neuroradiology, neurology, clinical epidemiology) group of 69 specialists was convened to develop and validate the UIATS model using a Delphi consensus. For internal (39 panel members involved in identification of relevant features) and external validation (30 independent external reviewers), 30 selected UIA cases were used to analyze agreement with UIATS management recommendations based on a 5-point Likert scale (5 indicating strong agreement). Interrater agreement (IRA) was assessed with standardized coefficients of dispersion (v(r)*) (v(r)* 5 0 indicating excellent agreement and v(r)* = 1 indicating poor agreement). Results: The UIATS accounts for 29 key factors in UIA management. Agreement with UIATS (mean Likert scores) was 4.2 (95% confidence interval [CI] 4.1-4.3) per reviewer for both reviewer cohorts; agreement per case was 4.3 (95% CI 4.1-4.4) for panel members and 4.5 (95% CI 4.3-4.6) for external reviewers (p = 0.017). Mean Likert scores were 4.2 (95% CI 4.1-4.3) for interventional reviewers (n = 56) and 4.1 (95% CI 3.9-4.4) for noninterventional reviewers (n = 12) (p = 0.290). Overall IRA (v(r)*) for both cohorts was 0.026 (95% CI 0.019-0.033). Conclusions: This novel UIA decision guidance study captures an excellent consensus among highly informed individuals on UIA management, irrespective of their underlying specialty. Clinicians can use the UIATS as a comprehensive mechanism for indicating how a large group of specialists might manage an individual patient with a UIA.Peer reviewe

Proceedings - IEEE International Conference on Multimedia and Expo

We propose a method to obtain a high quality motion field from decoded HEVC motion. We use the block motion vectors to establish a sparse set of correspondences, and then employ an affine, edge-preserving interpolation of correspondences (EPIC) to obtain a dense optical flow. Experimental results on a variety of sequences coded at a range of QP values show that the proposed HEVC-EPIC is over five times as fast as the original EPIC flow, which uses a sophisticated correspondence estimator, while only slightly decreasing the flow accuracy. The proposed work opens the door to leveraging HEVC motion into video enhancement and analysis methods. To provide some evidence of what can be achieved, we show that when used as input to a framerate upsampling scheme, the average Y-PSNR of the interpolated frames obtained using HEVC-EPIC motion is slightly lower (0.2dB) than when original EPIC flow is used, with hardly any visible differences

Multimedia Signal Processing (MMSP), 2016 IEEE 18th International Workshop

This paper continues our work on occlusion-aware temporal frame interpolation (TFI) that employs piecewise-smooth motion with sharp motion boundaries. In this work, we propose a triangular mesh sparsification algorithm, which allows to trade off computational complexity with reconstruction quality. Furthermore, we propose a method to create a background motion layer in regions that get disoccluded between the two reference frames, which is used to get temporally consistent interpolations among frames interpolated between the two reference frames. Experimental results on a large data set show the proposed mesh sparsification is able to reduce the processing time by 75%, with a minor drop in PSNR of 0.02 dB. The proposed TFI scheme outperforms various state-of-the-art TFI methods in terms of quality of the interpolated frames, while having the lowest processing times. Further experiments on challenging synthetic sequences highlight the temporal consistency in traditionally difficult regions of disocclusion

Temporal Frame Interpolation with Motion-divergence-guided Occlusion Handling

We present a high quality temporal frame interpolation(TFI) method that employs piecewise-smooth motion, andhandles (dis-)occluded regions using the observation that motiondiscontinuities travel with the foreground object. We derive a“motion discontinuity” likelihood map from the divergence of amotion field between the input frames. Motion which is modelledat the reference frame is mapped to the target frame using acellular-affine mapping strategy – a process during which regionsof disocclusion are readily observed. This information is then usedto guide the occlusion-aware, bidirectional frame interpolationprocess. Furthermore, we propose two computationally inexpensivetexture optimizations that selectively improve the qualityof the interpolated frames in regions around moving objects.The scheme produces very high quality interpolated frames, andoutperforms current high-quality state-of-the-art TFI schemes by2-2.5dB; the method works with a very low-complexity motionestimation scheme, and runs orders of magnitudes faster thanits competitors

Base-Anchored Model for Highly Scalable and Accessible Compression of Multiview Imagery

We present a compression scheme for multiview imagery that facilitates high scalability and accessibility of the compressed content. Our scheme relies upon constructing at a single base view, a disparity model for a group of views, and then utilizing this base-anchored model to infer disparity at all views belonging to the group. We employ a hierarchical disparity-compensated inter-view transform where the corresponding analysis and synthesis filters are applied along the geometric flows defined by the base-anchored disparity model. The output of this inter-view transform along with the disparity information is subjected to spatial wavelet transforms and embedded block-based coding. Rate-distortion results reveal superior performance to the x.265 anchor chosen by the JPEG Pleno standards activity for the coding of multiview imagery captured by high-density camera arrays