Estimation of Absolute States of Human Skeletal Muscle via Standard B-Mode Ultrasound Imaging and Deep Convolutional Neural Networks

Objective: To test automated in vivo estimation of active and passive skeletal muscle states using ultrasonic imaging. Background: Current technology (electromyography, dynamometry, shear wave imaging) provides no general, non-invasive method for online estimation of skeletal muscle states. Ultrasound (US) allows non-invasive imaging of muscle, yet current computational approaches have never achieved simultaneous extraction nor generalisation of independently varying, active and passive states. We use deep learning to investigate the generalizable content of 2D US muscle images. Method: US data synchronized with electromyography of the calf muscles, with measures of joint moment/angle were recorded from 32 healthy participants (7 female, ages: 27.5, 19-65). We extracted a region of interest of medial gastrocnemius and soleus using our prior developed accurate segmentation algorithm. From the segmented images, a deep convolutional neural network was trained to predict three absolute, driftfree, components of the neurobiomechanical state (activity, joint angle, joint moment) during experimentally designed, simultaneous, independent variation of passive (joint angle) and active (electromyography) inputs. Results: For all 32 held-out participants (16-fold cross-validation) the ankle joint angle, electromyography, and joint moment were estimated to accuracy 55±8%, 57±11%, and 46±9% respectively. Significance: With 2D US imaging, deep neural networks can encode in generalizable form, the activitylength-tension state relationship of these muscles. Observation only, low power, 2D US imaging can provide a new category of technology for non-invasive estimation of neural output, length and tension in skeletal muscle. This proof of principle has value for personalised muscle assessment in pain, injury, neurological conditions, neuropathies, myopathies and ageing

Employing the Gini coefficient to measure participation inequality in treatment-focused Digital Health Social Networks

Digital Health Social Networks (DHSNs) are common; however, there are few metrics that can be used to identify participation inequality. The objective of this study was to investigate whether the Gini coefficient, an economic measure of statistical dispersion traditionally used to measure income inequality, could be employed to measure DHSN inequality. Quarterly Gini coefficients were derived from four long-standing DHSNs. The combined data set included 625,736 posts that were generated from 15,181 actors over 18,671 days. The range of actors (8–2323), posts (29–28,684), and Gini coefficients (0.15–0.37) varied. Pearson correlations indicated statistically significant associations between number of actors and number of posts (0.527–0.835, p < .001), and Gini coefficients and number of posts (0.342–0.725, p < .001). However, the association between Gini coefficient and number of actors was only statistically significant for the addiction networks (0.619 and 0.276, p < .036). Linear regression models had positive but mixed R2 results (0.333–0.527). In all four regression models, the association between Gini coefficient and posts was statistically significant (t = 3.346–7.381, p < .002). However, unlike the Pearson correlations, the association between Gini coefficient and number of actors was only statistically significant in the two mental health networks (t = −4.305 and −5.934, p < .000). The Gini coefficient is helpful in measuring shifts in DHSN inequality. However, as a standalone metric, the Gini coefficient does not indicate optimal numbers or ratios of actors to posts, or effective network engagement. Further, mixed-methods research investigating quantitative performance metrics is required

Melaena with Peutz-Jeghers syndrome: a case report

Introduction: Peutz-Jeghers syndrome (PJS) is a rare familial disorder characterised by mucocutaneous pigmentation, gastrointestinal and extragastrointestinal hamartomatous polyps and an increased risk of malignancy. Peutz-Jeghers polyps in the bowel may result in intussusception. This complication usually manifests with abdominal pain and signs of intestinal obstruction. Case Presentation: We report the case of a 24-year-old Caucasian male who presented with melaena. Pigmentation of the buccal mucosa was noted but he was pain-free and examination of the abdomen was unremarkable. Upper gastrointestinal endoscopy revealed multiple polyps. An urgent abdominal computed tomography (CT) scan revealed multiple small bowel intussusceptions. Laparotomy was undertaken on our patient, reducing the intussusceptions and removing the polyps by enterotomies. Bowel resection was not needed. Conclusion: Melaena in PJS needs to be urgently investigated through a CT scan even in the absence of abdominal pain and when clinical examination of the abdomen shows normal findings. Although rare, the underlying cause could be intussusception, which if missed could result in grave consequences

Volume-Targeted Ventilation and Arterial Carbon Dioxide in Neonates

Objectives: To review the arterial carbon dioxide tensions (PaCO2) in newborn infants ventilated using synchronized intermittent mandatory ventilation (SIMV) in volume guarantee mode (using the Drager Babylog 8000+) with a unit policy targeting tidal volumes of approximately 4 mL/kg. Methods: Data on ventilator settings and arterial (PaCO2 levels were collected on all arterial blood gases (ABG; n = 288) from 50 neonates ( 65 mmHg) were determined. Results: The mean (SD) (PaCO2 during the first 48 h was 46.6 (9.0) mmHg. The mean (SD) (PaCO2 on the first blood gas of those infants commenced on volume guarantee from admission was 45.1 (12.5) mmHg. Severe hypo- or hypercapnoea occurred in 8% of infants at the time of their first blood gas measurement, and i

Simulations of a Line W-based observing system for the Atlantic meridional overturning circulation

In a series of observing system simulations, we test whether the Atlantic meridional overturning circulation (AMOC) can be observed based on the existing Line W deep western boundary array. We simulate a Line W array, which is extended to the surface and to the east to cover the basin to the Bermuda Rise. In the analyzed ocean circulation model ORCA025, such an extended Line W array captures the main characteristics of the western boundary current. Potential trans-basin observing systems for the AMOC are tested by combining the extended Line W array with a mid-ocean transport estimate obtained from thermal wind "measurements" and Ekman transport to the total AMOC (similarly to Hirschi et al., Geophys Res Lett 30(7):1413, 2003). First, we close Line W zonally supplementing the western boundary array with several "moorings" in the basin (Line W-32A degrees N). Second, we supplement the western boundary array with a combination of observations at Bermuda and the eastern part of the RAPID array at 26A degrees N (Line W-B-RAPID). Both, a small number of density profiles across the basin and also only sampling the eastern and western boundary, capture the variability of the AMOC at Line W-32A degrees N and Line W-B-RAPID. In the analyzed model, the AMOC variability at both Line W-32A degrees N and Line W-B-RAPID is dominated by the western boundary current variability. Away from the western boundary, the mid-ocean transport (east of Bermuda) shows no significant relation between the two Line W-based sections and 26A degrees N. Hence, a Line W-based AMOC estimate could yield an estimate of the meridional transport that is independent of the 26A degrees N RAPID estimate. The model-based observing system simulations presented here provide support for the use of Line W as a cornerstone for a trans-basin AMOC observing system

Do female association preferences predict the likelihood of reproduction?

Sexual selection acting on male traits through female mate choice is commonly inferred from female association preferences in dichotomous mate choice experiments. However, there are surprisingly few empirical demonstrations that such association preferences predict the likelihood of females reproducing with a particular male. This information is essential to confirm association preferences as good predictors of mate choice. We used green swordtails (&lt;i&gt;Xiphophorus helleri&lt;/i&gt;) to test whether association preferences predict the likelihood of a female reproducing with a male. Females were tested for a preference for long- or short-sworded males in a standard dichotomous choice experiment and then allowed free access to either their preferred or non-preferred male. If females subsequently failed to produce fry, they were provided a second unfamiliar male with similar sword length to the first male. Females were more likely to reproduce with preferred than non-preferred males, but for those that reproduced, neither the status (preferred/non-preferred) nor the sword length (long/short) of the male had an effect on brood size or relative investment in growth by the female. There was no overall preference based on sword length in this study, but male sword length did affect likelihood of reproduction, with females more likely to reproduce with long- than short-sworded males (independent of preference for such males in earlier choice tests). These results suggest that female association preferences are good indicators of female mate choice but that ornament characteristics of the male are also important

Computer-Based Interventions for Problematic Alcohol Use:a Review of Systematic Reviews

PURPOSE: The aim of this review is to provide an overview of knowledge and knowledge gaps in the field of computer-based alcohol interventions by (1) collating evidence on the effectiveness of computer-based alcohol interventions in different populations and (2) exploring the impact of four specified moderators of effectiveness: therapeutic orientation, length of intervention, guidance and trial engagement.  METHODS: A review of systematic reviews of randomized trials reporting on effectiveness of computer-based alcohol interventions published between 2005 and 2015.  RESULTS: Fourteen reviews met the inclusion criteria. Across the included reviews, it was generally reported that computer-based alcohol interventions were effective in reducing alcohol consumption, with mostly small effect sizes. There were indications that longer, multisession interventions are more effective than shorter or single session interventions. Evidence on the association between therapeutic orientation of an intervention, guidance or trial engagement and reductions in alcohol consumption is limited, as the number of reviews addressing these themes is low. None of the included reviews addressed the association between therapeutic orientation, length of intervention or guidance and trial engagement.  CONCLUSIONS: This review of systematic reviews highlights the mostly positive evidence supporting computer-based alcohol interventions as well as reveals a number of knowledge gaps that could guide future research in this field

Survival trends for small intestinal cancer in England and Wales, 1971–1990: national population-based study

This population-based study examines prognostic factors and survival trends among adults (15–99 years) diagnosed with small intestinal cancer in England and Wales during 1971–1990 and followed up to 1995. During this period, the 1- and 5-year age-standardised relative survival rates for small intestinal cancers combined were 42% and 23%, respectively. Duodenal tumours, adenocarcinomas, men, patients with advanced age and the most deprived patients had the poorest prognosis. For all small bowel tumours combined, the excess risk of death fell significantly by 6–9% every 4 years over the 20-year period (adjusted excess hazard ratio (EHR) 0.91 at 1 year after diagnosis, 0.94 at 5 years). For duodenal tumours, the EHR fell by about 14% (95% CI 5–22%) every 4 years between 1979 and 1990, and a similar trend for jejunal tumours was of borderline significance. Further population-based investigations linking survival data to individual data on diagnostic methods and types of treatment are needed