Compression of Deep Neural Networks for Image Instance Retrieval

Image instance retrieval is the problem of retrieving images from a database which contain the same object. Convolutional Neural Network (CNN) based descriptors are becoming the dominant approach for generating global image descriptors for the instance retrieval problem. One major drawback of CNN-based global descriptors is that uncompressed deep neural network models require hundreds of megabytes of storage making them inconvenient to deploy in mobile applications or in custom hardware. In this work, we study the problem of neural network model compression focusing on the image instance retrieval task. We study quantization, coding, pruning and weight sharing techniques for reducing model size for the instance retrieval problem. We provide extensive experimental results on the trade-off between retrieval performance and model size for different types of networks on several data sets providing the most comprehensive study on this topic. We compress models to the order of a few MBs: Two orders of magnitude smaller than the uncompressed models while achieving negligible loss in retrieval performance1

Low alanine aminotransferase and higher cardiovascular events in type 2 diabetes: analysis of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

Aims Non-alcoholic fatty liver disease (NAFLD) is common in type 2 diabetes and associated with higher risk of cardiovascular disease. This study aimed to determine whether alanine aminotransferase (ALT) or gamma-glutamyltransferase (GGT), as markers of liver health and NAFLD, might predict cardiovascular events in this population. Methods Data from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study were analysed to examine the relationship between liver enzymes and incident cardiovascular events (nonfatal myocardial infarction, stroke, coronary and other cardiovascular death, coronary or carotid revascularization) over 5 years. Results ALT had a linear inverse relationship with the first cardiovascular event on study. After adjustment, for every standard deviation higher baseline ALT (13.2U/L), the risk of an event was 7%(95%CI 4–13, P=0.02) lower. Participants with ALT below and above the reference range 8–41 U/L for women and 9–59 U/L for men, had a hazard ratio of an event of 1.86(95%CI, 1.12–3.09) and 0.65(95%CI, 0.49–0.87), respectively (P=0.001). No relationship was found for GGT. Conclusions The data may indicate that in type 2 diabetes — associated with higher ALT due to prevalent NAFLD — lower ALT is a marker of hepatic or systemic frailty rather than health

Oral versus intravenous high-dose methylprednisolone for treatment of relapses in patients with multiple sclerosis (COPOUSEP)

International audienceSummaryBackground High doses of intravenous methylprednisolone are recommended to treat relapses in patients with multiple sclerosis, but can be inconvenient and expensive. We aimed to assess whether oral administration of high-dose methylprednisolone was non-inferior to intravenous administration. Methods We did this multicentre, double-blind, randomised, controlled, non-inferiority trial at 13 centres for multiple sclerosis in France. We enrolled patients aged 18–55 years with relapsing-remitting multiple sclerosis who reported a relapse within the previous 15 days that caused an increase of at least one point in one or more scores on the Kurtzke Functional System Scale. With use of a computer-generated randomisation list and in blocks of four, we randomly assigned (1:1) patients to either oral or intravenous methylprednisolone, 1000 mg, once a day for 3 days. Patients, treating physicians and nurses, and data and outcome assessors were all masked to treatment allocation, which was achieved with the use of saline solution and placebo capsules. The primary endpoint was the proportion of patients who had improved by day 28 (decrease of at least one point in most affected score on Kurtzke Functional System Scale), without need for retreatment with corticosteroids, in the per-protocol population. The trial was powered to assess non-inferiority of oral compared with intravenous methylprednisolone with a predetermined non-inferiority margin of 15%. This trial is registered with ClinicalTrials.gov, number NCT00984984. Findings Between Jan 29, 2008, and June 14, 2013, we screened 200 patients and enrolled 199. We randomly assigned 100 patients to oral methylprednisolone and 99 patients to intravenous methylprednisolone with a mean time from relapse onset to treatment of 7·0 days (SD 3·6) and 7·4 days (3·9), respectively. In the per-protocol population, 66 (81%) of 82 patients in the oral group and 72 (80%) of 90 patients in the intravenous group achieved the primary endpoint (absolute treatment difference 0·5%, 90% CI −9·5 to 10·4). Rates of adverse events were similar, but insomnia was more frequently reported in the oral group (77 [77%]) than in the intravenous group (63 [64%]). Interpretation Oral administration of high-dose methylprednisolone for 3 days was not inferior to intravenous administration for improvement of disability scores 1 month after treatment and had a similar safety profile. This finding could have implications for access to treatment, patient comfort, and cost, but indication should always be properly considered by clinicians. Funding French Health Ministry, Ligue Française contre la SEP, Tev

Study of a Nonlocal Density scheme for electronic--structure calculations

An exchange-correlation energy functional beyond the local density approximation, based on the exchange-correlation kernel of the homogeneous electron gas and originally introduced by Kohn and Sham, is considered for electronic structure calculations of semiconductors and atoms. Calculations are carried out for diamond, silicon, silicon carbide and gallium arsenide. The lattice constants and gaps show a small improvement with respect to the LDA results. However, the corresponding corrections to the total energy of the isolated atoms are not large enough to yield a substantial improvement for the cohesive energy of solids, which remains hence overestimated as in the LDA.Comment: 4 postscript figure

Comparing health system performance assessment and management approaches in the Netherlands and Ontario, Canada

BACKGROUND: Given the proliferation and the growing complexity of performance measurement initiatives in many health systems, the Netherlands and Ontario, Canada expressed interests in cross-national comparisons in an effort to promote knowledge transfer and best practise. To support this cross-national learning, a study was undertaken to compare health system performance approaches in The Netherlands with Ontario, Canada. METHODS: We explored the performance assessment framework and system of each constituency, the embeddedness of performance data in management and policy processes, and the interrelationships between the frameworks. Methods used included analysing governmental strategic planning and policy documents, literature and internet searches, comparative descriptive tables, and schematics. Data collection and analysis took place in Ontario and The Netherlands. A workshop to validate and discuss the findings was conducted in Toronto, adding important insights to the study. RESULTS: Both Ontario and The Netherlands conceive health system performance within supportive frameworks. However they differ in their assessment approaches. Ontario's Scorecard links performance measurement with strategy, aimed at health system integration. The Dutch Health Care Performance Report (Zorgbalans) does not explicitly link performance with strategy, and focuses on the technical quality of healthcare by measuring dimensions of quality, access, and cost against healthcare needs. A backbone 'five diamond' framework maps both frameworks and articulates the interrelations and overlap between their goals, themes, dimensions and indicators. The workshop yielded more contextual insights and further validated the comparative values of each constituency's performance assessment system. CONCLUSION: To compare the health system performance approaches between The Netherlands and Ontario, Canada, several important conceptual and contextual issues must be addressed, before even attempting any future content comparisons and benchmarking. Such issues would lend relevant interpretational credibility to international comparative assessments of the two health systems

Safety of vaccination against SARS-CoV-2 in people with rheumatic and musculoskeletal diseases: results from the EULAR Coronavirus Vaccine (COVAX) physician-reported registry

OBJECTIVES: To describe the safety of vaccines against SARS-CoV-2 in people with inflammatory/autoimmune rheumatic and musculoskeletal disease (I-RMD). METHODS: Physician-reported registry of I-RMD and non-inflammatory RMD (NI-RMDs) patients vaccinated against SARS-CoV-2. From 5 February 2021 to 27 July 2021, we collected data on demographics, vaccination, RMD diagnosis, disease activity, immunomodulatory/immunosuppressive treatments, flares, adverse events (AEs) and SARS-CoV-2 breakthrough infections. Data were analysed descriptively. RESULTS: The study included 5121 participants from 30 countries, 90% with I-RMDs (n=4604, 68% female, mean age 60.5 years) and 10% with NI-RMDs (n=517, 77% female, mean age 71.4). Inflammatory joint diseases (58%), connective tissue diseases (18%) and vasculitis (12%) were the most frequent diagnostic groups; 54% received conventional synthetic disease-modifying antirheumatic drugs (DMARDs), 42% biological DMARDs and 35% immunosuppressants. Most patients received the Pfizer/BioNTech vaccine (70%), 17% AstraZeneca/Oxford and 8% Moderna. In fully vaccinated cases, breakthrough infections were reported in 0.7% of I-RMD patients and 1.1% of NI-RMD patients. I-RMD flares were reported in 4.4% of cases (0.6% severe), 1.5% resulting in medication changes. AEs were reported in 37% of cases (37% I-RMD, 40% NI-RMD), serious AEs in 0.5% (0.4% I-RMD, 1.9% NI-RMD). CONCLUSION: The safety profiles of SARS-CoV-2 vaccines in patients with I-RMD was reassuring and comparable with patients with NI-RMDs. The majority of patients tolerated their vaccination well with rare reports of I-RMD flare and very rare reports of serious AEs. These findings should provide reassurance to rheumatologists and vaccine recipients and promote confidence in SARS-CoV-2 vaccine safety in I-RMD patients

Improvement of psychometric properties of a scale measuring inpatient satisfaction with care: a better response rate and a reduction of the ceiling effect

<p>Abstract</p> <p>Background</p> <p>The objective was to solve two problems of an already validated scale measuring inpatient opinion on care: 1) a high non-response rate for some items due to the "not applicable" response option and 2) a skewed score distribution with high ceiling effect.</p> <p>Methods</p> <p>The EQS-H scale ("échelle de qualité des soins en hospitalisation") comprised 26 items and 2 sub-scales of 13 items each, 'quality of medical information' (MI) and 'relationships with staff and daily routine' (RS). Three studies were conducted: a first mono-centre study (n = 552, response rate = 83.4%, self-completion of the scale the day before discharge) to construct a shorter version of the scale without the items with high non-response rate and maintaining those useful to ensure good internal validity (construct, convergent and divergent) and reliability; a second mono-centre study (n = 1246, response rate = 77.9%, self-completion of the scale before discharge) to confirm psychometric properties of the new version; a third multi-centre national study (n = 886, response rate 41.7%, self-completion at home 15 days after discharge) to test a new response pattern in order to reduce ceiling effect.</p> <p>Results</p> <p>Six items having a non-response rate >20% were deleted, increasing rates of exhaustive response to all items from 15% to 48%. Factorial analysis supported the evidence for removing 4 more items to ensure good internal validity and reliability of the new version. These good results (initial variance explained: 43%; Cronbach's α: 0.80 (MI) and 0.81 (RS)) were confirmed by the second study. The new response format produced a normalisation of the 2 scores with a large decrease in ceiling effect (25% to 4% for MI subscale and 61% to 8% for RS). Psychometric properties of the final version were excellent: the 2 subscales (8 items each) explained 66% of the variance in principal component analysis, Cronbach's α were respectively 0.92 (MI) and 0.93 (RS).</p> <p>Conclusion</p> <p>The new version of the EQS-H has better psychometric properties than the previous one. Rates of missing values are lower, and score distribution is normalized. An English version of this scale focused on quality of medical information delivered and on relationship with staff already exists, and this could be useful to conduct cross-cultural studies of health care service quality.</p

Impact of a hospital improvement initiative in Bangladesh on patient experiences and satisfaction with services: two cross-sectional studies

<p>Abstract</p> <p>Background</p> <p>The Bangladesh government implemented a pilot Hospital Improvement Initiative (HII) in five hospitals in Sylhet division between 1998 and 2003. This included management and behaviour change training for staff, waste disposal and procurement, and referral arrangements. Two linked cross-sectional surveys in 2000 and 2003 assessed the impact of the HII, assessing both patients' experience and satisfaction and public views and use of the hospitals.</p> <p>Methods</p> <p>In each survey we asked 300 consecutive outpatients and a stratified random sample of 300 inpatients in the five hospitals about waiting and consultation time, use of an agent for admission, and satisfaction with privacy, cleanliness, and staff behaviour. The field teams observed cleanliness and privacy arrangements, and visited a sample of households in communities near the hospitals to ask about their opinions and use of the hospital services. Analysis examined changes over time in patients' experience and views. Multivariate analysis took account of other variables potentially associated with the outcomes. Survey managers discussed the survey findings with gender stratified focus groups in each sample community.</p> <p>Results</p> <p>Compared with 2000, an outpatient in three of the hospitals in 2003 was more likely to be seen within 10 minutes and for at least five minutes by the doctor, but outpatients were less likely to report receiving all the prescribed medicines from the hospital. In 2003, inpatients were more likely to have secured admission without using an agent. Although patients’ satisfaction with several aspects of care improved, most changes were not statistically significant. Households in 2003 were significantly more likely to rate the hospitals as good than in 2000. Use of the hospitals did not change, except that more households used the medical college hospital for inpatient care in 2003. Focus groups confirmed criticisms of services and suggested improvements.</p> <p>Conclusion</p> <p>Improvements in some aspects of patients' experience may have been due to the programme, but the decreased availability of medicines in government facilities across the country over the period also occurred in these hospitals. Monitoring patients’ experience and satisfaction as well as public views and use of hospital services is feasible and useful for assessing service interventions.</p

CCR5Δ32 Genotype Leads to a Th2 Type Directed Immune Response in ESRD Patients

BACKGROUND: In patients with end stage renal disease (ESRD) we observed protection from inflammation-associated mortality in CCR5Δ32 carriers, leading to CCR5 deficiency, suggesting impact of CCR5Δ32 on inflammatory processes. Animal studies have shown that CCR5 deficiency is associated with a more pronounced Th2 type immune response, suggesting that in human CCR5Δ32 carriers the immune response may be more Th2 type directed. So, in the present study we determined the Th1-Th2 type directed immune response in ESRD patients carrying and not carrying the CCR5Δ32 genetic variant after stimulation. METHODOLOGY/PRINCIPAL FINDINGS: We tested this hypothesis by determining the levels of IFN-γ and IL-4 and the distribution of Th1, Th2 and Th17 directed circulating CD4+ and CD8+ T cells and regulatory T cells (Tregs) after stimulation in ESRD patients with (n = 10) and without (n = 9) the CCR5Δ32 genotype. The extracellular levels of IFN-γ and IL-4 did not differ between CCR5Δ32 carriers and non carriers. However, based on their intracellular cytokine profile the percentages IL-4 secreting CD4+ and CD8+ T cells carrying the CCR5Δ32 genotype were significantly increased (p = 0.02, respectively p = 0.02) compared to non carriers, indicating a more Th2 type directed response. Based on their intracellular cytokine profile the percentages IFN-γ and IL-17 secreting T cells did not differ between carriers and non-carriers nor did the percentage Tregs, indicating that the Th1, Th17 and T regulatory response was not affected by the CCR5Δ32 genotype. CONCLUSIONS/SIGNIFICANCE: This first, functional human study shows a more pronounced Th2 type immune response in CCR5Δ32 carriers compared to non carriers. These differences may be involved in the previously observed protection from inflammation-associated mortality in ESRD patients carrying CCR5Δ32