Prospective randomized subject-masked study of intravitreal bevacizumab monotherapy versus dexamethasone implant monotherapy in the treatment of persistent diabetic macular edema

Purpose: To compare intravitreal bevacizumab monotherapy with intravitreal dexamethasone delayed delivery system monotherapy for persistent diabetic macular edema. Methods: Single-center, randomized, subject-masked study of eyes with persistent diabetic macular edema, defined as central subfield thickness (CST) >340 μm despite ≥3 anti–vascular endothelial growth factors injections within 5 months. The intravitreal bevacizumab monotherapy (n = 23 eyes) and delayed delivery system monotherapy (n = 27 eyes) groups received treatments q1month and q3months, respectively. Results: Baseline best-corrected visual acuity and CST were similar in the two groups. At Month 7, the mean final best-corrected visual acuity (mean ± SD) was 65 ± 16 letters (mean Snellen visual acuity 20/50) and 64 ± 11 letters (20/50) (P = 0.619), the mean change in best-corrected visual acuity was +5.6 ± 6.1 and +5.8 ± 7.6 letters (P = 0.785), the mean final CST was 471 ± 157 and 336 ± 89 μm (P = 0.001), and the mean change in CST was −13 ± 105 and −122 ± 120 μm (P = 0.005) in the intravitreal bevacizumab monotherapy and delayed delivery system monotherapy groups, respectively. The number of injections was 7.0 ± 0.2 and 2.7 ± 0.5 (P < 0.001) in the 2 groups. Conclusion: The two groups had similar best-corrected visual acuity gains. The delayed delivery system monotherapy group achieved a significantly greater reduction of CST compared with the intravitreal bevacizumab monotherapy group, with a q3month interval of treatment, and had no recurrent edema at any visit

Hierarchical fusion using vector quantization for visualization of hyperspectral images

Visualization of hyperspectral images that combines the data from multiple sensors is a major challenge due to huge data set. An efficient image fusion could be a primary key step for this task. To make the approach computationally efficient and to accommodate a large number of image bands, we propose a hierarchical fusion based on vector quantization and bilateral filtering. The consecutive image bands in the hyperspectral data cube exhibit a high degree of feature similarity among them due to the contiguous and narrow nature of the hyperspectral sensors. Exploiting this redundancy in the data, we fuse neighboring images at every level of hierarchy. As at the first level, the redundancy between the images is very high we use a powerful compression tool, vector quantization, to fuse each group. From second level onwards, each group is fused using bilateral filtering. While vector quantization removes redundancy, bilateral filter retains even the minor details that exist in individual image. The hierarchical fusion scheme helps in accommodating a large number of hyperspectral image bands. It also facilitates the midband visualization of a subset of the hyperspectral image cube. Quantitative performance analysis shows the effectiveness of the proposed method

An efficient adaptive fusion scheme for multifocus images in wavelet domain using statistical properties of neighborhood

In this paper we present a novel fusion rule which can efficiently fuse multifocus images in wavelet domain by taking weighted average of pixels. The weights are adaptively decided using the statistical properties of the neighborhood. The main idea is that the eigen value of unbiased estimate of the covariance matrix of an image block depends on the strength of edges in the block and thus makes a good choice for weight to be given to the pixel, giving more weightage to pixel with sharper neighborhood. The performance of the proposed method have been extensively tested on several pairs of multifocus images and also compared quantitatively with various existing methods with the help of well known parameters including Petrovic and Xydeas image fusion metric. Experimental results show that performance evaluation based on entropy, gradient, contrast or deviation, the criteria widely used for fusion analysis, may not be enough. This work demonstrates that in some cases, these evaluation criteria are not consistent with the ground truth. It also demonstrates that Petrovic and Xydeas image fusion metric is a more appropriate criterion, as it is in correlation with ground truth as well as visual quality in all the tested fused images. The proposed novel fusion rule significantly improves contrast information while preserving edge information. The major achievement of the work is that it significantly increases the quality of the fused image, both visually and in terms of quantitative parameters, especially sharpness with minimum fusion artifacts

Human-mobility-based sensor context-aware routing protocol for delay-tolerant data gathering in multi-sink cell-phone-based sensor networks

Ubiquitous use of cell phones encourages development of novel applications with sensors embedded in cell phones. The collection of information generated by these devices is a challenging task considering volatile topologies and energy-based scarce resources. Further, the data delivery to the sink is delay tolerant. Mobility of cell phones is opportunistically exploited for forwarding sensor generated data towards the sink. Human mobility model shows truncated power law distribution of flight length, pause time, and intercontact time. The power law behavior of inter-contact time often discourages routing of data using naive forwarding schemes. This work exploits the flight length and the pause time distributions of human mobility to design a better and efficient routing strategy. We propose a Human-Mobility-based Sensor Context-Aware Routing protocol (HMSCAR), which exploits human mobility patterns to smartly forward data towards the sink basically comprised of wi-fi hot spots or cellular base stations. The simulation results show that HMSCAR significantly outperforms the SCAR, SFR, and GRAD-MOB on the aspects of delivery ratio and time delay. A multi-sink scenario and single-copy replication scheme is assumed

Characterizing cognitive deficits and dementia in an aging urban population in India.

Rapid rise in the population of older adults in India will lead to the need for increased health care services related to diagnosis, management, and long-term care for those with dementia and cognitive impairment. A direct approach for service provision through memory clinics can be an effective, successful, and sustaining means of delivering specialized health care services. We have established a memory clinic in Mumbai, India by employing the diverse clinical skills available in Indian academic institutions, diagnostic and research expertise of clinicians and psychologists, and the support of the U.S. National Institutes of Health. Our project involved recruitment of patients, clinical and neuropsychological assessment, and standardized diagnostic procedures, demonstrating the feasibility of using research methods to develop a memory clinic. In this paper, we describe the development of a community-based memory clinic in urban India, including linguistic and cultural factors and present detailed results, including diagnostic characterization, on 194 subjects with various stages of cognitive deficits. Our findings support the feasibility of developing a memory clinic in a public hospital and successful use of research diagnostic criteria to categorize cognitive deficits observed in this population, which may be used to inform the development of other such clinics

Postenucleation adjuvant chemotherapy with vincristine, etoposide, and carboplatin for the treatment of high-risk retinoblastoma.

BACKGROUND: Analysis of 52 eyes with high-risk retinoblastoma managed with postenucleation adjuvant chemotherapy using vincristine sulfate, etoposide phosphate, and carboplatin showed no evidence of systemic metastasis in any case during a mean (range) follow-up of 66 (12-202) months. PURPOSE: To determine the efficacy of postenucleation adjuvant chemotherapy with vincristine, etoposide, and carboplatin in the prevention of metastasis for patients with high-risk retinoblastoma. METHODS: Retrospective, nonrandomized, interventional case series of 52 eyes in 51 patients with high-risk retinoblastoma consisting of tumor invasion into the anterior segment, posterior uvea 3 mm or greater, postlaminar optic nerve, or any combination of posterior uvea and optic nerve involvement. RESULTS: Of 51 consecutive patients with high-risk retinoblastoma, there were 30 males (59%) and 21 females (41%), with a median age of 28 months at diagnosis. All 52 eyes were classified as group E. The main histopathologic risk factors included anterior segment invasion (7 [13%]), isolated massive posterior uveal invasion of 3 mm or greater (6 [12%]), isolated postlaminar optic nerve invasion (15 [29%]), or any posterior uveal invasion with any optic nerve involvement (24 [46%]). There was additional invasion into the sclera (3 [6%]) and extrascleral structures, including the orbit (1 [2%]). A single histopathologic high-risk factor was present in 32 eyes (62%), whereas 20 eyes (38%) manifested 2 or more high-risk characteristics. Based on previously published series, untreated high-risk retinoblastoma carries at least a 24% risk for metastatic disease. In the present series, using vincristine, etoposide, and carboplatin in all cases, there was no metastasis during a mean follow-up of 66 months (median [range], 55 [12-202] months). CONCLUSIONS: Retinoblastoma with invasion into the postlaminar optic nerve and/or posterior uvea is at high risk for metastasis and death. In this study, postenucleation chemotherapy using vincristine, etoposide, and carboplatin was effective in preventing metastasis in every case (100%)