paraFaceTest: an ensemble of regression tree-based facial features extraction for efficient facial paralysis classification

Abstract Background Facial paralysis (FP) is a neuromotor dysfunction that losses voluntary muscles movement in one side of the human face. As the face is the basic means of social interactions and emotional expressions among humans, individuals afflicted can often be introverted and may develop psychological distress, which can be even more severe than the physical disability. This paper addresses the problem of objective facial paralysis evaluation. Methods We present a novel approach for objective facial paralysis evaluation and classification, which is crucial for deciding the medical treatment scheme. For FP classification, in particular, we proposed a method based on the ensemble of regression trees to efficiently extract facial salient points and detect iris or sclera boundaries. We also employ 2 n d degree polynomial of parabolic function to improve Daugman’s algorithm for detecting occluded iris boundaries, thereby allowing us to efficiently get the area of the iris. The symmetry score of each face is measured by calculating the ratio of both iris area and the distances between the key points in both sides of the face. We build a model by employing hybrid classifier that discriminates healthy from unhealthy subjects and performs FP classification. Results Objective analysis was conducted to evaluate the performance of the proposed method. As we explore the effect of data augmentation using publicly available datasets of facial expressions, experiments reveal that the proposed approach demonstrates efficiency. Conclusions Extraction of iris and facial salient points on images based on ensemble of regression trees along with our hybrid classifier (classification tree plus regularized logistic regression) provides a more improved way of addressing FP classification problem. It addresses the common limiting factor introduced in the previous works, i.e. having the greater sensitivity to subjects exposed to peculiar facial images, whereby improper identification of initial evolving curve for facial feature segmentation results to inaccurate facial feature extraction. Leveraging ensemble of regression trees provides accurate salient points extraction, which is crucial for revealing the significant difference between the healthy and the palsy side when performing different facial expressions

Stress-induced depressive-like behavior in male rats is associated with microglial activation and inflammation dysregulation in the hippocampus in adulthood

Neuroinflammation is increasingly recognized as playing a critical role in depression. Early-life stress exposure and constitutive differences in glucocorticoid responsiveness to stressors are two key risk factors for depression, but their impacts on the inflammatory status of the brain is still uncertain. Moreover, there is a need to identify specific molecules involved in these processes with the potential to be used as alternative therapeutic targets in inflammation-related depression. Here, we studied how peripubertal stress (PPS) combined with differential corticosterone (CORT)-stress responsiveness (CSR) influences depressive-like behaviors and brain inflammatory markers in male rats in adulthood, and how these alterations relate to microglia activation and miR-342 expression. We found that high-CORT stress-responsive (H-CSR) male rats that underwent PPS exhibited increased anhedonia and passive coping responses in adulthood. Also, animals exposed to PPS showed increased hippocampal TNF-α expression, which positively correlated with passive coping responses. In addition, PPS caused long-term effects on hippocampal microglia, particularly in H-CSR rats, with increased hippocampal IBA-1 expression and morphological alterations compatible with a higher degree of activation. H-CSR animals also showed upregulation of hippocampal miR-342, a mediator of TNF-α-driven microglial activation, and its expression was positively correlated with TNF-α expression, microglial activation and passive coping responses. Our findings indicate that individuals with constitutive H-CSR are particularly sensitive to developing protracted depression-like behaviors following PPS exposure. In addition, they show neuro-immunological alterations in adulthood, such as increased hippocampal TNF-α expression, microglial activation and miR-342 expression. Our work highlights miR-342 as a potential therapeutic target in inflammation-related depression

Acceptability of and treatment preferences for recurrent bacterial vaginosis-Topical lactic acid gel or oral metronidazole antibiotic: Qualitative findings from the VITA trial.

BACKGROUND Bacterial vaginosis (BV) is associated with an elevated vaginal pH and the presence of abnormal offensive discharge. It is common, often recurrent, and the most effective treatment regimen is unknown. 'Metronidazole Versus lactic acId for Treating bacterial vAginosis' (VITA) is a UK-based randomised controlled trial assessing clinical and cost-effectiveness of topical lactic acid gel compared to oral metronidazole antibiotic for treating second and subsequent BV episodes. Few BV trials report on women's preferences for treatment in the context of their own experiences. METHOD This qualitative study investigated the acceptability and tolerability of the two treatments. During the trial, semi-structured telephone interviews were undertaken between January-May 2018. A total of 33 women diagnosed with BV were consecutively sampled then interviewed from six sites across England. Thematic analysis was guided by the acceptability of health interventions framework. Potential causes of BV and its impact on women's lives were explored in addition to women's treatment preference and perceived treatment effectiveness. RESULTS Although women felt antibiotics treat BV effectively, and were associated with longer time periods between episodes, they generally preferred using the lactic acid gel because of ease of use, once daily application and less side-effects. Women would recommend the lactic acid gel to others for mild cases of BV but to take antibiotics when more severe. The risk of antibiotic drug resistance was a common concern. Self-help medicating or self-decision to not treat was also evident due to prior experience of poor outcomes from treatment. Triggers of BV were attributed to personal hygiene habits-soaps used to wash the vagina and sexual practices such as unprotected sex. CONCLUSION Acceptability and preference for topical lactic acid gel or oral metronidazole tablets in the treatment of recurrent BV was affected by personal choice relating to affective attitude, burden, ethicality, intervention coherence, opportunity costs, and self-efficacy. These differed depending on ease of use, tolerability and past experiences, but not necessarily based on perceived drug effectiveness. Knowledge of a patient preference for topical lactic acid gel therapy despite lower perceived effectiveness may be useful for clinicians when making treatment decisions