ELF: An End-to-end Local and Global Multimodal Fusion Framework for Glaucoma Grading

Glaucoma is a chronic neurodegenerative condition that can lead to blindness. Early detection and curing are very important in stopping the disease from getting worse for glaucoma patients. The 2D fundus images and optical coherence tomography(OCT) are useful for ophthalmologists in diagnosing glaucoma. There are many methods based on the fundus images or 3D OCT volumes; however, the mining for multi-modality, including both fundus images and data, is less studied. In this work, we propose an end-to-end local and global multi-modal fusion framework for glaucoma grading, named ELF for short. ELF can fully utilize the complementary information between fundus and OCT. In addition, unlike previous methods that concatenate the multi-modal features together, which lack exploring the mutual information between different modalities, ELF can take advantage of local-wise and global-wise mutual information. The extensive experiment conducted on the multi-modal glaucoma grading GAMMA dataset can prove the effiectness of ELF when compared with other state-of-the-art methods

Interval mapping of human QTL using Sib pair data

Ph.DDOCTOR OF PHILOSOPH

Locality Preserving Multiview Graph Hashing for Large Scale Remote Sensing Image Search

Hashing is very popular for remote sensing image search. This article proposes a multiview hashing with learnable parameters to retrieve the queried images for a large-scale remote sensing dataset. Existing methods always neglect that real-world remote sensing data lies on a low-dimensional manifold embedded in high-dimensional ambient space. Unlike previous methods, this article proposes to learn the consensus compact codes in a view-specific low-dimensional subspace. Furthermore, we have added a hyperparameter learnable module to avoid complex parameter tuning. In order to prove the effectiveness of our method, we carried out experiments on three widely used remote sensing data sets and compared them with seven state-of-the-art methods. Extensive experiments show that the proposed method can achieve competitive results compared to the other method.Comment: 5 pages,icassp accepte

Gender and BMI Differences in Physical Activity after Total Knee Replacement

Background Total knee replacement (TKR) is an effective procedure to eliminate knee pain due to osteoarthritis. However variation in functional outcome persists. Patient attributes, including age, gender, body mass index (BMI), and emotional health, influence degree of functional gain. The level of daily physical activity (PA) is important to weight management, knee OA care, and overall health. As the arthritis population becomes more overweight and inactive, it is important to understand the physical activity benefits accrued following TKR. Health promotion programs, conducted in community dwelling adults, have called attention to the use of accelerometers (step activity monitor devices) as a measure of general activity. The device, worn around the leg, gives an accurate number of daily steps (mean steps/ day), as well as, walking rate (mean steps/ minute). Unfortunately, there are limited data on the use of accelerometers in patients with knee OA. It is unknown if self-reported physical function correlates with objectively measured physical activity (e.g., steps/day) or if patient attributes influence the level of physical activity in patients with osteoarthritis before and after TKR. We hypothesized that patient physical activity at 6 months post-TKR varies with the two patients attributes, gender and body mass index (BMI). Materials and Methods A consecutive series of 89 TKR patients wore a small ankle accelerometer (StepWatch Activity Monitor/SAM; CYMA, Inc.) above the ankle of the operative leg before TKR and again at 6 months after surgery. Demographic attributes, self-reported function measured with SF36 and WOMAC, and physical activity as measured by accelerometer as quantity of steps/day and % of day inactive were recorded. Descriptive statistics and mean differences were calculated. Results Patients had a mean age of 67 years, mean BMI of 30, and 71% were women. Overall, physical activity significantly improved from a mean of 6600 steps/day before TKR to 7690 steps/day at 6 months. Women walked fewer steps/day than men before and after TKR (6,218 before, 7,150 after; a 15% increase). Non-obese patients improved steps/day, obese did not. While male reduced their inactive time after TKR, women did not. After adjusting for BMI and age, gender differences persisted in objectively measured physical activity. The number of steps/day was moderately but significant correlated with PCS and WOMAC function (r=0.28 – 0.4). Conclusions Physical activity as measured by accelerometer improved after TKR, varied with patient attributes, including gender and BMI, and was moderately correlated with self-reported function. A 15% increase in pre to post TKR patient steps/day is highly significant and contributes to the health status improvement of patients with advanced arthritis. Women‘s lower physical activity levels before surgery persists after TKR, despite significant pain relief. Physical activity differences should be considered when designing TKR patient pathways and rehabilitation programs

A Web-Based Treatment Decision Support Tool for Patients With Advanced Knee Arthritis: Evaluation of User Interface and Content Design

BACKGROUND: Data-driven surgical decisions will ensure proper use and timing of surgical care. We developed a Web-based patient-centered treatment decision and assessment tool to guide treatment decisions among patients with advanced knee osteoarthritis who are considering total knee replacement surgery. OBJECTIVE: The aim of this study was to examine user experience and acceptance of the Web-based treatment decision support tool among older adults. METHODS: User-centered formative and summative evaluations were conducted for the tool. A sample of 28 patients who were considering total knee replacement participated in the study. Participants\u27 responses to the user interface design, the clarity of information, as well as usefulness, satisfaction, and acceptance of the tool were collected through qualitative (ie, individual patient interviews) and quantitative (ie, standardized Computer System Usability Questionnaire) methods. RESULTS: Participants were older adults with a mean age of 63 (SD 11) years. Three-quarters of them had no technical questions using the tool. User interface design recommendations included larger fonts, bigger buttons, less colors, simpler navigation without extra next page click, less mouse movement, and clearer illustrations with simple graphs. Color-coded bar charts and outcome-specific graphs with positive action were easiest for them to understand the outcomes data. Questionnaire data revealed high satisfaction with the tool usefulness and interface quality, and also showed ease of use of the tool, regardless of age or educational status. CONCLUSIONS: We evaluated the usability of a patient-centered decision support tool designed for advanced knee arthritis patients to facilitate their knee osteoarthritis treatment decision making. The lessons learned can inform other decision support tools to improve interface and content design for older patients\u27 use

Racial Differences in the Effectiveness of Total Knee Arthroplasty (TKA) on Postoperative Pain and Function

Objective: African Americans are less likely than Caucasians to perceive TKA as an effective treatment option. We examined post-TKA pain and function by race, with and without adjusting for demographic and clinical factors on determining racial differences. Methods: We analyzed data from FORCE-TJR, a national cohort of TJR patients. Patients had primary and unilateral TKA surgeries 07/01/2011-12/31/2014, and completed surveys on demographic and clinical information, including a pre- and 6-month postoperative Knee Injury and Osteoarthritis Outcome Score (KOOS). The KOOS pain and function scores ranged from 0-100 (higher=better). We examined baseline, 6-month, and 6-month change in pain and function by race, and estimated the association between race and outcomes, adjusting for demographic and clinical factors. Results: Analyses included 5028 white (63% female, 65% income\u3e45k; mean age of 67. BMI of 31) and 270 black patients (80% female, 39% income\u3e45k; mean age of 63, BMI of 34). At baseline, black compared with white patients reported worse knee pain (mean: 39vs.48), and poorer function (mean: 46vs.54). While all patients reported significant gains at 6-month post-surgery, black patients had lower postoperative pain (mean: 71vs.82) and function scores (mean: 73vs.84) than white patients. Although not statistically significant, black patients on average had lower 6-month change than white patients in pain -1.9 (95%CI: -4.4, 0.6) and function -1.6 (95%CI: -3.9, 0.7). Adjusting for covariates, racial differences were significantly more pronounced in change in pain -5.5 (95%CI: -8.3, -2.7) and function -5.6 (95%CI: -8.2, -3.0). Conclusions: TKAs were as effective in reducing pain and improving functions in blacks as in whites. Adjusting for certain demographic and clinical factors can impact assessment of racial differences and the effectiveness of TKA on postoperative outcomes, as black patients were very different from white patients on these important factors

Study on the significance and mechanism of ASGR1 in hepatocellular carcinoma

Objective·To explore the significance and mechanism of asialoglycoprotein receptor 1 (ASGR1) in hepatocellular carcinoma.Methods·The expression of ASGR1 in patients with liver cancer in The Cancer Genome Atlas (TCGA) database was analyzed by R language and the related survival curves were drawn. The Human Protein Atlas (HPA) database was used to obtain the immunohistochemistry (IHC) data of normal human liver tissue and liver cancer tissue to analyze the protein expression of ASGR1. By using the hydrodynamic tail vein injection (HTVI) delivery method, Asgr1 was knocked out in the liver of fully immune mice to explore its tumorigenic function in vivo. Gene knockout efficiency was verified by Western blotting (WB). The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis and correlation analysis were performed by using R language. The GSEA hallmark correlation pathway analysis was performed by using Gene Set Enrichment Analysis (GSEA) software. The expression level of key genes of glycolysis in mouse liver cancer tissue was verified by quantitative real-time PCR (qPCR).Results·ASGR1 was significantly low-expressed in liver cancer tissue, and the low expression of ASGR1 in liver cancer patients was associated with poorer overall survival (OS), disease-free interval (DFI), progression-free interval (PFI), and disease-specific survival (DSS). The higher the degree of tumor grade, the lower the expression level of ASGR1 in patients with liver cancer. Immunohistochemistry showed that the protein expression of ASGR1 in normal human liver tissue was significantly higher than that in liver cancer tissue. In an immunocompetent mouse model of hepatocellular carcinoma, knockout of endogenous Asgr1 in mice increased the size and number of tumor nodules in liver tissue. In the TCGA database, patients with liver cancer in the ASGR1 low-expression group were enriched in multiple cancer and metabolic pathways. The expression of ASGR1 was negatively correlated with some key genes of glycolysis. The level of glycolysis in liver cancer tissues of mice in the Asgr1 knockout group was higher than that in the control group. It was suggested that the low expression of ASGR1 be likely to promote the growth and development of liver cancer and strengthen metabolic reprogramming to promote the anabolic development of tumors.Conclusion·The expression of ASGR1 is significantly reduced in patients with liver cancer, which is positively correlated with the prognosis of patients. Knocking out Asgr1 in mice can promote the occurrence and development of hepatocellular carcinoma. ASGR1 can be used as a potential biomarker for poor prognosis of liver cancer and a new target for potential treatment